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Stricker A, Jacobs R, Maes F, Fluegge T, Vach K, Fleiner J. Resorption of retromolar bone grafts after alveolar ridge augmentation-volumetric changes after 12 months assessed by CBCT analysis. Int J Implant Dent 2021; 7:7. [PMID: 33474648 PMCID: PMC7817723 DOI: 10.1186/s40729-020-00285-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 12/28/2020] [Indexed: 11/15/2022] Open
Abstract
In this pilot study, a volumetric analysis of retromolar onlay bone grafts over a period of 12 months was conducted, using repeated CBCT imaging combined with automated image registration. Eleven patients being treated with 16 bone grafts taken from the retromolar area were examined by CBCT scanning prior to bone augmentation (T0), immediately after bone augmentation (T1) and after a healing time of 12 months after augmentation (T2). Graft volumes were measured at each time point after automated image registration of consecutive CBCT scans. The mean volume of the augmented site was 372.2 ± 179.4 mm3. Resorption relative to the original augmented volume was 43.7% ± 19.0% after 12 months. Three-dimensional graft resorption could be precisely depicted by the use of automated image registration for CBCT data over a period of 12 months and demonstrated extensive volumetric changes of bone grafts taken from the ascending ramus of the mandible. Graft resorption and continuous bony remodeling of the grafted site before and after implant insertion have to be carefully considered by the clinician.
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Affiliation(s)
- Andres Stricker
- Center of Implantology, Periodontology and 3D Head-and-Neck Imaging, Konstanz, Germany. .,Department of Oral and Maxillofacial Surgery, Medical Center, University of Freiburg, Freiburg, Germany. .,Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Frederik Maes
- ESAT/PSI & Medical Imaging Research Center, Faculty of Engineering Sciences, University of Leuven, Leuven, Belgium
| | - Tabea Fluegge
- Department of Oral and Maxillofacial Surgery, Charité University of Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Jonathan Fleiner
- Center of Implantology, Periodontology and 3D Head-and-Neck Imaging, Konstanz, Germany.,OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium
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Morphological Evaluation of Bone by CT to Determine Primary Stability-Clinical Study. MATERIALS 2020; 13:ma13112605. [PMID: 32521622 PMCID: PMC7321591 DOI: 10.3390/ma13112605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/02/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022]
Abstract
Background: Primary stability is an important prognostic factor for dental implant therapy. In the present study, we evaluate the relationship between implant stability evaluation findings by the use of an implant stability quotient (ISQ), an index for primary stability, and a morphological evaluation of bone by preoperative computed tomography (CT). Subjects and methods: We analyzed 98 patients who underwent implant placement surgery in this retrospective study. For all 247 implants, the correlations of the ISQ value with cortical bone thickness, cortical bone CT value, cancellous bone CT value, insertion torque value, implant diameter, and implant length were examined. Results: 1. Factors affecting ISQ values in all cases: It was revealed that there were significant associations between the cortical bone thickness and cancellous bone CT values with ISQ by multiple regression analysis. 2. It was revealed that there was a significant correlation between cortical bone thickness and cancellous bone CT values with ISQ by multiple regression analysis in the upper jaw. 3. It was indicated that there was a significant association between cortical bone thickness and implant diameter with ISQ by multiple regression analysis in the lower jaw. Conclusion: We concluded that analysis of the correlation of the ISQ value with cortical bone thickness and values obtained in preoperative CT imaging were useful preoperative evaluations for obtaining implant stability.
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Nienkemper M, Willmann JH, Drescher D. Long-term stability behavior of paramedian palatal mini-implants: A repeated cross-sectional study. Am J Orthod Dentofacial Orthop 2020; 157:165-171. [PMID: 32005467 DOI: 10.1016/j.ajodo.2019.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 01/01/2019] [Accepted: 01/01/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The initial stability of orthodontic mini-implants is well investigated over a period of 6 weeks. There is no clinical data available dealing with the long-term stability. The aim of this study was the assessment of long-term stability of paramedian palatal mini-implants in humans. METHODS Stability of 20 implants was measured after removal of the orthodontic appliance (sliding mechanics for sagittal molar movement 200 cN each side) before explantation (T4) using resonance frequency analysis (RFA). Data were compared with a matched group of 21 mini-implants assessing the stability immediately after insertion, and after 2, 4, and 6 weeks (T0-T3). The mini-implants used in this study were machined self-drilling titanium implants (2.0 × 9.0 mm). Gingival thickness at the insertion site was 1-2 mm. RESULTS The implant stability quotient (ISQ) values before removal of the implant at T4 were 25.2 ± 2.9 after 1.7 ± 0.2 years and did not show a statistically significant change over time compared with the initial healing group (T0-T3). CONCLUSIONS Comparing the stability of mini-implants just after completion of the healing period and at the end of their respective usage period revealed no significant difference. An increase of secondary stability could not be detected. The level of stability seemed to be appropriate for orthodontic anchorage.
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Affiliation(s)
- Manuel Nienkemper
- Private practice, Düsseldorf, Germany; Department of Orthodontics, Heinrich Heine University, Düsseldorf, Germany
| | - Jan H Willmann
- Department of Orthodontics, Heinrich Heine University, Düsseldorf, Germany.
| | - Dieter Drescher
- Department of Orthodontics, Heinrich Heine University, Düsseldorf, Germany
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Nienkemper M, Willmann JH, Becker K, Drescher D. RFA measurements of survival midpalatal orthodontic mini-implants in comparison to initial healing period. Prog Orthod 2020; 21:5. [PMID: 32064547 PMCID: PMC7024683 DOI: 10.1186/s40510-020-0305-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/14/2020] [Indexed: 11/18/2022] Open
Abstract
Background In dental implantology, the development of stability over time is a well-investigated topic. In case of orthodontic mini-implants, quantitative data for long-term stability is not available yet. This study aims to clinically investigate the long-term stability of mini-implants inserted in the midsagittal suture of the anterior palate. Moreover, the influence of the length of implants was elucidated. The stability of 2 × 9 and 2 × 11 mm mini-implants after orthodontic treatment (9 mm, 2.84 years ± 1.25 years; 11 mm, 3.17 years ± 0.96 years) was assessed by resonance frequency analysis (RFA). The obtained long-term pieces of data were compared with each other (9 mm vs 11 mm), as well as with the data from the matched early stability groups, to assess the initial and early secondary stability after the insertion from previous clinical trials. Results For both lengths, the long-term stability (2 × 9 mm, 25.12 ± 7.11, n = 21; 2 × 11 mm, 24.39 ± 5.82, n = 18) was significantly lower than primary stability (2 × 9 mm, 36.14 ± 6.08, n = 19; 2 × 11 mm, 33.35 ± 3.53, n = 20). The differences within the groups disappeared over the initial healing period: after 4 weeks for the 2 × 9 mm implants and after 2 weeks for the 2 × 11 mm implants. Also, the 2 × 9 mm and 2 × 11 mm implants showed comparable long-term stability values. Conclusion The stability of midpalatal mini-implants does not change in the long term after the initial healing period. Moreover, 2 × 9 mm mini-implants seem to be appropriate for orthodontic anchorage, as the stability of 2 × 11 mm implants is not higher. Therefore, owing to lower invasiveness, 2 × 9 mm implants should be preferred.
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Affiliation(s)
- Manuel Nienkemper
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany.,Private Practice, Düsseldorf, Germany
| | - Jan H Willmann
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany.
| | - Kathrin Becker
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany
| | - Dieter Drescher
- Department of Orthodontics, Heinrich-Heine-University of Düsseldorf, Moorenstr.5, Building 18.21, 40225, Düsseldorf, Germany
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Using Osseointegrated Implants Concomitant With Onlay Bone Grafting for Auricular Reconstruction. J Craniofac Surg 2017; 28:1088-1089. [PMID: 28582958 DOI: 10.1097/scs.0000000000003510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Conventional dental implants have been reported for nasal and orbital regions but due to limited thickness of calvarium they are not used in mastoid region. Onlay bone grafting in skull concomitant with implants is a predictable method and experimental animal studies confirm it. Parietal bone and lateral mandibular ramus are suggested source of bone grafts and dental implants with 7 mm length can be used safely. Increased fixture length may lead to increase survival in long term.
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Scarano A, Carinci F, Mangano C, Quaranta A, Piattelli A. Removal Torque Values of Titanium Implants Inserted into Bone Defects Filled with Hydroxyapatite: A Histologic and Histomorphometric Analysis in Rabbit. Int J Immunopathol Pharmacol 2017; 20:49-53. [PMID: 17897502 DOI: 10.1177/039463200702001s11] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The successful clinical use of implants with microrough titanium surfaces has paved the way for the further development of surface topographies to promote enhanced peri-implant bone apposition during the early stages of bone regeneration. The aim of this study is to determine the torque resistance of the implant-bone interface of plasma sprayed titanium endosseous implants placed in the rabbit tibia in three different situations. Hydroxyapatite (HA) particles with a size ranging from 250 to 450 microm were used in the present study to fill out 6 mm bony defects created in rabbit tibia. Fourteen mature New Zealand white male rabbits, weighing about 2.5 Kg., were used in this study. The test sites were filled with HA and the non-grafted sites were used as control. A total of 28 bone defects (14 without HA and 14 with HA.) were created. Implants with plasma-spray surface were subsequently inserted. Six additional rabbits were used; in these animals no bone defects were created. The implant sites were divided into three groups: 1) implants inserted in the tibia without bone defects; 2) implants inserted in the tibia with bone defects not filled with HA; 3) implants inserted in the tibia with bone defects filled with HA particles. The purpose of this study is to measure reverse-torque in three different situations of clinically similar implant geometry in the articulation of rabbits. The null hypothesis stated that there is a difference in reversal torque between the bone regeneration with HA, native bone and bone defect without bone regeneration. Additionally, comparison between these 6-month data and the 3-month data from a previous study led to the following conclusions: a significant difference exists in the removed torque for the TPS implants in the bone regenerated by HA and native bone; increase in removal torque values was seen for the implant inserted in bone regenerated by HA compared to the implant nated in bone without biomaterials. In conclusion, bone regenerated with biomaterials possesses different mechanical characteristics to native bone.
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Affiliation(s)
- A Scarano
- Department of Stomatology and Oral Sciences, University of Chieti-Pescara, Chieti, Italy
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Sun C, Zhao J, Jianghao C, Hong T. Effect of Heavy Smoking on Dental Implants Placed in Male Patients Posterior Mandibles: A Prospective Clinical Study. J ORAL IMPLANTOL 2016; 42:477-483. [PMID: 27541691 DOI: 10.1563/aaid-joi-d-16-00078] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this study was to evaluate the implant stability and peri-implant tissue response in heavy smokers receiving dental implants due to partially edentulous posterior mandibles. Forty-five ITI Straumann dental implants were placed into the partially edentulous posterior mandibles of 16 heavy smokers and 16 nonsmokers. One implant in each patient was evaluated for implant stability after surgery and before loading, and for the modified plaque index (mPLI), modified sulcus bleeding index (mSBI), probing depth (PD), and marginal bone loss (MBL) after loading. Meanwhile, the osteogenic capability of jaw marrow samples collected from patients was evaluated via an in vitro mineralization test. For both groups, the implant stability quotient (ISQ) initially decreased from the initial ISQ achieved immediately after surgery and then increased starting from 2 weeks postsurgery. However, at 3, 4, 6, and 8 weeks postsurgery, the ISQ differed significantly between nonsmokers and heavy smokers. All implants achieved osseointegration without complications at least by the end of the 12th week postsurgery. At 6 or 12 months postloading, the MBL and PD were significantly higher in heavy smokers than in nonsmokers, whereas the mSBI and mPLI did not differ significantly between the 2 groups. The 1-year cumulative success rate of implants was 100% for both groups. Within the limitations of the present clinical study (such as small sample size and short study duration), which applied the loading at 3 months postoperation, heavy smoking did not affect the cumulative survival rate of dental implants placed at the posterior mandible in male patients, but heavy smoking did negatively affect bone healing around dental implants by decreasing the healing speed. These results implied that it might be of importance to select the right time point to apply the implant loading for heavy smokers. In addition, heavy smoking promoted the loss of marginal bone and the further development of dental pockets. Further clinical studies with larger patient populations are warranted to confirm our findings over a longer study duration.
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Affiliation(s)
- Cong Sun
- Department of Oral, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jinxiu Zhao
- Department of Oral, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chen Jianghao
- Department of Oral, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tao Hong
- Department of Oral, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Gómez-Polo M, Ortega R, Gómez-Polo C, Martín C, Celemín A, Del Río J. Does Length, Diameter, or Bone Quality Affect Primary and Secondary Stability in Self-Tapping Dental Implants? J Oral Maxillofac Surg 2016; 74:1344-53. [PMID: 27070843 DOI: 10.1016/j.joms.2016.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/08/2016] [Accepted: 03/12/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Implant stability is a clinically valuable measurement of the strength of implant anchorage in the bone during placement and in the post-osseointegration period. This study aimed to determine 1) the effect of implant diameter and length and bone quality on measurements of primary and secondary stability (insertion torque [IT] and implant stability quotient [ISQ]), 2) the correlation between IT and primary and secondary ISQ, and 3) differences in ISQ in the post-osseointegration period (secondary stability) compared with immediate post-placement (primary) stability. PATIENTS AND METHODS In this longitudinal clinical study, titanium self-tapping implants were inserted in edentulous patients. The implants were grouped according to 3 independent variables: length (10 and 11.5 mm), diameter (3.75 and 4.25 mm), and bone quality (Lekholm and Zarb classification) to analyze primary and secondary implant stability (outcome variables). Statistical analyses were performed using the Student t test for paired data, 1-way analysis of variance, and the Tukey procedure for multiple pairwise comparisons. RESULTS Data were collected on 88 self-tapping implants inserted in 63 partially edentulous patients. IT and implant stability were affected by diameter (3.75-mm implants, 26.5-N/cm IT and 74.0 ISQ; 4.25-mm implants, 33.8-N/cm IT and 77.0 ISQ) and bone type (type 1 + 2, 34.86-N/cm IT and 77.4 ISQ; type 3, 27.09-N/cm IT and 75.6 ISQ; type 4, 20.63-N/cm IT and 70.5 ISQ; P < .01 for all comparisons). Secondary ISQ was affected by diameter only (77.41 for 3.75- vs 75.51 for 4.25-mm implants). IT correlated with primary ISQ (R = 0.56; P < .01), although no clear correlation with secondary stability was found. CONCLUSIONS IT and primary ISQ in self-tapping implants differed in patients with different bone quality and implant diameter but did not differ between the 2 implant lengths compared in this study. Secondary stability was not substantially affected by any of these factors. Although IT was closely related to primary ISQ, it was unrelated to secondary ISQ. Very high primary ISQ values tended to decrease, whereas intermediate and low values tended to increase, in the transition to secondary stability.
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Affiliation(s)
- Miguel Gómez-Polo
- Doctor in Dental Surgery and Part-Time Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Rocío Ortega
- Doctor in Dental Surgery and Assistant Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Cristina Gómez-Polo
- Doctor in Dental Surgery and Part-Time Professor, Department of Surgery, Medicine School, University of Salamanca, Salamanca, Spain
| | - Cristina Martín
- Doctor in Dental Surgery and Assistant Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Alicia Celemín
- Medicine Doctor and Full-Time Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Jaime Del Río
- Medicine Doctor and Full-Time Professor, Department of Prosthetic Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Osseointegration of Titanium Implants in Onlay of Cerament™, a New Ceramic Bone Substitute. J Funct Biomater 2016; 7:jfb7010002. [PMID: 26751485 PMCID: PMC4810061 DOI: 10.3390/jfb7010002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/15/2015] [Accepted: 12/30/2015] [Indexed: 12/28/2022] Open
Abstract
The purpose was to investigate whether a new biphasic and injectable ceramic bone substitute Cerament™ that rapidly remodels to bone, may contribute to the retention of titanium implant screws during the healing period, and to analyze the pattern of bone formation around titanium implants.Titanium screws were implanted in rat tibiae and embedded with or without Cerament™ on the cortical surface. Torsional resistance was measured after 1 day, and after 6 and 12 weeks. Implant areas without bone substitute were analyzed histologically for comparison. The torsional resistance increased over time as the screws were osseointegrated. There was no difference in resistance between screws embedded in the bone substitute and control screws. The bone apposition was more pronounced on the proximal side of the screw than on the distal side. Cerament™ is capable of conducting bone growth from a cortical bone surface. The newly formed bone in this application does not significantly add to the osseointegrative strength of the implant screw, as measured by torque resistance, during the first 12 weeks.
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10
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Filho LCM, Cirano FR, Hayashi F, Feng HS, Conte A, Dib LL, Casati MZ. Assessment of the correlation between insertion torque and resonance frequency analysis of implants placed in bone tissue of different densities. J ORAL IMPLANTOL 2014; 40:259-62. [PMID: 24914911 DOI: 10.1563/aaid-joi-d-11-00183] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The primary stability of dental implants is fundamental for osseointegration. Therefore, this study aimed to assess the correlation between insertion torque (IT) and resonance frequency analysis (RFA) of implants placed in mandibles and maxillas of different bone densities. Eighty dental implants were placed in maxillas and mandibles, and IT and the implant stability quotient (ISQ) were measured at the time of implant insertion. Bone density was assessed subjectively by the Lekholm and Zarb index. The type I and II densities were grouped together (group A)as were the type III and IV densities (group B). The IT in group A was higher (Student t test, P = .0013) than in group B (46.27 ± 18.51 Ncm, 33.62 ± 14.74 Ncm, respectively). The implants placed in group A showed higher ISQ (Student t test, P = .0004) than those placed in group B (70.09 ± 7.50, 63.66 ± 8.00, respectively). A significant correlation between IT and the ISQ value was observed for group A (Pearson correlation test; r = 0.35; P = .0213) and for group B (r = 0.37; P = .0224). Within the limitations of this study, it was possible to conclude that there is a correlation between IT and RFA of implants placed in mandibles and maxillas of different bone densities.
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Stübinger S, Dard M. The rabbit as experimental model for research in implant dentistry and related tissue regeneration. J INVEST SURG 2013; 26:266-82. [PMID: 23617292 DOI: 10.3109/08941939.2013.778922] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The use of rabbits for experimental research has a long historical tradition. The aim of this review consists in outlining the use of the rabbit for research in implant dentistry and related tissue regeneration. Rabbits appear as a first-hand choice for fundamental implant design studies because of their size, easy handling, short life span, and economical aspects in purchasing and sustaining. In the following, the various anatomical sites in the rabbit will be summarized to provide an overview of current possibilities and limitations of this model for bone research in oral implantology.
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Affiliation(s)
- Stefan Stübinger
- Musculoskeletal Research Unit, University of Zurich , Zurich , Switzerland
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12
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Guler AU, Sumer M, Duran I, Sandikci EO, Telcioglu NT. Resonance Frequency Analysis of 208 Straumann Dental Implants During the Healing Period. J ORAL IMPLANTOL 2013; 39:161-7. [DOI: 10.1563/aaid-joi-d-11-00060] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The most important prerequisite for the success of an osseointegrated dental implant is achievement and maintenance of implant stability. The aim of the study was to measure the 208 Straumann dental implant stability quotient (ISQ) values during the osseointegration period and determine the factors that affect implant stability. A total of 164 of the implants inserted were standard surface, and 44 of them were SLActive surface. To determine implant stability as ISQ values, measurements were performed at the stage of implant placement and healing periods by the Osstell mentor. The ISQ value ranges showed a significant increase during the healing period. Except for the initial measurement, the posterior maxilla had the lowest ISQ values, and there was no significant difference among anterior mandible, posterior mandible, and anterior maxilla (P < .05). Implant length did not have a significant influence on ISQ value (P > .05). The second measurement was significantly higher in men compared with women (P < .05). The second measurement was significantly higher than the others at 4.8 mm, and for the final measurement, there were no significant differences between 4.8 and 4.1 mm, which were higher than 3.3 mm (P < .05). When comparing sandblasted, large-grit, acid-etched (SLA) and SLActive surface implants, there were no significant differences for insertion measurements, but for second measurements, SLActive was significantly higher (P = 0), and for the final measurement, there was no significant difference. It appears that repeated ISQ measurements of a specific implant have some diagnostic benefit, and the factors that affect implant stability during the healing period are presented.
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Affiliation(s)
- Ahmet Umut Guler
- Department of Prosthodontics, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey
| | - Mahmut Sumer
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Ibrahim Duran
- Department of Prosthodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Elif Ozen Sandikci
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Nazife Tuba Telcioglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
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Thoma DS, Martin IS, Mühlemann S, Jung RE. Systematic review of pre-clinical models assessing implant integration in locally compromised sites and/or systemically compromised animals. J Clin Periodontol 2012; 39 Suppl 12:37-62. [PMID: 22533946 DOI: 10.1111/j.1600-051x.2011.01833.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aim was to systematically search the dental literature for pre-clinical models assessing implant integration in locally compromised sites (part 1) and systemically compromised animals (part 2), and to evaluate the quality of reporting of included publications. METHODS A Medline search (1966-2011) was performed, complimented by additional hand searching. The quality of reporting of the included publications was evaluated using the 20 items of the ARRIVE (Animals in Research In Vivo Experiments) guidelines. RESULTS One-hundred and seventy-six (part 1; mean ARRIVE score = 15.6 ± 2.4) and 104 (part 2; 16.2 ± 1.9) studies met the inclusion criteria. The overall mean score for all included studies amounted to 15.8 ± 2.2. Housing (38.3%), allocation of animals (37.9%), numbers analysed (50%) and adverse events (51.4%) of the ARRIVE guidelines were the least reported. Statistically significant differences in mean ARRIVE scores were found depending on the publication date (p < 0.05), with the highest score of 16.7 ± 1.6 for studies published within the last 2 years. CONCLUSIONS A large number of studies met the inclusion criteria. The ARRIVE scores revealed heterogeneity and missing information for selected items in more than 50% of the publications. The quality of reporting shifted towards better-reported pre-clinical trials within recent years.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
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14
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Efficacy of Resonance Frequency Analysis in the Diagnosis of Compromised Bone-Implant Interface. IMPLANT DENT 2012; 21:394-8. [DOI: 10.1097/id.0b013e3182602b67] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Di Lallo S, Ricci L, Orecchioni S, Piattelli A, Iezzi G, Perrotti V. Resonance Frequency Analysis Assessment of Implants Placed with a Simultaneous or a Delayed Approach in Grafted and Nongrafted Sinus Sites: A 12-Month Clinical Study. Clin Implant Dent Relat Res 2012; 16:394-400. [DOI: 10.1111/cid.12002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Laura Ricci
- Dental School; University of Chieti-Pescara; Chieti Italy
| | | | | | - Giovanna Iezzi
- Dental School; University of Chieti-Pescara; Chieti Italy
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16
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Fraguas E, Ribeiro M, Croci A, Santos L, Pallos D, Sendyk W. Stability of implants placed simultaneously or in a delayed manner on fresh frozen onlay allografts in rabbits. Clin Oral Implants Res 2012; 24:1295-9. [PMID: 22905701 DOI: 10.1111/j.1600-0501.2012.02572.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2012] [Indexed: 12/01/2022]
Affiliation(s)
| | - Marna Ribeiro
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
| | - Alberto Croci
- Hospital das Clínicas of the School of Medicine of the University of São Paulo; Tissue Bank Medical Director; São Paulo Brazil
| | - Luiz Santos
- Institute of Orthopedics and Traumatology; Hospital das Clínicas of the School of Medicine; University of São Paulo; São Paulo Brazil
| | - Débora Pallos
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
| | - Wilson Sendyk
- Department of Peridontics and Implantology; UNISA; São Paulo Brazil
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Alghamdi H, Anand PS, Anil S. Undersized Implant Site Preparation to Enhance Primary Implant Stability in Poor Bone Density: A Prospective Clinical Study. J Oral Maxillofac Surg 2011; 69:e506-12. [DOI: 10.1016/j.joms.2011.08.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 08/03/2011] [Accepted: 08/05/2011] [Indexed: 10/15/2022]
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18
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Ho DSW, Yeung SCH, Zee KY, Curtis B, Hell P, Tumuluri V. Clinical and radiographic evaluation of NobelActiveTMdental implants. Clin Oral Implants Res 2011; 24:297-304. [DOI: 10.1111/j.1600-0501.2011.02313.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2011] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | - Bradley Curtis
- Discipline of Epidemiology and Biostatistics; Faculty of Dentistry; University of Sydney; Sydney; NSW; Australia
| | - Peter Hell
- Oral Restorative Sciences Department; Westmead Centre for Oral Health; Westmead Hospital; Westmead; NSW; Australia
| | - Vijay Tumuluri
- Periodontics Unit; Westmead Centre for Oral Health; Westmead Hospital; Westmead; NSW; Australia
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Slotte C, Lennerås M, Göthberg C, Suska F, Zoric N, Thomsen P, Nannmark U. 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. Clin Implant Dent Relat Res 2010; 14:723-36. [DOI: 10.1111/j.1708-8208.2010.00309.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Han J, Lulic M, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration: II. Implant surface modifications and implant diameter. Clin Oral Implants Res 2010; 21:605-11. [PMID: 20666787 DOI: 10.1111/j.1600-0501.2009.01909.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To monitor the development of the stability of Straumann tissue-level implants during the early phases of healing by resonance frequency analysis (RFA) and to determine the influence of implant surface modification and diameter. MATERIAL AND METHODS A total of twenty-five 10 mm length implants including 12 SLA RN v4.1 mm implants, eight SLActive RN v4.1 mm implants and five SLA WN v4.8 mm implants were placed. Implant stability quotient (ISQ) values were determined with Osstell mentor at baseline, 4 days, 1, 2, 3, 4, 6, 8 and 12 weeks post-surgery. ISQ values were compared between implant types using unpaired t-tests and longitudinally within implant types using paired t-tests. RESULTS During healing, ISQ decreased by 3-4 values after installation and reached the lowest values at 3 weeks. Following this, the ISQ values increased steadily for all implants and up to 12 weeks. No significant differences were noted over time. The longitudinal changes in the ISQ values showed the same patterns for SLA implants, SLActive implants and WB implants. At placement, the mean ISQ values were 72.6, 75.7 and 74.4, respectively. The mean lowest ISQ values, recorded at 3 weeks, were 69.9, 71.4 and 69.8, respectively. At 12 weeks, the mean ISQ values were 76.5, 78.8 and 77.8, respectively. The mean ISQ values at all observation periods did not differ significantly among the various types. Single ISQ values ranged from 55 to 84 during the entire healing period. Pocket probing depths of the implants ranged from 1 to 3 mm and bleeding on probing from 0 to 2 sites/implant post-surgically. CONCLUSIONS All ISQ values indicated the stability of Straumann implants over a 12-week healing period. All implants showed a slight decrease after installation, with the lowest ISQ values being reached at 3 weeks. ISQ values were restored 8 weeks post-surgically. It is recommended to monitor implant stability by RFA at 3 and 8 weeks post-surgically. However, neither implant surface modifications (SLActive) nor implant diameter were revealed by RFA.
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Affiliation(s)
- Jie Han
- Peking University School, Hospital of Stomatology, The University of Hong Kong, Prince Philip Dental Hospital, Sai Ying Pun, Hong Kong, SAR, China
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21
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Effects of Early Functional Loading on Maintenance of Free Autogenous Bone Graft and Implant Osseointegration: An Experimental Study in Dogs. J Oral Maxillofac Surg 2010; 68:825-32. [DOI: 10.1016/j.joms.2009.04.077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Revised: 04/07/2009] [Accepted: 04/21/2009] [Indexed: 11/18/2022]
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22
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Fenner M, Vairaktaris E, Stockmann P, Schlegel KA, Neukam FW, Nkenke E. Influence of residual alveolar bone height on implant stability in the maxilla: an experimental animal study. Clin Oral Implants Res 2009. [DOI: 10.1111/j.1600-0501.2009.01570.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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23
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Degidi M, Perrotti V, Strocchi R, Piattelli A, Iezzi G. Is insertion torque correlated to bone-implant contact percentage in the early healing period? A histological and histomorphometrical evaluation of 17 human-retrieved dental implants. Clin Oral Implants Res 2009; 20:778-81. [PMID: 19486080 DOI: 10.1111/j.1600-0501.2008.01599.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE A precise and scientifically established method for the evaluation of the bone quality/primary stability is the measure of the insertion torque (IT). The aim of this study was a comparison between the IT values and the bone-implant contact percentage (BIC) of human implants retrieved after a 4/8-week healing period. MATERIALS Seventeen implants, all with a sandblasted and acid-etched surface, were evaluated in the present study. METHODS The implants had been retrieved for different causes, after 4/8 weeks, with a 5 mm trephine bur, and immersed in 10% buffered formalin to be processed for histology. RESULTS A not statistically significant correlation was found between IT and BIC (P<or=0.892). CONCLUSIONS In the present study on human-retrieved implants, no statistically significant correlation was found between the IT values and BIC. These results could be due to a lack of relationship between bone structure and IT, or to the fact that primary stability may not only be influenced by bone volumetrical density and/or bone trabecular connectivity but also by the thickness and density of the cortical layer. Moreover, the present knowledge of the bone microstructure is not enough to explain the relationship of bone quality and primary implant stability.
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Affiliation(s)
- Marco Degidi
- Dental School, University of Chieti-Pescara, Chieti, Italy
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BROUWERS JEIG, LOBBEZOO F, VISSCHER CM, WISMEIJER D, NAEIJE M. Reliability and validity of the instrumental assessment of implant stability in dry human mandibles. J Oral Rehabil 2009; 36:279-83. [DOI: 10.1111/j.1365-2842.2009.01944.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Park JH, Lim YJ, Kim MJ, Kwon HB. The effect of various thread designs on the initial stability of taper implants. J Adv Prosthodont 2009; 1:19-25. [PMID: 21165250 PMCID: PMC2994669 DOI: 10.4047/jap.2009.1.1.19] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 11/26/2008] [Accepted: 02/03/2009] [Indexed: 11/26/2022] Open
Abstract
STATEMENT OF PROBLEM Primary stability at the time of implant placement is related to the level of primary bone contact. The level of bone contact with implant is affected by thread design, surgical procedure and bone quality, etc. PURPOSE The aim of this study was to compare the initial stability of the various taper implants according to the thread designs, half of which were engaged to inferior cortical wall of type IV bone (Group 1) and the rest of which were not engaged to inferior cortical wall (Group 2) by measuring the implant stability quotient (ISQ) and the removal torque value (RTV). MATERIAL AND METHODS In this study, 6 different implant fixtures with 10 mm length were installed. In order to simulate the sinus inferior wall of type IV bone, one side cortical bone of swine rib was removed. 6 different implants were installed in the same bone block following manufacturer's recommended procedures. Total 10 bone blocks were made for each group. The height of Group 1 bone block was 10 mm for engagement and that of group 2 was 13 mm. The initial stability was measured with ISQ value using Osstell mentor® and with removal torque using MGT50 torque gauge. RESULTS In this study, we found the following results. 1. In Group 1 with fixtures engaged to the inferior cortical wall, there was no significant difference in RTV and ISQ value among the 6 types of implants. 2. In Group 2 with fixtures not engaged to the inferior cortical wall, there was significant difference in RTV and ISQ value among the 6 types of implants (P < .05). 3. There was significant difference in RTV and ISQ value according to whether fixtures were engaged to the inferior cortical wall or not (P < .05). 4. Under-drilling made RTV and ISQ value increase significantly in the NT implants which had lower RTV and ISQ value in Group 2 (P < .05). CONCLUSIONS Without being engaged to the inferior cortical wall fixtures had initial stability affected by implant types. Also in poor quality bone, under-drilling improved initial stability.
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Affiliation(s)
- Ju-Hee Park
- Graduate Student, Department of Prosthodontics, Graduate School, Seoul National University, Seoul, Korea
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Heberer S, Rühe B, Krekeler L, Schink T, Nelson JJ, Nelson K. A prospective randomized split-mouth study comparing iliac onlay grafts in atrophied edentulous patients: covered with periosteum or a bioresorbable membrane. Clin Oral Implants Res 2009; 20:319-26. [DOI: 10.1111/j.1600-0501.2008.01638.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lundgren S, Sjöström M, Nyström E, Sennerby L. Strategies in reconstruction of the atrophic maxilla with autogenous bone grafts and endosseous implants. Periodontol 2000 2008; 47:143-61. [DOI: 10.1111/j.1600-0757.2008.00265.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Becker W, Goldstein M. Immediate implant placement: treatment planning and surgical steps for successful outcome. Periodontol 2000 2008; 47:79-89. [PMID: 18412575 DOI: 10.1111/j.1600-0757.2007.00242.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sennerby L, Meredith N. Implant stability measurements using resonance frequency analysis: biological and biomechanical aspects and clinical implications. Periodontol 2000 2008; 47:51-66. [DOI: 10.1111/j.1600-0757.2008.00267.x] [Citation(s) in RCA: 378] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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30
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Yang SM, Shin SY, Kye SB. Relationship between implant stability measured by resonance frequency analysis (RFA) and bone loss during early healing period. ACTA ACUST UNITED AC 2008; 105:e12-9. [PMID: 18230372 DOI: 10.1016/j.tripleo.2007.08.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 08/31/2007] [Indexed: 11/17/2022]
Affiliation(s)
- Seung-Min Yang
- Department of Periodontics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Ito Y, Sato D, Yoneda S, Ito D, Kondo H, Kasugai S. Relevance of resonance frequency analysis to evaluate dental implant stability: simulation and histomorphometrical animal experiments. Clin Oral Implants Res 2007; 19:9-14. [PMID: 17986265 DOI: 10.1111/j.1600-0501.2007.01419.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Resonance frequency analysis (RFA) is applied to evaluate implant stability, and the clinical relevance of this application is accepted. However, a discrepancy between resonance frequency (RF) and other parameters of implant stability such as implant insertion torque and bone mineral density at the insertion site has been reported. In addition, the relation between RF and histological implant-bone contact has not been well documented. PURPOSE To explain this discrepancy and to clarify the relation between RF and histological implant-bone contact, we conducted the present study. MATERIALS AND METHODS A hydroxyapatite-coated implant, 4 mm diameter and 10 mm length, was used. We placed the implant in a small plastic box vertically and fixed the implant in the box with small screws at different height positions. An 'Osstell' transducer was mounted on the implant and RF was measured with or without loosening the screws. Twenty-four implants were placed in the tibiae of four mini-pigs. The animals were sacrificed 1, 2 and 4 weeks after the placement, and the RF of each implant was measured. Ground sections were prepared and implant-bone contact was histomophometrically measured. RESULTS Loosening the screw at the neck region of the implant remarkably decreased RF compared with the screws of the other regions. Correlation between RF and implant-bone contact, which was measured all around the implant, was not significant (r=0.221, P=0.299). However, the correlation coefficient increased to '0.361' when implant-bone contact was measured at the neck of the implant (P=0.0835), although these two parameters were not statistically correlated. CONCLUSIONS Although RF did not correlate with histological implant-bone contact, the present results demonstrated that a connection between the implant and bone at the neck region of the implant affects RF the most effectively, further suggesting the superiority of RFA in the process of implant treatment and the follow-up. The present results could explain the discrepancy between RFA and other parameters of implant stability.
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Affiliation(s)
- Yoshihiro Ito
- Oral Implantology and Regenerative Dental Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
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Glauser R, Zembic A, Ruhstaller P, Windisch S. Five-year results of implants with an oxidized surface placed predominantly in soft quality bone and subjected to immediate occlusal loading. J Prosthet Dent 2007; 97:S59-68. [PMID: 17618935 DOI: 10.1016/s0022-3913(07)60009-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Numerous studies have demonstrated the feasibility and predictability of immediate implant loading or immediate implant restoration. However, most of these studies report primarily short-term outcomes. PURPOSE The purpose of this prospective clinical study was to document the 5-year outcome of immediate occlusally loaded implants with an oxidized, microtextured surface placed to support fixed prostheses in various regions of the jaws. MATERIAL AND METHODS Thirty-eight patients received a total of 51 implant-supported fixed prostheses, 29 mandibular and 22 maxillary, the day of implant insertion. Thirty were fixed partial dentures (FPDs), 20 replaced single teeth, and 1 was a fixed mandibular complete denture. The restorations were supported by 102 slightly tapered, screw-type implants, the majority of which were placed in posterior regions (88%) and primarily in soft bone quality (76%). Patients with ongoing signs of parafunctional habits were not included. All implants were placed using conventional flap procedures. Treatment with local regenerative procedures in connection with implant placement was accepted within the study design. Resonance frequency implant stability measurements and marginal periimplant soft tissue evaluations were conducted. Radiographic examinations were performed at the time of prosthesis insertion, at 1-and 6-month follow-ups, and annually at the 1- through 5-year follow-up visits. This report presents the results after 5 years of loading, summarized with descriptive statistics. RESULTS Three maxillary implants were removed, although stable, in 1 patient at the 8-week follow-up due to postoperative infection in the adjacent guided bone regeneration (GBR) area. No additional implants were lost. This resulted in a cumulative implant success rate of 97.1% after 5 years of prosthetic loading. The mean marginal bone remodeling (SD) after 5 years of function was 1.54 (0.99) mm. At the 5-year examination, absence of marginal plaque and absence of bleeding on probing was reported for 75% and 74% of the sites, respectively, and remained generally unchanged from the 1-month follow-up. CONCLUSIONS The 5-year follow-up data indicate that an immediate loading protocol using a slightly tapered implant design with an oxidized, microtextured surface is a successful treatment alternative in regions exhibiting soft bone quality.
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De Riu G, De Riu N, Spano G, Pizzigallo A, Petrone G, Tullio A. Histology and stability study of cortical bone graft influence on titanium implants. ACTA ACUST UNITED AC 2007; 103:e1-7. [PMID: 17275363 DOI: 10.1016/j.tripleo.2006.11.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2005] [Revised: 10/16/2006] [Accepted: 11/29/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The mechanisms for integrating titanium implants in recipient bone are still not well defined, and it is not known whether the process of bone formation around implants inserted into grafts is the same as that described for titanium implants in nongrafted cortical bone. This study compared the histology, stability, and osseointegration of titanium implants inserted in cortical bone with and without a simultaneous autologous cortical bone graft in an experimental animal model. METHODS Thirty titanium implants were inserted in 3 sheep. Half of the implants were inserted to fix the graft to the recipient bone, and the remainder were inserted in the distal part of the tibial metaphysis as controls. The animals were humanely killed at 2, 6, and 8 months after surgery. A stability test (unscrewing torque) was performed immediately on 12 fresh specimens (6 grafted implants and 6 control implants). The remaining unscrewed implants, both grafted and not grafted, were subjected to histomorphometric analysis. RESULTS After osseointegration, the unscrewing force exceeded the fracture limit of the titanium fixtures in both the grafted samples and controls, demonstrating their optimal stability but failing to demonstrate an improvement in the grafted bone. Histomorphometric analysis demonstrated newly formed tissue that extended from the contact area inside the graft, beginning at 6 months. At 8 months, the implant threads in the graft were surrounded by a large amount of newly formed bone mixed with necrotic fragments. CONCLUSIONS Our results show that onlay cortical grafts on cortical bone enhance the osteogenic potential of the host bone, ensuring solid, viable bone tissue support that results in a high rate of integration of the titanium fixtures. The loading forces affect the bone-healing process after implant insertion; bone matrix was deposited unequally, being greater proximally (90% versus 40%), which is perpendicular to the maximal load tension lines when the sheep are standing. This implies that in the human jaw, where the tension lines parallel the axis of the implants, the implants can play an important role in guiding new bone formation during osseointegration.
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Affiliation(s)
- Giacomo De Riu
- Assistant Professor, Maxillofacial Surgery Department, University of Sassari, Sassari, Italy
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Alsaadi G, Quirynen M, Michiels K, Jacobs R, van Steenberghe D. A biomechanical assessment of the relation between the oral implant stability at insertion and subjective bone quality assessment. J Clin Periodontol 2007; 34:359-66. [PMID: 17378890 DOI: 10.1111/j.1600-051x.2007.01047.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The study was set to evaluate the validity of subjective jaw bone quality assessment. MATERIALS AND METHODS A total of 298 patients (198 females, mean age 56.4) were treated with oral implants at the Periodontology Department at the University Hospital of KUL. A total of 761 TiUnite implants have been installed. Subjective bone quality assessment was performed on radiographs and by the surgeon's tactile sensation and was compared with torque measurements. In a subset of patients, implant stability was also assessed by implant stability quotient and/or periotest values. RESULTS Subjective assessment of bone quality was related to the PTV, ISQ and placement torque [in the crestal, the second and the apical third (N cm)], respectively; in grade 1: -5.3, 73.3 (4.2, 9.6, 15.2), and grade 3 or 4: -1.6, 55 (3.3, 5.5, 8.4). For the surgeon's tactile sensation, a good correlation was noted for the presence of a thick cortex: -4.6, 70.3 (4.2, 9.7, 15.1), or a thin one: -0.3, 65.9 (3.6, 6.9, 10.1). For dense trabecular bone, the values were -2.8, 69.4 (4.4, 9.7,14.8), while for poor trabecular bone, the values were-1.7, 66.4 (3.6, 6.4, 9.8). CONCLUSIONS Subjective assessment of bone quality is related to PTV, ISQ and placement torque measurements at implant insertion.
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Affiliation(s)
- Ghada Alsaadi
- Department of Periodontology, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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Becker W. Immediate implant placement: treatment planning and surgical steps for successful outcomes. Br Dent J 2007; 201:199-205. [PMID: 16936671 DOI: 10.1038/sj.bdj.4813881] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Diagnosis and treatment planning are key factors in achieving successful outcomes after placing and restoring implants placed immediately after tooth extraction. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. Some or all of the following suggestions, depending on individual circumstances, should be considered when evaluating a patient for dental implants: thorough medical and dental histories, clinical photographs, study casts, periapical and panogram radiographs as well as a linear tomography or computerised tomography of the proposed implant sites. Reasons for tooth extraction include but are not limited to: insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts, root resorption, teeth with deep furcation invasions being considered as abutments for fixed partial dentures and questionable teeth in need of endodontic retreatment.
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Affiliation(s)
- W Becker
- University of Southern California School of Dentistry, Los Angeles, USA.
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Scarano A, Degidi M, Iezzi G, Petrone G, Piattelli A. Correlation between implant stability quotient and bone-implant contact: a retrospective histological and histomorphometrical study of seven titanium implants retrieved from humans. Clin Implant Dent Relat Res 2007; 8:218-22. [PMID: 17100747 DOI: 10.1111/j.1708-8208.2006.00022.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Primary stability has a relevant role in the long-term success of dental implants. A quantitative method for the measurement of implant stability has been introduced (resonance frequency analysis [RFA]). Information about the significance of RFA measurements and about the relationship between RFA values and their association with implant osseointegration, success, or failure is important from a clinical point of view. PURPOSE The aim of the present histological and histomorphometric study was to see if a correlation existed between the bone-implant contact (BIC) percentage of retrieved human implants and RFA values. MATERIALS AND METHODS Seven implants inserted in the posterior mandible, with a sandblasted and acid-etched surface and retrieved after a 6-month period, were evaluated in the present study. These seven implants had been retrieved for different causes. All these implants were submerged and were retrieved with a 5-mm trephine bur and immersed in 10% buffered formalin to be processed for histology. RESULTS A statistically significant correlation could be detected between implant stability quotient and BIC (p=.016). CONCLUSIONS Even if the relationship between bone structure and RFA is still not fully understood, in our study, a statistically significant correlation was found between RFA and BIC values. Further studies are needed to evaluate a correlation of RFA and BIC in human implants retrieved after a range of healing periods.
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Affiliation(s)
- Antonio Scarano
- Researcher, Dental School, University of Chieti, Pescara, Italy
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Imoto H, Yamada A, Shimamura I, Matsunaga S, Ide Y. Influence of Mechanical Loading on Resonance Frequency Analysis and Trabecular Structure of Peri-implant Bone. ACTA ACUST UNITED AC 2007. [DOI: 10.2186/prp.6.120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Nelson K, Glatzer C, Hildebrand D, Hell B, Klein M. Clinical Evaluation of Endosseous Implants in Nonvascularized Fibula Bone Grafts for Reconstruction of the Severely Atrophied Mandibular Bone. J Oral Maxillofac Surg 2006; 64:1427-32. [PMID: 16916680 DOI: 10.1016/j.joms.2006.05.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2005] [Indexed: 10/24/2022]
Abstract
PURPOSE The purpose of the present study was to assess changes in graft height after augmentation of the severely atrophied mandibula with the use of avascular fibula bone grafts, as well as evaluation of the clinical success of endosseous implants placed in the grafted mandibula. PATIENTS AND METHODS This retrospective study included 10 patients with a mean observation period of 31 months (range, 3 to 76 months). A total of 40 implants were placed. Clinical criteria included implant success, graft success, and crestal bone resorption. RESULTS The grafting procedure was successfully performed in all patients. All implants were integrated, 2 implants could not be used for prosthetic rehabilitation. One implant was lost 2 years after abutment connection. The maximum bone resorption of 7.21% (+/- 2.7%) was seen within the first year; no significant resorption was seen thereafter. CONCLUSION In this clinical and radiographic evaluation, it was found that nonvascular fibula graft is a reliable material for augmentation procedures. The resorption takes place within the first year after augmentation. The possibility of improving the clinical results in bone grafting situations with avascular fibula grafts will be further evaluated in a prospective follow-up study providing long-term assessment of this procedure.
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Affiliation(s)
- Katja Nelson
- Clinic for Oral and Maxillofacial Surgery and Clinical Navigation and Robotics, Charité Campus Virchow Clinic, Berlin, Germany.
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Thor A, Wannfors K, Sennerby L, Rasmusson L. Reconstruction of the severely resorbed maxilla with autogenous bone, platelet-rich plasma, and implants: 1-year results of a controlled prospective 5-year study. Clin Implant Dent Relat Res 2006; 7:209-20. [PMID: 16336912 DOI: 10.1111/j.1708-8208.2005.tb00066.x] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Prosthetic treatment of the edentulous maxilla may require bone augmentation to enable placement and integration of dental implants. This constitutes a complex healing situation, and resorption of the grafted bone and failure of the implants often occur. The application of autogenous platelet-rich plasma (PRP) has been suggested to improve incorporation and preservation of bone grafts. PURPOSE The aim of this controlled clinical study was to evaluate whether PRP in conjunction with grafting of particulated autogenous bone to the maxilla could improve the integration and clinical function of dental implants. An additional aim was to compare block bone grafts without PRP with PRP-treated particulated bone. MATERIAL AND METHODS Nineteen consecutive patients were included in the study and treated with iliac bone grafts and dental implants in the maxilla according to a split-mouth design. In the anterior maxilla, particulated bone mixed with PRP (test) was compared with onlay block grafts without additional PRP (control). In the posterior maxilla, particulated bone grafts with (test) or without (control) PRP were placed as sinus inlay grafts. After 6 months of healing, 152 implants (8 implants/patient) (TiOblast, Astra Tech AB, Mölndal, Sweden) were placed. Test (PRP; 76 implants) and non-PRP (76 implants) sides were evaluated and compared by implant survival rate, marginal bone level, and implant stability using resonance frequency analysis (RFA) during 1 year in function. RESULTS Two control implants in control sites in two patients were lost at abutment connection. After 1 year in function, no further implants were lost, giving an overall survival rate of 98.7%. The marginal bone level measurements showed no significant differences, although there was a tendency toward less resorption on PRP sides. RFA measurements showed statistically significantly higher implant stability quotient values for PRP sites at abutment connection in the anterior but not in the posterior regions. CONCLUSIONS The present clinical study showed that a high implant survival rate and stable marginal bone conditions can be achieved after 1 year of loading in the maxilla following autogenous bone grafting whether or not PRP is used. RFA measurements revealed differences at abutment connection, which could be explained by the type of graft rather than as an effect of PRP. Although no obvious positive effects of PRP on bone graft healing could be demonstrated, the handling of the particulated bone grafts was improved.
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Affiliation(s)
- Andreas Thor
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala University Hospital, Sweden.
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Earthman JC, Li Y, VanSchoiack LR, Sheets CG, Wu JC. Reconstructive materials and bone tissue engineering in implant dentistry. Dent Clin North Am 2006; 50:229-44, ix. [PMID: 16530060 DOI: 10.1016/j.cden.2005.11.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Periodontal function for natural teeth and dental implants depends strongly on the mechanical integrity of the bone in the maxilla and mandible. Ongoing healthy bone remodeling around a natural tooth or implant is critical for longevity. Chemical factors that influence bone remodeling have been explored with the goal of enhancing the growth and maintenance of good quality bone. Less, but increasing, effort has been directed at understanding mechanical signals and factors, including those affected by implant/prosthesis materials that transmit loads directly to the surrounding bone. This article reviews research on the effects of synthetic materials and resulting mechanical stimuli on bone tissue engineering in dentistry.
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Affiliation(s)
- James C Earthman
- Department of Biomedical Engineering, University of California, Irvine, CA 92697-2575, USA.
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Büchter A, Joos U, Wiesmann HP, Seper L, Meyer U. Biological and biomechanical evaluation of interface reaction at conical screw-type implants. Head Face Med 2006; 2:5. [PMID: 16504052 PMCID: PMC1421389 DOI: 10.1186/1746-160x-2-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2005] [Accepted: 02/21/2006] [Indexed: 11/10/2022] Open
Abstract
Background Initial stability of the implant is, in effect, one of the fundamental criteria for obtaining long-term osseointegration. Achieving implant stability depends on the implant-bone relation, the surgical technique and on the microscopic and macroscopic morphology of the implant used. A newly designed parabolic screw-type dental implant system was tested in vivo for early stages of interface reaction at the implant surface. Methods A total of 40 implants were placed into the cranial and caudal part of the tibia in eight male Göttinger minipigs. Resonance frequency measurements (RFM) were made on each implant at the time of fixture placement, 7 days and 28 days thereafter in all animals. Block biopsies were harvested 7 and 28 days (four animals each) following surgery. Biomechanical testing, removable torque tests (RTV), resonance frequency analysis; histological and histomorphometric analysis as well as ultrastructural investigations (scanning electron microscopy (SEM)) were performed. Results Implant stability in respect to the measured RTV and RFM-levels were found to be high after 7 days of implants osseointegration and remained at this level during the experimented course. Additionally, RFM level demonstrated no alteration towards baseline levels during the osseointegration. No significant increase or decrease in the mean RFM (6029 Hz; 6256 Hz and 5885 Hz after 0-, 7- and 28 days) were observed. The removal torque values show after 7 and 28 days no significant difference. SEM analysis demonstrated a direct bone to implant contact over the whole implant surface. The bone-to-implant contact ratio increased from 35.8 ± 7.2% to 46.3 ± 17.7% over time (p = 0,146). Conclusion The results of this study indicate primary stability of implants which osseointegrated with an intimate bone contact over the whole length of the implant.
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Affiliation(s)
- Andre Büchter
- Department of Cranio-Maxillofacial Surgery, University of Münster, Waldeyerstraße 30, D-48129 Münster, Germany
| | - Ulrich Joos
- Department of Cranio-Maxillofacial Surgery, University of Münster, Waldeyerstraße 30, D-48129 Münster, Germany
| | - Hans-Peter Wiesmann
- Department of Cranio-Maxillofacial Surgery, University of Münster, Waldeyerstraße 30, D-48129 Münster, Germany
| | - László Seper
- Department of Cranio-Maxillofacial Surgery, University of Münster, Waldeyerstraße 30, D-48129 Münster, Germany
| | - Ulrich Meyer
- Department for Cranio- and Maxillofacial Surgery, Heinrich-Heine-University, Moorenstr, 5, D-40225 Dusseldorf, Germany
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Miyamoto I, Tsuboi Y, Wada E, Suwa H, Iizuka T. Influence of cortical bone thickness and implant length on implant stability at the time of surgery--clinical, prospective, biomechanical, and imaging study. Bone 2005; 37:776-80. [PMID: 16154396 DOI: 10.1016/j.bone.2005.06.019] [Citation(s) in RCA: 195] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2005] [Revised: 06/02/2005] [Accepted: 06/30/2005] [Indexed: 11/22/2022]
Abstract
This clinical study is the first to quantitatively evaluate both regional bone structure by computed tomography preoperatively and dental implant stability by resonance frequency analysis at the time of surgery to explore the relation between local bone structure and dental implant stability in humans. Implant stability at the time of installation is often difficult to achieve in lower density bone and implant stability might influence treatment efficacy. Few clinical studies have reported detailed bone characteristics obtained using computed tomography prior to surgery and comprehensive implant stability measurements at the time of surgery. We hypothesized that thicker cortical bone would improve the stability of the dental implant at the time of placement. Before radiographic examination, diagnostic radiographic templates were made by incorporating radiopaque indicators. Computed tomography scans were obtained for 50 edentulous subjects prior to surgery. Preoperatively, the thickness of the cortical bone at the sites of implant insertion was measured digitally, and then implant insertion surgery was performed. A total of 225-implant stability measurements were made using a resonance frequency analyzer. There was a strong linear correlation between cortical bone thickness and resonance frequency (r = 0.84, P < 0.0001). The implant length had a weak negative correlation with stability (r = -0.25, P < 0.0005). These results suggest that the initial stability at the time of implant installation is influenced more by cortical bone thickness than by implant length. The cortical and cancellous ratio of local bone is extremely important for implant stability at the time of surgery and determining the local bone condition is critical for treatment success.
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Affiliation(s)
- Ikuya Miyamoto
- Department Oral and Maxillofacial Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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Becker W, Sennerby L, Bedrossian E, Becker BE, Lucchini JP. Implant Stability Measurements for Implants Placed at the Time of Extraction: A Cohort, Prospective Clinical Trial. J Periodontol 2005; 76:391-7. [PMID: 15857073 DOI: 10.1902/jop.2005.76.3.391] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies indicate that implants placed at the time of extraction have high success rates. Implants must be stable at the time of insertion. Presently there are no data indicating the degree of implant stability when implants are placed at the time of extraction. This study evaluated changes in stability of implants from implant placement to abutment connection utilizing resonance frequency analysis (RFA). The unit of measurement was the international stability quotient (ISQ). METHODS Prior to treatment, patients were given medical history and dental evaluations. Periapical and panogram radiographs were taken. Fifty-two patients requiring extraction of one or two teeth and implant placement immediately after extraction were enrolled in this study. Under conscious sedation and local anesthesia or local anesthesia alone, teeth were atraumatically removed and the extraction sockets were debrided. A total of 73 dental implants (57 in the maxilla, 16 in the mandible) were placed. Using a one-stage approach, all implants were placed within the patient's alveolar envelope and were never placed directly into extraction sockets. All implants were placed into contained extraction sites. Bone augmentation procedures were not performed. After implant insertion, the RFA electronic transducer was attached to the head of the implant with the retaining screw. The device was attached to a computer designed to register RFA scores in ISQ units. RFA measurements were taken at implant placement and abutment connection. Bone qualities, quantity, implant length and width as well as site of placement were recorded. RESULTS The average interval between implant insertion and abutment connection was 5.6 months (SD 2.05). Two implants were lost between implant insertion and 1 year. At 2 to 3 years, the cumulative survival was 97.2%. Resonance frequency measurements at implant placement showed a mean primary stability of 62.0 (SE 1.1; range 43 to 83 ISQ) and a mean secondary stability after 1 year of 64.0 (SE 1.2; range 40 to 98 ISQ) for all implants. The increase was marginally significant (generalized estimating equation z-statistic = 1.79; P value = 0.07). CONCLUSIONS Implants placed at the time of extraction and inserted into native bone and not directly into extractions sockets have a high degree of initial stability as evidenced by RFA measurements. Implants with initial high ISQ levels revealed a slight drop in levels over time, while implants with levels lower than 60 had increases in levels between implant insertion and abutment connection. At 2 to 3 years the cumulative survival rate was 97.2%.
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Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing.. A clinical resonance-frequency analysis study with sandblasted-and-etched ITI implants. Clin Oral Implants Res 2004; 15:529-39. [PMID: 15355394 DOI: 10.1111/j.1600-0501.2004.01042.x] [Citation(s) in RCA: 208] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of the present study was (1) to measure the primary stability of ITI implants placed in both jaws and determine the factors that affect the implant stability quotient (ISQ) determined by the resonance frequency method and (2) to monitor implant stability during the first 3 months of healing and evaluate any difference between immediately loaded (IL) implants and standard delayed loaded (DL) implants. The IL and DL groups consisted of 18 patients/63 implants and 18 patients/43 implants. IL implants were loaded after 2 days; DL implants were left to heal according to the one-stage procedure. The ISQ was recorded with an Osstell apparatus (Integration Diagnostics AB, Gothenburg, Sweden) at implant placement, after 1, 2, 4, 6, 8, 10 and 12 weeks. Primary stability was affected by the jaw and the bone type. The ISQ was higher in the mandible (59.8+/-6.7) than the maxilla (55.0+/-6.8). The ISQ was significantly higher in type I bone (62.8+/-7.2) than in type III bone (56.0+/-7.8). The implant position, implant length, implant diameter and implant deepening (esthetic plus implants) did not affect primary stability. After 3 months, the gain in stability was higher in the mandible than in the maxilla. The influence of bone type was leveled off and bone quality did not affect implant stability. The resonance-frequency analysis method did not reveal any difference in implant stability between the IL and DL implants over the healing period. Implant stability remained constant or increased slightly during the first 4-6 weeks and then increased more markedly. One DL and IL implant failed; both were 8 mm long placed in type III bone. At the 1-year control, the survival rate of the IL and the DL implants was 98.4% and 97.7%, respectively. This study showed no difference in implant stability between the IL and DL procedures over the first 3 months. IL short-span bridges placed in the posterior region and full arch rehabilitation of the maxilla with ITI sandblasted-and-etched implants were highly predictable.
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Affiliation(s)
- Mark Bischof
- CdC Clinique Dentaire de Chauderon, Lausanne, Switzerland.
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Büchter A, Kleinheinz J, Wiesmann HP, Kersken J, Nienkemper M, Weyhrother HV, Joos U, Meyer U. Biological and biomechanical evaluation of bone remodelling and implant stability after using an osteotome technique. Clin Oral Implants Res 2004; 16:1-8. [PMID: 15642025 DOI: 10.1111/j.1600-0501.2004.01081.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The influence of the osteotome technique on the osseointegration and biomechanical behaviour of cylinder implants (SLA, ITI was compared with conventional preparation of the implant site in an animal model. A total of 56 implants were placed in the cranial and caudal tibia condyle of six Gottinger minipigs. The implant site was prepared either by the conventional technique with drills (control group A) or by the osteotome technique (experimental group B). Resonance frequency measurements (RFMs) were made on each implant at the time of fixture placement and at the time of scarification. Half of the minipigs were sacrificed 7 days and 28 days after implant placement and the implants were removed with the surrounding bone. Bone tissue responses were evaluated by histological analysis and removal torque testing. For histological evaluation 30-50 microm-thick ground sections were examined. Biomechanical testing revealed a significantly higher stability of implants in the control group (A) than in the experimental group (B) (P = 0.004) at day 7. After 28 days implant stability in the control group remained significant higher (47%) than those of group B (P > 0.001). RFM demonstrated no significant difference between both groups and during the experimental course. Histological analysis demonstrated fractured trabeculae in peri-implant bone in the experimental group at day 7, while they were not posed at day 28. We conclude that the decreased implant stability by using the osteotome technique is based on microfractures in peri-implant bone.
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Affiliation(s)
- André Büchter
- Department of Cranio-Maxillofacial Surgery, University of Münster, Waldeyerstrasse 30, D-48129 Münster, Germany.
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Büchter A, Kleinheinz J, Wiesmann HP, Seper L, Joos U, Meyer U. Tierexperimentelle Evaluation des periimplant�ren Knochens bei zylindrischen gegen�ber konischen Implantattypen. ACTA ACUST UNITED AC 2004; 8:282-8. [PMID: 15480869 DOI: 10.1007/s10006-004-0557-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The treatment of patients with early or immediately loaded dental implants has renewed interest in the behavior of osseointegration at the implant surface. Whereas it is generally accepted that peri-implant tissue formation and mineralization are dependent on the local mechanical environment in the interface zone, controversies exist concerning the impact of implant design on peri-implant bone formation. The aim of the present study was the in vivo evaluation of peri-implant bone formation by two different implant systems: cylindrical (ITI) versus conical (ILI). MATERIAL AND METHOD A total of 60 implants (30 ITI and 30 ILI) were placed in the cranial and caudal part of the tibia of eight Göttinger minipigs. Half of the minipigs were sacrificed at 7 days and 28 days of osseointegration. Implant-containing bone specimens were prepared for histological and ultrastructural investigations. RESULTS Histological and scanning electron-microscopic investigations showed a direct contact of bone-like minerals over the whole implant surface from day 7 of implant/bone interaction. Whereas the ILI implant showed direct contact up to the top of the crestal bone, ITI implants demonstrated a crestally located narrow gap without ossification over the whole experimental period. CONCLUSION Our investigations support the hypothesis of an implant design-inherent emergence and maintenance of crestal bone.
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Affiliation(s)
- A Büchter
- Klinik und Poliklinik für Mund- und Kiefer-Gesichtschirurgie, Universität Münster.
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Kramer FJ, Dempf R, Bremer B. Efficacy of dental implants placed into fibula-free flaps for orofacial reconstruction. Clin Oral Implants Res 2004; 16:80-8. [PMID: 15642034 DOI: 10.1111/j.1600-0501.2004.01040.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The transfer of the osseofasciocutaneus fibula-free flap has become a routine procedure in the reconstruction of comprehensive orofacial defects. Besides its length, major advantages of the fibula-free flap include the trigonal diameter of the fibular bone, which usually allows the placement of dental implants. PATIENTS AND METHODS In a prospective study, 16 consecutive patients who received free fibula grafts and in total 51 dental implants between 1999 and 2001 were examined. All implants were inserted secondary after bone grafting and loaded after 3 months of submerged healing. The observation period extended 2.5 years on average. The implant success was controlled clinically, radiographically and by resonance frequency analysis. RESULTS One implant that was located at the interface between the fibula graft and the mandible was lost due to dehiscence and local infection during the healing period. In two other patients, one implant had to remain unexposed as 'sleeper' due to an unfavourable soft tissue situation. The success rate calculated by Kaplan-Meier analysis was 96.1% after an observation period of 1400 days. Resonance frequency analysis (ISQ-values) revealed significant differences related to the orientation (vestibulo-oral/mesio-distal; vo/md) of the transducer unit (P < 0.01). In general, a high primary stability for implants placed in free fibula grafts could be achieved (vo/md 66/74.1), which on average increased slightly during the healing period (vo/md 67.4/75.4) and within 12 month of functional loading (vo/md 72.1/79.9). Additional augmentation with iliac bone grafts or reconstructions with a double barred fibula resulted in an improved reconstruction of the alveolar process, thus allowing superior individual implant positions or angulations, but no elevation of the ISQ-values. CONCLUSION The fibula-free flap provides a consistent bone graft that allows a reliable and predictable restoration with dental implants.
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Affiliation(s)
- Franz-Josef Kramer
- Department of Oral and Maxillofacial Surgery, Medical University of Hanover, Carl-Neuberg-Str. 1, D-30625 Hanover, Germany.
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Affiliation(s)
- Christoph H F Hämmerle
- Clinic for Fixed and Removable Prosthodontics, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zürich, Switzerland
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Cordioli G, Atiyeh F, Piattelli A, Majzoub Z. Healing of transplanted composite bone grafts-implants: a pilot animal study. Clin Oral Implants Res 2003; 14:750-8. [PMID: 15015952 DOI: 10.1046/j..2003.00956.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This experimental pilot study was undertaken to evaluate healing of titanium implants transplanted with the surrounding bone into recipient osseous sites in the rabbit mandible. One short implant was inserted in the horizontal portion of the mandible in each of 10 New Zealand rabbits. Subsequently, and during the same session, the implant with 1.5-2.0 mm of bone circumferentially was removed using a trephine bur and immediately transplanted in a through-and-through hole prepared in the contralateral aspect of the mandible. Three months following the transplantation, the animals were sacrificed and the mandibles processed for histological evaluation. The healing pattern was assessed in relation to (1) bone bridging at the interface between the bone core and the surrounding recipient osseous tissue, (2) differences in bone density between the transplanted bone cylinder and the bone at the margins of the recipient site, and (3) bone-to-implant contact (BIC) at the interface. The transplanted graft-implant cores were integrated within the recipient sites in five out of the 10 specimens while the remaining five bone-implant cores showed fibrous encapsulation. Various patterns of resorption were observed within the peri-implant transplanted hard tissues. Percentage BIC ranged between 1% and 72% in the fibrous-encapsulated specimens and between 20% and 62% in the integrated transplants. Within the limits of this pilot study, the results suggest that immediate transplantation of endosseous implants with their surrounding bone into congruous recipient osseous sites cannot predictably yield graft-implant incorporation and osseointegration of the implants. This alternative surgical modality of immediately transplanting a composite bone graft-implant from highly cortical intraoral or extraoral sites to enhance bone quality and/or volume in implant recipient sites such as the maxillary sinus and tuberosity areas needs to be further investigated.
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Affiliation(s)
- Giampiero Cordioli
- Department of Periodontology, University of Padova, Institute of Clinical Dentistry, Padova, Italy
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Büchter A, Kleinheinz J, Joos U, Meyer U. Primäre Implantatstabilität bei unterschiedlichen Knochenaufbereitungstechniken. ACTA ACUST UNITED AC 2003; 7:351-5. [PMID: 14648251 DOI: 10.1007/s10006-003-0504-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The treatment concept of osseointegration is based on a stable embodiment of implants in bone and the maintenance of stability during functional load. A goal of the surgical preparation technique is therefore to obtain a stable and firm implant anchorage. The aim of this study was to evaluate implant stability after different surgical treatment of the bony implantation bed. Thirty cylindrical solid-screw-shaped implants with standard SLA ITI configuration were implanted into the explanted mandibles of five minipigs. The implant sites were prepared either by a conventional burr technique (group A), by burr technique with additional thread cutting (group B), or by the osteotome technique (group C). Primary implant stability was evaluated by resonance frequency analysis and removal torque test. The average value of the resonance frequency analysis (RFA) was 6000+/-469 cycles/s in group A, 5700+/-557 cycles/s in group B, and 5540+/-527 cycles/s in group C. Removal torque values of group A (507+/-57 Nmm) were significantly higher than those of group B (466+/-45 Nmm) and group C (240+/-31 Nmm) (between group A and C p<0.05, group A to B p=0.39, and B to C p<0.05). It can be concluded from this study that the conventional burr technique achieves a statistically significantly better primary bone anchorage than the osteotome technique.
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Affiliation(s)
- A Büchter
- Klinik und Poliklinik für Mund- und Kiefer-Gesichtschirurgie, Westfälische Wilhelms-Universität Münster.
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