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Stoetzel S, Malhan D, Wild U, Helbing C, Hassan F, Attia S, Jandt KD, Heiss C, El Khassawna T. Osteocytes Influence on Bone Matrix Integrity Affects Biomechanical Competence at Bone-Implant Interface of Bioactive-Coated Titanium Implants in Rat Tibiae. Int J Mol Sci 2021; 23:374. [PMID: 35008800 PMCID: PMC8745552 DOI: 10.3390/ijms23010374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/07/2023] Open
Abstract
Osseointegration is a prerequisite for the long-term success of implants. Titanium implants are preferred for their biocompatibility and mechanical properties. Nonetheless, the need for early and immediate loading requires enhancing these properties by adding bioactive coatings. In this preclinical study, extracellular matrix properties and cellular balance at the implant/bone interface was examined. Polyelectrolyte multilayers of chitosan and gelatin or with chitosan and Hyaluronic acid fabricated on titanium alloy using a layer-by-layer self-assembly process were compared with native titanium alloy. The study aimed to histologically evaluate bone parameters that correlate to the biomechanical anchorage enhancement resulted from bioactive coatings of titanium implants in a rat animal model. Superior collagen fiber arrangements and an increased number of active osteocytes reflected a significant improvement of bone matrix quality at the bone interface of the chitosan/gelatin-coated titan implants over chitosan/hyaluronic acid-coated and native implants. Furthermore, the numbers and localization of osteoblasts and osteoclasts in the reparative and remodeling phases suggested a better cellular balance in the chitosan/Gel-coated group over the other two groups. Investigating the micro-mechanical properties of bone tissue at the interface can elucidate detailed discrepancies between different promising bioactive coatings of titanium alloys to maximize their benefit in future medical applications.
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Affiliation(s)
- Sabine Stoetzel
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (S.S.); (D.M.); (U.W.); (F.H.); (C.H.)
| | - Deeksha Malhan
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (S.S.); (D.M.); (U.W.); (F.H.); (C.H.)
| | - Ute Wild
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (S.S.); (D.M.); (U.W.); (F.H.); (C.H.)
| | - Christian Helbing
- Chair of Materials Science (CMS), Otto Schott Institute of Materials Research (OSIM), Faculty of Physics and Astronomy, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; (C.H.); (K.D.J.)
| | - Fathi Hassan
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (S.S.); (D.M.); (U.W.); (F.H.); (C.H.)
| | - Sameh Attia
- Department of Oral and Maxillofacial Surgery, Justus-Liebig University of Giessen, Klinikstrasse 33, 35392 Giessen, Germany;
| | - Klaus D. Jandt
- Chair of Materials Science (CMS), Otto Schott Institute of Materials Research (OSIM), Faculty of Physics and Astronomy, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; (C.H.); (K.D.J.)
| | - Christian Heiss
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (S.S.); (D.M.); (U.W.); (F.H.); (C.H.)
- Department of Trauma, Hand and Reconstructive Surgery, Justus-Liebig University Giessen, Rudolf-Buchheim-Strasse 7, 35392 Giessen, Germany
| | - Thaqif El Khassawna
- Experimental Trauma Surgery, Faculty of Medicine, Justus-Liebig-University, Aulweg 128, 35392 Giessen, Germany; (S.S.); (D.M.); (U.W.); (F.H.); (C.H.)
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Li W, Qiao W, Liu X, Bian D, Shen D, Zheng Y, Wu J, Kwan KYH, Wong TM, Cheung KMC, Yeung KWK. Biomimicking Bone-Implant Interface Facilitates the Bioadaption of a New Degradable Magnesium Alloy to the Bone Tissue Microenvironment. Adv Sci (Weinh) 2021; 8:e2102035. [PMID: 34713634 PMCID: PMC8655172 DOI: 10.1002/advs.202102035] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/17/2021] [Indexed: 05/03/2023]
Abstract
The most critical factor determining the success of biodegradable bone implants is the host tissue response, which greatly depends on their degradation behaviors. Here, a new magnesium-based implant, namely magnesium-silicon-calcium (Mg-0.2Si-1.0Ca) alloy, that coordinates its biodegradation along with the bone regenerative process via a self-assembled, multilayered bone-implant interface is designed. At first, its rapid biocorrosion contributes to a burst release of Mg2+ , leading to a pro-osteogenic immune microenvironment in bone. Meanwhile, with the simultaneous intervention of Ca and Si in the secondary phases of the new alloy, a hierarchical layered calcified matrix is rapidly formed at the degrading interface that favored the subsequent bone mineralization. In contrast, pure Mg or Mg-0.2Si alloy without the development of this interface at the beginning will unavoidably induce detrimental bone loss. Hence, it is believed this biomimicking interface justifies its bioadaptability in which it can modulate its degradation in vivo and accelerate bone mineralization.
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Affiliation(s)
- Wenting Li
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
- Department of Orthopedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Wei Qiao
- Department of Orthopedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Xiao Liu
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
| | - Dong Bian
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Danni Shen
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Yufeng Zheng
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
| | - Jun Wu
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Kenny Y H Kwan
- Department of Orthopedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Tak Man Wong
- Department of Orthopedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Kenneth M C Cheung
- Department of Orthopedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
| | - Kelvin W K Yeung
- Department of Orthopedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong, China
- Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, Department of Orthopaedics and Traumatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China
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Aliaj K, Feeney GM, Sundaralingam B, Hermans T, Foreman KB, Bachus KN, Henninger HB. Replicating dynamic humerus motion using an industrial robot. PLoS One 2020; 15:e0242005. [PMID: 33166328 PMCID: PMC7652298 DOI: 10.1371/journal.pone.0242005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/26/2020] [Indexed: 11/18/2022] Open
Abstract
Transhumeral percutaneous osseointegrated prostheses provide upper-extremity amputees with increased range of motion, more natural movement patterns, and enhanced proprioception. However, direct skeletal attachment of the endoprosthesis elevates the risk of bone fracture, which could necessitate revision surgery or result in loss of the residual limb. Bone fracture loads are direction dependent, strain rate dependent, and load rate dependent. Furthermore, in vivo, bone experiences multiaxial loading. Yet, mechanical characterization of the bone-implant interface is still performed with simple uni- or bi-axial loading scenarios that do not replicate the dynamic multiaxial loading environment inherent in human motion. The objective of this investigation was to reproduce the dynamic multiaxial loading conditions that the humerus experiences in vivo by robotically replicating humeral kinematics of advanced activities of daily living typical of an active amputee population. Specifically, 115 jumping jack, 105 jogging, 15 jug lift, and 15 internal rotation trials-previously recorded via skin-marker motion capture-were replicated on an industrial robot and the resulting humeral trajectories were verified using an optical tracking system. To achieve this goal, a computational pipeline that accepts a motion capture trajectory as input and outputs a motion program for an industrial robot was implemented, validated, and made accessible via public code repositories. The industrial manipulator utilized in this study was able to robotically replicate over 95% of the aforementioned trials to within the characteristic error present in skin-marker derived motion capture datasets. This investigation demonstrates the ability to robotically replicate human motion that recapitulates the inertial forces and moments of high-speed, multiaxial activities for biomechanical and orthopaedic investigations. It also establishes a library of robotically replicated motions that can be utilized in future studies to characterize the interaction of prosthetic devices with the skeletal system, and introduces a computational pipeline for expanding this motion library.
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Affiliation(s)
- Klevis Aliaj
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Bimedical Engineering, University of Utah, Salt Lake City, Utah, United States of America
| | - Gentry M. Feeney
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Bimedical Engineering, University of Utah, Salt Lake City, Utah, United States of America
| | | | - Tucker Hermans
- School of Computing, University of Utah, Salt Lake City, Utah, United States of America
- Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, United States of America
| | - K. Bo Foreman
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, United States of America
- Department of Physical Therapy & Athletic Training, University of Utah, Salt Lake City, Utah, United States of America
- U.S. Department of Veterans Affairs, Salt Lake City, Utah, United States of America
| | - Kent N. Bachus
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Bimedical Engineering, University of Utah, Salt Lake City, Utah, United States of America
- U.S. Department of Veterans Affairs, Salt Lake City, Utah, United States of America
| | - Heath B. Henninger
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Bimedical Engineering, University of Utah, Salt Lake City, Utah, United States of America
- Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, United States of America
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Taylor CE, Drew AJ, Zhang Y, Qiu Y, Bachus KN, Foreman KB, Henninger HB. Upper extremity prosthetic selection influences loading of transhumeral osseointegrated systems. PLoS One 2020; 15:e0237179. [PMID: 32760149 PMCID: PMC7410272 DOI: 10.1371/journal.pone.0237179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/21/2020] [Indexed: 11/19/2022] Open
Abstract
Percutaneous osseointegrated (OI) implants are increasingly viable as an alternative to socket suspension of prosthetic limbs. Upper extremity prostheses have also become more complex to better replicate hand and arm function and attempt to recreate pre-amputation functional levels. With more functionality comes heavier devices that put more stress on the bone-implant interface, which could be an issue for implant stability. This study quantified transhumeral loading at defined amputation levels using four simulated prosthetic limb-types: (1) body powered hook, (2) myoelectric hook, (3) myoelectric hand, and (4) advanced prosthetic limb. Computational models were constructed to replicate the weight distribution of each prosthesis type, then applied to motion capture data collected during Advanced Activities of Daily Living (AADLs). For activities that did not include a handheld weight, the body powered prosthesis bending moments were 13–33% (range of means for each activity across amputation levels) of the intact arm moments (reference 100%), torsional moments were 12–15%, and axial pullout forces were 30–40% of the intact case (p≤0.001). The myoelectric hook and hand bending moments were 60–99%, torsional moments were 44–97%, and axial pullout forces were 62–101% of the intact case. The advanced prosthesis bending moments were 177–201%, torsional moments were 164–326%, and axial pullout forces were 133–185% of the intact case (p≤0.001). The addition of a handheld weight for briefcase carry and jug lift activities reduced the overall impact of the prosthetic model itself, where the body powered forces and moments were much closer to those of the intact model, and more complex prostheses further increased forces and moments beyond the intact arm levels. These results reveal a ranked order in loading magnitude according to complexity of the prosthetic device, and highlight the importance of considering the patient’s desired terminal device when planning post-operative percutaneous OI rehabilitation and training.
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Affiliation(s)
- Carolyn E. Taylor
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, United States of America
| | - Alex J. Drew
- DJO Surgical, Austin, Texas, United States of America
| | - Yue Zhang
- Department of Epidemiology, University of Utah, Salt Lake City, Utah, United States of America
| | - Yuqing Qiu
- Department of Epidemiology, University of Utah, Salt Lake City, Utah, United States of America
| | - Kent N. Bachus
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, United States of America
- Department of Veterans Affairs, University of Utah, Salt Lake City, Utah, United States of America
| | - K. Bo Foreman
- Department of Veterans Affairs, University of Utah, Salt Lake City, Utah, United States of America
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, United States of America
| | - Heath B. Henninger
- Department of Orthopaedics, University of Utah, Salt Lake City, Utah, United States of America
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, United States of America
- * E-mail:
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Hériveaux Y, Audoin B, Biateau C, Nguyen VH, Haïat G. Ultrasonic Propagation in a Dental Implant. Ultrasound Med Biol 2020; 46:1464-1473. [PMID: 32139153 DOI: 10.1016/j.ultrasmedbio.2020.01.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 12/23/2019] [Accepted: 01/23/2020] [Indexed: 06/10/2023]
Abstract
Ultrasound techniques can be used to characterize and stimulate dental implant osseointegration. However, the interaction between an ultrasonic wave and the implant-bone interface (IBI) remains unclear. This study-combining experimental and numerical approaches-investigates the propagation of an ultrasonic wave in a dental implant by assessing the amplitude of the displacements along the implant axis. An ultrasonic transducer was excited in a transient regime at 10 MHz. Laser interferometric techniques were employed to measure the amplitude of the displacements, which varied 3.2-8.9 nm along the implant axis. The results demonstrated the propagation of a guided wave mode along the implant axis. The velocity of the first arriving signal was equal to 2110 m.s-1, with frequency components lower than 1 MHz, in agreement with numerical results. Investigating guided wave propagation in dental implants should contribute to improved methods for the characterization and stimulation of the IBI.
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Affiliation(s)
- Yoann Hériveaux
- CNRS, Laboratoire Modélisation et Simulation Multi-Échelle, Créteil, France
| | - Bertrand Audoin
- CNRS, Institut de Mécanique et d'Ingénierie, Talence, France
| | | | - Vu-Hieu Nguyen
- Université Paris-Est, Laboratoire Modélisation et Simulation Multi-Échelle, Créteil, France
| | - Guillaume Haïat
- CNRS, Laboratoire Modélisation et Simulation Multi-Échelle, Créteil, France
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Hériveaux Y, Haïat G, Nguyen VH. Reflection of an ultrasonic wave on the bone-implant interface: Comparison of two-dimensional and three-dimensional numerical models. J Acoust Soc Am 2020; 147:EL32. [PMID: 32007013 DOI: 10.1121/10.0000500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/14/2019] [Indexed: 06/10/2023]
Abstract
Quantitative ultrasound is used to characterize osseointegration at the bone-implant interface (BII). However, the interaction between an ultrasonic wave and the implant remains poorly understood. Hériveaux, Nguyen, and Haiat [(2018). J. Acoust. Soc. Am. 144, 488-499] recently employed a two-dimensional (2D) model of a rough BII to investigate the sensitivity of the ultrasonic response to osseointegration. The present letter aimed at assessing the validity of the 2D assumption. The values of the reflection coefficient of the BII obtained with two and three-dimensional models were found not to be significantly different for implant roughness lower than 20 μm. 2D modeling is sufficient to describe the interaction between ultrasound and the BII.
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Affiliation(s)
- Yoann Hériveaux
- Centre National de la Recherche Scientifique, Laboratoire Modélisation et Simulation Multi Echelle, Unité Mixte de Recherche 8208 CNRS, 61 avenue du Général de Gaulle, 94010 Créteil Cedex, France
| | - Guillaume Haïat
- Centre National de la Recherche Scientifique, Laboratoire Modélisation et Simulation Multi Echelle, Unité Mixte de Recherche 8208 CNRS, 61 avenue du Général de Gaulle, 94010 Créteil Cedex, France
| | - Vu-Hieu Nguyen
- Université Paris-Est, Laboratoire Modélisation et Simulation Multi Echelle, Unité Mixte de Recherche 8208 CNRS, 61 avenue du Général de Gaulle, 94010 Créteil Cedex, , ,
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Saruta J, Sato N, Ishijima M, Okubo T, Hirota M, Ogawa T. Disproportionate Effect of Sub-Micron Topography on Osteoconductive Capability of Titanium. Int J Mol Sci 2019; 20:ijms20164027. [PMID: 31426563 PMCID: PMC6720784 DOI: 10.3390/ijms20164027] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/16/2019] [Accepted: 08/17/2019] [Indexed: 12/14/2022] Open
Abstract
Titanium micro-scale topography offers excellent osteoconductivity and bone-implant integration. However, the biological effects of sub-micron topography are unknown. We compared osteoblastic phenotypes and in vivo bone and implant integration abilities between titanium surfaces with micro- (1-5 µm) and sub-micro-scale (0.1-0.5 µm) compartmental structures and machined titanium. The calculated average roughness was 12.5 ± 0.65, 123 ± 6.15, and 24 ± 1.2 nm for machined, micro-rough, and sub-micro-rough surfaces, respectively. In culture studies using bone marrow-derived osteoblasts, the micro-rough surface showed the lowest proliferation and fewest cells attaching during the initial stage. Calcium deposition and expression of osteoblastic genes were highest on the sub-micro-rough surface. The bone-implant integration in the Sprague-Dawley male rat femur model was the strongest on the micro-rough surface. Thus, the biological effects of titanium surfaces are not necessarily proportional to the degree of roughness in osteoblastic cultures or in vivo. Sub-micro-rough titanium ameliorates the disadvantage of micro-rough titanium by restoring cell attachment and proliferation. However, bone integration and the ability to retain cells are compromised due to its lower interfacial mechanical locking. This is the first report on sub-micron topography on a titanium surface promoting osteoblast function with minimal osseointegration.
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Affiliation(s)
- Juri Saruta
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA.
| | - Nobuaki Sato
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Manabu Ishijima
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Takahisa Okubo
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Makoto Hirota
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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Thiem DG, Adam M, Ganz C, Gerber T, Kämmerer PW. The implant surface and its role in affecting the dynamic processes of bone remodeling by means of distance osteogenesis: A comparative in vivo study. Int J Oral Maxillofac Implants 2018; 34:133–140. [PMID: 30282092 DOI: 10.11607/jomi.6729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study aimed to evaluate whether different surface modifications affect the dynamics of bone remodeling at the implant and the adjacent local bone. MATERIALS AND METHODS Seventy-two dental implants with different surfaces (smooth and rough control [smCtrl; rCtrl], smooth and rough + O2-plasma spray [smPlas; rPlas], smooth and rough + nanocrystalline SiO2-hydroxyapatite coating [ncSiO2HA] + O2-plasma spray [smNB-C; rNB-C]; each n = 12) were bilaterally inserted into the femora of 36 New Zealand white rabbits. Intravital fluorochrome labeling was performed to visualize the dynamics of bone formation. The objectives were quantification of bone-to-implant contact (BIC [%]) at 2 and 4 weeks and the dynamic bone formation (dbf [%]) at the implants' adjacent local bone within 1, 2, and 3 weeks. RESULTS After 2 weeks, BIC was significantly higher for both smNB-C (BIC: 59% ± 2% SEM) and rNB-C (BIC: 66% ± 3% SEM) compared with controls (BIC: 42% ± 1% SEM; P < .005). After 4 weeks, BIC for rNB-C (65% ± 2%) was superior to all test groups (BIC: 39% ± 2% SEM; P = .012). Regarding dbf (%), neither within 1 (P = .88), 2 (P = .48), nor after 3 weeks (P = .36) did any differences occur among the groups, even in accordance to the implant level. CONCLUSION Although distance osteogenesis seems crucial for the development of secondary stability and thus of osseointegration, it apparently does not get affected by a bioactive ncSiO2HA surface coating. Changing the surfaces' release kinetics and composition may increase distance osteogenesis.
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Makino T, Kaito T, Sakai Y, Takenaka S, Yoshikawa H. Computed tomography color mapping for evaluation of bone ongrowth on the surface of a titanium-coated polyetheretherketone cage in vivo: A pilot study. Medicine (Baltimore) 2018; 97:e12379. [PMID: 30213002 PMCID: PMC6155981 DOI: 10.1097/md.0000000000012379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Bone ongrowth on the surfaces of titanium (Ti)-coated polyetheretherketone (PEEK) materials has been demonstrated in animal models; however, whether this occurs on the surfaces of Ti-coated PEEK cages in lumbar interbody fusion has not been demonstrated clinically in vivo. This prospective observational study was aimed to develop and validate a computed tomography (CT) color mapping based on Hounsfield unit (HU) values for evaluation of bone ongrowth on the surfaces of the Ti-coated PEEK cage after posterior lumbar interbody fusion (PLIF).Twenty-four consecutive patients (11 men and 13 women; mean age, 67.0 years; range, 20-82 years) who underwent single- or 2-level PLIF since March 2015 were included. Two Ti-coated PEEK cages were inserted in all PLIF segments. From reconstructed sagittal planes from postoperative CT scans (within 1 week and 6 months postoperatively), bone ongrowth on the surfaces of cage frames was evaluated by CT color mapping. Inter- and intraobserver reliability of the assessment of bone ongrowth by CT color mapping was evaluated by Cohen's kappa coefficient. The relation between CT color mapping and HU values on the surfaces of cage frames was also analyzed.A total of 248 surfaces of cage frames were evaluated. Bone ongrowth was observed in 134 of 248 surfaces (54.0%) by CT color mapping. Intraobserver reliability for the evaluation of bone ongrowth was kappa = 0.831, and interobserver reliability was kappa = 0.713. The HU values in the local regions of interest (ROIs) on the surfaces of cage frames where the postoperative bone ongrowth existed on CT color mapping increased significantly postoperatively (P < .001), and the median postoperative change rate of the HU values in the local ROIs was 22.4%.The assessment of bone ongrowth on the surfaces of Ti-coated PEEK cages by CT color mapping had adequate inter- and intraobserver reliability, which was useful especially in detecting local increase in HU values on the surfaces of the cages. This method is an easy and visually comprehensible method for the assessment of bone ongrowth in the bone-implant interface.
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Affiliation(s)
- Takahiro Makino
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Abstract
In lamellar bone, a network of highly oriented interconnected osteocytes is organized in concentric layers. Through their cellular processes contained within canaliculi, osteocytes are highly mechanosensitive and locally modulate bone remodeling. We review the recent developments demonstrating the significance of the osteocyte lacuno-canalicular network in bone maintenance around implant biomaterials. Drilling during implant site preparation triggers osteocyte apoptosis, the magnitude of which correlates with drilling speed and heat generation, resulting in extensive remodeling and delayed healing. In peri-implant bone, osteocytes physically communicate with implant surfaces via canaliculi and are responsive to mechanical loading, leading to changes in osteocyte numbers and morphology. Certain implant design features allow peri-implant osteocytes to retain a less aged phenotype, despite highly advanced extracellular matrix maturation. Physicochemical properties of anodically oxidized surfaces stimulate bone formation and remodeling by regulating the expression of RANKL (receptor activator of nuclear factor-κB ligand), RANK, and OPG (osteoprotegerin) from implant-adherent cells. Modulation of certain osteocyte-related molecular signaling mechanisms (e.g., sclerostin blockade) may enhance the biomechanical anchorage of implants. Evaluation of the peri-implant osteocyte lacuno-canalicular network should therefore be a necessary component in future investigations of osseointegration to more completely characterize the biological response to materials for load-bearing applications in dentistry and orthopedics.
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Affiliation(s)
- F A Shah
- 1 Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - P Thomsen
- 1 Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - A Palmquist
- 1 Department of Biomaterials, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Andreasi Bassi M, Arosio P, Di Stefano DA. Evaluation of Peri-implant Bone Stress on D1 Bone Using a Computerized Torque-Measuring Implant Motor: A Study on Photoelastic Resin Blocks. Int J Oral Maxillofac Implants 2018; 33:770–778. [PMID: 29894547 DOI: 10.11607/jomi.6079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Recently, a torque-measuring micromotor that calculates the integral (I) of torque-depth curve at implant insertion was developed. This device was used to investigate the correlation between (I) and mechanical stress in photoelastic resin blocks with the density of D1 bone. MATERIALS AND METHODS Using the micromotor, 40 implants (3.75 × 12 mm) were placed in 40 D1 blocks that had been prepared in four different ways. Four groups of 10 blocks each were prepared according to tunnel length (12 or 14 mm) and debris removal (yes or no). After insertion, peri-implant mechanical stress and its correlation with (I) were assessed by photoelastic and linear regression analysis, respectively. Analysis of variance (ANOVA) and Kruskal-Wallis tests investigated differences in mechanical stress patterns and dynamic parameters among the groups. RESULTS (I) significantly correlated with mechanical stress in D1 resin under all conditions, except for 12-mm implant sites still containing debris. The correlation was significant concerning the whole dataset (r = 0.979) and separately for the coronal (r = 0.940), middle (r = 0.964), and apical (r = 0.948) portions of the implants. Peak torque did not correlate significantly with peri-implant mechanical stress. Longer implant sites and debris removal were significantly associated with lower peri-implant mechanical stress. CONCLUSION (I) provides a reliable measure of mechanical stress in D1 bone during implant placement. Preparation of longer osteotomies and routine removal of all debris might reduce peri-implant bone stress significantly.
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Abstract
Osseointegrated implants are frequently used in reconstructive surgery, both in the dental and orthopedic field, restoring physical function and improving the quality of life for the patients. The bone anchorage is typically evaluated at micrometer resolution, while bone tissue is a dynamic composite material composed of nanoscale collagen fibrils and apatite crystals, with defined hierarchical levels at different length scales. In order to understand the bone formation and the ultrastructure of the interfacial tissue, analytical strategies needs to be implemented enabling multiscale and multimodal analyses of the intact interface. This paper describes a sample preparation route for successive analyses allowing assessment of the different hierarchical levels of interest, going from macro to nano scale and could be implemented on single samples. Examples of resulting analyses of different techniques on one type of implant surface is given, with emphasis on correlating the length scale between the different techniques. The bone-implant interface shows an intimate contact between mineralized collagen bundles and the outermost surface of the oxide layer, while bone mineral is found in the nanoscale surface features creating a functionally graded interface. Osteocytes exhibit a direct contact with the implant surface via canaliculi that house their dendritic processes. Blood vessels are frequently found in close proximity to the implant surface either within the mineralized bone matrix or at regions of remodeling.
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Affiliation(s)
- Anders Palmquist
- Department of Biomaterials, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden.
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Abstract
PURPOSE This study evaluated the effect of drilling speed on early bone healing in the mandible of dogs. MATERIAL AND METHODS Six dogs were selected, and mandibular premolars and molars were extracted. After 2 months, 3 hydroxyapatite-surfaced fixtures were implanted with drilling speeds of 50, 800, and 1200 rpm on the right side first and then on the left side after 2 weeks. Implant stability quotient (ISQ) was measured on insertion, after 2 and 4 weeks. RESULTS Based on the ISQ measurement, the 1200-rpm group showed a higher value than the 50-rpm group at 2 weeks and 4 weeks (P < 0.05). New bone formation around the implant was highest for the 800-rpm group at 2 weeks and the 1200-rpm group at 4 weeks. The bone-implant contact of the superior half of the alveolar bone was highest for the 800-rpm group at 2 weeks and the 1200-rpm group at 4 weeks. There was no statistically significant difference. CONCLUSION This study suggests that 50, 800, and 1200 rpm are drilling speeds which can expect favorable outcome, yet, higher drilling speed presented overall the best biological responses.
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Affiliation(s)
- Dong-Uk Seo
- Graduate Student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Su-Gwan Kim
- Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea
| | - Ji-Su Oh
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Korea
| | - Sung-Chul Lim
- Professor, Department of Pathology, School of Medicine, Chosun University, Gwangju, Korea
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Jeyapalina S, Beck JP, Agarwal J, Bachus KN. A 24-month evaluation of a percutaneous osseointegrated limb-skin interface in an ovine amputation model. J Mater Sci Mater Med 2017; 28:179. [PMID: 28980174 DOI: 10.1007/s10856-017-5980-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 09/01/2017] [Indexed: 06/07/2023]
Abstract
Percutaneous osseointegrated (OI) prostheses directly connect an artificial limb to the residual appendicular skeleton via a permanently implanted endoprosthesis with a bridging connector that protrudes through the skin. The resulting stoma produces unique medical and biological challenges. Previously, a study using a large animal amputation model indicated that infection could be largely prevented, for at least a 12-month period, but the terminal epithelium continued to downgrow. The current study was undertaken to test the longer-term efficacy of this implant construct to maintain a stable skin-implant interface for 24 months. Using the previously successful amputation and implantation surgical procedure, a total of eight sheep were fitted with a percutaneous OI prosthesis. Two animals were removed from the study due to early complications. Of the remaining six sheep, one (16.7%) became infected at 15-months post-implantation and five remained infection-free for the intended 24 months. The histological data of the remaining animals further confirmed the grossly observable epithelial downgrowth. Albeit a receding interface, it was clear that all animals that survived to the end of the study had residual fibrous soft-tissue ingrowth into, and debris within, the exposed titanium porous-coated surface. Overall, the data demonstrated that the porous coated subdermal barrier offered initial protection against infection. However, the fibrous skin attachment was continuously lysed over time by the down-growing epithelium.
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Affiliation(s)
- Sujee Jeyapalina
- Orthopaedic Research Laboratories, University of Utah Orthopaedic Center and Department of Veterans Affairs Medical Center, Salt Lake City, UT, 84108, USA
- Department of Surgery, Division of Plastic Surgery, University of Utah, Salt Lake City, UT, 84112, USA
| | - James Peter Beck
- Orthopaedic Research Laboratories, University of Utah Orthopaedic Center and Department of Veterans Affairs Medical Center, Salt Lake City, UT, 84108, USA
| | - Jayant Agarwal
- Department of Surgery, Division of Plastic Surgery, University of Utah, Salt Lake City, UT, 84112, USA
| | - Kent N Bachus
- Orthopaedic Research Laboratories, University of Utah Orthopaedic Center and Department of Veterans Affairs Medical Center, Salt Lake City, UT, 84108, USA.
- Department of Bioengineering, University of Utah, Salt Lake City, UT, 84112, USA.
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Lawton JM, Habib M, Ma B, Brooks RA, Best SM, Lewis AL, Rushton N, Bonfield W. The effect of cationically-modified phosphorylcholine polymers on human osteoblasts in vitro and their effect on bone formation in vivo. J Mater Sci Mater Med 2017; 28:144. [PMID: 28819908 PMCID: PMC5561156 DOI: 10.1007/s10856-017-5958-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 08/03/2017] [Indexed: 06/07/2023]
Abstract
The effect of introducing cationic charge into phosphorylcholine (PC)-based polymers has been investigated in this study with a view to using these materials as coatings to improve bone formation and osseointegration at the bone-implant interface. PC-based polymers, which have been used in a variety of medical devices to improve biocompatibility, are associated with low protein adsorption resulting in reduced complement activation, inflammatory response and cell adhesion. However, in some applications, such as orthopaedics, good integration between the implant and bone is needed to allow the distribution of loading stresses and a bioactive response is required. It has previously been shown that the incorporation of cationic charge into PC-based polymers may increase protein adsorption that stimulates subsequent cell adhesion. In this paper, the effect of cationic charge in PC-based polymers on human osteoblasts (HObs) in vitro and the effect of these polymers on bone formation in the rat tibia was assessed. Increasing PC positive surface charge increased HOb cell adhesion and stimulated increased cell differentiation and the production of calcium phosphate deposits. However, when implanted in bone these materials were at best biotolerant, stimulating the production of fibrous tissue and areas of loosely associated matrix (LAM) around the implant. Their development, as formulated in this study, as bone interfacing implant coatings is therefore not warranted.
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Affiliation(s)
- Jonathan M Lawton
- Department of Materials Science and Metallurgy, Cambridge Centre for Medical Materials, University of Cambridge, New Museum Site, Cambridge, CB2 3QZ, UK
| | - Mariam Habib
- Department of Materials Science and Metallurgy, Cambridge Centre for Medical Materials, University of Cambridge, New Museum Site, Cambridge, CB2 3QZ, UK
| | - Bingkui Ma
- Orthopaedic Research Unit, University of Cambridge, Addenbrookes Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Roger A Brooks
- Orthopaedic Research Unit, University of Cambridge, Addenbrookes Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - Serena M Best
- Department of Materials Science and Metallurgy, Cambridge Centre for Medical Materials, University of Cambridge, New Museum Site, Cambridge, CB2 3QZ, UK
| | - Andrew L Lewis
- Biocompatibles UK Ltd, Chapman House, Farnham Business Park, Weydon Lane, Farnham, Surrey, GU9 8QL, UK.
| | - Neil Rushton
- Orthopaedic Research Unit, University of Cambridge, Addenbrookes Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - William Bonfield
- Department of Materials Science and Metallurgy, Cambridge Centre for Medical Materials, University of Cambridge, New Museum Site, Cambridge, CB2 3QZ, UK
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Romanos GE. Biomolecular Cell-Signaling Mechanisms and Dental Implants: A Review on the Regulatory Molecular Biologic Patterns Under Functional and Immediate Loading. Int J Oral Maxillofac Implants 2017; 31:939-51. [PMID: 27447163 DOI: 10.11607/jomi.4384] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Bone tissue adapts its structure and mass to the stresses of mechanical loading. The purpose of this review article was to summarize recent advances on cell signaling relating to the phenomenon of bone remodeling, focused on bone ossification and healing at the interface of dental implants and bone under loading conditions. MATERIALS AND METHODS When a dental implant is placed within an osteotomy, osteocytes, osteoblasts, and osteoclasts are all present. As functional loads are imposed, the remodeling processes adapt the peri-implant bony tissues to mechanical stimuli over time and reestablish a steady state. Based on the current literature, this article demonstrates fundamental information to these remodeling processes, such as the conversion of mechanical cues to electrical or biochemical signals. RESULTS Multiple intracellular signals are involved in cellular mechanotransduction; the two Wnt signaling pathways (the canonical, β-catenin-dependent and the noncanonical, β-catenin-independent Wnt pathway) are particularly significant. Knowledge of how these molecular signaling pathways are translated into intracellular signals that regulate cell behavior may provide new therapeutic approaches to enhancing osteogenesis, especially around implants with immediate function or placed in areas of poor bone quality. New knowledge about the primary cilia as an organelle and bone cellular mechanosensor is critical for endochondral ossification and proper signal transduction. Other mechanisms, such as the expression of sclerostin as a negative regulator of bone formation (due to deactivation of the Wnt receptor) and downregulation of sclerostin under loading conditions, also present new understanding of the cellular and pericellular mechanics of bone. CONCLUSION The complexity of the cell signaling pathways and the mechanisms involved in the mechanoregulation of the bone formation provide new technologies and perspectives for mechanically induced cellular response. Future novel therapeutic approaches based on the cell signaling pathways may improve and stimulate osseointegration of dental implants and accelerate the healing mechanisms.
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Klingvall Ek R, Hong J, Thor A, Bäckström M, Rännar LE. Micro- to Macroroughness of Additively Manufactured Titanium Implants in Terms of Coagulation and Contact Activation. Int J Oral Maxillofac Implants 2017; 32:565-574. [PMID: 28494040 DOI: 10.11607/jomi.5357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study aimed to evaluate how as-built electron beam melting (EBM) surface properties affect the onset of blood coagulation. The properties of EBM-manufactured implant surfaces for placement have, until now, remained largely unexplored in literature. Implants with conventional designs and custom-made implants have been manufactured using EBM technology and later placed into the human body. Many of the conventional implants used today, such as dental implants, display modified surfaces to optimize bone ingrowth, whereas custom-made implants, by and large, have machined surfaces. However, titanium in itself demonstrates good material properties for the purpose of bone ingrowth. MATERIALS AND METHODS Specimens manufactured using EBM were selected according to their surface roughness and process parameters. EBM-produced specimens, conventional machined titanium surfaces, as well as PVC surfaces for control were evaluated using the slide chamber model. RESULTS A significant increase in activation was found, in all factors evaluated, between the machined samples and EBM-manufactured samples. The results show that EBM-manufactured implants with as-built surfaces augment the thrombogenic properties. CONCLUSION EBM that uses Ti6Al4V powder appears to be a good manufacturing solution for load-bearing implants with bone anchorage. The as-built surfaces can be used "as is" for direct bone contact, although any surface treatment available for conventional implants can be performed on EBM-manufactured implants with a conventional design.
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Zhang J, Shirai M, Yamamoto R, Yamakoshi Y, Oida S, Ohkubo C, Zeng J. Effect of Nerve Growth Factor on Osseointegration of Titanium Implants in Type 2 Diabetic Rats. Int J Oral Maxillofac Implants 2017; 31:1189-94. [PMID: 27632277 DOI: 10.11607/jomi.4455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Compared with the general population, a poorer quality of bone-implant osseointegration occurs and at a higher failure rate in patients with type 2 diabetes mellitus. The aim of this study was to analyze the effects of local injection of nerve growth factor at the bone-implant interface after implantation in type 2 diabetic rats. MATERIALS AND METHODS Goto-Kakizaki (GK) rats (n = 30) were used as a model of type 2 diabetes mellitus, and Wistar rats were used as a control (n = 15). GK rats were assigned randomly into two groups (n = 15/group): the diabetes mellitus group (saline only) and the nerve growth factor group (received nerve growth factor treatment). One titanium implant was placed in each rat's left tibia. Immediately postoperatively, nerve growth factor group rats were injected with nerve growth factor (0.4 μg/day) intramuscularly around the implant, daily for 7 days. Diabetes mellitus and control group rats received normal saline in an identical manner. Rats were sacrificed at 2, 4, and 8 weeks following implant surgery. RESULTS Traditional light and confocal laser scanning microscopy were used on nondecalcified sections to investigate fluorochrome labeling changes and histologic features of bone adjoining the implants. Bone-to-implant contact and bone volume percentage in the diabetes mellitus group were significantly less than in the control and nerve growth factor groups, with no statistically significant differences between the control and nerve growth factor groups. Confocal laser scanning microscopy showed a significant increase in marked bone around the nerve growth factor group implant at 4 weeks (P < .01) and 8 weeks (P < .05) compared with the diabetes mellitus group. CONCLUSION This study showed that local injection of nerve growth factor could improve implant-bone osseointegration in diabetic rats and may have important clinical implications.
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Kwon TK, Kim HY, Yang JH, Wikesjö UM, Lee J, Koo KT, Yeo IS. First-Order Mathematical Correlation Between Damping and Resonance Frequency Evaluating the Bone-Implant Interface. Int J Oral Maxillofac Implants 2017; 31:1008-15. [PMID: 27632254 DOI: 10.11607/jomi.4468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Various advanced technologies have been designed to estimate dental implant stability, including insertion torque, implant damping using the Periotest, and resonance frequency analysis expressed in implant stability quotient units. This study aimed to establish the relationship between the estimates for these three techniques. MATERIALS AND METHODS Bovine cortical bone blocks were trimmed to square shapes of precisely controlled thickness and density. Thereafter, 4-mm-diameter × 10-mm-long implants were placed in the bone blocks using 30-, 45-, and 60-Ncm insertion torques. Implant damping and resonance frequency analysis were conducted at four angles for each implant. Spearman correlation coefficients were calculated to examine the relationship between insertion torque, resonance frequency analysis, and implant damping measured values. RESULTS Resonance frequency analysis and implant damping estimates exhibited a strong inverse correlation (r = -0.98, P < .001). A linear equation was formulated: Periotest value = 15.54 + (-0.26 × implant stability quotient). Implant damping and resonance frequency estimates revealed a weak correlation with insertion torque (P < .05). CONCLUSION This study mathematically defined a linear correlation between implant damping and resonance frequency estimates, thereby providing a guide for clinicians when deciding the loading time for dental implants using the implant damping or resonance frequency estimates.
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Babbush CA, Kanawati A, Kotsakis GA. Marginal Bone Stability Around Tapered, Platform-Shifted Implants Placed with an Immediately Loaded Four-Implant-Supported Fixed Prosthetic Concept: A Cohort Study. Int J Oral Maxillofac Implants 2017; 31:643-50. [PMID: 27183073 DOI: 10.11607/jomi.4354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To longitudinally evaluate marginal bone remodeling around tapered, platform-shifted implants placed for total arch rehabilitation with fixed hybrid prostheses. MATERIALS AND METHODS A retrospective cohort study was designed that evaluated radiographic data from patients undergoing implant surgical procedures with an immediately loaded four-implant-supported fixed prosthetic concept in a single clinic setting during a 36-month period. The primary outcome variable was the change in marginal bone levels during a 12- to 36-month follow-up postloading with the definitive prosthesis. All measurements were performed on matched and calibrated periapical radiographs obtained at: (1) the time of placement of the definitive prosthesis (baseline) versus (2) 12 to 36 months following definitive loading (follow-up). Other study variables, including duration of follow-up, implant position, maximum insertion torque, implant angulation, and implant diameter, were assessed for their association with changes in marginal bone levels. RESULTS One hundred sixty-nine patients (n = 856 implants) with a mean age of 59.5 ± 10.5 years were included in this study. Two implants failed, resulting in a 99.8% overall survival rate (mean follow-up: 15.2 ± 4.8 months, range: 12 to 36 months). The radiographic mean bone levels at baseline and follow-up were 1.16 ± 0.71 mm (n = 805) and 1.31 ± 0.93 mm (n = 805), respectively. The mean marginal bone loss from baseline to follow-up was 0.14 ± 0.59 mm (n = 805). The duration of follow-up had no effect on the extent of marginal bone loss (P = .154). CONCLUSION Within the limitations of this large-scale retrospective cohort study, it was concluded that the use of tapered, platform-shifted implants for total arch rehabilitation with the use of the All-on-Four protocol yields very favorable radiographic outcomes, at least after a minimum of 12 months in function.
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Hirota M, Ikeda T, Tabuchi M, Ozawa T, Tohnai I, Ogawa T. Effects of Ultraviolet Photofunctionalization on Bone Augmentation and Integration Capabilities of Titanium Mesh and Implants. Int J Oral Maxillofac Implants 2017; 32:52-62. [PMID: 28095515 DOI: 10.11607/jomi.4891] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Ultraviolet (UV)-mediated photofunctionalization has earned considerable attention for the enhancement of the biologic capabilities of titanium. The effects of photofunctionalization on bone augmentation and gap closure were examined using titanium implants and mesh in a rat femur model. MATERIALS AND METHODS An acid-etched titanium implant (4-mm length, 1-mm diameter) was placed in the gluteal tuberosity that resembles a knife-edge-like edentulous ridge. The lower half of the implant was located in a 2-mm-diameter defect created in the bone without cortical bone support; the upper half was exposed and covered with a titanium mesh to provide augmentation space. After 12 and 24 days of healing, specimens were subjected to microcomputed tomography (micro-CT)- and histology-based bone morphometry in three zones of analysis: augmentation, cortical bone-implant gap, and bone marrow. A biomechanical push-in test was performed to examine the strength of bone-implant integration. Photofunctionalization was performed by treating titanium implants and mesh with UV light for 12 minutes. RESULTS Photofunctionalized titanium mesh and implants were hydrophilic, whereas untreated controls were hydrophobic. Bone volume was significantly greater in photofunctionalized implants and mesh than in untreated implants in all zones on days 12 and 24. Bone-to-implant contact of photofunctionalized implants was greater than that of untreated implants, not just in the bone marrow but also in the gap and augmented zones. The strength of osseointegration was three times greater for photofunctionalized implants than for untreated implants. CONCLUSION Use of photofunctionalized titanium mesh and implants effectively enhanced vertical bone augmentation, cortical bone-implant gap closure, and osseointegration without innate bone support.
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Tsouknidas A, Giannopoulos D, Savvakis S, Michailidis N, Lympoudi E, Fytanidis D, Pissiotis A, Michalakis K. The Influence of Bone Quality on the Biomechanical Behavior of a Tooth-Implant Fixed Partial Denture: A Three-Dimensional Finite Element Analysis. Int J Oral Maxillofac Implants 2016; 31:e143-e154. [PMID: 27861651 DOI: 10.11607/jomi.5254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate whether or not bone quality has an effect on the biomechanical behavior of a tooth connected to an implant, when a rigid and a nonrigid attachment are used. MATERIALS AND METHODS Models of fixed partial dentures supported by a tooth and an implant were developed. These models were then imported into finite element analysis software to study the impact of forces on different types of attachments (rigid vs nonrigid) and bones (types 1 to 4). Each fixed partial denture was subjected to a vertical load of 200 N on the premolars and 230 N on the molar. The materials were considered linear, isotropic, and homogenous. Eight different scenarios were tested. The von Mises criterion was used to display the stress in five structures: fastening screw, implant, attachment, cortical, and trabecular bone. The displacements of the tooth and the implant were also examined. RESULTS The calculated maximum observed stress values differed among the simulated scenarios. The biggest values of stress concentrations were observed at the lingual cervical areas, the implant-cortical bone interface, the implant-crown interface, the butt-joint contact of the implant-abutment screw, and the apical parts of the tooth and implant. The main difference between the rigid and nonrigid connection was observed between the natural tooth retainer and the pontic. In the rigid connection, the movement of the natural tooth retainer was smooth. In the nonrigid connection, the attachment exhibited a partial buccal displacement. Von Mises stresses among the different tested structures ranged between 24 and 840 MPa. CONCLUSION The quality of the bone and the rigidity of the connection between a natural tooth and an implant influence both the generated stresses and the displacement of the tooth and the implant. The highest stresses for the implant-trabecular bone interface, the neck of the implant, and the fastening screw were observed in type 3 bone when a rigid connection was used. The lowest stresses for the implant-cortical bone interface, the neck of the implant, and the connector were registered in type 1 bone, when a rigid connection was used. The smallest tooth and implant displacement was observed in type 1 bone, when a rigid connection was used, while the biggest tooth and implant displacement was registered in type 4 bone when a nonrigid connection was used.
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Schiper L, Faintuch BL, da Silva Badaró RJ, de Oliveira EA, Chavez VEA, Chinen E, Faintuch J. Functional investigation of bone implant viability using radiotracers in a new model of osteonecrosis. Clinics (Sao Paulo) 2016; 71:617-625. [PMID: 27759852 PMCID: PMC5059423 DOI: 10.6061/clinics/2016(10)11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 07/27/2016] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES: Conventional imaging methods are excellent for the morphological characterization of the consequences of osteonecrosis; however, only specialized techniques have been considered useful for obtaining functional information. To explore the affinity of radiotracers for severely devascularized bone, a new mouse model of isolated femur implanted in a subcutaneous abdominal pocket was devised. To maintain animal mobility and longevity, the femur was harvested from syngeneic donors. Two technetium-99m-labeled tracers targeting angiogenesis and bone matrix were selected. METHODS: Medronic acid and a homodimer peptide conjugated with RGDfK were radiolabeled with technetium-99m, and biodistribution was evaluated in Swiss mice. The grafted and control femurs were evaluated after 15, 30 and 60 days, including computed tomography (CT) and histological analysis. RESULTS: Radiolabeling achieved high (>95%) radiochemical purity. The biodistribution confirmed good blood clearance 1 hour after administration. For 99mTc-hydrazinonicotinic acid (HYNIC)-E-[c(RGDfK)2, remarkable renal excretion was observed compared to 99mTc-methylene diphosphonate (MDP), but the latter, as expected, revealed higher bone uptake. The results obtained in the control femur were equal at all time points. In the implanted femur, 99mTc-HYNIC-E-[c(RGDfK)2 uptake was highest after 15 days, consistent with early angiogenesis. Regarding 99mTc-MDP in the implant, similar uptake was documented at all time points, consistent with sustained bone viability; however, the uptake was lower than that detected in the control femur, as confirmed by histology. CONCLUSIONS: 1) Graft viability was successfully diagnosed using radiotracers in severely ischemic bone at all time points. 2) Analogously, indirect information about angiogenesis could be gathered using 999mTc-HYNIC-E-[c(RGDfK)2. 3) These techniques appear promising and warrant further studies to determine their potential clinical applications.
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Affiliation(s)
- Luis Schiper
- Universidade Federal da Bahia, Faculdade de Medicina, Departamento de Ortopedia, Bahia/BA, Brazil
| | | | | | | | - Victor E. Arana Chavez
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Biomateriais e Biologia Oral, São Paulo/SP, Brazil
| | - Elisangela Chinen
- Universidade de São Paulo, Faculdade de Odontologia, Departamento de Biomateriais e Biologia Oral, São Paulo/SP, Brazil
| | - Joel Faintuch
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Divisão de Cirurgia Gastrointestinal, São Paulo/SP, Brazil
- E-mail:
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de Andrade CL, Carvalho MA, Del Bel Cury AA, Sotto-Maior BS. Biomechanical Effect of Prosthetic Connection and Implant Body Shape in Low-Quality Bone of Maxillary Posterior Single Implant-Supported Restorations. Int J Oral Maxillofac Implants 2016; 31:e92-7. [PMID: 27447166 DOI: 10.11607/jomi.4133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Dental implant macrogeometry parameters, such as the prosthetic connection and implant body shape, can influence the biomechanical behavior of the restoration. Using tridimensional finite element analysis (3D-FEA), this study evaluated the biomechanical behavior of two implant macrodesign parameters (prosthetic connection and implant body shape) in low-quality bone. MATERIALS AND METHODS Four groups were obtained by the combination of external hexagon and Morse taper connections, and cylindrical and conical body shapes. Implants (4ø × 10-mm) with a microthread collar and triangular thread shape received a single abutment and monolithic zirconia crown on the maxillary first molar. Bone was constructed on the basis of cross-sectional images of the posterior human maxilla obtained by cone beam computed tomography. A 200-N axial loading was distributed on five points of the occlusal surface. Data were acquired as shear stress (τmax, in megapascals) and strain (εmax, in micrometers) in the cortical and trabecular bone. RESULTS The external hexagon groups generated higher shear stress/strain values compared with Morse taper groups in the cortical bone, regardless of implant body shape. In the trabecular bone, the highest τmax and εmax values were observed in the Morse taper conical implant group (6.94 MPa and 21.926 × 10⁻⁴ μm, respectively), and the lowest values were observed in the external hexagon cylindrical implant group (4.47 MPa and 9.3155 × 10⁻⁴ μm, respectively). CONCLUSION The magnitudes of shear stress and strain in the peri-implant region of low-quality bone was lower with the use of Morse taper connection and cylindrical implants compared with external hexagon connection and conical implants.
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Abstract
Titanium implants can fail due to inappropriate biomechanics at the bone-implant interface that leads to suboptimal osseointegration. Titania nanotubes (TNTs) fabricated on Ti implants by the electrochemical process have emerged as a promising modification strategy to facilitate osseointegration. TNTs enable augmentation of bone cell functions at the bone-implant interface and can be tailored to incorporate multiple functionalities including the loading of active biomolecules into the nanotubes to target anabolic processes in bone conditions such as osteoporotic fractures. Advanced functions can be introduced, including biopolymers, nanoparticles and electrical stimulation to release growth factors in a desired manner. This review describes the application of TNTs for enhancing osteogenesis at the bone-implant interface, as an alternative approach to systemic delivery of therapeutic agents.
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Affiliation(s)
- Karan Gulati
- School of Chemical Engineering, University of Adelaide, SA, Australia
| | - Shaheer Maher
- School of Chemical Engineering, University of Adelaide, SA, Australia
- Faculty of Pharmacy, Assiut University, Assiut, 71526, Egypt
| | - David M Findlay
- Discipline of Orthopaedics & Trauma, University of Adelaide, SA, Australia
| | - Dusan Losic
- School of Chemical Engineering, University of Adelaide, SA, Australia
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van Eekeren P, Said C, Tahmaseb A, Wismeijer D. Resonance Frequency Analysis of Thermal Acid-Etched, Hydrophilic Implants During First 3 Months of Healing and Osseointegration in an Early-Loading Protocol. Int J Oral Maxillofac Implants 2016; 30:843-50. [PMID: 26252037 DOI: 10.11607/jomi.3985] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Safe loading of dental implants requires an optimal osseointegration. This osseointegration process during healing could be analyzed by resonance frequency analysis (RFA). The purpose of the study was to evaluate RFA changes during healing in splinted, early-loaded, thermal acid-etched, hydrophilic implants over time. MATERIALS AND METHODS Patients received a minimum of two implants: an implant with the prosthetic abutment connection at the crestal bone level (bone level) and one with the prosthetic abutment connection at a 2.5-mm supracrestal site (tissue level). Implant stability was measured at weeks 0, 2, 3, and 12 using the Osstell device. RESULTS Seventy-six implants were placed in 32 patients. By week 2, early-loaded tissue-level implants showed a significant drop in mean ± standard deviation (SD) implant stability quotient (ISQ) values of 2.2 ± 3.6 (P < .001). Changes in ISQ values were significant between weeks 3 and 12 and also between weeks 0 and 12, with mean differences of 4.2 (P < .001) and 2.8 (P < .001), respectively. Early-loaded bone-level implants show a significant change in ISQ of 2.3 ± 3.7 at week 2 (P < .01) and -1.3 ± 4.7 at week 12 when compared to an ISQ value of 2.9 ± 4.9 at week 3 (P < .01). Bone-level implants achieved higher ISQ values compared with tissue-level implants at weeks 0, 2, 3, and 12, with mean differences being 3.8 ± 5.5 (P < .01), 3.8 ± 6.1 (P < .01), 3.7 ± 6.7 (P < .01), and 2.3 ± 5.8 (P < .05), respectively. CONCLUSION This study found a significant dip in ISQ values, with the lowest point seen at week 2. ISQ values remained higher in bone-level implants throughout the process of healing and osseointegration.
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Blanquer A, Hynowska A, Nogués C, Ibáñez E, Sort J, Baró MD, Özkale B, Pané S, Pellicer E, Barrios L. Effect of Surface Modifications of Ti40Zr10Cu38Pd12 Bulk Metallic Glass and Ti-6Al-4V Alloy on Human Osteoblasts In Vitro Biocompatibility. PLoS One 2016; 11:e0156644. [PMID: 27243628 PMCID: PMC4887090 DOI: 10.1371/journal.pone.0156644] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/17/2016] [Indexed: 01/03/2023] Open
Abstract
The use of biocompatible materials, including bulk metallic glasses (BMGs), for tissue regeneration and transplantation is increasing. The good mechanical and corrosion properties of Ti40Zr10Cu38Pd12 BMG and its previously described biocompatibility makes it a potential candidate for medical applications. However, it is known that surface properties like topography might play an important role in regulating cell adhesion, proliferation and differentiation. Thus, in the present study, Ti40Zr10Cu38Pd12 BMG and Ti6-Al-4V alloy were surface-modified electrochemically (nanomesh) or physically (microscratched) to investigate the effect of material topography on human osteoblasts cells (Saos-2) adhesion, proliferation and differentiation. For comparative purposes, the effect of mirror-like polished surfaces was also studied. Electrochemical treatments led to a highly interconnected hierarchical porous structure rich in oxides, which have been described to improve corrosion resistance, whereas microscratched surfaces showed a groove pattern with parallel trenches. Cell viability was higher than 96% for the three topographies tested and for both alloy compositions. In all cases, cells were able to adhere, proliferate and differentiate on the alloys, hence indicating that surface topography plays a minor role on these processes, although a clear cell orientation was observed on microscratched surfaces. Overall, our results provide further evidence that Ti40Zr10Cu38Pd12 BMG is an excellent candidate, in the present two topographies, for bone repair purposes.
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Affiliation(s)
- Andreu Blanquer
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
| | - Anna Hynowska
- Departament de Física, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
| | - Carme Nogués
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
| | - Elena Ibáñez
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
| | - Jordi Sort
- Departament de Física, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Maria Dolors Baró
- Departament de Física, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
| | - Berna Özkale
- Multi-Scale Robotics Lab, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
| | - Salvador Pané
- Multi-Scale Robotics Lab, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland
| | - Eva Pellicer
- Departament de Física, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
- * E-mail: (LB); (EP)
| | - Leonardo Barrios
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, Edifici Cc, Bellaterra, Spain
- * E-mail: (LB); (EP)
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Chang YY, Kim SH, Park KO, Yun JH. Evaluation of a Reverse-Tapered Design on the Osseointegration of Narrow-Diameter Implants in Beagle Dogs: A Pilot Study. Int J Oral Maxillofac Implants 2016; 31:611-20. [PMID: 27183070 DOI: 10.11607/jomi.4260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate a reverse-tapered design on the osseointegration of narrow-diameter implants in comparison with a conventional tapered design in beagle dogs. MATERIALS AND METHODS All mandibular premolars and first molars were extracted bilaterally in four beagle dogs. Three months later, three kinds of implants were placed in both quadrants of the mandible: tapered narrow-diameter implants processed by cold working (TNC; n = 8), reverse-tapered narrow-diameter implants (RTN; n = 8), and reverse-tapered narrow-diameter implants processed by cold working (RTNC; n = 8). The animals were sacrificed at 4 weeks. Implant stability quotient (ISQ) values were measured at the time of implant placement and sacrifice. Histomorphometric analysis was performed. RESULTS The baseline ISQ values were significantly lower in the RTN (56.0 ± 11.6) and RTNC (57.2 ± 9.8) than in the TNC (68.0 ± 5.4; P = .021). At 4 weeks, the TNC (69.9 ± 5.1) exhibited significantly higher ISQ values compared with the RTNC (61.6 ± 4.1; P = .024). Histologic analysis in the RTN and RTNC revealed osseointegration without any signs of inflammation; however, unresolved coronal gap or dehiscence was also observed. The total bone-to-implant contact ratios (BIC) in TNC, RTN, and RTNC were 55.1% ± 11.5%, 47.8% ± 19.1%, and 60.2% ± 15.3%, respectively, and no significant differences were shown among them. The BIC for the coronal part in each group was 51.1% ± 29.4%, 28.8% ± 33.8%, and 23.9% ± 23.3%, respectively, and the differences were not significant. In the threaded part, TNC, RTN, and RTNC showed a BIC of 56.3% ± 9.6%, 50.7% ± 18.3%, and 65.3% ± 15.6%, respectively. There was no significant difference among them. CONCLUSION The reverse-tapered design on narrow-diameter implants showed a lower initial stability than the conventional tapered design; however, there was equivalent osseointegration in an early healing phase.
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Cakan U, Cakan M, Delilbasi C. Evaluation of Heat Transfer to the Implant-Bone Interface During Removal of Metal Copings Cemented onto Titanium Abutments. INT J PROSTHODONT 2016; 29:290-2. [PMID: 27148993 DOI: 10.11607/ijp.4561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this investigation was to measure the temperature increase due to heat transferred to the implant-bone interface when the abutment screw channel is accessed or a metal-ceramic crown is sectioned buccally with diamond or tungsten carbide bur using an air rotor, with or without irrigation. MATERIALS AND METHODS Cobalt-chromium copings were cemented onto straight titanium abutments. The temperature changes during removal of the copings were recorded over a period of 1 minute. RESULTS The sectioning of coping with diamond bur and without water irrigation generated the highest temperature change at the cervical part of the implant. CONCLUSION Both crown removal methods resulted in an increase in temperature at the implant-bone interface. However, this temperature change did not exceed 47°C, the potentially damaging threshold for bone reported in the literature.
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Mosavar A, Ziaei A, Kadkhodaei M. The Effect of Implant Thread Design on Stress Distribution in Anisotropic Bone with Different Osseointegration Conditions: A Finite Element Analysis. Int J Oral Maxillofac Implants 2015; 30:1317-26. [PMID: 26478976 DOI: 10.11607/jomi.4091] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Borie E, Orsi IA, Noritomi PY, Kemmoku DT. Three-Dimensional Finite Element Analysis of the Biomechanical Behaviors of Implants with Different Connections, Lengths, and Diameters Placed in the Maxillary Anterior Region. Int J Oral Maxillofac Implants 2015; 31:101-10. [PMID: 26478969 DOI: 10.11607/jomi.4120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate the biomechanical behaviors of multiple implant-supported prostheses with different implant lengths, connections, locations, and restoration materials in the maxillary anterior region using three-dimensional finite element analysis. MATERIALS AND METHODS A finite element model of a maxillary image was created from a tomography data bank. The simulations were executed in two types of models based on the treatment plan: (1) two implants with 4.0-mm diameters placed in the maxillary central incisors to simulate an implant-supported fixed prosthesis with four elements with a cantilever of both maxillary lateral incisors; (2) two implants with 3.75-mm diameters placed in the maxillary lateral incisors to simulate a conventional fixed prosthesis with four elements with pontics for maxillary central incisors. Subsequently, the models created were subdivided into eight subgroups according to implant length, connection type, and restoration material. A total static oblique load of 150 N was applied to the cingulum area of the palatal surfaces of the four incisors at an angle of 45 degrees to the long axis of the implant in the palatal-labial direction. Bone stresses were analyzed through maximum and minimum principal stresses and ductile material as implant, framework, and abutments were analyzed using von Mises stress criterion. RESULTS Regardless of implant diameter and type of treatment, the 8.5-mm-long implants exhibited the lowest tensile and compressive stresses. Maximum and minimum principal stresses were identified in the cortical bone. The lowest von Mises equivalent stress values were identified in the metal-ceramic prostheses, with the exception of the cantilever prosthesis model with flat top connection. Conical cone implant models exhibited maximum von Mises equivalent stress in contact with the abutment. CONCLUSION The lowest principal stresses in the peri-implant bone were observed in implants with conical cone connection and 8.5 mm in length. Also, in most cases, the models with metal-ceramic restorations exhibited better stress distributions.
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Abstract
BACKGROUND Regardless of the multiple options of connections, diameters and heights for dental implants, the clinician should know the biomechanical behavior of the bone to plan the treatment according to the biological and anatomical conditions of each patient, without risk to the long-term treatment success. REVIEW The following review attempts to summarize the relevant literature to establish guidelines for clinicians based on the scientific evidence regarding the influence by the implant's connection, diameter and length on the bone biomechanics. CONCLUSIONS The length, diameter and connection of each implant have a degree of influence in bone biomechanics. Despite the influence of different implant connections, diameters and lengths on peri-implant bone stress and strain, these characteristics should remain within the physiological limits to avoid a pathological overload, bone resorption and consequent risk to the long-term success of implant-prosthetic treatment.
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Affiliation(s)
- Eduardo Borie
- CIMOFIR Research Centre, Dental School, Universidad de La Frontera , Temuco , Chile
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Yamazaki M, Yamada M, Ishizaki K, Sakurai K. Ultraviolet-C irradiation to titanium implants increases peri-implant bone formation without impeding mineralization in a rabbit femur model. Acta Odontol Scand 2015; 73:302-11. [PMID: 25645878 DOI: 10.3109/00016357.2014.956332] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Volume and bone quality of peri-implant supporting bone, in particular, at implant neck region, as well as bone-implant contact ratio, is important for long-term stability of implants. Ultraviolet-C (UVC) irradiation is known to enhance the osseointegration capability of titanium implants. However, the histological determination was performed only on a rat model, but not pre-clinical animal model such as a rabbit model. The purpose of this study was to determine the effects of UVC irradiation on titanium implants on the volume and mineral density of peri-implant supporting bone formation in a rabbit femur model. MATERIALS AND METHODS Acid-etched pure titanium screw implants with or without 3 mW/cm2 UVC irradiation for 48 h were placed in rabbit femur diaphyses. Peri-implant bone tissue formation was analyzed at 3 and 8 weeks post-operatively by histology and micro-CT-based bone morphometry after calibration with hydroxyl apatite phantoms. RESULTS UVC pre-irradiated implants accumulated a higher density of cells and thicker and longer bone tissue attachments that continued into the inner basic lamellae of the surface of existing cortical bone at 3 and 8 weeks than the implants without irradiation. Although the bone mineral density around both implants was equivalent to that of the existing cortical bone, bone volume was greater with UVC pre-irradiation in two-thirds or more of the apical region throughout the observation period. CONCLUSIONS These results indicate that UVC treatment increased the volume of cortical-like bone tissue in the coronal region of titanium implants without deterioration of bone mineral density.
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Oliveira DP, Palmieri A, Carinci F, Bolfarini C. Gene expression of human osteoblasts cells on chemically treated surfaces of Ti-6Al-4V-ELI. Mater Sci Eng C Mater Biol Appl 2015; 51:248-55. [PMID: 25842132 DOI: 10.1016/j.msec.2015.03.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 02/13/2015] [Accepted: 03/09/2015] [Indexed: 11/17/2022]
Abstract
Surface modifications of titanium alloys are useful methods to enhance the biological stability of intraosseous implants and to promote a well succeeded osseointegration in the early stages of implantation. This work aims to investigate the influence of chemically modified surfaces of Ti-6Al-4V-ELI (extra-low interstitial) on the gene expression of human osteoblastic (HOb) cells. The surface treatments by acid etching or acid etching plus alkaline treatment were carried out to modify the topography, effective area, contact angle and chemical composition of the samples. The surface morphology was investigated using: scanning electron microscopy (SEM) and confocal laser-scanning microscope (CLSM). Roughness measurements and effective surface area were obtained using the CLSM. Surface composition was analysed by energy dispersive X-ray spectroscopy (EDX) and by X-Ray Diffraction (XRD). The expression levels of some bone related genes (ALPL, COL1A1, COL3A1, SPP1, RUNX2, and SPARC) were analysed using real-time Reverse Transcription Polymerase Chain Reaction (real-time RT-PCR). The results showed that all the chemical modifications studied in this work influenced the surface morphology, wettability, roughness, effective area and gene expression of human osteoblasts. Acid phosphoric combined to alkaline treatment presented a more accelerated gene expression after 7days while the only phosphoric etching or chloride etching combined to alkaline treatment presented more effective responses after 15days.
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Affiliation(s)
- D P Oliveira
- Department of Materials Engineering, Federal University of São Carlos, São Carlos, Brazil.
| | - A Palmieri
- Department of D.M.C.C.C., Section of Maxillofacial and Plastic Surgery, University of Ferrara, Ferrara, Italy
| | - F Carinci
- Department of D.M.C.C.C., Section of Maxillofacial and Plastic Surgery, University of Ferrara, Ferrara, Italy
| | - C Bolfarini
- Department of Materials Engineering, Federal University of São Carlos, São Carlos, Brazil
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35
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Abstract
The structural and functional union of the implant with living bone is greatly influenced by the surface properties of the implant. The success of a dental implant depends on the chemical, physical, mechanical, and topographic characteristics of its surface. The influence of surface topography on osseointegration has translated to shorter healing times from implant placement to restoration. This article presents a discussion of surface characteristics and design of implants, which should allow the clinician to better understand osseointegration and information coming from implant manufacturers, allowing for better implant selection.
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Affiliation(s)
- Orrett E Ogle
- Mona Dental Program, Faculty of Medical Sciences, University of the West Indies, Mona Campus, Kingston, Jamaica; The Brooklyn Hospital Center, Brooklyn, NY 11201, USA; Oral and Maxillofacial Surgery, Woodhull Hospital, Brooklyn, NY 11206, USA.
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