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Sung HH, Kwon HH, Stephan C, Reynolds SM, Dai Z, Van der Kraan PM, Caird MS, Blaney Davidson EN, Kozloff KM. Sclerostin antibody enhances implant osseointegration in bone with Col1a1 mutation. Bone 2024; 186:117167. [PMID: 38876270 PMCID: PMC11243590 DOI: 10.1016/j.bone.2024.117167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024]
Abstract
We evaluated the potential of sclerostin antibody (SclAb) therapy to enhance osseointegration of dental and orthopaedic implants in a mouse model (Brtl/+) mimicking moderate to severe Osteogenesis Imperfecta (OI). To address the challenges in achieving stable implant integration in compromised bone conditions, our aim was to determine the effectiveness of sclerostin antibody (SclAb) at improving bone-to-implant contact and implant fixation strength. Utilizing a combination of micro-computed tomography, mechanical push-in testing, immunohistochemistry, and Western blot analysis, we observed that SclAb treatment significantly enhances bone volume fraction (BV/TV) and bone-implant contact (BIC) in Brtl/+ mice, suggesting a normalization of bone structure toward WT levels. Despite variations in implant survival rates between the maxilla and tibia, SclAb treatment consistently improved implant stability and resistance to mechanical forces, highlighting its potential to overcome the inherent challenges of OI in dental and orthopaedic implant integration. These results suggest that SclAb could be a valuable therapeutic approach for enhancing implant success in compromised bone conditions.
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Affiliation(s)
- Hsiao H Sung
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA; Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA; Experimental Rheumatology, Department of Rheumatology, Radboud Medical Centre, Nijmegen, the Netherlands
| | - Hanna H Kwon
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Chris Stephan
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Skylar M Reynolds
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Zongrui Dai
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Peter M Van der Kraan
- Experimental Rheumatology, Department of Rheumatology, Radboud Medical Centre, Nijmegen, the Netherlands
| | - Michelle S Caird
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | | | - Kenneth M Kozloff
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
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Wang M, Li B, Feng H, Ye Q, Sun Y, Duan X, He J. Assessment of the osteogenic effect after maxillary sinus floor elevation and simultaneous implantation with or without bone grafts by analyzing trabecular bone parameters: a retrospective study. J Appl Oral Sci 2024; 32:e20230406. [PMID: 38359269 PMCID: PMC10984575 DOI: 10.1590/1678-7757-2023-0406] [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: 11/07/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE The aim of this population-based retrospective study was to compare the osteogenic effect of newly formed bone after maxillary sinus floor elevation (MSFE) and simultaneous implantation with or without bone grafts by quantitatively analyzing trabecular bone parameters. METHODOLOGY A total of 100 patients with missing posterior maxillary teeth who required MSFE and implantation were included in this study. Patients were divided into two groups: the non-graft group (n=50) and the graft group (n=50). Radiographic parameters were measured using cone beam computed tomography (CBCT), and the quality of newly formed bone was analyzed by assessing trabecular bone parameters using CTAn (CTAnalyzer, SkyScan, Antwerp, Belgium) software. RESULTS In the selected regions of interest, the non-graft group showed greater bone volume/total volume (BV/TV), bone surface/total volume (BS/TV), trabecular number (Tb. N), and trabecular thickness (Tb. Th) than the graft group (p<0.001). The non-graft group showed lower trabecular separation (Tb. Sp) than the graft group (p<0.001). The incidence of perforation and bleeding was higher in the graft group than in the non-graft group (p<0.001), but infection did not significantly differ between groups (p>0.05). Compared to the graft group, the non-graft group showed lower postoperative bone height, gained bone height and apical bone height (p<0.001). CONCLUSION MSFE with and without bone grafts can significantly improve bone formation. In MSFE, the use of bone grafts hinders the formation of good quality bone, whereas the absence of bone grafts can generate good bone quality and limited bone mass.
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Affiliation(s)
- Mohan Wang
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
- Shanghai Jiao Tong University School of MedicineNinth People's HospitalCollege of StomatologyShanghaiChinaShanghai Jiao Tong University School of Medicine, Ninth People's Hospital, College of Stomatology, Department of Oral and Maxillofacial Surgery, Shanghai, China.
| | - Beibei Li
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Hailiang Feng
- Zhejiang University School of MedicineThe Second Affiliated HospitalDepartment of StomatologyHangzhouChinaZhejiang University School of Medicine, The Second Affiliated Hospital, Linping Campus, Department of Stomatology, Hangzhou, China.
| | - Qingsong Ye
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Yahui Sun
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Xinxiu Duan
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
| | - Jiacai He
- Anhui Medical UniversityStomatologic Hospital & CollegeKey Laboratory of Oral Diseases Research of Anhui ProvinceHefeiChinaAnhui Medical University, Stomatologic Hospital & College, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, China.
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Aldesoki M, Bourauel C, Elshazly TM, Schkommodau E, Keilig L. Evaluation of micromotion in multirooted root analogue implants embedded in synthetic bone blocks: an in vitro study. BMC Oral Health 2024; 24:99. [PMID: 38233794 PMCID: PMC10792929 DOI: 10.1186/s12903-024-03854-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND While conventional threaded implants (TI) have proven to be effective for replacing missing teeth, they have certain limitations in terms of diameter, length, and emergence profile when compared to customised root analogue implants (RAI). To further investigate the potential benefits of RAIs, the aim of this study was to experimentally evaluate the micromotion of RAIs compared to TIs. METHODS A 3D model of tooth 47 (mandibular right second molar) was segmented from an existing cone beam computed tomography (CBCT), and a RAI was designed based on this model. Four RAI subgroups were fabricated as follows: 3D-printed titanium (PT), 3D-printed zirconia (PZ), milled titanium (MT), milled zirconia (MZ), each with a sample size of n = 5. Additionally, two TI subgroups (B11 and C11) were used as control, each with a sample size of n = 5. All samples were embedded in polyurethane foam artificial bone blocks and subjected to load application using a self-developed biomechanical Hexapod Measurement System. Micromotion was quantified by analysing the load/displacement curves. RESULTS There were no statistically significant differences in displacement in Z-axis (the loading direction) between the RAI group and the TI group. However, within the RAI subgroups, PZ exhibited significantly higher displacement values compared to the other subgroups (p < 0.05). In terms of the overall total displacement, the RAI group showed a statistically significant higher displacement than the TI group, with mean displacement values of 96.5 µm and 55.8 µm for the RAI and TI groups, respectively. CONCLUSIONS The RAI demonstrated promising biomechanical behaviour, with micromotion values falling within the physiological limits. However, their performance is less predictable due to varying anatomical designs.
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Affiliation(s)
- Mostafa Aldesoki
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany.
| | - Christoph Bourauel
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany
| | - Tarek M Elshazly
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany
| | - Erik Schkommodau
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland
| | - Ludger Keilig
- Dental School, Oral Technology, University Hospital Bonn, Welschnonnenstr.17, 53111, Bonn, Germany
- Department of Prosthodontics, Dental School, University Hospital Bonn, Bonn, Germany
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Putra RH, Cooray U, Nurrachman AS, Yoda N, Judge R, Putri DK, Astuti ER. Radiographic alveolar bone assessment in correlation with primary implant stability: A systematic review and meta-analysis. Clin Oral Implants Res 2024; 35:1-20. [PMID: 37840388 DOI: 10.1111/clr.14195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/27/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION The radiographic examination of alveolar bone using 3D radiographic examination is essential in dental implant treatment planning. Our study aimed to systematically review and quantitatively analyze the correlation between alveolar bone parameters, specifically bone density and cortical bone thickness, assessed using cone beam computed tomography (CBCT) and/or multidetector computed tomography (MDCT); and primary implant stability (PIS) determined using implant stability quotient (ISQ), Periotest® value (PTV), and insertion torque value (ITV). METHODS This review was registered in the PROSPERO database (registration number CRD42022307245). An electronic literature search was conducted on the PubMed, SCOPUS, and Web of Science databases for papers published until February 2022. The Quality Assessment in Prognostic Studies (QUIPS) tool was used to assess risk of bias. Meta-analyses were conducted to calculate the estimated average correlation coefficient based on a multilevel random-effects model, followed by subgroup analysis. RESULTS Twenty-six studies were included in this review, consisting of 17 prospective cohort studies, eight retrospective cohort studies, and one nonrandomized controlled trial. A total of 3109 implants placed in 1171 subjects were analyzed. Twenty-three studies were evaluated using meta-analysis. The alveolar bone condition was significantly correlated with ISQ (r = 0.60; p < .001), IT (r = 0.52; p < .001), and PTV (r = -0.42; p < .05). CONCLUSION Alveolar bone condition is significantly associated with PIS. Low bone density and thin cortical bone can lead to low PIS; therefore, modification of treatment planning and surgical procedures might be needed to avoid poor osseointegration.
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Affiliation(s)
- Ramadhan Hardani Putra
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Upul Cooray
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Division of International and Community Oral Health, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Aga Satria Nurrachman
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Nobuhiro Yoda
- Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Roy Judge
- Department of Prosthodontics, Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - Dina Karimah Putri
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
- Division of Dental Informatics and Radiology, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Eha Renwi Astuti
- Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia
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Romasco T, Pignatelli P, Tumedei M, Hossein HHS, Cipollina A, Piattelli A, Inchingolo F, Di Pietro N. The influence of truncated-conical implant length on primary stability in maxillary and mandibular regions: an in vitro study using polyurethane blocks. Clin Oral Investig 2023; 28:28. [PMID: 38147179 DOI: 10.1007/s00784-023-05444-x] [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: 09/07/2023] [Accepted: 12/17/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES This in vitro study is aimed at assessing whether implant primary stability is influenced by implant length in artificial bone with varying densities. MATERIALS AND METHODS A total of 120 truncated-conical implants (60 long-length: 3p L, 3.8 × 14 mm; 60 short-length: 3p S, 3.8 × 8 mm) were inserted into 20, 30, and 40 pounds per cubic foot (PCF) density polyurethane blocks. The insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) values were recorded for each experimental condition. RESULTS In 30 and 40 PCF blocks, 3p S implants exhibited significantly higher IT values (90 and 80 Ncm, respectively) than 3p L (85 and 50 Ncm, respectively). Similarly, RT was significantly higher for 3p S implants in 30 and 40 PCF blocks (57 and 90 Ncm, respectively). However, there were no significant differences in RFA values, except for the 20 PCF block, where 3pS implants showed significantly lower values (63 ISQ) than 3p L implants (67 ISQ) in both the distal and mesial directions. CONCLUSIONS These results demonstrated that the implant's length mainly influences the IT and RT values in the polyurethane blocks that mimic the mandibular region of the bone, resulting in higher values for the 3p S implants, while the RFA values remained unaffected. However, in the lowest density block simulating the maxillary bone, 3p L implants exhibited significantly higher ISQ values. CLINICAL RELEVANCE Therefore, our data offer valuable insights into the biomechanical behavior of these implants, which could be clinically beneficial for enhancing surgical planning.
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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 Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Pamela Pignatelli
- Department of Medical, Oral and Biotechnological Sciences, "G. D'Annunzio" University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Margherita Tumedei
- Department of Medical, Surgical, and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
| | - Hamid Heydari Sheikh Hossein
- 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
- Villa Serena Foundation for Research, Via Leonardo Petruzzi 42, 65013, Città Sant'Angelo, Italy
| | | | - 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
| | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Piazza Umberto I, 70121, Bari, Italy
| | - 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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Rai S, Misra D, Misra A, Tomar H, Dhawan A, Gupta R. Reliability of Grayscale Value for Bone Density Determination in Oral Rehabilitation using Dental Implants. Int J Appl Basic Med Res 2023; 13:143-148. [PMID: 38023594 PMCID: PMC10666835 DOI: 10.4103/ijabmr.ijabmr_3_23] [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: 01/02/2023] [Revised: 07/14/2023] [Accepted: 07/28/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Quality and quantity of jaw bones have been previously classified in literature using different methods. Imaging modalities such as computed tomography (CT), successfully determine bone density of jaws. This study aims to establish the role of cone-beam CT (CBCT) in determining the density of cortical and cancellous bones at different jaw sites. Materials and Methods Eighty-three possible implant sites in healthy patients were evaluated using NewTomGiano CBCT machine. Cross-sections were obtained and cortical and cancellous bone densities on different aspects of the virtual implant in terms of Hounsfield unit (HU) were determined using New Net Technologies software version 6.1 and were classified according to software from D1 to D4. Data were entered into SPSS software (version 19.0) and were statistically analyzed. Results The mean HU showed the highest value for cortical and cancellous in the anterior mandible (mean HU 1874.01 and 1131.73, respectively) followed by the posterior mandible (mean HU 1789.20 and 872.95, respectively) and least in posterior maxilla (mean HU 1068.26 and 830.04, respectively). Maximum D1 bone type was found in cortical bone and D2 bone type was noted in cancellous bone area. Males showed very highly significant cortical bone thickness (P < 0.001) whereas females showed more cancellous bone thickness but the results were nonsignificant. Conclusion A high degree of concordance between different regions of jaw bones with a strong correlation between the four bone types was obtained. Bone density plays a pivotal role in determining the prognosis of the implant. CBCT has proven to be beneficial in bone density analysis.
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Affiliation(s)
- Shalu Rai
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Deepankar Misra
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Akansha Misra
- Department of Oral Pathology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Himanshi Tomar
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Ayush Dhawan
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
| | - Rohit Gupta
- Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Ghaziabad, Uttar Pradesh, India
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Saponaro G, Todaro M, Barbera G, Scivoletto G, Foresta E, Gasparini G, Moro A. Patient-Specific Facial Implants in Polyetheretherketone and Their Stability: A Preliminary Study. Ann Plast Surg 2023; 90:564-567. [PMID: 36975101 DOI: 10.1097/sap.0000000000003527] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
BACKGROUND Polyetheretherketone (PEEK) is a synthetic material with many favorable characteristics; PEEK implants are increasingly used for a variety of applications ranging from cranioplasty to orthopedic surgery and facial implants. METHODS This study is a retrospective review of patients who underwent PEEK implant placement in our department over the last 5 years. Polyetheretherketone computer-aided design and manufacture facial implants were designed from high-resolution computed tomography (CT) scans of each patient. The implants placed were onlay implants used for facial rehabilitation purposes to correct malformative and posttraumatic malformations. RESULTS Twenty-eight consecutive patients (11 males and 17 females) underwent PEEK implant positioning between January 2015 and December 2020. Common indications were anterior plagiocephaly, hemifacial microsomia, and residual facial imbalance after orthognathic surgery. No complications of implant breakdown, exposure, infection, or displacement were noticed during the follow-up period. During routine controls on 3 patients, we requested a craniomaxillofacial CT scan for reasons unrelated to the implanted prostheses. The CT scans were all high resolution (<1-mm slices). The CT images indicated that bone was starting to form around the implant in all 3 patients as well as in the penetrating holes that were planned in the implants. CONCLUSIONS In our experience, computer-designed, patient-specific PEEK onlay implants are a valid option for the treatment of malformative and posttraumatic malformations. This is, to the best of our knowledge, the first clinical report on bone reaction to PEEK implantation in the maxillofacial field. Moreover, based on the signs of bone regrowth that we observed in CT controls we can presume that the design of this type of prosthesis can probably take advantage of some technical stratagems not yet codified and fully exploited. Despite our preliminary favorable results, further multicentric and comparative studies are necessary to evaluate outcomes and better understand the behavior of this promising material and thus optimize its use in craniomaxillofacial surgery.
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Affiliation(s)
- Gianmarco Saponaro
- From the Maxillo-Facial Surgery Unit, IRCCS Fondazione Policlinico Unviersitario "A. Gemelli"-Università Cattolica del Sacro Cuore sede di Roma, Rome, Italy
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Inchingolo AM, Malcangi G, Ferrante L, Del Vecchio G, Viapiano F, Inchingolo AD, Mancini A, Annicchiarico C, Inchingolo F, Dipalma G, Minetti E, Palermo A, Patano A. Surface Coatings of Dental Implants: A Review. J Funct Biomater 2023; 14:jfb14050287. [PMID: 37233397 DOI: 10.3390/jfb14050287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
Replacement of missing teeth is possible using biocompatible devices such as endosseous implants. This study aims to analyze and recognize the best characteristics of different implant surfaces that ensure good peri-implant tissue healing and thus clinical success over time. The present review was performed on the recent literature concerning endosseous implants made of titanium, a material most frequently used because of its mechanical, physical, and chemical characteristics. Thanks to its low bioactivity, titanium exhibits slow osseointegration. Implant surfaces are treated so that cells do not reject the surface as a foreign material and accept it as fully biocompatible. Analysis of different types of implant surface coatings was performed in order to identify ideal surfaces that improve osseointegration, epithelial attachment to the implant site, and overall peri-implant health. This study shows that the implant surface, with different adhesion, proliferation, and spreading capabilities of osteoblastic and epithelial cells, influences the cells involved in anchorage. Implant surfaces must have antibacterial capabilities to prevent peri-implant disease. Research still needs to improve implant material to minimize clinical failure.
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Affiliation(s)
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gaetano Del Vecchio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Ciro Annicchiarico
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Elio Minetti
- Department of Biomedical, Surgical, and Dental Science, University of Milan, 20122 Milan, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry Birmingham, University of Birmingham, Birmingham B4 6BN, UK
| | - Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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Machado A, Pereira I, Costa F, Brandão A, Pereira JE, Maurício AC, Santos JD, Amaro I, Falacho R, Coelho R, Cruz N, Gama M. Randomized clinical study of injectable dextrin-based hydrogel as a carrier of a synthetic bone substitute. Clin Oral Investig 2023; 27:979-994. [PMID: 36707442 PMCID: PMC9985577 DOI: 10.1007/s00784-023-04868-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 01/14/2023] [Indexed: 01/29/2023]
Abstract
OBJECTIVES This study aimed to improve the performance and mode of administration of a glass-reinforced hydroxyapatite synthetic bone substitute, Bonelike by Biosckin® (BL®), by association with a dextrin-based hydrogel, DEXGEL, to achieve an injectable and moldable device named DEXGEL Bone. METHODS Twelve participants requiring pre-molar tooth extraction and implant placement were enrolled in this study. BL® granules (250-500 µm) were administered to 6 randomized participants whereas the other 6 received DEXGEL Bone. After 6 months, a bone biopsy of the grafted area was collected for histological and histomorphometric evaluation, prior to implant placement. The performance of DEXGEL Bone and BL® treatments on alveolar preservation were further analyzed by computed tomography and Hounsfield density analysis. Primary implant stability was analyzed by implant stability coefficient technique. RESULTS The healing of defects was free of any local or systemic complications. Both treatments showed good osseointegration with no signs of adverse reaction. DEXGEL Bone exhibited increased granule resorption (p = 0.029) accompanied by a tendency for more new bone ingrowth (although not statistically significant) compared to the BL® group. The addition of DEXGEL to BL® granules did not compromise bone volume or density, being even beneficial for implant primary stability (p = 0.017). CONCLUSIONS The hydrogel-reinforced biomaterial exhibited an easier handling, a better defect filling, and benefits in implant stability. CLINICAL RELEVANCE This study validates DEXGEL Bone safety and performance as an injectable carrier of granular bone substitutes for alveolar ridge preservation. TRIAL REGISTRATION European Databank on Medical Devices (EUDAMED) No. CIV-PT-18-01-02,705; Registo Nacional de Estudos Clínicos, RNEC, No. 30122.
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Affiliation(s)
- Alexandra Machado
- CEB, Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.,LABBELS, Associate Laboratory, Braga, Guimarães, Portugal
| | - Isabel Pereira
- CEB, Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.,LABBELS, Associate Laboratory, Braga, Guimarães, Portugal
| | - Filomena Costa
- CEB, Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal.,LABBELS, Associate Laboratory, Braga, Guimarães, Portugal
| | - Ana Brandão
- Biosckin, Molecular and Cell Therapies S.A., TecMaia, Rua Engenheiro Frederico Ulrich 2650, 4470-605, Maia, Portugal
| | - José Eduardo Pereira
- CECAV, Animal and Veterinary Research Centre, University of Trás-os-Montes and Alto Douro, 5001-801, Vila Real, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, 5001-801, Vila Real, Portugal
| | - Ana Colette Maurício
- Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto (UP), Rua de Jorge Viterbo Ferreira, N° 228, 4050-313, Porto, Portugal.,Centro de Estudos de Ciência Animal (CECA), Instituto de Ciências, Tecnologias e Agroambiente da Universidade do Porto (ICETA), Rua D. Manuel II, Apartado 55142, 4051-401, Porto, Portugal
| | - José Domingos Santos
- REQUIMTE/LAQV, Departamento de Engenharia Metalúrgica e Materiais, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias, 4200-495, Porto, Portugal
| | - Inês Amaro
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3004-504, Coimbra, Portugal
| | - Rui Falacho
- Institute of Oral Implantology and Prosthodontics, Faculty of Medicine, University of Coimbra, 3004-504, Coimbra, Portugal
| | - Rui Coelho
- RESDEVMED, Unipessoal Lda., Travessa do Navega, 436 C, 3885-183, Ovar, Portugal
| | - Nuno Cruz
- Faculty of Dentistry, Universitat Internacional de Catalunya, 08017, Barcelona, Spain
| | - Miguel Gama
- CEB, Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal. .,LABBELS, Associate Laboratory, Braga, Guimarães, Portugal.
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10
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Kim SY, Kim HG, Yun PY, Kim YK. Effectiveness of ultra-wide implants in the mandibular and maxillary posterior areas: a 5-year retrospective clinical study. J Korean Assoc Oral Maxillofac Surg 2023; 49:13-20. [PMID: 36859371 PMCID: PMC9985996 DOI: 10.5125/jkaoms.2023.49.1.13] [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: 12/28/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
Objectives Ultra-wide implants may be used as a replacement if existing implants fail. This study was conducted to evaluate the factors influencing the prognosis and failure of ultra-wide implants. Patients and. Methods This study evaluated whether sex, age, site, diameter, length, additional surgery, implant stability (primary and secondary), and reason for ultra-wide implant placement affect the 5-year survival and success rates and marginal bone loss (MBL) of ultra-wide implants. Seventy-eight ultra-wide implants that were placed in 71 patients (39 males and 32 females) from 2008 to 2010 were studied. One-way ANOVA analysis was conducted to evaluate the statistical significance of MBL according to the patient's sex, implant site, and diameter. Independent sample t-tests were used to determine the statistical significance of MBL analysis which was used to determine the significance of the 5-year success and survival rates related to the variables. One-way ANOVA was conducted to evaluate the statistical significance of sex, implantation site, diameter, and MBL. Independent sample t-tests were used to evaluate the correlation between implantability and MBL for implantation reasons, while additional surgery, length, and Kaplan-Meier analysis were used to evaluate 5-year survival and success rates. Results The mean age of patients was 54.2 years with a survival rate of 92.3% and a success rate of 83.3% over a mean 97.8-month period of observation. MBL averaged 0.2 mm after one year of prosthetic function loading and 0.54 mm at the time of final observation. Success rates correlated with primary stability (P=0.045), survival rates correlated with secondary stability (P=0.036), and MBL did not correlate with any variables. Conclusion Ultra-wide implants can be used to achieve secure initial fixation in the maxillary and mandibular molar regions with poor bone quality or for alternative purposes in cases of previous implant failure.
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Affiliation(s)
- So-Yeon Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyeong-Gi Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Office of Human Resources Development, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Dentistry and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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11
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Gehrke SA, Cortellari GC, de Oliveira Fernandes GV, Scarano A, Martins RG, Cançado RM, Mesquita AMM. Randomized Clinical Trial Comparing Insertion Torque and Implant Stability of Two Different Implant Macrogeometries in the Initial Periods of Osseointegration. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010168. [PMID: 36676792 PMCID: PMC9862599 DOI: 10.3390/medicina59010168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/19/2023]
Abstract
Objectives: The present study compared two implants with different macrogeometries placed in healed alveolar sites, evaluating the insertion torque (ITV) and implant stability quotient (ISQ) values at three different periods. Methods: Seventy patients with a total of 100 dental implants were allocated into two groups (n = 50 per group): DuoCone implants (DC group) that included 28 implants in the maxilla and 22 in the mandible, and Maestro implants (MAE group) that included 26 in the maxilla and 24 in the mandible. The ITV was measured during the implant placement, and the ISQ values were measured immediately at implant placement (baseline) and after 30 and 45 days. Results: The mean and standard deviations of the ITV were statistically significant (p < 0.0001), 56.4 ± 6.41 Ncm for the DC group and 29.3 ± 9.65 Ncm for the MAE group. In the DC group, the ISQs ranged between 61.1 ± 3.78 and 69.8 ± 3.86, while the MAE group presented similar values compared with the other group, ranging between 61.9 ± 3.92 and 72.1 ± 2.37. Conclusions: The value of implant insertion torque did not influence the ISQ values measured immediately after implant placement. However, the ITV influenced the ISQ values measured in the two initial periods of osseointegration, with implants installed with lower torques presenting higher ISQ values.
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Affiliation(s)
- Sergio Alexandre Gehrke
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril s/n., 03202 Elche, Spain
- Department of Biotechnology, Universidad Católica de Murcia (UCAM), 30107 Murcia, Spain
- Department of Materials Engineering, Pontificia Universidade Católica do Rio Grande do Sul, Porto Alegre 90619-900, Brazil
- Correspondence: ; Tel./Fax: +598-29015634
| | | | | | - Antonio Scarano
- Department of Research, Bioface/PgO/UCAM, Calle Cuareim 1483, Montevideo 11100, Uruguay
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, 66100 Chieti, Italy
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12
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The Assessment of the Usefulness of Platelet-Rich Fibrin in the Healing Process Bone Resorption. COATINGS 2022. [DOI: 10.3390/coatings12020247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The main subject of this research was the use of PRF in dental surgery aimed at preventing changes in alveolar height and width after tooth extraction. Due to the large growth factor content, it seems to be particularly useful in bone loss management starting from the simplest loss occurring after tooth extraction through loss resulting from tooth resection ending with loss caused by large bone cysts. The study was performed on 50 patients. The extraction of two maxillary or mandibular homonymous teeth was carried out in each patient, where PRF was placed in one alveolus while the other alveolus was left empty. Then, the alveoli were surgically managed with a split flap technique. On the extraction day, after 10 days, and after 6 months, the alveolar process was measured, soft tissues healing was assessed, and imaging examinations were analyzed. It was proved that the healing of soft tissues in the PRF group was better. In the PRF group after 6 months from surgery, the newly formed bone had higher grayscale values in volumetric tomography (CBCT). Moreover, the reduced atrophy of the alveolar process at the site of the extracted tooth was proved in this study.
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13
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The Effect of Bone Density Measured by Cone Beam Computed Tomography and Implant Dimensions on the Stability of Dental Implants. J Craniofac Surg 2021; 33:e553-e557. [PMID: 34930876 DOI: 10.1097/scs.0000000000008429] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/26/2021] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT The aim of this study was to evaluate the effect of bone density value in Hounsfield unit derived from cone beam computed tomography (CBCT), and implant dimensions in relation to implant stability parameters namely the resonance frequency analysis and the insertion torque (IT) value. It included 24 patients who received 42 dental implants (DI). The bone density of the planned implant site was preoperatively measured using cone beam computed tomography. The implant stability was measured using Osstell implant stability quotient (ISQ). The ISQ values were recorded immediately postoperatively and after 16 weeks. The IT value was categorized as 35 N/cm or > 35 N/cm. The mean (standard deviation) primary stability was 79.58 (5.27) ISQ, which was significantly higher than the secondary stability 74.31 (6.34) ISQ (P < 0.0001). There was a significant moderate positive correlation of bone density with primary stability (r = 0.4, P = 0.0099) and no correlation with secondary stability (r = 0.003, P = 0.9867). The bone density of DI with 35 N/cm IT was significantly lower than with > 35 N/cm IT (P = 0.0390). Better stability was recorded with wider implants. Whereas the length of the DI showed a nonsignificant correlation with primary and secondary stability (P = 0.7633 and 0.4670, respectively). The DI dimensions showed a nonsignificant correlation with the IT. Cone beam computed tomography may be considered as a reliable method to assess bone density and predict the implant stability. The diameter of DI affected the implant stability favorably, whereas DI length showed no effect.
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