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Orhan ZD, Ciğerim L. Evaluation of Effect of Different Insertion Speeds and Torques on Implant Placement Condition and Removal Torque in Polyurethane Dense D1 Bone Model. Polymers (Basel) 2024; 16:1361. [PMID: 38794554 PMCID: PMC11125928 DOI: 10.3390/polym16101361] [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: 04/13/2024] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The aim of this study was to evaluate the effect of two different insertion speeds at eight different insertion torque values ranging from 25 to 60 during implantation in a dense polyurethane (PU) D1 bone model on the placement condition and removal torque of dental implants. In this study, 50 pcf single-layer PU plates were used. In the study, a total of 320 implant sockets were divided into two groups, Group 1 (30 rpm) and Group 2 (50 rpm), in terms of insertion speed. Group 1 and Group 2 were divided into eight subgroups with 25, 30, 35, 40, 45, 50, 55 and 60 torques. There were 20 implant sockets in each subgroup. During the implantations, the implant placement condition and removal torque values were assessed. There was a statistically significant difference between the 30 and 50 rpm groups in terms of overall implant placement condition (p < 0.01). It was found that the removal torque values at 50 rpm were statistically significantly higher than those at 30 rpm (p < 0.01). This study showed that in dense D1 bone, the minimum parameters at which all implants could be placed at the bone level were 50 torque at 30 rpm and 40 torque at 50 rpm.
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Affiliation(s)
| | - Levent Ciğerim
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Van Yuzuncu Yil University, Van 65090, Turkey;
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Stoilov M, Shafaghi R, Stark H, Marder M, Kraus D, Enkling N. Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols-An In Vitro Analysis. J Funct Biomater 2023; 14:469. [PMID: 37754883 PMCID: PMC10531925 DOI: 10.3390/jfb14090469] [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: 08/15/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023] Open
Abstract
(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25-50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant's superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.
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Affiliation(s)
- Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Ramin Shafaghi
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland;
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland;
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Gehrke SA, Cortellari GC, De Aza PN, Cavalcanti de Lima JH, Prados Frutos JC. Biomechanical evaluation of abutment stability in morse taper implant connections in different times: A retrospective clinical study compared with an in vitro analysis. Heliyon 2023; 9:e15312. [PMID: 37151670 PMCID: PMC10161598 DOI: 10.1016/j.heliyon.2023.e15312] [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: 12/23/2022] [Revised: 03/08/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Objectives Micromotion between a dental implant and abutment can adversely affect clinical performance and compromise successful osseointegration by creating a bacterial harbor, enabling screw loosening, and imparting disruptive lateral forces on the cortical bone. Thus, the aim of the present study was to measure the abutment stability evolution using resonance frequency analysis (RFA) in vivo at four different times (baseline, 3, 4, and 12 months), and compare these data obtained with the RFA measured after mechanical cycling (in vitro) corresponding to the proposed times in numbers of cycles. Methods To evaluate the abutment stability, RFA was performed in 70 sets of implant/abutment (IA) with a total of 54 patients (31 women, 23 men). These IA sets were divided into three groups, according to the abutment angulation: straight abutment (Abt1 group), 17-degree angled abutment (Abt2 group), and 30-degree angled abutment (Abt3 group). Abutment stability was measured immediately at implant placement and the abutment installation (T1), 3 (T2), 4 (T3), and 12 months (T4) later. For the in vitro analysis, ten sets of each group were submitted to mechanical cycling: T1 = 0 cycles, T2 = 90,000 cycles, T3 = 120,000 cycles, and T4 = 360,000 cycles. All data collected were statistically evaluated using the GraphPad Prism 5.01 software, with the level of significance was α = 0.05. Results In vivo, the overall data of implant stability quotient (ISQ) values obtained for all groups in each evaluation time were 61.5 ± 3.94 (95% CI: [60-63]) at T1, 62.8 ± 3.73 (95% CI, [61-64]) at T2, 63.4 ± 3.08 (95% CI: [61-64]) at T3, and 65.5 ± 4.33 (95% CI: [63-68]) at T4. Whereas in vitro, the ISQ were 61.5 ± 2.66 (95% CI: [59-63]) at T1, 63.2 ± 3.02 (95% CI, [61-65]) at T2, 63.9 ± 2.55 (95% CI: [62-66]) at T3, and 66.5 ± 2.97 (95% CI: [64-68]) at T4. In both evaluations (in vivo and in vitro), the data showed a significant difference (ANOVA test with p < 0.0001). Conclusions The RFA to measure the abutment stability used in this study showed that there was a progressive increase in stability among the predetermined times for the measurements, in both analysis (in vivo and in vitro). Furthermore, the values at each time point were similar, with no statistical difference between them.
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Affiliation(s)
- Sergio Alexandre Gehrke
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril S/n. 03202, Elche (Alicante), Spain
- Bioface/PgO/UCAM, Montevideo 11100, Uruguay
- Department of Biotechnology, Catholic University of Murcia, Murcia 30107, Spain
- Department of Materials Engineering, Pontificial Catholic University of Rio Grande Do Sul, Porto Alegre 90619-900, Brazil
- Corresponding author. Instituto de Bioingenieria; Universidad Miguel Hernández; Avda. Ferrocarril s/n, 03202, Elche (Alicante), Spain.
| | | | - Piedad N. De Aza
- Instituto de Bioingenieria, Universidad Miguel Hernández, Avda. Ferrocarril S/n. 03202, Elche (Alicante), Spain
| | | | - Juan Carlos Prados Frutos
- Department of Medical Specialties and Public Health, IDIBO Group (High Performance Group in Research and Development of Biomaterials in Dentistry), Rey Juan Carlos University, 28922, Alcorcón, Madrid, Spain
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Wakamatsu K, Doi K, Kobatake R, Makihara Y, Oki Y, Tsuga K. Investigation to Predict Primary Implant Stability Using Frictional Resistance Torque of Tap Drilling. J Oral Maxillofac Res 2022; 13:e1. [PMID: 36788798 PMCID: PMC9902023 DOI: 10.5037/jomr.2022.13401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
Objectives The purpose of this experimental study was to investigate the correlation between the frictional resistance torque of tap drilling prior to implant placement and the primary stability after implant placement. Material and Methods Solid rigid polyurethane bone blocks of four different densities were used in this study. A computerized surgical implant motor device was utilized to measure the frictional resistance torque of tap drilling. After the tap torque was measured, the dental implants were inserted at the prepared sites. During the implantation, the insertion torque was recorded, and resonance frequency analysis was performed, the value of which was calculated as the implant stability quotient. Thereafter, the correlation between the tap torque and the primary stability of the implant was evaluated and compared with the standard drilling protocol. Results A significant positive correlation was found between the tap torque and insertion torque (Pearson's r = 0.88, P < 0.0001). Similarly, there was a positive correlation between the tap torque and implant stability quotient (Pearson's r = 0.69, P < 0.0001). Conclusions These results suggest that measurement of the frictional resistance torque of tap drilling prior to implant placement could provide helpful information for implant primary stability.
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Affiliation(s)
- Kaien Wakamatsu
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, HiroshimaJapan.
| | - Kazuya Doi
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, HiroshimaJapan.
| | - Reiko Kobatake
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, HiroshimaJapan.
| | - Yusuke Makihara
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, HiroshimaJapan.
| | - Yoshifumi Oki
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, HiroshimaJapan.
| | - Kazuhiro Tsuga
- Department of Advanced Prosthodontics, Hiroshima University Graduate School of Biomedical and Health Sciences, HiroshimaJapan.
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Insertion Torque, Removal Torque, and Resonance Frequency Analysis Values of Ultrashort, Short, and Standard Dental Implants: An In Vitro Study on Polyurethane Foam Sheets. J Funct Biomater 2022; 14:jfb14010010. [PMID: 36662057 PMCID: PMC9866818 DOI: 10.3390/jfb14010010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
Short implants were introduced to reduce morbidity, treatment duration, and complex bone regeneration interventions in atrophic jaws and to improve patient-reported outcomes. This study aimed to determine the insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA) values of ultrashort (3 mm length), short (7 mm length), and standard implants (10 mm length) inserted in 1-, 2-, 3-, and 4-mm thickness polyurethane sheets with densities of 10, 20, and 30 pounds per cubic foot (PCF). Standard-length implants were the gold standard (control). Overall, short-length implant IT values were higher or similar to the control in most experimental conditions. Those inserted into a 3 mm/30 PCF lamina showed the highest IT values, whereas 5 mm diameter ultrashort-length implants inserted into 2 and 3 mm/20 PCF laminas were higher than other implants. RT values followed the same trend and RFA values were more appreciable in short- and standard-length implants in all the scenarios. However, ultrashort-length implants reached a primary stability comparable to that of standard implants in lower thicknesses. In conclusion, although further studies are needed to corroborate this in vitro model with preclinical and clinical studies, our data shed light on short- and ultrashort-length implants geometries to a potential application in critical atrophy of the posterior jaws.
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Korkmaz İH, Sağlam M. Determination of the Effect of TiN Coating on Self-Fitting Properties of Dental Implants Made of NiTi Alloy. ACS Biomater Sci Eng 2022; 8:4586-4595. [PMID: 36048733 DOI: 10.1021/acsbiomaterials.2c00550] [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] [Indexed: 11/28/2022]
Abstract
Design and material research continues to increase dental implants' success rates, which is a widely applied treatment type. The size and morphology of the implant-bone interface are essential for implant stability. Our study produced a dental implant with two artificial tooth roots from NiTi alloy to increase the implant-bone contact surface. The properties of NiTi alloy, such as transformation temperature and composition, were determined by material characterization tests. Using NiTi alloy's shape memory effect, these artificial roots at body temperature were programmed with appropriate heat treatments for the self-fitting feature. Dental-implant-like models are coated with TiN to prevent Ni ion release. The corrosion tests were performed in Ringer's solution to determine the effect of TiN coating on Ni ion release. The nickel ion emission values showed that the TiN coating inhibited the release. In addition, it was determined that the TiN coating increased the shape memory transformation time of the NiTi alloy. In in vitro tests of NiTi and TiN-coated NiTi implants, it was observed that they completed self-fitting by deforming the trabecular bone, but the placement in the cortical bone was not complete. During the use of a shape memory implant, it should complete its transformation without contacting the cortical bone and should not cause a stress concentration.
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Affiliation(s)
- İsmail Hakkı Korkmaz
- Department of Mechanical Engineering, Faculty of Engineering and Architecture, Erzurum Technical University, Omer Nasuhi Bilmen Mah. Havaalanı Yolu Cad. No:53 Yakutiye, Erzurum 25050, Turkey
| | - Miraç Sağlam
- Department of Mechanical Engineering, Faculty of Engineering and Architecture, Erzurum Technical University, Omer Nasuhi Bilmen Mah. Havaalanı Yolu Cad. No:53 Yakutiye, Erzurum 25050, Turkey
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Farronato M, Farronato D, Giannì AB, Inchingolo F, Nucci L, Tartaglia GM, Maspero C. Effects on Muscular Activity after Surgically Assisted Rapid Palatal Expansion: A Prospective Observational Study. Bioengineering (Basel) 2022; 9:bioengineering9080361. [PMID: 36004886 PMCID: PMC9404753 DOI: 10.3390/bioengineering9080361] [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: 06/30/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 12/03/2022] Open
Abstract
The study aims to investigate the modifications in the temporalis and the masseter activity in adult patients before and after SARPE (Surgically Assisted Rapid Palatal Expansion) by measuring electromyographic and electrokinesographic activity. 24 adult patients with unilateral posterior crossbite on the right side were selected from the Orthodontic Department of the University of Milan. Three electromyographic and electrokinesographic surface readings were taken respectively before surgery (T0) and 8 months after surgery (T1). The electromyographic data of both right and left masseter and anterior temporalis muscles were recorded during multiple tests: standardized maximum voluntary contraction (MVC)s, after transcutaneous electrical nerve stimulation (TENS) and at rest. T0 and T1 values were compared with paired Student’s t-test (p < 0.05). Results: Significant differences were found in the activity of right masseter (p = 0.03) and right temporalis (p = 0.02) during clench, in the evaluation of right masseter at rest (p = 0.03), also the muscular activity of masseters at rest after TENS from T0 to T1 (pr = 0.04, pl = 0.04). No significant differences were found in the activity of left masseter (p = 0.41) and left temporalis (p = 0.39) during clench and MVC, in the evaluation of left masseter at rest (p = 0.57) and in the activity during MVC of right masseter (p = 0.41), left masseter (p = 0.34), right temporalis (p = 0.51) and left temporalis (p = 0.77). Results showed that the activity of the masseter and temporalis muscles increased significantly after SARPE during rest and clenching on the side where the cross-bite was treated.
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Affiliation(s)
- Marco Farronato
- Department of Orthodontics, Faculty of Medicine, University of Milan, 20142 Milano, Italy; (G.M.T.); (C.M.)
- Correspondence:
| | - Davide Farronato
- School of Medicine and Surgery, University of Insubria, Via G. Piatti 10, 21100 Varese, Italy;
| | - Aldo Bruno Giannì
- Facial Surgery and Dentistry Fondazione IRCCS Cà Granda, UOC Maxillo, Ospedale Maggiore Policlinico, 20142 Milan, Italy;
| | - Francesco Inchingolo
- Interdisciplinary Department of Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Ludovica Nucci
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, Via Luigi de Crecchio 6, 80138 Naples, Italy;
| | - Gianluca Martino Tartaglia
- Department of Orthodontics, Faculty of Medicine, University of Milan, 20142 Milano, Italy; (G.M.T.); (C.M.)
- Facial Surgery and Dentistry Fondazione IRCCS Cà Granda, UOC Maxillo, Ospedale Maggiore Policlinico, 20142 Milan, Italy;
| | - Cinzia Maspero
- Department of Orthodontics, Faculty of Medicine, University of Milan, 20142 Milano, Italy; (G.M.T.); (C.M.)
- Facial Surgery and Dentistry Fondazione IRCCS Cà Granda, UOC Maxillo, Ospedale Maggiore Policlinico, 20142 Milan, Italy;
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Yang B, Irastorza-Landa A, Heuberger P, Ploeg HL. Analytical model for dental implant insertion torque. J Mech Behav Biomed Mater 2022; 131:105223. [DOI: 10.1016/j.jmbbm.2022.105223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 11/26/2022]
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Fixture Length and Primary Stability: An In Vitro Study on Polyurethane Foam. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12052683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
(1) Background: Recently, novel dental implants that are characterized by different levels of surface roughness in the distinct parts of the fixture’s body have been introduced in the market. These surface characteristics could affect the primary stability of the implants. The aim of this in vitro study was to compare the primary stability of short and long implants, characterized by multiscale surface roughness, inserted on polyurethane blocks. The secondary aim was to understand if the implant length could be a crucial factor in the decision-making in immediate or rather than delayed loading protocol in the different bone densities. (2) Methods: A total of 20 cylindrical dental implants with a diameter of 5.0 mm were tested for the lengths 6.0 mm (short implants) versus 13.0 mm (long implants) on two different solid rigid polyurethane blocks (20 and 30 PCF). The primary stability was evaluated by measuring the insertion torque value (ITV), the removal torque (RTV), and the resonance frequency analysis RFA. (3) Results: The values of ITV, RTV, and RFA showed the same trend in all measurements. Long implants showed a significantly higher primary stability on 30 PCF blocks that present mechanical properties similar to high-density bone. On the contrary, no relevant differences were found on 20 PCF blocks, which mimic trabecular bone density. (4) Conclusions: The impact of fixture length on the primary stability of implants with multiscale surface roughness is significant in 30 PCF polyurethane corresponding to higher bone density, but not in lower ones.
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Einafshar M, Hashemi A, van Lenthe GH. Replacement of Destructive Pull-out Test with Modal Analysis in Primary Fixation Stability Assessment of Spinal Pedicle Screw. THE ARCHIVES OF BONE AND JOINT SURGERY 2022; 10:204-212. [PMID: 35655738 PMCID: PMC9117904 DOI: 10.22038/abjs.2021.54294.2712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/02/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Pedicle screw fixation devices are the predominant stabilization systems adopted for a wide variety of spinal defects. Accordingly, both pedicle screw design and bone quality are known as the main parameters affecting the fixation strength as measured by the pull-out force and insertion torque. The pull-out test method, which is recommended by the standards of the American Society for Testing and Materials (ASTM), is destructive. A non-destructive test method was proposed to evaluate the mechanical stability of the pedicle screw using modal analysis. Natural frequency (ωn) extracted from the modal analysis was then correlated with peak pull-out force (PPF) and peak insertion torque (PIT). METHODS Cylindrical pedicle screws with a conical core were inserted into two different polyurethane (PU) foams with densities of 0.16 and 0.32 g/cm3. The PIT and PPF were measured according to the well-established ASTM-F543 standard at three different insertion depths of 10, 20, and 30 mm. Modal analysis was carried out through recording time response of an accelerometer attached to the head of the screw impacted by a shock hammer. The effect of the insertion depth and foam density on the insertion torque, natural frequency, and pull-out force were quantified. RESULTS The maximum values of ωn, PIT, and PPT were obtained at 2,186 Hz, 123.75 N.cm, and 981.50 N, respectively, when the screw was inserted into the high-density foam at the depth of 30 mm. The minimum values were estimated at 332 Hz, 16 N.cm, and 127 N, respectively, within the low-density PU at the depth of 10 mm. The higher value of ωn was originated from higher bone screw stability and thus more fixation strength. According to the regression analysis outcomes, the natural frequency (ωn) was linearly dependent on the PIT (ωn=14 PIT) and also on the PPF (ωn=1.7 PPF). Coefficients of variation as the results of the modal analysis were significantly less than those in conventional methods (i.e. pull-out and insertion torque). CONCLUSION The modal analysis was found to be a reliable, repeatable, and non-destructive method, which could be considered a prospective alternative to the destructive pull-out test that is limited to the in-vitro application only. The modal analysis could be applied to assess the stability of implantable screws, such as orthopedic and spinal screws.
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Affiliation(s)
- Mohammadjavad Einafshar
- Biomechanical Engineering Group, Department of Biomedical Engineering, Amirkabir University of Technology, Hafez Avenue, Tehran, Iran, Biomechanics Section, KU Leuven- University of Leuven, Celestijnenlaan, Leuven, Belgium
| | - Ata Hashemi
- Biomechanical Engineering Group, Department of Biomedical Engineering, Amirkabir University of Technology, Hafez Avenue, Tehran, Iran
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Mechanical Behaviour and Primary Stability of a Self-Condensing Implant: A Laboratory Critical Simulation of a Severe Maxillary Atrophy on Polyurethane Lamina. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12030966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: Posterior maxillary atrophies could emerge after the loss of teeth, trauma, infections, or lesions that often require regenerative approaches. In these critical conditions, the achievement of implant primary stability represents a clinical challenge in the operative practice. Therefore, a two-stage approach is often preferred with a delay of the rehabilitation time and a consistent increasing of the biological and the operative costs. The aim of this study was to evaluate the mechanical behaviour of a self-condenser implant compared to a standard implant in a critical simulation on different thicknesses and densities of polyurethane lamina. Materials and methods: A total of two implant models were tested: a self-condensing device (test) and a standard implant (control). The study evaluated the insertion torque and the pull-out strength values of the test and control implants inserted in different sizes (1, 2, and 3 mm) and density polyurethane lamina (10, 20, and 30 pcf) for a total of 320 experimental sites. Results: In total, 320 experimental sites were produced in the polyurethane samples. A statistically significant difference of insertion and pull-out torque values between the test and control Implants was found in the different bone densities (p < 0.05). The insertion and pull-out torque values were always higher for the test implants in all experimental conditions. In all bone densities, the insertion torque values were higher than the pull-out torque values. The self-condenser dental implant design evaluated in this in vitro study showed a high level of stability in all experimental conditions. Conclusions: The test implant could represent a useful tool for a one-stage surgical approach in the presence of limited residual native bone as an alternative to a delayed technique.
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12
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Can the design of the instruments used for undersized osteotomies influence the initial stability of implants installed in low-density bone? An in vitro pilot study. PLoS One 2021; 16:e0257985. [PMID: 34618848 PMCID: PMC8496820 DOI: 10.1371/journal.pone.0257985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/14/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives The aims of this study were to compare the initial implant stability obtained using four different osteotomy techniques in low-density synthetic bone, to evaluate the instrument design in comparison to the implant design, and to determinate a possible correlation between the insertion torque and initial stability quotient (ISQ). Materials and methods Four groups were identified in accordance with the osteotomy technique used (n = 10 implants per group): group G1, osteotomy using the recommended drilling sequence; group G2, osteotomy using an undersized compactor drill; group G3, osteotomy using an undersized drill; and group G4, osteotomy using universal osseodensification drills. Two polyurethane blocks were used: block 1, with a medullary portion of 10 pounds per cubic foot (PCF 10) and with a 1 mm cortical portion of PCF 40, and block 2, with a medullary of PCF 15 and with a 2 mm cortical portion of PCF 40. Tapered implants of 4 mm in diameter and 11 mm in length were used. The insertion torque (IT) and ISQ were measured. The dimensions of the final instrument used in each group and the dimensions of the implant were used to calculate the total area of each part, and these data were compared. Results Differences between the four groups were found for IT and ISQ values depending on the technique used for the osteotomy in the two synthetic bone models (p < 0.0001). All groups showed lower values of initial stability in block 1 than in block 2. Conclusions Undersized osteotomies with instruments designed according to the implant body significantly increased the initial stability values compared to beds prepared with universal drills and using the drilling sequence standardized by the manufacturer.
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Raz P, Meir H, Levartovsky S, Peleg M, Sebaoun A, Beitlitum I. Reliability and Correlation of Different Devices for the Evaluation of Primary Implant Stability: An In Vitro Study. MATERIALS 2021; 14:ma14195537. [PMID: 34639933 PMCID: PMC8509803 DOI: 10.3390/ma14195537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022]
Abstract
Our aim was to analyze the correlation between the IT evaluated by a surgical motor and the primary implant stability (ISQ) measured by two RFA devices, Osstell and Penguin, in an in vitro model. This study examines the effect of bone type (soft or dense), implant length (13 mm or 8 mm), and implant design (CC: conical connection; IH: internal hexagon), on this correlation. Ninety-six implants were inserted using a surgical motor (IT) into two types of synthetic foam blocks. Initial measurements for both the peak IT and ISQ were recorded at the point when implant insertion was stopped by the surgical motor, and the final measurements were recorded when the implant was completely inserted into the synthetic blocks using only the RFA devices. Our null hypothesis was that there is a good correlation between the devices, independent of the implant length, design, or bone type. We found a positive, significant correlation between the IT, and the Osstell and Penguin devices. Implant length and bone type did not affect this correlation. The correlation between the devices in the CC design was maintained; however, in the IH design it was maintained only between the RFA devices. We concluded that there is a high positive correlation between the IT and ISQ from a mechanical perspective, which was not affected by bone type or implant length but was affected by the implant design.
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Affiliation(s)
- Perry Raz
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
- Correspondence:
| | - Haya Meir
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
| | - Shifra Levartovsky
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Maia Peleg
- The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Alon Sebaoun
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
| | - Ilan Beitlitum
- Department of Periodontology and Dental Implants, The Maurice and Gabriela Goldschleger School of Dental Medicine, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (H.M.); (A.S.); (I.B.)
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14
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An In Vitro Analysis on Polyurethane Foam Blocks of the Insertion Torque (IT) Values, Removal Torque Values (RTVs), and Resonance Frequency Analysis (RFA) Values in Tapered and Cylindrical Implants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179238. [PMID: 34501824 PMCID: PMC8431239 DOI: 10.3390/ijerph18179238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 12/24/2022]
Abstract
Background: Several different dental implant microgeometries have been investigated in the literature for use in low-density bone sites. The polyurethane solid rigid blocks represent an optimal in vitro study model for dental implants, because their composition is characterized by symmetrical linear chains of monomers of hexa-methylene sequences producing a self-polymerization process. The aim of the present investigation was to evaluate the primary stability of cylindrical and tapered implants positioned into low-density polyurethane solid rigid blocks. Materials and Methods: Two different macrogeometries, cylindrical (4 mm diameter and 10 mm length) and tapered dental implants (4.20 mm diameter and 10 mm length), were investigated in the present study. The implants were inserted into 10 PCF and 20 PCF polyurethane blocks, with and without an additional cortical layer. The insertion torque (IT) values, the removal torque values (RTVs), and the resonance frequency analysis (RFA) values were measured and recorded. Results: A total of 80 sites were tested, and a significant increased primary stability (PS) was detected in favour of tapered dental implants when compared to cylindrical implants in all experimental conditions (p < 0.05). Higher IT, RT, and RFA values were measured in tapered implants in 10 and 20 PCF polyurethane blocks, both with and without the additional cortical layer. Conclusions: Both implants showed sufficient primary stability in poor density substrates, while, on the other hand, the tapered microgeometry showed characteristics that could also lead to clinical application in low-density posterior maxillary sites, even with a drastically decreased bone cortical component.
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15
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Gehrke SA, Scarano A, de Lima JHC, Bianchini MA, Dedavid BA, De Aza PN. Effects of the Healing Chambers in Implant Macrogeometry Design in a Low-Density Bone Using Conventional and Undersized Drilling. J Int Soc Prev Community Dent 2021; 11:437-447. [PMID: 34430506 PMCID: PMC8352059 DOI: 10.4103/jispcd.jispcd_96_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/14/2021] [Accepted: 05/22/2021] [Indexed: 11/04/2022] Open
Abstract
Background: The ideal installation technique or implant macrogeometry for obtaining an adequate osseointegration in low-density bone tissue follows a challenge in the implantology. Aims and Objective: The aim of the present study was to evaluate the behavior of three osteotomy techniques and two implant macrogeometries in two low-density polyurethane blocks. The insertion torque (IT), initial stability, pullout resistance, and weight of the residual bone material deposited on the implants were assessed. Materials and Methods: A total of 120 implants with two different macrogeometries were used. They were divided into six groups according to the implant macrogeometry and the drilling technique performed (n = 20 implants per group). The implants were installed in polyurethane blocks with pounds per cubic foot (PCF) 10 and PCF 20 densities. The IT, initial stability, pullout resistance, and weight residual bone were measured. Results: Differences were found in the values referring to the macrogeometry of the implants and the type of osteotomy performed. In all groups, the initial stability of the PCF 10 blocks was quite low. The undersized osteotomies significantly increased the values measured in all tests in the PCF 20 density blocks. Conclusions: In conclusion, even when a modified (undersized) osteotomy technique is used, implants inserted in low-quality bone (type IV) can present problems for osseointegration due their low initial stability and bone resistance. However, the modification in the implant macrogeometry (with healing chambers) presented more quantity of bone on the surface after the pullout test.
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Affiliation(s)
- Sergio A Gehrke
- Department of Research, Biotecnos, Montevideo, Uruguay.,Department of Biotechnology, Universidad Católica de Murcia, Murcia, Spain.,Instituto de Bioingenieria, Universidad Miguel Hernández, Elche (Alicante), Spain
| | - Antônio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - José H C de Lima
- Department of Rehabilitation, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Marco A Bianchini
- Post-Graduate Program in Implant Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Berenice A Dedavid
- Department of Materials Engineering, Pontificia Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Piedad N De Aza
- Instituto de Bioingenieria, Universidad Miguel Hernández, Elche (Alicante), Spain
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16
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Inchingolo AD, Inchingolo AM, Bordea IR, Xhajanka E, Romeo DM, Romeo M, Zappone CMF, Malcangi G, Scarano A, Lorusso F, Isacco CG, Marinelli G, Contaldo M, Ballini A, Inchingolo F, Dipalma G. The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis. MATERIALS 2021; 14:ma14051147. [PMID: 33671038 PMCID: PMC7957527 DOI: 10.3390/ma14051147] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/11/2022]
Abstract
Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.
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Affiliation(s)
- Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Correspondence: (I.R.B.); (F.L.); Tel.:+4-07-4491-9319 (I.R.B.); +39-087-1455-4100 (F.L.)
| | - Edit Xhajanka
- Department of Dental Prosthesis, University of Tirana, Nr 183 Tirana, Albania;
| | - Donato Mario Romeo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Mario Romeo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Carlo Maria Felice Zappone
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Freelancer Studio Dentistico Drs. Romeo, 75025 Policoro, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy;
- Correspondence: (I.R.B.); (F.L.); Tel.:+4-07-4491-9319 (I.R.B.); +39-087-1455-4100 (F.L.)
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
- Human Stem Cells Research Center HSC of Ho Chi Minh, Ho Chi Minh 70000, Vietnam
- Embryology and Regenerative Medicine and Immunology, Pham Chau Trinh University of Medicine Hoi An, Hoi An 70000, Vietnam
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138 Naples, Italy;
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario “Ernesto Quagliariello” University of Bari “Aldo Moro”, 70125 Bari, Italy;
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (D.M.R.); (M.R.); (C.M.F.Z.); (G.M.); (C.G.I.); (G.M.); (F.I.); (G.D.)
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17
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Comuzzi L, Tumedei M, De Angelis F, Lorusso F, Piattelli A, Iezzi G. Influence of the dental implant macrogeometry and threads design on primary stability: an in vitro simulation on artificial bone blocks. Comput Methods Biomech Biomed Engin 2021; 24:1242-1250. [PMID: 33492988 DOI: 10.1080/10255842.2021.1875219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The implant macrogeometry and thread profile represent one of the most important factors for a successful achievement of primary stability during the positioning procedure. The aim of the present investigation was to evaluate the insertion torque (IT), removal torque (RT) and Implant stability Quotient (ISQ) of two different implant macrogeometry and thread profile on solid rigid polyurethane model. Two different implants macrogeometries were tested: K2 (Group I) with 11° angle, 1.17 mm pitch and self-cutting V thread profile and K3 (Group II) implants with 30° angle, 0.71 mm pitch and spyral thread profile. A total of 120 specimens (n = 60 for each group) were positioned into different conditions of solid rigid polyurethane blocks. The insertion torque (IT), removal torque (RT) and ISQ were measured for each specimen. All specimens achieved the positioning into solid rigid polyurethane blocks for both of groups with no loss of stability. A significantly higher IT, RT and ISQ were detected in Group II (p < 0.05). In both groups the mean values for IT, RT and ISQ appeared promising from a clinical point of view. In spite of different macrogeometry and thread profile, both implant types achieved high primary stability on solid rigid polyurethane block to support the functional loading for a clinical application.
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Affiliation(s)
- Luca Comuzzi
- Private Practice, San Vendemiano-Conegliano (Treviso), Italy
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Francesco De Angelis
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.,Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Guadalupe, Murcia, Spain.,Villaserena Foundation for Research, Città Sant'Angelo (PE), Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
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18
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Sherman WF, Flick TR, Dranoff CS, Weintraub MJ, Kale NN, Sommi C, Sanchez FL. Variability of Cutting and Thermal Dynamics Between New and Used Acetabular Reamers During Total Hip Arthroplasty. Arthroplast Today 2021; 7:91-97. [PMID: 33521203 PMCID: PMC7818610 DOI: 10.1016/j.artd.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 11/29/2022] Open
Abstract
Background Aseptic loosening of the acetabular component remains one of the leading causes of early failure of total hip arthroplasty. Poor apposition of bone onto the implant surface can be due to inaccurate reaming and osteonecrosis of the acetabular bone due to the heat generated while reaming. Methods New and used acetabular reamers were tested on an MTS system using a clinically relevant force of 87.6 N. A thermal profile and depth achieved by the reamers were analyzed and compared between the 2 cohorts. Heat generated and force required for the community used reamers to achieve the same depth as the new reamers were subsequently analyzed. Results The new reamers achieved a depth 3.4 mm deeper than the community reamers (P < .001). The new reamers generated 4.1°C less heat than the community reamers (P = .007) under the same force and time. When programmed to ream to the average depth of the new reamers, the community reamers generated 16.8°C more heat (P = .002) and required forces 95-318% greater than the 87.6 N force used by the new reamers. Conclusions Community use of reamers will cause variations in depth of penetration and increased temperatures at a clinically generated force vs new reamers. When community reamers were forced to the same depths the new reamers achieved, a significantly greater amount of heat was generated, and an increased amount of time was needed, both of which are known risk factors for osteonecrosis.
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Affiliation(s)
- William F Sherman
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Travis R Flick
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Charles S Dranoff
- Tulane University School of Science and Engineering, New Orleans, LA, USA
| | | | - Nisha N Kale
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Corinne Sommi
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Fernando L Sanchez
- Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA
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19
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Tumedei M, Piattelli A, Falco A, De Angelis F, Lorusso F, Di Carmine M, Iezzi G. An in vitro evaluation on polyurethane foam sheets of the insertion torque, removal torque values, and resonance frequency analysis (RFA) of a self-tapping threads and round apex implant. CELLULAR POLYMERS 2020. [DOI: 10.1177/0262489320971796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The dental implant primary stability and micromovement absence represent critical factor for dental implant osseointegration. The aim of the present in vitro investigation was to simulate the bone response on different polyurethane densities the effect of self-tapping threads and round apex implant geometry. A total of 40 implants were positioned in D1, D2, D3 and D4 polyurethane block densities following a calibrated drilling protocol. The Insertion, removal Torque and resonance frequency analysis (RFA) means were calculated. All experimental conditions showed insertion torque values >30 Ncm. A significant higher insertion torque, removal and RFA was present in D1 polyurethane. Similar evidences were evidenced for D3 and D4. The effectiveness of the present study suggested a valuable clinical advantage for self-tapping threads and round apex implant using, such as in case of reduced bone density in the posterior maxilla
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Affiliation(s)
- Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
- Chair of Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Av. de los Jerónimos, Guadalupe, Murcia, Spain
- Fondazione Villa Serena per la Ricerca, Città Sant’Angelo (PE), Italy
| | | | - Francesco De Angelis
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
| | - Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
| | | | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, Chieti, Italy
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20
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Fanali S, Tumedei M, Pignatelli P, Inchingolo F, Pennacchietti P, Pace G, Piattelli A. Implant primary stability with an osteocondensation drilling protocol in different density polyurethane blocks. Comput Methods Biomech Biomed Engin 2020; 24:14-20. [PMID: 32840129 DOI: 10.1080/10255842.2020.1806251] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The implant primary stability is a fundamental condition for avoiding implant micro-motions that might result in fibrous encapsulation; its achievement is facilitated by macro- and micro-geometry of the implant, and by the bone density and architecture at the intended implant site. The aim was to evaluate an osteocondensing drilling protocol for dental implant positioning compared to standard protocol on polyurethane block. A total of 40 implants, 20 for each osteocondensing group (Test) and 20 for standard drilling group (Control), were positioned. Insertion torque (IT), removal torque (RT), and Periotest were measured. A IT, RT, and Periotest significant difference was present in favor of the implant osteocondensing protocol. The results suggested that osteocondensing protocol represents a useful technique for implant placement in poor density bone.
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Affiliation(s)
- Stefano Fanali
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Margherita Tumedei
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Pamela Pignatelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", Bari, Italy
| | | | - Gianluca Pace
- Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Guadalupe, Murcia, Spain
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.,Biomaterials Engineering, Catholic University of San Antonio de Murcia (UCAM), Guadalupe, Murcia, Spain.,Villaserena Foundation for Research, Città Sant'Angelo (PE), Italy
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21
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Osseodensification Drilling vs. Standard Protocol of Implant Site Preparation: An In Vitro Study on Polyurethane Foam Sheets. PROSTHESIS 2020. [DOI: 10.3390/prosthesis2020008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
(1) Background: The aim of the present in vitro investigation was to evaluate, on polyurethane sheets, two different drilling techniques for dental implant positioning using osteocondensing burs compared to a standard type protocol. (2) Methods: Three different implant designs (Implacil De Bortoli UN III 4 × 10 mm, Restore RBM 4 (HEX) × 10 mm; Implacil De Bortoli UN II 4 × 10 mm) were evaluated (test implant (osteocondensing drills) and control implant (standard drills)). The insertion torque (IT), the removal torque (RT) and the resonance frequency analysis (RFA) values of test and control implants inserted in different size and different density polyurethane foam models were compared for 120 experimental sites. Accordingly, 120 experimental holes were produced in different PCF polyurethane foams: 60 sites were produced in 10 PCF sheets and 60 sites in 10 PCF sheets with an additional 1 mm layer of 30 PCF. (3) Results: The IT, removal torque and RFA values were significantly higher for both of the evaluated implants, in the sites prepared with the osteocondenser drills when compared to sites prepared with standard drills (p < 0.05). The UNII and UN III showed significantly higher stability compared to the HEX implant; these differences increased drastically in the 10 PCF Polyurethane Block with the additional 1 mm cortical layer (p < 0.05). (4) Conclusions: The outcome of this investigation suggested a possible clinical application of osteocondensing burs in case of reduced bone quality and quantity in the posterior maxilla.
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22
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Primary Stability of Dental Implants in Low-Density (10 and 20 pcf) Polyurethane Foam Blocks: Conical vs Cylindrical Implants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082617. [PMID: 32290361 PMCID: PMC7216137 DOI: 10.3390/ijerph17082617] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 12/13/2022]
Abstract
Background: The aim of the present study was to compare, in low-density polyurethane blocks, the primary implant stability values (micromobility) and removal torque values of three different implant geometries in two different bone densities representing the structure of the human posterior jaws. Methods: A total of 60 implants were used in the present investigation: twenty implants for each of three groups (group A, group B, and group C), in both polyurethane 10 pcf and 20 pcf densities. The insertion torque, pull-out torque, and implant stability quotient (ISQ) values were obtained. Results: No differences were found in the values of Group A and Group B implants. In both these groups, the insertion torques were quite low in the 10 pcf blocks. Better results were found in the 20 pcf blocks, which showed very good stability of the implants. The pull-out values were slightly lower than the insertion torque values. High ISQ values were found in Group A and B implants. Lower values were present in Group C implants. Conclusions: The present investigation evaluated implants with different geometries that are available on the market, and not experimental implants specifically created for the study. The authors aimed to simulate real clinical conditions (poor-density bone or immediate post-extraction implants) in which knowledge of dental implant features, which may be useful in increasing the primary stability, may help the oral surgeon during the surgery planning.
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Kéki S. Functional Polyurethanes-In Memory of Prof. József Karger-Kocsis. Polymers (Basel) 2020; 12:polym12020434. [PMID: 32069776 PMCID: PMC7077621 DOI: 10.3390/polym12020434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sándor Kéki
- Department of Applied Chemistry, Faculty of Science and Technology, University of Debrecen, H-4032 Debrecen, Egyetem tér 1., Hungary
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Bafijari D, Benedetti A, Stamatoski A, Baftijari F, Susak Z, Veljanovski D. Influence of Resonance Frequency Analysis (RFA) Measurements for Successful Osseointegration of Dental Implants During the Healing Period and Its Impact on Implant Assessed by Osstell Mentor Device. Open Access Maced J Med Sci 2019; 7:4110-4115. [PMID: 32165961 PMCID: PMC7061400 DOI: 10.3889/oamjms.2019.716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 01/10/2023] Open
Abstract
AIM This study aimed to investigate and assess primary and secondary dental implant stability during the osseointegration period. METHODS A total of 77 implants were placed in 42 patients with 26 males and 16 females. The study was conducted by comparing the resonance frequency analysis (RFA) values of the implants inserted in the lower jaw. RFA was done immediately after implant insertion and after 12 weeks. Results were statistically evaluated using SPSS Statistics for Windows, Version 7.1. Level of significance was set at P < 0.05. RESULTS Significant differences were detected between the primary and secondary stability values, respectively. Maximum RFA value of 88 and the minimum value of 52 were observed. Stability values increased during the following three months, and all implants were successfully integrated without complication. CONCLUSION Our results indicate and suggest that there is a strong linear correlation between implant stability and ISQ values that can be directly estimated by the RFA, especially in the posterior edentulous mandible. Osstell implant device could represent a useful tool which can be used to identify the risk for implant failure.
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Affiliation(s)
- Denis Bafijari
- Dental Implant Center "Vita Dent", Tetovo, Republic of Macedonia
| | - Alberto Benedetti
- University Clinic for Maxillofacial Surgery, Ss "Cyril and Methodius" University of Skopje, Skopje, Republic of Macedonia
| | - Aleksandar Stamatoski
- University Clinic for Maxillofacial Surgery, Ss "Cyril and Methodius" University of Skopje, Skopje, Republic of Macedonia
| | - Florent Baftijari
- Department of Prosthodontics, Faculty of Dental Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Zoran Susak
- Sante Plus Aesthetic Hospital, Skopje, Republic of Macedonia
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Short vs. Standard Length Cone Morse Connection Implants: An In Vitro Pilot Study in Low Density Polyurethane Foam. Symmetry (Basel) 2019. [DOI: 10.3390/sym11111349] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of the investigation was to evaluate the insertion torque, pull-out torque and implant stability quotient (ISQ) of short implants (SI) and standard length implants (ST) inserted into linearly elastic and constitutive isotropic symmetry polyurethane foam blocks. Short dental titanium implants with a Cone Morse connection and a conical shape (test implants: Test Implant A—diameter 5.5 mm and length 6 mm) (Test Implant B—diameter 5.5 mm and length 5 mm) were used for the present in vitro investigation. ST implants (4 mm diameter and 10 mm length), with a Cone Morse connection and a conical shape, were used as Control Implant A and as Control Implants B. These two latter implants had a different macro design. A total of 20 implants (5 Test A, 5 Test B, 5 Control A and 5 Control B) were used for the present research. The results were similar when comparing the Test A and Test B implants. The test implants had very good stability in polyurethane 14.88–29.76 kgm3 density blocks. The insertion torque values were very high for both types of test implant (25–32 Ncm on 14.88 kgm blocks, and up to 45 Ncm in 29.76 kgm3 blocks). The pull-out test values were very similar to the insertion torque values. The ISQ values were significantly high with 75–80 in 14.88 kgm3 blocks, and 78–83 in 29.76 kgm3 blocks. No differences were found in the values of the Control A and Control B implants. In both these implants, the insertion torque was quite low in the 14.88 kgm3 blocks (16–28 Ncm). Better results were found in the 29.76 kgm3 blocks. The pull-out values for these control implants were slightly lower than the insertion torque values. High ISQ values were found in both control implants (57–80). When comparing SI and ST implants, the SI had a similar if not better performance in low quality polyurethane foam blocks (14.88–29.76 kgm), corresponding to D3 and D4 bone.
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Biomechanical Effects of a New Macrogeometry Design of Dental Implants: An In Vitro Experimental Analysis. J Funct Biomater 2019; 10:jfb10040047. [PMID: 31731451 PMCID: PMC6963387 DOI: 10.3390/jfb10040047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/21/2019] [Accepted: 10/23/2019] [Indexed: 12/25/2022] Open
Abstract
The purpose of the present study was to measure and compare the insertion torque, removal torque, and the implant stability quotient by resonance frequency analysis in different polyurethane block densities of two implant macrogeometries. Four different polyurethane synthetic bone blocks were used with three cortical thickness: Bone 1 with a cortical thickness of 1 mm, Bone 2 with a cortical thickness of 2 mm, Bone 3 with a cortical thickness of 3 mm, and Bone 4, which was totally cortical. Four groups were created in accordance with the implant macrogeometry (n = 10 per group) and surface treatment: G1—regular implant design without surface treatment; G2—regular implant design with surface treatment; G3—new implant design without surface treatment; G4—new implant design with surface treatment. All implants used were 4 mm in diameter and 10 mm in length and manufactured in commercially pure titanium (grade IV) by Implacil De Bortoli (São Paulo, Brazil). The implants were installed using a computed torque machine, and following installation of the implant, the stability quotient (implant stability quotient, ISQ) values were measured in two directions using Osstell devices. The data were analyzed by considering the 5% level of significance. All implant groups showed similar mean ISQ values without statistical differences (p > 0.05), for the same synthetic bone block: for Bone 1, the value was 57.7 ± 3.0; for Bone 2, it was 58.6 ± 2.2; for Bone 3, it was 60.6 ± 2.3; and for Bone 4, it was 68.5 ± 2.8. However, the insertion torque showed similar higher values for the regular macrogeometry (G1 and G2 groups) in comparison with the new implant macrogeometry (G3 and G4 groups). The analysis of the results found that primary stability does not simply depend on the insertion torque but also on the bone quality. In comparison with the regular implant macrogeometry, the new implant macrogeometry decreased the insertion torque without affecting the implant stability quotient values.
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