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Romasco T, De Bortoli Jr N, Paulo De Bortoli J, Jorge Jayme S, Piattelli A, Di Pietro N. Primary stability evaluation of different morse cone implants in low-density artificial bone blocks: A comparison between high-and low-speed drilling. Heliyon 2024; 10:e35225. [PMID: 39170202 PMCID: PMC11336439 DOI: 10.1016/j.heliyon.2024.e35225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 07/17/2024] [Accepted: 07/24/2024] [Indexed: 08/23/2024] Open
Abstract
This study aimed to evaluate various biomechanical parameters associated with the primary stability of Maestro and Due Cone implants placed in low-density artificial bones, prepared using high-speed drilling with irrigation and low-speed drilling without irrigation. The insertion torque (IT), removal torque (RT), and implant stability quotient (ISQ) values were recorded for Maestro and Due Cone implants placed in low-density polyurethane blocks (10 and 20 pounds per cubic foot (PCF) with and without a cortical layer) prepared using high-speed and low-speed with or without irrigation using a saline solution, respectively. A three-way ANOVA model and Tukey's post-hoc test were conducted, presenting data as means and standard deviations. P-values equal to or less than 0.05 were considered statistically significant. No statistically significant differences in IT, RT, and ISQ between drilling speeds were observed. However, Maestro implants exhibited lower IT and RT values after high- and low-speed drilling across almost all polyurethane blocks, significantly evident in the 20 PCF density block for IT and in the 20 PCF density block with the cortical layer for the RT with low-speed drilling (IT: 47.33 ± 10.02 Ncm and 16.00 ± 12.49 Ncm for Due Cone and Maestro implants, respectively, with p < 0.01; RT: 44.67 ± 22.81 Ncm and 20.01 ± 4.36 Ncm for Due Cone and Maestro implants, respectively, with p < 0.05) and among the same implant types inserted in different bone densities. Additionally, the study found that for all bone densities and drilling speeds, both implants registered ISQ values exceeding 60, except for the lowest-density polyurethane block. Overall, it can be inferred that low-speed drilling without irrigation achieved biomechanical parameters similar to conventional drilling with both implant types, even with lower IT values in the case of Maestro implants. These findings suggest a promising potential use of low-speed drilling without irrigation in specific clinical scenarios, particularly when focusing on preparation depth or when ensuring proper irrigation is challenging.
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Affiliation(s)
- Tea Romasco
- Center for Advanced Studies and Technology-CAST, “G. D'Annunzio” University of Chieti-Pescara, Via Luigi Polacchi 11, 66100, Chieti, Italy
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D'Annunzio” University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
| | - Nilton De Bortoli Jr
- Department of Oral Implantology, Associação Paulista Dos Cirurgiões Dentistas-APCD, São Bernardo Do Campo, 02011-000, Brazil
| | - Joao Paulo De Bortoli
- Biomaterials Division, New York University College of Dentistry, New York, 10010, NY, USA
| | - Sergio Jorge Jayme
- Department of Dental Materials and Prosthetics, School of Dentistry of Ribeirão Preto, University of São Paulo, 14040-904, Ribeirão Preto, SP, Brazil
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International, University of Health and Medical Sciences, Via di Sant’Alessandro 8, 00131, Rome, Italy
- Facultad de Medicina, UCAM Universidad Católica San Antonio de Murcia, Av. de Los Jerónimos 135, 30107, Guadalupe de Maciascoque, Spain
| | - Natalia Di Pietro
- Center for Advanced Studies and Technology-CAST, “G. D'Annunzio” University of Chieti-Pescara, Via Luigi Polacchi 11, 66100, Chieti, Italy
- Department of Medical, Oral and Biotechnological Sciences, “G. D'Annunzio” University of Chieti-Pescara, Via Dei Vestini 31, 66100, Chieti, Italy
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Sahrmann P, Kühl S, Dagassan-Berndt D, Bornstein MM, Zitzmann NU. Radiographic assessment of the peri-implant site. Periodontol 2000 2024. [PMID: 38951952 DOI: 10.1111/prd.12577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/09/2024] [Accepted: 05/12/2024] [Indexed: 07/03/2024]
Abstract
While peri-implant mucositis relies solely on clinical parameters, radiological assessment becomes indispensable for diagnosing peri-implantitis. Intraoral radiography, with its simplicity of application, low radiation exposure, and adequate representation of peri-implant structures, stands out as the standard of care for both immediate and follow-up assessments. Standardization by custom-made radiologic splints allows for excellent comparability with previous images and allows for the determination of even small changes in contour and density of the peri-implant bone. Furthermore, other radiographic modalities like panoramic radiography and cone beam computed tomography (CBCT) may provide useful features for specific patients and clinical cases while also showing innate limitations. Beyond the assessment of the marginal peri-implant bone level as the crucial parameter of clinical relevance, radiologic assessment may reveal various other findings related to the prosthetic restoration itself, the precision of its fit to the implant, and the peri-implant soft and hard tissues. Since such findings can be crucial for the assessment of peri-implant health and the implants' prognosis, a systematic diagnostic evaluation pathway for a thorough assessment is recommended to extract all relevant information from radiologic imaging. This article also provides an overview of the clinical and chronological indications for different imaging modalities in peri-implant issues.
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Affiliation(s)
- Philipp Sahrmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Dental Imaging, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Rugova S, Abboud M. Standardized Testing for Thermal Evaluation of Bone Drilling: Towards Predictive Assessment of Thermal Trauma. Bioengineering (Basel) 2024; 11:642. [PMID: 39061724 PMCID: PMC11274048 DOI: 10.3390/bioengineering11070642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
To ensure the prevention of thermal trauma and tissue necrosis during bone drilling in surgical procedures, it is crucial to maintain temperatures below the time- and temperature-dependent threshold of 50 °C for 30 s. However, the absence of a current standard for assessing temperatures attained during bone drilling poses a challenge when comparing findings across different studies. This article aims to address this issue by introducing a standardized testing method for acquiring thermal data during experimental bone drilling. The method requires the use of three controlled variables: infrared thermography, standard bone blocks, and a regulated drilling procedure involving a drill press with irrigation that simulates a surgeon. By utilizing this setup, we can obtain temperature data that can be effectively applied in the evaluation of other variables, such as surgical techniques or drill bit design, and translate the data into bone damage/clinical outcomes. Two surgical drill bits (2.0 mm-diameter twist drill bit and 3.3 mm-diameter multi-step drill bit) are compared using this experimental protocol. The results show the 2.0 mm bit reached significantly higher temperatures compared to the 3.3 mm bit when preparing an osteotomy (p < 0.05). The 2.0 mm drill bit reached temperatures over 100 °C while the 3.3 mm drill bit did not exceed 50 °C.
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Affiliation(s)
- Sihana Rugova
- Department of Oral Biology and Pathology, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Marcus Abboud
- School of Engineering, Stony Brook University, Stony Brook, NY 11794, USA
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Ali A, Brintouch I, Romanos G, Delgado-Ruiz R. Cooling Efficiency of Sleeveless 3D-Printed Surgical Guides with Different Cylinder Designs. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:239. [PMID: 38399527 PMCID: PMC10889961 DOI: 10.3390/medicina60020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: Surgical guides might impede the flow of coolant to the implant drills during the preparation of the implant bed, potentially contributing to increased temperatures during bone drilling. The objective of this experimental study was to assess the cooling efficiency of various guiding cylinder designs for sleeveless surgical guides used in guided surgery. Materials and Methods: In this experimental study, surgical guides with three different guiding cylinder designs were printed. One group had solid cylinders (control) and two test groups (cylinders with pores and cylinders with windows). Forty customized polyurethane blocks with type III bone characteristics were fitted into the guide and fixed in a vise, and implant bed preparations were completed using a simplified drilling protocol with and without irrigation. An infrared thermographic camera was used to record the temperature changes during drilling at the coronal, middle, and apical areas. ANOVA test and Games-Howell post hoc test were used to determine significant thermal differences among groups. Results: A significant thermal increase was observed at the coronal area in the group without irrigation (39.69 ± 8.82) (p < 0.05). The lowest thermal increase was recorded at the surgical guides with windows (21.451 ± 0.703 °C) compared to solid (25.005 ± 0.586 °C) and porous surgical guides (25.630 ± 1.004) (p < 0.05). In the middle and apical areas, there were no differences between solid and porous cylinders (p > 0.05). Conclusions: 3D-printed sleeveless surgical guides with window openings at the guiding cylinders reduce the temperature elevation at the cortical bone in guided implant surgery.
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Affiliation(s)
- Aisha Ali
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (A.A.); (I.B.)
| | - Ido Brintouch
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (A.A.); (I.B.)
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA;
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (A.A.); (I.B.)
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Troiano G, Fanelli F, Rapani A, Zotti M, Lombardi T, Zhurakivska K, Stacchi C. Can radiomic features extracted from intra-oral radiographs predict physiological bone remodelling around dental implants? A hypothesis-generating study. J Clin Periodontol 2023; 50:932-941. [PMID: 36843362 DOI: 10.1111/jcpe.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/02/2023] [Accepted: 02/19/2023] [Indexed: 02/28/2023]
Abstract
AIM The rate of physiological bone remodelling (PBR) occurring after implant placement has been associated with the later onset of progressive bone loss and peri-implantitis, leading to medium- and long-term implant therapy failure. It is still questionable, however, whether PBR is associated with specific bone characteristics. The aim of this study was to assess whether radiomic analysis could reveal not readily appreciable bone features useful for the prediction of PBR. MATERIALS AND METHODS Radiomic features were extracted from the radiographs taken at implant placement (T0) using LifeX software. Because of the multi-centre design of the source study, ComBat harmonization was applied to the cohort. Different machine-learning models were trained on selected radiomic features to develop and internally validate algorithms capable of predicting high PBR. In addition, results of the algorithm were included in a multivariate analysis with other clinical variables (tissue thickness and depth of implant position) to test their independent correlation with PBR. RESULTS Specific radiomic features extracted at T0 are associated with higher PBR around tissue-level implants after 3 months of unsubmerged healing (T1). In addition, taking advantage of machine-learning methods, a naive Bayes model was trained using radiomic features selected by fast correlation-based filter (FCBF), which showed the best performance in the prediction of PBR (AUC = 0.751, sensitivity = 66.0%, specificity = 68.4%, positive predictive value = 73.3%, negative predictive value = 60.5%). In addition, results of the whole model were included in a multivariate analysis with tissue thickness and depth of implant position, which were still found to be independently associated with PBR (p-value < .01). CONCLUSION The combination of radiomics and machine-learning methods seems to be a promising approach for the early prediction of PBR. Such an innovative approach could be also used for the study of not readily disclosed bone characteristics, thus helping to explain not fully understood clinical phenomena. Although promising, the performance of the radiomic model should be improved in terms of specificity and sensitivity by further studies in this field.
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Affiliation(s)
- Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Fanelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Matteo Zotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Teresa Lombardi
- Department of Health Sciences, University "Magna Graecia", Catanzaro, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Stacchi C, Lamazza L, Rapani A, Troiano G, Messina M, Antonelli A, Giudice A, Lombardi T. Marginal bone changes around platform-switched conical connection implants placed 1 or 2 mm subcrestally: A multicenter crossover randomized controlled trial. Clin Implant Dent Relat Res 2023; 25:398-408. [PMID: 36725016 DOI: 10.1111/cid.13186] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 02/03/2023]
Abstract
INTRODUCTION This study analyzes early marginal bone modifications occurring around platform-switched implants with conical connection placed 1 or 2 mm subcrestally. METHODS This crossover randomized controlled trial enrolled partially edentulous patients needing two implants in either the posterior maxilla or mandible. Each patient received two platform-switched implants with conical connection inserted 2 mm (Test) and 1 mm (Control) subcrestally. Definitive abutments were immediately connected and, after 4 months of unsubmerged healing, screwed metal-ceramic crowns were delivered. Radiographs were taken at implant placement (T0), prosthesis delivery (T1), and after 1 year of prosthetic loading (T2). RESULTS Fifty-one patients (25 males and 26 females; mean age 61.2 ± 12.1 years) totaling 102 implants were included in the final analysis. Mean peri-implant bone level (PBL) reduction from T0 to T2 was not significantly different around Test (0.49 ± 0.32 mm) and Control implants (0.46 ± 0.35 mm; p = 0.66). Multivariate linear regression models highlighted a significant positive correlation between history of periodontitis and PBL reduction. At T2, no Test group implant and 6 Control group implants exhibited PBL below the implant platform (11.8% of Control group implants). CONCLUSION No significant differences in peri-implant marginal bone changes were demonstrated after 1 year of prosthetic loading between platform-switched implants with conical connection inserted either 1 or 2 mm subcrestally. However, 2 mm subcrestal placement resulted in deeper implant positioning at T2, with no exposure of treated implant surface and potential preventive effect against subsequent peri-implant pathology.
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luca Lamazza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Rapani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | | | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
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Stacchi C, Troiano G, Montaruli G, Mozzati M, Lamazza L, Antonelli A, Giudice A, Lombardi T. Changes in implant stability using different site preparation techniques: Osseodensification drills versus piezoelectric surgery. A multi-center prospective randomized controlled clinical trial. Clin Implant Dent Relat Res 2023; 25:133-140. [PMID: 36190150 PMCID: PMC10092180 DOI: 10.1111/cid.13140] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Implant stability is influenced by bone density, implant design, and site preparation characteristics. Piezoelectric implant site preparation (PISP) has been demonstrated to improve secondary stability compared with conventional drilling techniques. Osseodensification drills (OD) have been recently introduced to enhance both bone density and implant secondary stability. The objective of the present multi-center prospective randomized controlled trial was to monitor implant stability changes over the first 90 days of healing after implant bed preparation with OD or PISP. METHODS Each patient received two identical, adjacent or contralateral implants in the posterior maxilla. Following randomization, test sites were prepared with OD and control sites with PISP. Resonance frequency analysis was performed immediately after implant placement and after 7, 14, 21, 28, 60, and 90 days. Implants were then restored with single screw-retained metal-ceramic crowns and followed for 12 months after loading. RESULTS Twenty-seven patients (15 males and 12 females; mean age 63.0 ± 11.8 years) were included in final analysis. Each patient received two identical implants in the posterior maxilla (total = 54 implants). After 1 year of loading, 53 implants were satisfactorily in function (one failure in test group 28 days after placement). Mean peak insertion torque (40.7 ± 12.3 Ncm and 39.5 ± 10.2 Ncm in test and control group, respectively) and mean implant stability quotient (ISQ) value at baseline (71.3 ± 6.9 and 69.3 ± 7.6 in test and control group, respectively) showed no significant differences between the two groups. After an initial slight stability decrease, a shift to increasing ISQ values occurred after 14 days in control group and after 21 days in test group, but with no significant differences in ISQ values between the two groups during the first 90 days of healing. CONCLUSION No significant differences in either primary or secondary stability or implant survival rate after 1 year of loading were demonstrated between implants inserted into sites prepared with OD and PISP.
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Affiliation(s)
- Claudio Stacchi
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Graziano Montaruli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | | - Luca Lamazza
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Teresa Lombardi
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
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Li S, Tanner A, Romanos G, Delgado-Ruiz R. Heat Accumulation in Implant Inter-Osteotomy Areas-An Experimental In Vitro Study. Biomedicines 2022; 11:biomedicines11010009. [PMID: 36672516 PMCID: PMC9855973 DOI: 10.3390/biomedicines11010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/26/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
To examine the influence of the distance between adjacent implant osteotomies on heat accumulation in the inter-osteotomy area, two experimental groups with 15 pairs of osteotomies in Type II polyurethane blocks were compared: 7 mm inter-osteotomy separations (Group A, n = 15) and 14 mm inter-osteotomy separations (Group B, n = 15). An infrared thermographic analysis of thermal changes in the inter-osteotomy area was completed. A one-way analysis of variance (ANOVA) and Fisher post-test were used to determine group differences. Higher temperatures were recorded in Group A at the coronal and middle levels compared to the apical level in both groups. The temperature reached max temperatures at T80s and T100s. In Group A, the threshold for thermal necrosis was exceeded. Meanwhile, Group B did not reach the threshold for thermal necrosis. Preparing adjacent implant osteotomies in dense bone with a 7 mm separation between their centers increases the temperature in the inter-osteotomy area, exceeding the threshold for bone thermal necrosis; meanwhile, increasing the distance between osteotomies reduces the thermal accumulation and the risk for thermal necrosis.
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Affiliation(s)
- Shanlin Li
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Adam Tanner
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Georgios Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, New York, NY 11794, USA
- Correspondence:
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Kotsakis GA, Romanos GE. Biological mechanisms underlying complications related to implant site preparation. Periodontol 2000 2022; 88:52-63. [PMID: 35103318 DOI: 10.1111/prd.12410] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Implant site preparation is a critical stage of implant surgery that may underpin various complications related to implant surgery. This review discusses the latest available scientific information on risk factors related to implant site preparation. The role of the drilling process in relation to the density of the available alveolar bone, the effects of insertion torque on peri-implant osseous healing, and implant-related variables such as macrodesign and implant-abutment connection are all factors that can influence implant success. Novel information that links osteotomy characteristics (including methods to improve implant initial stability, the impact of drilling speed, and increase of the implant insertion torque modifying the bone-implant interface) with the appropriate instrumentation techniques will be discussed, as well as interactions at the bone-biomaterial interface that may lead to biologic complications mediated by implant dissolution products.
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Affiliation(s)
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook, New York, USA.,Department of Oral Surgery and Implant Dentistry, Dental School, Johann Wolfgang Goethe University, Frankfurt, Germany
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10
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Effect of low-speed drilling without irrigation on osseointegration: an experimental study in dogs. Oral Maxillofac Surg 2021; 26:595-601. [PMID: 34826040 DOI: 10.1007/s10006-021-01023-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To study the early phases of osseointegration at implants installed in sites prepared with either high rotational speed with irrigation or low rotational speed without irrigation. MATERIAL AND METHODS After 3 months from tooth extraction, two implants were installed in one side of the mandible of twelve dogs. The osteotomies were prepared either at 60 rpm without irrigation or at 750 rpm with refrigeration. Biopsies were obtained after 4 and 8 weeks of healing, six animals each period for histological analyses. RESULTS After 4 weeks of healing, new bone percentage in contact with the implant surface (BIC%) was 46.6 ± 7.3% and 43.1 ± 6.8% at the low- and high-speed sites, respectively (p = 0.345). After 8 weeks of healing, the fractions increased to 60.0 ± 11.1% and 60.2 ± 6.2%, respectively (p = 0.753). CONCLUSIONS Implants installed in sites prepared using either low-rotational drilling without irrigation or high speed with irrigation presented similar amounts of osseointegration.
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11
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Ashry A, Elattar MS, Elsamni OA, Soliman IS. Effect of Guiding Sleeve Design on Intraosseous Heat Generation During Implant Site Preparation (In Vitro Study). J Prosthodont 2021; 31:147-154. [PMID: 33942432 DOI: 10.1111/jopr.13370] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare the effect of different designs of guiding sleeves on heat generation during implant surgery while using different cooling fluid temperatures. MATERIAL AND METHODS Temperature measurements were performed during guided implant site preparation in bovine rib samples using two K- type thermocouples at 2 mm and 8 mm depths. Three groups were tested according to guiding sleeve design: conventional cylindrical sleeve, open C-shaped sleeve, and modified cylindrical sleeve. Each group was irrigated with three fluid temperatures: 10°C, 15°C, and 20°C. The groups were compared using Kruskal Wallis test followed by post hoc comparisons with Bonferroni correction. The level of statistical significance was set at p = 0.05. RESULTS Surgical guides with conventional cylindrical sleeve design showed significantly higher heat generation during implant site preparation than guides with both the open C-shaped and the modified cylindrical sleeve designs at both 2mm and 8mm depths. The difference between C-shaped and modified cylindrical sleeves was not significant in any group. Using pre-cooled irrigation fluids (10°C and 15°C) reduced the generated heat; however, the differences within the same group were not statistically significant. CONCLUSIONS The use of a surgical guide with the conventional cylindrical sleeves led to higher heat generation than other sleeve designs, which might reach or near the critical threshold of bone thermal necrosis. Using surgical guides with open sleeves or modified cylindrical sleeves could be helpful in irrigation fluid delivery and decreasing the generated heat.
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Affiliation(s)
- Amal Ashry
- Prosthodontics Department, Faculty of Dentistry, Damanhour University, Damanhour, Egypt.,Prosthodontics Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Osama Ahmed Elsamni
- Mechanical Engineering Department, Faculty of Engineering, Alexandria University, Alexandria, Egypt
| | - Ingy Saied Soliman
- Prosthodontics Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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12
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Heuzeroth R, Pippenger BE, Sandgren R, Bellón B, Kühl S. Thermal exposure of implant osteotomies and its impact on osseointegration-A preclinical in vivo study. Clin Oral Implants Res 2021; 32:672-683. [PMID: 33629437 DOI: 10.1111/clr.13729] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Thermal and mechanical stresses during osteotomy preparation can impair implant osseointegration. This study investigated implant osseointegration following the measurement of temperature exposure during osteotomy drilling, varying drill design, sequence, and drill wear. MATERIALS AND METHODS 36 tapered implants were placed in a mandibular minipig model after guided drilling of implant osteotomies using 4 different groups: (1) control drills with a conservative, sequential drilling sequence, (2) control drills using a shortened drill sequence (PF), (3) novel test drill displaying an optimized drill design and surface treatment, PF, and (4) aged test drill, PF. Intraosseous temperatures during drilling were measured using a temperature probe. BIC, fBIC, and tissue reactions were histomorphometrically derived after 2 and 8 weeks of healing. RESULTS Compared to control drills (1) or (2), test drills (3) resulted in significantly lower maximum temperatures ((35.4 (CI 30.2-40.5)°C vs. (46.5 (CI 41.0-52.0)°C, p = .0021)) and shorter drill times ((4.5 (CI 1.6-7.3)sec vs. 10.3 (7.3-13.4)sec). Lower osteotomy temperature values and shorter drill times corroborated with significantly higher BIC after 2 and 8 weeks healing for the test (3) compared to control groups (2) (2 weeks: (44.9 (CI 34.1-55. 7)% vs. (31.3 (CI 20.5-42.2)%, p = <.0001 and 8 weeks: (73.7 ( CI 64.2-83.2)% vs. (66.2 (CI 57.0-75.4)%, p = <.0455). CONCLUSION The improved osseointegration of implants placed after osteotomy preparation with novel test drills using a shortened drill sequence compared to standard drills and conventional drill protocols might be attributed to more favorable thermal profiles and less mechanical stress exerted on the bone surrounding the implant osteotomy.
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Affiliation(s)
- Raphael Heuzeroth
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Benjamin E Pippenger
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland.,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland
| | - Rebecca Sandgren
- Biomedical Center, Faculty of Medicine, Lund University, Lund, Sweden
| | - Benjamin Bellón
- Department of Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland.,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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13
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Bone Temperature Variation Using a 3D-Printed Surgical Guide with Internal Irrigation. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11062588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bone overheating is a possible cause of implants early failure. When a surgical guide is used, the risk of heat injury is greater due to the reduced efficacy of the irrigation. The aim of this ex vivo study was to evaluate the effect of an additional built-in irrigation on bone temperature variation during implant osteotomy. Twelve bovine ribs were used. Cone beam computerized tomography (CBCT) was performed and a 3D-printed surgical guide with additional built-in irrigation tubes was produced for each rib. A total of 48 osteotomies were prepared, to compare the supplementary internal irrigation system (Group A) with external irrigation alone (Group B), no irrigation (Group C) and with free-hand surgery with external irrigation (Group D). Temperature was measured by three thermocouples placed at depths of 1.5, 7, and 12 mm. The largest temperature variation at each thermocouple showed median values of 3.0 °C, 1.9 °C, and 2.3 °C in Group 1; 2.3 °C, 1.7 °C, and 0.9 °C in Group 2; 3.2 °C, 1.6 °C, and 2.0 °C in Group 3; 2.0 °C, 2.0 °C, and 1.3 °C in Group 4, respectively. No differences were found among the four groups. In general, the highest temperature increase was observed with the use of the first drill (cortical perforator). Post-experimental CBCT revealed the presence of radiopaque material clogging the aperture of the internal irrigation channels. Additional internal irrigation was not found to significantly contribute to decrease bone temperature in this ex vivo setting.
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14
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Tur D, Giannis K, Unger E, Mittlböck M, Rausch-Fan X, Strbac GD. Thermal effects of various drill materials during implant site preparation-Ceramic vs. stainless steel drills: A comparative in vitro study in a standardised bovine bone model. Clin Oral Implants Res 2020; 32:154-166. [PMID: 33220104 PMCID: PMC7898889 DOI: 10.1111/clr.13685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/19/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate thermal effects of ceramic and metal implant drills during implant site preparation using a standardised bovine model. MATERIAL AND METHODS A total of 320 automated intermittent osteotomies of 10- and 16-mm drilling depths were performed using zirconium dioxide-based and stainless steel drills. Various drill diameters (2.0/ 2.2, 2.8, 3.5, 4.2 mm ∅) and different cooling methods (without/ with external saline irrigation) were investigated at room temperature (21 ± 1°C). Temperature changes were recorded in real time using two custom-built multichannel thermoprobes in 1- and 2-mm distance to the osteotomy site. For comparisons, a linear mixed model was estimated. RESULTS Comparing thermal effects, significantly lower temperatures could be detected with steel-based drills in various drill diameters, regardless of drilling depth or irrigation method. Recorded temperatures for metal drills of all diameters and drilling depths using external irrigation were below the defined critical temperature threshold of 47°C, whereas ceramic drills of smaller diameters reached or exceeded the harmful temperature threshold at 16-mm drilling depths, regardless of whether irrigation was applied or not. The results of this study suggest that the highest temperature changes were not found at the deepest point of the osteotomy site but were observed at subcortical and deeper layers of bone, depending on drill material, drill diameter, drilling depth and irrigation method. CONCLUSIONS This standardised investigation revealed drill material and geometry to have a substantial impact on heat generation, as well as external irrigation, drilling depth and drill diameter.
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Affiliation(s)
- Dino Tur
- Clinical Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Katharina Giannis
- Clinical Division Unit-Dentistry Training, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, AKH Vienna, Vienna, Austria
| | - Martina Mittlböck
- Section for Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Xiaohui Rausch-Fan
- Clinical Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Georg D Strbac
- Clinical Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
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15
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Baldi D, Colombo J, Verardi S, Rebaudi A, Rebaudi F, Makary C. Clinical osseointegration of bone level implants with conical shape and textured surface with low primary stability. ACTA ACUST UNITED AC 2020; 69:8-13. [PMID: 32214065 DOI: 10.23736/s0026-4970.20.04277-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Evidence shows lower chance for osseointegration of implants without sufficient primary stability. The present retrospective study observed bone level conical screw implants with textured surface without primary stability. METHODS Twenty-six Stark conical screw implants, with V-Blast (Vanish Blast) surface treatment were placed with low primary stability, (insertion torque lower than 10 N/cm and visible mobility at lateral load of 250 g). A soft diet was prescribed. osseointegration was assessed applying 30 Ncm of reverse torque 6 months after placement. RESULTS The 26 implants that did not achieve primary stability still had a survival rate of 96% after the observation period and were classified as successful according with ICOI Pisa consensus conference success, survival, failure classification .96% of the implants showed clinical osteointegration and were successfully restored. After 12 months, all implants remained functional. CONCLUSIONS It can be concluded that bone-level implants with V-Blast surface in absence of functional loading are able to achieve osteointegration, even with low primary stability.
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Affiliation(s)
- Domenico Baldi
- Division of Prosthetic Dentistry, Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | | | | | | | | | - Christian Makary
- Department of Oral Surgery, Faculty of Dental Medicine, St Joseph University, Beirut, Lebanon
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16
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Trisi P, Falco A, Berardini M. Single-drill implant induces bone corticalization during submerged healing: an in vivo pilot study. Int J Implant Dent 2020; 6:2. [PMID: 31938897 PMCID: PMC6960270 DOI: 10.1186/s40729-019-0198-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 12/04/2019] [Indexed: 01/22/2023] Open
Abstract
Purpose The aim of the present paper is to evaluate a simplified implant site preparation technique to preserve bone bulk and enhance osseointegration using a new conical self-tapping implant in cancellous bone. Materials and methods Ten Expander® 3.8 × 10 mm implants (NoDrill®, Milano, Italy) were inserted in the right side (test group) of sheep’s iliac crest using only the pilot drill 1.8 mm in diameter. Ten 3.8 × 10 mm Dynamix® implants (Cortex, Shlomi, Israel) were inserted in the right side (control group) of the same animals following the drilling protocol provided by the manufacturer. Histological, histomorphometric, and biomechanical analyses were performed after 2 months. Results Implants that belonged to the test group showed a %BIC of 70.91 ± 7.95 while the control group implants had a %BIC value of 49.33 ± 10.73. The %BV was 41.83 ± 6.30 in the test group and 29.61 ± 5.05 in the control group. These differences were statistically significant. A phenomenon of osseocorticalization, characterized by more bone volume percentage around implant area than in the neighboring areas, caused by implant threads geometry, was evident in the test group. Conclusion This surgical protocol allows to insert an innovative fixture geometry in low-density bone using only a pilot drill. This technique demonstrated many clinical and histological advantages with respect to standard implant drilling procedures and classical implant geometry.
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Affiliation(s)
- Paolo Trisi
- Biomaterial Clinical and Histological Research Association, Private Practice, Via Galilei 8, 65122, Pescara, Italy
| | - Antonello Falco
- Biomaterial Clinical and Histological Research Association, Private Practice, Via Galilei 8, 65122, Pescara, Italy
| | - Marco Berardini
- Biomaterial Clinical and Histological Research Association, Private Practice, Via Galilei 8, 65122, Pescara, Italy.
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17
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol 2019; 89 Suppl 1:S267-S290. [PMID: 29926957 DOI: 10.1002/jper.16-0350] [Citation(s) in RCA: 406] [Impact Index Per Article: 81.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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18
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Padhye NM, Padhye AM, Bhatavadekar NB. Osseodensification -- A systematic review and qualitative analysis of published literature. J Oral Biol Craniofac Res 2019; 10:375-380. [PMID: 31737477 DOI: 10.1016/j.jobcr.2019.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/29/2019] [Indexed: 11/24/2022] Open
Abstract
The recently introduced technique of osseodensification for dental implant involves the use of special drills (Densah) run in a counter-clockwise direction at the osteotomy site. It is claimed that this causes expansion of the osteotomy site, and increases density of the bone in immediate vicinity of the osteotomy. We reviewed published papers on the primary stability attained using this drilling technique. As a secondary finding, the bone to implant contact (BIC) and the bone area fraction occupancy (BAF) was also compared between the conventional drilling protocol and the osseodensification protocol, among these articles. A Systematic search was performed in PubMed-Medline, Embase and Google Scholar for clinical/animal studies up to November 2018. A total of 12 articles, from a database of 132 articles, consisting of 8 animal histologic studies, 2 human based clinical studies, 1 case series and 1 case report were assessed. 10/12 articles measured the insertion torque values, 7/12 articles measured the BIC and 6/12 articles estimated the BAF between the two techniques. Quality assessment of 8 studies performed using ARRIVE guidelines showed that 6/8 studies had a high score. An average increase in the insertion torque, BIC and BAF was noted in the osseodensification group as compared to the conventional drilling group. Since most of these studies are non-clinical, it can be inferred that osseodensification is an efficient way to enhance primary stability of implants in low density bone in an animal model. However, extrapolation to long term clinical success cannot be ascertained until further evidence becomes available.
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Affiliation(s)
| | - Ashvini Mukul Padhye
- Professor & Head of Department of Periodontics, Mahatma Gandhi Mission's Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Neel B Bhatavadekar
- Clarus Dental Specialties, Pune. Adjunct Faculty, University of North Carolina at Chapel Hill, USA
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19
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Jia P, Yang G, Hu W, Chung KH, Zhao Y, Liu M, Chen CS. Comparison of in situ cone beam computed tomography scan data with ex vivo optical scan data in the measurement of root surface area. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:552-557. [PMID: 31171483 DOI: 10.1016/j.oooo.2019.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/27/2019] [Accepted: 05/13/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to compare root surface area (RSA) measurements of single-root teeth in a sheep mandible based on cone beam computed tomography (CBCT) with measurements made with an optical scanner. STUDY DESIGN Eight anterior teeth of a sheep cadaver mandible were scanned in situ by using CBCT with 3 different exposure parameters, followed by treatment with smoothing software. The teeth were then extracted and scanned individually with an optical scanner. Three-dimensional digital models of the teeth were reconstructed on the basis of CBCT and optical scanner data. RSA data were calculated, and an equivalence test was used to statistically compare the measurements with significance of difference established at α = 0.05. RESULTS The means of the differences between RSA measurements from CBCT and optical scanning ranged from 0.33% to 3.01%. There were no statistically significant differences between the 2 methods. The smoothing parameters for good fitness of the linear regression were determined to be 0.8 for the smooth factor, 8 for iterations, and 0 for compensate shrinkage. CONCLUSIONS The proposed CBCT technique to measure RSA is feasible. RSA data obtained from CBCT in situ are as accurate as optical scanner measurements ex vivo.
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Affiliation(s)
- Pengcheng Jia
- Department of Periodontology & Second Clinical Division, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China. Pengcheng Jia is now employed in Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Gang Yang
- Department of Periodontology & Second Clinical Division, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China. Pengcheng Jia is now employed in Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wenjie Hu
- Department of Periodontology & Second Clinical Division, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China. Pengcheng Jia is now employed in Second Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, WA, USA
| | - Yijiao Zhao
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Muqing Liu
- Department of Oral & Maxillofacial Radiology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Curtis Sk Chen
- Division of Oral Radiology, Department of Oral Medicine, School of Dentistry, University of Washington, Seattle, WA, USA
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20
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Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Clin Periodontol 2019; 45 Suppl 20:S246-S266. [PMID: 29926484 DOI: 10.1111/jcpe.12954] [Citation(s) in RCA: 384] [Impact Index Per Article: 76.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This narrative review provides an evidence-based overview on peri-implantitis for the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. METHODS A literature review was conducted addressing the following topics: 1) definition of peri-implantitis; 2) conversion from peri-implant mucositis to peri-implantitis, 3) onset and pattern of disease progression, 4) characteristics of peri-implantitis, 5) risk factors/indicators for peri-implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation. CONCLUSIONS 1)Peri-implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant connective tissue and progressive loss of supporting bone. 2)The histopathologic and clinical conditions leading to the conversion from peri-implant mucositis to peri-implantitis are not completely understood. 3)The onset of peri-implantitis may occur early during follow-up and the disease progresses in a non-linear and accelerating pattern. 4a)Peri-implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements. 4b)At the histologic level, compared to periodontitis sites, peri-implantitis sites often have larger inflammatory lesions. 4c)Surgical entry at peri-implantitis sites often reveals a circumferential pattern of bone loss. 5a)There is strong evidence that there is an increased risk of developing peri-implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying "smoking" and "diabetes" as potential risk factors/indicators for peri-implantitis are inconclusive. 5b)There is some limited evidence linking peri-implantitis to other factors such as: post-restorative presence of submucosal cement, lack of peri-implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance. 6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, ZMK School of Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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21
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Intraosseous Heat Generation During Osteotomy Performed Freehand and Through Template With an Integrated Metal Guide Sleeve: An In Vitro Study. IMPLANT DENT 2018; 27:342-350. [PMID: 29762185 DOI: 10.1097/id.0000000000000763] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate drill wear and consequent intraosseous temperature elevation during freehand and guided bone drilling, with attention to the effect of metal-on-metal contact during guided drilling. MATERIALS AND METHODS Osteotomies were performed on bovine ribs, with 2.0 mm diameter stainless steel drill bits of the SMART Guide System, under 3 sterilization protocols, at 800, 1200, 1500, and 2000 rpm. Sterilization was performed after every 3 drilling. Temperature was measured after every 30 drilling. RESULTS The studied contributing factors had a cumulative effect, and each contributed significantly to temperature elevation. Whether guide use led to a near-necrotic (47°C) temperature increment depended largely on the applied sterilization protocol. CONCLUSION The metal sleeve is a significant contributing factor to heat generation during guided osteotomy, but its effect can be offset by keeping the other studied factors under control.
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22
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Nicolielo LFP, Van Dessel J, van Lenthe GH, Lambrichts I, Jacobs R. Computer-based automatic classification of trabecular bone pattern can assist radiographic bone quality assessment at dental implant site. Br J Radiol 2018; 91:20180437. [PMID: 30175923 DOI: 10.1259/bjr.20180437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE: To develop and validate an automated classification method that determines the trabecular bone pattern at implant site based on three-dimensional bone morphometric parameters derived from CBCT images. METHODS: 25 human cadaver mandibles were scanned using CBCT clinical scanning protocol. Volumes-of-interest comprising only the trabecular bone of the posterior regions were selected and segmented for three-dimensional morphometric parameters calculation. Three experts rated all bone regions into one of the three trabecular pattern classes (sparse, intermediate and dense) to generate a reference classification. Morphometric parameters were used to automatically classify the trabecular pattern with linear discriminant analysis statistical model. The discriminatory power of each morphometric parameter for automatic classification was indicated and the accuracy compared to the reference classification. Repeated-measures analysis of variances were used to statistically compare morphometric indices between the three classes. Finally, the outcome of the automatic classification was evaluated against a subjective classification performed independently by four different observers. RESULTS: The overall correct classification was 83% for quantity-, 86% for structure-related parameters and 84% for the parameters combined. Cross-validation showed a 79% model prediction accuracy. Bone volume fraction (BV/TV) had the most discriminatory power in the automatic classification. Trabecular bone patterns could be distinguished based on most morphometric parameters, except for trabecular thickness (Tb.Th) and degree of anisotropy (DA). The interobserver agreement between the subjective observers was fair (0.25), while the test-retest agreement was moderate (0.46). In comparison with the reference standard, the overall agreement was moderate (0.44). CONCLUSION: Automatic classification performed better than subjective classification with a prediction model comprising structure- and quantity-related morphometric parameters. ADVANCES IN KNOWLEDGE: Computer-aided trabecular bone pattern assessment based on morphometric parameters could assist objectivity in clinical bone quality classification.
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Affiliation(s)
- Laura Ferreira Pinheiro Nicolielo
- 1 Deparment Imaging & Pathology, OMFS-IMPATH research group, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven , Leuven , Belgium
| | - Jeroen Van Dessel
- 1 Deparment Imaging & Pathology, OMFS-IMPATH research group, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven , Leuven , Belgium
| | - G Harry van Lenthe
- 2 Department of Mechanical Engineering, Biomechanics Section , Leuven , Belgium
| | - Ivo Lambrichts
- 3 Morphology Group, Biomedical Research Institute, Hasselt University , Diepenbeek , Belgium
| | - Reinhilde Jacobs
- 1 Deparment Imaging & Pathology, OMFS-IMPATH research group, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven , Leuven , Belgium.,4 Department of Dental Medicine, Karolinska Institutet , Huddinge , Sweden
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23
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Healing at sites prepared using different drilling protocols. An experimental study in the tibiae of sheep. PLoS One 2018; 13:e0202957. [PMID: 30157237 PMCID: PMC6114797 DOI: 10.1371/journal.pone.0202957] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/13/2018] [Indexed: 11/19/2022] Open
Abstract
The aim of the experiment was to study the healing at implants installed in site prepared in bone type 1 using different rotation speeds and cooling strategies. The tibiae of twelve sheep were used as experimental sites. Two implant sites were prepared in each tibia using drills either at a high or a mixed speed under irrigation. At the mixed-speed sites, 60 rpm without irrigation were applied for the last drill, the countersink and during implant installation. Biopsies representing the healing after 1, 2, and 6 weeks were obtained and ground sections were prepared. At the histological analyses, after 1 week of healing, no new bone was found at both high- and mixed-speed sites. After 2 weeks of healing, small amounts of newly formed bone were observed in the cortical layer, reaching percentages of 3.6±3.0% at the mixed-speed sites, and of 2.2±1.5% at the high-speed sites. An irrelevant quantity of new bone was seen in the marrow compartments of a few specimens. After 6 weeks of healing, new bone was found in higher quantity, reaching in the cortical compartment 66.9±6.8% and 67.3±17.7% at the mixed- and high-speed sites, respectively. The respective percentages in the marrow compartment were 23.2±13.0% and 30.6±29.2%. No statistically significant differences between high- and mixed-speed groups were found. It was concluded that the use of the last drill and the installation of the implant with or without irrigation yielded similar bone healing and osseointegration.
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24
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Fauroux MA, De Boutray M, Malthiéry E, Torres JH. New innovative method relating guided surgery to dental implant placement. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 119:249-253. [DOI: 10.1016/j.jormas.2018.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/29/2017] [Accepted: 02/13/2018] [Indexed: 10/18/2022]
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25
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Correlation between Insertion Torque and Implant Stability Quotient in Tapered Implants with Knife-Edge Thread Design. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7201093. [PMID: 29862286 PMCID: PMC5976959 DOI: 10.1155/2018/7201093] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 04/16/2018] [Indexed: 11/17/2022]
Abstract
Aim To evaluate the correlation between insertion torque (IT) and implant stability quotient (ISQ) in tapered implants with knife-edge threads. Methods Seventy-five identical implants (Anyridge, Megagen) were inserted by using a surgical drilling unit with torque control and an integrated resonance frequency analysis module (Implantmed, W&H). IT (N/cm) and ISQ were recorded and implants were divided into three groups (n = 25) according to the IT: low (<30), medium (30 < IT < 50), and high torque (>50). ISQ difference among groups was assessed by Kruskal-Wallis test, followed by Bonferroni-corrected Mann–Whitney U-test for pairwise comparisons. The strength of the association between IT and ISQ was assessed by Spearman Rho correlation coefficient (α = 0.05). Results At the pairwise comparisons, a significant difference of ISQ values was demonstrated only between low torque and high torque groups. The strength of the association between IT and ISQ value was significant for both the entire sample and the medium torque group, while it was not significant in low and high torque groups. Conclusions For the investigated implant, ISQ and IT showed a positive correlation up to values around 50 N/cm: higher torques subject the bone-implant system to unnecessary biological and mechanical stress without additional benefits in terms of implant stability. This trial is registered with NCT03222219.
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26
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Comparative Evaluation of Cell Viability Immediately After Osteotomy for Implants With Drills and Piezosurgery: Immunohistochemistry Analysis. J Craniofac Surg 2018; 29:1578-1582. [PMID: 29742566 DOI: 10.1097/scs.0000000000004542] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate the effect of reusing drills and piezosurgery tips during implant osteotomy on immediate bone cell viability through immunohistochemical analysis. MATERIALS AND METHODS Six male rabbits were divided into 2 groups and then divided into 5 subgroups-correspond to drills and tips used 10, 20, 30, 40, and 50 times, respectively. All animals received 10 osteotomies in each tibia, by use of the classic drilling procedure in one group (G1) and the piezosurgery device in the other group (G2). For immunohistochemical technique were utilized the osteoprotegerin, RANKL, osteocalcin, and caspase 3. Control procedures were performed by omitting the primary antibodies (negative control). RESULTS Bone formation and resorption responses presented in more intense way during the piezosurgery. The expression of osteocalcin had become quite intense in piezosurgery groups, but with reduced immunostaining from the 30th osteotomy. The caspase 3 showed the viability of the osteoblast from the 20th osteotomy with piezosurgery and remained constant until the 50th. CONCLUSION Piezosurgery provides greater osteoblastic cell viability than the system of conventional drilling. CLINICAL RELEVANCE This study will provide data so that the authors can recycle the drills and tips for implant placement, thus enabling a better cell viability for osseointegration.
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Sendyk DI, de Oliveira NK, Pannuti CM, da Graça Naclério-Homem M, Wennerberg A, Deboni MCZ. Conventional Drilling Versus Piezosurgery for Implant Site Preparation: A Meta-Analysis. J ORAL IMPLANTOL 2018; 44:400-405. [PMID: 29583059 DOI: 10.1563/aaid-joi-d-17-00091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate if the stability of dental implants varies between dental implants placed by piezosurgery compared with those placed by conventional drilling. An electronic search in MEDLINE, SCOPUS, and the Cochrane Library was undertaken until August 2016 and was supplemented by manual searches and by unpublished studies at OpenGray. Only randomized controlled clinical trials that reported implant site preparation with piezosurgery and with conventional drilling were considered eligible for inclusion in this review. Meta-analyses were performed to evaluate the impact of piezosurgery on implant stability. Of 456 references electronically retrieved, 3 were included in the qualitative analysis and quantitative synthesis. The pooled estimates suggest that there is no significant difference between piezosurgery and conventional drilling at baseline (weighted mean differences [WMD]: 2.20; 95% confidence interval [CI]: -5.09, 9.49; P = .55). At 90 days, the pooled estimates revealed a statistically significant difference (WMD: 3.63; 95% CI: 0.58, 6.67, P = .02) favoring piezosurgery. Implant stability may be slightly improved when osteotomy is performed by a piezoelectric device. More randomized controlled clinical trials are needed to confirm these findings.
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Affiliation(s)
- Daniel Isaac Sendyk
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Natacha Kalline de Oliveira
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Claudio Mendes Pannuti
- 2 Department of Stomatology, Division of Periodontics, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Ann Wennerberg
- 3 Department of Prosthodontics, Faculty of Dentistry, Malmö University, Malmö, Sweden
| | - Maria Cristina Zindel Deboni
- 1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
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Seo DU, Kim SG, Oh JS, Lim SC. Comparative Study on Early Osseointegration of Implants According to Various Drilling Speeds in the Mandible of Dogs. IMPLANT DENT 2017; 26:841-847. [PMID: 29068799 DOI: 10.1097/id.0000000000000673] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE This study evaluated the effect of drilling speed on early bone healing in the mandible of dogs. MATERIAL AND METHODS Six dogs were selected, and mandibular premolars and molars were extracted. After 2 months, 3 hydroxyapatite-surfaced fixtures were implanted with drilling speeds of 50, 800, and 1200 rpm on the right side first and then on the left side after 2 weeks. Implant stability quotient (ISQ) was measured on insertion, after 2 and 4 weeks. RESULTS Based on the ISQ measurement, the 1200-rpm group showed a higher value than the 50-rpm group at 2 weeks and 4 weeks (P < 0.05). New bone formation around the implant was highest for the 800-rpm group at 2 weeks and the 1200-rpm group at 4 weeks. The bone-implant contact of the superior half of the alveolar bone was highest for the 800-rpm group at 2 weeks and the 1200-rpm group at 4 weeks. There was no statistically significant difference. CONCLUSION This study suggests that 50, 800, and 1200 rpm are drilling speeds which can expect favorable outcome, yet, higher drilling speed presented overall the best biological responses.
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Affiliation(s)
- Dong-Uk Seo
- Graduate Student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Su-Gwan Kim
- Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Ji-Su Oh
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Sung-Chul Lim
- Professor, Department of Pathology, School of Medicine, Chosun University, Gwangju, Korea
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Podaropoulos L. Increasing the Stability of Dental Implants: the Concept of Osseodensification. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Summary
One of the most important factors that affect osseointegration is the primary stability of the implant. Dental implants inserted at the posterior region of the maxilla exhibit the lowest success rates as the low density bone in this area often jeopardize rigid fixation of the implant. Many surgical techniques have been developed to increase the primary stability of an implant placed in low density bone, such as bicortical fixation of the implant, undersized preparation of the implant bed and bone condensation by the use of osteotomes. A new promising technique, named osseodensification, has been recently developed that creates an autograft layer of condensed bone at the periphery of the implant bed by the aid of specially designed burs rotating in a clockwise and anti-clockwise direction. The purpose of this review is to emphasize that implant primary stability is strongly influenced by the surgical technique, to quote and briefly analyse the various surgical procedures laying weight to osseodensification procedure.
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Affiliation(s)
- Leonidas Podaropoulos
- Department of Oral and Maxillofacial Surgery, Dental School, National and Kapodistrian, University of Athens , Greece
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Simon MJK, Beil FT, Pogoda P, Vettorazzi E, Clarke I, Amling M, Oheim R. Is centrally induced alveolar bone loss in a large animal model preventable by peripheral hormone substitution? Clin Oral Investig 2017; 22:495-503. [DOI: 10.1007/s00784-017-2138-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 05/22/2017] [Indexed: 11/24/2022]
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Feldmann A, Gavaghan K, Stebinger M, Williamson T, Weber S, Zysset P. Real-Time Prediction of Temperature Elevation During Robotic Bone Drilling Using the Torque Signal. Ann Biomed Eng 2017; 45:2088-2097. [PMID: 28477057 DOI: 10.1007/s10439-017-1845-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 04/26/2017] [Indexed: 11/30/2022]
Abstract
Bone drilling is a surgical procedure commonly required in many surgical fields, particularly orthopedics, dentistry and head and neck surgeries. While the long-term effects of thermal bone necrosis are unknown, the thermal damage to nerves in spinal or otolaryngological surgeries might lead to partial paralysis. Previous models to predict the temperature elevation have been suggested, but were not validated or have the disadvantages of computation time and complexity which does not allow real time predictions. Within this study, an analytical temperature prediction model is proposed which uses the torque signal of the drilling process to model the heat production of the drill bit. A simple Green's disk source function is used to solve the three dimensional heat equation along the drilling axis. Additionally, an extensive experimental study was carried out to validate the model. A custom CNC-setup with a load cell and a thermal camera was used to measure the axial drilling torque and force as well as temperature elevations. Bones with different sets of bone volume fraction were drilled with two drill bits ([Formula: see text]1.8 mm and [Formula: see text]2.5 mm) and repeated eight times. The model was calibrated with 5 of 40 measurements and successfully validated with the rest of the data ([Formula: see text]C). It was also found that the temperature elevation can be predicted using only the torque signal of the drilling process. In the future, the model could be used to monitor and control the drilling process of surgeries close to vulnerable structures.
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Affiliation(s)
- Arne Feldmann
- Institute for Surgical Technology and Biomechanics, Stauffacherstr. 78, 3014, Bern, Switzerland.
| | - Kate Gavaghan
- ARTORG Center for Biomedical Engineering Research, Murtenstr. 50, 3010, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | - Manuel Stebinger
- ARTORG Center for Biomedical Engineering Research, Murtenstr. 50, 3010, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | - Tom Williamson
- ARTORG Center for Biomedical Engineering Research, Murtenstr. 50, 3010, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | - Stefan Weber
- ARTORG Center for Biomedical Engineering Research, Murtenstr. 50, 3010, Bern, Switzerland
- University of Bern, Bern, Switzerland
| | - Philippe Zysset
- Institute for Surgical Technology and Biomechanics, Stauffacherstr. 78, 3014, Bern, Switzerland
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Effect of temperature on the dental implant osseointegration development in low-density bone: an in vivo histological evaluation. IMPLANT DENT 2016; 24:96-100. [PMID: 25621555 DOI: 10.1097/id.0000000000000204] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To make an in vivo evaluation of the effects of 2 different bone temperatures, on the development of implant osseointegration, in low-density bone. MATERIALS AND METHODS Fifteen implant osteotomic sites were prepared in the iliac crests of sheep. Before the implant insertion, 5 sites were heated to 50°C for 1 minute, 5 sites to 60°C for 1 minute, and 5 sites were not overheated. Fifteen titanium dental implants (Cortex, Israel) were inserted. After a healing period of 2 months, the histomorphometric parameters calculated for each implant were the Bone-Implant Contact percentage (%BIC) and the infrabony pocket depth. Unpaired t test was applied to find statistical differences between groups. RESULTS No implants failed. Statistical significant differences in %BIC and periimplant bone loss were found between the 60°C group and control group. No significant differences were found between the 50°C group and control group, although bone suffering signs were present. CONCLUSION An osteotomic site overheating up to 60°C for 1 minute in low-density bone, before implant insertion, did not lead to implant failure, but it induced significant crestal bone loss during healing and lower %BIC.
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Tawy GF, Rowe PJ, Riches PE. Thermal Damage Done to Bone by Burring and Sawing With and Without Irrigation in Knee Arthroplasty. J Arthroplasty 2016; 31:1102-8. [PMID: 26718777 DOI: 10.1016/j.arth.2015.11.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/29/2015] [Accepted: 11/02/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Heat from bone resecting tools used in knee surgery can induce thermal osteonecrosis, potentially causing aseptic implant loosening. This study compared oscillating saws to burrs in terms of temperature generation and histologic damage. Use of irrigation to reduce bone temperature was also investigated. METHODS Temperatures were recorded during sawing and burring with or without irrigation (uncooled or cooled). Histologic analyses were then carried out. Differences between groups were tested statistically (α = 0.05). RESULTS On average, burring produced higher temperatures than sawing (P < .001). When uncooled irrigation was used, bone temperatures were significantly lower in sawed bone than in burred bone (P < .001). Irrigation lowered temperatures and thermal damage depths and increased osteocyte viability (P < .001). CONCLUSION These results suggest that irrigating bone during resection could prevent osteonecrosis onset.
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Affiliation(s)
- Gwenllian F Tawy
- The Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, Glasgow, United Kingdom
| | - Philip J Rowe
- The Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, Glasgow, United Kingdom
| | - Philip E Riches
- The Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, Glasgow, United Kingdom
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Mason AG, Sutton A, Turkyilmaz I. An investigation of heat transfer to the implant-bone interface when drilling through a zirconia crown attached to a titanium or zirconia abutment. J Prosthet Dent 2014; 112:1119-25. [DOI: 10.1016/j.prosdent.2014.04.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 10/25/2022]
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