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  1. Dental Implants.

    PubMed

    Zohrabian, Vahe M; Sonick, Michael; Hwang, Debby; Abrahams, James J

    2015-10-01

    Dental implants restore function to near normal in partially or completely edentulous patients. A root-form implant is the most frequently used type of dental implant today. The basis for dental implants is osseointegration, in which osteoblasts grow and directly integrate with the surface of titanium posts surgically embedded into the jaw. Radiologic assessment is critical in the preoperative evaluation of the dental implant patient, as the exact height, width, and contour of the alveolar ridge must be determined. Moreover, the precise locations of the maxillary sinuses and mandibular canals, as well as their relationships to the site of implant surgery must be ascertained. As such, radiologists must be familiar with implant design and surgical placement, as well as augmentation procedures utilized in those patients with insufficient bone in the maxilla and mandible to support dental implants.

  2. Dental Implant Surgery

    MedlinePlus

    Dental implant surgery Overview By Mayo Clinic Staff Dental implant surgery is a procedure that replaces tooth roots with ... look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures ...

  3. Dental Implant Systems

    PubMed Central

    Oshida, Yoshiki; Tuna, Elif B.; Aktören, Oya; Gençay, Koray

    2010-01-01

    Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s) in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities. PMID:20480036

  4. Smoking and dental implants

    PubMed Central

    Kasat, V.; Ladda, R.

    2012-01-01

    Smoking is a prevalent behaviour in the population. The aim of this review is to bring to light the effects of smoking on dental implants. These facts will assist dental professionals when implants are planned in tobacco users. A search of “PubMed” was made with the key words “dental implant,” “nicotine,” “smoking,” “tobacco,” and “osseointegration.” Also, publications on tobacco control by the Government of India were considered. For review, only those articles published from 1988 onward in English language were selected. Smoking has its influence on general as well as oral health of an individual. Tobacco negatively affects the outcome of almost all therapeutic procedures performed in the oral cavity. The failure rate of implant osseointegration is considerably higher among smokers, and maintenance of oral hygiene around the implants and the risk of peri-implantitis are adversely affected by smoking. To increase implant survival in smokers, various protocols have been recommended. Although osseointegrated dental implants have become the state of the art for tooth replacement, they are not without limitations or complications. In this litigious era, it is extremely important that the practitioner clearly understands and is able and willing to convey the spectrum of possible complications and their frequency to the patients. PMID:24478965

  5. Nanotechnology for dental implants.

    PubMed

    Tomsia, Antoni P; Lee, Janice S; Wegst, Ulrike G K; Saiz, Eduardo

    2013-01-01

    With the advent of nanotechnology, an opportunity exists for the engineering of new dental implant materials. Metallic dental implants have been successfully used for decades, but they have shortcomings related to osseointegration and mechanical properties that do not match those of bone. Absent the development of an entirely new class of materials, faster osseointegration of currently available dental implants can be accomplished by various surface modifications. To date, there is no consensus regarding the preferred method(s) of implant surface modification, and further development will be required before the ideal implant surface can be created, let alone become available for clinical use. Current approaches can generally be categorized into three areas: ceramic coatings, surface functionalization, and patterning on the micro- to nanoscale. The distinctions among these are imprecise, as some or all of these approaches can be combined to improve in vivo implant performance. These surface improvements have resulted in durable implants with a high percentage of success and long-term function. Nanotechnology has provided another set of opportunities for the manipulation of implant surfaces in its capacity to mimic the surface topography formed by extracellular matrix components of natural tissue. The possibilities introduced by nanotechnology now permit the tailoring of implant chemistry and structure with an unprecedented degree of control. For the first time, tools are available that can be used to manipulate the physicochemical environment and monitor key cellular events at the molecular level. These new tools and capabilities will result in faster bone formation, reduced healing time, and rapid recovery to function.

  6. Current trends in dental implants

    PubMed Central

    Gaviria, Laura; Salcido, John Paul; Guda, Teja

    2014-01-01

    Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants. PMID:24868501

  7. A simplified impression technique for dental implants.

    PubMed

    Vogel, Robert E

    2002-03-01

    Dental implants have been considered an acceptable form of dental treatment since the early 1980s. A number of studies have been published describing impression techniques for dental implants. Many of the techniques described are so complex that they may seem daunting to the average restorative dentist. Most general practitioners do not wish to attempt to restore dental implants. This article describes a very simple, yet extremely accurate, technique for making impressions of dental implant fixtures.

  8. Simplifying fixed implant dental prosthetics.

    PubMed

    Tischler, Michael

    2011-01-01

    Through following the FPPD protocol for multiple adjacent implants, and delivering final abutments, picking up the metal framework, and delivering provisionals, many benefits are gained. The benefits of following the FPPD protocol are as follows: The restorative dentist is trying-in and delivering the final abutments in one visit as opposed to removing them and placing them multiple times. This requires less chair time and time for the patient. It also reduces the mechanical stress on the abutment screw and implant body due to the elimination of multiple try-in appointments. When the metal framework is tried-in and verified for fit, the restorative dentist has the opportunity check the retention, check the margins, and make any corrections that might be needed. The abutments will be staying in the mouth when the framework is picked up. This metal try-in allows for a verification of the bite to be given to the dental lab. The delivery of provisionals manufactured by the dental laboratory offers many advantages in the FPPD technique. The patient has a form of tooth much earlier in the traditional appointment sequence. The patient can now offer feedback to the doctor and laboratory for fabrication of the permanent prosthesis with regards to shape and color. The laboratory-fabricated provisionals offer progressive loading to the implants through having a reduced occlusion yet allowing food to stimulate the implants. Overall, the FPPD technique offers shorter appointment times, more rapid delivery of fixed supported teeth, improved doctor-technician communication, and less mechanical wear on the implant parts.

  9. Patients awareness and attitude towards dental implants

    PubMed Central

    Kohli, Shivani; Bhatia, Shekhar; Kaur, Arvinder; Rathakrishnan, Tiviya

    2015-01-01

    Aims: The aim of the study was to assess the awareness of the patients regarding implant-retained prosthesis as an option for tooth replacement and the knowledge about tooth replacement as a whole including source of information and attitude towards it amongst Malaysian population. Materials and Methods: Information on demographic characteristics, knowledge about implant as an option for missing tooth replacement, source of information and knowledge about other options of tooth replacement were obtained from patients visiting various dental outpatient departments of hospital and private dental clinics using nationwide self-explanatory survey. Results: Amongst the 1013 response retrieved, 27% of respondents felt moderately well informed about the dental implant treatment. Only 9% of the respondents had dental implant treatment before and 17% felt well informed about different alternatives of replacing missing teeth. The dentists were the main source of information regarding dental implant treatment modality followed by friends and electronic media. 55.6% respondents felt implant to be as good as own teeth during function whereas high cost was the major limiting factor for implant treatment. Conclusion: 56% of Malaysian population was aware of dental implant as an alternative for replacing missing teeth. Necessary efforts and measures should be made to raise the awareness of dental implant treatment in the country. PMID:26752875

  10. Techniques for dental implant nanosurface modifications

    PubMed Central

    Bathala, Lakshmana Rao; Sangur, Rajashekar

    2014-01-01

    PURPOSE Dental implant has gained clinical success over last decade with the major drawback related to osseointegration as properties of metal (Titanium) are different from human bone. Currently implant procedures include endosseous type of dental implants with nanoscale surface characteristics. The objective of this review article is to summarize the role of nanotopography on titanium dental implant surfaces in order to improve osseointegration and various techniques that can generate nanoscale topographic features to titanium implants. MATERIALS AND METHODS A systematic electronic search of English language peer reviewed dental literature was performed for articles published between December 1987 to January 2012. Search was conducted in Medline, PubMed and Google scholar supplemented by hand searching of selected journals. 101 articles were assigned to full text analysis. Articles were selected according to inclusion and exclusion criterion. All articles were screened according to inclusion standard. 39 articles were included in the analysis. RESULTS Out of 39 studies, seven studies demonstrated that bone implant contact increases with increase in surface roughness. Five studies showed comparative evaluation of techniques producing microtopography and nanotopography. Eight studies concluded that osteoblasts preferably adhere to nano structure as compared to smooth surface. Six studies illustrated that nanotopography modify implant surface and their properties. Thirteen studies described techniques to produce nano roughness. CONCLUSION Modification of dental osseous implants at nanoscale level produced by various techniques can alter biological responses that may improve osseointegration and dental implant procedures. PMID:25558347

  11. Choice of a dental implant system.

    PubMed

    Hunt, Peter R; Gartner, Judith L; Norkin, Frederic J

    2005-04-01

    Many dentists are bewildered by the intricacies and complexities of dental implants. They are constantly besieged by product advertisements and can find it difficult to choose which systems to work with. Some dentists are so intimidated by the subject that they choose to avoid getting involved with implants and instead stick to traditional tooth replacement systems. By breaking implants down into 4 main components, the body, collar, connection, and restorative post, it is easier to understand the structure and function of dental implants. Each portion should be designed to achieve certain objectives. Once these structural components are understood, it is easier to compare and contrast differing implant systems.

  12. Bone manipulation procedures in dental implants

    PubMed Central

    Mittal, Yuvika; Jindal, Govind; Garg, Sandeep

    2016-01-01

    The use of dental implants for the rehabilitation of missing teeth has broadened the treatment options for patients and clinicians equally. As a result of advances in research in implant design, materials, and techniques, the use of dental implants has increased dramatically in the past two decades and is expected to expand further in the future. Success of dental implants depends largely on the quality and quantity of the available bone in the recipient site. This however may be compromised or unavailable due to tumor, trauma, periodontal disease, etc., which in turn necessitates the need for additional bone manipulation. This review outlines the various bone manipulation techniques that are used to achieve a predictable long-term success of dental implants. PMID:27433052

  13. Diagnostic imaging for dental implant therapy.

    PubMed

    Nagarajan, Aishwarya; Perumalsamy, Rajapriya; Thyagarajan, Ramakrishnan; Namasivayam, Ambalavanan

    2014-01-01

    Dental implant is a device made of alloplastic (foreign) material implanted into the jaw bone beneath the mucosal layer to support a fixed or removable dental prosthesis. Dental implants are gaining immense popularity and wide acceptance because they not only replace lost teeth but also provide permanent restorations that do not interfere with oral function or speech or compromise the self-esteem of a patient. Appropriate treatment planning for replacement of lost teeth is required and imaging plays a pivotal role to ensure a satisfactory outcome. The development of pre-surgical imaging techniques and surgical templates helps the dentist place the implants with relative ease. This article focuses on various types of imaging modalities that have a pivotal role in implant therapy.

  14. Bacteremia following dental implant surgery: Preliminary results

    PubMed Central

    Özdemir, Tayfun; Öksüz, Lütfiye; Gürler, Nezahat

    2012-01-01

    Objectives: The aims of this study were to investigate the incidence of bacteremia, bacteriology and antibiotic susceptibility against to causative bacteria associated with dental implant installation. Study Design: 30 generally healthy patients were enrolled in this study. Blood samples were collected at baseline and at 30 minutes after dental implant installation and 24 hours after dental implant surgery. Blood samples were cultured in a BACTEC system. The isolated bacteria were identified using conventional methods. Antimicrobial sensitivity tests were performed by disc diffusion. Results: No bacteria were isolated at the baseline and 24 hours after surgery, whereas the prevalence of bacteremia at 30 minutes after dental implant installation was 23%. The isolated bacteria species were Staphylococcus epidermidis, Eubacterium spp., Corynebacterium spp. and Streptococcus viridans. The Staphylococcus epidermidis, which was isolated in three patients, was found to be resistant to penicillin which is first choice of many clinicians. Conclusion: Our findings suggest that installation of dental implants can produce bacteremia. Within the limitations of this study, it can be speculated that the resistance of antibiotics may compromise the routine prophylaxis against infective endocarditis. Therefore use of blood cultures and antibiograms may be suggested in risky patients. The outcome of the present study should be verified using a larger patient group with varying conditions. Key words: Dental implant, bacteremia, infective endocarditis, antibiotic prophylaxis. PMID:22157668

  15. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  16. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  17. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  18. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic component directly connected to the endosseous dental implant and is intended for use as an aid in...

  19. 21 CFR 872.3980 - Endosseous dental implant accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endosseous dental implant accessories. 872.3980... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3980 Endosseous dental implant accessories. (a) Identification. Endosseous dental implant accessories are manually powered devices...

  20. 21 CFR 872.3640 - Endosseous dental implant.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endosseous dental implant. 872.3640 Section 872...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3640 Endosseous dental implant. (a) Identification. An endosseous dental implant is a device made of a material such as titanium or titanium alloy,...

  1. 21 CFR 872.3630 - Endosseous dental implant abutment.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endosseous dental implant abutment. 872.3630... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3630 Endosseous dental implant abutment. (a) Identification. An endosseous dental implant abutment is a premanufactured prosthetic...

  2. Dental implants in patients with bruxing habits.

    PubMed

    Lobbezoo, F; Brouwers, J E I G; Cune, M S; Naeije, M

    2006-02-01

    Bruxism (teeth grinding and clenching) is generally considered a contraindication for dental implants, although the evidence for this is usually based on clinical experience only. So far, studies to the possible cause-and-effect relationship between bruxism and implant failure do not yield consistent and specific outcomes. This is partly because of the large variation in the literature in terms of both the technical aspects and the biological aspects of the study material. Although there is still no proof for the suggestion that bruxism causes an overload of dental implants and of their suprastructures, a careful approach is recommended. There are a few practical guidelines as to minimize the chance of implant failure. Besides the recommendation to reduce or eliminate bruxism itself, these guidelines concern the number and dimensions of the implants, the design of the occlusion and articulation patterns, and the protection of the final result with a hard occlusal stabilization splint (night guard).

  3. 21 CFR 872.3640 - Endosseous dental implant.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically... II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous...

  4. 21 CFR 872.3640 - Endosseous dental implant.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...) Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically... II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous...

  5. 21 CFR 872.3640 - Endosseous dental implant.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Classification. (1) Class II (special controls). The device is classified as class II if it is a root-form endosseous dental implant. The root-form endosseous dental implant is characterized by four geometrically... II Special Controls Guidance Document: Root-Form Endosseous Dental Implants and Endosseous...

  6. Interim Prosthesis Options for Dental Implants.

    PubMed

    Siadat, Hakimeh; Alikhasi, Marzieh; Beyabanaki, Elaheh

    2016-01-24

    Dental implants have become a popular treatment modality for replacing missing teeth. In this regard, the importance of restoring patients with function during the implant healing period has grown in recent decades. Esthetic concerns, especially in the anterior region of the maxilla, should also be considered until the definitive restoration is delivered. Another indication for such restorations is maintenance of the space required for esthetic and functional definitive restorations in cases where the implant site is surrounded by natural teeth. Numerous articles have described different types of interim prostheses and their fabrication techniques. This article aims to briefly discuss all types of implant-related interim prostheses by different classification including provisional timing (before implant placement, after implant placement in unloading and loading periods), materials, and techniques used for making the restorations, the type of interim prosthesis retention, and definitive restoration. Furthermore, the abutment torque for such restorations and methods for transferring the soft tissue from interim to definitive prostheses are addressed.

  7. Nanotechnology Approaches for Better Dental Implants

    PubMed Central

    Tomsia, Antoni P.; Launey, Maximilien E.; Lee, Janice S.; Mankani, Mahesh H.; Wegst, Ulrike G.K.; Saiz, Eduardo

    2011-01-01

    The combined requirements imposed by the enormous scale and overall complexity of designing new implants or complete organ regeneration are well beyond the reach of present technology in many dimensions, including nanoscale, as we do not yet have the basic knowledge required to achieve these goals. The need for a synthetic implant to address multiple physical and biological factors imposes tremendous constraints on the choice of suitable materials. There is a strong belief that nanoscale materials will produce a new generation of implant materials with high efficiency, low cost, and high volume. The nanoscale in materials processing is truly a new frontier. Metallic dental implants have been successfully used for decades but they have serious shortcomings related to their osseointegration and the fact that their mechanical properties do not match those of bone. This paper reviews recent advances in the fabrication of novel coatings and nanopatterning of dental implants. It also provides a general summary of the state of the art in dental implant science and describes possible advantages of nanotechnology for further improvements. The ultimate goal is to produce materials and therapies that will bring state-of-the-art technology to the bedside and improve quality of life and current standards of care. PMID:21464998

  8. Nanotechnology approaches to improve dental implants.

    PubMed

    Tomisa, Antoni P; Launey, Maximilien E; Lee, Janice S; Mankani, Mahesh H; Wegst, Ulrike G K; Saiz, Eduardo

    2011-01-01

    The requirements imposed by the enormous scale and overall complexity of designing new implants or complete organ regeneration are well beyond the reach of present technology in many dimensions, including nanoscale, as researchers do not yet have the basic knowledge required to achieve these goals. The need for a synthetic implant to address multiple physical and biologic factors imposes tremendous constraints on the choice of suitable materials. There is a strong belief that nanoscale materials will produce a new generation of implant materials with high efficiency, low cost, and high volume. The nanoscale in materials processing is truly a new frontier. Metallic dental implants have been used successfully for decades, but they have serious shortcomings related to their osseointegration and the fact that their mechanical properties do not match those of bone. This paper reviews recent advances in the fabrication of novel coatings and nanopatterning of dental implants. It also provides a general summary of the state of the art in dental implant science and describes possible advantages of nanotechnology for future improvements. The ultimate goal is to produce materials and therapies that will bring state-of-the-art technology to the bedside and improve quality of life and current standards of care.

  9. Tissue response: biomaterials, dental implants, and compromised osseous tissue.

    PubMed

    Babu RS, Arvind; Ogle, Orrett

    2015-04-01

    Tissue response represents an important feature in biocompatibility in implant procedures. This review article highlights the fundamental characteristics of tissue response after the implant procedure. This article also highlights the tissue response in compromised osseous conditions. Understanding the histologic events after dental implants in normal and abnormal bone reinforces the concept of case selection in dental implants.

  10. Short dental implants: a systematic review.

    PubMed

    Annibali, S; Cristalli, M P; Dell'Aquila, D; Bignozzi, I; La Monaca, G; Pilloni, A

    2012-01-01

    Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this review was to systematically evaluate clinical studies of implants < 10 mm in length, to determine short implant-supported prosthesis success in the atrophic jaw. Implant survival, incidence of biological and biomechanical complications, and radiographic peri-implant marginal bone loss were evaluated. Screening of eligible studies, quality assessment, and data extraction were conducted by two reviewers independently. Meta-analyses were performed by the pooling of survival data by implant surface, surgical technique, implant location, type of edentulism, and prosthetic restoration. Two randomized controlled trials and 14 observational studies were selected and analyzed for data extraction. In total, 6193 short-implants were investigated from 3848 participants. The observational period was 3.2 ± 1.7 yrs (mean ± SD). The cumulative survival rate (CSR) was 99.1% (95%CI: 98.8-99.4). The biological success rate was 98.8% (95%CI: 97.8-99.8), and the biomechanical success rate was 99.9% (95%CI: 99.4-100.0). A higher CSR was reported for rough-surfaced implants. The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

  11. Dental implants from functionally graded materials.

    PubMed

    Mehrali, Mehdi; Shirazi, Farid Seyed; Mehrali, Mohammad; Metselaar, Hendrik Simon Cornelis; Kadri, Nahrizul Adib Bin; Osman, Noor Azuan Abu

    2013-10-01

    Functionally graded material (FGM) is a heterogeneous composite material including a number of constituents that exhibit a compositional gradient from one surface of the material to the other subsequently, resulting in a material with continuously varying properties in the thickness direction. FGMs are gaining attention for biomedical applications, especially for implants, owing to their reported superior composition. Dental implants can be functionally graded to create an optimized mechanical behavior and achieve the intended biocompatibility and osseointegration improvement. This review presents a comprehensive summary of biomaterials and manufacturing techniques researchers employ throughout the world. Generally, FGM and FGM porous biomaterials are more difficult to fabricate than uniform or homogenous biomaterials. Therefore, our discussion is intended to give the readers about successful and obstacles fabrication of FGM and porous FGM in dental implants that will bring state-of-the-art technology to the bedside and develop quality of life and present standards of care.

  12. Cost-Effectiveness of Dental Implants: A Utility Analysis.

    ERIC Educational Resources Information Center

    Jacobson, J.; And Others

    1990-01-01

    A measure of dental patients' values and preferences was used to assess attitudes of 92 edentulous patients receiving implant and other dental reconstructive therapies. The implant group tended to be younger and better educated and to rate implant reconstruction as more desirable than the nonimplant denture group. (DB)

  13. Stress Analysis on the Bone Around Five Different Dental Implants

    DTIC Science & Technology

    2007-11-02

    University of Science and Technology, Tehran, IRAN Abstract- Implantology has a widespread application in dental cases these days. Although the life...System, in Mackinny RV: Endosteal Dental Implant, Mosby Year Book, 1991 [3] Weiss M, Titanium Fiber-Mesh Metal Implant, J. Oral Implantology , 1986...STRESS ANALYSIS ON THE BONE AROUND FIVE DIFFERENT DENTAL IMPLANTS S. M. Rajaai, S. Khorrami-mehr School of mechanical Engineering Iran

  14. Laser explantation of a failing endosseous dental implant.

    PubMed

    Smith, L P; Rose, T

    2010-06-01

    Explantation of failed dental implants has traditionally been performed by mechanical bone removal techniques. The advent of intraoral laser surgery has seen increasing numbers of applications in oral implantology. The technique demonstrates safe and efficient explantation of a failed dental implant using Er,Cr:YSGG laser. Laser assisted explantation of dental implants is a minimally invasive technique providing an alternative to conventional mechanical explantation techniques.

  15. PEEK dental implants: a review of the literature.

    PubMed

    Schwitalla, Andreas; Müller, Wolf-Dieter

    2013-12-01

    The insertion of dental implants containing titanium can be associated with various complications (eg, hypersensitivity to titanium). The aim of this article is to evaluate whether there are existing studies reporting on PEEK (polyetheretherketone) as an alternative material for dental implants. A systematic literature search of PubMed until December 2010 yielded 3 articles reporting on dental implants made from PEEK. One article analyzed stress distribution in carbon fiber-reinforced PEEK (CFR-PEEK) dental implants by the 3-dimensional finite element method, demonstrating higher stress peaks due to a reduced stiffness compared to titanium. Two articles reported on investigations in mongrel dogs. The first article compared CFR-PEEK to titanium-coated CFR-PEEK implants, which were inserted into the femurs and evaluated after 4 and 8 weeks. The titanium-coated implants showed significantly higher bone-implant contact (BIC) rates. In a second study, implants of pure PEEK were inserted into the mandibles beside implants made from titanium and zirconia and evaluated after 4 months, where PEEK presented the lowest BIC. The existing articles reporting on PEEK dental implants indicate that PEEK could represent a viable alternative material for dental implants. However, further experimental studies on the chemical modulation of PEEK seem to be necessary, mainly to increase the BIC ratio and to minimize the stress distribution to the peri-implant bone.

  16. Nondestructive methods to assess dental implant stability

    NASA Astrophysics Data System (ADS)

    Rizzo, Piervincenzo; Tabrizi, Aydin; Berhanu, Bruk; Ochs, Mark W.

    2012-04-01

    The robustness and reliability of two nondestructive evaluation methods to assess dental prostheses stability is presented. The study aims at addressing an increasing need in the biomedical area where robust, reliable, and noninvasive methods to assess the bone-interface of dental and orthopedic implants are increasingly demanded for clinical diagnosis and direct prognosis. The methods are based on the electromechanical impedance method and on the propagation of solitary waves. Nobel Biocare® 4.3 x 13 mm implants were entrenched inside bovine rib bones that were immersed inside Normal Saline for 24 hours before test in order to avoid dehydration and simulating physiologic osmolarity of the corticocancellous bone and plasma. Afterwards the bones were immersed in a solution of nitric acid to allow material degradation, inversely simulating a bone-healing process. This process was monitored by bonding a Piezoceramic Transducer (PZT) to the abutment and measuring the electrical admittance of the PZT over time. On the other hand the bones calcium loss was calculated after immersing in acid by Atomic Absorption Spectroscopy over time for comparison. Moreover a novel transducer based on the generation and detection of highly nonlinear solitary waves was used to assess the stiffness of the abutment-implant bone. In these experiments it was found that the PZT's conductance and some of the solitary waves parameters are sensitive to the degradation of the bones and was correlated to the bone calcium loss over time.

  17. Predoctoral dental implant education at King Abdulaziz University

    PubMed Central

    Aljohani, Hind Ahmed; AlGhamdi, Ali Saad Thafeed

    2009-01-01

    Objective In June 2008, a survey of freshly graduated dental students of King Abdulaziz University Jeddah was conducted to evaluate the extent of their exposure to oral implantology and their knowledge of some basic principles of dental implant treatment. Materials and methods Multiple-choice questionnaires were given to the fresh graduate dental students of King Abdulaziz University Jeddah to answer. Sixty-six students responded out of 86, yielding a response rate of 76.7%. Results Majority of the students (78.8%) thought that they did not have enough lectures about dental implants and all of them thought that they did not have enough training in dental implant. Most of the students were not familiar with different dental implant systems (61.1%), designs (60.6%) or sizes (74.2%). Majority of the students were lacking the knowledge about basic principles of dental implant treatment. At King Abdulaziz University, Faculty of Dentistry, implant dentistry is taught to the students in the form of implant-related lectures incorporated into their periodontic, oral surgery and prosthodontic courses with one or two lectures given on dental implant in each course. Conclusion There is an urgent need to develop a well-structured implant course that includes didactic, laboratory, preclinical and clinical components at the undergraduate curriculum of King Abdulaziz University Faculty of Dentistry. PMID:23960472

  18. [Extraction of 56 horizontally impacted teeth using dental implanter].

    PubMed

    Zhang, Yan-ping; Liang, Na

    2005-06-01

    50 cases, totally 56 horizontally impacted teeth were extracted using dental implanter to remove the alveolar bone. Another 56 horizontally impacted teeth were extracted using high speed turbine.It's concluded that is a safe and easy way using the dental implanter to remove the horizontally impacted teeth, and the reaction and the complications could be minimized.

  19. Subgingival microbiome in patients with healthy and ailing dental implants

    PubMed Central

    Zheng, Hui; Xu, Lixin; Wang, Zicheng; Li, Lianshuo; Zhang, Jieni; Zhang, Qian; Chen, Ting; Lin, Jiuxiang; Chen, Feng

    2015-01-01

    Dental implants are commonly used to replace missing teeth. However, the dysbiotic polymicrobial communities of peri-implant sites are responsible for peri-implant diseases, such as peri-implant mucositis and peri-implantitis. In this study, we analyzed the microbial characteristics of oral plaque from peri-implant pockets or sulci of healthy implants (n = 10), peri-implant mucositis (n = 8) and peri-implantitis (n = 6) sites using pyrosequencing of the 16S rRNA gene. An increase in microbial diversity was observed in subgingival sites of ailing implants, compared with healthy implants. Microbial co-occurrence analysis revealed that periodontal pathogens, such as Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia, were clustered into modules in the peri-implant mucositis network. Putative pathogens associated with peri-implantitis were present at a moderate relative abundance in peri-implant mucositis, suggesting that peri-implant mucositis an important early transitional phase during the development of peri-implantitis. Furthermore, the relative abundance of Eubacterium was increased at peri-implantitis locations, and co-occurrence analysis revealed that Eubacterium minutum was correlated with Prevotella intermedia in peri-implantitis sites, which suggests the association of Eubacterium with peri-implantitis. This study indicates that periodontal pathogens may play important roles in the shifting of healthy implant status to peri-implant disease. PMID:26077225

  20. Application of uniform design to improve dental implant system.

    PubMed

    Cheng, Yung-Chang; Lin, Deng-Huei; Jiang, Cho-Pei

    2015-01-01

    This paper introduces the application of uniform experimental design to improve dental implant systems subjected to dynamic loads. The dynamic micromotion of the Zimmer dental implant system is calculated and illustrated by explicit dynamic finite element analysis. Endogenous and exogenous factors influence the success rate of dental implant systems. Endogenous factors include: bone density, cortical bone thickness and osseointegration. Exogenous factors include: thread pitch, thread depth, diameter of implant neck and body size. A dental implant system with a crest module was selected to simulate micromotion distribution and stress behavior under dynamic loads using conventional and proposed methods. Finally, the design which caused minimum micromotion was chosen as the optimal design model. The micromotion of the improved model is 36.42 μm, with an improvement is 15.34% as compared to the original model.

  1. Exotic encounters with dental implants: managing complications with unidentified systems.

    PubMed

    Mattheos, N; Janda, M Schittek

    2012-06-01

    As the application of dental implants increases worldwide, so is the number of technical and biological complications that general dental practitioners will be called to manage, while maintaining implant patients. In addition, the greater patient mobility encountered today combined with a growing trend of 'dental implant tourism' will very often result in situations where the dentist is requested to deal with complications in implants placed elsewhere and which sometimes might be of an 'exotic' system one cannot directly recognize. Such a situation can pose significant challenges to even experienced clinicians. The challenges are not only in the scientific field, but often include professional and ethical implications. This case report will discuss strategies for the management of implant complications in cases of unidentified implant systems. Critical factors in such situations would be the clinician's experience and special training, the correct radiographic technique, as well as access to the appropriate tools and devices.

  2. Adherent endotoxin on dental implant surfaces: a reappraisal.

    PubMed

    Morra, Marco; Cassinelli, Clara; Bollati, Daniele; Cascardo, Giovanna; Bellanda, Marco

    2015-02-01

    Osteoimmunology is the crosstalk between cells from the immune and skeletal systems, suggesting a role of pro-inflammatory cytokines in the stimulation of osteoclast activity. Endotoxin or bacterial challenges to inflammatory cells are directly relevant to dental implant pathologies involving bone resorption, such as osseointegration failure and peri-implantitis. While the endotoxin amount on implant devices is regulated by standards, it is unknown whether commercially available dental implants elicit different levels of adherent-endotoxin stimulated cytokines. The objective of this work is to develop a model system and evaluate endotoxin-induced expression of pro-inflammatory cytokine genes relevant to osteoclast activation on commercially available dental implants. Murine J774-A1 macrophages were cultured on Ti disks with different level of lipopolysaccharide (LPS) contamination to define the time-course of the inflammatory response to endotoxin, as evaluated by reverse transcription polymerase chain reaction analysis. The developed protocol was then used to measure adherent endotoxin on commercially available packaged and sterile dental implants in the "as-implanted" condition. Results show that tested dental implants induce variable expression of endotoxin-stimulated genes, sometimes above the level expected to promote bone resorption in vivo. Results are unaffected by the specific surface treatment; rather, they likely reflect care in cleaning and packaging protocols. In conclusion, expression of genes that enhance osteoclast activity through endotoxin stimulation of inflammatory cells is widely different on commercially available dental implants. A reappraisal of the clinical impact of adherent endotoxins on dental (and bone) implant devices is required in light of increasing knowledge on crosstalk between cells from the immune and skeletal systems.

  3. Research on dental implant and its industrialization stage

    NASA Astrophysics Data System (ADS)

    Dongjoon, Yang; Sukyoung, Kim

    2017-02-01

    Bone cell attachment to Ti implant surfaces is the most concerned issue in the clinical implant dentistry. Many attempts to achieve the fast and strong integration between bone and implant have been tried in many ways, such as selection of materials (for example, Ti, ZrO2), shape design of implant (for example, soft tissue level, bone level, taped or conical, etc), and surface modification of implants (for example, roughed. coated, hybrid), etc. Among them, a major consideration is the surface design of dental implants. The surface with proper structural characteristics promotes or induces the desirable responses of cells and tissues. To obtain such surface which has desirable cell and tissue response, a variety of surface modification techniques has been developed and employed for many years. In this review, the method and trend of surface modification will be introduced and explained in terms of the surface topography and chemistry of dental implants.

  4. Three-dimensional imaging and guided surgery for dental implants.

    PubMed

    Ganz, Scott D

    2015-04-01

    Clinicians worldwide are increasingly adopting guided surgical applications for dental implants. Clinicians are becoming more aware of the benefits of proper planning through advanced imaging modalities and interactive treatment planning applications. All aspects of the planning phase are based on sound surgical and restorative fundamentals. As an integral part of the implant team, dental laboratories have now moved from analog to the digital world, providing the necessary support to the new digital workflow.

  5. The feasibility of immediately loading dental implants in edentulous jaws

    PubMed Central

    2016-01-01

    Purpose Immediate loading of dental implants has been proved to be feasible in partially edentulous jaws. The purpose of this retrospective investigation was to assess the feasibility of immediately loading dental implants in fully edentulous jaws. Methods A total of 24 patients aged between 53 and 89 years received a total of 154 implants in their edentulous maxillae or mandibles. Among the implants, 45 were set in fresh extracted sockets and 109 in consolidated alveolar bones. The implants were provisionally managed with chair-side made provisional resin bridges and exposed to immediate loading. Implants were followed up for 1–8 years, including radiographic imaging. Marginal bone levels were evaluated based on radiographic imaging. Results A total of 148 out of the 154 implants survived over the follow-up period of 1 to 8 years, giving a survival rate of 96%. The time or region of the implantation, the pre-implant augmentation, and the length and diameter of the implants had no statistically significant influence on the survival or the success rate. The marginal bone level remained stable with only minimal loss of 0.3 mm after 60 months of loading. Conclusions Within the limitations of this study, immediate loading is feasible for dental implants in edentulous jaws. PMID:27588213

  6. Radiographic dental implants recognition for geographic evaluation in human identification.

    PubMed

    Nuzzolese, E; Lusito, S; Solarino, B; Di Vella, G

    2008-06-01

    Dental implants for prosthetic rehabilitation with fixed crown or mobile partial/total dentures is a very common oral treatment among the population in Italy as elsewhere. There is a great number of implant systems of different designs. However, a catalogue of radiographic images and a description of the dental implants available in Italy would be useful in order to identify the manufacturer and the type of implant encountered in forensic casework. When an unidentified body is found with one or more implants in the jaws, and no dental record is available, clues gleaned from the type of implants used could give direction to the investigation. In this study Italian implant manufactures were contacted and asked to provide specimen implants. Digital radiographs were taken of all the implants donated at 0º, 30º, and 60º horizontal rotation, combined with -20º, -10º, 0º, +10º, and +20º vertical inclination relative to the radiographic beam and the X-ray sensor. A total of 15 images per implant were taken and examined to identify consistent, unique features that would aid in implant recognition. Only those observations made from radiographs between -10º and +10º vertical inclination would ever be used for definite identification of any implant. The information from this study should be considered a survey of the commercial distribution of dental implants in Italy through their digital radiographic images. It is also a starting point for a wider geographical evaluation of different manufacturers in other countries and continents. The radiographic images provided should help both the forensic odontologist and the prosthodontist to identify pre-existing implants which they may discover from their radiographic images.

  7. Implant Education Programs in North American Dental Schools.

    ERIC Educational Resources Information Center

    Arbree, Nancy S.; Chapman, Robert J.

    1991-01-01

    A survey of 52 dental schools found that dental implant techniques were taught in 34 pre- and 34 postdoctoral curricula, involving mostly prosthodontics and oral surgery departments, with periodontology departments lagging behind. Most predoctoral programs did not have research involvement. Cooperation among specialties is recommended over implant…

  8. The Role of Occlusion in the Dental Implant and Peri-implant Condition: A Review

    PubMed Central

    Graves, Carmen V.; Harrel, Steve K.; Rossmann, Jeffrey A.; Kerns, David; Gonzalez, Jorge A.; Kontogiorgos, Elias D.; Al-Hashimi, Ibtisam; Abraham, Celeste

    2016-01-01

    Dental implants have become a widely used dental treatment approach. It is important to identify factors that can be detrimental to dental implants and the peri-implant complex. There is controversy regarding whether occlusion plays a role in the implant and peri-implant condition. The present study aims to review the scientific literature regarding this topic. Animal and human studies, and previous reviews on the topic are included and presented. There is a wide heterogeneity among study designs. Several articles demonstrated that occlusion and occlusion overload could detrimentally affect the peri-implant condition, while other articles did not support these results. More studies are needed to help understand the mechanisms by which occlusion might play a role in the peri-implant condition. PMID:27990184

  9. A Brief Historical Perspective on Dental Implants, Their Surface Coatings and Treatments

    PubMed Central

    Abraham, Celeste M

    2014-01-01

    This review highlights a brief, chronological sequence of the history of dental implants. This historical perspective begins with ancient civilizations and spotlights predominant dentists and their contributions to implant development through time. The physical, chemical and biologic properties of various dental implant surfaces and coatings are discussed, and specific surface treatments include an overview of machined implants, etched implants, and sand-blasted implants. Dental implant coatings such as hydroxyapatite, fluoride, and statin usage are further reviewed. PMID:24894638

  10. Dental Implant Patients and Their Satisfaction with Treatment.

    ERIC Educational Resources Information Center

    Tawares, Mary; And Others

    1990-01-01

    The study developed a profile of dental implant patients from 38 private practices to document characteristics of endosseous implant recipients of the past 10 years. Data were then analyzed using multivariate techniques to examine the relationship between these characteristics and patient-reported outcomes. Patients tended to have high incomes and…

  11. Imunohistological aspects of the tissue around dental implants

    NASA Astrophysics Data System (ADS)

    Nimigean, Victor; Nimigean, Vanda R.; Sǎlǎvǎstru, Dan I.; Moraru, Simona; BuÅ£incu, Lavinia; Ivaşcu, Roxana V.; Poll, Alexandru

    2016-03-01

    Objectives: study of soft and hard tissues around implants. Material and methods: For the immunohistochemical and histological study of the implant/soft tissue interface, we examined pieces of peri-implant mucosa harvested from 35 patients. The implant/bone interface was assessed using histologic and histomorphometric examination of hard tissues around unloaded, early loaded or delayed loaded dental implants with pre-established design, with a sandblasted and acid-etched surface, placed both in extraction sockets, or after bone healing following tooth removal. This study was performed on 9 common race dogs. Results: The histological study of the implant/soft tissue interface showed regenerative modifications and moderate chronic subepithelial inflammatory reactions. Immunohistochemical evaluation of the soft tissue biopsies revealed the presence of specific immunocompetent cells and proteins of the matrix metalloproteinase (MMP) expression. Bone-implants contacts were more obvious in the apical half of the implants and at the edges of the threads, than between them. A mature, lamelliform bone containing lacunae with osteocytes and lack of connective tissue were noticed around implants that were late placed and loaded. The new-formed bone was also abundant in the crestal zone, not only in the apical part of the implants. Conclusions: A thorough understanding of the microstructure of dental implant/soft and hard tissue interface will improve the longevity of osseointegrated implants.

  12. Antibiotics in dental implants: A review of literature

    PubMed Central

    Surapaneni, Hemchand; Yalamanchili, Pallavi Samatha; Basha, Md. Hafeez; Potluri, Sushma; Elisetti, Nirupa; Kiran Kumar, M. V.

    2016-01-01

    The routine use of antibiotics in oral implant treatment seems to be widespread. The pre- or post-operative use of antibiotics in conjunction with implant surgery and its correlation with failure and success rates are poorly documented in the literature. The debate regarding overprescription of antibiotics raises the need for a critical evaluation of proper antibiotic coverage in association with implant treatment. The benefits of prophylactic antibiotics are well-recognized in dentistry. However, their routine use in the placement of endosseous dental implants remains controversial. The purpose of this review is to know the efficacy of antibiotic prophylaxis in implant dentistry. PMID:27829741

  13. Impact of Dental Implant Surface Modifications on Osseointegration

    PubMed Central

    Smeets, Ralf; Stadlinger, Bernd; Schwarz, Frank; Beck-Broichsitter, Benedicta; Jung, Ole; Precht, Clarissa; Kloss, Frank; Gröbe, Alexander; Heiland, Max

    2016-01-01

    Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions. PMID:27478833

  14. [Current dental implant design and its clinical importance].

    PubMed

    Ye, Lin

    2017-02-01

    The development of clinical implant dentistry was intensively affected by dental implant design improvement and innovation, which brought about new concept, even milestone-like changes of clinical protocol. The current improvements of dental implant design and their clinical importance could be highlighted as followings: 1) The implant apical design influences the implant preliminary stability in immediate implant. The apical 3-5 mm design of implant makes implant stable in immediate implant, because this part would be screwed into alveolar bone through fresh socket, the other part of implant could not be tightly screwed in the socket because of smaller implant diameter. Implant apical form, screw design, self-taping of apical part would be essential for immediate implant. 2) The enough preliminary stability of implant makes immediate prosthesis possible. When osseointegration does not occur, the implant stability comes from a mechanical anchorage, which depends on implant form, screw thread and self-taping design. 3) Implant neck design may have influence for soft tissue recession in esthetic zone. The implant with large shoulder would not be selected for the esthetic area. The platform design may be more favorable in the area. 4) The connection design between implant and abutment is thought a very important structure in implant long-term stability. Moose taper and "tube in tube" were well documented structure design in 20-year clinical practice in Peking University. 5) In last 15 years, the plenty studies showed the platform design of implant had positive influence in implant marginal bone level. Whatever in single implant restoration or multi-implant prosthesis. 6) The digital technology makes clinical work more precise and high-tech. This would be a trend in implant dentistry. New generation of chair-side digital computer-aided design/computer-aided manufacturing makes immediate prosthesis without conventional impression possible. 7) New abutment design have

  15. Electromechanical impedance method to assess dental implant stability

    NASA Astrophysics Data System (ADS)

    Tabrizi, Aydin; Rizzo, Piervincenzo; Ochs, Mark W.

    2012-11-01

    The stability of a dental implant is a prerequisite for supporting a load-bearing prosthesis and establishment of a functional bone-implant system. Reliable and noninvasive methods able to assess the bone interface of dental and orthopedic implants (osseointegration) are increasingly demanded for clinical diagnosis and direct prognosis. In this paper, we propose the electromechanical impedance method as a novel approach for the assessment of dental implant stability. Nobel Biocare® implants with a size of 4.3 mm diameter ×13 mm length were placed inside bovine bones that were then immersed in a solution of nitric acid to allow material degradation. The degradation simulated the inverse process of bone healing. The implant-bone systems were monitored by bonding a piezoceramic transducer (PZT) to the implants’ abutment and measuring the admittance of the PZT over time. It was found that the PZT’s admittance and the statistical features associated with its analysis are sensitive to the degradation of the bones and can be correlated to the loss of calcium measured by means of the atomic absorption spectroscopy method. The present study shows promising results and may pave the road towards an innovative approach for the noninvasive monitoring of dental implant stability and integrity.

  16. Surface Modifications and Their Effects on Titanium Dental Implants

    PubMed Central

    Jemat, A.; Ghazali, M. J.; Razali, M.; Otsuka, Y.

    2015-01-01

    This review covers several basic methodologies of surface treatment and their effects on titanium (Ti) implants. The importance of each treatment and its effects will be discussed in detail in order to compare their effectiveness in promoting osseointegration. Published literature for the last 18 years was selected with the use of keywords like titanium dental implant, surface roughness, coating, and osseointegration. Significant surface roughness played an important role in providing effective surface for bone implant contact, cell proliferation, and removal torque, despite having good mechanical properties. Overall, published studies indicated that an acid etched surface-modified and a coating application on commercial pure titanium implant was most preferable in producing the good surface roughness. Thus, a combination of a good surface roughness and mechanical properties of titanium could lead to successful dental implants. PMID:26436097

  17. Cytocompatibility, cytotoxicity and genotoxicity analysis of dental implants

    NASA Astrophysics Data System (ADS)

    Reigosa, M.; Labarta, V.; Molinari, G.; Bernales, D.

    2007-11-01

    Several types of materials are frequently used for dental prostheses in dental medicine. Different treatments with titanium are the most used. The aim of the present study was to analyze by means of cytotoxicity and cytocompatibility techniques the capacity of dental implants to integrate to the bone tissue. Cultures of UMR 106 cell line derived from an osteosarcoma were used for bioassays mainly because they show many of the properties of osteoblasts. Dental implant samples provided by B&W company were compared with others of recognized trademarks. The first ones contain ASTM titanium (8348 GR2) with acid printing. Cytotoxicity was analyzed by means of lysosome activity, using the neutral red technique and alkaline phosphatase enzyme activity. Cell variability was determined by means of the acridine ethidium-orange bromide technique. One-way ANOVA and Bonferroni and Duncan post-ANOVA tests were used for the statistical analysis. The assays did not show significant differences among the dental implants analyzed. Our findings show that the dental prostheses studied present high biocompatibility, quantified by the bioassays performed. The techniques employed revealed that they can be a useful tool for the analysis of other materials for dental medicine use.

  18. Corrosion of machined titanium dental implants under inflammatory conditions.

    PubMed

    Messer, Regina L W; Tackas, Gyula; Mickalonis, John; Brown, Yolanda; Lewis, Jill B; Wataha, John C

    2009-02-01

    The effects of hyperglycemia, altered cell function, or inflammatory mediators on implant corrosion are not well studied; yet, these effects are critical to implant biocompatibility and osseointegration. Because implant placement is burgeoning, patients with medically compromising systemic conditions such as diabetes are increasingly receiving implants, and the role of other inflammatory diseases on implant corrosion also needs investigation. In the current study, the corrosion properties of commercially available, machined titanium implants were studied in blood, cultures of monocytic cells, and solutions containing elevated dextrose concentrations. Implant corrosion was estimated by open circuit potentials, linear polarization resistance, and electrical impedance spectroscopy (EIS) for 26 h. In selected samples, THP1 monocytic cells were activated for 2 h with Lipopolysaccharide prior to implant exposure, and IL-1beta secretion was measured to assess the affect of the implants on monocyte activation. Implants under conditions of inflammatory stress exhibited more negative E(corr) values, suggesting an increased potential for corrosion. Linear polarization measurements detected increased corrosion rates in the presence of elevated dextrose conditions over PBS conditions. EIS measurements suggested that implants underwent surface passivation reactions that may have limited corrosion over the short term of this test. This result was supported by cyclic polarization tests. IL-1beta secretion was not altered under conditions of corrosion or implant exposure. The results suggest that inflammatory stress and hyperglycemia may increase the corrosion of dental endosseous titanium-based implants, but that longer, more aggressive electrochemical conditions may be necessary to fully assess these effects.

  19. Analysis of surface cleanliness of three commercial dental implants.

    PubMed

    Edwards, B N; Gold, B R

    1992-01-01

    Six routinely packaged commercially pure titanium dental implants (three commercial brands) were analysed using secondary ion mass spectrometry to examine the outermost surface layer. The aim of the analysis was to compare the surface purity (99.95%) of the implants with the substrate metal, common to all three brands. The use of a low primary ion current density provided a nominal protection limit of 0.01% or 100 p.p.m. All the implants examined had extremely pure surfaces. However, only one brand of implant had an ultraclean oxide surface in relation to the substrate.

  20. Heat generated during seating of dental implant fixtures.

    PubMed

    Flanagan, Dennis

    2014-04-01

    Frictional heat can be generated during seating of dental implants into a drill-prepared osteotomy. This in vitro study tested the heat generated by implant seating in dense bovine mandible ramus. A thermocouple was placed approximately 0.5 mm from the rim of the osteotomy during seating of each dental implant. Four diameters of implants were tested. The average temperature increases were 0.075°C for the 5.7-mm-diameter implant, 0.97°C for the 4.7-mm-diameter implant, 1.4°C for the 3.7-mm-diameter implant, and 8.6°C for the 2.5-mm-diameter implant. The results showed that heat was indeed generated and a small temperature rise occurred, apparently by the friction of the implant surface against the fresh-cut bone surface. Bone is a poor thermal conductor. The titanium of the implant and the steel of the handpiece are much better heat conductors. Titanium may be 70 times more heat conductive than bone. The larger diameter and displacement implant may act as a heat sink to draw away any heat produced from the friction of seating the implant at the bone-implant interface. The peak temperature duration was momentary, and not measured, but this was approximately less than 1 second. Except for the 2.5-mm-diameter implants, the temperature rises and durations were found to be below those previously deemed to be detrimental, so no clinically significant osseous damage would be expected during dental implant fixture seating of standard and large-diameter-sized implants. A 2.5-mm implant may generate detrimental heat during seating in nonvital bone, but this may be clinically insignificant in vital bone. The surface area and thermal conductivity are important factors in removing generated heat transfer at the bone-implant interface. The F value as determined by analysis of variance was 69.22, and the P value was less than .0001, demonstrating significant differences between the groups considered as a whole.

  1. Bisphosphonate treatment and dental implants: A systematic review

    PubMed Central

    de-Freitas, Nayara-Ribeiro; de-Moura, Marcos-Boaventura; Veloso-Guedes, Cizelene-do-Carmo-Faleiros; Simamoto-Júnior, Paulo-César; de-Magalhães, Denildo

    2016-01-01

    Background To analyze articles that studied patients submitted to diphosphonates therapy and who received dental implants before, during or after bisphosphonate (BP) treatment, compared to healthy patients, analyzing the increase of failure and loss of implants or bisphosphonate related osteonecrosis of the jaw (BRONJ) incidence. Material and Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in “PICO” format was: In patients under bisphosphonate therapy, do dental implants placement, compared to healthy patients, increase the failure and loss of implants or bisphosphonate related osteonecrosis of the jaw incidence? PubMed/MEDLINE was searched for articles published up until April 15, 2015 using a combination of MeSH terms and their Entry terms. Results The search resulted in 375 articles. After selection according to the eligibility criteria, 15 studies fulfilled were included (eight retrospective, one prospective and six case series), with a total of 1339 patients analyzed, 3748 implants placed, 152 loss of implants and 78 cases of BRONJ. Conclusions Due to the lack of randomized clinical trials looking at this theme, further studies with longer follow-up are needed to elucidate the remaining questions. Thus, it is wise to be careful when planning dental implant surgery in patients undergoing bisphosphonate therapy because of the risk of developing BRONJ as well as occurring failure of implant. Moreover, complete systemic condition of the patient must be also taking into considering when such procedures are performed. Key words:Bisphosphonates, diphosphonates, dental implants, osteonecrosis. PMID:27475681

  2. Dental implants with versus without peri-implant bone defects treated with guided bone regeneration

    PubMed Central

    Peñarrocha-Oltra, David; Peñarrocha-Diago, Maria; Peñarrocha-Diago, Miguel

    2015-01-01

    Background The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects. The aim was to determine whether or not implants associated with GBR due to peri-implant defects show the same survival and success rates as implants placed in native bone without defects. Material and Methods Patients with a minimum of two submerged dental implants: one suffering a dehiscence or fenestration defect during placement and undergoing simultaneous guided bone regeneration (test group), versus the other entirely surrounded by bone (control group) were treated and monitored annually for three years. Complications with the healing procedure, implant survival, implant success and peri-implant marginal bone loss were assessed. Statistical analysis was performed with non-parametric tests setting an alpha value of 0.05. Results Seventy-two patients and 326 implants were included (142 test, 184 control). One hundred and twenty-five dehiscences (average height 1.92±1.11) and 18 fenestrations (average height 3.34±2.16) were treated. At 3 years post-loading, implant survival rates were 95.7% (test) and 97.3% (control) and implant success rates were 93.6% and 96.2%, respectively. Mean marginal bone loss was 0.54 (SD 0.26 mm) for the test group and 0.43 (SD 0.22 mm) for the control group. No statistically significant differences between both groups were found. Conclusions Within the limits of this study, implants with peri-implant defects treated with guided bone regeneration exhibited similar survival and success rates and peri-implant marginal bone loss to implants without those defects. Large-scale randomized controlled studies with longer follow-ups involving the assessment of esthetic parameters and hard and soft peri-implant tissue stability are needed. Key words:Guided bone regeneration, peri-implant defects, dental implants, marginal bone level, success rate, survival rate. PMID:26330931

  3. Immediate placement of dental implants in the mandible

    PubMed Central

    Puttaraju, Gurkar Haraswarupa; Visveswariah, Paranjyothi Magadi

    2013-01-01

    This case describes extraction of teeth in the mandibular arch, i.e., 41 42 43 44 45 51 52 53 54 55 56 57 58 (grade two mobility), followed by immediate placement of four dental implants (3i biomet), two in the 45 55 region and two dental implants in 12 21 region. A prefabricated provisional mandibular denture was immediately placed. The purpose of immediate placement was to aid the patient resume his professional duties the next day itself along with esthetic and functional comfort, psychological well-being and most importantly preserving the remaining tissue in a healthy condition. PMID:23956594

  4. Resonance Frequency Analysis for Osseointegration in Four Surgical Conditions of Dental Implants

    DTIC Science & Technology

    2001-10-25

    Abstract-The establishment of osseointegration following dental implant placement is a major contributing factor to the clinical success and long...period. Our results showed that there was an increase in resonance frequency related to stiffness increment during osseointegration. Keywords – dental ...implant, osseointegration, resonance frequency, stability I. INTRODUCTION Dental implants are being used increasingly to provide support and retention

  5. An Overview of the Mechanical Integrity of Dental Implants

    PubMed Central

    Shemtov-Yona, Keren; Rittel, Daniel

    2015-01-01

    With the growing use of dental implants, the incidence of implants' failures grows. Late treatment complications, after reaching full osseointegration and functionality, include mechanical failures, such as fracture of the implant and its components. Those complications are deemed severe in dentistry, albeit being usually considered as rare, and therefore seldom addressed in the clinical literature. The introduction of dental implants into clinical practice fostered a wealth of research on their biological aspects. By contrast, mechanical strength and reliability issues were seldom investigated in the open literature, so that most of the information to date remains essentially with the manufacturers. Over the years, implants have gone through major changes regarding the material, the design, and the surface characteristics aimed at improving osseointegration. Did those changes improve the implants' mechanical performance? This review article surveys the state-of-the-art literature about implants' mechanical reliability, identifying the known causes for fracture, while outlining the current knowledge-gaps. Recent results on various aspects of the mechanical integrity and failure of implants are presented and discussed next. The paper ends by a general discussion and suggestions for future research, outlining the importance of mechanical considerations for the improvement of their future performance. PMID:26583117

  6. On the mechanical integrity of retrieved dental implants.

    PubMed

    Shemtov-Yona, K; Rittel, D

    2015-09-01

    The objective of this work is to investigate the potential state of mechanical damage in used, albeit mechanically intact, dental implants, after their retrieval from the oral cavity because of progressive bone loss (peri-implantitis). 100 retrieved dental implants were characterized with no medical record made available prior to the analysis. The implants' composition, dimensions, and surface treatments were characterized using energy dispersive X-ray analysis and scanning electron microscopy (SEM-EDX). Each implant was thoroughly examined for signs of mechanical defects and damage. The implants represent a random combination of two materials, titanium alloy (Ti-6Al-4V) and commercially pure titanium (CP-Ti), surface treatments and geometries. Two kinds of surface defects were identified: crack-like defects and full cracks that were arbitrarily divided according to their length and appearance. We found that over 60% of the implants contained both crack-like defects and full cracks. In the retrieved sample, we observed that the CP-Ti implants contained more defects and cracks than the Ti-6Al-4V ones. For the various surface roughening treatments, a general correlation with the presence of defects was observed, but without a clear differentiation between the treatments. The high incidence of embedded particles among the observed defect further strengthens the role played by the particles upon defects generation, some of which later evolve into full cracks. It was also found that the dimensions of the implant (width and length) were not correlated with the observed defects, for this specific sample. Our observations indicate that early retrieval of biologically failed implants, many of which contain early signs of mechanical failure as shown here, does actually hinder the later occurrence of implant fracture. It seems that once biological complications will be successfully overcome, such defects might grow later into full cracks as a result of cyclic mastication

  7. Treatment strategies for infraoccluded dental implants.

    PubMed

    Zitzmann, Nicola U; Arnold, Dario; Ball, Judith; Brusco, Daniel; Triaca, Albino; Verna, Carlalberta

    2015-03-01

    Single-tooth implants in the maxillary anterior region have the highest risk of esthetic complications from infrapositioning due to continuing maxillary growth and the eruption of adjacent teeth. Although the placement of anterior single-tooth implants should normally be postponed, particularly girls and young women with a hyperdivergent growth pattern, if an infraposition of an implant is present, then thorough examination and strategic planning are required. According to the severity, the strategic treatment options are as follows: simple retention; adjustment or replacement of the implant restoration, possibly including adjacent teeth; surgical implant repositioning by segmental osteotomy combined with osseodistraction; or submergence or removal of the implant. With the patient presented, an interdisciplinary approach that combined orthodontic alignment, surgical segmental osteotomy, distraction osteogenesis, and restorative features offered the opportunity to realign the adjacent teeth into the arch and to harmonize the gingival contour by means of continuous soft tissue enlargement and adaptation.

  8. Cooling profile following prosthetic preparation of 1-piece dental implants.

    PubMed

    Cohen, Omer; Gabay, Eran; Machtei, Eli E

    2010-01-01

    The aim of this study was to evaluate the effect of water irrigation on heat dissipation kinetics following abutment preparation of 1-piece dental implants. UNO 1-piece dental implants were mounted on Plexiglas apparatus clamping the implant at the collar. T-type thermocouple was attached to the first thread of the implant and recorded thermal changes at 100 millisecond intervals. Implants were prepared using highspeed dental turbine at 400,000 RPM with a coarse diamond bur. Once temperature reached 47 degrees C, abutment preparation was discontinued. Thirty implants were divided into 2 groups. Group A: Passive cooling without water irrigation. Group B: Cooling with turbine's water spray adjacent to the implant (30 mL/min). The following parameters were measured: T47 (time from peak temperature to 47 degrees C), T50%, T75% (time until the temperature amplitude decayed by 50% and 75%, respectively), dTemp50%/dt decay, and dTemp75%/dt decay (cooling rate measured at 50% and 75% of amplitude decay, respectively). Water spray irrigation significantly reduced T47 (1.37+/-0.29 seconds vs 19.97+/-3.06 seconds, P<0.0001), T50% (3.04+/-0.34 seconds vs 27.37+/-2.56 seconds, P<0.0001), and T75% (5.71+/-0.57 seconds vs 57.61+/-5.47 seconds, P<0.0001). Water spray irrigation also increased cooling capacity ninefold: dTemp50%/dt decay (4.14+/-0.61 degrees C/s vs 0.48+/-0.06 degrees C/s, P<0.0001), and dTemp50%/dt decay (1.70+/-0.29 degrees C/s vs 0.19+/-0.03 degrees C/s, P<0.0001). The continuous use of water spray adjacent to the abutment following the cessation of implant preparation might prove beneficial for rapid cooling of the implant.

  9. CO2 laser surface treatment of failed dental implants for re-implantation: an animal study.

    PubMed

    Kasraei, Shahin; Torkzaban, Parviz; Shams, Bahar; Hosseinipanah, Seyed Mohammad; Farhadian, Maryam

    2016-07-01

    The aim of the present study was to evaluate the success rate of failed implants re-implanted after surface treatment with CO2 laser. Despite the widespread use of dental implants, there are many incidents of failures. It is believed that lasers can be applied to decontaminate the implant surface without damaging the implant. Ten dental implants that had failed for various reasons other than fracture or surface abrasion were subjected to CO2 laser surface treatment and randomly placed in the maxillae of dogs. Three failed implants were also placed as the negative controls after irrigation with saline solution without laser surface treatment. The stability of the implants was evaluated by the use of the Periotest values (PTVs) on the first day after surgery and at 1, 3, and 6 months post-operatively. The mean PTVs of treated implants increased at the first month interval, indicating a decrease in implant stability due to inflammation followed by healing of the tissue. At 3 and 6 months, the mean PTVs decreased compared to the 1-month interval (P < 0.05), indicating improved implant stability. The mean PTVs increased in the negative control group compared to baseline (P < 0.05). Independent t-test showed that the mean PTVs of treated implants were significantly lower than control group at 3 and 6 months after implant placement (P < 0.05). Based on the PTVs, re-implantation of failed implants in Jack Russell Terrier dogs after CO2 laser surface debridement is associated with a high success rate in terms of implant stability.

  10. Allergy related to dental implant and its clinical significance

    PubMed Central

    Chaturvedi, TP

    2013-01-01

    The oral cavity provides an ideal and unique environment for study of biological processes involving metallic dental aids. Dental materials within the mouth interact continually with physiological fluids. Oral tissues are exposed to a veritable bombardment of both chemical and physical stimuli as well as the metabolism of many species of bacteria; yet, for the most part, oral tissues remain healthy. The pH of saliva varies from 5.2 to 7.8. Teeth, restorations, or any prosthesis including dental implants in the oral cavity have to function in one of the most inhospitable environments in the human body. They are subject to larger temperature and pH variations than most other parts of the body. Corrosion, the graded degradation of materials by electrochemical attack, is of concern particularly when dental implants are placed in the hostile electrolytic environment provided by the human mouth. Allergic reactions may occur from the presence of ions produced from the corrosion of implants. The present article describes various manifestations of allergic reactions due to implant material in the oral cavity. PMID:23990733

  11. 21 CFR 872.3640 - Endosseous dental implant.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Endosseous dental implant. 872.3640 Section 872.3640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... for prosthetic devices, such as artificial teeth, in order to restore a patient's chewing function....

  12. Positional vertigo afterwards maxillary dental implant surgery with bone regeneration.

    PubMed

    Rodríguez Gutiérrez, Carlos; Rodríguez Gómez, Enrique

    2007-03-01

    Benign paroxysmal positional vertigo (BPPV) is the most common form of vertigo. It is caused by loose otoconia from the utricle which, in certain positions, displaced the cupula of the posterior semicircular canal. BPPV most often is a result of aging. It also can occur after a blow to the head. Less common causes include a prolonged positioning on the back (supine) during some surgical procedures. Additionally one can include in this ethiopathogenesis the positioning required during the maxillary dental implant surgery with bone regeneration related to a forced head positioning and inner ear trauma induced by dental turbine noise working in the maxillary bone. Two cases of patients who suffered BPPV after undergoing maxillary dental implant with bone regeneration procedures are reported. Diagnosis and treatment are also described.

  13. Axial relationship between dental implants and teeth/implants: a radiographic study.

    PubMed

    Machtei, Eli E; Oettinger-Barak, Orit; Horwitz, Jacob

    2014-08-01

    The relationship of dental implants with neighboring teeth will affect both occlusal relationship and distribution of forces; thus, the purpose of this study was to examine implants' axial relationship with adjacent and opposing teeth/implants. Data of dental implants patients was retrieved. Panoramic X rays were digitized. Computer-based software was used to measure the angular relationship between the implants and adjacent/opposing teeth and implants. Data was further sorted by the mode of placement and implants position. 50 patients (219 implants) were included. Mean angle to adjacent tooth/implant was 178.71° ± 9.18° (range 129.7°-206°). Implants were more parallel to adjacent teeth (180.99° ± 1.06°) than to adjacent implants (176.32° ± 0.54°; P = .0001). Mean angular relationship to opposite tooth was 167.88° ± 8.92° (range 137.7°-179.8°). Implants that were placed freehand or with positional guide had similar intra-arch relationship (178.22° and 178.81°, respectively) and similar inter-arch angulations (164.46° and 167.74°). Molars had greater deviation of the angular relationship (175.54°) compared to premolars (181.62°) and incisors (180.55°, P = .0001). Implants placed in the maxilla had smaller axial deviation compared to implants in the mandible (180.41° ± 0.64 vs 177.14° ± 1.02; P = .0081). Good axial relationship may be obtained in most implants placed by an experienced clinician, even when placed freehand. The mandibular posterior region is more prone to axial deviation and as such requires special attention.

  14. Melatonin plus porcine bone on discrete calcium deposit implant surface stimulates osteointegration in dental implants.

    PubMed

    Calvo-Guirado, José Luis; Gómez-Moreno, Gerardo; Barone, Antonio; Cutando, Antonio; Alcaraz-Baños, Miguel; Chiva, Fernando; López-Marí, Laura; Guardia, Javier

    2009-09-01

    The aim of this study was to evaluate the effect of the topical application of melatonin mixed with collagenized porcine bone to accelerate the osteointegration on the rough discrete calcium deposit (DCD) surface implants in Beagle dogs 3 months after their insertion. In preparation for subsequent insertion of dental implants, lower premolars and molars were extracted from 12 Beagle dogs. Each mandible received three parallel wall implants with discrete calcium deposit (DCD) surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each side of the mandible in three groups: group I implants alone, group II implants with melatonin and group III implants with melatonin and porcine bone. Prior to implanting, 5 mg lyophylized powdered melatonin was applied to one bone hole at each side of the mandible. None was applied at the control sites. Ten histological sections per implant were obtained for histomorphometric studies. After a 4-wk treatment period, melatonin significantly increased the perimeter of bone that was in direct contact with the treated implants (P < 0.0001), bone density (P < 0.0001), new bone formation (P < 0.0001) in comparison with control implants. Topical application of melatonin on DCD surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhance the osteointegration. Melatonin combined with porcine bone on DCD implants reveals more bone to implant contact at 12 wk (84.5 +/- 1.5%) compared with melatonin treated (75.1 +/- 1.4%) and nonmelatonin treated surface implants (64 +/- 1.4%).

  15. Mechanical assessment of grit blasting surface treatments of dental implants.

    PubMed

    Shemtov-Yona, K; Rittel, D; Dorogoy, A

    2014-11-01

    This paper investigates the influence of surface preparation treatments of dental implants on their potential (mechanical) fatigue failure, with emphasis on grit-blasting. The investigation includes limited fatigue testing of implants, showing the relationship between fatigue life and surface damage condition. Those observations are corroborated by a detailed failure analysis of retrieved fracture dental implants. In both cases, the negative effect of embedded alumina particles related to the grit-blasting process is identified. The study also comprises a numerical simulation part of the grit blasting process that reveals, for a given implant material and particle size, the existence of a velocity threshold, below which the rough surface is obtained without damage, and beyond which the creation of significant surface damage will severely reduce the fatigue life, thus increasing fracture probability. The main outcome of this work is that the overall performance of dental implants comprises, in addition to the biological considerations, mechanical reliability aspects. Fatigue fracture is a central issue, and this study shows that uncontrolled surface roughening grit-blasting treatments can induce significant surface damage which accelerate fatigue fracture under certain conditions, even if those treatments are beneficial to the osseointegration process.

  16. [Survival and success rate of dental implants treated with high intensity laser].

    PubMed

    Joób-Fancsaly, Arpád; Divinyi, Tamás; Karacs, Albert; Koncz, Szilvia; Pető, Gábor; Sulyok, Lili

    2015-09-01

    Clinical and radiological evaluations were conducted in patients with high energy Nd : glass laser-treated dental implants. These patients underwent dental implantation surgery between 1997 and 2006. Strict success criteria were used for the examination and analysis of implants. Based on clinical and radiological evaluation, success and survival rates of laser surface treated dental implants were similar to those of sandblasted, acid-etched surface implants frequently reported in the literature. Specific surface morphology and high degree of purity of laser surface treated dental implants ensure excellent osseointegration and a good clinical performance also on the long-term.

  17. Design optimization of a radial functionally graded dental implant.

    PubMed

    Ichim, Paul I; Hu, Xiaozhi; Bazen, Jennifer J; Yi, Wei

    2016-01-01

    In this work, we use FEA to test the hypothesis that a low-modulus coating of a cylindrical zirconia dental implant would reduce the stresses in the peri-implant bone and we use design optimization and the rule of mixture to estimate the elastic modulus and the porosity of the coating that provides optimal stress shielding. We show that a low-modulus coating of a dental implant significantly reduces the maximum stresses in the peri-implant bone without affecting the average stresses thus creating a potentially favorable biomechanical environment. Our results suggest that a resilient coating is capable of reducing the maximum compressive and tensile stresses in the peri-implant bone by up to 50% and the average stresses in the peri-implant bone by up to 15%. We further show that a transitional gradient between the high-modulus core and the low-modulus coating is not necessary and for a considered zirconia/HA composite the optimal thickness of the coating is 100 µ with its optimal elastic at the lowest value considered of 45 GPa.

  18. The issue of corrosion in dental implants: a review.

    PubMed

    Olmedo, Daniel G; Tasat, Déborah R; Duffó, Gustavo; Guglielmotti, Maria B; Cabrini, Rómulo L

    2009-01-01

    Pure titanium or titanium alloys, and to a lesser extent, zirconium, are metals that are often used in direct contact with host tissues. These metallic biomaterials are highly reactive, and on exposure to fluid media or air, quickly develop a layer of titanium dioxide (TiO2) or zirconium dioxide (ZrO2). This layer of dioxide forms a boundary at the interface between the biological medium and the metal structure, determining the degree of biocompatibility and the biological response of the implant. Corrosion is the deterioration a metal undergoes as a result of the surrounding medium (electrochemical attack), which causes the release of ions into the microenvironment. No metal or alloy is entirely inert in vivo. Corrosion phenomena at the interlace are particularly important in the evolution of both dental and orthopedic implants and one of the possible causes of implant failure after initial success. This paper comprises a review of literature and presents results of our laboratory experiments related to the study of corrosion, with special emphasis on dental implants. In situ degradation of a metallic implant is undesirable because it alters the structural integrity of the implant. The issue of corrosion is not limited to a local problem because the particles pmduced as a result could migrate to distant sites, whose evolution would require further studies.

  19. Predoctoral Dental Students' Perceptions of Dental Implant Training: Effect of Preclinical Simulation and Clinical Experience.

    PubMed

    Prasad, Soni; Bansal, Naveen

    2017-04-01

    The aims of this study were to assess 1) differences in perceptions of dental implant training between dental students who received didactic training alone (control group) and those who received didactic plus simulation training (test group); 2) differences in response between students with and without clinical experience in implant dentistry; and 3) the interaction effect of simulation training and clinical experience on students' satisfaction. A survey was distributed to the control group in 2014 and to the test group in 2015; both groups were at the same U.S. dental school. Data were collected on confidence levels with various implant restorative procedures along with overall satisfaction and number of implant restorations performed by each student. The response rate was 78.7% in the control group and 81.3% in the test group. In the control group, 85.7% of students reported being satisfied with implant training compared to 90.8% of students in the test group. The interaction effect of simulation training and clinical experience on overall student satisfaction was OR=1.5 at 95% CI: 0.8, 3.0. The students who had clinical experience with implant restorative procedures had significantly greater satisfaction than those who did not (OR=4.8, 95% CI: 2.1, 11.1, p<0.01). This study found that both the simulation and clinical experience affected these students' confidence and satisfaction levels with implant education: they were almost five times more satisfied with implant training when clinical experience in implant restorative procedures was a part of their implant education.

  20. Outcomes of implants and restorations placed in general dental practices

    PubMed Central

    Da Silva, John D.; Kazimiroff, Julie; Papas, Athena; Curro, Frederick A.; Thompson, Van P.; Vena, Donald A.; Wu, Hongyu; Collie, Damon; Craig, Ronald G.

    2017-01-01

    implants, 20 (2.2 percent) had restorations replaced or judged as needing to be replaced. The majority of P-Is and patients were satisfied with the esthetic outcomes for both the implant and restoration. Conclusions These results suggest that implant survival and success rates in general dental practices may be lower than those reported in studies conducted in academic or specialty settings. Practical Implications The results of this study, generated in the private general practice setting, add to the evidence base to facilitate implant treatment planning. PMID:24982276

  1. Dynamics of dental implants and orthodontics in today's periodontal prosthesis.

    PubMed

    Cheng, Y M

    2000-03-01

    Periodontal prosthesis refers to multidisciplinary efforts to stop disease progression, correct deformities created by dental diseases, and establish a therapeutic occlusion to restore the form and function of the masticatory system. These efforts are critical for the long-term prognosis and maintenance of the guarded teeth and the overall prosthesis. This article presents a functionally and esthetically challenging case, which illustrates a multidisciplinary approach--specifically implantology and orthodontics--and how they impact on each other during treatment. The role and importance of dental implants and orthodontics in setting up a case is illustrated in this article.

  2. Novel nanostructured hydroxyapatite coating for dental and orthopedic implants

    NASA Astrophysics Data System (ADS)

    Liu, Huinan; Jiang, Wenping; Malshe, Ajay

    2009-09-01

    A novel hybrid coating process, combining NanoSpray® (built on electrostatic spray coating) technology with microwave sintering process, was developed for synthesizing hydroxyapatite- (HA-) based nanostructured coating with favorable properties for dental and orthopedic implants. Specifically, HA nanoparticles were deposited on commercially pure titanium substrates using NanoSpray technique to produce the HA coating, which was then sintered in a microwave furnace under controlled conditions. The study showed that the use of NanoSpray followed by microwave sintering results in nanoscale HA coating for dental/orthopedic application.

  3. Influence of implant shape, surface morphology, surgical technique and bone quality on the primary stability of dental implants.

    PubMed

    Elias, Carlos Nelson; Rocha, Felipe Assis; Nascimento, Ana Lucia; Coelho, Paulo Guilherme

    2012-12-01

    The primary stability of dental implants has been investigated before, but a study of the influence of implant shape, size and surface morphology (machined, acid etched or anodized), surgical technique (press-fit or undersized) and substrate (natural or simulated bone) on the primary stability of dental implants has not been reported. The present work intends to fill this gap. In this work, six different dental implants were inserted into and removed from synthetic and natural bone while measuring the torque. A total of 255 dental implants with three shapes, four sizes and three surface topographies were inserted into pig rib, PTFE and polyurethane. The implant sites were prepared using straight and tapered drills. The primary stability was estimated from the maximum insertion torque. Comparisons between samples were based on the maximum insertion torque (MIT), the maximum removal torque (MRT) and the torque ratio (TR=MRT/MIT). The insertion torque into pig ribs showed larger dispersion. All parameters (shape, size and surface morphology of the implant, surgical technique and substrate type) were found to have a significant influence on primary stability. The insertion of a tapered implant requires a higher torque than the insertion of a straight implant. Surface treatments improve the primary stability. The influence of the surgical technique is smaller than that of implant size and shape. The highest insertion torque was that of anodized tapered implants inserted into undersized sites. Finally, the primary stability of dental implants is highly dependent on implant design, surgical technique and substrate type.

  4. The clinical significance of keratinized gingiva around dental implants.

    PubMed

    Greenstein, Gary; Cavallaro, John

    2011-10-01

    Whether or not keratinized tissue is needed around dental implants to maintain peri-implant health is a controversial subject. To clarify this issue a search was conducted for clinical trials that appraised the significance ofkeratinized gingiva (KG) around teeth and dental implants. A critical assessment of the data revealed that the literature is replete with studies that contradict one another with respect to the need for KG as it relates to survivability of implants, gingival response to plaque, inflammation, probing depths, recession, and loss of bone. When groups of patients with and without KG were compared with respect to various clinical parameters, a statistically significant better result in the presence of KG could be interpreted to indicate that having KG is advantageous. However, quantitative differences between groups with and without KG were usually very small. Overall, the data was interpreted to indicate that some patients may need augmentation of keratinized tissue to maintain peri-implant health. Ultimately, the decision to augment KG is a judgment call that needs to be made by the treating clinician, because there are not enough data to facilitate development of definitive guidelines relevant to this subject. Apparently, the need for KG is patient specific, and at present there is no method to reliably predict who would benefit from tissue augmentation.

  5. Topographic characterisation of dental implants for commercial use

    PubMed Central

    Mendoza-Arnau, Amparo; Vallecillo-Capilla, Manuel-Francisco; Cabrerizo-Vílchez, Miguel-Ángel

    2016-01-01

    Background To characterize the surface topography of several dental implants for commercial use. Material and Methods Dental implants analyzed were Certain (Biomet 3i), Tissue Level (Straumann), Interna (BTI), MG-InHex (MozoGrau), SPI (Alphabio) and Hikelt (Bioner). Surface topography was ascertained using a confocal microscope with white light. Roughness parameters obtained were: Ra, Rq, Rv, Rp, Rt, Rsk and Rku. The results were analysed using single-factor ANOVA and Student-Neuman-Keuls(p<0.05) tests. Results Certain and Hikelt obtained the highest Ra and Rq scores, followed by Tissue Level. Interna and SPI obtained lower scores, and MG-InHex obtained the lowest score. Rv scores followed the same trend. Certain obtained the highest Rp score, followed by SPI and Hikelt, then Interna and Tissue Level. MG-InHex obtained the lowest scores. Certain obtained the highest Rt score, followed by Interna and Hikelt, then SPI and Tissue Level. The lowest scores were for MG-InHex. Rsk was negative (punctured surface) in the MG-InHex, SPI and Tissue Level systems, and positive (pointed surface) in the other systems. Rku was higher than 3 (Leptokurtic) in Tissue Level, Interna, MG-InHex and SPI, and lower than 3 (Platykurtic) in Certain and Hikelt. Conclusions The type of implant determines surface topography, and there are differences in the roughness parameters of the various makes of implants for clinical use. Key words:Implants for clinical use, topography, confocal microscopy. PMID:27475680

  6. Management of a patient suffering with Cherubism with dental implants.

    PubMed

    Dewan, Karun; Bishop, Karl

    2011-06-01

    Cherubism is a rare non-neoplastic, fibro-osseous hereditary disorder characterized by bilateral expansion of the maxilla and mandible producing a characteristic facial appearance. It can affect the facial and dental growth of the individual and often results in gross aesthetic and functional deficiencies. The teeth may also be displaced or submerged and these problems can often compromise successful restorative rehabilitation. This paper describes the restorative management of an adult patient with Cherubism involving a fixed implant retained mandibular restoration. The care utilized 3D planning software and implant insertion guides to facilitate an early loading protocol and the use of optimum bone quality/volume areas.

  7. Noninvasive method for retrieval of broken dental implant abutment screw

    PubMed Central

    Gooty, Jagadish Reddy; Palakuru, Sunil Kumar; Guntakalla, Vikram Reddy; Nera, Mahipal

    2014-01-01

    Dental implants made of titanium for replacement of missing teeth are widely used because of ease of technical procedure and high success rate, but are not free of complications and may fail. Fracturing of the prosthetic screw continues to be a problem in restorative practice and great challenge to remove the fractured screw conservatively. This case report describes and demonstrates the technique of using an ultrasonic scaler in the removal of the fracture screw fragment as a noninvasive method without damaging the hex of implants. PMID:24963261

  8. Human study of ion implantation as a surface treatment for dental implants.

    PubMed

    De Maeztu, M A; Braceras, I; Álava, J I; Recio, C; Piñera, M; Gay-Escoda, C

    2013-07-01

    This clinical study evaluated a new surface treatment of ion implantation with CO ions which has previously been subjected to extensive study in animal models. The aim of this work was to assess its effect in humans. Experimental mini-implants were used; half of their longitudinal surface was machined and the other half was treated with CO ion implantation. The study was conducted in healthy volunteer patients who required prosthetic treatment with dental implants, and in accordance with the corresponding ethics committees. Coinciding with the insertion of commercial implants for oral restoration, one or two mini-implants were placed in the upper maxillary tuberosity or in the retromolar trigone of the mandible. The mini-implants were removed with a trephine jointly with a small volume of surrounding bone after a 3-month period. Two evaluation methods were used and both showed a greater degree of bone integration in the mini-implant section that underwent CO ion implantation treatment in comparison with the non-treated surface: 62.9% vs. 57.9%, and 54.8% vs. 46.2%. In addition, no adverse reactions were observed in the surface treatment with CO ion implantation. These results confirm the positive benefits in humans, based on the findings obtained from previous animal experiments.

  9. The bone-implant interface of dental implants in humans on the atomic scale.

    PubMed

    Sundell, Gustav; Dahlin, Christer; Andersson, Martin; Thuvander, Mattias

    2017-01-15

    Osseointegration of dental implants occurs on a hierarchy of length scales down to the atomic level. A deeper understanding of the complex processes that take place at the surface of an implant on the smallest scale is of interest for the development of improved biomaterials. To date, transmission electron microscopy (TEM) has been utilized for examination of the bone-implant interface, providing details on the nanometer level. In this study we show that TEM imaging can be complemented with atom probe tomography (APT) to reveal the chemical composition of a Ti-based dental implant in a human jaw on the atomic level of resolution. As the atom probe technique has equal sensitivity for all elements, it allows for 3 dimensional characterizations of osseointegrated interfaces with unprecedented resolution. The APT reconstructions reveal a Ca-enriched zone in the immediate vicinity of the implant surface. A surface oxide of some 5nm thickness was measured on the titanium implant, with a sub-stoichiometric composition with respect to TiO2. Minor incorporation of Ca into the thin oxide film was also evident. We conclude that the APT technique is capable of revealing chemical information from the bone-implant interface in 3D with unprecedented resolution, thus providing important insights into the mechanisms behind osseointegration.

  10. Biomechanical determinants of the stability of dental implants: influence of the bone-implant interface properties.

    PubMed

    Mathieu, Vincent; Vayron, Romain; Richard, Gilles; Lambert, Grégory; Naili, Salah; Meningaud, Jean-Paul; Haiat, Guillaume

    2014-01-03

    Dental implants are now widely used for the replacement of missing teeth in fully or partially edentulous patients and for cranial reconstructions. However, risks of failure, which may have dramatic consequences, are still experienced and remain difficult to anticipate. The stability of biomaterials inserted in bone tissue depends on multiscale phenomena of biomechanical (bone-implant interlocking) and of biological (mechanotransduction) natures. The objective of this review is to provide an overview of the biomechanical behavior of the bone-dental implant interface as a function of its environment by considering in silico, ex vivo and in vivo studies including animal models as well as clinical studies. The biomechanical determinants of osseointegration phenomena are related to bone remodeling in the vicinity of the implants (adaptation of the bone structure to accommodate the presence of a biomaterial). Aspects related to the description of the interface and to its space-time multiscale nature will first be reviewed. Then, the various approaches used in the literature to measure implant stability and the bone-implant interface properties in vitro and in vivo will be described. Quantitative ultrasound methods are promising because they are cheap, non invasive and because of their lower spatial resolution around the implant compared to other biomechanical approaches.

  11. Scattering effects of irradiation on surroundings calculated for a small dental implant.

    PubMed

    Friedrich, Reinhard E; Todorovic, Manuel; Heiland, Max; Scheuer, Hanna A; Krüll, Andreas

    2012-05-01

    A fundamental improvement of restorative dentistry is the compensation of missing teeth by insertion of artificial dental roots allowing retention of dental prosthesis. The function of dental implants conserves a permanent perforation of the mucosa and upholds a non-physiological contact of bone with foreign material and oral micro-organisms. Occasionally head and neck cancer patients are scheduled to receive radiotherapy but are wearing dental implants. An earlier study had shown that the distribution of x-rays is noteworthily changed when dental implants are present in the irradiation field. New implants of smaller size are currently being designed that allow sufficient retention for dental prosthesis. The aim of this consecutive study was to calculate alterations in the irradiated bone caused by a foreign body, representing an implant of reduced size and physical qualities equivalent to titanium, using a stochastic (Monte Carlo) simulation. A clinical linear accelerator was simulated using BEAM/EGS4. The calculations showed that the presence of a dimension-reduced implant results in remarkable differences of the dose distribution all around the implant. Titanium dental implants of reduced size located in the field of irradiation were capable of causing significant radiation scattering. Similar to standard implants, the risk for dose enhancement was notably important for the bone in direct contact with the implant. All therapists involved in the therapy of cancer patients undergoing head and neck radiotherapy should consider the impact of dental implants on the radiation beam as a catalyst of osteoradionecrosis.

  12. Bacterial communities associated with apical periodontitis and dental implant failure

    PubMed Central

    Dingsdag, Simon; Nelson, Stephen; Coleman, Nicholas V.

    2016-01-01

    Background Previously, we demonstrated that bacteria reside in apparently healed alveolar bone, using culture and Sanger sequencing techniques. Bacteria in apparently healed alveolar bone may have a role in peri-implantitis and dental implant failure. Objective To compare bacterial communities associated with apical periodontitis, those colonising a failed implant and alveolar bone with reference biofilm samples from healthy teeth. Methods and results The study consisted of 196 samples collected from 40 patients undergoing routine dental implant insertion or rehabilitation. The bacterial 16S ribosomal DNA sequences were amplified. Samples yielding sufficient polymerase chain reaction product for further molecular analyses were subjected to terminal restriction fragment length polymorphism (T-RFLP; 31 samples) and next generation DNA sequencing (454 GS FLX Titanium; 8 samples). T-RFLP analysis revealed that the bacterial communities in diseased tissues were more similar to each other (p<0.049) than those from the healthy reference samples. Next generation sequencing detected 13 bacterial phyla and 373 putative bacterial species, revealing an increased abundance of Gram-negative [Prevotella, Fusobacterium (p<0.004), Treponema, Veillonellaceae, TG5 (Synergistetes)] bacteria and a decreased abundance of Gram-positive [(Actinomyces, Corynebacterium (p<0.008)] bacteria in the diseased tissue samples (n=5) relative to reference supragingival healthy samples (n=3). Conclusion Increased abundances of Prevotella, Fusobacterium and TG5 (Synergistetes) were associated with apical periodontitis and a failed implant. A larger sample set is needed to confirm these trends and to better define the processes of bacterial pathogenesis in implant failure and apical periodontitis. The application of combined culture-based, microscopic and molecular technique-based approaches is suggested for future studies. PMID:27834171

  13. Fracture analysis of randomized implant-supported fixed dental prostheses

    PubMed Central

    Esquivel-Upshaw, Josephine F.; Mehler, Alex; Clark, Arthur E.; Neal, Dan; Anusavice, Kenneth J.

    2014-01-01

    Objective Fractures of posterior fixed dental all-ceramic prostheses can be caused by one or more factors including prosthesis design, flaw distribution, direction and magnitude of occlusal loading, and nature of supporting infrastructure (tooth root/implant), and presence of adjacent teeth. This clinical study of implant-supported, all-ceramic fixed dental prostheses, determined the effects of (1) presence of a tooth distal to the most distal retainer; (2) prosthesis loading either along the non-load bearing or load bearing areas; (3) presence of excursive contacts or maximum intercuspation contacts in the prosthesis; and (4) magnitude of bite force on the occurrence of veneer ceramic fracture. Methods 89 implant-supported FDPs were randomized as either a three-unit posterior metal-ceramic (Au-Pd-Ag alloy and InLine POM, Ivoclar, Vivadent) FDP or a ceramic-ceramic (ZirCAD and ZirPress, Ivoclar, Vivadent) FDP. Two implants (Osseospeed, Dentsply) and custom abutments (Atlantis, Dentsply) supported these FDPs, which were cemented with resin cement (RelyX Universal Cement). Baseline photographs were made with markings of teeth from maximum intercuspation (MI) and excursive function. Patients were recalled at 6 months and 1 to 3 years. Fractures were observed, their locations recorded, and images compared with baseline photographs of occlusal contacts. Conclusion No significant relationship exists between the occurrence of fracture and: (1) the magnitude of bite force; (2) a tooth distal to the most distal retainer; and (3) contacts in load-bearing or non-load-bearing areas. However, there was a significantly higher likelihood of fracture in areas with MI contacts only. Clinical Significance This clinical study demonstrates that there is a need to evaluate occlusion differently with implant-supported prostheses than with natural tooth supported prostheses because of the absence of a periodontal ligament. Implant supported prostheses should have minimal occlusion and

  14. Mini-dental implant insertion with the auto-advance technique for ongoing applications.

    PubMed

    Balkin, B E; Steflik, D E; Naval, F

    2001-01-01

    The clinical and histological results of two cases demonstrating retrieved Sendax mini-dental implants in two different patients is the focus of this report. The mini-dental implants were inserted using the auto-advance technique and loaded immediately. The implants were retrieved at 4 months following insertion and at 5 months following insertion and were prepared and reviewed histologically. Clinically, the implants had no mobility, with no apparent exudate or bleeding upon probing, prior to removal. At the time explant procedures were performed, the mini-dental implants had provided immediate support for prostheses during the integration of traditional root-form endosteal implants. Upon explantation, the mini-dental implants were in a state of health and functioning in their intended purpose. Histologically, the bone appeared to be integrated to the surface of the implant at the light microscope level, and the bone appeared to be relatively mature and healthy in the areas observed, more so than one would expect in this amount of time from insertion of mini-dental implants with immediate loading. A discussion of the purposes and technique used for insertion and removal of these mini-dental implants is discussed. This is the first human histological report on the auto-advance technique with immediate loading of mini-dental implants, demonstrating feasibility in ongoing applications.

  15. From acid etching treatments to tribocorrosive properties of dental implants: do some experimental results on surface treatments have an influence on the tribocorrosion behaviour of dental implants?

    NASA Astrophysics Data System (ADS)

    Geringer, Jean; Demanget, Nicolas; Pellier, Julie

    2013-10-01

    Surface treatments of dental implants aim at promoting osseointegration, i.e. the anchorage of the metallic part. Titanium-, grade II-V, based material is used as a bulk material for dental implants. For promoting the anchorage of this metallic biomaterial in human jaw, some strategies have been applied for improving the surface state, i.e. roughness, topography and coatings. A case study, experimental study, is described with the method of acid etching on titanium grade 4, CpTi. The main goal is to find the right proportion in a mixture of two acids in order to obtain the best surface state. Finally, a pure theoretical prediction is quite impossible and some experimental investigations are necessary to improve the surface state. The described acid etching is compared with some other acid etching treatments and some coatings available on dental implants. Thus, the discussion is focused on the tribocorrosion behaviour of titanium-based materials. The purpose of the coating is that the lifetime under tribocorrosion is limited. Moreover, the surgery related to the implantation has a huge impact on the stability of dental implants. Thus, the performance of dental implants depends on factors related to surgery (implantation) that are difficult to predict from the biomaterial characteristics. From the tribocorrosion point of view, i.e. during the mastication step, the titanium material is submitted to some deleterious factors that cause the performance of dental implants to decrease.

  16. Non-Destructive Analysis of Basic Surface Characteristics of Titanium Dental Implants Made by Miniature Machining

    NASA Astrophysics Data System (ADS)

    Babík, Ondrej; Czán, Andrej; Holubják, Jozef; Kameník, Roman; Pilc, Jozef

    2016-12-01

    One of the most best-known characteristic and important requirement of dental implant is made of biomaterials ability to create correct interaction between implant and human body. The most implemented material in manufacturing of dental implants is titanium of different grades of pureness. Since most of the implant surface is in direct contact with bone tissue, shape and integrity of said surface has great influence on the successful osseointegration. Among other characteristics of titanium that predetermine ideal biomaterial, it shows a high mechanical strength making precise machining miniature Increasingly difficult. The article is focused on evaluation of the resulting quality, integrity and characteristics of dental implants surface after machining.

  17. Numerical simulation of electrically stimulated osteogenesis in dental implants.

    PubMed

    Vanegas-Acosta, J C; Garzón-Alvarado, D A; Lancellotti, V

    2014-04-01

    Cell behavior and tissue formation are influenced by a static electric field (EF). Several protocols for EF exposure are aimed at increasing the rate of tissue recovery and reducing the healing times in wounds. However, the underlying mechanisms of the EF action on cells and tissues are still a matter of research. In this work we introduce a mathematical model for electrically stimulated osteogenesis at the bone-dental implant interface. The model describes the influence of the EF in the most critical biological processes leading to bone formation at the bone-dental implant interface. The numerical solution is able to reproduce the distribution of spatial-temporal patterns describing the influence of EF during blood clotting, osteogenic cell migration, granulation tissue formation, displacements of the fibrillar matrix, and formation of new bone. In addition, the model describes the EF-mediated cell behavior and tissue formation which lead to an increased osteogenesis in both smooth and rough implant surfaces. Since numerical results compare favorably with experimental evidence, the model can be used to predict the outcome of using electrostimulation in other types of wounds and tissues.

  18. Fracture mechanisms of retrieved titanium screw thread in dental implant.

    PubMed

    Yokoyama, Ken'ichi; Ichikawa, Tetsuo; Murakami, Hiroki; Miyamoto, Youji; Asaoka, Kenzo

    2002-06-01

    Titanium and its alloy are increasingly attracting attention for use as biomaterials. However, delayed fracture of titanium dental implants has been reported, and factors affecting the acceleration of corrosion and fatigue have to be determined. The fractured surface of a retrieved titanium screw and metallurgical structures of a dental implant system were analyzed. The outer surface of the retrieved screw had a structure different from that of the as-received screw. It was confirmed that a shear crack initiated at the root of the thread and propagated into the inner section of the screw. Gas chromatography revealed that the retrieved screw had absorbed a higher amount of hydrogen than the as-received sample. The grain structure of a titanium screw, immersed in a solution known to induce hydrogen absorption, showed features similar to those of the retrieved screw. It was concluded that titanium in a biological environment absorbs hydrogen and this may be the reason for delayed fracture of a titanium implant.

  19. Optimally oriented grooves on dental implants improve bone quality around implants under repetitive mechanical loading.

    PubMed

    Kuroshima, Shinichiro; Nakano, Takayoshi; Ishimoto, Takuya; Sasaki, Muneteru; Inoue, Maaya; Yasutake, Munenori; Sawase, Takashi

    2017-01-15

    The aim was to investigate the effect of groove designs on bone quality under controlled-repetitive load conditions for optimizing dental implant design. Anodized Ti-6Al-4V alloy implants with -60° and +60° grooves around the neck were placed in the proximal tibial metaphysis of rabbits. The application of a repetitive mechanical load was initiated via the implants (50N, 3Hz, 1800 cycles, 2days/week) at 12weeks after surgery for 8weeks. Bone quality, defined as osteocyte density and degree of biological apatite (BAp) c-axis/collagen fibers, was then evaluated. Groove designs did not affect bone quality without mechanical loading; however, repetitive mechanical loading significantly increased bone-to-implant contact, bone mass, and bone mineral density (BMD). In +60° grooves, the BAp c-axis/collagen fibers preferentially aligned along the groove direction with mechanical loading. Moreover, osteocyte density was significantly higher both inside and in the adjacent region of the +60° grooves, but not -60° grooves. These results suggest that the +60° grooves successfully transmitted the load to the bone tissues surrounding implants through the grooves. An optimally oriented groove structure on the implant surface was shown to be a promising way for achieving bone tissue with appropriate bone quality. This is the first report to propose the optimal design of grooves on the necks of dental implants for improving bone quality parameters as well as BMD. The findings suggest that not only BMD, but also bone quality, could be a useful clinical parameter in implant dentistry.

  20. Advanced glycation endproducts and rat dental implant osseointegration.

    PubMed

    Quintero, David G; Winger, Julia N; Khashaba, Rania; Borke, James L

    2010-01-01

    Advanced glycation endproducts (AGEs) are a diverse group of molecular adducts formed in environments high in reducing sugars that accumulate with aging and in diabetes. This study tests the hypothesis that AGEs inhibit the stabile osseointegration of dental implants through tissue interactions that interfere with bone turnover and compromise the biomechanical properties at the bone-implant interface. Maxillary first molars were extracted from 32 rats and allowed to heal for 4 weeks. Titanium implants (1 mm x 3 mm) were placed in the healed sockets of 2 groups of 16 rats consisting of 8 rats injected 3 times/wk for 1 month with AGE (prepared from glucose and lysine) and 8 rats injected with vehicle as a control. AGE injections continued for an additional 14 or 28 days before sacrifice. X-ray images, blood, and tissues were collected to examine bone/implant contact ratio, serum pyridinoline ([PYD] a collagen breakdown marker), osteocalcin ([OSC] a bone formation marker), and for immunohistochemistry with antibodies to AGE and the bone turnover-marker protein matrix metalloproteinase1. Compared with the AGE-treated groups, the controls showed significantly higher bone/implant contact at both 14- and 28-day time points. PYD (P < .05) and OSC (trend) levels from controls showed decreases at 28 days when compared with AGE-treated groups. Immunohistochemistry with AGE-specific and bone turnover marker antibodies showed stronger staining associated with the implant/tissue interface in AGE-treated rats. Our studies indicate an association between AGE and inhibition of bone turnover, suggesting that the formation of AGE in high glycemic conditions, such as diabetes, may contribute to a slower rate of osseointegration that negatively affects implant stability.

  1. Microscopic Study of Surface Microtopographic Characteristics of Dental Implants

    PubMed Central

    Sezin, M.; Croharé, L.; Ibañez, J.C.

    2016-01-01

    Objective: To determine and compare the micro topographic characteristics of dental implants submitted to different surface treatments, using scanning electron microscopy (SEM). Materials and Methods: Implants were divided into 7 groups of 3 specimens each, according to the surface treatment used: group 1: Osseotite, BIOMET 3i; group 2: SLA surface, Institut Straumann AG; group 3: Oxalife surface, Tree-Oss implant; group 4: B&W implant surface; group 5: Q-implant surface; group 6: ML implant surface; group 7: RBM surface, Rosterdent implant. The surfaces were examined under SEM (Carl Zeiss FE-SEM-SIGMA). Image Proplus software was used to determine the number and mean diameter of pores per area unit (mm). The data obtained were analyzed with the Mann-Whitney test. A confocal laser microscope (LEXT-OLS4100 Olympus) was used to conduct the comparative study of surface roughness (Ra). Data were analyzed using Tukey's HSD test. Results: The largest average pore diameter calculated in microns was found in group 5 (3.45 µm+/-1.91) while the smallest in group 7 (1.47µm+/-1.29). Significant differences were observed among each one of the groups studied (p<0.05). The largest number of pores/mm2 was found in group 2 (229343) and the smallest number in group 4 (10937). Group 2 showed significant differences regarding the other groups (p<0.05). The greatest roughness (Ra) was observed in group 2 (0.975µm+/-0.115) and the smallest in group 4 (0.304µm+/-0.063). Group 2 was significantly different from the other groups (p<0.05). Conclusion: The micro topography observed in the different groups presented dissimilar and specific features, depending on the chemical treatment used for the surfaces.. PMID:27335615

  2. Local complications in dental implant surgery: prevention and treatment

    PubMed Central

    ANNIBALI, S.; RIPARI, M.; LA MONACA, G.; TONOLI, F.; CRISTALLI, M.P.

    2008-01-01

    SUMMARY There are many detailed articles regarding accidents and local complications in dental implantation. Comparison of the data they report is not always easy because different criteria have been followed in the various classifications and there is confusion between the terms accident and complication. The aim of this paper is to propose a classification that considers the timing of the events and makes a distinction between the two terms. Accidents are events that occur during surgery and complications are all the pathological conditions that appear postoperatively. The proper diagnostic procedures and surgical techniques for complications prevention and treatment are also described. PMID:23285333

  3. Nonlinear contact analysis of preload in dental implant screws.

    PubMed

    Sakaguchi, R L; Borgersen, S E

    1995-01-01

    Clinical studies indicate that loosening or fracture of dental implant prostheses occurs in 5% to 45% of cases during the first year. The nature of loosening or displacement of prosthetic components is complex, since it involves cycling fatigue, oral fluids, and varied chewing patterns and loads. A finite element contact analysis method was used to study the load-transfer mechanism between prosthetic components caused by torque application to the threaded fasteners used for assembly. Screw elongation is achieved while allowing for elastic recovery of the screw to produce a clamping force on the fastened elements. Clamping forces were additive along the axis of the prosthetic components. When the gold retaining screw is fastened into the abutment screw, clamping force on the implant is increased at the expense of decreasing the clamping force at the abutment screw-abutment interface by 50%. Maximum tensile stresses in the screws after preload were less than 55% of the yield stress.

  4. The dosimetric impact of dental implants on head-and-neck volumetric modulated arc therapy

    NASA Astrophysics Data System (ADS)

    Lin, Mu-Han; Li, Jinsheng; Price, Robert A., Jr.; Wang, Lu; Lee, Chung-Chi; Ma, C.-M.

    2013-02-01

    This work aims to investigate the dosimetric impact of dental implants on volumetric modulated arc therapy (VMAT) for head-and-neck patients and to evaluate the effectiveness of using the material's electron-density ratio for the correction. An in-house Monte Carlo (MC) code was utilized for the dose calculation to account for the scattering and attenuation caused by the high-Z implant material. Three different dental implant materials were studied in this work: titanium, Degubond®4 and gold. The dose perturbations caused by the dental implant materials were first investigated in a water phantom with a 1 cm3 insert. The per cent depth dose distributions of a 3 × 3 cm2 photon field were compared with the insert material as water and the three selected dental implant materials. To evaluate the impact of the dental implant on VMAT patient dose calculation, four head-and-neck cases were selected. For each case, the VMAT plan was designed based on the artifact-corrected patient geometry using a treatment planning system (TPS) that was typically utilized for routine patient treatment. The plans were re-calculated using the MC code for five situations: uncorrected geometry, artifact-corrected geometry and artifact-corrected geometry with one of the three different implant materials. The isodose distributions and the dose-volume histograms were cross-compared with each other. To evaluate the effectiveness of using the material's electron-density ratio for dental implant correction, the implant region was set as water with the material's electron-density ratio and the calculated dose was compared with the MC simulation with the real material. The main effect of the dental implant was the severe attenuation in the downstream. The 1 cm3 dental implant can lower the downstream dose by 10% (Ti) to 51% (Au) for a 3 × 3 cm2 field. The TPS failed to account for the dose perturbation if the dental implant material was not precisely defined. For the VMAT patient dose calculation

  5. The role of the dental technician in fabricating the single-stage implant prosthesis.

    PubMed

    Fedoretz, M; Fedoretz, T

    1999-01-01

    With the initiation of the concept of osseointegration, the use of dental implants has become a predictable and frequently used addition to comprehensive planning and treatment of edentulous patients. Implantology poses challenges for the dental laboratory not present in any other existing specialty. Single-stage implant surgery represents such an innovation.

  6. Biocompatibility of natural latex implanted into dental alveolus of rats.

    PubMed

    Balabanian, Cláudia A C A; Coutinho-Netto, Joaquim; Lamano-Carvalho, Teresa L; Lacerda, Suzie A; Brentegani, Luiz G

    2006-12-01

    The present study investigated the biocompatibility of a biopolymer based on vegetable latex extracted from the Hevea brasiliensis rubber tree, implanted into the bony alveolar cavity after dental extraction in rats. A granule of latex (area = 0.25 +/- 0.04 mm(2)) was implanted inside the alveolus immediately after extraction of the upper right incisor, and the animals were sacrificed 7, 21 and 42 days after the procedure. The hemi-maxillas were decalcified and processed for embedding in paraffin to obtain semi-serial longitudinal sections 5 mum thick, and then stained with hematoxylin-eosin. The latex granule was observed in the cervical third of the alveolus without any foreign body reaction, or persistence of the initial acute inflammatory reaction. Bone repair in the areas adjacent to the material was quantified, and a decrease was noted in the thickness of the fibrous capsule surrounding the implants from 92.8 +/- 9.3 microm on day 7 to 9.4 +/- 1.8 microm on day 42 (ANOVA, P = 0.01). The quantitative data confirmed acceleration of bone formation (statistically significant at 5%) in parallel with a decrease of connective tissue in the areas around the implants. These results show that the tested material is biologically compatible, and progressively integrated into the alveolar bone, simultaneously accelerating bone formation and playing an important role in the healing process.

  7. Longevity of dental implants in type IV bone: a systematic review.

    PubMed

    Goiato, M C; dos Santos, D M; Santiago, J F; Moreno, A; Pellizzer, E P

    2014-09-01

    Bone quality and quantity are important factors with regard to the survival rate of dental implants. The aim of this study was to conduct a systematic review of dental implants inserted in low-density bone and to determine the survival rate of dental implants with surface treatments over time. A systematic review of the literature was undertaken by two independent individuals; the Medline/PubMed database was searched for the period July 1975 to March 2013. Relevant reports on bone quality and osseointegration of dental implants were selected. The search retrieved 1018 references, and after inclusion and exclusion criteria were applied, 19 studies were selected for review. A total of 3937 patients, who had received a total of 12,465 dental implants, were analyzed. The survival rates of dental implants according to the bone density were: type I, 97.6%; type II, 96.2%; type III, 96.5%; and type IV, 88.8%. The survival rate of treated surface implants inserted in low-density bone was higher (97.1%) than that of machined surface implants (91.6%). Surface-treated dental implants inserted in low-density bone have a high survival rate and may be indicated for oral rehabilitation. However, more randomized studies are required to better evaluate this issue.

  8. Development and Applications of Porous Tantalum Trabecular Metal Enhanced Titanium Dental Implants

    PubMed Central

    Bencharit, Sompop; Byrd, Warren C.; Altarawneh, Sandra; Hosseini, Bashir; Leong, Austin; Reside, Glenn; Morelli, Thiago; Offenbacher, Steven

    2013-01-01

    Statement of Problem Porous tantalum trabecular metal has recently been incorporated in titanium dental implants as a new form of implant surface enhancement. However, there is little information on the applications of this material in implant dentistry. Methods We, therefore review the current literature on the basic science and clinical uses of this material. Results Porous tantalum metal is used to improve the contact between osseous structure and dental implants; and therefore presumably facilitate osseointegration. Success of porous tantalum metal in orthopedic implants led to the incorporation of porous tantalum metal in the design of root-from endosseous titanium implants. The porous tantalum three-dimensional enhancement of titanium dental implant surface allows for combining bone ongrowth together with bone ingrowth, or osseoincorporation. While little is known about the biological aspect of the porous tantalum in the oral cavity, there seems to be several possible advantages of this implant design. This article reviews the biological aspects of porous tantalum enhanced titanium dental implants, in particular the effects of anatomical consideration and oral environment to implant designs. Conclusions We propose here possible clinical situations and applications for this type of dental implant. Advantages and disadvantages of the implants as well as needed future clinical studies are discussed. PMID:23527899

  9. Surgical templates for dental implant positioning; current knowledge and clinical perspectives.

    PubMed

    Kola, Mohammed Zaheer; Shah, Altaf H; Khalil, Hesham S; Rabah, Ahmed Mahmoud; Harby, Nehad Mohammed H; Sabra, Seham Ali; Raghav, Deepti

    2015-01-01

    Dental implants have been used in a variety of different forms for many years. Since the mid-20(th) century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.

  10. Marginal Bone Level Evaluation after Functional Loading Around Two Different Dental Implant Designs

    PubMed Central

    Ho, Ko-Ning; Salamanca, Eisner; Lin, Hsi-Kuai

    2016-01-01

    Purpose. To investigate peri-implant alveolar bone changes using periapical radiographs before and after prosthetic delivery in submerged and nonsubmerged dental implants. Methods. Digital periapical films of 60 ITI Straumann nonsubmerged dental implants and 60 Xive Dentsply submerged dental implants were taken before, immediately after, and 12 and 24 weeks after the prosthetic restoration was delivered. Results. The 60-nonsubmerged dental implant group showed mean marginal bone resorption at baseline of 0.10 ± 0.23 mm and 24 weeks later, marginal bone resorption was 0.16 ± 0.25 mm. The submerged dental implant group showed a significantly higher distal marginal bone resorption over the mesial side. Mean marginal bone resorption at baseline was 0.16 ± 0.32 on the mesial and 0.41 ± 0.56 on the distal side. Twenty-four weeks later, it was 0.69 ± 0.69 mm on the mesial and 0.99 ± 0.90 mm on the distal side. Conclusion. First, it was possible to determine that submerged implants had a higher mean marginal bone resorption and less bone-to-implant contact than nonsubmerged implants. And second, the distal side of submerged dental implants presented higher marginal bone loss than the mesial side. PMID:27999789

  11. Dental Implants – Perceiving Patients’ Satisfaction in Relation to Clinical and Electromyography Study on Implant Patients

    PubMed Central

    Saha, Soumendra

    2015-01-01

    The aim of this study is to evaluate the satisfaction of patients with posterior implants in relation to the clinical success criteria and surface electromyography (sEMG) findings of the masseter and temporalis muscles. Total 42 subjects were investigated. Twenty one subjects with posterior dental implants were interviewed using a questionnaire and the clinical success criteria were determined based on The International Congress of Oral Implantologists. The myofunction of the masticatory muscles were assessed using sEMG (21 subjects) and compared to the control group of subjects without implants (21 subjects). Out of 21 subjects, all were satisfied with the aesthetics of their implant. Twenty of them (95.2%) were satisfied with its function and stability. As for clinical criteria, 100% (50) of the implants were successful with no pain, mobility or exudates. sEMG findings showed that patients have significantly lower (p<0.01) basal or resting median power frequency but with muscle burst. During chewing, control subjects showed faster chewing action. There was no difference in reaction and recovery time of clenching for both groups. In conclusion, the satisfaction of implant patients was high, and which was in relation to the successful clinical success criteria and sEMG findings. PMID:26465146

  12. Pulsed Nd:YAG laser treatment for failing dental implants due to peri-implantitis

    NASA Astrophysics Data System (ADS)

    Nicholson, Dawn; Blodgett, Kris; Braga, Charles; Finkbeiner, Larry; Fourrier, Jeanne; George, John; Gregg, Robert; Honigman, Allen; Houser, Bruce; Lamas, William; Lehrman, Neal; Linden, Eric; McCarthy, Delwin; McCawley, Tom; McCormick, Randy; Marcus, Ed; Noraian, Kirk; Rubelman, Peter; Salama, Maurice; Saunders, Steven; Seamons, Brandon; Thein, David; Toms, Michael; Vassos, George; Harris, David M.

    2014-02-01

    A large percentage of dental implants experience complications, most commonly, infection leading to peri-implantitis and peri-mucositis, inflammatory disease involving pathogen contamination. It presents with radiographic findings of crestal bone loss. At this time there appears to be no compelling evidence for an effective intervention. The LANAP protocol is a FDA cleared surgical protocol that produces new attachment and bone regeneration when applied to periodontally infected natural teeth. The LANAP protocol and laser dosimetry have been modified to treat ailing and failing implants. Twenty-one clinicians who have been trained to perform the LANAP protocol and the LAPIPTM protocol have volunteered 26 LAPIP case reports. The time from implant to intervention ranges from 3 months to 16 years. Post-LAPIP radiographs range from 2-48 months. Ten cases were excluded for technical reasons. All 16 remaining cases provide radiographic evidence of increase in crestal bone mass around the implant and, when reported, probe depth reductions. All treating clinicians report control of the infection, reversal of bone loss and rescue of the incumbent implant. Although the success/failure rate cannot be judged from these data, any successes in this area deserve reporting and further study.

  13. Relationship between surface properties (roughness, wettability and morphology) of titanium and dental implant removal torque.

    PubMed

    Elias, Carlos Nelson; Oshida, Yoshiki; Lima, José Henrique Cavalcanti; Muller, Carlos Alberto

    2008-07-01

    The biological properties of titanium depend on its surface oxide film. Several mechanical and chemical treatments have been used to modify the surface morphology and properties of titanium dental implants. One possible method of improving dental implant biocompatibility is to increase surface roughness and decrease the contact angle. In the present work, the biological properties of dental implants were investigated through in vivo and in vitro tests. The effects of surface roughness, contact angle and surface morphology on titanium dental implant removal torque were investigated. Machined dental implants and discs made with commercially pure titanium ASTM grade 4 were submitted to sandblasting treatments, acid etching and anodizing. The sample surface morphologies were characterized by SEM, the surface roughness parameters were quantified using a laser non-contact profilometer, and a contact angle measurement was taken. Dental implants were placed in the tibia of rabbits and removed 12 weeks after the surgery. It was found that: (i) acid etching homogenized the surface roughness parameters; (ii) the anodized surface presented the smallest contact angle; (iii) the in vivo test suggested that, in similar conditions, the surface treatment had a beneficial effect on the implant biocompatibility measured through removal torque; and (iv) the anodized dental implant presented the highest removal torque.

  14. Bioactive and thermally compatible glass coating on zirconia dental implants.

    PubMed

    Kirsten, A; Hausmann, A; Weber, M; Fischer, J; Fischer, H

    2015-02-01

    The healing time of zirconia implants may be reduced by the use of bioactive glass coatings. Unfortunately, existing glasses are either bioactive like Bioglass 45S5 but thermally incompatible with the zirconia substrate, or they are thermally compatible but exhibit only a very low level of bioactivity. In this study, we hypothesized that a tailored substitution of alkaline earth metals and alkaline metals in 45S5 can lead to a glass composition that is both bioactive and thermally compatible with zirconia implants. A novel glass composition was analyzed using x-ray fluorescence spectroscopy, dilatometry, differential scanning calorimetry, and heating microscopy to investigate its chemical, physical, and thermal properties. Bioactivity was tested in vitro using simulated body fluid (SBF). Smooth and microstructured glass coatings were applied using a tailored spray technique with subsequent thermal treatment. Coating adhesion was tested on implants that were inserted in bovine ribs. The cytocompatibility of the coating was analyzed using L929 mouse fibroblasts. The coefficient of thermal expansion of the novel glass was shown to be slightly lower (11.58 · 10(-6) K(-1)) than that of the zirconia (11.67 · 10(-6) K(-1)). After storage in SBF, the glass showed reaction layers almost identical to the bioactive glass gold standard, 45S5. A process window between 800 °C and 910 °C was found to result in densely sintered and amorphous coatings. Microstructured glass coatings on zirconia implants survived a minimum insertion torque of 60 Ncm in the in vitro experiment on bovine ribs. Proliferation and cytotoxicity of the glass coatings was comparable with the controls. The novel glass composition showed a strong adhesion to the zirconia substrate and a significant bioactive behavior in the SBF in vitro experiments. Therefore, it holds great potential to significantly reduce the healing time of zirconia dental implants.

  15. Bioactive and Thermally Compatible Glass Coating on Zirconia Dental Implants

    PubMed Central

    Kirsten, A.; Hausmann, A.; Weber, M.; Fischer, J.

    2015-01-01

    The healing time of zirconia implants may be reduced by the use of bioactive glass coatings. Unfortunately, existing glasses are either bioactive like Bioglass 45S5 but thermally incompatible with the zirconia substrate, or they are thermally compatible but exhibit only a very low level of bioactivity. In this study, we hypothesized that a tailored substitution of alkaline earth metals and alkaline metals in 45S5 can lead to a glass composition that is both bioactive and thermally compatible with zirconia implants. A novel glass composition was analyzed using x-ray fluorescence spectroscopy, dilatometry, differential scanning calorimetry, and heating microscopy to investigate its chemical, physical, and thermal properties. Bioactivity was tested in vitro using simulated body fluid (SBF). Smooth and microstructured glass coatings were applied using a tailored spray technique with subsequent thermal treatment. Coating adhesion was tested on implants that were inserted in bovine ribs. The cytocompatibility of the coating was analyzed using L929 mouse fibroblasts. The coefficient of thermal expansion of the novel glass was shown to be slightly lower (11.58·10–6 K–1) than that of the zirconia (11.67·10–6 K–1). After storage in SBF, the glass showed reaction layers almost identical to the bioactive glass gold standard, 45S5. A process window between 800 °C and 910 °C was found to result in densely sintered and amorphous coatings. Microstructured glass coatings on zirconia implants survived a minimum insertion torque of 60 Ncm in the in vitro experiment on bovine ribs. Proliferation and cytotoxicity of the glass coatings was comparable with the controls. The novel glass composition showed a strong adhesion to the zirconia substrate and a significant bioactive behavior in the SBF in vitro experiments. Therefore, it holds great potential to significantly reduce the healing time of zirconia dental implants. PMID:25421839

  16. Fatigue limits of different PEEK materials for dental implants.

    PubMed

    Schwitalla, Andreas Dominik; Zimmermann, Tycho; Spintig, Tobias; Kallage, Ilona; Müller, Wolf-Dieter

    2016-12-23

    The increasing use of PEEK (poly-ether-ether-ketone) as a substitute for metal implant components has led to the suggestion that it could also be used as an alternative to titanium in the field of dental implants. A major requirement for dental implant materials is their resistance to cyclic loading due to mastication. A special fatigue test was designed to evaluate the elastic behavior and long-term form stability of cylindrically shaped PEEK specimens of 4, 5 and 6mm in diameter, using 11 different PEEK materials of various grades: unfilled, filled with titanium dioxide or barium sulfate powder, reinforced with short carbon fibers or short glass fibers, and reinforced with continuous carbon fibers. The samples were exposed to cyclic loads of up to 2000N. The elastic limits ranged between 46.57±6.44MPa for short carbon fiber reinforced specimens of 6mm diameter and 107.62±8.23MPa for samples of a different short carbon fiber reinforced PEEK compound of 4mm diameter. The elastic limits of the two PEEK grades containing continuous carbon fibers could not be observed because they exceeded the limits of the test specification. The elastic moduli ranged between 2.06±0.18GPa for barium sulfate powder filled PEEK-specimens of 6 mm diameter and 57.53±14.3GPa for continuous carbon fibers reinforced PEEK-specimens of 4 mm diameter. In terms of the elastic limit all the PEEK materials in consideration were able to resist the pressure caused by maximum masticatory forces.

  17. Digital process for an implant-supported fixed dental prosthesis: A clinical report.

    PubMed

    Brandt, Jan; Lauer, Hans-Christoph; Peter, Thorsten; Brandt, Silvia

    2015-10-01

    A digital process is presented for an implant-supported single-tooth and a 3-unit fixed dental prosthesis (FDP) with customized abutments and monolithic prosthetic zirconia restorations. The digital impression on the implant level was made with a TRIOS intraoral scanner (3Shape). This process included the fabrication of an implant cast with the fused deposition modeling technique and a 3-dimensional printing process with integrated implant analogs. The process enabled the FDPs to be designed with CAD/CAM on the cast before patient contact. Designing a printed implant cast expands the use of the digital workflow in the dental field.

  18. Silicon Nitride (Si3N4) implants: the future of dental implantology?

    PubMed

    Badran, Zahi; Struillou, Xavier; Hughes, Francis J; Soueidan, Assem; Hoornaert, Alain; Ide, Mark

    2017-03-16

    For decades titanium has been the preferred material for dental implant fabrication, with mechanical and biological performance resulting in high clinical success rates. Tshese have been further enhanced by incremental development of surface modifications aimed at improving speed and degree of osseointegration and resulting in enhanced clinical treatment options and outcomes. However, increasing demand for metal-free dental restorations has also led to the development of ceramic-based dental implants such as zirconia. In orthopaedics, alternative biomaterials have been used for implant applications such as polyetheretherketone or silicon nitride. The latter is potentially of particular interest for oral use as it has been shown to have antibacterial properties. In this paper we aim to shed light on this particular biomaterial as a future promising candidate for dental implantology applications, addressing basic specifications required for any dental implant material.

  19. [Experience with the use of short dental implants in the literature].

    PubMed

    Vajdovich, István; Orosz, Mihály

    2015-06-01

    According to the literature short dental implants have often been used for the replacement of teeth in the daily praxis. The implantation of short dental implants raise a lot of questions. The autors's aim is to collect the most important experiences of current literature on the mentioned theme to oral implantologists. In the article 33 reviews and clinical studies have been overviewed. The analysis of the different studies suggest that the use of short implants--taking into account of indications and contraindications--decreases the incidence of complications and the patient's discomfort as well as the cost of treatment. The use of short dental implants is proposed as an alternative method in the daily dental praxis.

  20. A graphene/zinc oxide nanocomposite film protects dental implant surfaces against cariogenic Streptococcus mutans.

    PubMed

    Kulshrestha, Shatavari; Khan, Shakir; Meena, Ramovatar; Singh, Braj R; Khan, Asad U

    2014-01-01

    Oral biofilms play a crucial role in the development of dental caries and other periodontal diseases. Streptococcus mutans is one of the primary etiological agents in dental caries. Implant systems are regularly employed to replace missing teeth. Oral biofilms accumulate on these implants and are the chief cause of dental implant failure. In the present study, the potential of graphene/zinc oxide nanocomposite (GZNC) against the cariogenic properties of Streptococcus mutans was explored and the anti-biofilm behaviour of artificial acrylic teeth surfaces coated with GZNC was examined. Acrylic teeth are a good choice for implants as they are low cost, have low density and can resist fracture. Microscopic studies and anti-biofilm assays showed a significant reduction in biofilm in the presence GZNC. GZNC was also found to be nontoxic against HEK-293 (human embryonic kidney cell line). The results indicate the potential of GZNC as an effective coating agent for dental implants by efficiently inhibiting S. mutans biofilms.

  1. Biofilm and saliva affect the biomechanical behavior of dental implants.

    PubMed

    Bordin, Dimorvan; Cavalcanti, Indira M G; Jardim Pimentel, Marcele; Fortulan, Carlos A; Sotto-Maior, Bruno S; Del Bel Cury, Altair A; da Silva, Wander José

    2015-04-13

    Friction coefficient (FC) was quantified between titanium-titanium (Ti-Ti) and titanium-zirconia (Ti-Zr), materials commonly used as abutment and implants, in the presence of a multispecies biofilm (Bf) or salivary pellicle (Pel). Furthermore, FC was used as a parameter to evaluate the biomechanical behavior of a single implant-supported restoration. Interface between Ti-Ti and Ti-Zr without Pel or Bf was used as control (Ctrl). FC was recorded using tribometer and analyzed by two-way Anova and Tukey test (p<0.05). Data were transposed to a finite element model of a dental implant-supported restoration. Models were obtained varying abutment material (Ti and Zr) and FCs recorded (Bf, Pel, and Ctrl). Maximum and shear stress were calculated for bone and equivalent von Misses for prosthetic components. Data were analyzed using two-way ANOVA (p<0.05) and percentage of contribution for each condition (material and FC) was calculated. FC significant differences were observed between Ti-Ti and Ti-Zr for Ctrl and Bf groups, with lower values for Ti-Zr (p<0.05). Within each material group, Ti-Ti differed between all treatments (p<0.05) and for Ti-Zr, only Pel showed higher values compared with Ctrl and Bf (p<0.05). FC contributed to 89.83% (p<0.05) of the stress in the screw, decreasing the stress when the FC was lower. FC resulted in an increase of 59.78% of maximum stress in cortical bone (p=0.05). It can be concluded that the shift of the FC due to the presence of Pel or Bf is able to jeopardize the biomechanical behavior of a single implant-supported restoration.

  2. Dental Implantation of Atrophic Jaws Reconstructed with Iliac Bone Graft Crest - Outcome of Seven Cases

    PubMed Central

    Bllaca, Florian; Toci, Ervin

    2016-01-01

    BACKGROUND: Iliac bone grafts are used to augment alveolar ridges followed by subsequent dental implants in completely edentulous patients. In Albania the information about these issues is scarce. AIM: To describe the procedure of iliac bone grafts augmentation of alveolar ridges and evaluate the survival rate of dental implants in completely edentulous patients in Albania. SUBJECTS AND METHODS: Seven totally edentulous patients (three males, average age 45.9 years) presenting at Durrës Regional Hospital during 2008-2015 and seeking a solution to their problem through implantation procedures were included in the study. Patients were thoroughly examined, evaluated and the best augmentation procedure, using iliac crest bone grafts, and dental implantation technique was chosen. The number of dental implants placed was recorded and their survival rate was calculated. RESULTS: The most common intervention site was maxillae (in 71.4% of cases). Dental implants were installed six months after augmentation, all fixed on the very stable augmented alveolar ridge. On average between 20%-30% of bone grafts, volume was resorbed. Of 37 implants settled, 36 of them or 97.3% survived. CONCLUSION: Iliac bone grafts are a suitable augmentation source of bone in a patient suffering from complete edentulism in Albania. The survival rate of dental implants is very satisfactory. PMID:28028420

  3. On the use of EMI for the assessment of dental implant stability

    NASA Astrophysics Data System (ADS)

    La Malfa Ribolla, Emma; Rizzo, Piervincenzo; Gulizzi, Vincenzo

    2014-03-01

    The achievement and the maintenance of dental implant stability are prerequisites for the long-term success of the osseointegration process. Since implant stability occurs at different stages, it is clinically required to monitor an implant over time, i.e. between the surgery and the placement of the artificial tooth. In this framework, non-invasive tests able to assess the degree of osseointegration are necessary. In this paper, the electromechanical impedance (EMI) method is proposed to monitor the stability of dental implants. A 3D finite element model of a piezoceramic transducer (PZT) bonded to a dental implant placed into the bone was created, considering the presence of a bone-implant interface subjected to Young's modulus change. The numerical model was validated experimentally by testing bovine bone samples. The EMI response of a PZT, bonded to the abutment screwed to implants inserted to the bone, was measured. To simulate the osseointegration process a pulp canal sealer was used to secure the implant to the bone. It was found that the PZT's admittance is sensitive to the stiffness variation of the bone-implant interface. The results show that EMIbased method is able (i) to evaluate the material properties around the implant, and (ii) to promote a novel non-invasive monitoring of dental implant surgical procedure.

  4. Stabilization of a computer-aided implant surgical guide using existing dental implants with conversion of an overdenture to a fixed prosthesis.

    PubMed

    Rathi, Nakul; Scherer, Michael D; McGlumphy, Edwin

    2014-12-01

    This clinical report describes a technique to stabilize a computer-aided dental implant surgical guide to existing implants. A patient requested conversion of her existing mandibular implant-assisted overdenture into a fixed complete denture. The surgical procedure was planned virtually, and the two existing dental implants were integrated into the surgical plan as a means to fixate the surgical guide. The implants were placed, and the patient's prosthesis was converted into an interim fixed complete denture.

  5. Maxillary reconstruction and placement of dental implants after treatment of a maxillary sinus fungus ball.

    PubMed

    Colletti, Giacomo; Felisati, Giovanni; Biglioli, Federico; Tintinelli, Roberto; Valassina, Davide

    2010-01-01

    A fungus ball is one of the fungal diseases that can affect the paranasal sinuses. It requires surgical treatment. Because there is only one previously reported case of dental implant placement after treatment of a maxillary sinus fungus ball, the authors here report on a case of a maxillary sinus fungus ball with bone erosion that was treated surgically with a combined endoscopic endonasal and endoral (Caldwell-Luc) approach. One year later, a graft from the ilium was obtained and a sinus elevation was performed to allow the placement of dental implants. Three months later, the dental implants were placed, and they were all osseointegrated at the 9-month follow-up.

  6. Intraoral Digital Impressioning for Dental Implant Restorations Versus Traditional Implant Impression Techniques.

    PubMed

    Wilk, Brian L

    2015-01-01

    Over the course of the past two to three decades, intraoral digital impression systems have gained acceptance due to high accuracy and ease of use as they have been incorporated into the fabrication of dental implant restorations. The use of intraoral digital impressions enables the clinician to produce accurate restorations without the unpleasant aspects of traditional impression materials and techniques. This article discusses the various types of digital impression systems and their accuracy compared to traditional impression techniques. The cost, time, and patient satisfaction components of both techniques will also be reviewed.

  7. Accidental displacement of a dental implant into the sublingual space: A Case report

    PubMed Central

    Fernández-Solís, José; Marín-Fernández, Ana-Belén; Valencia-Laseca, Alfredo; Monsalve-Iglesias, Fernando

    2016-01-01

    Dental implant surgery is continuously expanding. In fact, every day more and more surgeons are choosing dental implants for allowing great results in the field of oral rehabilitation. However, these procedures are not exempt from complications. This report presents the case of a 66 years old man underwent implant surgery by a specialized dentist. No problems were reported during implant placement. Despite this, three months later, it was displaced into the sublingual space at the time of uncovering. Against this backdrop, the patient was referred to an expert maxillofacial surgeon. Next day, the implant was removed using an intraoral approach to reach the sublingual space. According with our knowledge, there are no cases reported in the literature that describe this complication. Key words:Dental implant, sublingual space, bone atrophy, complications of oral surgery. PMID:27703616

  8. Evidence-based techniques to assess the performance of dental implants.

    PubMed

    Kashi, Ajay; Saha, Subrata

    2013-12-01

    The clinical use of evidence-based medicine has been regarded as one of the most significant medical advancements of the last century. As the costs of medical care escalate, clinical decisions have to be made prudently and with a high degree of efficacy. One of the most expensive treatments in dentistry includes the use of dental implants to rehabilitate partial and fully edentulous patients. Due to the high costs of treatments and the ever increasing varieties of dental implants becoming available, the clinician is often faced with a challenging situation to decide the best prostheses for their patients. Furthermore, navigating through the vast database of literature pertaining to dental implants and their related research can be very time consuming and challenging to a dental surgeon before they can make appropriate clinical decisions. Similar to other orthopedic implants, dental implants need to be evaluated for their long-term efficacy in vivo before they are clinically acceptable. In order to help clinician(s) make patient oriented decisions, evidence-based techniques are becoming increasingly popular. This can be a very useful tool in translating research findings into clinical practice, thus narrowing the gap between research and clinical dentistry. This article discusses ways in which evidence-based techniques can help dental surgeons analyze and make informed clinical decisions about dental implant treatments.

  9. Pyogenic granuloma in relation to dental implants: Clinical and histopathological findings

    PubMed Central

    Pinas, Laura

    2015-01-01

    Background The occurrence of pyogenic granuloma in association to dental implants is rare and only five cases have been reported in the literature. Material and Methods Patients charts were analyzed to select patients who had been diagnosed for pyogenic granuloma and its association with dental implants had been evaluated. The clinical status of the dental implants and the prosthesis had also been assessed. Results Clinical and histopathological diagnosis of pyogenic granuloma had been reached for soft mass growth in association with dental implants in 10 patients. Histological analysis of all samples was performed to obtain a firm diagnosis of finding against pyogenic granuloma lesions. Accumulation of dental plaque due to poor oral hygiene and improper design of the prosthesis had been related to the occurrence of pyogenic granuoloma. This lesion showed no predilection to specific surface type and had no significant association with marginal bone loss. Conclusions Pyogenic granuloma should be included in the differential diagnosis of soft mass growth around dental implants. Key words:Reactive lesion, soft mass, pyogenic granuloma, dental implant, titanium. PMID:26535087

  10. Galvanic corrosion behavior of titanium implants coupled to dental alloys.

    PubMed

    Cortada, M; Giner, L; Costa, S; Gil, F J; Rodríguez, D; Planell, J A

    2000-05-01

    The corrosion of five materials for implant suprastructures (cast-titanium, machined-titanium, gold alloy, silver-palladium alloy and chromium-nickel alloy), was investigated in vitro, the materials being galvanically coupled to a titanium implant. Various electrochemical parameters E(CORR), i(CORR) Evans diagrams, polarization resistance and Tafel slopes) were analyzed. The microstructure of the different dental materials was observed before and after corrosion processes by optical and electron microscopy. Besides, the metallic ions released in the saliva environment were quantified during the corrosion process by means of inductively coupled plasma-mass spectrometry technique (ICP-MS). The cast and machined titanium had the most passive current density at a given potential and chromium-nickel alloy had the most active critical current density values. The high gold content alloys have excellent resistance corrosion, although this decreases when the gold content is lower in the alloy. The palladium alloy had a low critical current density due to the presence of gallium in this composition but a selective dissolution of copper-rich phases was observed through energy dispersive X-ray analysis.

  11. Biofilm formation on dental restorative and implant materials.

    PubMed

    Busscher, H J; Rinastiti, M; Siswomihardjo, W; van der Mei, H C

    2010-07-01

    Biomaterials for the restoration of oral function are prone to biofilm formation, affecting oral health. Oral bacteria adhere to hydrophobic and hydrophilic surfaces, but due to fluctuating shear, little biofilm accumulates on hydrophobic surfaces in vivo. More biofilm accumulates on rough than on smooth surfaces. Oral biofilms mostly consist of multiple bacterial strains, but Candida species are found on acrylic dentures. Biofilms on gold and amalgam in vivo are thick and fully covering, but barely viable. Biofilms on ceramics are thin and highly viable. Biofilms on composites and glass-ionomer cements cause surface deterioration, which enhances biofilm formation again. Residual monomer release from composites influences biofilm growth in vitro, but effects in vivo are less pronounced, probably due to the large volume of saliva into which compounds are released and its continuous refreshment. Similarly, conflicting results have been reported on effects of fluoride release from glass-ionomer cements. Finally, biomaterial-associated infection of implants and devices elsewhere in the body is compared with oral biofilm formation. Biomaterial modifications to discourage biofilm formation on implants and devices are critically discussed for possible applications in dentistry. It is concluded that, for dental applications, antimicrobial coatings killing bacteria upon contact are more promising than antimicrobial-releasing coatings.

  12. Prevalence and risk factors for peri-implant diseases in Japanese adult dental patients.

    PubMed

    Ogata, Yorimasa; Nakayama, Yohei; Tatsumi, Junichi; Kubota, Takehiko; Sato, Shuichi; Nishida, Tetsuya; Takeuchi, Yasuo; Onitsuka, Tokuya; Sakagami, Ryuji; Nozaki, Takenori; Murakami, Shinya; Matsubara, Naritoshi; Tanaka, Maki; Yoshino, Toshiaki; Ota, Junya; Nakagawa, Taneaki; Ishihara, Yuichi; Ito, Taichi; Saito, Atsushi; Yamaki, Keiko; Matsuzaki, Etsuko; Hidaka, Toshirou; Sasaki, Daisuke; Yaegashi, Takashi; Yasuda, Tadashi; Shibutani, Toshiaki; Noguchi, Kazuyuki; Araki, Hisao; Ikumi, Noriharu; Aoyama, Yukihiko; Kogai, Hideki; Nemoto, Kenji; Deguchi, Shinji; Takiguchi, Takashi; Yamamoto, Matsuo; Inokuchi, Keita; Ito, Takatoshi; Kado, Takashi; Furuichi, Yasushi; Kanazashi, Mikimoto; Gomi, Kazuhiro; Takagi, Yukie; Kubokawa, Keita; Yoshinari, Nobuo; Hasegawa, Yoshiaki; Hirose, Tetsushi; Sase, Toshinaga; Arita, Hirokazu; Kodama, Toshiro; Shin, Kitetsu; Izumi, Yuichi; Yoshie, Hiromasa

    2017-03-31

    We investigated the prevalences and risk factors for peri-implant diseases in Japanese adult dental patients attending a follow-up visit at dental hospitals or clinics as part of their maintenance program. This cross-sectional multicenter study enrolled patients with dental implants who attended regular check-ups as part of a periodontal maintenance program during the period from October 2012 through September 2013. Patients with implants with at least 3 years of loading time were included in the study. The condition of peri-implant tissue was examined and classified into the following categories: healthy, peri-implant mucositis, and peri-implantitis. Patients were also evaluated for implant risk factors. A total of 267 patients (110 men, 157 women; mean age: 62.5 ± 10.7 years) were analyzed. The prevalence of patient-based peri-implant mucositis was 33.3% (n = 89), and the prevalence of peri-implantitis was 9.7% (n = 26). Poor oral hygiene and a history of periodontitis were strong risk factors for peri-implant disease. The present prevalences were lower than those previously reported. The quality of periodontal therapy before and after implant installation and patient compliance and motivation, as indicated by plaque control level, appear to be important in maintaining peri-implant tissue health.

  13. Persistent pain and neurosensory disturbance after dental implant surgery: prevention and treatment.

    PubMed

    Al-Sabbagh, Mohanad; Okeson, Jeffrey P; Bertoli, Elizangela; Medynski, Denielle C; Khalaf, Mohd W

    2015-01-01

    Nerve trauma caused by dental implant placement is associated with altered sensation and chronic pain. Complete or partial loss of sensation is often reported by patients who have experienced nerve trauma during implant surgery. Some patients report persistent pain and neurosurgery disturbance long after the normal healing time has passed. In addition, neuropathic pain is reported after implant surgery. Practitioners who place dental implants must be familiar with the differential diagnosis, prevention, and management of neuropathic pain. This article provides insights into the prevention and management of neurosensory deficits and chronic persistent neuropathic pain and considerations for patient referral.

  14. Persistent pain and neurosensory disturbance after dental implant surgery: pathophysiology, etiology, and diagnosis.

    PubMed

    Al-Sabbagh, Mohanad; Okeson, Jeffrey P; Khalaf, Mohd W; Bhavsar, Ishita

    2015-01-01

    Many studies have documented the successful outcomes of dental implants, but have also reported the association of sensory disturbances with the surgical implant procedure. Postsurgical pain is a normal response to tissue injury, and usually resolves after the tissue heals. However, some patients who receive dental implants experience persistent pain even after normal healing. This article describes the basic anatomy and pathophysiology associated with nerve injury. The incidence and diagnosis of these problems, in addition to factors that result in the development of chronic persistent neuropathic pain and sensory disturbances associated with surgical implant placement, are discussed.

  15. 21 CFR 872.3980 - Endosseous dental implant accessories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... abutments, aid in the fabrication of dental prosthetics, and be used as an accessory with endosseous dental..., countertorque devices, placement and removal tools, laboratory pieces used for fabrication of dental...

  16. 21 CFR 872.3980 - Endosseous dental implant accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... abutments, aid in the fabrication of dental prosthetics, and be used as an accessory with endosseous dental..., countertorque devices, placement and removal tools, laboratory pieces used for fabrication of dental...

  17. 21 CFR 872.3980 - Endosseous dental implant accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... abutments, aid in the fabrication of dental prosthetics, and be used as an accessory with endosseous dental..., countertorque devices, placement and removal tools, laboratory pieces used for fabrication of dental...

  18. 21 CFR 872.3980 - Endosseous dental implant accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... abutments, aid in the fabrication of dental prosthetics, and be used as an accessory with endosseous dental..., countertorque devices, placement and removal tools, laboratory pieces used for fabrication of dental...

  19. Effect of Offset Implant Placement on the Stress Distribution Around a Dental Implant: A Three-Dimensional Finite Element Analysis.

    PubMed

    Siadat, Hakimeh; Hashemzadeh, Shervin; Geramy, Allahyar; Bassir, Seyed Hossein; Alikhasi, Marzieh

    2015-12-01

    There are some anatomical restrictions in which implants are not possible to be inserted in their conventional configuration. Offset placement of implants in relation to the prosthetic unit could be a treatment solution. The aim of this study was to evaluate the effect of the offset placement of implant-supported prosthesis on the stress distribution around a dental implant using 3D finite element analysis. 3D finite element models of implant placement in the position of a mandibular molar with 4 configurations (0, 0.5, 1, 1.5 mm offset) were created in order to investigate resultant stress/strain distribution. A vertical load of 100 N was applied on the center of the crown of the models. The least stress in peri-implant tissue was found in in-line configuration (0 mm offset). Stress concentration in the peri-implant tissue increased by increasing the amount of offset placement. Maximum stress concentration in all models was detected at the neck of the implant. It can be concluded that the offset placement of a single dental implant does not offer biomechanical advantages regarding reducing stress concentration over the in-line implant configuration. It is suggested that the amount of offset should be as minimum as possible.

  20. [Comparative study of two different types of dental implants in dogs. Experimental study].

    PubMed

    Sanromán, F; Montolio, J; Llorens, M P

    1990-03-01

    Mandibular incisors were taken out in 13 adult dogs. Twenty days after the extraction, two implants either of titanium or hydroxylapatite were placed in a second operation. The clinical, pathological and radiological results suggest that metallic implants produce fibrous tissue around the implant. In most cases, fibrous tissue does not ossify and this facilitates the formation of a malunion and the mobilization of the implant. However, the results with hydroxylapatite implants appear to be satisfactory due to the formation of an osseous tissue mandibular bone. This tissue prevents the mobilization of the implant allowing support to a dental prostheses.

  1. New approach towards mini dental implants and small-diameter implants: an option for long-term prostheses.

    PubMed

    Gleiznys, Alvydas; Skirbutis, Gediminas; Harb, Ali; Barzdziukaite, Ingrida; Grinyte, Ieva

    2012-01-01

    BACKGROUND. Mini dental implants (MDI) and small diameter implants (SDI) have been extensively used as temporary or orthodontic anchorage; however there have been studies that proved their availability as a mean for long term prosthodontics. Our aim was to review the indications, advantages of MDI and SDI, and their long-term survival. METHODS. Computerized searches were conducted for clinical studies between year 2000 and 2011 that involved either implants with 3.3 mm diameter or less, used in prosthodontics; or provided a follow up of MDI or SDI duration of at least 4 months following implant placement including survival rate data. All studies about implants used in orthodontics were excluded. The range of available MDI and SDI has been found in cataloges of the companies: 3M ESPE IMTEC, Bicon Dental, Zimmer, Implant Direct, Intra lock, Hiossen, Simpler Implant, KAT Implants, OCO Biomedical, American Dental Implant. RESULTS. 41 studies meeting the above criteria were selected, 22 out of them reviewed survival rates of MDI and SDI. The follow up duration varried from 4 months to 8 years with survival rates between 91.17 and 100%. Nevertheless, the companies showed a big variety of MDI and SDI provided in the market for long term prostheses. CONCLUSIONS. Implants with small diameters can be used successfully in a variety of clinical situations. Less surgical time, less postoperative pain, ability of direct loading after surgery with no harm to bone and cost effectiveness are the advantages. The reduced surface implants require correct treatment planning so that the loading force would not cause bone loss or implant failure. MDI and SDI show high survival rates, but special cautions for bone quality and good oral hygiene should be maintained.

  2. Evaluation of bone loss in antibacterial coated dental implants: An experimental study in dogs.

    PubMed

    Godoy-Gallardo, Maria; Manzanares-Céspedes, Maria Cristina; Sevilla, Pablo; Nart, José; Manzanares, Norberto; Manero, José M; Gil, Francisco Javier; Boyd, Steven K; Rodríguez, Daniel

    2016-12-01

    The aim of this study was to evaluate the in vivo effect of antibacterial modified dental implants in the first stages of peri-implantitis. Thirty dental implants were inserted in the mandibular premolar sites of 5 beagle dogs. Sites were randomly assigned to Ti (untreated implants, 10units), Ti_Ag (silver electrodeposition treatment, 10units), and Ti_TSP (silanization treatment, 10units). Coated implants were characterized by scanning electron microscopy, interferometry and X-ray photoelectron spectroscopy. Two months after implant insertion, experimental peri-implantitis was initiated by ligature placement. Ligatures were removed 2months later, and plaque formation was allowed for 2 additional months. Clinical and radiographic analyses were performed during the study. Implant-tissue samples were prepared for micro computed tomography, backscattered scanning electron microscopy, histomorphometric and histological analyses and ion release measurements. X-ray, SEM and histology images showed that vertical bone resorption in treated implants was lower than in the control group (P<0.05). This effect is likely due to the capacity of the treatments to reduce bacteria colonization on the implant surface. Histological analysis suggested an increase of peri-implant bone formation on silanized implants. However, the short post-ligature period was not enough to detect differences in clinical parameters among implant groups. Within the limits of this study, antibacterial surface treatments have a positive effect against bone resorption induced by peri-implantitis.

  3. A pilot study in the recovery and recognition of non-osseointegrated dental implants following cremation.

    PubMed

    Berketa, J; James, H; Marino, V

    2011-12-01

    Minimal dimensional changes in free standing dental implants when incinerated in a kiln to a temperature of 1125°C have been reported previously. However, in the same study colour changes were observed between commercially pure titanium and titanium alloy type of implants, with speculation that this change may be a useful distinguishing tool in cases requiring forensic identification. The present study was instigated to determine what changes occur following cremation to bone-supported dental implants placed within mandibles of sheep. A selection of dental implants was photographed and radiographed. They were then surgically placed in sheep mandibles and the entire sheep heads cremated in a commercial cremator. There was detachment of the dental implants from the mandible, which could have implications for scene recovery. Following retrieval and re-irradiating of the implants, image subtraction evaluation of the radiographs was recorded using Adobe(®) Photoshop.(®) As with the previous study there was slight oxidation of the implant surfaces leading to minor alteration of the images. There was, however, no gold crust colour change in the commercially pure titanium. Photography within the retrieved implants revealed the batch number within the Straumann™ implant was still visible, which could significantly add weight to the identification of deceased persons.

  4. The status of undergraduate implant education in dental schools outside the United States.

    PubMed

    Seckinger, R J; Weintraub, A M; Berthold, P; Weintraub, G S

    1995-01-01

    Over the past 20 years the incorporation of implant dentistry into academia has been documented in some detail for North American dental schools but has not been pursued on an international level. In June of 1993, we surveyed 51 dental schools outside of the United States affiliated with the University of Pennsylvania School of Dental Medicine's Office of International Relations concerning their teaching involvement with implant dentistry. Results from the 44 (86 percent) responding schools suggest that implant dentistry is being incorporated into predoctoral curriculums. Industrialized countries were more inclined to provide implant education. Insufficient time and the thought that the predoctoral level was not the place for implant dentistry were cited as some of the reasons for not incorporating implant dentistry into the curriculum. Oral surgery, prosthodontics, and periodontics departments developed and administered the implant curriculum. Formats varied among schools with respect to allotted time, curricular placement, laboratory experience, and clinical participation. Didactic material most frequently presented included a historical overview, diagnosis and treatment planning, classification of dental implants, and surgical and prosthetic concepts. Clinical involvement varied from actual implant placement to observation of prosthodontic procedures. Results were categorized based on the TOEFL (Test of English as a Foreign Language) classification of countries in six regions.

  5. The design and production of Ti-6Al-4V ELI customized dental implants

    NASA Astrophysics Data System (ADS)

    Chahine, Gilbert; Koike, Mari; Okabe, Toru; Smith, Pauline; Kovacevic, Radovan

    2008-11-01

    This paper addresses the production of customized Ti-6Al-4V ELI dental implants via electron beam melting (EBM). The melting of Ti-6Al-4V ELI powder produces implants with great biocompatibility, fi ne mechanical performance, and a high bone ingrowth potential. The EBM technology is used to produce one-component dental implants that mimic the exact shape of the patient’s tooth, replacing the traditional, three-component, “screw-like” standardized dental implants currently used. The new generation of implants provides the possibility of simplifying pre-insertion procedures leading to faster healing time, and the potential of better and stronger osseointegration, specifi cally through incorporating lattice structure design.

  6. Conservative surgical and microsurgical techniques for the management of dental implants that impinge on the inferior alveolar nerve.

    PubMed

    Gennaro, Paolo; Chisci, Glauco; Gabriele, Guido; Iannetti, Giorgio

    2014-07-01

    Loss of sensation in the lip after insertion of an implant is annoying. The aim of this paper was to describe two techniques for management of osseointegrated dental implants that impinge on the mandibular nerve, the purpose of which is to improve sensation without unscrewing the dental implant.

  7. Effect of Zirconia Dental Implant Surfaces on Bone Integration: A Systematic Review and Meta-Analysis.

    PubMed

    Hafezeqoran, Ali; Koodaryan, Roodabeh

    2017-01-01

    Background. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from sufficient. Objective. The purpose of this systematic review and meta-analysis was to evaluate and compare zirconia dental implants with different surface topographies, with a focus on bone to implant contact and removal torque. Methods. The systematic review of the extracted publications was performed to compare the bone to implant contact (BIC) with removal torque (RT) values of titanium dental implants and machined and surfaced modified zirconia implants. Results. A total of fifteen articles on BIC and RT values were included in the quantitative analysis. No significant difference in the BIC values was observed between titanium and machined zirconia implants (p = 0.373; 95% CI: -0.166 to 0.443). However, a significantly better BIC values were observed for acid etched zirconia implants compared with those of titanium implants (p = 0.032; 95% CI: 0.068 to 1.461). Unmodified zirconia implants showed favorable BIC values compared to modified-surface zirconia implants (p = 0.021; 95% CI: -0.973 to -0.080). Conclusion. Acid etched zirconia implants may serve as a possible substitute for successful osseointegration.

  8. Effect of Zirconia Dental Implant Surfaces on Bone Integration: A Systematic Review and Meta-Analysis

    PubMed Central

    2017-01-01

    Background. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from sufficient. Objective. The purpose of this systematic review and meta-analysis was to evaluate and compare zirconia dental implants with different surface topographies, with a focus on bone to implant contact and removal torque. Methods. The systematic review of the extracted publications was performed to compare the bone to implant contact (BIC) with removal torque (RT) values of titanium dental implants and machined and surfaced modified zirconia implants. Results. A total of fifteen articles on BIC and RT values were included in the quantitative analysis. No significant difference in the BIC values was observed between titanium and machined zirconia implants (p = 0.373; 95% CI: −0.166 to 0.443). However, a significantly better BIC values were observed for acid etched zirconia implants compared with those of titanium implants (p = 0.032; 95% CI: 0.068 to 1.461). Unmodified zirconia implants showed favorable BIC values compared to modified-surface zirconia implants (p = 0.021; 95% CI: −0.973 to −0.080). Conclusion. Acid etched zirconia implants may serve as a possible substitute for successful osseointegration. PMID:28299337

  9. In situ microradioscopy and microtomography of fatigue-loaded dental two-piece implants.

    PubMed

    Wiest, Wolfram; Zabler, Simon; Rack, Alexander; Fella, Christian; Balles, Andreas; Nelson, Katja; Schmelzeisen, Rainer; Hanke, Randolf

    2015-11-01

    Synchrotron real-time radioscopy and in situ microtomography are the only techniques providing direct visible information on a micrometre scale of local deformation in the implant-abutment connection (IAC) during and after cyclic loading. The microgap formation at the IAC has been subject to a number of studies as it has been proposed to be associated with long-term implant success. The next step in this scientific development is to focus on the in situ fatigue procedure of two-component dental implants. Therefore, an apparatus has been developed which is optimized for the in situ fatigue analysis of dental implants. This report demonstrates both the capability of in situ radioscopy and microtomography at the ID19 beamline for the study of cyclic deformation in dental implants. The first results show that it is possible to visualize fatigue loading of dental implants in real-time radioscopy in addition to the in situ fatigue tomography. For the latter, in situ microtomography is applied during the cyclic loading cycles in order to visualize the opening of the IAC microgap. These results concur with previous ex situ studies on similar systems. The setup allows for easily increasing the bending force, to simulate different chewing situations, and is, therefore, a versatile tool for examining the fatigue processes of dental implants and possibly other specimens.

  10. Pressure behavior of different PEEK materials for dental implants.

    PubMed

    Schwitalla, Andreas Dominik; Spintig, Tobias; Kallage, Ilona; Müller, Wolf-Dieter

    2016-02-01

    Due to its mechanical properties, the biocompatible high-performance material PEEK (polyetheretherketone) and PEEK-based compounds may represent viable alternatives to titanium in the field of dental implantology. Therefore we performed static pressure tests with 11 PEEK materials (two unfilled grades, two grades filled with titanium-dioxide-powder, two grades filled with barium-sulfate-powder, two grades reinforced with short carbon fibers, one grade reinforced with glass fibers and two grades reinforced with continuous carbon fibers) in the form of cylindrical specimens with a diameter of 4, 5 and 6mm. The specimens had a height to diameter ratio of 2:1 and were therefore 8, 10 and 12mm high. The parameters elastic modulus, elastic limit and pressure strength were evaluated. The elastic moduli ranged between 2.65±0.03GPa for specimens of a titanium-dioxide-filled grade and 106.71±14.83GPa for specimens reinforced with continuous carbon fibers. The elastic limits ranged between 808.1±42.44N for specimens of a barium-sulfate-filled grade and 7256.4±519.86N for specimens reinforced with continuous carbon fibers. The lowest pressure strength of 122.77MPa was observed for specimens of an unfilled grade, whereas the highest pressure strength of 712.67±66.02MPa could be evaluated for specimens containing continuous carbon fibers. Regarding the maximum bite force of a first molar, all tested materials seem to be suitable for the use as dental implants.

  11. The combined effects of undersized drilling and implant macrogeometry on bone healing around dental implants: an experimental study.

    PubMed

    Jimbo, R; Tovar, N; Anchieta, R B; Machado, L S; Marin, C; Teixeira, H S; Coelho, P G

    2014-10-01

    This study investigated the effect of undersized preparations with two different implant macrogeometries. There were four experimental groups: group 1, conical implant with an undersized osteotomy of 3.2mm; group 2, conical implant with an undersized osteotomy of 3.5mm; group 3, cylindrical implant with an undersized osteotomy of 3.2mm; group 4, cylindrical implant with an undersized osteotomy of 3.5mm. Implants were placed in one side of the sheep mandible (n=6). After 3 weeks, the same procedure was conducted on the other side; 3 weeks later, euthanasia was performed. All implants were 4mm×10mm. Insertion torque was recorded for all implants during implantation. Retrieved samples were subjected to histological sectioning and histomorphometry. Implants of groups 1 and 2 presented significantly higher insertion torque than those of groups 3 and 4 (P<0.001). No differences in bone-to-implant contact or bone area fraction occupied were observed between the groups at 3 weeks (P>0.24, and P>0.25, respectively), whereas significant differences were observed at 6 weeks between groups 1 and 2, and between groups 3 and 4 (P<0.01). Undersized drilling affected the biological establishment of bone formation around both dental implant macrogeometries.

  12. Nano-crystalline diamond-coated titanium dental implants - a histomorphometric study in adult domestic pigs.

    PubMed

    Metzler, Philipp; von Wilmowsky, Cornelius; Stadlinger, Bernd; Zemann, Wolfgang; Schlegel, Karl Andreas; Rosiwal, Stephan; Rupprecht, Stephan

    2013-09-01

    Promising biomaterial characteristics of diamond-coatings in biomedicine have been described in the literature. However, there is a lack of knowledge about implant osseointegration of this surface modification compared to the currently used sandblasted acid-etched Ti-Al6-V4 implants. The aim of this study was to investigate the osseointegration of microwave plasma-chemical-vapour deposition (MWP-CVD) diamond-coated Ti-Al6-V4 dental implants after healing periods of 2 and 5 months. Twenty-four MWP-CVD diamond-coated and 24 un-coated dental titanium-alloy implants (Ankylos(®)) were placed in the frontal skull of eight adult domestic pigs. To evaluate the effects of the nano-structured surfaces on bone formation, a histomorphometric analysis was performed after 2 and 5 months of implant healing. Histomorphometry analysed the bone-to-implant contact (BIC). No significant difference in BIC for the diamond-coated implants in comparison to reference implants could be observed for both healing periods. Scanning electron microscopy revealed an adequate interface between the bone and the diamond surface. No delamination or particle-dissociation due to shearing forces could be detected. In this study, diamond-coated dental titanium-alloy implants and sandblasted acid-etched implants showed a comparable degree of osseointegration.

  13. Polymorphisms of Il-10 (-1082) and RANKL (-438) Genes and the Failure of Dental Implants

    PubMed Central

    Ribeiro, Rodrigo; Melo, Rayanne; Tortamano Neto, Pedro; Vajgel, André

    2017-01-01

    Background. Genetic polymorphisms in certain cytokines and chemokines have been investigated to understand why some individuals display implant flaws despite having few risk factors at the time of implant. Purpose. To investigate the association of genetic polymorphisms in interleukin- (IL-) 10 [-1082 region (A/G)] and RANKL [-438 region (A/G)] with the failure of dental implants. Materials and Methods. This study included 90 partially edentulous male and female patients who were rehabilitated with a total of 245 Straumann dental implants. An implant was considered a failure if any of the following occurred: mobility, persistent subjective complaint, recurrent peri-implant infection with suppuration, continuous radiolucency around the implant, probing depth ≥ 5 mm, and bleeding on probing. Buccal mucosal cells were collected for analysis of RANKL438 and IL-10. Results. The implant success rate in this population was 34.4%. The mutant allele (G) in RANKL had an incidence of 52.3% and mutant allele (A) in IL-10 was observed in 37.8%. No statistically significant difference was detected between the failure of the implant and the genotypes and allelic frequencies. Conclusion. No association was detected between the genetic polymorphisms of RANKL (-438) and IL-10 (-1082) and the failure of dental implants in the population studied. PMID:28348592

  14. Predicting bone remodeling around tissue- and bone-level dental implants used in reduced bone width.

    PubMed

    Eser, Atilim; Tonuk, Ergin; Akca, Kivanc; Dard, Michel M; Cehreli, Murat Cavit

    2013-09-03

    The objective of this study was to predict time-dependent bone remodeling around tissue- and bone-level dental implants used in patients with reduced bone width. The remodeling of bone around titanium tissue-level, and titanium and titanium-zirconium alloy bone-level implants was studied under 100 N oblique load for one month by implementing the Stanford theory into three-dimensional finite element models. Maximum principal stress, minimum principal stress, and strain energy density in peri-implant bone and displacement in x- and y- axes of the implant were evaluated. Maximum and minimum principal stresses around tissue-level implant were higher than bone-level implants and both bone-level implants experienced comparable stresses. Total strain energy density in bone around titanium implants slightly decreased during the first two weeks of loading followed by a recovery, and the titanium-zirconium implant showed minor changes in the axial plane. Total strain energy density changes in the loading and contralateral sides were higher in tissue-level implant than other implants in the cortical bone at the horizontal plane. The displacement values of the implants were almost constant over time. Tissue-level implants were associated with higher stresses than bone-level implants. The time-dependent biomechanical outcome of titanium-zirconium alloy bone-level implant was comparable to the titanium implant.

  15. Temporal sequence of hard and soft tissue healing around titanium dental implants.

    PubMed

    Salvi, Giovanni E; Bosshardt, Dieter D; Lang, Niklaus P; Abrahamsson, Ingemar; Berglundh, Tord; Lindhe, Jan; Ivanovski, Saso; Donos, Nikos

    2015-06-01

    The objective of the present review was to summarize the evidence available on the temporal sequence of hard and soft tissue healing around titanium dental implants in animal models and in humans. A search was undertaken to find animal and human studies reporting on the temporal dynamics of hard and soft tissue integration of titanium dental implants. Moreover, the influence of implant surface roughness and chemistry on the molecular mechanisms associated with osseointegration was also investigated. The findings indicated that the integration of titanium dental implants into hard and soft tissue represents the result of a complex cascade of biological events initiated by the surgical intervention. Implant placement into alveolar bone induces a cascade of healing events starting with clot formation and continuing with the maturation of bone in contact with the implant surface. From a genetic point of view, osseointegration is associated with a decrease in inflammation and an increase in osteogenesis-, angiogenesis- and neurogenesis-associated gene expression during the early stages of wound healing. The attachment and maturation of the soft tissue complex (i.e. epithelium and connective tissue) to implants becomes established 6-8 weeks following surgery. Based on the findings of the present review it can be concluded that improved understanding of the mechanisms associated with osseointegration will provide leads and targets for strategies aimed at enhancing the clinical performance of titanium dental implants.

  16. Bruxism and dental implant failures: a multilevel mixed effects parametric survival analysis approach.

    PubMed

    Chrcanovic, B R; Kisch, J; Albrektsson, T; Wennerberg, A

    2016-11-01

    Recent studies have suggested that the insertion of dental implants in patients being diagnosed with bruxism negatively affected the implant failure rates. The aim of the present study was to investigate the association between the bruxism and the risk of dental implant failure. This retrospective study is based on 2670 patients who received 10 096 implants at one specialist clinic. Implant- and patient-related data were collected. Descriptive statistics were used to describe the patients and implants. Multilevel mixed effects parametric survival analysis was used to test the association between bruxism and risk of implant failure adjusting for several potential confounders. Criteria from a recent international consensus (Lobbezoo et al., J Oral Rehabil, 40, 2013, 2) and from the International Classification of Sleep Disorders (International classification of sleep disorders, revised: diagnostic and coding manual, American Academy of Sleep Medicine, Chicago, 2014) were used to define and diagnose the condition. The number of implants with information available for all variables totalled 3549, placed in 994 patients, with 179 implants reported as failures. The implant failure rates were 13·0% (24/185) for bruxers and 4·6% (155/3364) for non-bruxers (P < 0·001). The statistical model showed that bruxism was a statistically significantly risk factor to implant failure (HR 3·396; 95% CI 1·314, 8·777; P = 0·012), as well as implant length, implant diameter, implant surface, bone quantity D in relation to quantity A, bone quality 4 in relation to quality 1 (Lekholm and Zarb classification), smoking and the intake of proton pump inhibitors. It is suggested that the bruxism may be associated with an increased risk of dental implant failure.

  17. Stress and strain distribution in three different mini dental implant designs using in implant retained overdenture: a finite element analysis study

    PubMed Central

    AUNMEUNGTONG, W.; KHONGKHUNTHIAN, P.; RUNGSIYAKULL, P.

    2016-01-01

    SUMMARY Finite Element Analysis (FEA) has been used for prediction of stress and strain between dental implant components and bone in the implant design process. Purpose Purpose of this study was to characterize and analyze stress and strain distribution occurring in bone and implants and to compare stress and strain of three different implant designs. Materials and methods Three different mini dental implant designs were included in this study: 1. a mini dental implant with an internal implant-abutment connection (MDIi); 2. a mini dental implant with an external implant-abutment connection (MDIe); 3. a single piece mini dental implant (MDIs). All implant designs were scanned using micro-CT scans. The imaging details of the implants were used to simulate models for FEA. An artificial bone volume of 9×9 mm in size was constructed and each implant was placed separately at the center of each bone model. All bone-implant models were simulatively loaded under an axial compressive force of 100 N and a 45-degree force of 100 N loading at the top of the implants using computer software to evaluate stress and strain distribution. Results There was no difference in stress or strain between the three implant designs. The stress and strain occurring in all three mini dental implant designs were mainly localized at the cortical bone around the bone-implant interface. Oblique 45° loading caused increased deformation, magnitude and distribution of stress and strain in all implant models. Conclusions Within the limits of this study, the average stress and strain in bone and implant models with MDIi were similar to those with MDIe and MDIs. The oblique 45° load played an important role in dramatically increased average stress and strain in all bone-implant models. Clinical implications Mini dental implants with external or internal connections have similar stress distribution to single piece mini dental implants. In clinical situations, the three types of mini dental implant

  18. Dental implants in irradiated versus nonirradiated patients: A meta-analysis.

    PubMed

    Chrcanovic, Bruno Ramos; Albrektsson, Tomas; Wennerberg, Ann

    2016-03-01

    The purpose of the present meta-analysis was to test the null hypothesis of no difference in dental implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants and being previously irradiated in the head and neck region versus nonirradiated patients against the alternative hypothesis of a difference. The study suggests that irradiation negatively affects the survival of implants, as well as the difference in implant location (maxilla vs mandible), but there is no statistically significant difference in survival when implants are inserted before or after 12 months after radiotherapy. The study failed to support the effectiveness of hyperbaric oxygen therapy in irradiated patients. It was observed that there was a tendency of lower survival rates of implants inserted in the patients submitted to higher irradiation doses. The results should be interpreted with caution because of the presence of uncontrolled confounding factors in the included studies.

  19. Insights on Metal Based Dental Implants and their Interaction with the Surrounding Tissues.

    PubMed

    Popa, Marcela; Hussien, Mohamed D; Cirstea, Alexandra; Grigore, Raluca; Lazar, Veronica; Bezirtzoglou, Eugenia; Chifiriuc, Mariana Carmen; Sakizlian, Monica; Stavropoulou, Elisavet; Bertesteanu, Serban

    2015-01-01

    At present, the use of dental implants is a very common practice as tooth loss is a frequent problem and can occur as a result of disease or trauma. An implant is usually made of biocompatible materials that do not cause rejection reactions and allow the implant union with the respective bone. To achieve this goal, the implant surface may have different structures and coatings, generally used to increase the adherence of the implant to the bone and to decrease the risk of the periimplantar inflammatory reactions. This review gives some insights of the metal based materials used for dental implants, their limits, improvement strategies as well as the pathophysiology, diagnosis, treatment and prevention of periimplantary diseases.

  20. Biomechanical and histomorphometric study of dental implants with different surface characteristics.

    PubMed

    Yeo, In-Sung; Han, Jung-Suk; Yang, Jae-Ho

    2008-11-01

    The aim of this study was to investigate the early bone response to the titanium dental implants with different surface characteristics using the rabbit tibia model. Calcium metaphosphate coated, anodic oxidized, hydroxyapatite particle-blasted, and turned (control) surfaces were compared. Surface topography was evaluated by field emission scanning electron microscope and optical interferometer. Eighteen rabbits received 72 implants in the tibia. Resonance frequency was analyzed every week for 6 weeks. Removal torque values were measured 2 and 6 weeks after placement. The implant-bone interfaces were directly observed by light microscope and bone-to-implant contact ratios were measured 2 and 6 weeks after insertion. All the surface-modified implants showed superior initial bone responses to the control. No significant differences were found among the surface-modified groups. Data suggest that various surface modification methods can provide favorable bone responses for early functioning and healing of dental implants.

  1. Cost-effectiveness of anterior implants versus fixed dental prostheses.

    PubMed

    Zitzmann, N U; Krastl, G; Weiger, R; Kühl, S; Sendi, P

    2013-12-01

    For the restoration of an anterior missing tooth, implant-supported single crowns (ISCs) or fixed dental prostheses (FDPs) are indicated, but it is not clear which type of restoration is more cost-effective. A self-selected trial was performed with 15 patients with ISCs and 11 with FDPs. Patient preferences were recorded with visual analog scales before treatment, 1 month following restoration, and then annually. Quality-adjusted tooth years (QATYs) were estimated by considering the type of reconstruction for replacing the missing tooth and its effect on the adjacent teeth. A stochastic cost-effectiveness model was developed using Monte Carlo simulation. The expected costs and QATYs were summarized in cost-effectiveness acceptability curves. ISC was the dominant strategy, with a QATY increase of 0.01 over 3 years and 0.04 over 10 years with a higher probability of being cost-effective. While both treatment options provided satisfactory long-term results from the patient's perspective, the lower initial costs, particularly laboratory fees, were responsible for the dominance of ISCs over FDPs.

  2. Indications and contraindications of dental implants in medically compromised patients: Update

    PubMed Central

    Gómez-de Diego, Rafael; Mang-de la Rosa, María del Rocío; Romero-Pérez, María J.; Cutando-Soriano, Antonio

    2014-01-01

    The aim of this study was to review the current scientific literature in order to analyse the indications and contraindications of dental implants in medically compromised patients. A reference research was carried out on PubMed using the key words “implant” AND (oral OR dental) AND (systemic disease OR medically compromised), in articles published between 1993 and 2013. The inclusion criteria were the following: clinical studies in which, at least, 10 patients were treated, consensus articles, reviewed articles and meta-analysis performed in humans treated with dental implants, and which included the disease diagnosis. A total of 64 articles were found, from which 16 met the inclusion criteria. Cardiac systemic diseases, diabetic endocrine pathologies or controlled metabolic disorders do not seem to be a total or partial contraindication to the placement of dental implants. Tobacco addiction, and head and neck radiotherapy are correlated to a higher loss of dental implants. Patients suffering from osteoporosis undergoing biphosphonates therapy show an increased risk of developing bone necrosis after an oral surgery, especially if the drugs are administered intravenously or they are associated to certain concomitant medication. Key words:Dental implants, medically compromised patient, systemic diseases. PMID:24608222

  3. Treatment with dental implants in patients with severe osteoporosis: a case report.

    PubMed

    Friberg, B

    1994-08-01

    The case report of a woman with severe osteoporosis who was treated with dental implants is presented. Polyarthritis was diagnosed in 1955, and a corticosteroid medication treatment was started in 1960. During the years, the patient has undergone multiple joint surgeries. Dental implants were inserted in the maxilla in 1987 and in the mandible in 1988. Due to a compression of the spine, the patient lost 12 cm in body height between 1991 and 1993; a spontaneous femur fracture was diagnosed in December 1992. However, the arch bone has been stable; the 6- and 5-year follow-up results of the maxillary and mandibular implants, respectively, are presented.

  4. Extraordinary sneeze: Spontaneous transmaxillary-transnasal discharge of a migrated dental implant

    PubMed Central

    Procacci, Pasquale; De Santis, Daniele; Bertossi, Dario; Albanese, Massimo; Plotegher, Cristina; Zanette, Giovanni; Pardo, Alessia; Nocini, Pier Francesco

    2016-01-01

    This case report describes an extraordinary case of the spontaneous transmaxillary-transnasal discharge of a dental implant, which occurred during a sneeze. The patient was complained of symptoms of acute sinusitis. She underwent a computed tomography scan that revealed a dental implant dislocated in the maxillary sinus. Medical treatment based on antibiotics and mucolytics was administered to the patient in order to prepare her for endoscopic endonasal surgery. The implant was spontaneously discharged two days after during a sneeze. Mucociliary clearance in combination with a local osteolytic inflammatory process and mucolytics therapy are the likely causes of this unusual discharge. PMID:27574611

  5. Extraordinary sneeze: Spontaneous transmaxillary-transnasal discharge of a migrated dental implant.

    PubMed

    Procacci, Pasquale; De Santis, Daniele; Bertossi, Dario; Albanese, Massimo; Plotegher, Cristina; Zanette, Giovanni; Pardo, Alessia; Nocini, Pier Francesco

    2016-08-16

    This case report describes an extraordinary case of the spontaneous transmaxillary-transnasal discharge of a dental implant, which occurred during a sneeze. The patient was complained of symptoms of acute sinusitis. She underwent a computed tomography scan that revealed a dental implant dislocated in the maxillary sinus. Medical treatment based on antibiotics and mucolytics was administered to the patient in order to prepare her for endoscopic endonasal surgery. The implant was spontaneously discharged two days after during a sneeze. Mucociliary clearance in combination with a local osteolytic inflammatory process and mucolytics therapy are the likely causes of this unusual discharge.

  6. Management of Patients With Cardiovascular Implantable Electronic Devices in Dental, Oral, and Maxillofacial Surgery

    PubMed Central

    Tom, James

    2016-01-01

    The prevalence of cardiovascular implantable electronic devices as life-prolonging and life-saving devices has evolved from a treatment of last resort to a first-line therapy for an increasing number of patients. As these devices become more and more popular in the general population, dental providers utilizing instruments and medications should be aware of dental equipment and medications that may affect these devices and understand the management of patients with these devices. This review article will discuss the various types and indications for pacemakers and implantable cardioverter-defibrillators, common drugs and instruments affecting these devices, and management of patients with these devices implanted for cardiac dysrhythmias. PMID:27269668

  7. Management of Patients With Cardiovascular Implantable Electronic Devices in Dental, Oral, and Maxillofacial Surgery.

    PubMed

    Tom, James

    2016-01-01

    The prevalence of cardiovascular implantable electronic devices as life-prolonging and life-saving devices has evolved from a treatment of last resort to a first-line therapy for an increasing number of patients. As these devices become more and more popular in the general population, dental providers utilizing instruments and medications should be aware of dental equipment and medications that may affect these devices and understand the management of patients with these devices. This review article will discuss the various types and indications for pacemakers and implantable cardioverter-defibrillators, common drugs and instruments affecting these devices, and management of patients with these devices implanted for cardiac dysrhythmias.

  8. Infrared Thermographic Assessment of Cooling Effectiveness in Selected Dental Implant Systems.

    PubMed

    Kirstein, Karol; Dobrzyński, Maciej; Kosior, Piotr; Chrószcz, Aleksander; Dudek, Krzysztof; Fita, Katarzyna; Parulska, Olga; Rybak, Zbigniew; Skalec, Aleksandra; Szklarz, Magdalena; Janeczek, Maciej

    2016-01-01

    The excessive temperature fluctuations during dental implant site preparation may affect the process of bone-implant osseointegration. In the presented studies, we aimed to assess the quality of cooling during the use of 3 different dental implant systems (BEGO®, NEO BIOTECH®, and BIOMET 3i®). The swine rib was chosen as a study model. The preparation of dental implant site was performed with the use of 3 different speeds of rotation (800, 1,200, and 1,500 rpm) and three types of cooling: with saline solution at room temperature, with saline solution cooled down to 3°C, and without cooling. A statistically significant difference in temperature fluctuations was observed between BEGO and NEO BIOTECH dental systems when cooling with saline solution at 3°C was used (22.3°C versus 21.8°C). In case of all three evaluated dental implant systems, the highest temperature fluctuations occurred when pilot drills were used for implant site preparation. The critical temperature, defined in the available literature, was exceeded only in case of pilot drills (of all 3 systems) used at rotation speed of 1,500 rpm without cooling.

  9. Infrared Thermographic Assessment of Cooling Effectiveness in Selected Dental Implant Systems

    PubMed Central

    Kirstein, Karol; Dobrzyński, Maciej; Kosior, Piotr; Chrószcz, Aleksander; Dudek, Krzysztof; Fita, Katarzyna; Parulska, Olga; Rybak, Zbigniew; Skalec, Aleksandra; Szklarz, Magdalena; Janeczek, Maciej

    2016-01-01

    The excessive temperature fluctuations during dental implant site preparation may affect the process of bone-implant osseointegration. In the presented studies, we aimed to assess the quality of cooling during the use of 3 different dental implant systems (BEGO®, NEO BIOTECH®, and BIOMET 3i®). The swine rib was chosen as a study model. The preparation of dental implant site was performed with the use of 3 different speeds of rotation (800, 1,200, and 1,500 rpm) and three types of cooling: with saline solution at room temperature, with saline solution cooled down to 3°C, and without cooling. A statistically significant difference in temperature fluctuations was observed between BEGO and NEO BIOTECH dental systems when cooling with saline solution at 3°C was used (22.3°C versus 21.8°C). In case of all three evaluated dental implant systems, the highest temperature fluctuations occurred when pilot drills were used for implant site preparation. The critical temperature, defined in the available literature, was exceeded only in case of pilot drills (of all 3 systems) used at rotation speed of 1,500 rpm without cooling. PMID:27110558

  10. In situ microradioscopy and microtomography of fatigue-loaded dental two-piece implants

    PubMed Central

    Wiest, Wolfram; Zabler, Simon; Rack, Alexander; Fella, Christian; Balles, Andreas; Nelson, Katja; Schmelzeisen, Rainer; Hanke, Randolf

    2015-01-01

    Synchrotron real-time radioscopy and in situ microtomography are the only techniques providing direct visible information on a micrometre scale of local deformation in the implant–abutment connection (IAC) during and after cyclic loading. The microgap formation at the IAC has been subject to a number of studies as it has been proposed to be associated with long-term implant success. The next step in this scientific development is to focus on the in situ fatigue procedure of two-component dental implants. Therefore, an apparatus has been developed which is optimized for the in situ fatigue analysis of dental implants. This report demonstrates both the capability of in situ radioscopy and microtomography at the ID19 beamline for the study of cyclic deformation in dental implants. The first results show that it is possible to visualize fatigue loading of dental implants in real-time radioscopy in addition to the in situ fatigue tomography. For the latter, in situ microtomography is applied during the cyclic loading cycles in order to visualize the opening of the IAC microgap. These results concur with previous ex situ studies on similar systems. The setup allows for easily increasing the bending force, to simulate different chewing situations, and is, therefore, a versatile tool for examining the fatigue processes of dental implants and possibly other specimens. PMID:26524314

  11. To what extent should dental implant placement be adopted as a standard for diabetic patients?

    PubMed Central

    Alzahrani, Ahmed S.; Abed, Hassan H.

    2016-01-01

    Diabetes mellitus (DM) is considered one of the major chronic diseases in the world. Long-term hyperglycemia considerably affects the body tissues, and consequently, can lead to morbidity and mortality. Moreover, many oral complications have been observed with DM but little consideration in relation to the placement of dental implants has been investigated. Dental research has analyzed the relation of dental implants and bone osseointegration in diabetic patients. Theoretically, an impaired immune system and delayed wound healing of these patients might decrease the success rate of implant placement; however, with noticeable advances in evidence-based dentistry and statistically significant results, successful implant treatment could be achieved significantly in well-controlled diabetic patients. PMID:27761554

  12. Parameter on placement and management of the dental implant. American Academy of Periodontology.

    PubMed

    2000-05-01

    The American Academy of Periodontology has developed the following parameter on the placement and management of dental implants. Dental implants are a recognized form of tooth replacement and as such should be presented as an alternative for the replacement of missing teeth. A comprehensive treatment plan should be developed in consultation with all parties involved. Patients should be informed about all therapeutic alternatives, including non-replacement, potential complications, expected results, and their responsibility in treatment. The patient should also be informed that, to insure implant health, close monitoring and professional care by the dental team and good personal home care are imperative. Appropriate educational materials are an essential part of gaining informed consent. Given this information, patients should then be able to make informed decisions regarding their implant therapy.

  13. Biomechanics and Load Resistance of Short Dental Implants: A Review of the Literature

    PubMed Central

    Bourauel, Christoph; Mundt, Torsten; Heinemann, Friedhelm

    2013-01-01

    This paper was aimed to review the studies published about short dental implants. In the focus were the works that investigated the effect of biting forces of the rate of marginal bone resorption around short implants and their survival rates. Bone deformation defined by strain was obviously higher around short implants than the conventional ones. The clinical outcomes of 6 mm short implants after 2 years showed a survival rate of 94% to 95% and lower survival rate (<80%) for 7 mm short implants after 3 to 6 years for single crown restorations. The short implants used for supporting fixed partial prostheses had a survival rate of 98.9%. Short implants can be considered as a good alternative implant therapy to support single crown or partial fixed restorations. PMID:23738085

  14. Proton Pump Inhibitors and the Risk of Osseointegrated Dental Implant Failure: A Cohort Study.

    PubMed

    Wu, Xixi; Al-Abedalla, Khadijeh; Abi-Nader, Samer; Daniel, Nach G; Nicolau, Belinda; Tamimi, Faleh

    2017-04-01

    Proton pump inhibitors (PPIs) have a negative impact on bone accrual. Because osseointegration is influenced by bone metabolism, this study investigates the association between PPIs and the risk of osseointegrated implant failure. This retrospective cohort study included a total of 1,773 osseointegrated dental implants in 799 patients (133 implants in 58 PPIs users and 1,640 in 741 non-users) who were treated at the East Coast Oral Surgery Clinic in Moncton, Canada, from January 2007 to September 2015. Kaplan-Meier estimator was used to describe the hazard function of dental implant failure by PPIs usage. Multilevel mixed effects parametric survival analyses were used to test the association between PPIs exposure and risk of implant failure adjusting for potential confounders. The failure rates were 6.8% for people using PPIs compared to 3.2% for non-users. Subjects using PPIs had a higher risk of dental implant failure (HR = 2.73; 95% CI = 1.10-6.78) compared to those who did not use the drugs. The findings suggest that treatment with PPIs may be associated with an increased risk of osseointegrated dental implant failure.

  15. Squamous cell carcinoma in association with dental implants: an assessment of previously hypothesized carcinogenic mechanisms and a case report.

    PubMed

    Bhatavadekar, Neel B

    2012-12-01

    Although dental implants have seen tremendous clinical success over the past few decades, there are some worrying reports in literature describing squamous cell carcinoma (SCC) in close association with dental implants. This article also provides a critical assessment of the published literature relating to the presence of carcinoma in association with dental implants, analyzing the previously published and hypothesized carcinogenic responses to an implant, to try and come to a conclusion regarding the plausibility and clinical risk for cancer formation in association with dental implants. An unusual case of an SCC noted in close proximity to a dental implant is also presented. A systematic search was conducted using Medline (PubMed), Cochrane Database, and Google Scholar with the search terms "cancer," "squamous cell carcinoma," "dental implant," "SCC," "peri-implantitis," "oral cancer," and "implantology" and using multiple combinations using Boolean operators "or" and "and." The search was not limited to dental literature; orthopedic and biomedical literature was also included. The results were then hand screened to pick out the relevant articles. In total, 14 previous published reports were found, where 24 dental implants were reported to be associated with SCC. Not all the reported patients had a history of cancer, but contributory factors such as smoking were found. An analysis of the biological plausibility of previously proposed carcinogenic mechanisms, such as corrosion, metallic ion release, and particulate debris, did not support the etiologic role for dental implants in cancer development, and the standardized incidence ratio was found to be extremely low (0.00017). Peri-implantitis should be assessed cautiously in patients receiving implants who have a previous history of cancer. Dental implants are a safe treatment modality based on the published data, and any change in surgical protocol is not mandated.

  16. Does the Implant Surgical Technique Affect the Primary and/or Secondary Stability of Dental Implants? A Systematic Review

    PubMed Central

    Shadid, Rola Muhammed; Sadaqah, Nasrin Rushdi; Othman, Sahar Abdo

    2014-01-01

    Background. A number of surgical techniques for implant site preparation have been advocated to enhance the implant of primary and secondary stability. However, there is insufficient scientific evidence to support the association between the surgical technique and implant stability. Purpose. This review aimed to investigate the influence of different surgical techniques including the undersized drilling, the osteotome, the piezosurgery, the flapless procedure, and the bone stimulation by low-level laser therapy on the primary and/or secondary stability of dental implants. Materials and methods. A search of PubMed, Cochrane Library, and grey literature was performed. The inclusion criteria comprised observational clinical studies and randomized controlled trials (RCTs) conducted in patients who received dental implants for rehabilitation, studies that evaluated the association between the surgical technique and the implant primary and/or secondary stability. The articles selected were carefully read and classified as low, moderate, and high methodological quality and data of interest were tabulated. Results. Eight clinical studies were included then they were classified as moderate or high methodological quality and control of bias. Conclusions. There is a weak evidence suggesting that any of previously mentioned surgical techniques could influence the primary and/or secondary implant stability. PMID:25126094

  17. Optimal restoration of dental esthetics and function with advanced implant-supported prostheses: a clinical report.

    PubMed

    Meulen, Peter van der; Linden, Wynand van der; Eeden, Ronnie van

    2012-07-01

    For more than 25 years, computer-aided design and computer-aided manufacturing (CAD/CAM) technology has been used in implant restorative dentistry. Today this technology offers a means of milling titanium frameworks that fit dental implants accurately. This report presents a restoratively driven protocol employing advanced implant restorative and surgical techniques. Treatment of a patient with advanced periodontitis with extensive loss of hard and soft tissues is presented. After extraction of the patient's remaining hopeless teeth, dental implants were placed, along with interim, fixed-margin abutments and abutment protection caps. Two days later, acrylic resin fixed-interim prostheses restored the patient's esthetics and partial masticatory function. After implant osseointegration, maxillary, and mandibular frameworks for definitive prostheses were milled from Ti alloy, using one specific CAD/CAM technology. The benefits of this technology are also discussed.

  18. A case of recovery of oral function with dental implants following facial bone trauma.

    PubMed

    Kamoi, Hisahiro

    2012-01-01

    A 44-year-old woman had sustained facial lacerations, loss of several teeth, alveolar bone fracture, and severe vertical bone resorption in conjunction with a shattered alveolar bone and marked loss of intraoral function and facial disfigurement in a car accident. She underwent 9 surgical procedures by plastic surgeons to treat the facial lesions, including hold facial scar formation reduction surgery, reduction of fractures of the nasal and cheek bones, and bone transplants. To restore intraoral function and improve facial appearance, plastic surgeons transplanted a rib into the maxillary sinus while dental surgeons simultaneously inserted 5 dental implants. Eleven months after the dental implant surgery, a complete upper denture and a mandibular gingival ceramometal-casting crown were fitted. After insertion of the final prosthodontics, regular follow-up examinations were performed to check dental occlusion, oral hygiene, and the condition of the gingival tissue. In the years since the upper dental implants were fitted, there have been no bone resorption and no functional problems. Transplantation of rib bones is an effective method for maxillary reconstruction and remains effective even after the insertion of dental implants. The patient is extremely satisfied with the results. A means of maintaining oral health over the long term, and of motivating the patient to maintain oral health, should be established.

  19. Measurement of Primary and Secondary Stability of Dental Implants by Resonance Frequency Analysis Method in Mandible

    PubMed Central

    Shokri, Mehran; Daraeighadikolaei, Arash

    2013-01-01

    Background. There is no doubt that the success of the dental implants depends on the stability. The aim of this work was to measure the stability of dental implants prior to loading the implants, using a resonance frequency analysis (RFA) by Osstell mentor device. Methods. Ten healthy and nonsmoker patients over 40 years of age with at least six months of complete or partial edentulous mouth received screw-type dental implants by a 1-stage procedure. RFA measurements were obtained at surgery and 1, 2, 3, 4, 5, 7, and 11 weeks after the implant surgery. Results. Among fifteen implants, the lowest mean stability measurement was for the 4th week after surgery in all bone types. At placement, the mean ISQ obtained with the magnetic device was 77.2 with 95% confidence interval (CI) = 2.49, and then it decreased until the 4th week to 72.13 (95% CI = 2.88), and at the last measurement, the mean implant stability significantly (P value <0.05) increased and recorded higher values to 75.6 (95% CI = 1.88), at the 11th week. Conclusions. The results may be indicative of a period of time when loading might be disadvantageous prior to the 4th week following implant placement. These suggestions need to be further assessed through future studies. PMID:23737790

  20. Indications and contraindications of dental implants in medically compromised patients: update.

    PubMed

    Gómez-de Diego, Rafael; Mang-de la Rosa, María del Rocío; Romero-Pérez, María-Jesús; Cutando-Soriano, Antonio; López-Valverde-Centeno, Antonio

    2014-09-01

    The aim of this study was to review the current scientific literature in order to analyse the indications and contraindications of dental implants in medically compromised patients. A reference research was carried out on PubMed using the key words "implant" AND (oral OR dental) AND (systemic disease OR medically compromised), in articles published between 1993 and 2013. The inclusion criteria were the following: clinical studies in which, at least, 10 patients were treated, consensus articles, reviewed articles and meta-analysis performed in humans treated with dental implants, and which included the disease diagnosis. A total of 64 articles were found, from which 16 met the inclusion criteria. Cardiac systemic diseases, diabetic endocrine pathologies or controlled metabolic disorders do not seem to be a total or partial contraindication to the placement of dental implants. Tobacco addiction, and head and neck radiotherapy are correlated to a higher loss of dental implants. Patients suffering from osteoporosis undergoing biphosphonates therapy show an increased risk of developing bone necrosis after an oral surgery, especially if the drugs are administered intravenously or they are associated to certain concomitant medication.

  1. Comparison of imaging methods used for dental implant osseous integration assessment.

    PubMed

    Sprecher, C M; Gahlert, M; Röhling, S; Kniha, H; Gueorguiev, B; Milz, S

    2013-09-01

    Two different imaging techniques used to determine bone tissue response to dental implants were compared. Dental implants were implanted into the maxillae of 18 pigs, which were sacrificed after 4, 8 and 12 weeks. Implants with surrounding bone tissue were retrieved for methyl methacrylate histology and contact radiography. On identical sections peri-implant bone density and bone implant contact (BIC) ratio were assessed with two different imaging methods. Evaluation of Giemsa eosin stained and contact radiographed sections showed direct osseous integration for all implants and both methods showed a strong correlation with correlation coefficient r = 0.930 (P < 0.0001) for peri-implant bone density and r = 0.817 (P < 0.0001) for bone implant contact ratio. While the two imaging methods showed moderate differences for peri-implant bone density there were significant differences between the BIC values determined. In general, contact radiography tends to underestimate BIC for approximately 4.5 % (P = 0.00003).

  2. Computer-aided recognition of dental implants in X-ray images

    NASA Astrophysics Data System (ADS)

    Morais, Pedro; Queirós, Sandro; Moreira, António H. J.; Ferreira, Adriano; Ferreira, Ernesto; Duque, Duarte; Rodrigues, Nuno F.; Vilaça, João. L.

    2015-03-01

    Dental implant recognition in patients without available records is a time-consuming and not straightforward task. The traditional method is a complete user-dependent process, where the expert compares a 2D X-ray image of the dental implant with a generic database. Due to the high number of implants available and the similarity between them, automatic/semi-automatic frameworks to aide implant model detection are essential. In this study, a novel computer-aided framework for dental implant recognition is suggested. The proposed method relies on image processing concepts, namely: (i) a segmentation strategy for semi-automatic implant delineation; and (ii) a machine learning approach for implant model recognition. Although the segmentation technique is the main focus of the current study, preliminary details of the machine learning approach are also reported. Two different scenarios are used to validate the framework: (1) comparison of the semi-automatic contours against implant's manual contours of 125 X-ray images; and (2) classification of 11 known implants using a large reference database of 601 implants. Regarding experiment 1, 0.97±0.01, 2.24±0.85 pixels and 11.12±6 pixels of dice metric, mean absolute distance and Hausdorff distance were obtained, respectively. In experiment 2, 91% of the implants were successfully recognized while reducing the reference database to 5% of its original size. Overall, the segmentation technique achieved accurate implant contours. Although the preliminary classification results prove the concept of the current work, more features and an extended database should be used in a future work.

  3. Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery.

    PubMed

    Cebrian-Carretero, José-Luis; Guiñales-Díaz de Cevallos, Jorge; Sobrino, José-Andrés; Yu, Tomás; Burgueño-García, Miguel

    2014-11-01

    The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality. Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses. In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result.

  4. The effect of bruxism on treatment planning for dental implants.

    PubMed

    Misch, Carl E

    2002-09-01

    Bruxism is a potential risk factor for implant failure. Excessive force is the primary cause of late implant complications. An appreciation of the etiology of crestal bone loss, failure of implants, failure to retain implant restorations, and fracture of components will lead the practitioner to develop a treatment plan that reduces force on implants and their restorations. The forces are considered in terms of magnitude, duration, direction, type, and magnification. Once the dentist has identified the source(s) of additional force on the implant system, the treatment plan is altered to contend with and reduce the negative sequelae on the bone, implant, and final restoration. One viable approach is to increase the implant-bone surface area. Additional implants can be placed to decrease stress on any one implant, and implants in molar regions should have an increased width. Use of more and wider implants decreases the strain on the prosthesis and also dissipates stress to the bone, especially at the crest. The additional implants should be positioned with intent to eliminate cantilevers when possible. Greater surface area implant designs made of titanium alloy and with an external hex design can also prove advantageous. Anterior guidance in mandibular excursions further decreases force and eliminates or reduces lateral posterior force. Metal occlusal surfaces decrease the risk of porcelain fracture and do not require as much abutment reduction, which in turn enhances prosthesis retention. The retention of the final prosthesis or super-structure is also improved with additional implant abutments. Night guards designed with specific features also are a benefit to initially diagnose the influence of occlusal factors for the patient, and as importantly, to reduce the influence of extraneous stress on implants and implant-retained restorations.

  5. [Dental implantation and soft tissue augmentation after ridge preservation in a molar site: a case report].

    PubMed

    Zhao, L P; Zhan, Y L; Hu, W J; Wang, H J; Wei, Y P; Zhen, M; Xu, T; Liu, Y S

    2016-12-18

    For ideal implant rehabilitation, an adequate bone volume, optical implant position, and stable and healthy soft tissue are required. The reduction of alveolar bone and changes in its morphology subsequent to tooth extraction will result in insufficient amount of bone and adversely affect the ability to optimally place dental implants in edentulous sites. Preservation of alveolar bone volume through ridge preservation has been demonstrated to reduce the vertical and horizontal contraction of the alveolar bone crest after tooth extraction and reduce the need for additional bone augmentation procedures during implant placement. In this case, a patient presented with a mandible molar of severe periodontal disease, the tooth was removed as atraumatically as possible and the graft material of Bio-Oss was loosely placed in the alveolar socket without condensation and covered with Bio-Gide to reconstruct the defects of the alveolar ridge. Six months later, there were sufficient height and width of the alveolar ridge for the dental implant, avoiding the need of additional bone augmentation and reducing the complexity and unpredictability of the implant surgery. Soft tissue defects, such as gingival and connective tissue, played crucial roles in long-term implant success. Peri-implant plastic surgery facilitated development of healthy peri-implant structure able to withstand occlusal forces and mucogingival stress. Six months after the implant surgery, the keratinized gingiva was absent in the buccal of the implant and the vestibular groove was a little shallow. The free gingival graft technique was used to solve the vestibulum oris groove supersulcus and the absence of keratinized gingiva around the implant. The deepening of vestibular groove and broadening of keratinized gingiva were conducive to the long-term health and stability of the tissue surrounding the implant. Implant installation and prosthetic restoration showed favorable outcome after six months.

  6. Squamous cell carcinoma and dental implants: A systematic review of case reports

    PubMed Central

    Jeelani, S.; Rajkumar, E.; Mary, G. Geena; Khan, Parvez Ahmad; Gopal, Harish; Roy, Soumya; Maheswaran, T.; Anand, B.

    2015-01-01

    Cancer is one of the leading causes of death world-wide. Apart from the most common etiopathological factors related to cancer, at times very rare causes such as irritant or foreign body induced carcinogenesis is not to be overlooked. To systematically review case reports concerned with the association between dental implants and oral squamous cell carcinoma. A Medline (PubMed), Cochrane database, and Google Scholar search was conducted of dental article published in English related to case reports concerned with oral squamous cell carcinoma occurring around dental implants from 2000 to 2014. Twenty articles were retrieved, which included 20 rare case reports which were systematically reviewed and the results were obtained pertaining to age, clinical symptoms, habits, previous history of cancer, potentially malignant disorders, systemic illness, and local factors. It is imperative to identify promptly persisting inflammation associated with implants. Since malignancy may disguise as periimplantitis, especially in patients who are at risk with contributing prominent predisposing factors. PMID:26538881

  7. Osseointegration of Dental Implants in a Patient with Hajdu-cheney Syndrome

    PubMed Central

    Dokou, Panagiota; Karoussis, Ioannis K.; Papavasiliou, George; Kamposiora, Phophi; Vrahopoulos, Theophilos P.; Vrotsos, John A.

    2016-01-01

    Background: Hajdu-Cheney Syndrome (HCS) is a rare hereditary bone metabolism disorder characterized by acro-osteolysis, short stature, craniofacial changes, periodontitis and premature tooth loss. Extensive search of the current literature revealed no reports of implant placement in patients with HCS. Case Report: A 22-year old woman with osteoporosis, generalized advanced chronic periodontitis and premature tooth loss was referred to the Postgraduate Clinic of Periodontology, University of Athens-Greece. The patient was diagnosed in 2001 with HCS. The patient received non-surgical periodontal treatment and several teeth were extracted due to extensive alveolar bone loss. After careful consideration of the possible implications deriving from the patient’s condition and having taken her young age into account, initially, a dental implant was placed in the upper right first premolar region. Specific protocols such as longer healing periods were implemented, so five years after placement and successful osseointegration of this implant, four additional dental implants were placed in the posterior regions of the maxilla and the mandible. Prosthetic rehabilitation followed 6 months after implant placement. Upon completion of periodontal treatment, the patient was enrolled in a periodontal maintenance program. Results: Clinical and radiographic examination of the patient during the periodontal maintenance program after implant placement revealed no abnormalities in the implant region. Conclusion: Patients with HCS suffer from periodontitis, bone destruction and premature tooth loss. This case indicates the successful osseointegration of dental implants in patients with HCS. However, further research is required in order to determine the predictability of dental implant placement in those patients. PMID:27857819

  8. Numerical Method for the Design of Healing Chamber in Additive-Manufactured Dental Implants.

    PubMed

    Lee, Hsiao-Chien; Tsai, Pei-I; Huang, Chih-Chieh; Chen, San-Yuan; Chao, Chuen-Guang; Tsou, Nien-Ti

    2017-01-01

    The inclusion of a healing chamber in dental implants has been shown to promote biological healing. In this paper, a novel numerical approach to the design of the healing chamber for additive-manufactured dental implants is proposed. This study developed an algorithm for the modeling of bone growth and employed finite element method in ANSYS to facilitate the design of healing chambers with a highly complex configuration. The model was then applied to the design of dental implants for insertion into the posterior maxillary bones. Two types of ITI® solid cylindrical screwed implant with extra rectangular-shaped healing chamber as an initial design are adopted, with which to evaluate the proposed system. This resulted in several configurations for the healing chamber, which were then evaluated based on the corresponding volume fraction of healthy surrounding bone. The best of these implants resulted in a healing chamber surrounded by around 9.2% more healthy bone than that obtained from the original design. The optimal design increased the contact area between the bone and implant by around 52.9%, which is expected to have a significant effect on osseointegration. The proposed approach is highly efficient which typically completes the optimization of each implant within 3-5 days on an ordinary personal computer. It is also sufficiently general to permit extension to various loading conditions.

  9. The effect of mucosal cuff shrinkage around dental implants during healing abutment replacement.

    PubMed

    Nissan, J; Zenziper, E; Rosner, O; Kolerman, R; Chaushu, L; Chaushu, G

    2015-10-01

    Soft tissue shrinkage during the course of restoring dental implants may result in biological and prosthodontic difficulties. This study was conducted to measure the continuous shrinkage of the mucosal cuff around dental implants following the removal of the healing abutment up to 60 s. Individuals treated with implant-supported fixed partial dentures were included. Implant data--location, type, length, diameter and healing abutments' dimensions--were recorded. Mucosal cuff shrinkage, following removal of the healing abutments, was measured in bucco-lingual direction at four time points--immediately after 20, 40 and 60 s. anova was used to for statistical analysis. Eighty-seven patients (49 women and 38 men) with a total of 311 implants were evaluated (120 maxilla; 191 mandible; 291 posterior segments; 20 anterior segments). Two-hundred and five (66%) implants displayed thick and 106 (34%) thin gingival biotype. Time was the sole statistically significant parameter affecting mucosal cuff shrinkage around dental implants (P < 0.001). From time 0 to 20, 40 and 60 s, the mean diameter changed from 4.1 to 4.07, 3.4 and 2.81 mm, respectively. The shrinkage was 1%, 17% and 31%, respectively. The gingival biotype had no statistically significant influence on mucosal cuff shrinkage (P = 0.672). Time required replacing a healing abutment with a prosthetic element should be minimised (up to 20/40 s), to avoid pain, discomfort and misfit.

  10. Numerical Method for the Design of Healing Chamber in Additive-Manufactured Dental Implants

    PubMed Central

    Lee, Hsiao-Chien; Tsai, Pei-I; Huang, Chih-Chieh; Chen, San-Yuan; Chao, Chuen-Guang

    2017-01-01

    The inclusion of a healing chamber in dental implants has been shown to promote biological healing. In this paper, a novel numerical approach to the design of the healing chamber for additive-manufactured dental implants is proposed. This study developed an algorithm for the modeling of bone growth and employed finite element method in ANSYS to facilitate the design of healing chambers with a highly complex configuration. The model was then applied to the design of dental implants for insertion into the posterior maxillary bones. Two types of ITI® solid cylindrical screwed implant with extra rectangular-shaped healing chamber as an initial design are adopted, with which to evaluate the proposed system. This resulted in several configurations for the healing chamber, which were then evaluated based on the corresponding volume fraction of healthy surrounding bone. The best of these implants resulted in a healing chamber surrounded by around 9.2% more healthy bone than that obtained from the original design. The optimal design increased the contact area between the bone and implant by around 52.9%, which is expected to have a significant effect on osseointegration. The proposed approach is highly efficient which typically completes the optimization of each implant within 3–5 days on an ordinary personal computer. It is also sufficiently general to permit extension to various loading conditions. PMID:28293628

  11. Superior biofunctionality of dental implant fixtures uniformly coated with durable bioglass films by magnetron sputtering.

    PubMed

    Popa, A C; Stan, G E; Enculescu, M; Tanase, C; Tulyaganov, D U; Ferreira, J M F

    2015-11-01

    Bioactive glasses are currently considered the suitable candidates to stir the quest for a new generation of osseous implants with superior biological/functional performance. In congruence with this vision, this contribution aims to introduce a reliable technological recipe for coating fairly complex 3D-shaped implants (e.g. dental screws) with uniform and mechanical resistant bioactive glass films by the radio-frequency magnetron sputtering method. The mechanical reliability of the bioactive glass films applied to real Ti dental implant fixtures has been evaluated by a procedure comprised of "cold" implantation in pig mandibular bone from a dead animal, followed by immediate tension-free extraction tests. The effects of the complex mechanical strains occurring during implantation were analysed by scanning electron microscopy coupled with electron dispersive spectroscopy. Extensive biocompatibility assays (MTS, immunofluorescence, Western blot) revealed that the bioactive glass films stimulated strong cellular adhesion and proliferation of human dental pulp stem cells, without promoting their differentiation. The ability of the implant coatings to conserve a healthy stem cell pool is promising to further endorse the fabrication of new osseointegration implant designs with extended lifetime.

  12. Survival of batch numbers within dental implants following incineration as an aid to identification.

    PubMed

    Berketa, J; James, H; Marino, V

    2010-12-01

    Dental implants have become a popular choice of treatment in replacing individual lost teeth or entire dentitions. The physical properties of high corrosion resistance, high structural strength and high melting point, suggest the retention of intact implants following most physical assaults. As the implants are machine made, they lack the individualisation required for their use as identifiers of the deceased, however the Straumann™ Company (Waldenburg, Switzerland) has recently released information that within the chamber of their implants they have laser etched batch numbers. The number of implants with the same batch number varies from 24 to 2400. The purpose of this study was to ascertain if the batch number was still identifiable following intense heat exposure in a furnace. A Straumann™ Standard Plus 3.3 x 8 mm implant, with no healing cap nor abutment attached was incinerated to 1125 degrees Celsius. Another Straumann™ Standard Plus 3.3 x 8 mm implant was also incinerated in the same way as the first implant but with an abutment attached. The results indicated that the first implant had totally oxidised within the internal chamber whilst the second implant following the removal of the abutment revealed an intact identifiable batch number. If the companies constructing implants were to place individual serial numbers rather than batch numbers on these implants then the potential exists for a new approach to be established for the identification of the deceased.

  13. Maxillary segmental osteoperiosteal flap with simultaneous placement of dental implants: case report of a novel technique.

    PubMed

    Tsegga, Tibebu; Wright, Thomas

    2017-12-01

    Dental restorative space from the opposing dentition requires adequate distance for restorative material for an acceptable restoration. Typically, long-standing edentulous alveolar ridges will have vertical and or horizontal defects that require alveolar ridge augmentation for ideal dental implant restorations. Along with these defects, one will see the opposing dentition supra erupt which can obliterate the restorative space. Multiple surgical techniques have been described to address these dilemmas. The use of osteoperiosteal flaps has been described to address vertical height deficiencies. The purpose of this paper is to document and introduce a maxillary segmental osteoperiosteal flap intrusion to increase the restorative space with simultaneous dental implant placement. As with most dilemmas in treatment planning dental implants, multiple acceptable treatment options are available to the practitioner. This technique is another of many that can be added to the available options. When appropriately planned in select cases, this technique will result with ideal dental implant restorations without compromising the esthetic and functional harmony of the native dentition.

  14. Fibronectin-Grafted Titanium Dental Implants: An In Vivo Study

    PubMed Central

    Chang, Yu-Chi; Ho, Kuo-Ning; Feng, Sheng-Wei; Huang, Haw-Ming; Chang, Chia-Hsun; Lin, Che-Tong; Teng, Nai-Chia; Pan, Yu Hwa; Chang, Wei-Jen

    2016-01-01

    Modification of the physiochemical properties of titanium surfaces using glow discharge plasma (GDP) and fibronectin coating has been shown to enhance the surface hydrophilicity, surface roughness, cell adhesion, migration, and proliferation. This in vivo study aimed to evaluate the bone integration efficacy of a biologically modified implant surface. Two different surface-modified implants (Ar-GDP and GDP-fib) were placed in the mandibular premolar area of six beagle dogs for 2–8 weeks. Three techniques [histologic evaluation, resonance frequency analysis (RFA), and microcomputed tomography (micro-CT) evaluation] were used to detect the implant stability and bone-implant contact. The implant stability quotient values of GDP-fib implants were significantly greater than the Ar-GDP implants at 2 and 4 weeks (P < 0.01). The bone volume/total volume ratio of GDP-fib implants was greater than the Ar-GDP implants in micro-CT evaluation. A high positive correlation was observed between RFA and micro-CT measurements. At 2 weeks, osteoblasts were seen to line the implant surface, and multinuclear osteoclasts could be seen on the surface of old parent bone. After 8 weeks, a majority of the space in the wound chamber appeared to be replaced by bone. Enhancement of the stability of biologically modified implants was proved by the results of RFA, micro-CT, and histological analysis. This enhanced stability may help fasten treatment and be clinically beneficial. PMID:27366739

  15. Fibronectin-Grafted Titanium Dental Implants: An In Vivo Study.

    PubMed

    Chang, Yu-Chi; Ho, Kuo-Ning; Feng, Sheng-Wei; Huang, Haw-Ming; Chang, Chia-Hsun; Lin, Che-Tong; Teng, Nai-Chia; Pan, Yu Hwa; Chang, Wei-Jen

    2016-01-01

    Modification of the physiochemical properties of titanium surfaces using glow discharge plasma (GDP) and fibronectin coating has been shown to enhance the surface hydrophilicity, surface roughness, cell adhesion, migration, and proliferation. This in vivo study aimed to evaluate the bone integration efficacy of a biologically modified implant surface. Two different surface-modified implants (Ar-GDP and GDP-fib) were placed in the mandibular premolar area of six beagle dogs for 2-8 weeks. Three techniques [histologic evaluation, resonance frequency analysis (RFA), and microcomputed tomography (micro-CT) evaluation] were used to detect the implant stability and bone-implant contact. The implant stability quotient values of GDP-fib implants were significantly greater than the Ar-GDP implants at 2 and 4 weeks (P < 0.01). The bone volume/total volume ratio of GDP-fib implants was greater than the Ar-GDP implants in micro-CT evaluation. A high positive correlation was observed between RFA and micro-CT measurements. At 2 weeks, osteoblasts were seen to line the implant surface, and multinuclear osteoclasts could be seen on the surface of old parent bone. After 8 weeks, a majority of the space in the wound chamber appeared to be replaced by bone. Enhancement of the stability of biologically modified implants was proved by the results of RFA, micro-CT, and histological analysis. This enhanced stability may help fasten treatment and be clinically beneficial.

  16. Dental implants in patients treated with oral bisphosphonates: a bibliographic review.

    PubMed

    Montoya-Carralero, José-Maria; Parra-Mino, Pablo; Ramírez-Fernández, Piedad; Morata-Murcia, Isabel Maria; Mompeán-Gambín, Maria del Carmen; Calvo-Guirado, José-Luis

    2010-01-01

    Bisphosphonates inhibit bone resorption and are used to treat a range of pathologies, including Paget disease, osteoporosis, multiple myeloma and metastases associated with breast or prostate cancer. At present, there is no effective treatment for bisphosphonate induced osteonecrosis, so prevention is extremely important. Since quality of life deteriorates for those suffering osteonecrosis, maximum precautions should be taken with patients at risk, and especially whenever oral surgery, including dental implant placement, is contemplated. Dentists and oral or maxillofacial surgeons must keep up to date with the latest approaches to prevention, particularly when treating patients who are presently taking, or who will be taking bisphosphonates and are also candidates for dental implants.

  17. Metallic ion content and damage to the DNA in oral mucosa cells patients treated dental implants.

    PubMed

    López-Jornet, Pía; Perrez, Francisco Parra; Calvo-Guirado, José Luis; Ros-Llor, Irene; LLor-Ros, Irene; Ramírez-Fernández, Piedad

    2014-07-01

    The aim of this study was to assess the potential genotoxicity of dental implants, evaluating biomarkers of DNA damage (micronuclei and/or nuclear buds), cytokinetic defects (binucleated cells) and the presence of trace metals in gingival cells of patients with implants, comparing these with a control group. A total of 60 healthy adults (30 patients with dental implants and 30 control patients without) were included in the study. Medical and dental histories were made for each including life-style factors. Genotoxicity effects were assessed by micronucleus assays in the gingival epithelial cells of each patient; 1,000 epithelial cells were analyzed, evaluating the frequency of micronucleated cells and other nuclear anomalies. The concentration of metals (Al(27), Ag(107), Co (59), Cr (52), Cu(63), Fe(56), Sn(118), Mn(55), Mo(92), Ni(60), Pb(208), Ti(47)) were assayed by means of coupled plasma-mass spectrophotometry (ICP-MS). The frequency of micronuclei in the patient group with implants was higher than in the control group but without statistically significant differences (P > 0.05). Similar results were found for binucleated cells and nuclear buds (P > 0.05). For metals assayed by ICP-MS, significant differences were found for Ti(47) (P ≤ 0.045). Univariate analysis identified a significant association between the presence of micronuclei and age. Dental implants do not induce DNA damage in gingival cells, the slight effects observed cannot be indicated as biologically relevant.

  18. Capacity of dental equipment to interfere with cardiac implantable electrical devices.

    PubMed

    Lahor-Soler, Eduard; Miranda-Rius, Jaume; Brunet-Llobet, Lluís; Sabaté de la Cruz, Xavier

    2015-06-01

    Patients with cardiac implantable electrical devices should take precautions when exposed to electromagnetic fields. Possible interference as a result of proximity to electromagnets or electricity flow from electronic tools employed in clinical odontology remains controversial. The objective of this study was to examine in vitro the capacity of dental equipment to provoke electromagnetic interference in pacemakers and implantable cardioverter defibrillators. Six electronic dental instruments were tested on three implantable cardioverter defibrillators and three pacemakers from different manufacturers. A simulator model, submerged in physiological saline, with elements that reproduced life-size anatomic structures was used. The instruments were analyzed at differing distances and for different time periods of application. The dental instruments studied displayed significant differences in their capacity to trigger electromagnetic interference. Significant differences in the quantity of registered interference were observed with respect to the variables manufacturer, type of cardiac implant, and application distance but not with the variable time of application. The electronic dental equipment tested at a clinical application distance (20 cm) provoked only slight interference in the pacemakers and implantable cardioverter defibrillators employed, irrespective of manufacturer.

  19. A contrast and registration template for magnetic resonance image data guided dental implant placement

    NASA Astrophysics Data System (ADS)

    Eggers, Georg; Cosgarea, Raluca; Rieker, Marcus; Kress, Bodo; Dickhaus, Hartmut; Mühling, Joachim

    2009-02-01

    An oral imaging template was developed to address the shortcomings of MR image data for image guided dental implant planning and placement. The template was conctructed as a gadolinium filled plastic shell to give contrast to the dentition and also to be accurately re-attachable for use in image guided dental implant placement. The result of segmentation and modelling of the dentition from MR Image data with the template was compared to plaster casts of the dentition. In a phantom study dental implant placement was performed based on MR image data. MR imaging with the contrast template allowed complete representation of the existing dentition. In the phantom study, a commercially available system for image guided dental implant placement was used. Transformation of the imaging contrast template into a surgical drill guide based on the MR image data resulted in pilot burr hole placement with an accuracy of 2 mm. MRI based imaging of the existing dentition for proper image guided planning is possible with the proposed template. Using the image data and the template resulted in less accurate pilot burr hole placement in comparison to CT-based image guided implant placement.

  20. The team approach to managing dental implant complications: the periodontist's point of view.

    PubMed

    Froum, Stuart J

    2013-10-01

    Implant-related complications are a fact of life among practitioners who place or restore implants. They occur for a variety of reasons with varying consequences. Those classified as minor complications are most easily corrected and may have little impact on the course of treatment, but severe complications can have serious consequence in expense, complexity, and ultimate success. Many severe complications may be irreversible, leaving the patient with less desirable esthetic options, or worse, permanent disability in terms of speech and function. While various members of the dental team may have different points of view, implant complications are a concern to all. Successful results require comprehensive care, collaborative treatment, and knowledge of dental implant complications. Therefore, it is in the best interest of the patient that all involved in treatment be aware of the different types of complications that can be experienced and learn how to work together as a team to achieve successful outcomes.

  1. Atomic force microscopy analysis of different surface treatments of Ti dental implant surfaces

    NASA Astrophysics Data System (ADS)

    Bathomarco, Ti R. V.; Solorzano, G.; Elias, C. N.; Prioli, R.

    2004-06-01

    The surface of commercial unalloyed titanium, used in dental implants, was analyzed by atomic force microscopy. The morphology, roughness, and surface area of the samples, submitted to mechanically-induced erosion, chemical etching and a combination of both, were compared. The results show that surface treatments strongly influence the dental implant physical and chemical properties. An analysis of the length dependence of the implant surface roughness shows that, for scan sizes larger than 50 μm, the average surface roughness is independent of the scanning length and that the surface treatments lead to average surface roughness in the range of 0.37 up to 0.48 μm. It is shown that the implant surface energy is sensitive to the titanium surface area. As the area increases there is a decrease in the surface contact angle.

  2. Immediate Dental Implant Placements Using Osteotome Technique: A Case Report and Literature Review

    PubMed Central

    Al-Almaie, Saad

    2016-01-01

    This clinical case describes the effect of the osteotome technique on the osseointegration of a mandibular dental implant in a 42-year-old female patient with dento-alveolar bony defects and to review the literature regarding immediate implant placement using osteotome technique. The amount of bone expansion at the alveolar ridge and the marginal bone resorption from the time of implant placement to one year after the implant’s functional loading were recorded clinically. The esthetic outcome for the restored implant (the gingival margin) was achieved one years after the implant’s functional loading. The surgical and prosthetic sites for the implant showed no postoperative complications, and no infection or wound dehiscence was recorded during the follow-up period. The osteotome technique is good for the purpose for which it was introduced, and its advantages with immediate implant placement include reduced surgical trauma and a shorter treatment time. PMID:27583046

  3. Multifunctions of dual Zn/Mg ion co-implanted titanium on osteogenesis, angiogenesis and bacteria inhibition for dental implants.

    PubMed

    Yu, Yiqiang; Jin, Guodong; Xue, Yang; Wang, Donghui; Liu, Xuanyong; Sun, Jiao

    2017-02-01

    In order to improve the osseointegration and long-term survival of dental implants, it is urgent to develop a multifunctional titanium surface which would simultaneously have osteogeneic, angiogeneic and antibacterial properties. In this study, a potential dental implant material-dual Zn/Mg ion co-implanted titanium (Zn/Mg-PIII) was developed via plasma immersion ion implantation (PIII). The Zn/Mg-PIII surfaces were found to promote initial adhesion and spreading of rat bone marrow mesenchymal stem cells (rBMSCs) via the upregulation of the gene expression of integrin α1 and integrin β1. More importantly, it was revealed that Zn/Mg-PIII could increase Zn(2+) and Mg(2+) concentrations in rBMSCs by promoting the influx of Zn(2+) and Mg(2+) and inhibiting the outflow of Zn(2+), and then could enhance the transcription of Runx2 and the expression of ALP and OCN. Meanwhile, Mg(2+) ions from Zn/Mg-PIII increased Mg(2+) influx by upregulating the expression of MagT1 transporter in human umbilical vein endothelial cells (HUVECs), and then stimulated the transcription of VEGF and KDR via activation of hypoxia inducing factor (HIF)-1α, thus inducing angiogenesis. In addition to this, it was discovered that zinc in Zn/Mg-PIII had certain inhibitory effects on oral anaerobic bacteria (Pg, Fn and Sm). Finally, the Zn/Mg-PIII implants were implanted in rabbit femurs for 4 and 12weeks with Zn-PIII, Mg-PIII and pure titanium as controls. Micro-CT evaluation, sequential fluorescent labeling, histological analysis and push-out test consistently demonstrated that Zn/Mg-PIII implants exhibit superior capacities for enhancing bone formation, angiogenesis and osseointegration, while consequently increasing the bonding strength at bone-implant interfaces. All these results suggest that due to the multiple functions co-produced by zinc and magnesium, rapid osseointegration and sustained biomechanical stability are enhanced by the novel Zn/Mg-PIII implants, which have the potential

  4. Interruption of Electrical Conductivity of Titanium Dental Implants Suggests a Path Towards Elimination Of Corrosion

    PubMed Central

    Pozhitkov, Alex E.; Daubert, Diane; Brochwicz Donimirski, Ashley; Goodgion, Douglas; Vagin, Mikhail Y.; Leroux, Brian G.; Hunter, Colby M.; Flemmig, Thomas F.; Noble, Peter A.; Bryers, James D.

    2015-01-01

    Peri-implantitis is an inflammatory disease that results in the destruction of soft tissue and bone around the implant. Titanium implant corrosion has been attributed to the implant failure and cytotoxic effects to the alveolar bone. We have documented the extent of titanium release into surrounding plaque in patients with and without peri-implantitis. An in vitro model was designed to represent the actual environment of an implant in a patient’s mouth. The model uses actual oral microbiota from a volunteer, allows monitoring electrochemical processes generated by biofilms growing on implants and permits control of biocorrosion electrical current. As determined by next generation DNA sequencing, microbial compositions in experiments with the in vitro model were comparable with the compositions found in patients with implants. It was determined that the electrical conductivity of titanium implants was the key factor responsible for the biocorrosion process. The interruption of the biocorrosion current resulted in a 4–5 fold reduction of corrosion. We propose a new design of dental implant that combines titanium in zero oxidation state for osseointegration and strength, interlaid with a nonconductive ceramic. In addition, we propose electrotherapy for manipulation of microbial biofilms and to induce bone healing in peri-implantitis patients. PMID:26461491

  5. Does milling one-piece titanium dental implants induce osteocyte and osteoclast changes?

    PubMed

    Russe, P; Pascaretti-Grizon, F; Aguado, E; Goyenvale, E; Filmon, R; Baslé, M-F; Chappard, D

    2011-06-01

    One-piece dental implants avoid adverse effects sometimes associated with the traditional implant-abutment interface and may provide a suitable alternative to two-piece implants; however, one-piece implants often need in situ milling, which may exacerbate cell apoptosis from excessive heat at the bone-implant interface and induce secondary crestal bone loss. Twelve implants were placed in the metaphyses of two sheep under general anesthesia. Six implants were milled with a diamond bur while the other six implants remained intact. Animals were euthanized after four days, and bone blocks were harvested. Bone samples were studied without decalcification. Osteocytes were stained with Hoechst 33342 and osteoclasts by the TRAcP reaction. Both cell types, in the cortical and trabecular bone around the implant's cervical region, were counted utilizing morphometric methods. Values were compared to areas at a distance from the cervical region. No difference was observed between milled and unmilled implants, which suggested that the amount of generated heat did not provoke osteocyte loss or induce osteoclastogenesis. Intraoral abutment preparations did not increase cellular apoptosis at the bone-implant interface after four days in the ovine model.

  6. Early detachment of titanium particles from various different surfaces of endosseous dental implants.

    PubMed

    Franchi, M; Bacchelli, B; Martini, D; Pasquale, V De; Orsini, E; Ottani, V; Fini, M; Giavaresi, G; Giardino, R; Ruggeri, A

    2004-05-01

    Titanium (Ti) endosseous dental screws with different surfaces (smooth titanium--STi, titanium plasma-sprayed-TPS, alumina oxide sandblasted and acid-etched--Al-SLA, zirconium oxide sandblasted and acid etched--Zr-SLA) were implanted in femura and tibiae of sheep to investigate the biological evolution of the peri-implant tissues and detachment of Ti debris from the implant surfaces in early healing. Implants were not loaded. Sections of the screws and the peri-implant tissues obtained by sawing and grinding were analysed by light microscopy immediately after implantation (time 0) and after 14 days. All samples showed new bone trabeculae and vascularised medullary spaces in those areas where gaps between the implants and host bone were visible. In contrast, no osteogenesis was induced in the areas where the implants were initially positioned in close contact with the host bone. Chips of the pre-existing bone inducing new peri-implant neo-osteogenesis were surrounded by new bone trabeculae. The threads of some screws appeared to be deformed where the host bone showed fractures. Ti granules of 3-60 microm were detectable only in the peri-implant tissues of TPS implants both immediately after surgery and after 14 days, thus suggesting that this phenomenon may be related to the friction of the TPS coating during surgical insertion.

  7. Temperature evaluation of dental implant surface irradiated with high-power diode laser.

    PubMed

    Rios, F G; Viana, E R; Ribeiro, G M; González, J C; Abelenda, A; Peruzzo, D C

    2016-09-01

    The prevalence of peri-implantitis and the absence of a standard approach for decontamination of the dental implant surface have led to searches for effective therapies. Since the source of diode lasers is portable, has reduced cost, and does not cause damage to the titanium surface of the implant, high-power diode lasers have been used for this purpose. The effect of laser irradiation on the implants is the elevation of the temperature surface. If this elevation exceeds 47 °C, the bone tissue is irreversibly damaged, so for a safety therapy, the laser parameters should be controlled. In this study, a diode laser of GaAsAl was used to irradiate titanium dental implants, for powers 1.32 to 2.64 W (real) or 2.00 to 4.00 W (nominal), in continuous/pulsed mode DC/AC, with exposure time of 5/10 s, with/without air flow for cooling. The elevation of the temperature was monitored in real time in two positions: cervical and apical. The best results for decontamination using a 968-nm diode laser were obtained for a power of 1.65 and 1.98 W (real) for 10 s, in DC or AC mode, with an air flow of 2.5 l/min. In our perspective in this article, we determine a suggested approach for decontamination of the dental implant surface using a 968-nm diode laser.

  8. Unusual Case of Osseointegrated Dental Implant Migration into Maxillary Sinus Removed 12 Years after Insertion

    PubMed Central

    Laureti, Mauro; Ferrigno, Nicola; Mencio, Francesca; Pompa, Giorgio; Di Carlo, Stefano

    2017-01-01

    Displacement of dental implants into the maxillary sinus is not an uncommon event in implant dentistry and may lead to serious complications, such as sinusitis. To avoid systemic problems, performing the removal of the foreign body as soon as possible is suggested. Despite the fact that early implants dislocation has been reported several times, late migration into maxillary sinus has been described by just a few studies. The purpose of this study was to report a rare case of dental implant migration into maxillary sinus after 12 years of function. A 61-year-old woman came to our attention in June 2015 after being visited by an otolaryngologist and being diagnosed with sinusitis and presence of a foreign body into the right maxillary sinus. A panoramic radiograph and a CT scan showed the migration of dental implant sited in 1.6 positions into the maxillary sinus. The implant was removed following a Caldwell-Luc procedure under local anesthesia. Postoperative course was uncomplicated and the patient reported no symptoms of sinusitis after 12 months of follow-up. PMID:28392949

  9. Paying for treatments? Influences on negotiating clinical need and decision-making for dental implant treatment

    PubMed Central

    Exley, Catherine E; Rousseau, Nikki S; Steele, Jimmy; Finch, Tracy; Field, James; Donaldson, Cam; Thomason, J Mark; May, Carl R; Ellis, Janice S

    2009-01-01

    Background The aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment is an effective treatment for missing teeth, but is only available via the NHS in some specific clinical circumstances. The majority of people who receive this treatment therefore pay privately, often at substantial cost to themselves. People are used to paying towards dental treatment costs. However, dental implant treatment is much more expensive than existing treatments – such as removable dentures. We know very little about how dentists make decisions about whether to offer such treatments, or what patients consider when deciding whether or not to pay for them. Methods/Design Mixed methods will be employed to provide insight and understanding into how clinical need is determined, and what influences people's decision making processes when deciding whether or not to pursue a dental implant treatment. Phase 1 will use a structured scoping questionnaire with all the General dental practitioners (GDPs) in three Primary Care Trust areas (n = 300) to provide base-line data about existing practice in relation to dental implant treatment, and to provide data to develop a systematic sampling procedure for Phase 2. Phases 2 (GDPs) and 3 (patients) use qualitative focused one to one interviews with a sample of these practitioners (up to 30) and their patients (up to 60) to examine their views and experiences of decision making in relation to dental implant treatment. Purposive sampling for phases 2 and 3 will be carried out to ensure participants represent a range of socio-economic circumstances, and choices made. Discussion Most dental implant treatment is conducted in primary care. Very little information was available prior to this study about the quantity and type of treatment carried out privately. It became apparent during phase 2 that ISOD treatment was an unusual treatment in

  10. Multiple teeth replacement with endosseous one-piece yttrium-stabilized zirconia dental implants

    PubMed Central

    Borgonovo, Andrea E.; Fabbri, Alberto; Censi, Rachele; Maiorana, Carlo

    2012-01-01

    Objectives: The purpose of this study is to clinically and radiographically evaluate survival and success rate of multiple zirconia dental implants positioned in each patient during a follow-up period of at least 12 months up to 48 months. Study Design: Eight patients were treated for multiple edentulism with 29 zirconia dental implants. All implants received immediate temporary restorations and 6 months after surgery were definitively restored. 6 months to 4 years after implant insertion, a clinical-radiographic evaluation was performed in order to estimate peri-implant tissues health and peri-implant marginal bone loss. Results: Survival rate within follow-up period was therefore 100%. The average marginal bone loss (MBL) from baseline to 6 months was +1.375±0.388 mm; from 6 months to 1 year was +0.22±0.598 mm; from 1 year to 2 years was -0.368±0.387 mm; from 2 years to 3 years was -0.0669±0.425 mm; from 3 years to 4 years +0.048±0.262 mm. The mean marginal bone loss at 4 years from the implants insertion was +1.208 mm. Conclusions: According to several studies, when using a radiographic criterion for implant success, marginal bone loss below 0.9-1.6 mm during the first year in function can be considered acceptable. In our work, radiographic measurements of MBL showed values not exceeding 1.6 mm during the first year of loading and also 1 year up to 4 years after surgery further marginal bone loss was minimal and not significant. This peri-implant bone preservation may be associated to the absence of micro-gap between fixture and abutment since zirconia dental implants are one-piece implant. Moreover, zirconia is characterized by high biocompatibility and it accumulates significantly fewer bacteria than titanium. Key words:Zirconia dental implants, multiple implants, radiographic evaluation, marginal bone loss (MBL). PMID:22926479

  11. Immediate loading of dental implants in the esthetic region using computer-guided implant treatment software and stereolithographic models for a patient with eating disorders.

    PubMed

    Galindo, Daniel F; Butura, Caesar C

    2014-02-01

    This manuscript describes the reconstruction of a maxillary anterior segment using immediate implant placement and immediate implant loading techniques, aided by computer-guided implant treatment software and stereolithographic models and surgical templates, in a patient with a history of eating disorder. Her medical and dental histories did not make her a candidate for the use of conventional 2-stage implant surgery and restorative procedures along with an interim removable prosthesis.

  12. Custom abutments alone will not eliminate the clinical effects of poor cementation techniques around dental implants.

    PubMed

    Piñeyro, Alfonso; Ganeles, Jeffrey

    2014-10-01

    With proper planning, placement, prosthetic treatment, and maintenance, dental implants have been shown to be a predictable and reliable treatment option with a high success rate. Clinicians who place cement-retained implant restorations, however, should be aware of the potential and sometimes irreversible biological complications associated with residual excess cement and should be prepared to consider using different practices that may reduce the problem. The present case reports describe the use of custom abutments to restore deeply placed implants with the intent of minimizing residual excess cement.

  13. Resonance frequency analysis of 208 Straumann dental implants during the healing period.

    PubMed

    Guler, Ahmet Umut; Sumer, Mahmut; Duran, Ibrahim; Sandikci, Elif Ozen; Telcioglu, Nazife Tuba

    2013-04-01

    The most important prerequisite for the success of an osseointegrated dental implant is achievement and maintenance of implant stability. The aim of the study was to measure the 208 Straumann dental implant stability quotient (ISQ) values during the osseointegration period and determine the factors that affect implant stability. A total of 164 of the implants inserted were standard surface, and 44 of them were SLActive surface. To determine implant stability as ISQ values, measurements were performed at the stage of implant placement and healing periods by the Osstell mentor. The ISQ value ranges showed a significant increase during the healing period. Except for the initial measurement, the posterior maxilla had the lowest ISQ values, and there was no significant difference among anterior mandible, posterior mandible, and anterior maxilla (P < .05). Implant length did not have a significant influence on ISQ value (P > .05). The second measurement was significantly higher in men compared with women (P < .05). The second measurement was significantly higher than the others at 4.8 mm, and for the final measurement, there were no significant differences between 4.8 and 4.1 mm, which were higher than 3.3 mm (P < .05). When comparing sandblasted, large-grit, acid-etched (SLA) and SLActive surface implants, there were no significant differences for insertion measurements, but for second measurements, SLActive was significantly higher (P = 0), and for the final measurement, there was no significant difference. It appears that repeated ISQ measurements of a specific implant have some diagnostic benefit, and the factors that affect implant stability during the healing period are presented.

  14. Marsupialization of large residual cyst and subsequent dental implant insertion: Technical note.

    PubMed

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2017-02-20

    Marsupialization is an option for treatment of large jaw cysts. In this article with a case report successful marsupialization of a large residual cyst is demonstrated. Selecting appropriate case and device is necessary for success. Dental implant insertion at the end of treatment restores the function. This article presents a simple device, made from disposable hypodermic syringe as marsupialization device.

  15. New Design for Rapid Prototyping of Digital Master Casts for Multiple Dental Implant Restorations

    PubMed Central

    Romero, Luis; Jiménez, Mariano; Espinosa, María del Mar; Domínguez, Manuel

    2015-01-01

    Aim This study proposes the replacement of all the physical devices used in the manufacturing of conventional prostheses through the use of digital tools, such as 3D scanners, CAD design software, 3D implants files, rapid prototyping machines or reverse engineering software, in order to develop laboratory work models from which to finish coatings for dental prostheses. Different types of dental prosthetic structures are used, which were adjusted by a non-rotatory threaded fixing system. Method From a digital process, the relative positions of dental implants, soft tissue and adjacent teeth of edentulous or partially edentulous patients has been captured, and a maser working model which accurately replicates data relating to the patients oral cavity has been through treatment of three-dimensional digital data. Results Compared with the conventional master cast, the results show a significant cost savings in attachments, as well as an increase in the quality of reproduction and accuracy of the master cast, with the consequent reduction in the number of patient consultation visits. The combination of software and hardware three-dimensional tools allows the optimization of the planning of dental implant-supported rehabilitations protocol, improving the predictability of clinical treatments and the production cost savings of master casts for restorations upon implants. PMID:26696528

  16. Long-term follow-up of autogenous tooth bone graft blocks with dental implants.

    PubMed

    Kim, Young-Kyun; Pang, Kang-Mi; Yun, Pil-Young; Leem, Dae-Ho; Um, In-Woong

    2017-02-01

    Demineralized dentin matrix block (ABTB: Autogenous Tooth Bone Graft Block) is 3-D scaffold with same components and geometry with alveolar bone. ABTB is well incorporated and remodelled into cortico-cancellous bone with dental implant. The shape and volume were maintained with little marginal bone loss after average 44 months of follow-up.

  17. FEM Analysis of Mandibular Prosthetic Overdenture Supported by Dental Implants: Evaluation of Different Retention Methods

    PubMed Central

    Cicciù, M.; Cervino, G.; Bramanti, E.; Lauritano, F.; Lo Gudice, G.; Scappaticci, L.; Rapparini, A.; Guglielmino, E.; Risitano, G.

    2015-01-01

    Prosthetic rehabilitation of total edentulous jaws patients is today a common technique that clinicians approach in their daily practice. The use of dental implants for replacing missing teeth is going to be a safe technique and the implant-prosthetic materials give the possibility of having long-term clinical success. Aim of this work is to evaluate the mechanical features of three different prosthetic retention systems. By applying engineering systems of investigations like FEM and von Mises analyses, how the dental implant material holds out against the masticatory strength during the chewing cycles has been investigated. Three common dental implant overdenture retention systems have been investigated. The ball attachment system, the locator system, and the common dental abutment have been processed by Ansys Workbench 15.0 and underwent FEM and von Mises investigations. The elastic features of the materials used in the study have been taken from recent literature data. Results revealed different response for both types of device, although locator system showed better results for all conditions of loading. The data of this virtual model show all the features of different prosthetic retention systems under the masticatory load. Clinicians should find the better prosthetic solution related to the patients clinical condition in order to obtain long-term results. PMID:26798405

  18. Risk of electromagnetic interference induced by dental equipment on cardiac implantable electrical devices.

    PubMed

    Miranda-Rius, Jaume; Lahor-Soler, Eduard; Brunet-Llobet, Lluís; Sabaté de la Cruz, Xavier

    2016-12-01

    Patients with cardiac implantable electrical devices should take special precautions when exposed to electromagnetic fields. Proximity to equipment used in clinical dentistry may cause interference. This study evaluated in vitro the risks associated with different types/makes of cardiac devices and types of dental equipment. Six electronic dental tools were tested on three implantable cardioverter defibrillators and three pacemakers made by different manufacturers. Overall, the risk of interference with the pacemakers was 37% lower than with the implantable cardioverter defibrillators. Regarding the types/makes of cardiac devices analysed, that from Boston Scientific had a five-fold greater risk of interference than did that from Biotronik [prevalence ratio (PR) = 5.58]; there was no difference between that from Biotronik and that from Medtronic. Among the dental equipment, the electric pulp tester had the greatest risk of inducing interference and therefore this device was used as the benchmark. The electronic apex locator (PR = 0.29), Periotest M (PR = 0.47), and the ultrasonic dental scaler (PR = 0.59) were less likely to induce interference than the electric pulp tester. The risk was lowest with the electronic apex locator. Pacemakers presented a lower risk of light to moderate interference (PR = 0.63). However, the risk of severe electromagnetic interference was 3.5 times higher with pacemakers than with implantable cardioverter defibrillators (PR = 3.47).

  19. Relationship between Sponsorship and Failure Rate of Dental Implants: A Systematic Approach

    PubMed Central

    Popelut, Antoine; Valet, Fabien; Fromentin, Olivier; Thomas, Aurélie; Bouchard, Philippe

    2010-01-01

    Background The number of dental implant treatments increases annually. Dental implants are manufactured by competing companies. Systematic reviews and meta-analysis have shown a clear association between pharmaceutical industry funding of clinical trials and pro-industry results. So far, the impact of industry sponsorship on the outcomes and conclusions of dental implant clinical trials has never been explored. The aim of the present study was to examine financial sponsorship of dental implant trials, and to evaluate whether research funding sources may affect the annual failure rate. Methods and Findings A systematic approach was used to identify systematic reviews published between January 1993 and December 2008 that specifically deal with the length of survival of dental implants. Primary articles were extracted from these reviews. The failure rate of the dental implants included in the trials was calculated. Data on publication year, Impact Factor, prosthetic design, periodontal status reporting, number of dental implants included in the trials, methodological quality of the studies, presence of a statistical advisor, and financial sponsorship were extracted by two independent reviewers (kappa  = 0.90; CI95% [0.77–1.00]). Univariate quasi-Poisson regression models and multivariate analysis were used to identify variables that were significantly associated with failure rates. Five systematic reviews were identified from which 41 analyzable trials were extracted. The mean annual failure rate estimate was 1.09%.(CI95% [0.84–1.42]). The funding source was not reported in 63% of the trials (26/41). Sixty-six percent of the trials were considered as having a risk of bias (27/41). Given study age, both industry associated (OR = 0.21; CI95% [0.12–0.38]) and unknown funding source trials (OR = 0.33; (CI95% [0.21–0.51]) had a lower annual failure rates compared with non-industry associated trials. A conflict of interest statement was disclosed in 2

  20. Engineered Protein Coatings to Improve the Osseointegration of Dental and Orthopaedic Implants

    PubMed Central

    Raphel, Jordan; Karlsson, Johan; Galli, Silvia; Wennerberg, Ann; Lindsay, Christopher; Haugh, Matthew; Pajarinen, Jukka; Goodman, Stuart B.; Jimbo, Ryo; Andersson, Martin; Heilshorn, Sarah C.

    2016-01-01

    Here we present the design of an engineered, elastin-like protein (ELP) that is chemically modified to enable stable coatings on the surfaces of titanium-based dental and orthopaedic implants by novel photocrosslinking and solution processing steps. The ELP includes an extended RGD sequence to confer bio-signaling and an elastin-like sequence for mechanical stability. ELP thin films were fabricated on cp-Ti and Ti6Al4V surfaces using scalable spin and dip coating processes with photoactive covalent crosslinking through a carbene insertion mechanism. The coatings withstood procedures mimicking dental screw and hip replacement stem implantations, a key metric for clinical translation. They promoted rapid adhesion of MG63 osteoblast-like cells, with over 80% adhesion after 24 hours, compared to 38% adhesion on uncoated Ti6Al4V. MG63 cells produced significantly more mineralization on ELP coatings compared to uncoated Ti6Al4V. Human bone marrow mesenchymal stem cells (hMSCs) had an earlier increase in alkaline phosphatase activity, indicating more rapid osteogenic differentiation and mineral deposition on adhesive ELP coatings. Rat tibia and femur in vivo studies demonstrated that cell-adhesive ELP-coated implants increased bone-implant contact area and interfacial strength after one week. These results suggest that ELP coatings withstand surgical implantation and promote rapid osseointegration, enabling earlier implant loading and potentially preventing micromotion that leads to aseptic loosening and premature implant failure. PMID:26790146

  1. Direct Metal Laser Sintering Titanium Dental Implants: A Review of the Current Literature

    PubMed Central

    Mangano, F.; Chambrone, L.; van Noort, R.; Miller, C.; Hatton, P.; Mangano, C.

    2014-01-01

    Statement of Problem. Direct metal laser sintering (DMLS) is a technology that allows fabrication of complex-shaped objects from powder-based materials, according to a three-dimensional (3D) computer model. With DMLS, it is possible to fabricate titanium dental implants with an inherently porous surface, a key property required of implantation devices. Objective. The aim of this review was to evaluate the evidence for the reliability of DMLS titanium dental implants and their clinical and histologic/histomorphometric outcomes, as well as their mechanical properties. Materials and Methods. Electronic database searches were performed. Inclusion criteria were clinical and radiographic studies, histologic/histomorphometric studies in humans and animals, mechanical evaluations, and in vitro cell culture studies on DMLS titanium implants. Meta-analysis could be performed only for randomized controlled trials (RCTs); to evaluate the methodological quality of observational human studies, the Newcastle-Ottawa scale (NOS) was used. Results. Twenty-seven studies were included in this review. No RCTs were found, and meta-analysis could not be performed. The outcomes of observational human studies were assessed using the NOS: these studies showed medium methodological quality. Conclusions. Several studies have demonstrated the potential for the use of DMLS titanium implants. However, further studies that demonstrate the benefits of DMLS implants over conventional implants are needed. PMID:25525434

  2. Engineered protein coatings to improve the osseointegration of dental and orthopaedic implants.

    PubMed

    Raphel, Jordan; Karlsson, Johan; Galli, Silvia; Wennerberg, Ann; Lindsay, Christopher; Haugh, Matthew G; Pajarinen, Jukka; Goodman, Stuart B; Jimbo, Ryo; Andersson, Martin; Heilshorn, Sarah C

    2016-03-01

    Here we present the design of an engineered, elastin-like protein (ELP) that is chemically modified to enable stable coatings on the surfaces of titanium-based dental and orthopaedic implants by novel photocrosslinking and solution processing steps. The ELP includes an extended RGD sequence to confer bio-signaling and an elastin-like sequence for mechanical stability. ELP thin films were fabricated on cp-Ti and Ti6Al4V surfaces using scalable spin and dip coating processes with photoactive covalent crosslinking through a carbene insertion mechanism. The coatings withstood procedures mimicking dental screw and hip replacement stem implantations, a key metric for clinical translation. They promoted rapid adhesion of MG63 osteoblast-like cells, with over 80% adhesion after 24 h, compared to 38% adhesion on uncoated Ti6Al4V. MG63 cells produced significantly more mineralization on ELP coatings compared to uncoated Ti6Al4V. Human bone marrow mesenchymal stem cells (hMSCs) had an earlier increase in alkaline phosphatase activity, indicating more rapid osteogenic differentiation and mineral deposition on adhesive ELP coatings. Rat tibia and femur in vivo studies demonstrated that cell-adhesive ELP-coated implants increased bone-implant contact area and interfacial strength after one week. These results suggest that ELP coatings withstand surgical implantation and promote rapid osseointegration, enabling earlier implant loading and potentially preventing micromotion that leads to aseptic loosening and premature implant failure.

  3. Three-dimensional image contribution for evaluation of operative procedural errors in endodontic therapy and dental implants.

    PubMed

    Silva, Julio Almeida; de Alencar, Ana Helena Gonçalves; da Rocha, Sicknan Soares; Lopes, Lawrence Gonzaga; Estrela, Carlos

    2012-01-01

    Acceptable therapeutic protocol in dentistry depends on the outcomes obtained with follow up. Operative procedural errors (OPE) may occur and they represent risk factors able to compromise a tooth or a dental implant. The aim of this study was to detect the OPE in endodontically treated teeth and dental implants, using cone beam computed tomography (CBCT).Eight hundred and sixteen CBCT exams were performed between January 2009 and October 2010, and only those which presented endodontically treated teeth and/or dental implants were selected. The sample was as follows: 195 CBCT exams (n=200 teeth and 200 dental implants), 72 male, 123 female, with mean age of 51 years.In endodontically treated teeth, OPE included underfilling, overfilling, and root perforation; OPEin dental implants were thread exposures, contact with anatomical structures, and contact with adjacent teeth. Kolmogorov-Smirnov test was used for statistical analysis, with significance level set at α=0.05. Underfilling, overfilling, and root perforations were detected in 33.5%, 8% and 4.5% of the teeth, respectively. Dental implants with thread exposures, contact with important anatomical structures and contact with adjacent teeth were seen in 37.5%, 13% and 6.5% of the cases, respectively. OPE were detected in endodontically treated teeth and dental implants, and underfilling and thread exposures were the most frequent occurrences, respectively.

  4. Long-Term Fatigue and Its Probability of Failure Applied to Dental Implants.

    PubMed

    Prados-Privado, María; Prados-Frutos, Juan Carlos; Gehrke, Sérgio Alexandre; Sánchez Siles, Mariano; Calvo Guirado, José Luis; Bea, José Antonio

    2016-01-01

    It is well known that dental implants have a high success rate but even so, there are a lot of factors that can cause dental implants failure. Fatigue is very sensitive to many variables involved in this phenomenon. This paper takes a close look at fatigue analysis and explains a new method to study fatigue from a probabilistic point of view, based on a cumulative damage model and probabilistic finite elements, with the goal of obtaining the expected life and the probability of failure. Two different dental implants were analysed. The model simulated a load of 178 N applied with an angle of 0°, 15°, and 20° and a force of 489 N with the same angles. Von Mises stress distribution was evaluated and once the methodology proposed here was used, the statistic of the fatigue life and the probability cumulative function were obtained. This function allows us to relate each cycle life with its probability of failure. Cylindrical implant has a worst behaviour under the same loading force compared to the conical implant analysed here. Methodology employed in the present study provides very accuracy results because all possible uncertainties have been taken in mind from the beginning.

  5. Localized maxillary ridge augmentation with a block allograft for dental implant placement: case reports.

    PubMed

    Leonetti, Joseph A; Koup, Richard

    2003-01-01

    Autogenous block bone grafts have been highly successful in treating human periodontal defects, restoring esthetics, and developing adequate bone volume for dental implant placement. Limitations in available donor bone, the need for an added surgical procedure, and other potential complications have made the use of allogenic bone graft materials an important alternative. One patient described in this report presented with fractured root syndrome of the right maxillary incisor with severe resorption of the buccal plate. After atraumatic tooth extraction, a staged treatment approach involving localized ridge augmentation with an allogenic iliac bone block material and dental implant placement was used. The host bone completely incorporated the graft with only minor resorption, which enabled the implant to be placed. The allogenic bone block material used in this study was an effective alternative to harvesting and grafting autogenous bone for implant site development. The cases presented in this article clinically demonstrate the efficacy of using a block allograft in generating effective new bone fill for dental implant placement.

  6. Long-Term Fatigue and Its Probability of Failure Applied to Dental Implants

    PubMed Central

    Prados-Frutos, Juan Carlos; Gehrke, Sérgio Alexandre; Calvo Guirado, José Luis; Bea, José Antonio

    2016-01-01

    It is well known that dental implants have a high success rate but even so, there are a lot of factors that can cause dental implants failure. Fatigue is very sensitive to many variables involved in this phenomenon. This paper takes a close look at fatigue analysis and explains a new method to study fatigue from a probabilistic point of view, based on a cumulative damage model and probabilistic finite elements, with the goal of obtaining the expected life and the probability of failure. Two different dental implants were analysed. The model simulated a load of 178 N applied with an angle of 0°, 15°, and 20° and a force of 489 N with the same angles. Von Mises stress distribution was evaluated and once the methodology proposed here was used, the statistic of the fatigue life and the probability cumulative function were obtained. This function allows us to relate each cycle life with its probability of failure. Cylindrical implant has a worst behaviour under the same loading force compared to the conical implant analysed here. Methodology employed in the present study provides very accuracy results because all possible uncertainties have been taken in mind from the beginning. PMID:27517052

  7. Decontamination of dental implant surface in peri-implantitis treatment: A literature review

    PubMed Central

    Buitrago-Vera, Pedro; Solá-Ruiz, María F.; Ferrer-García, Juan C.

    2013-01-01

    Etiological treatment of peri-implantitis aims to reduce the bacterial load within the peri-implant pocket and decontaminate the implant surface in order to promote osseointegration. The aim of this literature review was to evaluate the efficacy of different methods of implant surface decontamination. A search was conducted using the PubMed (Medline) database, which identified 36 articles including in vivo and in vitro studies, and reviews of different decontamination systems (chemical, mechanical, laser and photodynamic therapies). There is sufficient consensus that, for the treatment of peri-implant infections, the mechanical removal of biofilm from the implant surface should be supplemented by chemical decontamination with surgical access. However, more long-term research is needed to confirm this and to establish treatment protocols responding to different implant characterics. Key words:Peri-implantitis, treatment, decontamination, implant surface, laser. PMID:23986023

  8. Peri-implant crevicular fluid levels of cathepsin-K, RANKL, and OPG around standard, short, and mini dental implants after prosthodontic loading

    PubMed Central

    Marakoğlu, İsmail; Haliloğlu, Seyfullah

    2015-01-01

    Purpose Despite the high success rates of endosseous dental implants, their placement is restricted according to the height and volume of bone available. The use of short or mini dental implants could be one way to overcome this limitation. Thus, this study aimed to compare standard, short, and mini dental implants with regard to associated clinical parameters and peri-implant crevicular fluid (PICF) levels of cathepsin -K (CTSK), RANK ligand (RANKL), and osteoprotegerin (OPG), after prosthodontic loading. Methods A total of 78 non-submerged implants (Euroteknika, Aesthetica+2, Sallanches, France) were installed in 30 subjects (13 male, 17 female; range, 26-62 years) who visited the clinic of the Periodontology Department, Faculty of Dentistry, Selcuk University. Sampling and measurements were performed on the loading date (baseline) and 2, 14, and 90 days after loading. Assessment of the peri-implant status for the implant sites was performed using the pocket probing depth (PPD), modified plaque index, modified gingival index, modified sulcular bleeding index, and radiographic signs of bone loss. PICF samples collected from each implant were evaluated for CTSK, RANKL, and OPG levels using the ELISA method. Keratinized tissue and marginal bone loss (MBL) were also noted. Results Clinical parameters statistically significantly increased in each group but did not show statistical differences between groups without PPD. Although implant groups showed a higher MBL in the upper jaw, only the standard dental group demonstrated a statistically significant difference. At 90 days, the OPG: sRANKL ratio and total amounts of CTSK for each group did not differ from baseline. Conclusions Within the limitations of this study, both short and mini dental implants were achieving the same outcomes as the standard dental implants in the early period after loading. PMID:26550525

  9. In Vitro Evaluation of the Effects of Multiple Oral Factors on Dental Implants Surfaces.

    PubMed

    Sridhar, Sathyanarayanan; Abidi, Zain; Wilson, Thomas G; Valderrama, Pilar; Wadhwani, Chandur; Palmer, Kelli; Rodrigues, Danieli C

    2016-06-01

    Presence of metal ions and debris resulting from corrosion processes of dental implants in vivo can elicit adverse tissue reactions, possibly leading to peri-implant bone loss and eventually implant failure. This study hypothesized that the synergistic effects of bacterial biofilm and micromotion can cause corrosion of dental implants and release of metal ions in vivo. The goal is to simulate the oral environment where an implant will be exposed to a combination of acidic electrochemical environment and mechanical forces. Four conditions were developed to understand the individual and synergistic effects of mechanical forces and bacterial biofilm on the surface of dental implants; In condition 1, it was found that torsional forces during surgical insertion did not generate wear particle debris or metal ions. In condition 2, fatigue tests were performed in a wet environment to evaluate the effect of cyclic occlusal forces. The mechanical forces applied on the implants were able to cause implant fracture as well as surface corrosion features such as discoloration, delamination, and fatigue cracks. Immersion testing (condition 3) showed that bacteria ( Streptococcus mutans ) were able to create an acidic condition that triggered surface damage such as discoloration, rusting, and pitting. A novel testing setup was developed to understand the conjoint effects of micromotion and bacterial biofilm (condition 4). Surface damage initiated by acidic condition due to bacteria (condition 3), can be accelerated in tandem with mechanical forces through fretting-crevice corrosion. Permanent damage to surface layers can affect osseointegration and deposition of metal ions in the surrounding tissues can trigger inflammation.

  10. Adipose-Derived Stem Cells as a Tool for Dental Implant Osseointegration: an Experimental Study in the Dog

    PubMed Central

    Bressan, Eriberto; Botticelli, Daniele; Sivolella, Stefano; Bengazi, Franco; Guazzo, Riccardo; Sbricoli, Luca; Ricci, Sara; Ferroni, Letizia; Gardin, Chiara; Velez, Joaquin Urbizo; Zavan, Barbara

    2015-01-01

    The biological interaction between the jaw bones and dental implant is fundamental for the long-term success of dental implant placement. Nevertheless, the insufficient bone volume remains a major clinical problem, especially in case of immediate dental implant. Using a canine model, the present study proves the regenerative potential of adipose- derived stem cells (ADSCs) to repair peri-implant bone defects occurring in immediate dental implant placement. In six labradors, all mandibular premolars and the first molars were extracted bilaterally and three months later dental implants were installed with a marginal gap. The marginal defects were filled with hydroxyapatite (HA)-based scaffolds previously seeded with ADSCs. After one month of healing, specimens were prepared for histological and histomorphometric evaluations. Histological analyses of ground sections show that ADSCs significantly increase bone regeneration. Several new vessels, osteoblasts and new bone matrix were detected. By contrast, no inflammatory cells have been revealed. ADSCs could be used to accelerate bone healing in peri- implant defects in case of immediate dental implant placement. PMID:27014644

  11. Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series

    PubMed Central

    Gay-Escoda, Cosme; Pérez-Álvarez, Débora; Camps-Font, Octavi

    2016-01-01

    Background The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. Material and Methods A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Results Nine participants (57 implants) were included. The patients’ median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Conclusions Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented. Key words:HIV infection, dental implants, oral implantology, complications, peri-implantitis, peri-implant diseases. PMID:26946205

  12. Magnet-Retained Orbital Prosthesis Using a Dental Implant.

    PubMed

    Kim, Soung Min

    2016-12-30

    The loss of an eye and the associated facial disharmony has major physical, psychological, and social consequences for patients undergoing orbital exenteration. A magnet-retained prosthesis with an implant has various advantages over both adhesive and spectacle-retained prostheses for reconstruction of the exenterated orbit.The author demonstrates one representative patient with our orbital reconstruction patients with magnetic implants, which will be applied to various maxillofacial prosthesis strategies in the near future.

  13. Morse taper dental implants and platform switching: The new paradigm in oral implantology

    PubMed Central

    Macedo, José Paulo; Pereira, Jorge; Vahey, Brendan R.; Henriques, Bruno; Benfatti, Cesar A. M.; Magini, Ricardo S.; López-López, José; Souza, Júlio C. M.

    2016-01-01

    The aim of this study was to conduct a literature review on the potential benefits with the use of Morse taper dental implant connections associated with small diameter platform switching abutments. A Medline bibliographical search (from 1961 to 2014) was carried out. The following search items were explored: “Bone loss and platform switching,” “bone loss and implant-abutment joint,” “bone resorption and platform switching,” “bone resorption and implant-abutment joint,” “Morse taper and platform switching.” “Morse taper and implant-abutment joint,” Morse taper and bone resorption,” “crestal bone remodeling and implant-abutment joint,” “crestal bone remodeling and platform switching.” The selection criteria used for the article were: meta-analysis; randomized controlled trials; prospective cohort studies; as well as reviews written in English, Portuguese, or Spanish languages. Within the 287 studies identified, 81 relevant and recent studies were selected. Results indicated a reduced occurrence of peri-implantitis and bone loss at the abutment/implant level associated with Morse taper implants and a reduced-diameter platform switching abutment. Extrapolation of data from previous studies indicates that Morse taper connections associated with platform switching have shown less inflammation and possible bone loss with the peri-implant soft tissues. However, more long-term studies are needed to confirm these trends. PMID:27011755

  14. Importance of diameter-to-length ratio in selecting dental implants: a methodological finite element study.

    PubMed

    Demenko, V; Linetskiy, I; Nesvit, K; Hubalkova, H; Nesvit, V; Shevchenko, A

    2014-01-01

    Implant dimensions greatly influence load transfer characteristics and the lifetime of a dental system. Excessive stresses at peri-implant area may result in bone failure. Finding the critical point at the implant-bone interface and evaluating the influence of implant diameter-to-length ratio on adjacent bone stresses makes it possible to select implant dimensions. For this, different cylindrical implants were numerically analysed using geometrical models generated from computed tomography images of mandible with osseointegrated implants. All materials were assumed to be linearly elastic and isotropic. Masticatory load was applied in its natural direction, oblique to occlusal plane. Maximum von Mises stresses were located around the implant neck at the critical point of its intersection with the plane of loading and were functions of implant diameter-to-length ratio. It was demonstrated that there exists a certain spectrum of diameter-to-length ratios, which will keep maximum bone stresses at a preset level chosen in accordance with patient's bone strength.

  15. Bisphosphonate coating might improve fixation of dental implants in the maxilla: a pilot study.

    PubMed

    Abtahi, J; Tengvall, P; Aspenberg, P

    2010-07-01

    This pilot study evaluates the clinical stability of bisphosphonate-coated dental implants placed using a two-stage surgical procedure in five patients. Each patient received seven regular Brånemark implants, one of which was coated with bisphosphonate in a fibrinogen matrix. The coated implant was inserted where the bone was expected to have the least favourable quality. The level of the marginal bone around each implant was measured by intraoral periapical radiographs and implant stability was recorded using resonance frequency measurements. Frequency values (ISQ) were obtained peroperatively before flap closure and after 6 months at abutment connection. At abutment connection the bisphosphonate-coated implants were removed en bloc in two patients for histological examination. An animal experiment had previously confirmed that gamma-sterilization did not reduce bioactivity of the bisphosphonate coating. In each patient, the bisphosphonate-coated implant showed the largest improvement in ISQ level of all implants. Their values at the start tended to be lower, and the absolute value at 6 months did not differ. No complications occurred with the coated implants. Histology showed no abnormalities. Improvement in ISQ values was an expected effect of the bisphosphonate coating, but could be due to the choice of insertion site. This finding warrants a randomized, blinded study.

  16. Coordinated reconstruction with bilateral condylar replacement and dental implant rehabilitation: a clinical report.

    PubMed

    Schneider, Robert; Burton, Richard

    2014-02-01

    The evaluation of complex facial-cranial trauma and subsequent restoration requires multidisciplinary treatment planning for optimal success and patient satisfaction. Patients with bilateral subcondylar fractures and facial-dental trauma are invariably challenging. Consideration of total joint replacement, along with the comprehensive evaluation of facial-dental esthetics and occlusion is critical for an optimal long-term outcome and for patient comfort. This patient treatment illustrates team cooperation and an optimal patient treatment outcome with long-term follow-up in the reconstruction of a complex cranial-facial injury from an unrestrained motor vehicle accident. The treatment included bilateral temporomandibular joint replacement with computer-aided design and computer-aided manufacturing fitted total temporomandibular joint reconstruction, grafting of a deficient anterior maxillary alveolar ridge, and dental implant placement and subsequent restoration with a partial fixed dental prosthesis.

  17. Simulation of scattering effects of irradiation on surroundings using the example of titanium dental implants: a Monte Carlo approach.

    PubMed

    Friedrich, Reinhard E; Todorovic, Manuel; Todrovic, Manuel; Krüll, Andreas

    2010-05-01

    Occasionally, head and neck cancer patients treated with high-energy X-rays and gamma rays have titanium dental implants. The aim of this study was to calculate alterations in the irradiated bone caused by a foreign body, representing a titanium implant in size and physical qualities, using a stochastic (Monte Carlo) simulation. A clinical linear accelerator was simulated using BEAM/EGS4. The calculations showed that the presence of an implant results in differences of the dose distribution all around the implant. Titanium dental implants in the field of irradiation were capable of causing significant radiation scattering. The risk for dose enhancement was notably important for the bone in direct contact with the foreign body. Therapists involved in radiation planning should consider the impact of dental implants on the radiation beam as a putative cause of osteoradionecrosis.

  18. Immediately loaded non-submerged versus delayed loaded submerged dental implants: a meta-analysis.

    PubMed

    Chrcanovic, B R; Albrektsson, T; Wennerberg, A

    2015-04-01

    The purpose of the present meta-analysis was to test the null hypothesis of no difference in the implant failure rate, postoperative infection, and marginal bone loss for patients being rehabilitated with immediately loaded non-submerged dental implants or delayed loaded submerged implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 28 publications. The inverse variance method was used for a random- or fixed-effects model, depending on the heterogeneity. The estimates of an intervention were expressed as the risk ratio (RR) and mean difference (MD) in millimetres. Twenty-three studies were judged to be at high risk of bias, one at moderate risk of bias, and four studies were considered at low risk of bias. The difference between procedures (submerged vs. non-submerged implants) significantly affected the implant failure rate (P = 0.02), with a RR of 1.78 (95% confidence interval (CI) 1.12-2.83). There was no apparent significant effect of non-submerged dental implants on the occurrence of postoperative infection (P = 0.29; RR 2.13, CI 0.52-8.65) or on marginal bone loss (P = 0.77; MD -0.03, 95% CI -0.23 to 0.17).

  19. Bruxism: overview of current knowledge and suggestions for dental implants planning.

    PubMed

    Manfredini, Daniele; Bucci, Marco Brady; Sabattini, Vincenzo Bucci; Lobbezoo, Frank

    2011-10-01

    Bruxism is commonly considered a detrimental motor activity, potentially causing overload of the stomatognathic structures and representing a risk factor for dental implant survival. The available literature does not provide evidence-based guidelines for the management of bruxers undergoing implant-retained restorations. The present paper reviewed current concepts on bruxism etiology, diagnosis and management, underlining its effects on dental implants in an attempt to provide clinically useful suggestions based on scientifically sound data. Unfortunately, very little data exists on the subject of a cause-and-effect relationship between bruxism and implant failure, to the point that expert opinions and cautionary approaches are still considered the best available sources for suggesting good practice indicators. By including experimental literature data on the effects of different types of occlusal loading on peri-implant marginal bone loss along with data from studies investigating the intensity of the forces transmitted to the bone itself during tooth-clenching and tooth-grinding activities, the authors were able to compile the suggestions presented here for prosthetic implant rehabilitations in patients with bruxism.

  20. Acidic pH resistance of grafted chitosan on dental implant.

    PubMed

    Campos, Doris M; Toury, Bérengère; D'Almeida, Mélanie; Attik, Ghania N; Ferrand, Alice; Renoud, Pauline; Grosgogeat, Brigitte

    2015-05-01

    Over the last decade, access to dental care has increasingly become a service requested by the population, especially in the case of dental implants. However, the major cause of implant failure is an inflammatory disease: peri-implantitis. Currently, the adhesion strength of antibacterial coatings at implant surfaces remains a problem to solve. In order to propose a functionalized implant with a resistant antibacterial coating, a novel method of chitosan immobilization at implant surface has been investigated. Functionalization of the pre-active titanium (Ti) surface was performed using triethoxysilylpropyl succinic anhydride (TESPSA) as a coupling agent which forms a stable double peptide bond with chitosan. The chitosan presence and the chemical resistibility of the coating under acid pH solutions (pH 5 and pH 3) were confirmed by FTIR-ATR and XPS analyses. Furthermore, peel test results showed high adhesive resistance of the TESPSA/chitosan coating at the substrate. Cytocompatibility was evaluated by cell morphology with confocal imaging. Images showed healthy morphology of human gingival fibroblasts (HGF-1). Finally, the reported method for chitosan immobilization on Ti surface via peptide bindings allows for the improvement of its adhesive capacities and resistibility while maintaining its cytocompatibility. Surface functionalization using the TESPSA/chitosan coupling method is noncytotoxic and stable even in drastic environments as found in oral cavity, thus making it a valuable candidate for clinical implantology applications.

  1. Turned versus anodised dental implants: a meta-analysis.

    PubMed

    Chrcanovic, B R; Albrektsson, T; Wennerberg, A

    2016-09-01

    The aim of this meta-analysis was to test the null hypothesis of no difference in the implant failure rates, marginal bone loss (MBL)and post-operative infection for patients being rehabilitated by turned versus anodised-surface implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in November 2015. Eligibility criteria included clinical human studies, either randomised or not. Thirty-eight publications were included. The results suggest a risk ratio of 2·82 (95% CI 1·95-4·06, P < 0·00001) for failure of turned implants, when compared to anodised-surface implants. Sensitivity analyses showed similar results when only the studies inserting implants in maxillae or mandibles were pooled. There were no statistically significant effects of turned implants on the MBL (mean difference-MD 0·02, 95%CI -0·16-0·20; P = 0·82) in comparison to anodised implants. The results of a meta-regression considering the follow-up period as a covariate suggested an increase of the MD with the increase in the follow-up time (MD increase 0·012 mm year(-1) ), however, without a statistical significance (P = 0·813). Due to lack of satisfactory information, meta-analysis for the outcome 'post-operative infection' was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.

  2. Decontamination of dental implant surface in peri-implantitis treatment: a literature review.

    PubMed

    Mellado-Valero, Ana; Buitrago-Vera, Pedro; Solá-Ruiz, María-Fernanda; Ferrer-García, Juan-Carlos

    2013-11-01

    Etiological treatment of peri-implantitis aims to reduce the bacterial load within the peri-implant pocket and decontaminate the implant surface in order to promote osseointegration. The aim of this literature review was to evaluate the efficacy of different methods of implant surface decontamination. A search was conducted using the PubMed (Medline) database, which identified 36 articles including in vivo and in vitro studies, and reviews of different decontamination systems (chemical, mechanical, laser and photodynamic therapies). There is sufficient consensus that, for the treatment of peri-implant infections, the mechanical removal of biofilm from the implant surface should be supplemented by chemical decontamination with surgical access. However, more long-term research is needed to confirm this and to establish treatment protocols responding to different implant characterics.

  3. Highly Nonlinear Solitary Waves for the Assessment of Dental Implant Mobility.

    PubMed

    Berhanu, Bruk; Rizzo, Piervincenzo; Ochs, Mark

    2013-01-01

    In this paper we present a noninvasive technique based on the propagation of highly nonlinear solitary waves (HNSWs) to monitor the stability of dental implants. HNSWs are nondispersive mechanical waves that can form and travel in highly nonlinear systems, such as one-dimensional chains of spherical particles. The technique is based on the hypothesis that the mobility of a dental implant affects certain characteristics of the HNSWs reflected at the interface between a crystal-based transducer and the implant. To validate the research hypothesis we performed two experiments: first we observed the hydration of commercial plaster to simulate at large the osseointegration process that occurs in the oral connective tissue once a dental-endosteal threaded implant is surgically inserted; then, we monitored the decalcification of treated bovine bones immersed in an acid bath to simulate the inverse of the osseointegration process. In both series, we found a good correlation between certain characteristics of the HNSWs and the stiffness of the material under testing.

  4. Mixed zirconia calcium phosphate coatings for dental implants: tailoring coating stability and bioactivity potential.

    PubMed

    Pardun, Karoline; Treccani, Laura; Volkmann, Eike; Streckbein, Philipp; Heiss, Christian; Li Destri, Giovanni; Marletta, Giovanni; Rezwan, Kurosch

    2015-03-01

    Enhanced coating stability and adhesion are essential for long-term success of orthopedic and dental implants. In this study, the effect of coating composition on mechanical, physico-chemical and biological properties of coated zirconia specimens is investigated. Zirconia discs and dental screw implants are coated using the wet powder spraying (WPS) technique. The coatings are obtained by mixing yttria-stabilized zirconia (TZ) and hydroxyapatite (HA) in various ratios while a pure HA coating served as reference material. Scanning electron microscopy (SEM) and optical profilometer analysis confirm a similar coating morphology and roughness for all studied coatings, whereas the coating stability can be tailored with composition and is probed by insertion and dissections experiments in bovine bone with coated zirconia screw implants. An increasing content of calcium phosphate (CP) resulted in a decrease of mechanical and chemical stability, while the bioactivity increased in simulated body fluid (SBF). In vitro experiments with human osteoblast cells (HOB) revealed that the cells grew well on all samples but are affected by dissolution behavior of the studied coatings. This work demonstrates the overall good mechanical strength, the excellent interfacial bonding and the bioactivity potential of coatings with higher TZ contents, which provide a highly interesting coating for dental implants.

  5. Guided bone regeneration for fenestration defects in dental implants.

    PubMed

    Yeh, Hwey-Chin; Hsu, Kuang-Wei

    2003-09-01

    Guided bone regeneration has been applied in implant dentistry for increasing the width and height of the alveolar ridge in areas with insufficient bone. Various materials and techniques have been used for this purpose. It refers to a surgical procedure by which utilizing a mechanical barrier to create a secluded space around the defect to permit bone regeneration without the competition of other tissues. This report presents a case with buccal fenestrations on maxillary implant sites observed during a surgical procedure. An allograft and a non-resorbable membrane were concomitantly used to increase the width of the alveolar ridge. Hard tissue regeneration was evident clinically. The implants were restored for functioning and followed for 2 years. Factors affecting outcomes are also discussed. Membrane stability and the space-making effect remain the keys to success.

  6. [Modern approaches to dental implants placement in deficient alveolar bone].

    PubMed

    Kulakov, A A; Gvetadze, R Sh; Brailovskaya, T V; Khar'kova, A A; Dzikovitskaya, L S

    2017-01-01

    The paper presents statistical data on implant placement procedures in Central Research Institute of Dentistry and Maxillofacial Surgery (Moscow, Russia) in 2010-2015. In 64% of cases inadequate bone volume was attributed to alveolar bone atrophy. Bone deficiency was equally often in upper and lower jaws (in 49.3 and 50.7%, correspondently) but varied in forms with complex configurations to be more specific for maxilla. The study also includes a series of clinical cases illustrating implant placement procedures in anatomically unfavorable settings.

  7. Progressive plateau root form dental implant osseointegration: A human retrieval study.

    PubMed

    Gil, Luiz F; Suzuki, Marcelo; Janal, Malvin N; Tovar, Nick; Marin, Charles; Granato, Rodrigo; Bonfante, Estevam A; Jimbo, Ryo; Gil, Jose N; Coelho, Paulo G

    2015-08-01

    Although preclinical and sparse human histology retrieval studies have shown that the interface between implant and bone is constantly remodeling, no human retrieval database has been developed to determine the effect of functional loading time and other clinical/implant design variables on osseointegration. The present study tested the hypothesis that bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) increase over functional loading time around dental implants. Due to prosthetic retreatment reasons, 93 human implant retrievals from the same manufacturer (Bicon LLC, Boston, MA, USA) were obtained over a period of approximately 15 years. The retrieved implants were under functional loading from 120 days to ∼18 years and were histomorphologic/metrically evaluated. BIC/BAFO were assessed as a function of multiple independent variables: implant surface type, diameter, length, jaw (maxilla/mandible), region (anterior/posterior), and time of functional loading. The results showed that both BIC and BAFO increased over time independently of implant design/clinical variables, supporting the postulated hypothesis.

  8. Clinical efficacy of early loading versus conventional loading of dental implants

    PubMed Central

    Zhu, Yanfei; Zheng, Xinyi; Zeng, Guanqi; Xu, Yi; Qu, Xinhua; Zhu, Min; Lu, Eryi

    2015-01-01

    The aim of this study was to determine the clinical differences between early and conventional loading protocols for dental implants. A comprehensive search of the Medline, Embase, and OVID databases for studies published through January 10, 2015 was conducted. Fourteen studies were included in our analysis. We found that early loading imposed a significantly higher risk of implant failure than did conventional loading (risk ratio = 2.09, 95% confidence interval [CI] [1.18, 3.69], P = 0.01), while no significant differences between the methods were found with regards to the marginal bone loss (weighted mean differences [WMD] = 0.11, 95% CI [−0.07, 0.28], P = 0.23), periotest value (WMD = 0.02, 95% CI [−0.83, 0.87], P = 0.96), or implant stability quotient (WMD = 0.79, 95% CI [−0.03, 1.62], P = 0.06). As for the health status of the peri-implant tissue, conventionally loaded implants demonstrated better performance than did early loaded implants. Subgroup analyses demonstrated that the sample size, time of publication, loading definition, implant position, extent, and restoration type influenced the results. Although early implant loading is convenient and comfortable for patients, this method still cannot achieve the same clinical outcomes as the conventional loading method. PMID:26542097

  9. Accuracy of Dynamic Navigation for Dental Implant Placement-Model-Based Evaluation.

    PubMed

    Emery, Robert W; Merritt, Scott A; Lank, Kathryn; Gibbs, Jason D

    2016-10-01

    The purpose of this model-based study was to determine the accuracy of placing dental implants using a new dynamic navigation system. This investigation focuses on measurements of overall accuracy for implant placement relative to the virtual plan in both dentate and edentulous models, and provides a comparison with a meta-analysis of values reported in the literature for comparable static guidance, dynamic guidance, and freehand placement studies. This study involves 1 surgeon experienced with dynamic navigation placing implants in models under clinical simulation using a dynamic navigation system (X-Guide, X-Nav Technologies, LLC, Lansdale, Pa) based on optical triangulation tracking. Virtual implants were placed into planned sites using the navigation system computer. Post-implant placement cone-beam scans were taken. These scans were mesh overlaid with the virtual plan and used to determine deviations from the virtual plan. The primary outcome variables were platform and angular deviations comparing the actual placement to the virtual plan. The angular accuracy of implants delivered using the tested device was 0.89° ± 0.35° for dentate case types and 1.26° ± 0.66° for edentulous case types, measured relative to the preoperative implant plan. Three-dimensional positional accuracy was 0.38 ± 0.21 mm for dentate and 0.56 ± 0.17 mm for edentulous, measured from the implant apex.

  10. Effect of sinus membrane perforation on dental implant integration: a retrospective study on 128 patients.

    PubMed

    Oh, Eric; Kraut, Richard A

    2011-02-01

    A common complication of sinus augmentation is perforation of the sinus membrane during augmentation and/or implant placement. This retrospective study examines the effect of sinus membrane perforation with regard to graft survival and implant integration. A total of 175 sinuses were augmented with 115 of the membranes being reported intact at the time of surgery. A total of three infections occurred in patients who sustained perforated sinuses and one infection occurred in a patient who had an intact sinus. All four infections resolved after culture sensitivity and placement of the patient on an appropriate antibiotic for 10 days. Of 438 dental implants placed in the augmented sinuses, five implants failed, four of which were associated with perforated sinuses and and which was not associated with a perforated grafted sinus.

  11. Evaluation of design parameters of dental implant shape, diameter and length on stress distribution: a finite element analysis.

    PubMed

    Mohammed Ibrahim, M; Thulasingam, C; Nasser, K S G A; Balaji, V; Rajakumar, M; Rupkumar, P

    2011-09-01

    The aim was to evaluate the design parameters of dental implants shape, diameter and length on stress distribution by finite element analysis (FEA).The objectives of the study was to compare the influence of stress distribution in the implants of screw-vent tapered and parallel design by varying the implant diameter with a standard implant length. Six dental implant models have been simulated three-dimensionally. The influence of diameter and length on stress distribution was evaluated by Group I: for screw-vent tapered design (Zimmer Dental Implant Carlsbad, CA, USA) (1) Dental implant model with diameter 3.7 mm and length 13 mm. (2) Dental implant model with diameter 4.1 mm and length 13 mm. (3) Dental implant model with diameter 4.7 mm and length 13 mm. Group II: for parallel design (Zimmer Dental Implant Carlsbad, CA, USA) (4) Dental implant model with diameter 3.7 mm and length 13 mm. (5) Dental implant model with diameter 4.1 mm and length 13 mm. (6) Dental implant model with diameter 4.7 mm and length 13 mm. The 3-D model of the implant was created in the pro-e wildfire 4.0 software by giving various commands. This model was imported to the ANSYS software through IGES (initial graphic exchange specification) file for further analysis. All six models were loaded with a force of 17.1, 114.6 and 23.4 N in a lingual, an axial and disto-mesial direction respectively, simulating average masticatory force in a natural oblique direction, to analyze the stress distribution on these implants. The increase in implant diameter in Group I and Group II from 3.7 to 4.1 mm and from 4.1 to 4.7 mm with constant 13 mm length for screw-vent tapered and parallel design implant resulted in a reduction in maximum value of Von Mises stress in the bone surrounding the implant was statistically significant at 5% level done by student "t" test. The overall maximum value of Von Mises stress was decreased in parallel design implant diameter of 4.7 mm with constant

  12. Clinical outcome of conservative treatment of injured inferior alveolar nerve during dental implant placement

    PubMed Central

    Kim, Yoon-Tae; Pang, Kang-Mi; Jung, Hun-Jong; Kim, Soung-Min; Kim, Myung-Jin

    2013-01-01

    Objectives Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. Materials and Methods Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2007 at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, were retrospectively investigated. The objective tests and subjective evaluations were performed to evaluate the degree of damage and duration of sensory disturbance recovery. Tests were performed on the day of the first visit and every two months afterward. Patient's initial symptoms, proximity of the implant to the IAN, time interval between implant surgery and the first visit to our clinic, and treatment after implant surgery were analyzed to determine whether these factors affected the final outcomes. Results Among the 64 patients, 23 had a chief complaint of sensory disturbance and others with dysesthesia. The mean time until first visit to our hospital after the injury was 10.9 months.One year after nerve injury, the sensation was improved in 9 patients, whereas not improved in 38 patients, even 4 patients experienced deterioration. Better prognosis was observed in the group of patients with early visits and with implants placed or managed not too close to the IAN. Conclusion Nearly 70% of patients with IAN injury during implant placement showed no improvement in sensation or dysesthesia with the conservative management. Earlier decision for active treatment needs to be considered because of possibility of deterioration of symptoms and unsatisfactory recovery. PMID:24471030

  13. A light and scanning electron microscopy study of human direct laser metal forming dental implants.

    PubMed

    Mangano, Carlo; Piattelli, Adriano; Scarano, Antonio; Raspanti, Mario; Shibli, Jamil A; Mangano, Francesco G; Perrotti, Vittoria; Iezzi, Giovanna

    2014-01-01

    Direct laser metal forming (DLMF) is a procedure in which a high-power laser beam is directed on a metal powder bed and programmed to fuse particles according to a computer-aided design file, thus generating a thin metal layer. With DLMF, it is now possible to fabricate dental implants with a superficial porous surface. The aim of the present study was to evaluate the peri-implant soft tissues around human-retrieved DLMF dental implants. Collagen fibers, in the form of bundles, were oriented perpendicularly to a distance of 100 μm from the surface, where they became parallel, running in several directions. In some portions, only a few collagen fiber bundles appeared to be oriented perpendicularly or obliquely to the plane of the section. Collagen fibers appeared to form a dense chaotic three-dimensional network running in different, more or less parallel directions to the surface. Under scanning electron microscopy, an intimate contact of the fibrous matrix with the implant surface was evident, and some collagen bundles could be seen to bind directly to the metal surface. By changing the surface microtexture, it was possible to change the response of the peri-implant soft tissues.

  14. An Alumina Toughened Zirconia Composite for Dental Implant Application: In Vivo Animal Results

    PubMed Central

    Schierano, Gianmario; Faga, Maria Giulia; Menicucci, Giulio; Sabione, Cristian; Genova, Tullio; von Degerfeld, Mitzy Mauthe; Peirone, Bruno; Cassenti, Adele; Cassoni, Paola; Carossa, Stefano

    2015-01-01

    Ceramic materials are widely used for biomedical applications because of their remarkable biological and mechanical properties. Composites made of alumina and zirconia are particularly interesting owing to their higher toughness with respect to the monolithic materials. On this basis, the present study is focused on the in vivo behavior of alumina toughened zirconia (ATZ) dental implants treated with a hydrothermal process. A minipig model was implemented to assess the bone healing through histology and mRNA expression at different time points (8, 14, 28, and 56 days). The novel ATZ implant was compared to a titanium clinical standard. The implants were analyzed in terms of microstructure and surface roughness before in vivo tests. The most interesting result deals with a statistically significant higher digital histology index for ATZ implants with respect to titanium standard at 56 days, which is an unprecedented finding, to the authors' knowledge. Even if further investigations are needed before proposing the clinical use in humans, the tested material proved to be a promising candidate among the possible ceramic dental implants. PMID:25945324

  15. Electrochemical coating of dental implants with anodic porous titania for enhanced osteointegration

    PubMed Central

    Shayganpour, Amirreza; Rebaudi, Alberto; Cortella, Pierpaolo; Diaspro, Alberto

    2015-01-01

    Summary Clinical long-term osteointegration of titanium-based biomedical devices is the main goal for both dental and orthopedical implants. Both the surface morphology and the possible functionalization of the implant surface are important points. In the last decade, following the success of nanostructured anodic porous alumina, anodic porous titania has also attracted the interest of academic researchers. This material, investigated mainly for its photocatalytic properties and for applications in solar cells, is usually obtained from the anodization of ultrapure titanium. We anodized dental implants made of commercial grade titanium under different experimental conditions and characterized the resulting surface morphology with scanning electron microscopy equipped with an energy dispersive spectrometer. The appearance of nanopores on these implants confirm that anodic porous titania can be obtained not only on ultrapure and flat titanium but also as a conformal coating on curved surfaces of real objects made of industrial titanium alloys. Raman spectroscopy showed that the titania phase obtained is anatase. Furthermore, it was demonstrated that by carrying out the anodization in the presence of electrolyte additives such as magnesium, these can be incorporated into the porous coating. The proposed method for the surface nanostructuring of biomedical implants should allow for integration of conventional microscale treatments such as sandblasting with additive nanoscale patterning. Additional advantages are provided by this material when considering the possible loading of bioactive drugs in the porous cavities. PMID:26665091

  16. Laser-induced novel patterns: As smart strain actuators for new-age dental implant surfaces

    NASA Astrophysics Data System (ADS)

    Çelen, Serap; Özden, Hüseyin

    2012-12-01

    Surface morphologies of titanium implants are of crucial importance for long-term mechanical adaptation for following implantation. One major problem is the stress shielding effect which originates from the mismatch of the bone and the implant elasticity. It is time for a paradigm shift and for an exploration of novel smart surfaces to prevent this problem. Several surface treatment methods have traditionally been used to modify the surface morphology of titanium dental implants. The laser micro-machining can be considered as a unique and promising, non-contact, no media, contamination free, and flexible treatment method for modifying surface properties of materials in the biomedical industry. The aim of the present study is two folds; to develop novel 3D smart surfaces which can be acted as strain actuators by nanosecond laser pulse energies and irradiation strategies. And analyze these smart surface morphologies using finite element methods in order to estimate their internal stiffness values which play a great role on stress shielding effect. Novel 3D smart strain actuators were prepared using an ytterbium fiber laser (λ = 1060 nm) with 200-250 ns pulse durations on commercial pure titanium dental implant material specimen surfaces and optimum operation parameters were suggested.

  17. Myxofibroma of the maxilla. Reconstruction with iliac crest graft and dental implants after tumor resection.

    PubMed

    Infante-Cossío, Pedro; Martínez-de-Fuentes, Rafael; García-Perla-García, Alberto; Jiménez-Castellanos, Emilio; Gómez-Izquierdo, Lourdes

    2011-07-01

    Odontogenic fibromyxomas are benign odontogenic tumors of mesenchymal origin of rare presentation in the oral cavity, which exhibit locally aggressive behavior and are prone to local recurrence. The controversy has mainly been on therapeutic management with recommendations varying, depending on the clinical cases, from simple curettage of lesion to segmental bone resection. We present a case report describing the reconstruction of an osseous defect in the maxilla and the restoration with dental implants in a 32 year old female patient after radical surgical excision due to an odontogenic fibromyxoma with locally aggressive behavior. The primary reconstruction of maxillary discontinuity defect was carried out by an immediate non-vascularized cortico-cancellous iliac crest graft. Using a computer-guided system for the implant treatment-planning, three dental implants were secondary placed in the bone graft by means of flapless implant surgery. The patient was subsequently restored with an implant-supported fixed prosthesis that has remained in continuous function for a period of three years. The surgical, reconstructive and restorative treatment sequence and techniques are discussed.

  18. Dental implants in children: A multidisciplinary perspective for long-term success

    PubMed Central

    Agarwal, Nidhi; Kumar, Dipanshu; Anand, Ashish; Bahetwar, Surendrakumar Kaluram

    2016-01-01

    Congenital hypodontia or trauma is a frequent cause of loss of teeth in children. The absence of teeth leads to loss of function and lack of normal alveolar growth, along with unpleasant esthetics that hamper the psychosocial development of the young child. Traditionally, the management of tooth loss in the young child is done by conservative means. None of those methods of treatment are completely satisfactory and have their own drawbacks. Dental implants in a young child would be an ideal mode of treatment for the absence of teeth. One of the main deterring factors for implant placement in children is the impending growth. Growth in the maxilla and mandible does not happen uniformly in one plane. It is multidirectional, occurring in sagittal, vertical, and transverse planes. It does not happen at a fixed pace, slow periods of growth are followed by phases of accelerated growth called the growth spurts. Successful implant treatment in children has been achieved by several clinicians when they incorporated a multidisciplinary approach in their treatment plan. The design and type of implant system used in pediatric patients is also responsible for successful treatment outcome. The purpose of this review is to understand the implications of growth and growth assessment and recommendations for the formulation of the treatment plan in pediatric dental implant patients. PMID:28356682

  19. Bone-Implant Contact around Crestal and Subcrestal Dental Implants Submitted to Immediate and Conventional Loading

    PubMed Central

    Pontes, Ana Emília Farias; Ribeiro, Fernando Salimon; Pires, Juliana Rico; Zuza, Elizangela Partata; Piattelli, Adriano

    2014-01-01

    The present study aims to evaluate the influence of apicocoronal position and immediate and conventional loading in the percentage of bone-implant contact (BIC). Thus, 36 implants were inserted in the edentulous mandible from six dogs. Three implants were installed in each hemimandible, in different positions in relation to the ridge: Bone Level (at crestal bone level), Minus 1 (one millimeter apical to crestal bone), and Minus 2 (two millimeters apical to crestal bone). In addition, each hemimandible was submitted to a loading protocol: immediate (prosthesis installed 24 hours after implantation) or conventional (prosthesis installed 120 days after implantation). Ninety days after, animals were killed, and implant and adjacent tissues were prepared for histometric analysis. BIC values from immediate loaded implants were 58.7%, 57.7%, and 51.1%, respectively, while conventional loaded implants were 61.8%, 53.8%, and 68.4%. Differences statistically significant were not observed among groups (P = 0.10, ANOVA test). These findings suggest that different apicocoronal positioning and loading protocols evaluated did not interfere in the percentage of bone-implant contact, suggesting that these procedures did not jeopardize osseointegration. PMID:25371911

  20. The team approach to managing dental implant complications: strategies for treating peri-implantitis.

    PubMed

    Rosen, Paul S

    2013-10-01

    Practitioners who are knowledgeable about the risk factors identified by the Consensus Report of the Sixth European Workshop on Periodontology and who are trained in techniques to eliminate or reduce them may be able to significantly improve long-term implant outcomes. A careful review of the literature suggests that this will include treatment planning, restoring a patient to periodontal heath before initiating care, appropriate implant selection, complete cement removal, and diligent recordkeeping that will track changes and enable early intervention should complications arise. In the case of the biologic complication of peri-implantitis, recent reports suggest that regenerative care may restore implants back to health.

  1. Revisiting the hopeless ridge: Part II--Inductive orthopedic allograft applied to dental implant regeneration.

    PubMed

    Lupovici, John

    2009-05-01

    Part I of "Revisiting the Hopeless Ridge" highlighted the higher complication rates, greater resorption profile, and lower implant success rates associated with autogenous block grafts. The conclusions described in that article were based on a comprehensive literature review, rather than an individual clinician's experience in clinical practice. Additionally, the idea that such grafts were the gold standard for traditional dental implant-associated bone regeneration was challenged. This article explores the advantageous properties of new commercially available allograft bone in a variety of clinical applications. One such product that combines demineralized bone with lecithin is reviewed, and two case reports using it are presented.

  2. Replacement of hopeless retained primary teeth by immediate dental implants: a case report.

    PubMed

    de Oliveira, Rafael R; Macedo, Guilherme O; Muglia, Valdir A; Souza, Sérgio L S; Novaes, Arthur B; Taba, Mário

    2009-01-01

    Hopeless retained primary teeth without permanent successors represent a restorative challenge for clinicians, along with esthetic and functional problems for patients. While various treatment approaches for congenitally missing teeth have been proposed, the replacement of a missing tooth with a dental implant offers specific advantages, such as preservation of the alveolar crest and elimination of the need to restore the adjacent teeth, over other options for tooth replacement. The aim of this article was to illustrate the surgical and prosthetic treatment with implants of a patient with primary teeth without permanent successors.

  3. Photogrammetric determination of discrepancies between actual and planned position of dental implants

    NASA Astrophysics Data System (ADS)

    Forlani, G.; Rivara, F.

    2014-05-01

    The paper describes the design and testing of a photogrammetric measurement protocol set up to determine the discrepancies between the planned and actual position of computer-guided template-based dental implants. Two moulds with the implants positioned in pre- and post- intervention are produced and separately imaged with a highly redundant block of convergent images; the model with the implants is positioned on a steel frame with control points and with suitable targets attached. The theoretical accuracy of the system is better than 20 micrometers and 0.3-0.4° respectively for positions of implants and directions of implant axes. In order to compare positions and angles between the planned and actual position of an implant, coordinates and axes directions are brought to a common reference system with a Helmert transformation. A procedure for comparison of positions and directions to identify out-of-tolerance discrepancies is presented; a numerical simulation study shows the effectiveness of the procedure in identifying the implants with significant discrepancies between pre- and post- intervention.

  4. Cell adhesion and in vivo osseointegration of sandblasted/acid etched/anodized dental implants.

    PubMed

    Kim, Mu-Hyon; Park, Kyeongsoon; Choi, Kyung-Hee; Kim, Soo-Hong; Kim, Se Eun; Jeong, Chang-Mo; Huh, Jung-Bo

    2015-05-06

    The authors describe a new type of titanium (Ti) implant as a Modi-anodized (ANO) Ti implant, the surface of which was treated by sandblasting, acid etching (SLA), and anodized techniques. The aim of the present study was to evaluate the adhesion of MG-63 cells to Modi-ANO surface treated Ti in vitro and to investigate its osseointegration characteristics in vivo. Four different types of Ti implants were examined, that is, machined Ti (control), SLA, anodized, and Modi-ANO Ti. In the cell adhesion study, Modi-ANO Ti showed higher initial MG-63 cell adhesion and induced greater filopodia growth than other groups. In vivo study in a beagle model revealed the bone-to-implant contact (BIC) of Modi-ANO Ti (74.20%±10.89%) was much greater than those of machined (33.58%±8.63%), SLA (58.47%±12.89), or ANO Ti (59.62%±18.30%). In conclusion, this study demonstrates that Modi-ANO Ti implants produced by sandblasting, acid etching, and anodizing improve cell adhesion and bone ongrowth as compared with machined, SLA, or ANO Ti implants. These findings suggest that the application of Modi-ANO surface treatment could improve the osseointegration of dental implant.

  5. Persistent idiopathic facial pain following dental implant placement: a case report.

    PubMed

    Queral-Godoy, Elena; Vazquez-Delgado, Eduardo; Okeson, Jeffrey P; Gay-Escoda, Cosme

    2006-01-01

    The present case report depicts the management of a patient with persistent idiopathic facial pain following the placement of 2 dental implants in the mandibular anterior alveolar ridge. After 15 months of unsuccessful diagnosis and management, the patient was seen at the Orofacial Pain Unit of the Oral Surgery and Implantology master's degree program of the University of Barcelona. Seven months after treatment onset, a combination of nortriptyline, clonazepam, and relaxation procedures has successfully controlled the patient's facial pain symptoms.

  6. Corrosion behaviour of Ti-15Mo alloy for dental implant applications.

    PubMed

    Kumar, Satendra; Narayanan, T S N Sankara

    2008-07-01

    The corrosion behaviour of Ti-15Mo alloy in 0.15M NaCl solution containing varying concentrations of fluoride ions (190, 570, 1140 and 9500 ppm) is evaluated using potentiodynamic polarization, electrochemical impedance spectroscopy (EIS) and chronoamperometric/current-time transient (CTT) studies to ascertain its suitability for dental implant applications. The study reveals that there is a strong dependence of the corrosion resistance of Ti-15Mo alloy on the concentration of fluoride ions in the electrolyte medium. Increase in fluoride ion concentration from 0 to 9500 ppm shifts the corrosion potential (E(corr)) from -275 to -457 mV vs. SCE, increases the corrosion current density (i(corr)) from 0.31 to 2.30 microA/cm(2), the passive current density (i(pass)) from 0.07 to 7.32 mA/cm(2) and the double-layer capacitance (C(dl)) from 9.63 x 10(-5) to 1.79 x 10(-4)F and reduces the charge transfer resistance (R(ct)) from 6.58 x 10(4) to 6.64 x 10(3)Omega cm(2). In spite of the active dissolution, the Ti-15Mo alloy exhibit passivity at anodic potentials at all concentrations of the fluoride ions studied. In dental implants since the exposure of the alloy will be limited only to its 'neck', the amount of Mo ions released from Ti-15Mo alloy is not likely to have an adverse and hence, in terms of biocompatibility this alloy seems to be acceptable for dental implant applications. The results of the study suggest that Ti-15Mo alloy can be a suitable alternative for dental implant applications.

  7. Management of Limited Vertical Bone Height in the Posterior Mandible: Short Dental Implants Versus Nerve Lateralization With Standard Length Implants.

    PubMed

    Dursun, Erhan; Keceli, Huseyin Gencay; Uysal, Serdar; Güngör, Hamiyet; Muhtarogullari, Mehmet; Tözüm, Tolga Fikret

    2016-05-01

    Inferior alveolar nerve lateralization (IANL) and short dental implants (SDI) are 2 viable implant-based treatment approaches in the presence of atrophied posterior mandible. Despite the risks of dysfunction, infection, and pathologic fractures in IANL, it becomes possible to place standard implants. The purpose of this study was to compare SDI and IANL approaches from clinical and radiographic aspects. Fifteen subjects having unilateral atrophic mandibles were allocated to SDI and IANL treatment groups. Following surgical procedures, early postoperative complications, implant survival, and periimplant clinical and radiographic parameters including probing pocket depth, attachment level, keratinized tissue amount, vertical tissue recession, and marginal bone loss were recorded at baseline and 1-year after prosthetic rehabilitation. In both groups, no implant was lost. Except usual postoperative complications, 2 patients had transient paraesthesia after IANL. According to time-dependent evaluation, both groups showed significant increase in probing pocket depth and attachment level at 1-year follow-up compared with baseline (P < 0.05). Except a slight but significant increase in mesial surface of SDI group (P < 0.05), no remarkable time-dependent change was identified in vertical tissue recession. Keratinized tissue amount did not exhibit any inter- or intragroup difference during whole study period. Marginal bone loss did not show any difference between IANL and SDI groups at follow-up. SDI placement or standard length implant placement with IANL can be considered promising alternatives in the treatment of atrophic mandibular posterior regions. However, SDI may be preferred in terms of lower complication risk.

  8. A retrospective study on a series of 556 zimmer dental implants

    PubMed Central

    Soardi, Carlo Maria; Zandanel, Ezio; Rebuffini, Elena; Carinci, Rebuffini

    2012-01-01

    Background: One-stage surgery with immediate loading is possible, with good clinical results. Many types of dental implants are available in the market. Zimmer Dental Implants (ZDIs) have been used since the nineties, but few reports have analyzed the clinical outcome of these fixtures. We planned a retrospective study on a series 566 ZDIs, to evaluate their clinical outcome. Materials and Methods: In the period between January 2007 and June 2011, 125 patients were treatetd with ZDIs. The last check-up was performed in June 2012, with a mean follow-up period of 17 ± 9 months (minimum – maximum, 8-4 months). ZDIs were inserted as follows: 295 (53.1%) in the maxilla and 261 (46.9%) in the mandible. There were 480 (86.3%) Screw-vents, 51 (9.2%) Swiss Plusses, and 25 (4.5%) Splines. Sixteen, 355, 34, 90, 55, and six fixtures had a diameter of 3.25, 3.7, 3.75, 4.1, 4.7, and 4.8 mm, respectively. Twenty-eight, 145, 5, 217, 8, 141, and 12 implants hade a length of 8, 10, 11, 11.5, 12, 13, and 14 mm, respectively. The implants were inserted to replace 136 (24.5%) incisors, 80 (14.4%) cuspids, 198 (35.6%) premolars, and 142 (25.5%) molars. Results: No implants were lost (i.e., SRV = 100%). Among the studied variables, only those for the jaws were statistically significant, with a better outcome for implants inserted in the maxilla (P = 0.017). Conclusions: ZDIs are reliable devices to be used in implantology, althougth a higher marginal bone loss has to be expected when these implants are inserted in mandible. PMID:23814580

  9. The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis

    PubMed Central

    Chun, June Sang; Har, Alix; Lim, Hyun-Pil

    2016-01-01

    PURPOSE This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. MATERIALS AND METHODS The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. RESULTS When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10th year after the treatment, and more cost-effective regardless of the WTP from 20th year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10th year after the prosthodontic treatment, more than 35,000 won at the 20th year after prosthodontic treatment. CONCLUSION The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10th year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed. PMID:26949488

  10. Convergent methods assessing bone growth in an experimental model at dental implants in the minipig.

    PubMed

    Friedmann, Anton; Friedmann, Asisa; Grize, Leticia; Obrecht, Marcel; Dard, Michel

    2014-05-01

    Implant dentistry demonstrated its reliability in treating successfully an increased amount of patients with dental implants exhibiting hydrophilic (modSLA) or non-hydrophilic (SLA) surfaces. Objectives of this minipig study consisted in assessing bone regeneration at both types of dental implants in a new experimental model (lateral bone defects) by implementing a convergent analysis approach combining histology and contact radiography. In six adult female minipigs standardized acute alveolar defects were created, then receiving two implants in the mandibles bilaterally (modSLA and SLA, one of each combined with Guided Bone Regeneration). Animals were sacrificed after 28 days of healing. Mid-crestal specimen were analyzed assessing missing BIC to implant shoulder (fBIC); vertical bone growth upon implant surface, bone:tissue ratio and grafting material area occupied by material remnants for GBR sites. Values obtained from both analyses were compared and statistical correlations scrutinized. Although dimensions of mean differences and adjusted means given by radiographic method were lower than histological ones, comparison of different implants yielded similar results. Statistical analyses of correlation and concordance coefficients used to evaluate radiological method of measurement showed high level of concordance (concordance coefficient=0.912 and correlation coefficient=0.939) for fBIC. Similar results were observed for vertical new bone and for remnants of graft. Discrepancies for new bone and for mineralized tissue resulted in concordance coefficient of 0.182 and 0.054. The results indicate that contact X-rays can be used for morphometric assessments regarding defect fill; however, histological staining remains beneficial if greater resolution for distinguishing qualitative differences in the tissues is required.

  11. Alveolar Bone Grafting in Cleft Patients from Bone Defect to Dental Implants

    PubMed Central

    Vuletić, Marko; Jokić, Dražen; Rebić, Jerko; Žabarović, Domagoj; Macan, Darko

    2014-01-01

    Cleft lip and palate is the most common congenital deformity affecting craniofacial structures. Orofacial clefts have great impact on the quality of life which includes aesthetics, function, psychological impact, dental development and facial growth. Incomplete fusion of facial prominences during the fourth to tenth week of gestation is the main cause. Cleft gaps are closed with alveolar bone grafts in surgical procedure called osteoplasty. Autogenic bone is taken from the iliac crest as the gold standard. The time of grafting can be divided into two stages: primary and secondary. The alveolar defect is usually reconstructured between 7 and 11 years and is often related to the development of the maxillary canine root. After successful osteoplasty, cleft defect is closed but there is still a lack of tooth. The space closure with orthodontic treatment has 50-75% success. If the orthodontic treatment is not possible, in order to replace the missing tooth there are three possibilities: adhesive bridgework, tooth transplantation and implants. Dental implant has the role of holding dental prosthesis, prevents pronounced bone atrophy and loads the augmentation material in the cleft area. Despite the fact that autologous bone from iliac crest is the gold standard, it is not a perfect source for reconstruction of the alveolar cleft. Bone morphogenic protein (BMP) is appropriate as an alternative graft material. The purpose of this review is to explain morphology of cleft defects, historical perspective, surgical techniques and possibilities of implant and prosthodontic rehabilitation. PMID:27688373

  12. Clinical and Radiological Classification of the Jawbone Anatomy in Endosseous Dental Implant Treatment

    PubMed Central

    Kubilius, Marius

    2013-01-01

    ABSTRACT Objectives The purpose of present article was to review the classifications suggested for assessment of the jawbone anatomy, to evaluate the diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone, as well as to suggest new classification system of the jawbone anatomy in endosseous dental implant treatment. Material and Methods Literature was selected through a search of PubMed, Embase and Cochrane electronic databases. The keywords used for search were mandible; mandibular canal; alveolar nerve, inferior; anatomy, cross-sectional; dental implants; classification. The search was restricted to English language articles, published from 1972 to March 2013. Additionally, a manual search in the major anatomy and oral surgery books were performed. The publications there selected by including clinical and human anatomy studies. Results In total 109 literature sources were obtained and reviewed. The classifications suggested for assessment of the jawbone anatomy, diagnostic possibilities of mandibular canal identification and risk of inferior alveolar nerve injury, aesthetic considerations in aesthetic zone were discussed. New classification system of the jawbone anatomy in endosseous dental implant treatment based on anatomical and radiologic findings and literature review results was suggested. Conclusions The classification system proposed here based on anatomical and radiological jawbone quantity and quality evaluation is a helpful tool for planning of treatment strategy and collaboration among specialists. Further clinical studies should be conducted for new classification validation and reliability evaluation. PMID:24422030

  13. Assessment of human gingival fibroblast interaction with dental implant abutment materials.

    PubMed

    Rutkunas, Vygandas; Bukelskiene, Virginija; Sabaliauskas, Vaidotas; Balciunas, Evaldas; Malinauskas, Mangirdas; Baltriukiene, Daiva

    2015-04-01

    The biocompatibility of dental implant abutment materials depends on numerous factors including the nature of the material, its chemical composition, roughness, texture, hydrophilicity and surface charge. The aim of the present study was to compare the viability and adhesion strength of human gingival fibroblasts (HGFs) grown on several dental materials used in implant prosthodontics. Surfaces of the tested materials were assessed using an optical imaging profiler. For material toxicity and cellular adhesion evaluation, primary human gingival fibroblast cells were used. To evaluate the strength of cellular adhesion, gingival fibroblasts were cultured on the tested materials and subjected to lateral shear forces by applying 300 and 500 rpm shaking intensities. Focal adhesion kinase (FAK) expression and phosphorylation in cells grown on the specimens were registered by cell-based ELISA. There was a tendency of fibroblast adhesion strength to decrease in the following order: sandblasted titanium, polished titanium, sandblasted zirconium oxide, polished zirconium oxide, gold-alloy, chrome-cobalt alloy. Higher levels of total as well as phospho-FAK protein were registered in HGFs grown on roughened titanium. Material type and surface processing technique have an impact on gingival fibroblast interaction with dental implant abutment materials.

  14. How could multimedia information about dental implant surgery effects patients’ anxiety level?

    PubMed Central

    Dahhan, Ameer-Shani; Acar, Ahmet-Hüseyin

    2017-01-01

    Background To evaluate the effects of different patient education techniques on patients’ anxiety levels before and after dental implant surgery. Material and Methods Sixty patients were randomized into three groups; each contained 20 patients; [group 1, basic information given verbally, with details of operation and recovery; group 2 (study group), basic information given verbally with details of operative procedures and recovery, and by watching a movie on single implant surgery]; and a control group [basic information given verbally “but it was devoid of the details of the operative procedures and recovery”]. Anxiety levels were assessed using the Spielberger’s State-Trait Anxiety Inventory (STAI) and Modified Dental Anxiety Scale (MDAS). Pain was assessed with a visual analog scale (VAS). Results The most significant changes were observed in the movie group (P < 0.05). Patients who were more anxious also used more analgesic medication. Linear regression analysis showed that female patients had higher levels of anxiety (P < 0.05). Conclusions Preoperative multimedia information increases anxiety level. Key words:Implant, anxiety, pain, dental, video and patient knowledge. PMID:27918733

  15. Mechanical behavior of single-layer ceramized zirconia abutments for dental implant prosthetic rehabilitation

    PubMed Central

    Jiménez-Melendo, Manuel; Llena-Blasco, Oriol; Bruguera, August; Llena-Blasco, Jaime; Yáñez-Vico, Rosa-María; García-Calderón, Manuel; Vaquero-Aguilar, Cristina; Velázquez-Cayón, Rocío; Gutiérrez-Pérez, José-Luis

    2014-01-01

    Objectives: This study was undertaken to characterize the mechanical response of bare (as-received) and single-layer ceramized zirconia abutments with both internal and external connections that have been developed to enhanced aesthetic restorations. Material and Methods: Sixteen zirconia implant abutments (ZiReal Post®, Biomet 3i, USA) with internal and external connections have been analyzed. Half of the specimens were coated with a 0.5mm-thick layer of a low-fusing fluroapatite ceramic. Mechanical tests were carried out under static (constant cross-head speed of 1mm/min until fracture) and dynamic (between 100 and 400N at a frequency of 1Hz) loading conditions. The failure location was identified by electron microscopy. The removal torque of the retaining screws after testing was also evaluated. Results: The average fracture strength was above 300N for all the abutments, regardless of connection geometry and coating. In most of the cases (94%), failure occurred by abutment fracture. No significant differences were observed either in fatigue behavior and removal torque between the different abutment groups. Conclusions: Mechanical behavior of Zireal zirconia abutments is independent of the type of internal/external connection and the presence/absence of ceramic coating. This may be clinically valuable in dental rehabilitation to improve the aesthetic outcome of zirconia-based dental implant systems. Key words:Dental implant, zirconia, ceramic structure, mechanical properties. PMID:25674313

  16. Bioinspired micro/nano fabrication on dental implant-bone interface

    NASA Astrophysics Data System (ADS)

    Wang, Feng; Shi, Liang; He, Wen-Xi; Han, Dong; Yan, Yan; Niu, Zhong-Ying; Shi, Sheng-Gen

    2013-01-01

    Pioneering research suggests fabricating a biomimetic interface with multiscaled surfacial architecture can greatly improve biomaterials' function and property. According to this inspiration, we chiefly single out and analyze the natural hierarchical micro/nano structure in rat's alveolar bone. Then, a combined hierarchical structure, i.e. micro-pits interlaced self-assemble TiO2 nanotubes of several tens of nanometers on dental implant's surface is developed. The as-prepared surface showed that hundreds of self-assembled TiO2 nanotubes were tightly arrayed with a diameter range of 30-50 nm, similar to collagen fibers within rat's mandible (60-80 nm). Meanwhile, this hierarchical micro/nano surface can provide a larger surface energy and roughness, a preferable hydrophilicity, a more adaptive mechanical property and adhesion work, a better bioactivity and biocompatibity, a superior attachment and growth of osteoblasts as compared to the smooth and purely micro-treated counterparts. The results indicated that this bioinspired micro/nano fabrication on dental implant-bone interface can be potentially applied in the update of dental implant in patients' clinical therapy and provide a new strategy for fabricating other osteocompatible materials.

  17. Analysis of the compatibility of dental implant systems in fibula free flap reconstruction.

    PubMed

    Carbiner, Ramin; Jerjes, Waseem; Shakib, Kaveh; Giannoudis, Peter V; Hopper, Colin

    2012-06-21

    As a result of major ablative surgery, head and neck oncology patients can be left with significant defects in the orofacial region. The resultant defect raises the need for advanced reconstruction techniques. The reconstruction in this region is aimed at restoring function and facial contour. The use of vascularised free flaps has revolutionised the reconstruction in the head and neck. Advances in reconstruction techniques have resulted in continuous improvement of oral rehabilitation. For example, endosteal implants are being used to restore the masticatory function by the way of prosthetic replacement of the dentition. Implant rehabilitation usually leads to improved facial appearance, function, restoration of speech and mastication. Suitable dental implant placement's site requires satisfactory width, height and quality of bone. Reconstruction of hard tissue defects therefore will need to be tailored to meet the needs for implant placement.The aim of this feasibility study was to assess the compatibility of five standard commercially available dental implant systems (Biomet 3i, Nobel Biocare, Astra tech, Straumann and Ankylos) for placement into vascularised fibula graft during the reconstruction of oromandibular region.Radiographs (2D) of the lower extremities from 142 patients in the archives of the Department of Radiology in University College London Hospitals (UCLH) were analysed in this study. These radiographs were from 61 females and 81 males. Additionally, 60 unsexed dry fibular bones, 30 right sided, acquired from the collection of the Department of Anatomy, University College London (UCL) were also measured to account for the 3D factor.In the right fibula (dry bone), 90% of the samples measured had a width of 13.1 mm. While in the left fibula (dry bone), 90% of the samples measured had a width of 13.3 mm. Fibulas measured on radiographs had a width of 14.3 mm in 90% of the samples. The length ranges of the dental implants used in this study were: 7

  18. Analysis of the compatibility of dental implant systems in fibula free flap reconstruction

    PubMed Central

    2012-01-01

    As a result of major ablative surgery, head and neck oncology patients can be left with significant defects in the orofacial region. The resultant defect raises the need for advanced reconstruction techniques. The reconstruction in this region is aimed at restoring function and facial contour. The use of vascularised free flaps has revolutionised the reconstruction in the head and neck. Advances in reconstruction techniques have resulted in continuous improvement of oral rehabilitation. For example, endosteal implants are being used to restore the masticatory function by the way of prosthetic replacement of the dentition. Implant rehabilitation usually leads to improved facial appearance, function, restoration of speech and mastication. Suitable dental implant placement’s site requires satisfactory width, height and quality of bone. Reconstruction of hard tissue defects therefore will need to be tailored to meet the needs for implant placement. The aim of this feasibility study was to assess the compatibility of five standard commercially available dental implant systems (Biomet 3i, Nobel Biocare, Astra tech, Straumann and Ankylos) for placement into vascularised fibula graft during the reconstruction of oromandibular region. Radiographs (2D) of the lower extremities from 142 patients in the archives of the Department of Radiology in University College London Hospitals (UCLH) were analysed in this study. These radiographs were from 61 females and 81 males. Additionally, 60 unsexed dry fibular bones, 30 right sided, acquired from the collection of the Department of Anatomy, University College London (UCL) were also measured to account for the 3D factor. In the right fibula (dry bone), 90% of the samples measured had a width of 13.1 mm. While in the left fibula (dry bone), 90% of the samples measured had a width of 13.3 mm. Fibulas measured on radiographs had a width of 14.3 mm in 90% of the samples. The length ranges of the dental implants used in this study

  19. Effect of a multiporous beta-tricalicum phosphate on bone density around dental implants inserted into fresh extraction sockets.

    PubMed

    Daif, Emad Tawfik

    2013-06-01

    The aim of this study was to assess, via multi-slice helical computerized tomography (CT), the influence of the pure-phase multiporous beta-tricalcium phosphate (beta-TCP) on bone density around dental implants inserted into fresh extraction sockets. Twenty-eight patients (18 women and 10 men), indicated for extraction of their lower premolars and insertion of immediate dental implants, were included in this study. They were randomly divided into two equal groups (14 patients each). Group A received immediate dental implants without any filling material around the implants, while in group B, a pure-phase multiporous beta-TCP was gently packed into the bone gaps around the implants. Three and 6 months after loading the implants, a CT, sagittal and coronal, was made to measure the bone density around the implants. The results of the current study have shown that the mean values of the bone density measurements around the implants in group A were 1150 ± 205 (range, 645-1460) at 3 months and 1245 ± 165 (range, 884-1650) at 6 months after loading the implants. In group B, the mean values of the bone density measurements around the implants were 1280 ± 320 (range, 876-1790) and 1490 ± 358 (range, 1061-1965) at 3 and 6 months after loading the implants, respectively. The statistical analysis of the collected data showed a significant increase in the bone density measurements from 3 to 6 months only in group B (P < .05). Also, the difference between group A and B in the bone density measurements around the implants was statistically significant (P < .05) at only 6 months after loading. On the basis of the results presented in this study, it may be possible to mention that the pure-phase multiporous beta-TCP may enhance the bone density when inserted into the bone gaps around immediate dental implants.

  20. Ag-plasma modification enhances bone apposition around titanium dental implants: an animal study in Labrador dogs.

    PubMed

    Qiao, Shichong; Cao, Huiliang; Zhao, Xu; Lo, Hueiwen; Zhuang, Longfei; Gu, Yingxin; Shi, Junyu; Liu, Xuanyong; Lai, Hongchang

    2015-01-01

    Dental implants with proper antibacterial ability as well as ideal osseointegration are being actively pursued. The antimicrobial ability of titanium implants can be significantly enhanced via modification with silver nanoparticles (Ag NPs). However, the high mobility of Ag NPs results in their potential cytotoxicity. The silver plasma immersion ion-implantation (Ag-PIII) technique may remedy the defect. Accordingly, Ag-PIII technique was employed in this study in an attempt to reduce the mobility of Ag NPs and enhance osseointegration of sandblasted and acid-etched (SLA) dental implants. Briefly, 48 dental implants, divided equally into one control and three test groups (further treated by Ag-PIII technique with three different implantation parameters), were inserted in the mandibles of six Labrador dogs. Scanning electron microscopy, X-ray photoelectron spectroscopy, and inductively coupled plasma optical emission spectrometry were used to investigate the surface topography, chemical states, and silver release of SLA- and Ag-PIII-treated titanium dental implants. The implant stability quotient examination, Microcomputed tomography evaluation, histological observations, and histomorphometric analysis were performed to assess the osseointegration effect in vivo. The results demonstrated that normal soft tissue healing around dental implants was observed in all the groups, whereas the implant stability quotient values in Ag-PIII groups were higher than that in the SLA group. In addition, all the Ag-PIII groups, compared to the SLA-group, exhibited enhanced new bone formation, bone mineral density, and trabecular pattern. With regard to osteogenic indicators, the implants treated with Ag-PIII for 30 minutes and 60 minutes, with the diameter of the Ag NPs ranging from 5-25 nm, were better than those treated with Ag-PIII for 90 minutes, with the Ag NPs diameter out of that range. These results suggest that Ag-PIII technique can reduce the mobility of Ag NPs and enhance

  1. Ag-plasma modification enhances bone apposition around titanium dental implants: an animal study in Labrador dogs

    PubMed Central

    Qiao, Shichong; Cao, Huiliang; Zhao, Xu; Lo, Hueiwen; Zhuang, Longfei; Gu, Yingxin; Shi, Junyu; Liu, Xuanyong; Lai, Hongchang

    2015-01-01

    Dental implants with proper antibacterial ability as well as ideal osseointegration are being actively pursued. The antimicrobial ability of titanium implants can be significantly enhanced via modification with silver nanoparticles (Ag NPs). However, the high mobility of Ag NPs results in their potential cytotoxicity. The silver plasma immersion ion-implantation (Ag-PIII) technique may remedy the defect. Accordingly, Ag-PIII technique was employed in this study in an attempt to reduce the mobility of Ag NPs and enhance osseointegration of sandblasted and acid-etched (SLA) dental implants. Briefly, 48 dental implants, divided equally into one control and three test groups (further treated by Ag-PIII technique with three different implantation parameters), were inserted in the mandibles of six Labrador dogs. Scanning electron microscopy, X-ray photoelectron spectroscopy, and inductively coupled plasma optical emission spectrometry were used to investigate the surface topography, chemical states, and silver release of SLA- and Ag-PIII-treated titanium dental implants. The implant stability quotient examination, Microcomputed tomography evaluation, histological observations, and histomorphometric analysis were performed to assess the osseointegration effect in vivo. The results demonstrated that normal soft tissue healing around dental implants was observed in all the groups, whereas the implant stability quotient values in Ag-PIII groups were higher than that in the SLA group. In addition, all the Ag-PIII groups, compared to the SLA-group, exhibited enhanced new bone formation, bone mineral density, and trabecular pattern. With regard to osteogenic indicators, the implants treated with Ag-PIII for 30 minutes and 60 minutes, with the diameter of the Ag NPs ranging from 5–25 nm, were better than those treated with Ag-PIII for 90 minutes, with the Ag NPs diameter out of that range. These results suggest that Ag-PIII technique can reduce the mobility of Ag NPs and

  2. Bacterial contamination along implant-abutment interface in external and internal-hex dental implants

    PubMed Central

    de Oliveira, Greison Rabelo; Olate, Sergio; Pozzer, Leandro; Cavalieri-Pereira, Lucas; Rodrigues-Chessa, Jaime G; Albergaría-Barbosa, José Ricardo

    2014-01-01

    The aim of this research was to evaluate bacterial contamination along the implant-abutment interface in relation to the size of the interface. 80 brand name implants were used, 40 internal-hex and 40 external-hex. The implants were handled in a sterile atmosphere inside a box, where they were inoculated with 0.3 μl of the Streptococcus sanguis ATCC10556 bacterium in the interior and the abutment was immediately installed with a torque of 30 Ncm for the external-hex and 20 Ncm for the internal-hex; the system was included in an Eppendorf control for 30 seconds and then placed in an Eppendorf control for 30 days. The implants were removed and assessed under a scanning electron microscope while the Eppendorf controls were bred in blood agar to analyze the colonies formed. The data were analyzed using the Chi-squared, Kruskal-Wallis and Mann-Whitney tests, considering a value of p<0.05 to obtain statistical significance. Five implants were excluded due to probable external contamination. Microspaces of up to 86.8 μm were observed in the external-hex implants and up to 53.9 μm in the internal-hex implants with no significant differences between the different systems being observed (p>0.05). The contamination observed was produced mainly in the external-hex implants and statistically significant differences were observed between the different hex systems from the same company. No significant differences were observed between interface size and bacterial contamination. Within our limitations, there was no relation between the size of the implant-abutment interface and bacterial contamination with Streptococcus sanguis ATCC10556. PMID:24753751

  3. Chlorhexidine hexametaphosphate nanoparticles as a novel antimicrobial coating for dental implants.

    PubMed

    Wood, Natalie J; Jenkinson, Howard F; Davis, Sean A; Mann, Stephen; O'Sullivan, Dominic J; Barbour, Michele E

    2015-06-01

    Dental implants are an increasingly popular solution to missing teeth. Implants are prone to colonisation by pathogenic oral bacteria which can lead to inflammation, destruction of bone and ultimately implant failure. The aim of this study was to investigate the use of chlorhexidine (CHX) hexametaphosphate (HMP) nanoparticles (NPs) with a total CHX concentration equivalent to 5 mM as a coating for dental implants. The CHX HMP NPs had mean diameter 49 nm and composition was confirmed showing presence of both chlorine and phosphorus. The NPs formed micrometer-sized aggregated surface deposits on commercially pure grade II titanium substrates following immersion-coating for 30 s. When CHX HMP NP-coated titanium specimens were immersed in deionised water, sustained release of soluble CHX was observed, both in the absence and presence of a salivary pellicle, for the duration of the study (99 days) without reaching a plateau. Control specimens exposed to a solution of aqueous 25 µM CHX (equivalent to the residual aqueous CHX present with the NPs) did not exhibit CHX release. CHX HMP NP-coated surfaces exhibited antimicrobial efficacy against oral primary colonising bacterium Streptococcus gordonii within 8 h. The antimicrobial efficacy was greater in the presence of an acquired pellicle which is postulated to be due to retention of soluble CHX by the pellicle.

  4. Prosthetic outcome of cement-retained implant-supported fixed dental restorations: a systematic review.

    PubMed

    Chaar, M S; Att, W; Strub, J R

    2011-09-01

    The aim of the article is to assess the current literature in terms of the prosthetic outcome of cement-retained implant-supported fixed restorations, as well as to determine the type of cement that can be recommended for clinical application. A review of the literature published up to May 2010 was conducted to identify clinical studies about cement-retained implant-supported fixed restorations. The search strategy applied was a combination of MeSH terms and free text words, including the following keywords: implants, implant-supported fixed dental prostheses (FDPs), bridges, implant-supported single crowns (SCs), cement-retained, cement fixation, cement, cementation, cement failure, retention, and loss of retention, technical complications, mechanical complications, prosthetic complication, retrievability and maintenance. Thirty-two studies met the inclusion criteria. The studies were divided into two categories: 15 short-term clinical studies with an observation period of less than 5 years, and 17 long-term clinical studies with an observation period of 5 years and more. The most common technical complications of cement-retained implant-supported fixed restorations were loss of retention, chipping and abutment screw loosening. The results of the current review revealed no guidelines about cement or cementation procedures. It may be stated that despite the questionable retrievability of cement-retained implant-supported fixed restorations, this treatment modality is a reliable and effective option, especially for implant-supported SCs and short-span FDPs. The literature does not provide accurate information about the clinical outcome of cement-retained implant-supported fixed restorations nor about the ideal type of cement that facilitates stability and maintains retrievability. Standardised randomised clinical trials will provide valuable information to this issue.

  5. Prevalence of Antibiotic Resistance Genes in Subjects with Successful and Failing Dental Implants. A Pilot Study

    PubMed Central

    Koukos, Georgios; Papadopoulos, Christos; Tsalikis, Lazaros; Sakellari, Dimitra; Arsenakis, Minas; Konstantinidis, Antonios

    2015-01-01

    Objectives : To investigate the prevalence of the bacterial genes encoding resistance to beta-lactams, tetracyclines and metronidazole respectively, in subjects with successful and failing dental implants and to assess the presence of Staphylococcus aureus and the mecA gene encoding for Methicillin Resistant Staphylococcus aureus (MRSA) in the same samples. Materials and Methodology: The subject sample included 20 participants with clinically healthy osseointegrated implants and 20 participants with implants exhibiting peri-implantitis. Clinical parameters were assessed with an automated probe, samples were collected from the peri-implant sulcus or pocket and analyzed with Polymerase Chain Reaction for blaTEM, tetM, tetQ and nim genes, S. aureus and MRSA using primers and conditions previously described in the literature. Results: Findings have shown high frequencies of detection for both groups for the tetracycline resistance genes tetM (>30%), tetQ (>65%) with no statistical differences between them (z-test with Bonferroni corrections, p<0.05). The blaTEM gene, which encodes resistance to beta-lactams, was detected in <15% of the samples. The nim gene, which encodes resistance to metronidazole, S.aureus and the mecA gene encoding for MRSA were not detected in any of the analyzed samples. Conclusions: Healthy peri-implant sulci and peri-implantitis cases often harbor bacterial genes encoding for resistance to the tetracyclines and less often for beta-lactams. Thus, the antimicrobial activity of the tetracyclines and to a lower extent to beta-lactams, might be compromised for treatment of peri-implantitis. Since no metronidazole resistance genes were detected in the present study, its clinical use is supported by the current findings. S.aureus may not participate in peri-implant pathology. PMID:25646133

  6. A novel workflow for computer guided implant surgery matching digital dental casts and CBCT scan.

    PubMed

    DE Vico, G; Ferraris, F; Arcuri, L; Guzzo, F; Spinelli, D

    2016-01-01

    Nowadays computer-guided "flap-less" surgery for implant placement using stereolithographic tem-plates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical discomfort and reduced time required for definitive rehabilitation. Aim of this work is to describe a new protocol (Smart Fusion by Nobel Biocare), thanks to which is now possible to do a mini-invasive static guided implant surgery, in partially edentulous patients with at least 6 remaining teeth, without the use of a radiographic guide. This is possible thanks to a procedure named surface mapping based on the matching between numerous points on the surface of patient's dental casts and the corresponding anatomical surface points in the CBCT data. The full protocol is examined focusing the attention on the clinical and laboratory procedures.

  7. Pulsed laser-induced micro-and nanosized morphology and composition of titanium dental implants

    NASA Astrophysics Data System (ADS)

    Joób-Fancsaly, Á.; Divinyi, T.; Fazekas, Á.; Daroczi, Cs; Karacs, A.; Petõ, G.

    2002-10-01

    The surface morphology of machined screw-shaped titanium dental implants was modified by pulsed irradiation with an Nd glass laser. This method supplied very different surface elements in nanometer and micrometer ranges identified with scanning electron microscopy and atomic force microscopy as well. The surface composition was unchanged during these treatments. A rabbit experiment was carried out to investigate the direct bone contact (osseointegration) which was characterized by the removal torque of the implants. The 50 nm and 10-50 µm sized droplike elements were formed from the machined flat surface by the laser irradiation depending on the laser intensity. The osseointegration was enhanced by the increase of the density of nanosized elements and by the size of the microsized elements, showing the importance of this surface morphology in the direct bone-implant contact.

  8. Magnetic Resonance Imaging Distortion and Targeting Errors from Strong Rare Earth Metal Magnetic Dental Implant Requiring Revision.

    PubMed

    Seong-Cheol, Park; Chong Sik, Lee; Seok Min, Kim; Eu Jene, Choi; Do Hee, Lee; Jung Kyo, Lee

    2016-12-22

    Recently, the use of magnetic dental implants has been re-popularized with the introduction of strong rare earth metal, for example, neodymium, magnets. Unrecognized magnetic dental implants can cause critical magnetic resonance image distortions. We report a case involving surgical failure caused by a magnetic dental implant. A 62-year-old man underwent deep brain stimulation for medically insufficiently controlled Parkinson's disease. Stereotactic magnetic resonance imaging performed for the first deep brain stimulation showed that the overdenture was removed. However, a dental implant remained and contained a neodymium magnet, which was unrecognized at the time of imaging; the magnet caused localized non-linear distortions that were the largest around the dental magnets. In the magnetic field, the subthalamic area was distorted by a 4.6 mm right shift and counter clockwise rotation. However, distortions were visually subtle in the operation field and small for distant stereotactic markers, with approximately 1-2 mm distortions. The surgeon considered the distortion to be normal asymmetry or variation. Stereotactic marker distortion was calculated to be in the acceptable range in the surgical planning software. Targeting errors, approximately 5 mm on the right side and 2 mm on the left side, occurred postoperatively. Both leads were revised after the removal of dental magnets. Dental magnets may cause surgical failures and should be checked and removed before stereotactic surgery. Our findings should be considered when reviewing surgical precautions and making distortion-detection algorithm improvements.

  9. Dental implants inserted in male versus female patients: a systematic review and meta-analysis.

    PubMed

    Chrcanovic, B R; Albrektsson, T; Wennerberg, A

    2015-09-01

    The aim of this meta-analysis was to test the null hypothesis of no difference in the failure rates, marginal bone loss (MBL) and post-operative infection for implants inserted in male or female patients, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in December 2014. Eligibility criteria included clinical human studies, either randomized or not. Ninety-one publications were included, with a total of 27,203 implants inserted in men (1185 failures), and 25,154 implants inserted in women (1039 failures). The results suggest that the insertion of dental implants in male patients statistically affected the implant failure rates (RR 1.21, 95% CI 1.07-1.37, P = 0.002). Due to the limited number of studies reporting results on MBL, it is difficult to estimate the real effect of the insertion of implants in different sexes on the marginal bone level. Due to lack of satisfactory information, meta-analysis for the outcome 'post-operative infection' was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.

  10. The effect of hydroxyapatite nanocrystals on early bone formation surrounding dental implants.

    PubMed

    Svanborg, L M; Hoffman, M; Andersson, M; Currie, F; Kjellin, P; Wennerberg, A

    2011-03-01

    The knowledge of how nanostructures might affect early bone healing and osseointegration is limited. The aim of this study was to investigate if nanometer thick coatings of hydroxyapatite nanocrystals applied on a moderately rough surface might enhance early bone healing on screw-shaped dental implants and to evaluate if the thickness of the coat influences healing. Sandblasted and acid etched titanium implants coated with two different thicknesses of hydroxyapatite (test implants) and sandblasted and acid etched titanium implants (control implants), were inserted in rabbit tibia. After a healing time of 2, 4 and 9 weeks, a removal torque analysis and a histological evaluation were performed. The results from the removal torque analysis showed a tendency for higher values for the double coated hydroxyapatite after 4 weeks and for both the coated surfaces after 9 weeks of healing. The histological evaluations indicated slightly more new bone formation with the coated implants compared with the control; the differences did not reach statistical significance. The present study could not support the importance of nanometer thick coatings of hydroxyapatite nanocrystals in early bone healing, at least not when applied on a blasted and etched surface and placed in a cortical bone.

  11. Adhesion of Candida albicans to various dental implant surfaces and the influence of salivary pellicle proteins.

    PubMed

    Bürgers, Ralf; Hahnel, Sebastian; Reichert, Torsten E; Rosentritt, Martin; Behr, Michael; Gerlach, Till; Handel, Gerhard; Gosau, Martin

    2010-06-01

    Dental implants may be considered a potential reservoir for (re)infection with oral Candida albicans. Our aim was to evaluate initial fungal adhesion to three differentially textured titanium and one zirconia implant surface, and to correlate these findings to differences in specific surface characteristics (surface roughness (R(a)) and surface free energy (SFE)). Additionally, we investigated the influence of salivary protein films and two pellicle proteins (mucin and albumin). Implant surfaces were characterized by perthometer (R(a)) and goniometer (SFE) measurements. Implant specimens were rinsed with human whole saliva, mucin, albumin, or phosphate buffered saline and incubated in C. albicans suspension for 2.5h. Adherent fungi were quantified by means of a bioluminometric assay. The lowest amount of fungal cells was found on sand-blasted titanium, whereas zirconia implants did not show any reduced potential to adhere C. albicans. The influence of the implant SFE on fungal biofilm formation appears to be more important than the influence of R(a). The protein mucin enhanced C. albicans accumulation. In contrast, albumin is unlikely to be involved in the adhesion process of C. albicans.

  12. A Review on the Wettability of Dental Implant Surfaces: Theoretical and Experimental Aspects

    PubMed Central

    Rupp, Frank; Gittens, Rolando A.; Scheideler, Lutz; Marmur, Abraham; Boyan, Barbara D.; Schwartz, Zvi; Geis-Gerstorfer, Jürgen

    2014-01-01

    The surface wettability of biomaterials determines the biological cascade of events at the biomaterial/host interface. Wettability is modulated by surface characteristics, such as surface chemistry and surface topography. However, the design of current implant surfaces focuses mainly on specific micro- and nanotopographical features and is still far from predicting the concomitant wetting behavior. There is an increasing interest in understanding the wetting mechanisms of implant surfaces and the role of wettability on the biological response at the implant/bone or implant/soft tissue interface. Fundamental knowledge related to the influence of surface roughness (i.e., a quantification of surface topography) on titanium and titanium alloy surface wettability, and the different associated wetting regimes, can improve our understanding of the role of wettability of rough implant surfaces on the biological outcome. Such an approach has been applied to biomaterial surfaces only in a limited way. Focusing on titanium dental and orthopaedic implants, the present study reviews the current knowledge on the wettability of biomaterial surfaces, encompassing basic and applied aspects that include measurement techniques, thermodynamic aspects of wetting, and models predicting topographical and roughness effects on the wetting behavior. PMID:24590162

  13. A Review on the Wettability of Dental Implant Surfaces II: Biological and Clinical Aspects

    PubMed Central

    Gittens, Rolando A.; Scheideler, Lutz; Rupp, Frank; Hyzy, Sharon L.; Geis-Gerstorfer, Jürgen; Schwartz, Zvi; Boyan, Barbara D.

    2014-01-01

    Dental and orthopaedic implants have been under continuous advancement to improve their interactions with bone and ensure a successful outcome for patients. Surface characteristics such as surface topography and surface chemistry can serve as design tools to enhance the biological response around the implant, with in vitro, in vivo and clinical studies confirming their effects. However, the comprehensive design of implants to promote early and long-term osseointegration requires a better understanding of the role of surface wettability and the mechanisms by which it affects the surrounding biological environment. This review provides a general overview of the available information about the contact angle values of experimental and of marketed implant surfaces, some of the techniques used to modify surface wettability of implants, and results from in vitro and clinical studies. We aim to expand the current understanding on the role of wettability of metallic implants at their interface with blood and the biological milieu, as well as with bacteria, and hard and soft tissues. PMID:24709541

  14. Titanium dental implant surfaces obtained by anodic spark deposition - From the past to the future.

    PubMed

    Kaluđerović, Milena R; Schreckenbach, Joachim P; Graf, Hans-Ludwig

    2016-12-01

    Commercial titanium-based dental implants are obtained applying various methods such as machining, acid etching, anodization, plasma spraying, grit blasting or combination techniques yielding materials with smooth or micro-roughened surfaces. Those techniques are used to optimize the surface properties and to maximize biocompatibility and bioactivity with bone tissue. Present review is focused on the material surfaces obtained by anodic spark deposition (ASD). From the early 1980s till present, the results of numerous studies have shown that anodically oxidized surfaces with different dopants express a positive effect on osteoblasts behavior in vitro and osseointegration in vivo. Those surfaces demonstrated a high biocompatibility and rapid osseointegration in clinical application. This paper provides an overview of the preparation of implant surfaces by employing ASD process. Moreover, reviewed are clinically used ASD implant surfaces (Ticer, TiUnite, Osstem, etc.). The electrolyte variations in ASD process and their influence on surface properties are given herein. Using different electrolytes, anode voltages and temperatures, the above fabrication process can yield various surface morphologies from smooth to rough, porous surfaces. Furthermore, ASD enables thickening of oxide layers and enrichment with different dopands from used electrolyte, which hinder release of potentially toxic titanium ions in surrounding tissue. Particularly exciting results were achieved by calcium and phosphorus doping of the oxide layer (Ticer, ZL Microdent; TiUnite, Nobel Biocare Holding AB) which significantly increased the osteocompatibility. Ticer, a dental implant with anodically oxidized surface and the first among similar materials employed in clinical practice, was found to promote fast osteoblast cell differentiation and mineralization processes. Moreover, Ticer accelerate the integration with the bone, increase the bone/implant contact and improve primary and secondary

  15. Autogenous bone graft combined with polylactic polyglycolic acid polymer for treatment of dehiscence around immediate dental implants.

    PubMed

    Hassan, Khalid S

    2009-11-01

    The use of composite bone grafts in dehiscence defects around immediate dental implants are aimed at improving the outcome of the regenerative process. The present study was designed to evaluate the efficacy of combinations of autogenous bone graft with a synthetic copolymer polylactic and polyglycolic acid (Fisiograft) on bone healing of buccal dehiscence defects around immediate dental implants. Sixteen adult male patients who each received an immediate implant for a single tooth replacement at a maxillary anterior or premolar site were included in this study. Patients were divided into 2 groups. One group received immediate dental implants augmented with autogenous bone graft combined with Fisiograft. The other group received immediate dental implants augmented with autogenous bone graft alone. The results revealed that both treatment modalities led to significant improvements for the primary outcome regarding bone fill as well as a significant reduction of probing pocket depth and gain of attachment level. Moreover, there were slightly statistically significant differences between the groups. In conclusion, the combination of autogenous bone graft and Fisiograft showed a slight superiority to autogenous bone graft alone, suggesting that it could be an optimum bone substitute for treatment of dehiscence around immediate dental implant.

  16. Clinical and radiographic evaluation of single tantalum dental implants: a prospective pilot clinical study

    PubMed Central

    DE FRANCESCO, M.; GOBBATO, E.A.; NOCE, D.; CAVALLARI, F.; FIORETTI, A.

    2016-01-01

    SUMMARY Objective The aim of this prospective pilot clinical case series report was to evaluate, through a clinical and radiographic analysis, the peri-implant bone resorption of the tantalum dental implants (TMT) (Zimmer TMT, Parsippany, NJ, USA) one year after prosthetic rehabilitation. Methods Twenty tantalum dental implants were placed in both maxillas and mandibles of 20 patients. Patients were asked to attend a radiographic and clinical follow-up and their previous clinical records and X-rays were assessed. Bone levels were calculated by digitally measuring the distance from the implant shoulder to the first bone-to-implant on periapical radiographs taken at surgery and after 6 and 12 months of functioning. The Pearson correlation analysis was performed to assess it there was a correlation between the measurement of the marginal bone loss (MBL). The Anova Test with a post-hoc analysis using Bonferroni’s test was used to compare the three group (0, 6 months and 12 months). Results The mean total MBL for the group 0 months was 0.84 mm (SD 0.21), 6 months was 0.87 mm (SD 0.22) and for 12 months was 0.89 mm (SD 0.23). The values of the Pearson’s coefficients showed that the data measurement were positively correlated. The Anova test showed a statistically significant difference between the groups. Conclusion The statistically significant difference in marginal bone loss can be considered physiological. Within the limits of this study it can be concluded that TMT implants have an excellent bone crest’s stability, however, to have most accurate information, will be necessary extend the sample. PMID:28280531

  17. Hierarchical micro/nanostructured titanium with balanced actions to bacterial and mammalian cells for dental implants

    PubMed Central

    Zhu, Yu; Cao, Huiliang; Qiao, Shichong; Wang, Manle; Gu, Yingxin; Luo, Huiwen; Meng, Fanhao; Liu, Xuanyong; Lai, Hongchang

    2015-01-01

    A versatile strategy to endow dental implants with long-term antibacterial ability without compromising the cytocompatibility is highly desirable to combat implant-related infection. Silver nanoparticles (Ag NPs) have been utilized as a highly effective and broad-spectrum antibacterial agent for surface modification of biomedical devices. However, the high mobility and subsequent hazardous effects of the particles on mammalian cells may limit its practical applications. Thus, Ag NPs were immobilized on the surface of sand-blasted, large grit, and acid-etched (SLA) titanium by manipulating the atomic-scale heating effect of silver plasma immersion ion implantation. The silver plasma immersion ion implantation-treated SLA surface gave rise to both good antibacterial activity and excellent compatibility with mammalian cells. The antibacterial activity rendered by the immobilized Ag NPs was assessed using Fusobacterium nucleatum and Staphylococcus aureus, commonly suspected pathogens for peri-implant disease. The immobilized Ag NPs offered a good defense against multiple cycles of bacteria attack in both F. nucleatum and S. aureus, and the mechanism was independent of silver release. F. nucleatum showed a higher susceptibility to Ag NPs than S. aureus, which might be explained by the presence of different wall structures. Moreover, the immobilized Ag NPs had no apparent toxic influence on the viability, proliferation, and differentiation of rat bone marrow mesenchymal stem cells. These results demonstrated that good bactericidal activity could be obtained with very small quantities of immobilized Ag NPs, which were not detrimental to the mammalian cells involved in the osseointegration process, and promising for titanium-based dental implants with commercial SLA surfaces. PMID:26604743

  18. Impact of a "TED-Style" presentation on potential patients' willingness to accept dental implant therapy: a one-group, pre-test post-test study

    PubMed Central

    Ghanem, Henry; Abi-Nader, Samer

    2015-01-01

    PURPOSE A survey was conducted to assess the impact of a TED-like educational session on participants' willingness to accept dental implant therapy. MATERIALS AND METHODS Volunteers interested in having information about dental implant therapies were recruited and asked to complete a two-part survey before and after an educational session. The initial survey elicited demographic information, self-perceived knowledge on dental implants and willingness to this kind of treatment. A "TED-style" presentation that provided information about dental implant treatments was conducted before asking the participants to complete a second set of questions assessing the impact of the session. RESULTS The survey was completed by 104 individuals, 78.8% were women and the mean age was 66.5±10.8. Before the educational session, 76.0% of the participants refused dental implants mainly due to lack of knowledge. After the educational session, the rejection of dental implants decreased by almost four folds to 20.2%. CONCLUSION This study proved that an educational intervention can significantly increase willingness to accept treatment with dental implants in a segment of the population who is interested in having information about dental implant therapy. Furthermore, educational interventions, such as TED-like talks, might be useful to increase popular awareness on dental implant therapy. PMID:26816573

  19. Osseointegration of dental implants and osteonecrosis of the jaw in patients treated with bisphosphonate therapy: A systematic review.

    PubMed

    Chadha, Gurpreet K; Ahmadieh, Azadeh; Kumar, Satish K S; Sedghizadeh, Parish P

    2012-04-16

    Abstract Bisphosphonate (BP) drugs are a commonly prescribed group of medications used in the treatment of metabolic and oncologic bone pathoses. The aim of this study was to conduct a systematic review in order to evaluate whether patients on BP therapy are appropriate candidates for dental implants as compared to patients not taking BP with respect to successful implant osseointegration and the risk of developing bisphosphonate-related osteonecrosis of the jaw (BRONJ). Based on the current literature, a history of oral or intravenous BP use is not an absolute contraindication for dental implant placement, and dental implants can osseointegrate successfully in this patient population. Importantly, the studies currently available on this topic are of moderate to weak strength of evidence with inherent bias and limitations and hence results must be interpreted in this context. Well-controlled studies with higher strength of evidence and larger population sizes are required to more accurately address this topic in the future.

  20. Osseointegration of dental implants and osteonecrosis of the jaw in patients treated with bisphosphonate therapy: a systematic review.

    PubMed

    Chadha, Gurpreet K; Ahmadieh, Azadeh; Kumar, Satish; Sedghizadeh, Parish P

    2013-08-01

    Bisphosphonate (BP) drugs are a commonly prescribed group of medications used in the treatment of metabolic and oncologic bone disorders. The aim of this study was to conduct a systematic review in order to evaluate whether patients on BP therapy are appropriate candidates for dental implants as compared to patients not taking BP drugs with respect to successful implant osseointegration and the risk of developing bisphosphonate-related osteonecrosis of the jaw. Based on the current literature, a history of oral or intravenous BP use is not an absolute contraindication for dental implant placement, and dental implants can osseointegrate successfully in this patient population. Importantly, the studies currently available on this topic are of moderate to weak strength of evidence with inherent bias and limitations, and hence results must be interpreted in this context. Well-controlled studies with higher strength of evidence and larger population sizes are required to address this topic more accurately in the future.

  1. A Comparative and a Qualitative Analysis of Patient’s Motivations, Expectations and Satisfaction with Dental Implants

    PubMed Central

    Walia, Komal; Kulkarni, Prasad; Darak, Praveen; Swamy, Shanmukha

    2016-01-01

    Introduction Dental Implants are the norm of today’s prosthetic and restorative dentistry but, is it the answer for edentulism that can affect both individual’s appearance and functioning, therefore having an impact on the psychological and the social well being of the person is an ongoing quest. Also, patient’s beliefs and personal expectations for dental implants vary, which may influence the treatment outcome, thus emphasizing the importance of a good clinician–patient communication. Hence in this study a qualitative analysis was carried out with an earnest attempt to gain an insight into patient’s motivations, personal expectations, satisfaction and impact of clinician’s motivation for implant maintenance. Aim To learn about patient’s expectations and their level of satisfaction from dental implants. To know the impact of clinician’s instructions and motivation for implant maintenance, with the patient’s level of understanding and compare the level of motivation for implant maintenance and care provided by a dentist with Bachelor’s degree to a dentist with a Master’s degree. Materials and Methods A 30 systemically healthy patients who had undergone implant treatment (aged 25-65 years) were considered and divided into two groups: Group A: 15 patients in whom implant placement was done by a dentist with Bachelor’s degree (24 years, 18 years in general and implant practice respectively) and Group B: 15 patients in whom implant placement was done by a dentist with a Master’s degree (Periodontics; 20 years,17 years in general and implant practice respectively). A qualitative analysis with the help of appropriate questionnaires comprising of multiple choice questions specifically designed for this purpose and few open ended questions was carried out with an earnest attempt to gain an insight into patient’s motivations, personal expectations, satisfaction and impact of clinician’s motivation for implant maintenance. Results Patients

  2. Identification card and codification of the chemical and morphological characteristics of 14 dental implant surfaces.

    PubMed

    Dohan Ehrenfest, David M; Vazquez, Lydia; Park, Yeong-Joon; Sammartino, Gilberto; Bernard, Jean-Pierre

    2011-10-01

    Dental implants are commonly used in daily practice; however, most surgeons do not really know the characteristics of these biomedical devices they are placing in their patients. The objective of this work is to describe the chemical and morphological characteristics of 14 implant surfaces available on the market and to establish a simple and clear identification (ID) card for all of them, following the classification procedure developed in the Dohan Ehrenfest et al (2010) Codification (DEC) system. Fourteen implant surfaces were characterized: TiUnite (Nobel Biocare), Ospol (Ospol), Kohno HRPS (Sweden & Martina), Osseospeed (AstraTech), Ankylos (Dentsply Friadent), MTX (Zimmer), Promote (Camlog), BTI Interna (Biotechnology Institute), EVL Plus (SERF), Twinkon Ref (Tekka), Ossean (Intra-Lock), NanoTite (Biomet 3I), SLActive (ITI Straumann), Integra-CP/NanoTite (Bicon). Three samples of each implant were analyzed. Superficial chemical composition was analyzed using X-ray photoelectron spectroscopy/electron spectroscopy for chemical analysis, and the 100 nm in-depth profile was established using Auger electron spectroscopy. The microtopography was quantified using light interferometry. The general morphology and nanotopography were evaluated using a field emission-scanning electron microscope. Finally, the characterization code of each surface was established using the DEC system, and the main characteristics of each surface were summarized in a reader-friendly ID card. From a chemical standpoint, of the 14 different surfaces, 10 were based on a commercially pure titanium (grade 2 or 4), 3 on a titanium-aluminum alloy (grade 5 titanium), and one on a calcium phosphate core. Nine surfaces presented different forms of chemical impregnation or discontinuous coating of the titanium core, and 3 surfaces were covered with residual aluminablasting particles. Twelve surfaces presented different degrees of inorganic pollutions, and 2 presented a severe organic pollution

  3. Numerical assessment of bone remodeling around conventionally and early loaded titanium and titanium-zirconium alloy dental implants.

    PubMed

    Akça, Kıvanç; Eser, Atılım; Çavuşoğlu, Yeliz; Sağırkaya, Elçin; Çehreli, Murat Cavit

    2015-05-01

    The aim of this study was to investigate conventionally and early loaded titanium and titanium-zirconium alloy implants by three-dimensional finite element stress analysis. Three-dimensional model of a dental implant was created and a thread area was established as a region of interest in trabecular bone to study a localized part of the global model with a refined mesh. The peri-implant tissues around conventionally loaded (model 1) and early loaded (model 2) implants were implemented and were used to explore principal stresses, displacement values, and equivalent strains in the peri-implant region of titanium and titanium-zirconium implants under static load of 300 N with or without 30° inclination applied on top of the abutment surface. Under axial loading, principal stresses in both models were comparable for both implants and models. Under oblique loading, principal stresses around titanium-zirconium implants were slightly higher in both models. Comparable stress magnitudes were observed in both models. The displacement values and equivalent strain amplitudes around both implants and models were similar. Peri-implant bone around titanium and titanium-zirconium implants experiences similar stress magnitudes coupled with intraosseous implant displacement values under conventional loading and early loading simulations. Titanium-zirconium implants have biomechanical outcome comparable to conventional titanium implants under conventional loading and early loading.

  4. [Monocrystalline aluminum dental implants in animals: a study of the peri-implant tissue].

    PubMed

    Gatti, A M; Zaffe, D; Poli, G P

    1990-04-01

    After the extraction of two molars in a dog's jaw, a single crystal alumina screw was implanted. Monthly radiographs were taken and analyzed by means of a video display computer (VDC) to obtain densitometric informations about the interface. After one year implantation, the bone segment containing the prosthesis was fixed in 4% paraformaldehyde, embedded in methacrylate and sectioned by a microtome saw. The results in light microscopy with ordinary and polarized light, in SEM and X-ray microanalysis, show the presence of a thick connective tissue layer interposed between the screw and the bone. The histological findings confirm the results obtained through the VDC analysis of the radiographic images.

  5. Study of corrosion between a titanium implant and dental alloys.

    PubMed

    Reclaru, L; Meyer, J M

    1994-06-01

    The infiltration of saliva into the multi-metallic structures on titanium implants brings different types of alloys into temporary or permanent contact. In this way a galvanic cell is established as a result of their potential difference. The galvanic cell phenomenon is compounded by another type of corrosion resulting from the geometry of the assembly: localized crevice corrosion. Fifteen galvanic couples (Ti/gold-based alloys, Ti/palladium-based alloy and Ti/non-precious alloys) were studied. Various electrochemical parameters (Ecorr, Ecommon, Ecouple corr, Ecrevice, icorr, icouple corr and Tafel slopes) were analysed. The galvanic currents measured are of the same order of magnitude (except Ti/stainless steel). They remain low. Application of the mixed-potential theory shows that titanium in coupling with the alloys studied will be under either cathodic or anodic control. According to the results obtained, an alloy that is potentially usable for superstructures in a galvanic coupling with titanium must fulfil a certain number of parameters: in a coupling, titanium must have a weak anodic polarization; the current generated by the galvanic cell must also be weak; the crevice potential must be markedly higher than the common potential.

  6. Dental cone beam computed tomography: justification for use in planning oral implant placement.

    PubMed

    Jacobs, Reinhilde; Quirynen, Marc

    2014-10-01

    Intra-oral and panoramic radiographs are most frequently used in oral health care. Yet, the inherent nature of jaws and teeth renders three-dimensional diagnosis essential, especially in relation to oral surgery. Nowadays, this can be accomplished by dental cone beam computed tomography, which provides high-quality images at low radiation doses and low costs. Nonetheless, the effective dose ranges of cone beam computed tomography machines may easily vary from 10 to 1000 μSv, this being equivalent to two to 200 panoramic radiographs, even for similar presurgical indications. Moreover, the diagnostic image quality varies massively among available machines and parameter settings. Apart from the radiodiagnostic possibilities, dental cone beam computed tomography may offer a vast therapeutic potential, including opportunities for surgical guidance and further prosthetic rehabilitation via computer-aided design/computer-aided manufacturing solutions. These additional options may definitely explain part of the success of cone beam computed tomography for oral implant placement. In conclusion, dental cone beam computed tomography imaging could be justified for oral implant-related diagnosis, planning and transfer to surgical and further prosthetic treatment, but guidelines for justification and cone beam computed tomography optimization remain mandatory.

  7. Treatment of Patients with Tiolox-Dentaurum Dental Implants at the Polyclinic Shoshi

    PubMed Central

    Shoshi, Avdyl; Alushi, Adem; Isufi, Ramazan

    2014-01-01

    Introduction: The importance of the dental implantology has influenced the development of many treatment methods in this field. The aim of our study is to evaluate the advantages and disadvantages of the treatment with TIOLOX-DENTAURUM dental implants in cases of partial and total lack of teeth, compared to classic dentures. To conduct our research we have used the prospective method. Material and methods: The analyzed cases have undergone surgical treatment at the “Policlinic Shoshi” in Prishtina during 2010–2011. This study included 29 patients, 23 in the research group and 6 in the control group. The patients involved in the study were 30-59 years old. 52,2% of our patients were 30-39 years old, while 17,4% were 50-59 years old. Results: In the research group, the average time of placing the dental bridges in the lower jaw was 2 months and 4.2 months in the control group. In the upper jaw, the average time was 3 months for the experimental group and 5,4 months for the control group. Conclusion: The period after the placement of implants until the placement of dentures, can be shortened from 4-6 months to 3 months for the upper jaw and from 3 to 2 months for the lower jaw. PMID:25568555

  8. A comparative analysis based on different strength criteria for evaluation of risk factor for dental implants.

    PubMed

    Natali, A N; Pavan, P G

    2002-04-01

    A numerical analysis is developed to study the interaction phenomena between endousseus titanium dental implants and surrounding jawbone tissue. The interest is focused on the most appropriate evaluation of the stress state arising in the tissue because of the implant under physiological loading. The problem is considered with regard to linear elastic response of the one and to short time effect. Different configurations of bone-implant system are described, using axial-symmetrical and three-dimensional models, by means of finite and geometric element method. The investigation attains to the stress states induced in bone that lead to a limit condition near the effective failure surface. The parameter commonly adopted in literature, such as the Von Mises stress, represents an excessive simplification of problem formulation, leading to an incorrect evaluation of the real failure risk for the implant, due to the assumption of the isotropic and deviatoric nature of the adopted stress measure. More suitable criterion can be assumed, such as the Tsai-Wu criterion, to take into account the anisotropy that characterises the response of bone, as well as the influence of a hydrostatic stress state. The analysis developed offers a comparison of results by using different criteria, leading to an evaluation of reliability of the procedure to be followed and addressing also to an evaluation of a risk factor for the implant investigated.

  9. Prosthodontic Perspective to All-On-4® Concept for Dental Implants

    PubMed Central

    Chittaranjan, B; Sudheer, N; Tella, Suchita; Abusaad, Md.

    2014-01-01

    The clinical success and longevity of endosteal dental implants as load bearing abutments are controlled largely by the mechanical setting in which they function. The treatment plan is responsible for the design, number and position of the implants. In biomechanically compromised environment such as poor quality bone, strain to the crestal bone can be reduced by increasing the anterioposterior spread of implants, placement of longer implants and maximizing the number of implants. The All-on-4® concept is one such treatment procedure which enlightens us for its use in the completely edentulous patients and which also leaves behind the routine treatment alternative of conventional dentures with successful outcome in the short term, long term and the retrospective studies that have been done in the past. The area of concern for any treatment alternative lies in the success of the prosthesis and its prosthodontic perspective involving the principles of occlusion. This article reviews the All-on-4® concept and its prosthodontic aspects. PMID:25478475

  10. A novel workflow for computer guided implant surgery matching digital dental casts and CBCT scan

    PubMed Central

    DE VICO, G.; FERRARIS, F.; ARCURI, L.; GUZZO, F.; SPINELLI, D.

    2016-01-01

    SUMMARY Nowadays computer-guided “flap-less” surgery for implant placement using stereolithographic tem-plates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical discomfort and reduced time required for definitive rehabilitation. Aim of this work is to describe a new protocol (Smart Fusion by Nobel Biocare), thanks to which is now possible to do a mini-invasive static guided implant surgery, in partially edentulous patients with at least 6 remaining teeth, without the use of a radiographic guide. This is possible thanks to a procedure named surface mapping based on the matching between numerous points on the surface of patient’s dental casts and the corresponding anatomical surface points in the CBCT data. The full protocol is examined focusing the attention on the clinical and laboratory procedures. Conclusions Also with some critical points and needing an adequate learning curve, this protocol allows to select the ideal implant position in depth, inclination and mesio-distal distance between natural teeth and or other implants enabling a very safe and predictable rehabilitation compared with conventional surgery. It represents a good tool for the best compromise between anatomy, function and aesthetic, able to guarantee better results in all clinical situations. PMID:28042429

  11. Esthetic outcome for maxillary anterior single implants assessed by different dental specialists

    PubMed Central

    Al-Dosari, Abdullah; Al-Rowis, Ra'ed; Moslem, Feras; Alshehri, Fahad

    2016-01-01

    PURPOSE The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients. MATERIALS AND METHODS Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) for 23 implant-supported single restorations. The satisfactions of the patients on the esthetic outcome of the treatment have been evaluated according to the visual analog scale (VAS). RESULTS The mean total PES/WES was 12.26 ± 4.76. The mean PES was 6.45 ± 2.78 and mean WES was 5.80 ± 2.82. There was a statistically significant difference among the different specialties for WES (P<.01) and Total PES/WES (P<.01). Prosthodontists were found to have assigned poorer ratings among the other specialties, while oral surgeons gave the higher ratings than periodontists, orthodontists, and prosthodontists. CONCLUSION Prosthodontists seemed to be stricter when assessing aesthetic outcome among other specialties. Moreover, a clear correlation existed between dentists' and patients' esthetic perception, thereby providing rationales for involving patients in the treatment plan to achieve higher levels of patient satisfaction. PMID:27826384

  12. Evaluation of bone remodeling around single dental implants of different lengths: a mechanobiological numerical simulation and validation using clinical data.

    PubMed

    Sotto-Maior, Bruno Salles; Mercuri, Emílio Graciliano Ferreira; Senna, Plinio Mendes; Assis, Neuza Maria Souza Picorelli; Francischone, Carlos Eduardo; Del Bel Cury, Altair Antoninha

    2016-01-01

    Algorithmic models have been proposed to explain adaptive behavior of bone to loading; however, these models have not been applied to explain the biomechanics of short dental implants. Purpose of present study was to simulate bone remodeling around single implants of different lengths using mechanoregulatory tissue differentiation model derived from the Stanford theory, using finite elements analysis (FEA) and to validate the theoretical prediction with the clinical findings of crestal bone loss. Loading cycles were applied on 7-, 10-, or 13-mm-long dental implants to simulate daily mastication and bone remodeling was assessed by changes in the strain energy density of bone after a 3, 6, and 12 months of function. Moreover, clinical findings of marginal bone loss in 45 patients rehabilitated with same implant designs used in the simulation (n = 15) were computed to validate the theoretical results. FEA analysis showed that although the bone density values reduced over time in the cortical bone for all groups, bone remodeling was independent of implant length. Clinical data showed a similar pattern of bone resorption compared with the data generated from mathematical analyses, independent of implant length. The results of this study showed that the mechanoregulatory tissue model could be employed in monitoring the morphological changes in bone that is subjected to biomechanical loads. In addition, the implant length did not influence the bone remodeling around single dental implants during the first year of loading.

  13. Assessment and Evaluation of Quality of Life (OHRQoL) of Patients with Dental Implants Using the Oral Health Impact Profile (OHIP-14) - A Clinical Study

    PubMed Central

    2016-01-01

    Introduction Peri-implant tissue health is a requisite for success of dental implant therapy. Plaque accumulation leads to initiation of gingivitis around natural teeth and peri-implantitis around dental implants. Peri-implantitis around dental implants may result in implant placement failure. For obtaining long-term success, timely assessment of dental implant site is mandatory. Aim To assess and evaluate Quality of Life (OHRQoL) of individuals with dental implants using the Oral Health Impact Profile (OHIP-14). Materials and Methods Total 92 patients were evaluated for assessment of the health of peri-implant tissues by recording, Plaque Index (PI), Probing Pocket Depth (PD), Bleeding On Probing (BOP) and Probing Attachment Level (PAL) as compared to contra-lateral natural teeth (control). In the same patients Quality of Life Assessment was done by utilizing Oral Health Impact Profile Index (OHIP-14). Results The mean plaque index around natural teeth was more compared to implants and it was statistically significant. Other three dimensions mean bleeding on probing; mean probing attachment level and mean pocket depth around both natural teeth and implant surfaces was found to be not statistically significant. OHIP-14 revealed that patients with dental implants were satisfied with their Oral Health-Related Quality of Life (OHRQoL). Conclusion Similar inflammatory conditions are present around both natural teeth and implant prostheses as suggested by results of mean plaque index, mean bleeding on probing, mean pocket depth and mean probing attachment level, hence reinforcing the periodontal health maintenance both prior to and after incorporation of dental implants. Influence of implant prostheses on patient’s oral health related quality of life (as depicted by OHIP-14) and patients’ perceptions and expectations may guide the clinician in providing the best implant services. PMID:27190953

  14. Magnification rate of digital panoramic radiographs and its effectiveness for pre-operative assessment of dental implants

    PubMed Central

    Kim, Y-K; Park, J-Y; Kim, S-G; Kim, J-S; Kim, J-D

    2011-01-01

    Objectives The purpose of this study was to determine the accuracy and effectiveness of digital panoramic radiographs for pre-operative assessment of dental implants. Methods We selected 86 patients (221 implants) and calculated the length of the planned implant based on the distance between a selection of critical anatomical structures and the alveolar crest using the scaling tools provided in the digital panoramic system. We analysed the magnification rate and the difference between the actual inserted implant length and planned implant length according to the location of the implant placement and the clarity of anatomical structures seen in the panoramic radiographs. Results There was no significant difference between the planned implant length and actual inserted implant length (P > 0.05). The magnification rate of the width and length of the inserted implants, seen in the digital panoramic radiographs, was 127.28 ± 13.47% and 128.22 ± 4.17%, respectively. The magnification rate of the implant width was largest in the mandibular anterior part and there was a significant difference in the magnification rate of the length of implants between the maxilla and the mandible (P < 0.05). When the clarity of anatomical structures seen in the panoramic radiographs is low, the magnification rate of the width of the inserted implants is significantly higher (P < 0.05), but there is no significant difference between the planned implant length and actual inserted implant length according to the clarity of anatomical structures (P < 0.05). Conclusions Digital panoramic radiography can be considered a simple, readily available and considerably accurate pre-operative assessment tool in the vertical dimension for dental implant therapy. PMID:21239569

  15. Comparison of the fracture resistance of dental implants with different abutment taper angles.

    PubMed

    Wang, Kun; Geng, Jianping; Jones, David; Xu, Wei

    2016-06-01

    To investigate the effects of abutment taper angles on the fracture strength of dental implants with TIS (taper integrated screwed-in) connection. Thirty prototype cylindrical titanium alloy 5.0mm-diameter dental implants with different TIS-connection designs were divided into six groups and tested for their fracture strength, using a universal testing machine. These groups consisted of combinations of 3.5 and 4.0 mm abutment diameter, each with taper angles of 6°, 8° or 10°. 3-Dimensional finite element analysis (FEA) was also used to analyze stress states at implant-abutment connection areas. In general, the mechanical tests found an increasing trend of implant fracture forces as the taper angle enlarged. When the abutment diameter was 3.5 mm, the mean fracture forces for 8° and 10° taper groups were 1638.9 N ± 20.3 and 1577.1 N ± 103.2, respectively, both larger than that for the 6° taper group of 1475.0 N ± 24.4, with the largest increasing rate of 11.1%. Furthermore, the difference between 8° and 6° taper groups was significant, based on Tamhane's multiple comparison test (P<0.05). In 4.0 mm-diameter abutment groups, as the taper angle was enlarged from 6° to 8° and 10°, the mean fracture value was increased from 1066.7 N ± 56.1 to 1241.4 N ± 6.4 and 1419.3 N ± 20.0, with the largest increasing rate of 33.1%, and the differences among the three groups were significant (P<0.05). The FEA results showed that stress values varied in implants with different abutment taper angles and supported the findings of the static tests. In conclusion, increases of the abutment taper angle could significantly increase implant fracture resistance in most cases established in the study, which is due to the increased implant wall thickness in the connection part resulting from the taper angle enlargement. The increasing effects were notable when a thin implant wall was present to accommodate wide abutments.

  16. Importance of the Roughness and Residual Stresses of Dental Implants on Fatigue and Osseointegration Behavior. In Vivo Study in Rabbits.

    PubMed

    Velasco, Eugenio; Monsalve-Guil, Loreto; Jimenez, Alvaro; Ortiz, Iván; Moreno-Muñoz, Jesús; Nuñez-Marquez, Enrique; Pegueroles, Marta; Pérez, Román A; Gil, Francisco Javier

    2016-12-01

    This study focuses on the fatigue behavior and bone-implant attachment for the more usual surfaces of the different CP-titanium dental implants. The implants studied were: as-received (CTR), acid etching (AE), spark-anodization (SA), and with a grit-blasted surface (GB). Residual stresses were determined by means of X-ray diffraction. The fatigue tests were carried out at 37°C on 160 dental implants, and the stress-failure (S-N) curve was determined. The fatigue tests showed that the grit-blasting process improved fatigue life. This is a consequence of the layer of compressive residual stresses that the treatment generates in titanium surfaces. Further, our aim was to assess and compare the short- and midterm bone regenerative potential and mechanical retention of the implants in bone of New Zealand rabbits. The mechanical retention after 4 and 10 weeks of implantation was evaluated with histometric and pull-out tests, respectively, as a measure of the osseointegration of the implants. The results demonstrated that the GB treatment produced microrough that accelerated bone tissue regeneration and increased mechanical retention in the bone bed at short periods of implantation in comparison with all other implants tested. The GB surface produced an improvement in mechanical long-time behavior and improved bone growth. These types of treated implants can have great potential in clinical applications, as evidenced by the outcomes of the current study.

  17. Actions of melatonin mixed with collagenized porcine bone versus porcine bone only on osteointegration of dental implants.

    PubMed

    Calvo-Guirado, José Luis; Gómez-Moreno, Gerardo; López-Marí, Laura; Guardia, Javier; Marínez-González, José María; Barone, Antonio; Tresguerres, Isabel F; Paredes, Sergio D; Fuentes-Breto, Lorena

    2010-04-01

    This study evaluated the effect of the topical application of melatonin mixed with collagenized porcine bone on the osteointegration on the rough discrete calcium deposit (DCD) surface implants in Beagle dogs 3 months after their insertion. In preparation for subsequent insertion of dental implants, lower molars were extracted from 12 Beagle dogs. Each mandible received two parallel wall expanded platform implants with a DCD surface of 4 mm in diameter and 10 mm in length. The implants were randomly assigned to the distal sites on each mandible in the molar area and the gaps were filled with 5 mg lyophilized powdered melatonin and porcine bone and collagenized porcine bone alone. Ten histological sections per implant were obtained for histomorphometric studies. After a 4-wk treatment period, melatonin plus porcine bone significantly increased the perimeter of bone that was in direct contact with the treated implants (P < 0.0001), bone density (P < 0.0001), and new bone formation (P < 0.0001) in comparison with porcine bone alone around the implants. Melatonin plus collagenized porcine bone on DCD surface may act as a biomimetic agent in the placement of endo-osseous dental implants and enhance the osteointegration. Melatonin combined with porcine bone on DCD implants reveals more bone in implant contact at 12 wk (84.5 +/- 1.5%) compared with porcine bone alone treated area (67.17 +/- 1.2%).

  18. Three dimensional finite element analysis of a novel osteointegrated dental implant designed to reduce stress peak of cortical bone.

    PubMed

    Zheng, Li; Yang, Jingsong; Hu, Xuefeng; Luo, Jiaoming

    2014-01-01

    A new type of dental implant was designed as multi-component mainly including inset and abutment between which a gap was introduced to guide the force to transmit from the cancellous bone to cortical bone, with the intention to lower the stress peak at cortical bone. By way of finite element analysis (FEA) associated with advanced computer tomography (CT) and 3D model reconstruction technology to construct precise mandible model, biomechanical aspects of implant were investigated. Compared with traditional implant that created stress dominantly at cortical bone, stress peak at the implant/bone interface in the cervical cortex decreased sharply (about 51%) for the new type of implant. Furthermore, applying varying implant shape and gap dimensions helped to optimize the design of this new implant. Optimization results revealed that: (1) screwed cylindrical implant is superior to tapered, stepped and smooth cylindrical implant in effectively decreasing the stress peak of bone; (2) deepening and widening gap would contribute to the decline of stress peak, but at the cost of break and destruction of the inset; (3) suitable gap size with the depth of 7 mm and width of 0.3 mm would be applicable. This work may provide reference for clinical application of dental implant.

  19. In vivo evaluation of micro-rough and bioactive titanium dental implants using histometry and pull-out tests.

    PubMed

    Aparicio, Conrado; Padrós, Alejandro; Gil, Francisco-Javier

    2011-11-01

    We report on the in vivo histological and mechanical performance of titanium dental implants with a new surface treatment (2Step) consisting of an initial grit-blasting process to produce a micro-rough surface, followed by a combined chemical and thermal treatment that produces a potentially bioactive surface, i.e., that can form an apatitic layer when exposed to biomimetic conditions in vitro. Our aim was to assess the short- and mid-term bone regenerative potential and mechanical retention of 2Step implants in mandible and maxilla of minipigs and compare them with micro-rough grit-blasted, micro-rough acid-etched, and smooth as-machined titanium implants. The percent of bone-to-implant contact after 2, 4, 6, and 10 weeks of implantation as well as the mechanical retention after 4, and 6 weeks of implantation were evaluated with histometric and pull-out tests, respectively, as a measure of the osseointegration of the implants. We also aimed to assess the bioactive nature of 2Step surfaces in vivo. Our results demonstrated that the 2Step treatment produced micro-rough and bioactive implants that accelerated bone tissue regeneration and increased mechanical retention in the bone bed at short periods of implantation in comparison with all other implants tested. This was mostly attributed to the ability of 2Step implants to form in vivo a layer of apatitic mineral that coated the implant and could rapidly stimulate (a) bone nucleation directly on the implant surface, and (b) bone growing from the implant surface. We also proved that roughness values of Ra≈4.5 μm favoured osseointegration of dental implants at short- and mid-term healing periods, as grit-blasted implants and 2Step implants had higher retention values than as machined and acid-etched implants. The surface quality resulting from the 2Step treatment applied on cpTi provided dental implants with a unique combination of rapid bone regeneration and high mechanical retention.

  20. Dental sequellae of alveolar clefts: utility of endosseous implants. Part I: therapeutic protocols.

    PubMed

    Samama, Yves; Tulasne, Jean-François

    2014-06-01

    The aim of this publication is to offer teams specializing in the primary and secondary treatment of labio-alveolar-palatal clefts a prosthetic evaluation for more rational management of the dental sequellae of clefts for patients who, when they reach adulthood, often wish to improve their facial esthetics, in which the dental element plays a significant part. The reorganization and restoration of the upper anterior teeth, and their esthetic integration with respect to the face and lips, would then be less of a problem for plastic surgeons or orthodontists. In this respect, the installation in this sector of implants, following ambitious bone surgery involving the sacrifice, in bilateral forms, of the teeth of the medial process is a protocol that could usefully be taken into account.

  1. Dental sequellae of alveolar clefts: utility of endosseous implants. Part II: clinical cases.

    PubMed

    Samama, Yves; Tulasne, Jean-François

    2014-09-01

    This second part follows on from part 1 published in the previous issue of this journal. The aim of this publication is to offer teams specializing in the primary and secondary treatment of labio-alveolar-palatal clefts a prosthetic evaluation for more rational management of the dental sequellae of clefts for patients who, when they reach adulthood, often wish to improve their facial esthetics, in which the dental element plays an important part. The reorganization and restoration of the maxillary anterior teeth and their esthetic integration with respect to the face and lips would then be less of a problem for plastic surgeons and orthodontists. In this regard, the installation in this sector of implants, following ambitious bone surgery involving the sacrifice of the teeth of the medial nasal process in bilateral forms, is a protocol that could usefully be taken into account.

  2. [A biomechanical study of the mechanical stress transmission of dental implants using finite element analysis. Part II. Experiments].

    PubMed

    Szucs, Attila; Divinyi, Tamás; Bojtár, Imre; Polgár, Krisztina; Nasztanovics, Ferenc; Füstös, Attila; Lorincz, Adam; Barabás, József

    2006-10-01

    In the first part of this two-part study the possible uses of finite element analysis in studying the stress transmission of dental implants were reviewed. In the present second part our own experiments are presented. In the first series the effect of the geometric parameters and load types on mechanical stresses arising around cylindrical implants in bone were studied with 2D and 3D finite element analysis. In the second series the stress transmissions of various implant geometries were compared and an attempt was made to determine the optimal implant shape from the point of view of stress transmission.

  3. Use of digital data acquisition and CAD/CAM technology for the fabrication of a fixed complete dental prosthesis on dental implants.

    PubMed

    Lin, Wei-Shao; Harris, Bryan T; Zandinejad, Amirali; Morton, Dean

    2014-01-01

    The work flow in this report describes a metal-resin fixed complete dental prosthesis fabricated by using digital data acquisition at the implant fixture level with a computer-aided design and computer-aided manufacturing (CAD/CAM) fabricated tissue-colored anodized titanium framework.

  4. Endosseous dental implant vis-à-vis conservative management: Is it a dilemma?

    PubMed Central

    Chandra, Ramesh; Bains, Rhythm; Loomba, Kapil; Pal, U. S.; Ram, Hari; Bains, Vivek K.

    2010-01-01

    To overview the current prospective of endosseous dental implant and conservative management. Although emphasis has been made in reinstating the oral functions, less consideration has been given to formulate the best treatment tactics in a particular situation. Properly restored, root canal treated natural teeth surrounded by healthy periodontium tissues yield a very high longevity, and periodontally compromised teeth that are treated and maintained regularly may have longer survival rate. Current trends in implantology have weakened the conservative paradigm, and practitioner's objectivity has been inclined more toward providing the tooth substitutes often flaunted as equal or even superior to conservation of natural tooth PMID:22442546

  5. Early healing of nanothickness bioceramic coatings on dental implants. An experimental study in dogs.

    PubMed

    Coelho, Paulo G; Cardaropoli, Giuseppe; Suzuki, Marcelo; Lemons, Jack E

    2009-02-01

    Thick bioceramic coatings like plasma sprayed hydroxyapatite have been shown to increase the overall tissue response and biomechanical fixation of dental implants. However, the presence and potential fracture of a bone-coating-metallic substrate interface at long times after implantation led these implants to fall from favor in clinical practice. The purpose of this study was to evaluate the biomechanical fixation and biological response of Ca- and P-based, 20-50 nm thickness bioceramic deposition on a previously alumina-blasted/acid-etched Ti-6Al-4V implant surface in a dog model. Cylindrical alumina-blasted/acid-etched (AB/AE) (Control, n = 16), and Nanothickness bioceramic coated AB/AE(Nano, n = 16) implant surfaces were surgically placed in dogs proximal tibia and remained for 2 and 4 weeks in vivo. Following euthanization, the implants-in-bone were mounted in epoxy and pullout at a 0.5 mm/min rate. Following mechanical testing, the specimens were decalcified and processed (Hematoxylin and Eosin) for standard transmitted light microscopy evaluation. Percent bone-to-implant contact (BIC) to the pulled out implant surface was determined through computer software. Statistical analyses were performed by one-way ANOVA at 95% level of significance and Tukey's post-hoc multiple comparisons. No significant differences in pullout force were observed (p > 0.88): 2W Control (212.08 +/- 42.96 N), 2W Nano (224.35 +/- 42.97 N), 4W Control (207.07 +/- 42.97 N), and 4W Nano (190.15 +/- 45.94 N). No significant differences in %BIC were observed (p > 0.94): 2W Control (72.66 +/- 8.51), 2W Nano (69.44 +/- 8.51), 4W Control (70.44 +/- 8.51), and 4W Nano (69.11 +/- 9.09). It is shown that 20-50 nm thickness bioceramic depositions onto previously alumina-blasted/acid-etched substrates did not improve the biomechanical fixation and the BIC at early implantation times, and studies concerning shorter and longer implantation times are recommended for confirmation or before a conclusion

  6. [Prosthodontic rehabilitation of immediately placed dental implants following soft tissue augmentation. Case report].

    PubMed

    Windisch, Péter; Fazekas, Réka; Fazekas, Arpád

    2013-09-01

    A 68-year-old nonsmoking male patient with thin gingival biotype presented for treatment of mobile mandibular left premolars. Extraction of teeth and immediate dental implant placement has been suggested. To prevent vestibular gingival recession and insure tissue stability by increasing thickness of marginal gingiva, acellular dermal matrix allograft was applied using the coronally advanced modified tunnelling technique. Six months later premolars were extracted, immediately replaced with implants and temporary crowns. After another four months, definitive gold ceramic crowns were cemented on prefabricated titanium abutments. Due to the altered gingival biotype and application of the platform switching phenomenon no vertical bone resorption and gingival recession was recorded at 6, 12 and 24 month follow-up with a well acceptable esthetic appearance.

  7. Displacement of dental implants into the focal osteoporotic bone marrow defect: a report of three cases

    PubMed Central

    Lee, Sang-Chil; Jeong, Chang-Hwa; Im, Ho-Yong; Kim, Seong-Young; Ryu, Jae-Young; Yeom, Hak-Yeol

    2013-01-01

    Focal osteoporotic bone marrow defect (FOBMD) is a radiolucent area corresponding to the presence of hematopoietic tissue rarely found in the jaws. FOBMD is most commonly located in the mandibular edentulous posterior area of a middle-aged female. From November 2011 to November 2012, we experienced three cases involving removal of implants that had accidentally fallen into the FOBMD area. All patients happened to be female, with a mean age of 54 years (range: 51-60 years). One case involved hypoesthesia of the lower lip and chin, while two cases healed without any complication. Displacement of an implant into the FOBMD area is an unusual event, which occurs rarely during placement of a dental fixture. The purpose of this study was to report on three cases of FOBMD and to provide a review of related literature. PMID:24471025

  8. Purposeful exposure of a polylactic acid barrier to achieve socket preservation for placement of dental implants: case series report.

    PubMed

    Rosen, Paul S; Rosen, Adam D

    2013-01-01

    This retrospective case series reports on the use of a polylactic acid barrier that was left exposed in the process of socket preparation for the placement of dental implants. A retrospective chart review found 43 patients with 48 extraction sockets that were treated in this manner. Teeth were removed and the sockets were thoroughly debrided, with 40 of them receiving a bone replacement graft covered by the polylactic acid barrier and the additional 8 receiving the membrane alone. Suturing left the barrier exposed, and the sites were re-entered on average at 23 weeks for the placement of a dental implant. All sites were able to receive a dental implant, demonstrating the ability to leave a polylactic acid barrier exposed and achieve successful guided bone regeneration (GBR) results. This ultimately helped avoid some of the negative sequelae of trying to achieve primary closure of the flaps at the time of tooth extraction.

  9. Voxel-based registration of simulated and real patient CBCT data for accurate dental implant pose estimation

    NASA Astrophysics Data System (ADS)

    Moreira, António H. J.; Queirós, Sandro; Morais, Pedro; Rodrigues, Nuno F.; Correia, André Ricardo; Fernandes, Valter; Pinho, A. C. M.; Fonseca, Jaime C.; Vilaça, João. L.

    2015-03-01

    The success of dental implant-supported prosthesis is directly linked to the accuracy obtained during implant's pose estimation (position and orientation). Although traditional impression techniques and recent digital acquisition methods are acceptably accurate, a simultaneously fast, accurate and operator-independent methodology is still lacking. Hereto, an image-based framework is proposed to estimate the patient-specific implant's pose using cone-beam computed tomography (CBCT) and prior knowledge of implanted model. The pose estimation is accomplished in a threestep approach: (1) a region-of-interest is extracted from the CBCT data using 2 operator-defined points at the implant's main axis; (2) a simulated CBCT volume of the known implanted model is generated through Feldkamp-Davis-Kress reconstruction and coarsely aligned to the defined axis; and (3) a voxel-based rigid registration is performed to optimally align both patient and simulated CBCT data, extracting the implant's pose from the optimal transformation. Three experiments were performed to evaluate the framework: (1) an in silico study using 48 implants distributed through 12 tridimensional synthetic mandibular models; (2) an in vitro study using an artificial mandible with 2 dental implants acquired with an i-CAT system; and (3) two clinical case studies. The results shown positional errors of 67+/-34μm and 108μm, and angular misfits of 0.15+/-0.08° and 1.4°, for experiment 1 and 2, respectively. Moreover, in experiment 3, visual assessment of clinical data results shown a coherent alignment of the reference implant. Overall, a novel image-based framework for implants' pose estimation from CBCT data was proposed, showing accurate results in agreement with dental prosthesis modelling requirements.

  10. The relationship between resonance frequency analysis (RFA) and lateral displacement of dental implants: an in vitro study.

    PubMed

    Pagliani, L; Sennerby, L; Petersson, A; Verrocchi, D; Volpe, S; Andersson, P

    2013-03-01

    This in vitro investigation was conducted to study the relationship between resonance frequency analysis (RFA) and lateral displacement measurements of dental implants. A total of 30 implant sites were prepared in nine fresh bovine bone specimens. The bone density around each preparation was determined by using cone beam computerized tomography (CBCT) and imaging software. Dental implants were then inserted during continuous registration of insertion torque. RFA measurements were performed in perpendicular and parallel to the long axis of the specimens. The bone blocks were embedded in plaster and fixated in a specially designed rig for displacement measurements. A lateral force of 25 N was applied via an abutment perpendicular and parallel to each implant and the displacement measured in μm. In addition, a flex constant (μm N(-1) ) was calculated for each measurement. There was a significant inverse correlation between RFA and lateral implant displacement (μm) measurements and between RFA measurements and the flex constant in both perpendicular and parallel directions in bone (P ≤ 0·001). Moreover, both RFA and displacement measurements correlated with bone density (P ≤ 0·001). It is concluded that RFA measurements reflect the micromobility of dental implants, which in turn is determined by the bone density at the implant site.

  11. The effect of microstructured surfaces and laminin-derived peptide coatings on soft tissue interactions with titanium dental implants.

    PubMed

    Werner, Sandra; Huck, Olivier; Frisch, Benoît; Vautier, Dominique; Elkaim, René; Voegel, Jean-Claude; Brunel, Gérard; Tenenbaum, Henri

    2009-04-01

    In the present study, we investigated the dental implant protection from peri-implant inflammation by improving the soft tissue adhesion on the titanium surface. Porous titanium was used to create, at the level of the transmucosal part of the implants (the "neck"), a microstructured 3-dimensional surface that would tightly seal the interface between the implant and soft tissue. Cell-specific adhesion properties were induced via an adhesion peptide derived from laminin-5 coupled to native or cross-linked PLL/PGA multilayered polyelectrolyte films (MPFs), which are used for biomedical device coatings. Porous titanium exhibited good cell-adhesion properties, but the colonisation of the material was further improved by a coating with laminin-5 functionalised MPFs and especially with (PLL/PGA)(6,5)-PGA-peptide film. Focal contact formation was observed on cross-linked architectures, reflecting cell anchorage on these surfaces. In contrast, when seeded on laminin-5-functionalised native films, epithelial cells formed only very diffuse focal contacts, but adhered via hemidesmosome formation. In vivo experiments confirmed that the porous titanium was colonised by cells of soft tissue. Altogether, the results indicate that the microstructure of the implant neck combined with a specific bioactive coating could constitute efficient routes to improve the integration of soft tissue on titanium dental implants, which could significantly protect implants from peri-implant inflammation and enhance long-term implant stabilisation.

  12. Clinical and Radiographic Evaluation of Immediate Loaded Dental Implants With Local Application of Melatonin: A Preliminary Randomized Controlled Clinical Trial.

    PubMed

    El-Gammal, Mona Y; Salem, Ahmed S; Anees, Mohamed M; Tawfik, Mohamed A

    2016-04-01

    Immediate loading of dental implants in situations where low bone density exist, such as the posterior maxillary region, became possible recently after the introduction of biomimetic agents. This 1-year preliminary clinical trial was carried out to clinically and radiographically evaluate immediate-loaded 1-piece implants with local application of melatonin in the osteotomy site as a biomimetic material. 14 patients with missing maxillary premolars were randomized to receive 14 implants of 1-piece type that were subjected to immediate loading after 2 weeks of initial placement. Group I included 7 implants with acid-etched surface while group II included 7 implants with acid-etched surface combined with local application of melatonin gel at the osteotomy site. Patients were recalled for follow up at 1, 3, 6, and 12 months after loading. All implants were considered successful after 12 months of follow-up. Significant difference (P < 0.05) was found between both groups at 1 month of implant loading when considering the implant stability. At 1 and 3 months there were significant differences in the marginal bone level between the 2 groups. These results suggest that the local application of melatonin at the osteotomy site is associated with good stability and minimal bone resorption. However, more studies for longer follow-up periods are required to confirm the effect of melatonin hormone on osseointegration of dental implants.

  13. Dental management of a patient fitted with subcutaneous Implantable Cardioverter Defibrillator device and concomitant warfarin treatment.

    PubMed

    Shah, Altaf Hussain; Khalil, Hesham Saleh; Kola, Mohammed Zaheer

    2015-07-01

    Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on anticoagulant therapy. The desired International Normalized Ratio (INR) for these patients is in the range of 2-3 to prevent any subsequent cardiac event. These patients possess a challenge to the dentist in many ways, especially during oral surgical procedures, and these challenges include risk of sudden death, control of post-operative bleeding and pain. This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death.

  14. [Implantation of flakes of castor oil resin in rat dental alveolus].

    PubMed

    Calixto, R F; Teófilo, J M; Brentegani, L G; Carvalho, T L

    2001-01-01

    The purposes of the present study were: 1) to investigate the biocompatibility of a natural resin (made of fatty acids extracted from Ricinus communis) implanted in the dental alveolus of rats and 2) to verify any possible interference of that material in the osseous healing following tooth extraction. The resin (AUG-EX, Poliquil Araraquara Polímeros Químicos LTDA, Araraquara--SP) was placed inside de alveoli immediately after extraction of the upper right incisors. The animals were sacrificed 1, 2, 3 and 6 weeks after extraction or extraction + implantation. The hemi-maxillae were decalcified and processed for paraffin embedding. Longitudinal 6-micrometer-thick semi-serial sections stained with hematoxylin and eosin were obtained. Histologic examination showed particles of irregular shape and variable size (700-1200 microns) localized in the medium/cervical alveolar thirds, with a scanty but persistent foreign body reaction. From the second week on, as the relative volume of bone trabeculae increased, it was seen in close contact with the surface of the implanted material in some regions. Histometric analysis (differential point counting method), used to quantify the healing process in the apical third, showed a small but significant decrease (13%-20%) in new bone formation in the implanted rats. In conclusion, the results show that, in spite of its biocompatible nature, the studied resin hinders the post-extration healing process.

  15. Dental management of a patient fitted with subcutaneous Implantable Cardioverter Defibrillator device and concomitant warfarin treatment

    PubMed Central

    Shah, Altaf Hussain; Khalil, Hesham Saleh; Kola, Mohammed Zaheer

    2015-01-01

    Automated Implantable Cardioverter Defibrillators (AICD), simply known as an Implantable Cardioverter Defibrillator (ICD), has been used in patients for more than 30 years. An Implantable Cardioverter Defibrillator (ICD) is a small battery-powered electrical impulse generator that is implanted in patients who are at a risk of sudden cardiac death due to ventricular fibrillation, ventricular tachycardia or any such related event. Typically, patients with these types of occurrences are on anticoagulant therapy. The desired International Normalized Ratio (INR) for these patients is in the range of 2–3 to prevent any subsequent cardiac event. These patients possess a challenge to the dentist in many ways, especially during oral surgical procedures, and these challenges include risk of sudden death, control of post-operative bleeding and pain. This article presents the dental management of a 60 year-old person with an ICD and concomitant anticoagulant therapy. The patient was on multiple medications and was treated for a grossly neglected mouth with multiple carious root stumps. This case report outlines the important issues in managing patients fitted with an ICD device and at a risk of sudden cardiac death. PMID:26236132

  16. Bruxism: its multiple causes and its effects on dental implants - an updated review.

    PubMed

    Lobbezoo, F; Van Der Zaag, J; Naeije, M

    2006-04-01

    There is a growing interest in bruxism, as evidenced by the rapidly increasing number of papers about this subject during the past 5 years. The aim of the present review was to provide an update of two previous reviews from our department (one about the aetiology of bruxism and the other about the possible role of this movement disorder in the failure of dental implants) and to describe the details of the literature search strategies used, thus enabling the readers to judge the completeness of the review. Most studies that were published about the etiology during the past 5 years corroborate the previously drawn conclusions. Similarly, the update of the review about the possible causal relationship between bruxism and implant failure reveals no new points of view. Thus, there is no reason to assume otherwise than that bruxism is mainly regulated centrally, not peripherally, and that there is still insufficient evidence to support or refute a causal relationship between bruxism and implant failure. This illustrates that there is a vast need for well-designed studies to study both the aetiology of bruxism and its purported relationship with implant failure.

  17. Endoscopic retrieval of a dental Implant into the maxillary sinus: a case report

    PubMed Central

    BASSI, M. ANDREASI; ANDRISANI, C.; LICO, S.; ORMANIER, Z.; ARCURI, C.

    2016-01-01

    SUMMARY Purpose In this article the Authors show a safe and predictable technique to remove displaced implants from the maxillary sinus. Materials and methods A 49-year-old female was referred, to this centre by a general dentist, for the retrieval of the ectopic dental implant. After a preliminary clinical and radiological evaluation of the case the surgical procedure was performed. A loco-regional anesthesia was carried out and then the Maxillary Sinus Retrieval Device (MSRD), proposed in this study, was inserted in the canine fossa, via a circular antrostomy 5,5mm wide, previous execution of a mucoperiosteal flap. The MSRD is a trocar, modified with a funnel-shaped cannula in order to allow the easy access of both an endoscope and a suction cannula or, in alternative, a straight forceps. The implant was easily found end retrieved thanks to the endoscopic control. The postoperative was uneventful and no nasal bleeding was reported by the patient. Conclusion The Authors recommend the use of the MSRD in order to minimize the biological sacrifice consequent to the implant retrieval in the maxillary sinus. PMID:28042433

  18. Is Low Serum Vitamin D Associated with Early Dental Implant Failure? A Retrospective Evaluation on 1625 Implants Placed in 822 Patients

    PubMed Central

    Mangano, Natale

    2016-01-01

    Aim. To investigate whether there is a correlation between early dental implant failure and low serum levels of vitamin D. Methods. All patients treated with dental implants in a single centre, in the period 2003–2015, were considered for enrollment in this study. The main outcome was early implant failure. The influence of patient-related variables on implant survival was calculated using the Chi-square test. Results. 822 patients treated with 1625 implants were selected for this study; 27 early failures (3.2%) were recorded. There was no link between gender, age, smoking, history of periodontitis, and an increased incidence of early failures. Statistical analysis reported 9 early failures (2.2%) in patients with serum levels of vitamin D > 30 ng/mL, 16 early failures (3.9%) in patients with levels between 10 and 30 ng/mL, and 2 early failures (9.0%) in patients with levels <10 ng/mL. Although there was an increasing trend in the incidence of early implant failures with the worsening of vitamin D deficiency, the difference between these 3 groups was not statistically significant (P = 0.15). Conclusions. This study failed in proving an effective link between low serum levels of vitamin D and an increased risk of early implant failure. Further studies are needed to investigate this topic. PMID:27738389

  19. Prosthodontic Rehabilitation of Accidental Maxillofacial Gunshot Injury Using Dental Implants: A Five Year Follow-Up Clinical Report

    PubMed Central

    Balla, Vinod; Daniel, Angleena Y

    2016-01-01

    Gunshot injuries to the face can have serious aesthetic, functional, and psychological consequences. The incapacitating nature of maxillofacial defects makes reconstruction of the maxilla and mandible challenging, owing to multiple surgeries and extensive rehabilitation phase. Outcome of prosthodontic treatment is one of the important parameters by which a patient measures the success of rehabilitation. A 5-year follow-up of comprehensive surgical and prosthodontic reconstruction of a gunshot injury using dental implants is described. This case report illustrates the contribution of immediate dental implants with proper oral hygiene follow-up as an effective treatment modality in restoring a patient to near normal function and aesthetics. PMID:27790591

  20. Nanosurface design of dental implants for improved cell growth and function

    NASA Astrophysics Data System (ADS)

    Pan, Hsu-An; Hung, Yao-Ching; Chiou, Jin-Chern; Tai, Shih-Ming; Chen, Hsin-Hung; Huang, G. Steven

    2012-08-01

    A strategy was proposed for the topological design of dental implants based on an in vitro survey of optimized nanodot structures. An in vitro survey was performed using nanodot arrays with dot diameters ranging from 10 to 200 nm. MG63 osteoblasts were seeded on nanodot arrays and cultured for 3 days. Cell number, percentage undergoing apoptotic-like cell death, cell adhesion and cytoskeletal organization were evaluated. Nanodots with a diameter of approximately 50 nm enhanced cell number by 44%, minimized apoptotic-like cell death to 2.7%, promoted a 30% increase in microfilament bundles and maximized cell adhesion with a 73% increase in focal adhesions. An enhancement of about 50% in mineralization was observed, determined by von Kossa staining and by Alizarin Red S staining. Therefore, we provide a complete range of nanosurfaces for growing osteoblasts to discriminate their nanoscale environment. Nanodot arrays present an opportunity to positively and negatively modulate cell behavior and maturation. Our results suggest a topological approach which is beneficial for the design of dental implants.

  1. FEM and Von Mises analyses of different dental implant shapes for masticatory loading distribution

    PubMed Central

    CICCIÙ, M.; BRAMANTI, E.; CECCHETTI, F.; SCAPPATICCI, L.; GUGLIELMINO, E.; RISITANO, G.

    2014-01-01

    SUMMARY The rehabilitation of edentulous patients is today a challenge for the clinicians. The healthy of the hard and soft issue may be considered a fundamental element for having long-term results. The dental implant progresses about the predictable and safe results made this technique chosen from a large group of practitioners. However some problems related intra-operative and postoperative conditions may create discomfort on the patients and consequently to the clinician. The unfavourable results are often related to the bone tissue quality but sometime the dental implant shape and the prosthesis framework may undergo to technical difficulties. The purpose of this work is, through the use of appropriate FEM models, to analyse the effect of all these parameters in the construction of a prosthesis type “Toronto”, evaluating all the surgical and prosthetic components in order to direct the choices made by the surgeon and to optimize the distribution of loads reducing the patient’s discomfort and having a long term clinical success. PMID:25694795

  2. Characterization and nanomechanical properties of novel dental implant coatings containing copper decorated-carbon nanotubes.

    PubMed

    Sasani, N; Vahdati Khaki, J; Mojtaba Zebarjad, S

    2014-09-01

    Fluorapatite-titania coated Ti-based implants are promising for using in dental surgery for restoring teeth. One of the challenges in implantology is to achieve a bioactive coating with appropriate mechanical properties. In this research, simple sol-gel method was developed for synthesis of fluorapatite-titania-carbon nanotube decorated with antibacterial agent. Triethyl phosphate [PO4(C2H5)3], calcium nitrate [Ca(NO3)2] and ammonium fluoride (NH4F) were used as precursors under an ethanol-water based solution for fluorapatite (FA) production. Titanium isopropoxide and isopropanol were used as starting materials for making TiO2 sol-gels. Also, Copper acetate [Cu(C2H3O2)2·H2O] was used as precursor for decoration of multi walled carbon nanotubes (MWCNTs) with wet chemical method. The decorated MWCNTs (CNT(Cu)) were evaluated by transmission electron microscopy (TEM). The phase identification of the FA-TiO2-CNT(Cu) coating was carried out by XRD analysis. Morphology of coated samples was investigated by SEM observations. The surface elastic modulus and hardness of coatings were studied using nanoindentation technique. The results indicate that novel dental implant coating containing FA, TiO2 and copper decorated MWCNTs have proper morphological features. The results of nanoindentation test show that incorporation of CNT(Cu) in FA-TiO2 matrix can improve the nanomechanical properties of composite coating.

  3. Systemic Trans- and Postoperative Evaluations of Patients Undergoing Dental Implant Surgery

    PubMed Central

    Goiato, Marcelo Coelho; Junior, Joel Ferreira Santiago; Pellizzer, Eduardo Piza; Moreno, Amália; Villa, Luiz Marcelo Ribeiro; de Carvalho Dekon, Stefan Fiuza; de Carvalho, Paulo Sérgio Perri; dos Santos, Daniela Micheline

    2016-01-01

    OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State–Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p=0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation. PMID:27074177

  4. Corrosion of phosphate-enriched titanium oxide surface dental implants (TiUnite) under in vitro inflammatory and hyperglycemic conditions.

    PubMed

    Messer, Regina L W; Seta, Francesca; Mickalonis, John; Brown, Yolanda; Lewis, Jill B; Wataha, John C

    2010-02-01

    Endosseous dental implants use is increasing in patients with systemic conditions that compromise wound healing. Manufacturers recently have redesigned implants to ensure more reliable and faster osseointegration. One design strategy has been to create a porous phosphate-enriched titanium oxide (TiUnite) surface to increase surface area and enhance interactions with bone. In the current study, the corrosion properties of TiUnite implants were studied in cultures of monocytic cells and solutions simulating inflammatory and hyperglycemic conditions. Furthermore, to investigate whether placement into bone causes enough mechanical damage to alter implant corrosion properties, the enhanced surface implants as well as machined titanium implants were placed into human cadaver mandibular bone, the bone removed, and the corrosion properties measured. Implant corrosion behavior was characterized by open circuit potentials, linear polarization resistance, and electrical impedance spectroscopy. In selected samples, THP1 cells were activated with lipopolysaccharide prior to implant exposure to simulate an inflammatory environment. No significant differences in corrosion potentials were measured between the TiUnite implants and the machined titanium implants in previous studies. TiUnite implants exhibited lower corrosion rates in all simulated conditions than observed in PBS, and EIS measurements revealed two time constants which shifted with protein-containing electrolytes. In addition, the TiUnite implants displayed a significantly lower corrosion rate than the machined titanium implants after placement into bone. The current study suggests that the corrosion risk of the enhanced oxide implant is lower than its machined surface titanium implant counterpart under simulated conditions of inflammation, elevated dextrose concentrations, and after implantation into bone.

  5. A 6-year Evaluation of 223 Tapered Dental Implants and associated prosthesis in 92 patients at a University Hospital.

    PubMed

    Nagi, Sana Ehsen; Khan, Farhan Raza; Ali, Rabia

    2016-10-01

    The aim of the retrospective study was to assess the clinical and radiographic outcome of the dental implant surgery and prosthetics. It was conducted at the Aga Khan University Hospital, Karachi, and comprised of medical charts and radiographic records of patients visiting between 2010 and 2015. Variables such as implant dimensions, final prosthesis, method of retention, loading protocol and patient factors were analysed. A total of 223 implants (143(64.1%) in maxilla and 80(35.9%) in mandible) were placed in 92 subjects (50(54.3%) males and 42(45.7%) females). All implants were Zimmer tapered screw-vent. Length of 108(48.4%) implants was 11.5mm and diameter of 84(37.7%) implants was 4.7mm. Besides, 6(2.7%) implants failed to osseointegrate, whereas 1(0.4%) implant failed at 12 months of loading. Among the 216(96.9%) successful implants, 140(64.8%) served as bridge abutments, 72(33.3%) were single crown abutments and 4(1.9%) were overdenture abutments. Also, 37(17.1%) implants were immediately loaded. The six-year survival rate of implants was 96.9%.

  6. A novel root analogue dental implant using CT scan and CAD/CAM: selective laser melting technology.

    PubMed

    Figliuzzi, M; Mangano, F; Mangano, C

    2012-07-01

    Direct laser metal forming (DLMF) is a new technique which allows solids with complex geometry to be produced by annealing metal powder microparticles in a focused laser beam, according to a computer-generated three-dimensional (3D) model. For dental implants, the fabrication process involves the laser-induced fusion of titanium microparticles, in order to build, layer by layer, the desired object. Modern computed tomography (CT) acquisition and 3D image conversion, combined with the DLMF process, allows the fabrication of custom-made, root-analogue implants (RAI), perfect copies of the radicular units that need replacing. This report demonstrates the successful clinical use of a custom-made, root-analogue DLMF implant. CT images of the residual non-restorable root of a right maxillary premolar were acquired and modified with specific software into a 3D model. From this model, a custom-made, root-analogue, DLMF implant was fabricated. Immediately after tooth extraction, the root-analogue implant was placed in the extraction socket and restored with a single crown. At the 1-year follow-up examination, the custom-made implant showed almost perfect functional and aesthetic integration. The possibility of fabricating custom-made, root-analogue DLMF implants opens new interesting perspectives for immediate placement of dental implants.

  7. Using the "final-on-four" concept to deliver an immediate metal-resin implant-fixed complete dental prosthesis.

    PubMed

    Yilmaz, Burak; Ozcelik, Tuncer Burak; McGlumphy, Edwin

    2015-08-01

    In traditional dental implant therapy, the time between implant placement and delivery of the definitive prosthesis can be long and uncomfortable for a patient wearing a conventional removable denture on an atrophied ridge. New clinical protocols, often with tilted implants, are being used to immediately restore mandibular implants with interim restorations, thus shortening the patient's return to function. However, these conversion type interim restorations do not decrease the time to definitive prosthetic rehabilitation. The Ohio State University (OSU) developed an immediate load surgical and prosthetic protocol to compensate for the disadvantages of previous techniques. With this protocol, a custom, definitive, screw-retained metal-resin fixed prosthesis can be delivered 2 to 4 days postoperatively and has been described using 5 implants. This clinical report presents the OSU immediate loading protocol, combined with a tilted implant technique, for the fabrication of a mandibular metal-resin implant fixed complete dental prosthesis (MRIFCDP) in 3 days postoperatively and with only 4 implants. Replacing the mandibular dentition with an immediate load-fixed metal-resin prosthesis by means of the "final-on-four" technique resulted in a custom, definitive, and functional restorative solution immediately after surgery.

  8. Surface Topographical Changes of a Failing Acid-Etched Long-Term in Function Retrieved Dental Implant.

    PubMed

    Monje, Alberto; González-García, Raúl; Fernández-Calderón, María Coronada; Hierro-Oliva, Margarita; González-Martín, María Luisa; Del Amo, Fernando Suarez-Lopez; Galindo-Moreno, Pablo; Wang, Hom-Lay; Monje, Florencio

    2016-02-01

    The aim of the present study was to report the main topographical and chemical changes of a failing 18-year in function retrieved acid-etching implant in the micro- and nanoscales. A partially edentulous 45 year old rehabilitated with a dental implant at 18 years of age exhibited mobility. After careful examination, a 3.25 × 13-mm press-fit dental implant was retrieved. Scanning electron microscope (SEM) analysis was carried out to study topographical changes of the retrieved implant compared with an unused implant with similar topographical characteristics. Moreover, X-ray photoelectron spectroscopy (XPS) analysis was used to study the surface composition of the retrieved failing implant. Clear changes related to the dual dioxide layer are present as visible in ≥×500 magnification. In addition, it was found that, for the retrieved implant, the surface composition consisted mainly of Ti2p, O1s, C1s, and Al2p. Also, a meaningful decrease of N and C was noticed, whereas the peaks of Ti2p, Al2p, and O1s increased when analyzing deeper (up to ×2000s) in the sample. It was shown that the superficial surface of a retrieved press-fit dual acid-etched implant 18 years after placement is impaired. However, the causes and consequences for these changes cannot be determined.

  9. Biocompatibility and anti-microbiological activity characterization of novel coatings for dental implants: A primer for non-biologists

    NASA Astrophysics Data System (ADS)

    Monsees, Thomas

    2016-08-01

    With regard to biocompatibility, the cardinal requirement for dental implants and other medical devices that are in long-term contact with tissue is that the material does not cause any adverse effect to the patient. To warrant stability and function of the implant, proper osseointegration is a further prerequisite. Cells interact with the implant surface as the interface between bulk material and biological tissue. Whereas structuring, deposition of a thin film or other modifications of the surface are crucial parameters in determining favorable adhesion of cells, corrosion of metal surfaces and release of ions can affect cell viability. Both parameters are usually tested using in vitro cytotoxicity and adhesion assays with bone or fibroblasts cells. For bioactive surface modifications, further tests should be considered for biocompatibility evaluation. Depending on the type of modification, this may include analysis of specific cell functions or the determination of antimicrobial activities. The latter is of special importance as bacteria and yeast present in the oral cavity can be introduced during the implantation process and this may lead to chronic infections and implant failure. An antimicrobial coating of the implant is a way to avoid that. This review describes the essential biocompatibility assays for evaluation of new implant materials required by ISO 10993 and also gives an overview on recent test methods for specific coatings of dental implants.

  10. Osseointegration properties of titanium dental implants modified with a nanostructured coating based on ordered porous silica and bioactive glass nanoparticles

    NASA Astrophysics Data System (ADS)

    Covarrubias, Cristian; Mattmann, Matías; Von Marttens, Alfredo; Caviedes, Pablo; Arriagada, Cristián; Valenzuela, Francisco; Rodríguez, Juan Pablo; Corral, Camila

    2016-02-01

    The fabrication of a nanoporous silica coating loaded with bioactive glass nanoparticles (nBG/NSC) on titanium dental implant surface and its in vitro and in vivo evaluation is presented. The coating was produced by a combined sol-gel and evaporation induced self-assembly process. In vitro bioactivity was assessed in simulated body fluid (SBF) and investigating the osteogenic differentiation of human bone marrow mesenchymal stem cells (hBMSCs). A rat tibial model was employed to analyze the bone response to nBG/NSC-modified titanium implant surface in vivo. The nBG/NSC coating was confirmed at nano level to be constituted by a highly ordered nanoporous silica structure. The coating nanotopography in conjunction with the bioactivity of the BG particles accelerate the in vitro apatite formation and promote the osteogenic differentiation of hBMSCs in absence of osteogenic supplements. These properties accelerate the formation of bone tissue in the periphery of the implant after 3 weeks of implantation. Backscattered scanning electron microscopy images revealed the presence of gaps and soft tissue in the unmodified implant after 6 weeks, whereas the nBG/NSC-modified implant showed mature bone in intimate contact with the implant surface. The nBG/NSC coating appears promising for accelerating the osseointegration of dental implants.

  11. Magnesium-containing mixed coatings on zirconia for dental implants: mechanical characterization and in vitro behavior.

    PubMed

    Pardun, Karoline; Treccani, Laura; Volkmann, Eike; Streckbein, Philipp; Heiss, Christian; Gerlach, Juergen W; Maendl, Stephan; Rezwan, Kurosch

    2015-07-01

    An important challenge in the field of dental and orthopedic implantology is the preparation of implant coatings with bioactive functions that feature a high mechanical stability and at the same time mimic structural and compositional properties of native bone for a better bone ingrowth. This study investigates the influence of magnesium addition to zirconia-calcium phosphate coatings. The mixed coatings were prepared with varying additions of either magnesium oxide or magnesium fluoride to yttria-stabilized zirconia and hydroxyapatite. The coatings were deposited on zirconia discs and screw implants by wet powder spraying. Microstructure studies confirm a porous coating with similar roughness and firm adhesion not hampered by the coating composition. The coating morphology, mechanical flexural strength and calcium dissolution showed a magnesium content-dependent effect. Moreover, the in vitro results obtained with human osteoblasts reveal an improved biological performance caused by the presence of Mg(2+) ions. The magnesium-containing coatings exhibited better cell proliferation and differentiation in comparison to pure zirconia-calcium phosphate coatings. In conclusion, these results demonstrate that magnesium addition increases the bioactivity potential of zirconia-calcium phosphate coatings and is thus a highly suitable candidate for bone implant coatings.

  12. Biological characterization of a new silicon based coating developed for dental implants.

    PubMed

    Martínez-Ibáñez, M; Juan-Díaz, M J; Lara-Saez, I; Coso, A; Franco, J; Gurruchaga, M; Suay Antón, J; Goñi, Isabel

    2016-04-01

    Taking into account the influence of Si in osteoblast cell proliferation, a series of sol-gel derived silicon based coating was prepared by controlling the process parameters and varying the different Si-alkoxide precursors molar rate in order to obtain materials able to release Si compounds. For this purpose, methyltrimethoxysilane (MTMOS) and tetraethyl orthosilicate (TEOS) were hydrolysed together and the sol obtained was used to dip-coat the different substrates. The silicon release ability of the coatings was tested finding that it was dependent on the TEOS precursor content, reaching a Si amount value around ninefolds higher for coatings with TEOS than for the pure MTMOS material. To test the effect of this released Si, the in vitro performance of developed coatings was tested with human adipose mesenchymal stem cells finding a significantly higher proliferation and mineralization on the coating with the higher TEOS content. For in vivo evaluation of the biocompatibility, coated implants were placed in the tibia of the rabbit and a histological analysis was performed. The evaluation of parameters such as the bone marrow state, the presence of giant cells and the fibrous capsule proved the biocompatibility of the developed coatings. Furthermore, coated implants seemed to produce a qualitatively higher osteoblastic activity and a higher number of bone spicules than the control (uncoated commercial SLA titanium dental implant).

  13. Optimizing Maxillary Aesthetics of a Severe Compromised Tooth through Orthodontic Movement and Dental Implants

    PubMed Central

    de Avila, Erica Dorigatti; Cirelli, Joni Augusto; Cardoso, Mauricio de Almeida; Capelozza-Filho, Leopoldino; Borelli Barros, Luiz Antonio

    2014-01-01

    Treatment of severe compromised tooth in the maxillary anterior area still poses great challenge to the clinicians. Several treatment modalities have been proposed to restore the function and aesthetics in teeth with advanced periodontal disease. The present study aims to report a case of traumatic injury of a left-maxillary central incisor with ridge preservation, orthodontic movement, and implant therapy. A 45-year-old woman underwent the proposed treatment for her left central incisor: basic periodontal therapy, xenogenous bone graft, and guided bone regeneration (GBR). Six months after the graft procedure, orthodontic movement by means of alignment and leveling was made and a coronal displacement of the gingival margin and vertical bone apposition could be observed after 13 months of active movement. Afterwards, a dental implant was placed followed by a connective tissue graft and immediate provisionalization of the crown. In conclusion, orthodontic movement was effective to improve the gingival tissue and alveolar bone prior to implant placement favoring the aesthetic results. Six years postoperatively, the results revealed height and width alveolar bone gain indicating that the treatment proposed was able to restore all the functional and aesthetic parameters. PMID:24523969

  14. Jaw osteonecrosis management around a dental implant inserted 2 years before starting treatment with zoledronic acid

    PubMed Central

    Marín-Fernández, Ana-Belén; García Medina, Blas; Aguilar-Salvatierra, Antonio; Jiménez-Burkhardt, Alberto

    2015-01-01

    Bisphosphonates (BP) are a type of drug known to inhibit bone resorption through complex interventions. Their primary mechanism of action is aimed at the cellular level, inhibiting osteoclast activity and so bone resorption. BPs are widely used, with many patients receiving continuous treatment for years. But it is well known that these drugs can produce osteonecrosis of the jaw (ONJ). Zoledronic acid (ZA) is an intravenous BP used in the treatment and prophylaxis of bone disease in patients with malignant tumors with bone implication. ZA is the most potent BP in clinical development. This report describes the case of a 62-year-old woman with breast cancer antecedents which relapsed, who had received a maxillary dental implant two years before the start of therapy with zoledronic acid. She later developed osteonecrosis of the jaw (ONJ), which began in the peri-implant area, and was treated for stage 3 ONJ by sub-total maxillectomy. Key words:Bisphosphonates, zoledronic acid, osteonecrosis of the jaw, peri-implantitis, maxillectomy. PMID:26330946

  15. Biomechanical Consequences of the Elastic Properties of Dental Implant Alloys on the Supporting Bone: Finite Element Analysis

    PubMed Central

    Chávarri-Prado, David; Jiménez-Garrudo, Antonio; Solaberrieta-Méndez, Eneko; Diéguez-Pereira, Markel; Fernández-González, Felipe J.; Dehesa-Ibarra, Borja; Monticelli, Francesca

    2016-01-01

    The objective of the present study is to evaluate how the elastic properties of the fabrication material of dental implants influence peri-implant bone load transfer in terms of the magnitude and distribution of stress and deformation. A three-dimensional (3D) finite element analysis was performed; the model used was a section of mandibular bone with a single implant containing a cemented ceramic-metal crown on a titanium abutment. The following three alloys were compared: rigid (Y-TZP), conventional (Ti-6Al-4V), and hyperelastic (Ti-Nb-Zr). A 150-N static load was tested on the central fossa at 6° relative to the axial axis of the implant. The results showed no differences in the distribution of stress and deformation of the bone for any of the three types of alloys studied, mainly being concentrated at the peri-implant cortical layer. However, there were differences found in the magnitude of the stress transferred to the supporting bone, with the most rigid alloy (Y-TZP) transferring the least stress and deformation to cortical bone. We conclude that there is an effect of the fabrication material of dental implants on the magnitude of the stress and deformation transferred to peri-implant bone. PMID:27995137

  16. Biomechanical Consequences of the Elastic Properties of Dental Implant Alloys on the Supporting Bone: Finite Element Analysis.

    PubMed

    Pérez-Pevida, Esteban; Brizuela-Velasco, Aritza; Chávarri-Prado, David; Jiménez-Garrudo, Antonio; Sánchez-Lasheras, Fernando; Solaberrieta-Méndez, Eneko; Diéguez-Pereira, Markel; Fernández-González, Felipe J; Dehesa-Ibarra, Borja; Monticelli, Francesca

    2016-01-01

    The objective of the present study is to evaluate how the elastic properties of the fabrication material of dental implants influence peri-implant bone load transfer in terms of the magnitude and distribution of stress and deformation. A three-dimensional (3D) finite element analysis was performed; the model used was a section of mandibular bone with a single implant containing a cemented ceramic-metal crown on a titanium abutment. The following three alloys were compared: rigid (Y-TZP), conventional (Ti-6Al-4V), and hyperelastic (Ti-Nb-Zr). A 150-N static load was tested on the central fossa at 6° relative to the axial axis of the implant. The results showed no differences in the distribution of stress and deformation of the bone for any of the three types of alloys studied, mainly being concentrated at the peri-implant cortical layer. However, there were differences found in the magnitude of the stress transferred to the supporting bone, with the most rigid alloy (Y-TZP) transferring the least stress and deformation to cortical bone. We conclude that there is an effect of the fabrication material of dental implants on the magnitude of the stress and deformation transferred to peri-implant bone.

  17. Segmental alveolar osteotomy by palatal approach to correct excessive angulated dental implants in anterior and posterior maxilla.

    PubMed

    Akkas, Ismail; Toptas, Orcun; Akpinar, Yusuf Ziya; Ozan, Fatih

    2015-04-01

    Dental implants have been used for a long time to achieve better prosthetic and health conditions in the mouth. With the increase in their usage, more complications have occurred, and methods of solving these problems have been developed. One complication is insertion of the implant in the wrong direction. The aim of this case report is to describe an osteotomy technique to reposition a malpositioned dental implant. A female patient, aged 38 years, and a male patient aged 48 years, were referred complaining of the malpositioned osseointegrated implants, which had been placed in the region of the left maxillary first premolar and molar tooth, and in the region of the left maxillary lateral incisor. Due to severe buccal positioning of the implant fixtures, acceptable prosthetic treatment was not possible. Alveolar osteotomy procedure was used to reposition the implants. Satisfactory results were obtained by osteotomy for 18-month of follow up. We conclude that inadequately axially inclined implants can be successfully treated by alveolar osteotomy. The preservation of marginal gingiva permits obtaining better prosthetic results. To avoid the recession of attached gingiva, palatal approach technique may help the clinicians.

  18. Assessment of the Survival of Dental Implants in Irradiated Jaws Following Treatment of Oral Cancer: A Retrospective Study

    PubMed Central

    Rana, Meenakshi Chauhan; Solanki, Swati; Pujari, Sudarshan C; Shaw, Eisha; Sharma, Swati; Anand, Abhishek; Singh, Harkanwal Preet

    2016-01-01

    Background: In patients undergoing head and neck surgery for various pathologic conditions, implants are one of the best restorative options and are increasing widely used. Therefore, we evaluated the success of dental implants in the irradiated jaws of patients following treatment of oral cancer oral cancer treated patients. Materials and Methods: Data of oral cancer treated patients was collected retrospectively from 2002 to 2008. We took 46 oral cancer treated patients in which implants were placed in irradiated jaws for rehabilitation. Results: It was found that out of 162 dental implants placed, 52 failed. Furthermore, there was no variation in the implant survival rate in between both the jaws. Radiation dose of <50 Gy units also showed significantly increased amount of implant survival rate. Conclusions: Implant survival is multifactorial and depends upon a number of factors like level of radiation exposure in that area, time gap between last radiation doses etc., Further research is required in this field to improve the esthetics and quality of life of cancer treated patients. PMID:27843270

  19. Coherent Synchrotron-Based Micro-Imaging Employed for Studies of Micro-Gap Formation in Dental Implants

    SciTech Connect

    Rack, T.; Stiller, M.; Nelson, K.; Zabler, S.; Rack, A.; Riesemeier, H.; Cecilia, A.

    2011-09-09

    Biocompatible materials such as titanium are regularly applied in oral surgery. Titanium-based implants for the replacement of missing teeth demand a high mechanical precision in order to minimize micro-bacterial leakage, especially when two-piece concepts are used. Synchrotron-based hard x-ray radiography, unlike conventional laboratory radiography, allows high spatial resolution in combination with high contrast even when micro-sized features in such highly attenuating objects are visualized. Therefore, micro-gap formation at interfaces in two-piece dental implants with the sample under different mechanical loads can be studied. We show the existence of micro-gaps in implants with conical connections and study the mechanical behavior of the mating zone of conical implants during loading. The micro-gap is a potential source of implant failure, i.e., bacterial leakage, which can be a stimulus for an inflammatory process.

  20. Coherent Synchrotron-Based Micro-Imaging Employed for Studies of Micro-Gap Formation in Dental Implants

    NASA Astrophysics Data System (ADS)

    Rack, T.; Zabler, S.; Rack, A.; Stiller, M.; Riesemeier, H.; Cecilia, A.; Nelson, K.

    2011-09-01

    Biocompatible materials such as titanium are regularly applied in oral surgery. Titanium-based implants for the replacement of missing teeth demand a high mechanical precision in order to minimize micro-bacterial leakage, especially when two-piece concepts are used. Synchrotron-based hard x-ray radiography, unlike conventional laboratory radiography, allows high spatial resolution in combination with high contrast even when micro-sized features in such highly attenuating objects are visualized. Therefore, micro-gap formation at interfaces in two-piece dental implants with the sample under different mechanical loads can be studied. We show the existence of micro-gaps in implants with conical connections and study the mechanical behavior of the mating zone of conical implants during loading. The micro-gap is a potential source of implant failure, i.e., bacterial leakage, which can be a stimulus for an inflammatory process.

  1. Validity of ridge mapping and cone beam computed tomography in dental implant therapy

    PubMed Central

    Castro-Ruiz, Carmen Teresa; Noriega, Jorge; Guerrero, Maria Eugenia

    2015-01-01

    Aim: The purpose of this study was to compare the validity of alveolar ridge measurements obtained with ridge mapping (RM) technique against cone beam computed tomography (CBCT) measurements. Materials and Methods: Twenty partially edentulous patients were recruited for implant placement in the Clinic of San Martin de Porres University. For all the measurements, a vacuum-formed stent was fabricated for each subject. A buccal and lingual point was made in the stent to provide a reference of measurement for each implant site. RM measurements with the stent were obtained before and after surgical flap reflection. Two calibrated observers made the CBCT images measurements. T-test was used for the statistical analysis. Values <0.05 were considered statistically significant. Also, specificity and sensibility of CBCT and RM were compared. Intra-class correlation coefficient (ICC)_ was measure between CBCT measurements. Results: A total of 62 implants sites were evaluated. No statistical significant differences were obtained with CBCT and RM measurements (P = 0,207). Detecting proper buccal-lingual ridge, the sensitivity and specificity were 59% and 91% for RM while CBCT obtained 92% of sensitivity and 94% of specificity. Concordance was found “good” (ICC 0.82). Conclusion: Both methods provide valid measurements. Even though, we found diagnostic limitations in the RM, it demonstrated to be a useful method for its exactitude, low cost, the immediate result and no need of radiation. CBCT was recommended when the bone ridge width and height were in the less than ideal for conventional dental implant placement. PMID:26229269

  2. [Drug release of coated dental implant neck region to improve tissue integration].

    PubMed

    Wolf, Jens; Sternberg, Katrin; Behrend, Detlef; Schmitz, Klaus-Peter; von Schwanewede, Heinrich

    2009-08-01

    In order to improve tissue integration, the neck region of dental implants was coated with the biodegradable polymer poly (L-lactide) incorporating tetracycline, ibuprofen and the combination of both drugs using a solvent dip-coating process. Metallographic analysis, light microscopy and electron microscopy were used to detect the thickness range and the surface characteristics of the coatings. Cytotoxicity was evaluated using the tetrazolium colorimetric method with the fibroblast cell line L929. The in vitro drug release was measured in isotonic sodium chloride solution by UV spectroscopy. To explore if drug release is concentration-dependent, the total amount of drug was varied in the coating (20% wt, 30% wt and 40% wt). The results showed a continuous release of the embedded drugs in relevant dosage over a period of 6 months. In contrast to high tetracycline concentrations, high ibuprofen concentrations resulted in a decreased metabolic activity of the L929 fibroblasts.

  3. Microstructure and mechanical properties of Ti-15Zr alloy used as dental implant material.

    PubMed

    Medvedev, Alexander E; Molotnikov, Andrey; Lapovok, Rimma; Zeller, Rolf; Berner, Simon; Habersetzer, Philippe; Dalla Torre, Florian

    2016-09-01

    Ti-Zr alloys have recently started to receive a considerable amount of attention as promising materials for dental applications. This work compares mechanical properties of a new Ti-15Zr alloy to those of commercially pure titanium Grade4 in two surface conditions - machined and modified by sand-blasting and etching (SLA). As a result of significantly smaller grain size in the initial condition (1-2µm), the strength of Ti-15Zr alloy was found to be 10-15% higher than that of Grade4 titanium without reduction in the tensile elongation or compromising the fracture toughness. The fatigue endurance limit of the alloy was increased by around 30% (560MPa vs. 435MPa and 500MPa vs. 380MPa for machined and SLA-treated surfaces, respectively). Additional implant fatigue tests showed enhanced fatigue performance of Ti-15Zr over Ti-Grade4.

  4. [A biomechanical study of the mechanical stress transmission of dental implants using finite element analysis. Review of literature. Part I].

    PubMed

    Szucs, Attila; Divinyi, Tamás; Lorincz, Adám

    2006-08-01

    Finite Element Analysis (FEA) is a computerised investigative method that is capable of determining the mechanical stress arising in various objects and their environment as a result of forces effecting the system by using a mathematical model. The method is most often used for purposes of technical, engineering design, but is very useful for medical purposes-the static and functional investigation of the skeletal and motor system of the human body-as well. The transmission of mechanical stress between the implant and bone depends on a number of factors, and its description is quite complicated. A model has to be created to perform a FEA, the geometric data of the implant, the mechanical properties of the bone and the parameters of the bone-implant interface have to be determined, a so-called finite element network has to be created. Valuable data can be obtained by changing the individual elements of the system. The study of dental implants makes it possible to better investigate biomechanical conditions and thus the further perfection of implant methods. In the first part of the present two-part publication authors review the possibilities of use of the finite element analysis in examining the stress transmission of dental implants. In the second part of the publication their own studies will be presented.

  5. Mechanical design, analysis, and laboratory testing of a dental implant with axial flexibility similar to natural tooth with periodontal ligament.

    PubMed

    Pektaş, Ömer; Tönük, Ergin

    2014-11-01

    At the interface between the jawbone and the roots of natural teeth, a thin, elastic, shock-absorbing tissue, called the periodontal ligament, forms a cushion which provides certain flexibility under mechanical loading. The dental restorations supported by implants, however, involve comparatively rigid connections to the jawbone. This causes overloading of the implant while bearing functional loading together with neighboring natural teeth, which leads to high stresses within the implant system and in the jawbone. A dental implant, with resilient components in the upper structure (abutment) in order to mimic the mechanical behavior of the periodontal ligament in the axial direction, was designed, analyzed in silico, and produced for mechanical testing. The aims of the design were avoiding high levels of stress, loosening of the abutment connection screw, and soft tissue irritations. The finite element analysis of the designed implant revealed that the elastic abutment yielded a similar axial mobility with the natural tooth while keeping stress in the implant at safe levels. The in vitro mechanical testing of the prototype resulted in similar axial mobility predicted by the analysis and as that of a typical natural tooth. The abutment screw did not loosen under repeated loading and there was no static or fatigue failure.

  6. An Ex Vivo Model in Human Femoral Heads for Histopathological Study and Resonance Frequency Analysis of Dental Implant Primary Stability

    PubMed Central

    Hernández-Cortés, Pedro; Galindo-Moreno, Pablo; Catena, Andrés; Ortega-Oller, Inmaculada; Salas-Pérez, José; Gómez-Sánchez, Rafael; Aguilar, Mariano; Aguilar, David

    2014-01-01

    Objective. This study was designed to explore relationships of resonance frequency analysis (RFA)—assessed implant stability (ISQ values) with bone morphometric parameters and bone quality in an ex vivo model of dental implants placed in human femoral heads and to evaluate the usefulness of this model for dental implant studies. Material and Methods. This ex vivo study included femoral heads from 17 patients undergoing surgery for femoral neck fracture due to osteoporosis (OP) (n = 7) or for total prosthesis joint replacement due to severe hip osteoarthrosis (OA) (n = 10). Sixty 4.5 × 13 mm Dentsply Astra implants were placed, followed by RFA. CD44 immunohistochemical analysis for osteocytes was also carried out. Results. As expected, the analysis yielded significant effects of femoral head type (OA versus OA) (P < 0.001), but not of the implants (P = 0.455) or of the interaction of the two factors (P = 0.848). Bonferroni post hoc comparisons showed a lower mean ISQ for implants in decalcified (50.33 ± 2.92) heads than in fresh (66.93 ± 1.10) or fixated (70.77 ± 1.32) heads (both P < 0.001). The ISQ score (fresh) was significantly higher for those in OA (73.52 ± 1.92) versus OP (67.13 ± 1.09) heads. However, mixed linear analysis showed no significant association between ISQ scores and morphologic or histomorphometric results (P > 0.5 in all cases), and no significant differences in ISQ values were found as a function of the length or area of the cortical layer (both P > 0.08). Conclusion. Although RFA-determined ISQ values are not correlated with morphometric parameters, they can discriminate bone quality (OP versus OA). This ex vivo model is useful for dental implant studies. PMID:24995307

  7. Effect of different types of prosthetic platforms on stress-distribution in dental implant-supported prostheses.

    PubMed

    Minatel, Lurian; Verri, Fellippo Ramos; Kudo, Guilherme Abu Halawa; de Faria Almeida, Daniel Augusto; de Souza Batista, Victor Eduardo; Lemos, Cleidiel Aparecido Araujo; Pellizzer, Eduardo Piza; Santiago, Joel Ferreira

    2017-02-01

    A biomechanical analysis of different types of implant connections is relevant to clinical practice because it may impact the longevity of the rehabilitation treatment. Therefore, the objective of this study is to evaluate the Morse taper connections and the stress distribution of structures associated with the platform switching (PSW) concept. It will do this by obtaining data on the biomechanical behavior of the main structure in relation to the dental implant using the 3-dimensional finite element methodology. Four models were simulated (with each containing a single prosthesis over the implant) in the molar region, with the following specifications: M1 and M2 is an external hexagonal implant on a regular platform; M3 is an external hexagonal implant using PSW concept; and M4 is a Morse taper implant. The modeling process involved the use of images from InVesalius CT (computed tomography) processing software, which were refined using Rhinoceros 4.0 and SolidWorks 2011 CAD software. The models were then exported into the finite element program (FEMAP 11.0) to configure the meshes. The models were processed using NeiNastram software. The main results are that M1 (regular diameter 4mm) had the highest stress concentration area and highest microstrain concentration for bone tissue, dental implants, and the retaining screw (P<0.05). Using the PSW concept increases the area of the stress concentrations in the retaining screw (P<0.05) more than in the regular platform implant. It was concluded that the increase in diameter is beneficial for stress distribution and that the PSW concept had higher stress concentrations in the retaining screw and the crown compared to the regular platform implant.

  8. Guided bone regeneration utilizing expanded polytetrafluoroethylene membranes in combination with submerged and nonsubmerged dental implants in beagle dogs.

    PubMed

    Fiorellini, J P; Engebretson, S P; Donath, K; Weber, H P

    1998-05-01

    Treatment of partial and total edentulism with submerged and nonsubmerged dental implants which follows the concept of osseointegration has become an accepted treatment modality. With compromised implant sites, practitioners have begun to combine one-stage implants with established techniques including guided bone regeneration. However, the clinical evaluation of this technique is limited. Therefore, the purpose of this study was to evaluate osseointegration and bone regeneration around nonsubmerged or submerged implants placed directly into surgically created osseous defects with or without expanded polytetrafluoroethylene (ePTFE) membranes. A total of 24 implants were placed in the mandibles of 4 beagle dogs and randomly assigned to 1 of 3 treatment groups. In group A, nonsubmerged implants were placed into osseous defects and treated with a poncho style ePTFE membrane. These membranes had a hole punched into the center and were slipped over the nonsubmerged implants. In group B, nonsubmerged implants were placed into osseous defects without an ePTFE membrane. In group C, submerged implants were placed into osseous defects and covered with an ePTFE membrane. Histometric measurements of each treatment group were made to determine percent bone gain or loss along the implant surface. Although a number of membrane removals occurred during the healing period, histological analysis indicated osseous ingrowth and osseointegration around nonsubmerged and submerged implants. An overall comparison of the treatment groups with ANOVA revealed that there were no significant differences between treatment groups, P > or = 0.05. However, when the data were stratified into sites which retained or lost the ePTFE membrane, the percent of bone regeneration was reduced in group A. Therefore, it may be recommended that nonsubmerged implants be placed with a submerged or "semi-submerged" protocol when utilized in conjunction with ePTFE membranes.

  9. Dosimetric distribution of the surroundings of different dental crowns and implants during LINAC photon irradiation

    NASA Astrophysics Data System (ADS)

    Chang, Kwo-Ping; Lin, Wei-Ting; Shiau, An-Cheng; Chie, Yu-Huang

    2014-11-01

    In radiotherapy of the head and neck, metal dentures or implants will increase the risk of complications such as mucositis and osteoradionecrosis. The aim of this study is to explore the back scatter effect of commercially available dental metal alloys on the mucosa and bone under 6 MV LINAC irradiation. The Monte Carlo method has been employed to calculate the dose distribution in the heterogeneous media of the designed oral phantom based on the oral cavity geometry. Backscatter dose increases up to a maximum of 53%, and is primarily dependent on the physical density and electron density of the metal crown alloy. Ceramic metal crowns have been quantified to increase backscatter dose up to 10% on mucosa. Ceramic serves as an inherent shield of mucosa. The backscatter dose will be greater for a small field size if the tumor is located at a deeper region. Titanium implants will increase the backscatter dose by 13% to bone but will not affect the mucosa. QC-20 (polystyrene resin) is recommended as a shield material (3 mm) to eliminate the backscatter dose on mucosa due to the high density metals.

  10. Stereo imaging and cytocompatibility of a model dental implant surface formed by direct laser fabrication.

    PubMed

    Mangano, Carlo; Raspanti, Mario; Traini, Tonino; Piattelli, Adriano; Sammons, Rachel

    2009-03-01

    Direct laser fabrication (DLF) allows solids with complex geometry to be produced by sintering metal powder particles in a focused laser beam. In this study, 10 Ti6Al4V alloy model dental root implants were obtained by DLF, and surface characterization was carried out using stereo scanning electron microscopy to produce 3D reconstructions. The surfaces were extremely irregular, with approximately 100 microm deep, narrow intercommunicating crevices, shallow depressions and deep, rounded pits of widely variable shape and size, showing ample scope for interlocking with the host bone. Roughness parameters were as follows: R(t), 360.8 microm; R(z), 358.4 microm; R(a), 67.4 microm; and R(q), 78.0 microm. Disc specimens produced by DLF with an identically prepared surface were used for biocompatibility studies with rat calvarial osteoblasts: After 9 days, cells had attached and spread on the DLF surface, spanning across the crevices, and voids. Cell density was similar to that on a commercial rough microtextured surface but lower than on commercial smooth machined and smooth-textured grit-blasted, acid-etched surfaces. Human fibrin clot extension on the DLF surface was slightly improved by inorganic acid etching to increase the microroughness. With further refinements, DLF could be an economical means of manufacturing implants from titanium alloys.

  11. Novel bioactive tetracycline-containing electrospun polymer fibers as a potential antibacterial dental implant coating.

    PubMed

    Shahi, R G; Albuquerque, M T P; Münchow, E A; Blanchard, S B; Gregory, R L; Bottino, M C

    2016-09-01

    The purpose of this investigation was to determine the ability of tetracycline-containing fibers to inhibit biofilm formation of peri-implantitis-associated pathogens [i.e., Porphyromonas gingivalis (Pg), Fusobacterium nucleatum (Fn), Prevotella intermedia (Pi), and Aggregatibacter actinomycetemcomitans (Aa)]. Tetracycline hydrochloride (TCH) was added to a poly(DL-lactide) [PLA], poly(ε-caprolactone) [PCL], and gelatin [GEL] polymer blend solution at distinct concentrations to obtain the following fibers: PLA:PCL/GEL (TCH-free, control), PLA:PCL/GEL + 5 % TCH, PLA:PCL/GEL + 10 % TCH, and PLA:PCL/GEL + 25 % TCH. The inhibitory effect of TCH-containing fibers on biofilm formation was assessed by colony-forming units (CFU/mL). Qualitative analysis of biofilm inhibition was done via scanning electron microscopy (SEM). Statistical significance was reported at p < 0.05. Complete inhibition of biofilm formation on the fibers was observed in groups containing TCH at 10 and 25 wt%. Fibers containing TCH at 5 wt% demonstrated complete inhibition of Aa biofilm. Even though a marked reduction in CFU/mL was observed with an increase in TCH concentration, Pi proved to be the most resilient microorganism. SEM images revealed the absence of or a notable decrease in bacterial biofilm on the TCH-containing nanofibers. Collectively, our data suggest that tetracycline-containing fibers hold great potential as an antibacterial dental implant coating.

  12. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up.

    PubMed

    Tunchel, Samy; Blay, Alberto; Kolerman, Roni; Mijiritsky, Eitan; Shibli, Jamil Awad

    2016-01-01

    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26-67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results.

  13. 3D Printing/Additive Manufacturing Single Titanium Dental Implants: A Prospective Multicenter Study with 3 Years of Follow-Up

    PubMed Central

    2016-01-01

    This prospective 3-year follow-up clinical study evaluated the survival and success rates of 3DP/AM titanium dental implants to support single implant-supported restorations. After 3 years of loading, clinical, radiographic, and prosthetic parameters were assessed; the implant survival and the implant-crown success were evaluated. Eighty-two patients (44 males, 38 females; age range 26–67 years) were enrolled in the present study. A total of 110 3DP/AM titanium dental implants (65 maxilla, 45 mandible) were installed: 75 in healed alveolar ridges and 35 in postextraction sockets. The prosthetic restorations included 110 single crowns (SCs). After 3 years of loading, six implants failed, for an overall implant survival rate of 94.5%; among the 104 surviving implant-supported restorations, 6 showed complications and were therefore considered unsuccessful, for an implant-crown success of 94.3%. The mean distance between the implant shoulder and the first visible bone-implant contact was 0.75 mm (±0.32) and 0.89 (±0.45) after 1 and 3 years of loading, respectively. 3DP/AM titanium dental implants seem to represent a successful clinical option for the rehabilitation of single-tooth gaps in both jaws, at least until 3-year period. Further, long-term clinical studies are needed to confirm the present results. PMID:27313616

  14. Flapless versus Conventional Flapped Dental Implant Surgery: A Meta-Analysis

    PubMed Central

    Chrcanovic, Bruno Ramos; Albrektsson, Tomas; Wennerberg, Ann

    2014-01-01

    The aim of this study was to test the null hypothesis of no difference in the implant failure rates, postoperative infection, and marginal bone loss for patients being rehabilitated by dental implants being inserted by a flapless surgical procedure versus the open flap technique, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomized or not. The search strategy resulted in 23 publications. The I2 statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used for random-effects model or fixed-effects model, when indicated. The estimates of relative effect were expressed in risk ratio (RR) and mean difference (MD) in millimeters. Sixteen studies were judged to be at high risk of bias, whereas two studies were considered of moderate risk of bias, and five studies of low risk of bias. The funnel plots indicated absence of publication bias for the three outcomes analyzed. The test for overall effect showed that the difference between the procedures (flapless vs. open flap surgery) significantly affect the implant failure rates (P = 0.03), with a RR of 1.75 (95% CI 1.07–2.86). However, a sensitivity analysis revealed differences when studies of high and low risk of bias were pooled separately. Thus, the results must be interpreted carefully. No apparent significant effects of flapless technique on the occurrence of postoperative infection (P = 0.96; RR 0.96, 95% CI 0.23–4.03) or on the marginal bone loss (P = 0.16; MD −0.07 mm, 95% CI −0.16–0.03) were observed. PMID:24950053

  15. Relevant aspects in the surface properties in titanium dental implants for the cellular viability.

    PubMed

    Velasco-Ortega, E; Alfonso-Rodríguez, C A; Monsalve-Guil, L; España-López, A; Jiménez-Guerra, A; Garzón, I; Alaminos, M; Gil, F J

    2016-07-01

    Roughness and topographical features are the most relevant of the surface properties for a dental implant for its osseointegration. For that reason, we studied the four surfaces more used in titanium dental implants: machined, sandblasted, acid etching and sandblasted plus acid etching. The roughness and wettability (contact angle and surface free energy) was studied by means 3D-interferometric microscope and sessile drop method. Normal human gingival fibroblasts (HGF) were obtained from small oral mucosa biopsies and were used for cell cultures. To analyze cell integrity, we first quantified the total amount of DNA and LDH released from dead cells to the culture medium. Then, LIVE/DEAD assay was used as a combined method assessing cell integrity and metabolism. All experiments were carried out on each cell type cultured on each Ti material for 24h, 48h and 72h. To evaluate the in vivo cell adhesion capability of each Ti surface, the four types of discs were grafted subcutaneously in 5 Wistar rats. Sandblasted surfaces were significantly rougher than acid etching and machined. Wettability and surface free energy decrease when the roughness increases in sand blasted samples. This fact favors the protein adsorption. The DNA released by cells cultured on the four Ti surfaces did not differ from that of positive control cells (p>0.05). The number of cells per area was significantly lower (p<0.05) in the sand-blasted surface than in the machined and surface for both cell types (7±2 cells for HGF and 10±5 cells for SAOS-2). The surface of the machined-type discs grafted in vivo had a very small area occupied by cells and/or connective tissue (3.5%), whereas 36.6% of the sandblasted plus acid etching surface, 75.9% of sandblasted discs and 59.6% of acid etching discs was covered with cells and connective tissue. Cells cultured on rougher surfaces tended to exhibit attributes of more differentiated osteoblasts than cells cultured on smoother surfaces. These surface

  16. The effects of flute shape and thread profile on the insertion torque and primary stability of dental implants.

    PubMed

    Wu, Shu-Wei; Lee, Chia-Ching; Fu, Ping-Yuen; Lin, Shang-Chih

    2012-09-01

    Easy insertion of the implant and stable bone purchase is essential for an ideal dental implantation. At the implant tip, the cutting flutes and conical profile are respectively designed to reduce insertion resistance and facilitate the initial insertion. However, the tapered tip might reduce the self-tapping and bone-purchasing abilities of the flutes and the tip threads. Using sawbone blocks as standard specimens, this study experimentally measures the insertion torque, holding power, and bending strength of eight varieties of implant (4 shapes×2 profiles). The bony contact, interfacial mechanism, and the altered shape of the flutes, at different section planes, are used to explain the experimental results. The results reveal that the bone-implant gaps at the tip region significantly suppress both the self-tapping and bone-purchasing abilities of the flutes and the tip threads. This makes initial insertion of the conical implant easier. However, the conical implant eventually requires a higher insertion torque and holding power, due to tighter bony contact, at the tail threads. The bowl-fluted design has the least flute space to store the squeezed bone chips, so both insertion torque and bending strength are significantly higher. For the conical group, the holding powers of three flute designs are nearly comparable. Overall, the conical implant with bowl flutes is the optimal design, with a lower resistance to initial insertion and higher stability, for final instrumentation.

  17. Antibacterial effect of acrylic dental devices after surface modification by fluorine and silver dual-ion implantation.

    PubMed

    Shinonaga, Yukari; Arita, Kenji

    2012-03-01

    The purpose of the present study was to examine the effectiveness of fluorine and silver ions implanted and deposited into acrylic resin (poly(methyl methacrylate)) using a hybrid process of plasma-based ion implantation and deposition. The surface characteristics were evaluated by X-ray photoelectron spectroscopy (XPS), contact angle measurements, and atomic force microscopy. In addition, an antibacterial activity test was performed by the adenosine-5'-triphosphate luminescence method. XPS spectra of modified specimens revealed peaks due to fluoride and silver. The water contact angle increased significantly due to implantation and deposition of both fluorine and silver ions. In addition, the presence of fluorine and silver was found to inhibit bacterial growth. These results suggest that fluorine and silver dual-ion implantation and deposition can provide antibacterial properties to acrylic medical and dental devices.

  18. Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data

    PubMed Central

    Brandão-Filho, E. M.; Deliberador, F. R.; Giovanini, A. F.; Deliberador, T. M.

    2017-01-01

    Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14), the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient. PMID:28299226

  19. Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data.

    PubMed

    Vieira, J S; Brandão-Filho, E M; Deliberador, F R; Zielak, J C; Giovanini, A F; Deliberador, T M

    2017-01-01

    Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14), the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.

  20. Mechanical response comparison in an implant overdenture retained by ball attachments on conventional regular and mini dental implants: a finite element analysis.

    PubMed

    Chang, Shih-Hao; Huang, Shiang-Rung; Huang, Shao-Fu; Lin, Chun-Li

    2016-01-01

    This study investigates the bone/implant mechanical responses in an implant overdenture retained by ball attachments on two conventional regular dental implants (RDI) and four mini dental implants (MDI) using finite element (FE) analysis. Two FE models of overdentures retained by RDIs and MDIs for a mandibular edentulous patient with validation within 6% variation errors were constructed by integrating CT images and CAD system. Bone grafting resulted in 2 mm thickness at the buccal side constructed for the RDIs-supported model to mimic the bone augmentation condition for the atrophic alveolar ridge. Nonlinear hyperelastic material and frictional contact element were used to simulate characteristic of the ball attachment-retained overdentures. The results showed that a denture supported by MDIs presented higher surrounding bone strains than those supported by RDIs under different load conditions. Maximum bone micro strains were up to 6437/2987 and 13323/5856 for MDIs/RDIs under single centric and lateral contacts, respectively. Corresponding values were 4429/2579 and 9557/5774 under multi- centric and lateral contacts, respectively. Bone micro strains increased 2.06 and 1.96-folds under single contact, 2.16 and 2.24-folds under multiple contacts for MDIs and RDIs when lateral to axial loads were compared. The maximum RDIs and MDIs implant stresses in all simulated cases were found by far lower than their yield strength. Overdentures retained using ball attachments on MDIs in poor edentulous bone structure increase the surrounding bone strain over the critical value, thereby damaging the bone when compared to the RDIs. Eliminating the occlusal single contact and oblique load of an implant-retained overdenture reduces the risk for failure.

  1. Observations on an in-vivo failure of a titanium dental implant/abutment screw system: a case report.

    PubMed

    Manda, Marianthi G; Psyllaki, Pandora P; Tsipas, Dimitrios N; Koidis, Petros T

    2009-04-01

    Titanium and its alloys are widely used in prosthetic dentistry, due to their biocompatibility, excellent mechanical and anti-corrosion behavior. However, delayed fracture of dental prosthetics is frequently encountered. Mechanisms leading to fracture are not generic but are strongly related to the particular environmental (quality of biological fluids) and mechanical loading conditions (mastication habits, presence of prosthetic metallic/ceramic components) in the patients' oral cavity. In this study, a commercially pure titanium implant-screw system has failed after 15 years of operation in the oral cavity of an old female. The system was retrieved in three pieces: the upper part of the implant, part of the abutment screw, and the apical part of the implant to which a part of the screw was embedded. This is considered as a rare case, where the whole dental assembly was retrieved after fracture allowing the extensive fractographic analysis of the conjugate pieces and the establishment of a thorough in-vivo failure scenario. Scanning electron microscopy observations performed on all three retrieved parts indicated a synergistic effect of distinct mechanisms, which led to total failure under extrinsic common fatigue loading. The principal mechanism was the propagation of a main crack, which was previously initiated in the body of the implant and affected by a wedging mechanism due to Ca/P aggregates developed within the crack. Because of the strong fixation between the implant and the abutment screw, this main crack was transferred to the latter causing eventually total failure of the assembly.

  2. Alternative to the inferior alveolar nerve block anesthesia when placing mandibular dental implants posterior to the mental foramen.

    PubMed

    Heller, A A; Shankland, W E

    2001-01-01

    Local anesthesia block of the inferior alveolar nerve is routinely taught throughout dental education. This commonly used technique eliminates all somatosensory perception of the mandible, mandibular teeth, floor of the mouth, ipsilateral tongue, and all but the lateral (buccal) gingivae. Generally, the dentist or surgeon desires these structures to be anesthetized. However, in the placement of mandibular implants, it may be useful for the patient to be able to sense when the inferior alveolar nerve is in danger of being damaged, possibly producing permanent paresthesia. In this article, the technique of mandibular infiltration prior to mandibular implant placement in the mandible is discussed.

  3. A Three-Dimensional Finite Element Study on the Biomechanical Simulation of Various Structured Dental Implants and Their Surrounding Bone Tissues

    PubMed Central

    Zhang, Gong; Yuan, Hai; Chen, Xianshuai; Wang, Weijun; Chen, Jianyu; Liang, Jimin; Zhang, Peng

    2016-01-01

    Background/Purpose. This three-dimensional finite element study observed the stress distribution characteristics of 12 types of dental implants and their surrounding bone tissues with various structured abutments, implant threads, and healing methods under different amounts of concentrated loading. Materials and Methods. A three-dimensional geometrical model of a dental implant and its surrounding bone tissue was created; the model simulated a screw applied with a preload of 200 N or a torque of 0.2 N·m and a prosthetic crown applied with a vertical or an inclined force of 100 N. The Von Mises stress was evaluated on the 12 types of dental implants and their surrounding bone tissues. Results. Under the same loading force, the stress influence on the implant threads was not significant; however, the stress influence on the cancellous bone was obvious. The stress applied to the abutment, cortical bone, and cancellous bone by the inclined force applied to the crown was larger than the stress applied by the vertical force to the crown, and the abutment stress of the nonsubmerged healing implant system was higher than that of the submerged healing implant system. Conclusion. A dental implant system characterised by a straight abutment, rectangle tooth, and nonsubmerged healing may provide minimum value for the implant-bone interface. PMID:26904121

  4. Mini dental implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period.

    PubMed

    Shatkin, Todd E; Shatkin, Samuel; Oppenheimer, Benjamin D; Oppenheimer, Adam J

    2007-02-01

    Over the past decade, endosseous implants of increasingly smaller diameters have been introduced into the field of dentistry. Small diameter implants (SDIs) are generally 2.75 mm to 3.3 mm in diameter. They are frequently used in cases of limited alveolar anatomy Mini dental implants (MDIs) are smaller than their SDI counterparts, with diameters ranging from 1.8 mm to 2.4 mm. They are suitable for long-term use-a task for which the device was approved by the Food and Drug Administration. The following study describes the authors' experience with MDIs under this indication. Over a 5-year period, 2514 MDIs were placed in 531 patients. The mean duration of follow-up was 2.9 years. The implants supported fixed (1278) and removable prostheses (1236), with nearly equal placement in the mandible and maxilla (1256 and 1258, respectively). The overall implant survival was 94.2%. Based on a Cox proportional hazards model, statistically significant predictors of failure include use in removable prostheses (hazard ratio = 4.28), the posterior maxilla (3.37), atrophic bone (3.32), and cigarette smokers (2.28). Implant failures (145) were attributed to mobility with or without suppuration (19% vs 81%, respectively). The mean failure time for these implants was approximately 6.4 months (193+/-42 days). This temporally correlates with the osseointegration period. A learning curve was established for this procedure, and implant survival improved with placement experience. Based on these results, the authors have devised treatment guidelines for the use of MDIs in long-term fixed and removable prostheses. MDIs are not a panacea; however, proper training enables the general dentist to successfully implement MDIs into clinical practice.

  5. Point-cloud-to-point-cloud technique on tool calibration for dental implant surgical path tracking

    NASA Astrophysics Data System (ADS)

    Lorsakul, Auranuch; Suthakorn, Jackrit; Sinthanayothin, Chanjira

    2008-03-01

    Dental implant is one of the most popular methods of tooth root replacement used in prosthetic dentistry. Computerize navigation system on a pre-surgical plan is offered to minimize potential risk of damage to critical anatomic structures of patients. Dental tool tip calibrating is basically an important procedure of intraoperative surgery to determine the relation between the hand-piece tool tip and hand-piece's markers. With the transferring coordinates from preoperative CT data to reality, this parameter is a part of components in typical registration problem. It is a part of navigation system which will be developed for further integration. A high accuracy is required, and this relation is arranged by point-cloud-to-point-cloud rigid transformations and singular value decomposition (SVD) for minimizing rigid registration errors. In earlier studies, commercial surgical navigation systems from, such as, BrainLAB and Materialize, have flexibility problem on tool tip calibration. Their systems either require a special tool tip calibration device or are unable to change the different tool. The proposed procedure is to use the pointing device or hand-piece to touch on the pivot and the transformation matrix. This matrix is calculated every time when it moves to the new position while the tool tip stays at the same point. The experiment acquired on the information of tracking device, image acquisition and image processing algorithms. The key success is that point-to-point-cloud requires only 3 post images of tool to be able to converge to the minimum errors 0.77%, and the obtained result is correct in using the tool holder to track the path simulation line displayed in graphic animation.

  6. Bone Regeneration of Blood-derived Stem Cells within Dental Implants.

    PubMed

    Zheng, R C; Park, Y K; Kim, S K; Cho, J; Heo, S J; Koak, J Y; Lee, S J; Park, J M; Lee, J H; Kim, J H

    2015-09-01

    Peripheral blood (PB) is known as a source of mesenchymal stem cells (MSCs), as is bone marrow (BM), and is acquired easily. However, it is difficult to have enough MSCs, and their osteogenic capacity with dental implantations is scarce. Therefore, we characterized peripheral blood mesenchymal stem cells (PBMSCs) cultured on a bone marrow-derived mesenchymal stem cell (BMMSC) natural extracellular matrix (ECM) and demonstrated the osteogenic capability in an experimental chamber implant surgery model in rabbits. We isolated PBMSCs from rabbits by culturing on a natural ECM-coated plate during primary culture. We characterized the PBMSCs using a fluorescence-activated cell scanner, cell proliferation assay, and multiple differentiation assay and compared them with BMMSCs. We also analyzed the osteogenic potential of PBMSCs mixed with hydroxyapatite/tricalcium phosphate (HA/TCP) by transplanting them into immunocompromised mice. Then, the mixture was applied to the canals. After 3 and 6 wk, we analyzed new bone (NB) formation inside the chambers using histological and histomorphometric analyses. The PBMSCs had a similar rate of BrdU-positive cells to BMMSCs, positively expressing CD90 but negative for CD14. The PBMSCs also showed osteogenic, adipogenic, and chondrogenic ability in vitro and osteogenic ability in vivo. Histological and histomorphometric results illustrated that the PBMSC and BMMSC groups showed higher NB than the HA/TCP and defect groups in the upper and lower chambers at 6 wk and in the upper canal at 3 wk; however, there was no difference in NB among all groups in the lower canal at 3 wk. The PBMSCs have characteristics and bone regeneration ability similar to BMMSCs both in vitro and in vivo. ECM was effective for obtaining PBMSCs. Therefore, PBMSCs are a promising source for bone regeneration for clinical use.

  7. Intraosseous transcutaneous amputation prostheses versus dental implants: a comparison between keratinocyte and gingival epithelial cell adhesion in vitro.

    PubMed

    Pendegrass, C J; Lancashire, H T; Fontaine, C; Chan, G; Hosseini, P; Blunn, G W

    2015-04-19

    Infection is the primary failure modality for transcutaneous implants because the skin breach provides a route for pathogens to enter the body. Intraosseous transcutaneous amputation prostheses (ITAP) are being developed to overcome this problem by creating a seal at the skin-implant interface. Oral gingival epithelial cell attachment creates an infection-free seal around dental implants. However, this has yet to be achieved consistently outside of the oral environment. Epithelial cells attach to metal substrates by means of hemidesmosomes and focal adhesions. Their density per unit cell is an indicator of attachment strength. We postulate that gingival epithelial cells express more hemidesmosomes and focal adhesions at earlier time points, compared with epidermal keratinocytes, and this increased speed and strength of attachment may be the reason why an infection-free seal is often achieved around dental implants but less frequently around ITAP. The aim of this study was to compare epidermal keratinocyte with oral gingival cell attachment on titanium alloy in vitro, to determine whether these two cell types differ in their speed and strength of attachment. We aimed to test the hypothesis that gingival cells up-regulate focal adhesion and hemidesmosome formation at earlier time points compared with extra-oral keratinocytes. To test this hypothesis we cultured epidermal keratinocytes and oral gingival cells on titanium alloy substrates and assessed cell attachment by focal adhesions and hemidesmosome expression at 4, 24, 48 and 72 hours. Formation and expression of hemidesmosomes temporally lagged behind that of focal adhesions in both cell types. Gingival derived cells up-regulated focal adhesion and hemidesmosome expression at earlier time points compared with epidermal keratinocytes. Hemidesmosome expression in oral gingival cells was 3 times greater compared with epidermal keratinocytes at 4 hours. Our findings indicate that earlier attachment may be key to the

  8. Initial torque stability of a new bone condensing dental implant. A cohort study of 140 consecutively placed implants.

    PubMed

    Irinakis, Tassos; Wiebe, Colin

    2009-01-01

    The aim of this paper was to determine the torque resistance of this new implant during placement in different types of bone, immediate placement into sockets, and in grafted bone. The torque at time of placement serves as an indication of initial stability, which is accepted as an important factor for implant osseointegration and immediate loading. Within a 13-month period, 140 NobelActive implants in 84 consecutive patients were placed into types I-IV bone in fresh sockets, and into grafted bone (both in maxillary sinuses and on the facial alveolar surfaces where bone had been lost). The final torque was measured with a manual torque control wrench as manufactured by Nobel Biocare for clinical use with this type of implant. One hundred forty implants with 3.5 to 5 mm diameters and 10 to 15 mm lengths were placed in different types of bone, either as delayed or immediate implants into fresh extraction sockets. These implants demonstrated a mean torque stability value of 50.8 Ncm. The average insertion torque for delayed implants was 49.7 Ncm. For immediate implants the average torque was 52.6 Ncm. Placement into soft bone was also favorable at an average of 47.9 Ncm. Typical straight walled and tapered implants generally exhibit 10 to 35 Ncm insertion torques. The NobelActive implant consistently reaches higher torque levels. This may indicate they are more favorably suited to early provisionalization and loading. Soft bone (type IV) did not seem to decrease significantly the torque of insertion of these implants. Further longer term studies are needed to investigate whether this indeed makes these implants more suited for early provisionalization and loading than traditional root form. Long term studies are also needed to investigate maintenance of bone levels surrounding these implants.

  9. BMP-2/ACS/allograft for combined maxillary alveolar split/sinus floor grafting with and without simultaneous dental implant placement: report of 21 implants placed into 7 alveolar split sites followed for up to 3 years.

    PubMed

    Jensen, Ole T; Kuhlke, K Lee; Leopardi, Aldo; Adams, Mark W; Ringeman, Jason L

    2014-01-01

    This report presents seven patients who were treated with combined alveolar split/sinus grafting technique and dental implants and followed for 1 to 3 years. The grafting material included bone morphogenetic protein-2 in an absorbable collagen sponge plus allograft. The procedure was successful in all patients, who received implants either simultaneously with grafting or 4 to 6 months after grafting.

  10. Digital data acquisition for a CAD/CAM-fabricated titanium framework and zirconium oxide restorations for an implant-supported fixed complete dental prosthesis.

    PubMed

    Lin, Wei-Shao; Metz, Michael J; Pollini, Adrien; Ntounis, Athanasios; Morton, Dean

    2014-12-01

    This dental technique report describes a digital workflow with digital data acquisition at the implant level, computer-aided design and computer-aided manufacturing fabricated, tissue-colored, anodized titanium framework, individually luted zirconium oxide restorations, and autopolymerizing injection-molded acrylic resin to fabricate an implant-supported, metal-ceramic-resin fixed complete dental prosthesis in an edentulous mandible. The 1-step computer-aided design and computer-aided manufacturing fabrication of titanium framework and zirconium oxide restorations can provide a cost-effective alternative to the conventional metal-resin fixed complete dental prosthesis.

  11. Introducing high-cost health care to patients: dentists' accounts of offering dental implant treatment

    PubMed Central

    Vernazza, Christopher R; Rousseau, Nikki; Steele, Jimmy G; Ellis, Janice S; Thomason, John Mark; Eastham, Jane; Exley, Catherine

    2015-01-01

    Objectives The decision-making process within health care has been widely researched, with shared decision-making, where both patients and clinicians share technical and personal information, often being cited as the ideal model. To date, much of this research has focused on systems where patients receive their care and treatment free at the point of contact (either in government-funded schemes or in insurance-based schemes). Oral health care often involves patients making direct payments for their care and treatment, and less is known about how this payment affects the decision-making process. It is clear that patient characteristics influence decision-making, but previous evidence suggests that clinicians may assume characteristics rather than eliciting them directly. The aim was to explore the influences on how dentists' engaged in the decision-making process surrounding a high-cost item of health care, dental implant treatments (DITs). Methods A qualitative study using semi-structured interviews was undertaken using a purposive sample of primary care dentists (n = 25). Thematic analysis was undertaken to reveal emerging key themes. Results There were differences in how dentists discussed and offered implants. Dentists made decisions about whether to offer implants based on business factors, professional and legal obligations and whether they perceived the patient to be motivated to have treatment and their ability to pay. There was evidence that assessment of these characteristics was often based on assumptions derived from elements such as the appearance of the patient, the state of the patient's mouth and demographic details. The data suggest that there is a conflict between three elements of acting as a healthcare professional: minimizing provision of unneeded treatment, trying to fully involve patients in shared decisions and acting as a business person with the potential for financial gain. Conclusions It might be expected that in the context of a high

  12. Fretting corrosion behaviour of ball-and-socket joint on dental implants with different prosthodontic alloys.

    PubMed

    Gil, F J; Canedo, R; Padrós, A; Bañeres, M V; Arano, J M

    2003-01-01

    The fretting corrosion of five materials for implant suprastructures (cast-titanium, machined-titanium, gold alloy, silver-palladium alloy and chromium-nickel alloy), was investigated in vitro, the materials being galvanically coupled to a titanium ball-and-socket-joint with tetrafluoroethylene under mechanical load. Various electrochemical parameters (E(corr), i(corr), Evans diagrams, polarization resistance and Tafel slopes) were analyzed. The microstructure of the different dental materials was observed before and after corrosion processes by optical and electron microscopy. It can be observed that the mechanical load produces an important decrease of the corrosion resistance. The cast and machined titanium had the most passive current density at a given potential and chromium-nickel alloy had the most active critical current density values. The high gold content alloys have excellent resistance corrosion, although this decreases when the gold content is lower in the alloy. The palladium alloy had a low critical current density due to the presence of gallium in this composition but a selective dissolution of copper-rich phases was observed through energy dispersive X-ray analysis.

  13. Towards a bimodal proximity sensor for in situ neurovascular bundle detection during dental implant surgery

    PubMed Central

    Weber, Jessie R.; Baribeau, François; Grenier, Paul; Émond, Frédéric; Dubois, Sylvain; Duchesne, François; Girard, Marc; Pope, Timothy; Gallant, Pascal; Mermut, Ozzy; Moghadam, Hassan Ghaderi

    2013-01-01

    Proof of concept results are presented towards an in situ bimodal proximity sensor for neurovascular bundle detection during dental implant surgery using combined near infrared absorption (NIR) and optical coherence tomography (OCT) techniques. These modalities are shown to have different sensitivity to the proximity of optical contrast from neurovascular bundles. NIR AC and DC signals from the pulsing of an artery enable qualitative ranging of the bundle in the millimeter range, with best sensitivity around 0.5-3mm distance in a custom phantom setup. OCT provides structural mapping of the neurovascular bundle at sub-millimeter distances in an ex vivo human jaw bone. Combining the two techniques suggests a novel ranging system for the surgeon that could be implemented in a “smart drill.” The proximity to the neurovascular bundle can be tracked in real time in the range of a few millimeters with NIR signals, after which higher resolution imaging OCT to provide finer ranging in the sub-millimeter distances. PMID:24466473

  14. Electrodeposition of nanostructured bioactive hydroxyapatite-heparin composite coatings on titanium for dental implant applications.

    PubMed

    Bozzini, Benedetto; Barca, Amilcare; Bogani, Francesco; Boniardi, Marco; Carlino, Paolo; Mele, Claudio; Verri, Tiziano; Romano, Alessandro

    2014-06-01

    In this paper we describe the one-pot fabrication of hydroxyapatite (HA)-heparin composites by electrodeposition onto Ti substrates and their characterisation in terms of structure, morphology, heparin content and bioactivity. HA coatings are well known and widely applied osteointegration enhancers, but post-implant healing rate in dental applications is still suboptimal: e.g. coagulation control plays a key role and the incorporation of an anticoagulant is considered a highly desirable option. In this study, we have developed an improved, simple and robust growth procedure for single-phase, pure HA-heparin films of thickness 1/3 μm. HA-heparin, forming nanowires, has the ideal morphology for bone mineralisation. Staining assays revealed homogeneous incorporation of sizable amounts of heparin in the composite films. The bioactivities of the HA and HA-heparin coatings on Ti were compared by HeLa cell proliferation/viability tests and found to be enhanced by the presence of the anticoagulant.

  15. Tetracycline-incorporated polymer nanofibers as a potential dental implant surface modifier.

    PubMed

    Bottino, Marco C; Münchow, Eliseu A; Albuquerque, Maria T P; Kamocki, Krzysztof; Shahi, Rana; Gregory, Richard L; Chu, Tien-Min G; Pankajakshan, Divya

    2016-07-13

    This study investigated the antimicrobial and osteogenic properties of titanium (Ti) disks superficially modified with tetracycline (TCH)-incorporated polymer nanofibers. The experiments were carried out in two phases. The first phase dealt with the synthesis and characterization (i.e., morphology, mechanical strength, drug release, antimicrobial activity, and cytocompatibility) of TCH-incorporated fibers. The second phase was dedicated to evaluating both the antimicrobial and murine-derived osteoprecursor cell (MC3T3-E1) response of Ti-modified with TCH-incorporated fibers. TCH was successfully incorporated into the submicron-sized and cytocompatible fibers. All TCH-incorporated mats presented significant antimicrobial activity against periodontal pathogens. The antimicrobial potential of the TCH-incorporated fibers-modified Ti was influenced by both the TCH concentration and bacteria tested. At days 5 and 7, a significant increase in MC3T3-E1 cell number was observed for TCH-incorporated nanofibers-modified Ti disks when compared to that of TCH-free nanofibers-modified Ti-disks and bare Ti. A significant increase in alkaline phosphatase (ALP) levels on the Ti disks modified with TCH-incorporated nanofiber on days 7 and 14 was seen, suggesting that the proposed surface promotes early osteogenic differentiation. Collectively, the data suggest that TCH-incorporated nanofibers could function as an antimicrobial surface modifier and osteogenic inducer for Ti dental implants. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2016.

  16. Osteoblast integration of dental implant materials after challenge by sub-gingival pathogens: a co-culture study in vitro

    PubMed Central

    Zhao, Bingran; van der Mei, Henny C; Rustema-Abbing, Minie; Busscher, Henk J; Ren, Yijin

    2015-01-01

    Sub-gingival anaerobic pathogens can colonize an implant surface to compromise osseointegration of dental implants once the soft tissue seal around the neck of an implant is broken. In vitro evaluations of implant materials are usually done in monoculture studies involving either tissue integration or bacterial colonization. Co-culture models, in which tissue cells and bacteria battle simultaneously for estate on an implant surface, have been demonstrated to provide a better in vitro mimic of the clinical situation. Here we aim to compare the surface coverage by U2OS osteoblasts cells prior to and after challenge by two anaerobic sub-gingival pathogens in a co-culture model on differently modified titanium (Ti), titanium-zirconium (TiZr) alloys and zirconia surfaces. Monoculture studies with either U2OS osteoblasts or bacteria were also carried out and indicated significant differences in biofilm formation between the implant materials, but interactions with U2OS osteoblasts were favourable on all materials. Adhering U2OS osteoblasts cells, however, were significantly more displaced from differently modified Ti surfaces by challenging sub-gingival pathogens than from TiZr alloys and zirconia variants. Combined with previous work employing a co-culture model consisting of human gingival fibroblasts and supra-gingival oral bacteria, results point to a different material selection to stimulate the formation of a soft tissue seal as compared to preservation of osseointegration under the unsterile conditions of the oral cavity. PMID:26674427

  17. Osteoblast integration of dental implant materials after challenge by sub-gingival pathogens: a co-culture study in vitro.

    PubMed

    Zhao, Bingran; van der Mei, Henny C; Rustema-Abbing, Minie; Busscher, Henk J; Ren, Yijin

    2015-12-18

    Sub-gingival anaerobic pathogens can colonize an implant surface to compromise osseointegration of dental implants once the soft tissue seal around the neck of an implant is broken. In vitro evaluations of implant materials are usually done in monoculture studies involving either tissue integration or bacterial colonization. Co-culture models, in which tissue cells and bacteria battle simultaneously for estate on an implant surface, have been demonstrated to provide a better in vitro mimic of the clinical situation. Here we aim to compare the surface coverage by U2OS osteoblasts cells prior to and after challenge by two anaerobic sub-gingival pathogens in a co-culture model on differently modified titanium (Ti), titanium-zirconium (TiZr) alloys and zirconia surfaces. Monoculture studies with either U2OS osteoblasts or bacteria were also carried out and indicated significant differences in biofilm formation between the implant materials, but interactions with U2OS osteoblasts were favourable on all materials. Adhering U2OS osteoblasts cells, however, were significantly more displaced from differently modified Ti surfaces by challenging sub-gingival pathogens than from TiZr alloys and zirconia variants. Combined with previous work employing a co-culture model consisting of human gingival fibroblasts and supra-gingival oral bacteria, results point to a different material selection to stimulate the formation of a soft tissue seal as compared to preservation of osseointegration under the unsterile conditions of the oral cavity.

  18. Dental implants after the use of bichat's buccal fat pad for the sealing of oro-antral communications. A case report and literature review.

    PubMed

    Galletti, Cosimo; Cammaroto, Giovanni; Galletti, Francesco; Camps-Font, Octavi; Gay-Escoda, Cosme; Bara-Casaus, José-Javier

    2016-12-01

    Oro-antral communications are frequent complications in oral surgery, and generally occur after molar extractions, maxillary sinus elevations or dental implant procedures. The presence of these defects may increase the morbidity and often need a surgical approach. The present report describes an oro-antral communication in a 52-year-old female who presented a 2 week-course of painless nasal obstruction and rhinorrea after a right maxillary sinus floor elevationwith simultaneous dental implant placement. Based on the anamnesis, clinical examination and a computed tomographyof the paranasal sinuses, a diagnosis of odontogenic rhinosinusitis associated with a 1.5 cm diameter oro-antral communicationwas establishedand its surgical closure using Bichat's buccal fat pad was planned.After 15 months, the patient was successfully rehabilitated with an implant-supported 3 unit fixed partial denture. Key words:Dental implants, buccal fat pad, oro-antral communications.

  19. Dental implants after the use of bichat’s buccal fat pad for the sealing of oro-antral communications. A case report and literature review

    PubMed Central

    Cammaroto, Giovanni; Galletti, Francesco; Camps-Font, Octavi; Gay-Escoda, Cosme; Bara-Casaus, José-Javier

    2016-01-01

    Oro-antral communications are frequent complications in oral surgery, and generally occur after molar extractions, maxillary sinus elevations or dental implant procedures. The presence of these defects may increase the morbidity and often need a surgical approach. The present report describes an oro-antral communication in a 52-year-old female who presented a 2 week-course of painless nasal obstruction and rhinorrea after a right maxillary sinus floor elevationwith simultaneous dental implant placement. Based on the anamnesis, clinical examination and a computed tomographyof the paranasal sinuses, a diagnosis of odontogenic rhinosinusitis associated with a 1.5 cm diameter oro-antral communicationwas establishedand its surgical closure using Bichat’s buccal fat pad was planned.After 15 months, the patient was successfully rehabilitated with an implant-supported 3 unit fixed partial denture. Key words:Dental implants, buccal fat pad, oro-antral communications. PMID:27957285

  20. Solcoseryl, a tissue respiration stimulating agent, significantly enhances the effect of capacitively coupled electric field on the promotion of bone formation around dental implants.

    PubMed

    Ochi, Morio; Wang, Pao-Li; Ohura, Kiyoshi; Takashima, Shigenori; Kagami, Hiroyuki; Hirose, Yukito; Kaku, Tohru; Sakaguchi, Kunihiko

    2003-06-01

    In the present study we examined the combined effect of application of a capacitively coupled electric field (CCEF) and the tissue respiration stimulating agent, Solcoseryl, on the promotion of bone formation around dental implants histologically and mechanically. After a dental implant was inserted into each femur of Japanese white rabbits, Solcoseryl (2 ml/kg) was administered intravenously in the ear vein and a CCEF was applied for 4 h per day for 14 days. The degree of bone formation on microscopic observation, bone contact ratio, bone surface area ratio, and the level of removal torque of the implant in the Solcoseryl- and CCEF-treated group were significantly higher than the respective value in the control group, which had not been treated with Solcoseryl nor CCEF. Thus, the combination of CCEF stimulation and Solcoseryl effectively promoted the formation of new bone. It is suggested that the clinical use of a combination of CCEF stimulation and Solcoseryl for dental implants promotes osseointegration.

  1. Dental cone beam computed tomography analyses of postoperative labial bone thickness in maxillary anterior implants: comparing immediate and delayed implant placement.

    PubMed

    Miyamoto, Yasukazu; Obama, Tadakazu

    2011-06-01

    This study aimed to evaluate the influence of labial alveolar bone thickness and the corresponding vertical bone loss on postoperative gingival recessions around anterior maxillary dental implants. Using cone beam computed tomography (CBCT) scanning, the temporal changes of three-dimensional images of alveolar bone were monitored to determine hard and soft tissue outcomes of two different implant placement techniques: delayed two-stage and immediate placement. Furthermore, for the delayed two-stage placement, guided bone regeneration was applied using either nonresorbable or resorbable membranes combined with anorganic bovine bone matrix. The comparative results suggested that gingival recessions were significantly lower in delayed two-stage placement, especially when using a nonresorbable membrane, compared to immediate placement, and labial bone thickness, measured by CBCT, offered an effectual indicator to assess gingival recession in the anterior region.

  2. Effects of fluoride-ion-implanted titanium surface on the cytocompatibility in vitro and osseointegatation in vivo for dental implant applications.

    PubMed

    Wang, Xue-jin; Liu, Hui-ying; Ren, Xiang; Sun, Hui-yan; Zhu, Li-ying; Ying, Xiao-xia; Hu, Shu-hai; Qiu, Ze-wen; Wang, Lang-ping; Wang, Xiao-feng; Ma, Guo-wu

    2015-12-01

    As an attractive technique for the improvement of biomaterials, Plasma immersion ion implantation (PIII) has been applied to modifying the titanium material for dental implant application. The present study investigated the cytocompatibility and early osseointegration of fluoride-ion-implanted titanium (F-Ti) surface and implants, both characterizing in their composition of titanium oxide and titanium fluoride. The cytocompatibility of F-Ti was evaluated in vitro by using scanning electron microscope, Cell Counting Kit-8 assay, alkaline phosphatase activity assay, and quantitative real-time polymerase chain reaction. The results showed that the F-Ti weakened the effects that Porphyromonas gingivalis exerted on the MG-63 cells in terms of morphology, proliferation, differentiation, and genetic expression when MG-63 cells and Porphyromonas gingivalis were co-cultured on the surface of F-Ti. Meanwhile, the osteogenic activity of F-Ti implants was assessed in vivo via evaluating the histological morphology and estimating histomorphometric parameters. The analysis of toluidine blue staining indicated that the new bone was more mature in subjects with F-Ti group, which exhibited the Haversian system, and the mean bone-implant contact value of F-Ti group was slightly higher than that of cp-Ti group (p>0.05). Fluorescence bands were wider and brighter in the F-Ti group, and the intensity of fluorochromes deposited at the sites of mineralized bone formation was significantly higher for F-Ti surfaces than for cp-Ti surfaces, within the 2nd, 3rd and 4th weeks (p<0.05). An indication is that the fluoride modified titanium can promote cytocompatibility and early osseointegration, thus providing a promising alternative for clinical use.

  3. Studying the issues in the additive manufacturing of dental implants by Electron Beam MeltingRTM (EBM)

    NASA Astrophysics Data System (ADS)

    Jamshidinia, Mahdi

    The ability of additive manufacturing (AM) processes to produce complex geometries is resulting in their rapid acceptance by a number of industries. This unique capability could be used for the optimization of the design of functional components that could find an application in different industries such as aerospace, automotive, energy, medical, and implants. However, there are still some challenges confronting this technology such as surface finish, residual stress, dimensional tolerance, processing speed, and anisotropy in microstructure and mechanical properties. Any of the mentioned issues could be influenced by the thermal history of a 3D printed component during the layer-by-layer manufacturing. Therefore, an understanding of the thermal cycling during the AM process is essential. In recent years, significant advances have been achieved in the design, manufacturing, and materials used for dental implants. However, there are still some differences between the natural tooth and a dental implant that might decrease patient satisfaction. One of the differences between the natural tooth and a dental implant is in its modulus of elasticity, which could result in an issue known as bone atrophy. The second important difference between a dental implant and a natural tooth is the fact that a natural tooth is surrounded by a periodontal ligament that allows the tooth to move in three directions. However, the periodontal ligament is destroyed during the extraction of a natural tooth. In the absence of the periodontal ligament, the biting force is directly transferred to the jawbone, resulting in discomfort for the patient. Also, the implant cannot be incorporated with the surrounding natural tooth and form a bridge. In this study, the application of a lattice structure for the manufacturing of a biocompatible dental implant is investigated. Three different lattice structures with different unit cell sizes were experimentally and numerically analyzed. The mechanical

  4. FEM evaluation of cemented-retained versus screw-retained dental implant single-tooth crown prosthesis

    PubMed Central

    Cicciu, Marco; Bramanti, Ennio; Matacena, Giada; Guglielmino, Eugenio; Risitano, Giacomo

    2014-01-01

    Prosthetic rehabilitation of partial or total edentulous patients is today a challenge for clinicians and dental practitioners. The application of dental implants in order to recover areas of missing teeth is going to be a predictable technique, however some important points about the implant angulation, the stress distribution over the bone tissue and prosthetic components should be well investigated for having final long term clinical results. Two different system of the prosthesis fixation are commonly used. The screw retained crown and the cemented retained one. All of the two restoration techniques give to the clinicians several advantages and some disadvantages. Aim of this work is to evaluate all the mechanical features of each system, through engineering systems of investigations like FEM and Von Mises analyses. The FEM is today a useful tool for the prediction of stress effect upon material and biomaterial under load or strengths. Specifically three different area has been evaluated through this study: the dental crown with the bone interface; the passant screw connection area; the occlusal surface of the two different type of crown. The elastic features of the materials used in the study have been taken from recent literature data. Results revealed an adequate response for both type of prostheses, although cemented retained one showed better results over the occlusal area. PMID:24955150

  5. An advanced navigational surgery system for dental implants completed in a single visit: an in vitro study.

    PubMed

    Kim, Sung-Goo; Lee, Woo-Jin; Lee, Sam-Sun; Heo, Min-Suk; Huh, Kyung-Hoe; Choi, Soon-Chul; Kim, Tae-Il; Yi, Won-Jin

    2015-01-01

    In this study, we have developed an advanced navigational implant surgery system to overcome some disadvantages of the conventional method and have evaluated the accuracy of the system under in vitro environment. The patient splint for registration and tracking was improvised using a bite splint without laboratory work and the offset of an exchanged drill was calibrated directly without pivoting during surgery. The mean target registration errors (TRE) were 0.35 ± 0.11 mm using the registration body, 0.34 ± 0.18 mm for the registration method with prerecorded fiducials, and 0.35 ± 0.16 mm for the direct calibration of a drill offset. The mean positional deviations between the planned and placed implants in 110 implant surgeries were 0.41 ± 0.12 mm at the center point of the platform and 0.56 ± 0.14 mm at the center point of the apex. The mean angular deviation was 2.64°± 1.31 for the long axis of the implant. In conclusion, the developed system exhibited high accuracy, and the improved tools and simplified procedures increased the convenience and availability. With this advanced approach, it will be possible to complete dental implant surgery during a single visit at local clinics using a navigational guidance involving cone-beam computed tomographic images.

  6. Implant-supported fixed dental prostheses with CAD/CAM-fabricated porcelain crown and zirconia-based framework.

    PubMed

    Takaba, Masayuki; Tanaka, Shinpei; Ishiura, Yuichi; Baba, Kazuyoshi

    2013-07-01

    Recently, fixed dental prostheses (FDPs) with a hybrid structure of CAD/CAM porcelain crowns adhered to a CAD/CAM zirconia framework (PAZ) have been developed. The aim of this report was to describe the clinical application of a newly developed implant-supported FDP fabrication system, which uses PAZ, and to evaluate the outcome after a maximum application period of 36 months. Implants were placed in three patients with edentulous areas in either the maxilla or mandible. After the implant fixtures had successfully integrated with bone, gold-platinum alloy or zirconia custom abutments were first fabricated. Zirconia framework wax-up was performed on the custom abutments, and the CAD/CAM zirconia framework was prepared using the CAD/CAM system. Next, wax-up was performed on working models for porcelain crown fabrication, and CAD/CAM porcelain crowns were fabricated. The CAD/CAM zirconia frameworks and CAD/CAM porcelain crowns were bonded using adhesive resin cement, and the PAZ was cemented. Cementation of the implant superstructure improved the esthetics and masticatory efficiency in all patients. No undesirable outcomes, such as superstructure chipping, stomatognathic dysfunction, or periimplant bone resorption, were observed in any of the patients. PAZ may be a potential solution for ceramic-related clinical problems such as chipping and fracture and associated complicated repair procedures in implant-supported FDPs.

  7. Comparison of Azithromycin and Amoxicillin Prior to Dental Implant Placement: An Exploratory Study of Bioavailability and Resolution of Postoperative Inflammation

    PubMed Central

    Escalante, Mariana Gil; Eubank, Tim D.; Leblebicioglu, Binnaz; Walters, John D.

    2015-01-01

    Background Studies suggest that a single prophylactic dose of amoxicillin reduces early implant complications, but it is unclear whether other antibiotics are also effective. This study compared the local antimicrobial and anti-inflammatory effects resulting from a single dose of azithromycin or amoxicillin prior to surgical placement of one-stage dental implants. Methods Healthy adult patients requiring one-stage dental implant placement were randomly allocated to receive either 2g amoxicillin (n=7) or 500mg azithromycin (n=6) prior to surgery. Peri-implant crevicular fluid (PICF) samples from the new implant and gingival crevicular fluid (GCF) from adjacent teeth were sampled on postoperative days 6, 13 and 20. Inflammatory mediators in the samples were analyzed by immunoassay and antibiotic levels were measured by bioassay. Results On day 6, azithromycin concentrations in GCF and PICF were 3.39±0.73μg/ml and 2.77±0.90μg/ml, respectively, while amoxicillin was below the limit of detection. During early healing, patents in the azithromycin group exhibited a significantly greater decrease in GCF volume (p=0.03, ANOVA). At specific times during healing, the azithromycin group exhibited significantly lower levels of IL-6 and IL-8 in GCF than the amoxicillin group and exhibited significantly lower levels of G-CSF, IL-8, MIP-1β and IP-10 in PICF. Conclusions Azithromycin was available at the surgical site for a longer period of time than amoxicillin, and patients taking azithromycin exhibited lower levels of specific pro-inflammatory cytokines and chemokines in GCF and PICF. Thus, preoperative azithromycin may enhance resolution of postoperative inflammation to a greater extent than amoxicillin. PMID:26252749

  8. Numerical investigation into blood clotting at the bone-dental implant interface in the presence of an electrical stimulus.

    PubMed

    Vanegas-Acosta, J C; Garzón-Alvarado, D A; Lancellotti, V

    2013-12-01

    The insertion of a dental implant activates a sequence of wound healing events ending with bone formation and implant osseointegration. This sequence starts with the blood coagulation process and the formation of a fibrin network that detains spilt blood. Fibrin formation can be simplified as the kinetic reaction between thrombin and fibrinogen preceding the conversion of fibrinogen into fibrin. Based on experimental observations of the electrical properties of these molecules, we present a hypothesis for the mechanism of a static electrical stimulus in controlling the formation of the blood clot. Specifically, the electrical stimulus increases the fibrin network formation in such a way that a preferential region of higher fibrin density is obtained. This hypothesis is validated by means of a numerical model for the blood clot formation at the bone-dental implant interface. Numerical results compare favorably to experimental observations for blood clotting with and without the static electrical stimulus. It is concluded that the density of the fibrin network depends on the strength of the static electrical stimulus, and that the blood clot formation has a preferential direction of formation in the presence of the electrical signal.

  9. Modulation of human dermal microvascular endothelial cell and human gingival fibroblast behavior by micropatterned silica coating surfaces for zirconia dental implant applications.

    PubMed

    Laranjeira, Marta S; Carvalho, Ângela; Pelaez-Vargas, Alejandro; Hansford, Derek; Ferraz, Maria Pia; Coimbra, Susana; Costa, Elísio; Santos-Silva, Alice; Fernandes, Maria Helena; Monteiro, Fernando Jorge

    2014-04-01

    Dental ceramic implants have shown superior esthetic behavior and the absence of induced allergic disorders when compared to titanium implants. Zirconia may become a potential candidate to be used as an alternative to titanium dental implants if surface modifications are introduced. In this work, bioactive micropatterned silica coatings were produced on zirconia substrates, using a combined methodology of sol-gel processing and soft lithography. The aim of the work was to compare the in vitro behavior of human gingival fibroblasts (HGFs) and human dermal microvascular endothelial cells (HDMECs) on three types of silica-coated zirconia surfaces: flat and micropatterned (with pillars and with parallel grooves). Our results showed that cells had a higher metabolic activity (HGF, HDMEC) and increased gene expression levels of fibroblast-specific protein-1 (FSP-1) and collagen type I (COL I) on surfaces with pillars. Nevertheless, parallel grooved surfaces were able to guide cell growth. Even capillary tube-like networks of HDMEC were oriented according to the surface geometry. Zirconia and silica with different topographies have shown to be blood compatible and silica coating reduced bacteria adhesion. All together, the results indicated that microstructured bioactive coating seems to be an efficient strategy to improve soft tissue integration on zirconia implants, protecting implants from peri-implant inflammation and improving long-term implant stabilization. This new approach of micropatterned silica coating on zirconia substrates can generate promising novel dental implants, with surfaces that provide physical cues to guide cells and enhance their behavior.

  10. Modulation of human dermal microvascular endothelial cell and human gingival fibroblast behavior by micropatterned silica coating surfaces for zirconia dental implant applications

    PubMed Central

    Laranjeira, Marta S; Carvalho, Ângela; Pelaez-Vargas, Alejandro; Hansford, Derek; Ferraz, Maria Pia; Coimbra, Susana; Costa, Elísio; Santos-Silva, Alice; Fernandes, Maria Helena; Monteiro, Fernando Jorge

    2014-01-01

    Dental ceramic implants have shown superior esthetic behavior and the absence of induced allergic disorders when compared to titanium implants. Zirconia may become a potential candidate to be used as an alternative to titanium dental implants if surface modifications are introduced. In this work, bioactive micropatterned silica coatings were produced on zirconia substrates, using a combined methodology of sol–gel processing and soft lithography. The aim of the work was to compare the in vitro behavior of human gingival fibroblasts (HGFs) and human dermal microvascular endothelial cells (HDMECs) on three types of silica-coated zirconia surfaces: flat and micropatterned (with pillars and with parallel grooves). Our results showed that cells had a higher metabolic activity (HGF, HDMEC) and increased gene expression levels of fibroblast-specific protein-1 (FSP-1) and collagen type I (COL I) on surfaces with pillars. Nevertheless, parallel grooved surfaces were able to guide cell growth. Even capillary tube-like networks of HDMEC were oriented according to the surface geometry. Zirconia and silica with different topographies have shown to be blood compatible and silica coating reduced bacteria adhesion. All together, the results indicated that microstructured bioactive coating seems to be an efficient strategy to improve soft tissue integration on zirconia implants, protecting implants from peri-implant inflammation and improving long-term implant stabilization. This new approach of micropatterned silica coating on zirconia substrates can generate promising novel dental implants, with surfaces that provide physical cues to guide cells and enhance their behavior. PMID:27877662

  11. Modulation of human dermal microvascular endothelial cell and human gingival fibroblast behavior by micropatterned silica coating surfaces for zirconia dental implant applications

    NASA Astrophysics Data System (ADS)

    Laranjeira, Marta S.; Carvalho, Ângela; Pelaez-Vargas, Alejandro; Hansford, Derek; Ferraz, Maria Pia; Coimbra, Susana; Costa, Elísio; Santos-Silva, Alice; Fernandes, Maria Helena; Monteiro, Fernando Jorge

    2014-04-01

    Dental ceramic implants have shown superior esthetic behavior and the absence of induced allergic disorders when compared to titanium implants. Zirconia may become a potential candidate to be used as an alternative to titanium dental implants if surface modifications are introduced. In this work, bioactive micropatterned silica coatings were produced on zirconia substrates, using a combined methodology of sol-gel processing and soft lithography. The aim of the work was to compare the in vitro behavior of human gingival fibroblasts (HGFs) and human dermal microvascular endothelial cells (HDMECs) on three types of silica-coated zirconia surfaces: flat and micropatterned (with pillars and with parallel grooves). Our results showed that cells had a higher metabolic activity (HGF, HDMEC) and increased gene expression levels of fibroblast-specific protein-1 (FSP-1) and collagen type I (COL I) on surfaces with pillars. Nevertheless, parallel grooved surfaces were able to guide cell growth. Even capillary tube-like networks of HDMEC were oriented according to the surface geometry. Zirconia and silica with different topographies have shown to be blood compatible and silica coating reduced bacteria adhesion. All together, the results indicated that microstructured bioactive coating seems to be an efficient strategy to improve soft tissue integration on zirconia implants, protecting implants from peri-implant inflammation and improving long-term implant stabilization. This new approach of micropatterned silica coating on zirconia substrates can generate promising novel dental implants, with surfaces that provide physical cues to guide cells and enhance their behavior.

  12. High-density dental implants and radiotherapy planning: evaluation of effects on dose distribution using pencil beam convolution algorithm and Monte Carlo method.

    PubMed

    Çatli, Serap

    2015-09-01

    High atomic number and density of dental implants leads to major problems at providing an accurate dose distribution in radiotherapy and contouring tumors and organs caused by the artifact in head and neck tumors. The limits and deficiencies of the algorithms using in the treatment planning systems can lead to large errors in dose calculation, and this may adversely affect the patient's treatment. In the present study, four commercial dental implants were used: pure titanium, titanium alloy (Ti-6Al-4V), amalgam, and crown. The effects of dental implants on dose distribution are determined with two methods: pencil beam convolution (PBC) algorithm and Monte Carlo code for 6 MV photon beam. The central axis depth doses were calculated on the phantom for a source-skin distance (SSD) of 100 cm and a 10×10 cm2 field using both of algorithms. The results of Monte Carlo method and Eclipse TPS were compared to each other and to those previously reported. In the present study, dose increases in tissue at a distance of 2 mm in front of the dental implants were seen due to the backscatter of electrons for dental implants at 6 MV using the Monte Carlo method. The Eclipse treatment planning system (TPS) couldn't precisely account for the backscatter radiation caused by the dental prostheses. TPS underestimated the back scatter dose and overestimated the dose after the dental implants. The large errors found for TPS in this study are due to the limits and deficiencies of the algorithms. The accuracy of the PBC algorithm of Eclipse TPS was evaluated in comparison to Monte Carlo calculations in consideration of the recommendations of the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 65. From the comparisons of the TPS and Monte Carlo calculations, it is verified that the Monte Carlo simulation is a good approach to derive the dose distribution in heterogeneous media. PACS numbers: 87.55.K.

  13. High-density dental implants and radiotherapy planning: evaluation of effects on dose distribution using pencil beam convolution algorithm and Monte Carlo method.

    PubMed

    Çatli, Serap

    2015-09-08

    High atomic number and density of dental implants leads to major problems at providing an accurate dose distribution in radiotherapy and contouring tumors and organs caused by the artifact in head and neck tumors. The limits and deficiencies of the algorithms using in the treatment planning systems can lead to large errors in dose calculation, and this may adversely affect the patient's treatment. In the present study, four commercial dental implants were used: pure titanium, titanium alloy (Ti-6Al-4V), amalgam, and crown. The effects of dental implants on dose distribution are determined with two methods: pencil beam convolution (PBC) algorithm and Monte Carlo code for 6 MV photon beam. The central axis depth doses were calculated on the phantom for a source-skin distance (SSD) of 100 cm and a 10 × 10 cm2 field using both of algorithms. The results of Monte Carlo method and Eclipse TPS were compared to each other and to those previously reported. In the present study, dose increases in tissue at a distance of 2 mm in front of the dental implants were seen due to the backscatter of electrons for dental implants at 6 MV using the Monte Carlo method. The Eclipse treatment planning system (TPS) couldn't precisely account for the backscatter radiation caused by the dental prostheses. TPS underestimated the back scatter dose and overestimated the dose after the dental implants. The large errors found for TPS in this study are due to the limits and deficiencies of the algorithms. The accuracy of the PBC algorithm of Eclipse TPS was evaluated in comparison to Monte Carlo calculations in consideration of the recommendations of the American Association of Physicists in Medicine Radiation Therapy Committee Task Group 65. From the comparisons of the TPS and Monte Carlo calculations, it is verified that the Monte Carlo simulation is a good approach to derive the dose distribution in heterogeneous media.

  14. Macrophage proinflammatory response to the titanium alloy equipment in dental implantation.

    PubMed

    Chen, X; Li, H S; Yin, Y; Feng, Y; Tan, X W

    2015-08-07

    Titanium alloy and stainless steel (SS) had been widely used as dental implant materials because of their affinity with epithelial tissue and connective tissue, and good physical, chemical, biological, mechanical properties and processability. We compared the effects of titanium alloy and SS on macrophage cytokine expression as well as their biocompatibility. Mouse macrophage RAW264.7 cells were cultured on titanium alloy and SS surfaces. Cells were counted by scanning electron microscopy. A nitride oxide kit was used to detect released nitric oxide by macrophages on the different materials. An enzyme linked immunosorbent assay was used to detect monocyte chemoattractant protein-1 levels. Scanning electron microscopy revealed fewer macrophages on the surface of titanium alloy (48.2 ± 6.4 x 10(3) cells/cm(2)) than on SS (135 ± 7.3 x 10(3) cells/cm(2)). The nitric oxide content stimulated by titanium alloy was 22.5 mM, which was lower than that stimulated by SS (26.8 mM), but the difference was not statistically significant (P = 0.07). The level of monocyte chemoattractant protein-1 released was significantly higher in the SS group (OD value = 0.128) than in the titanium alloy group (OD value = 0.081) (P = 0.024). The transforming growth factor-b1 mRNA expression levels in macrophages after stimulation by titanium alloy for 12 and 36 h were significantly higher than that after stimulation by SS (P = 0.31 and 0.25, respectively). Macrophages participate in the inflammatory response by regulating cytokines such as nitric oxide, monocyte chemoattractant protein-1, and transforming growth factor-b1. There were fewer macrophages and lower inflammation on the titanium alloy surface than on the SS surface. Titanium alloy materials exhibited better biological compatibility than did SS.

  15. Biomechanical investigations of the secondary stability of commercial short dental implants in porcine ribs.

    PubMed

    Wilhelm, Rebecca; Hasan, Istabrak; Keilig, Ludger; Heinemann, Friedhelm; Stark, Helmut; Bourauel, Christoph

    2014-12-01

    The use of short implants has increased widely within the last years. However, the stability of these implants has not yet been comprehensively investigated, in particular the difference in geometry and dimension of short implants. The aim of the present study was to investigate experimentally the difference of the secondary stability of different commercial short implants by measuring their displacements. Eleven implant geometries were investigated in this study. A total of 22 implants were inserted in porcine rib segments, two implants for each system. Implant displacements were measured using a self-developed biomechanical hexapod measurement system (HexMeS). The highest displacement was observed with Straumann BL NC 3.3×8.0 mm (266 μm), followed by Straumann Standard 4.1×6.0 mm (156 μm), while the lowest displacement of 61 μm was shown by Dentaurum type 1 implant (4.2×5.0 mm). No obvious difference of displacements was observed between hammered and screw-shaped implants with relevant dimensions. The experimental results were in good agreement with the numerical ones (19-42%) for Dentaurum implants. However, a difference of 70-80% was obtained for the Astra implant (4.0×6.0 mm) and Bicon implant (6.0×5.7 mm). The geometry of short implants directly affects their stability within the bone.

  16. Micro-arc oxidation as a tool to develop multifunctional calcium-rich surfaces for dental implant applications.

    PubMed

    Ribeiro, A R; Oliveira, F; Boldrini, L C; Leite, P E; Falagan-Lotsch, P; Linhares, A B R; Zambuzzi, W F; Fragneaud, B; Campos, A P C; Gouvêa, C P; Archanjo, B S; Achete, C A; Marcantonio, E; Rocha, L A; Granjeiro, J M

    2015-09-01

    Titanium (Ti) is commonly used in dental implant applications. Surface modification strategies are being followed in last years in order to build Ti oxide-based surfaces that can fulfill, simultaneously, the following requirements: induced cell attachment and adhesion, while providing a superior corrosion and tribocorrosion performance. In this work micro-arc oxidation (MAO) was used as a tool for the growth of a nanostructured bioactive titanium oxide layer aimed to enhance cell attachment and adhesion for dental implant applications. Characterization of the surfaces was performed, in terms of morphology, topography, chemical composition and crystalline structure. Primary human osteoblast adhesion on the developed surfaces was investigated in detail by electronic and atomic force microscopy as well as immunocytochemistry. Also an investigation on the early cytokine production was performed. Results show that a relatively thick hybrid and graded oxide layer was produced on the Ti surface, being constituted by a mixture of anatase, rutile and amorphous phases where calcium (Ca) and phosphorous (P) were incorporated. An outermost nanometric-thick amorphous oxide layer rich in Ca was present in the film. This amorphous layer, rich in Ca, improved fibroblast viability and metabolic activity as well as osteoblast adhesion. High-resolution techniques allowed to understand that osteoblasts adhered less in the crystalline-rich regions while they preferentially adhere and spread over in the Ca-rich amorphous oxide layer. Also, these surfaces induce higher amounts of IFN-γ cytokine secretion, which is known to regulate inflammatory responses, bone microarchitecture as well as cytoskeleton reorganization and cellular spreading. These surfaces are promising in the context of dental implants, since they might lead to faster osseointegration.

  17. Association between tumor necrosis factor-alpha G-308A polymorphism and dental peri-implant disease risk

    PubMed Central

    Mo, Yuan-Yuan; Zeng, Xian-Tao; Weng, Hong; Cen, Ying; Zhao, Qian; Wen, Xiujie

    2016-01-01

    Abstract Background: Tumor necrosis factor-alpha (TNF-α) is a potent immune-inflammatory mediator involved in the regulation of bone resorption. The single nucleotide polymorphism G-308A in the TNF-α gene increases the level of this cytokine. This phenomenon is also related to several diseases. Although the association between TNF-α (G-308A) polymorphism and dental peri-implant disease has been investigated, results have remained controversial. Hence, we performed this meta-analysis to provide a comprehensive and systematic conclusion on this topic. Methods: We performed a systematic literature search in PubMed, Embase, ISI Web of Science, Cochrane Library, and Chinese National Knowledge Infrastructure until July 2015. A fixed-effect model was established to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). The calculated values were then used to assess the strength of the association between the TNF-α (G-308A) polymorphism and the dental peri-implant disease risk. The heterogeneity between included studies was evaluated with Cochran Q and I2 statistics. Interstudy publication bias was investigated with a funnel plot. Results: Six eligible studies were included in this meta-analysis. The pooled ORs did not reveal a significant relationship between the TNF-α (G-308A) polymorphism and the disease susceptibility. Subgroup analyses in terms of ethnicity and disease type yielded similar results. Conclusion: Our meta-analysis revealed that TNF-α (G-308A) polymorphism was not significantly associated with the risk of dental peri-implant disease. However, further studies with large sample sizes should be performed to verify these results. PMID:27583850

  18. Radiation absorbed from dental implant radiography: a comparison of linear tomography, CT scan, and panoramic and intra-oral techniques

    SciTech Connect

    Clark, D.E.; Danforth, R.A.; Barnes, R.W.; Burtch, M.L. )

    1990-01-01

    Absorbed radiation dose in bone marrow, thyroid, salivary gland, eye, and skin entrance was determined by placement of lithium fluoride thermoluminescent dosimeters (TLD's) at selected anatomical sites within and on a human-like x-ray phantom. The phantom was exposed to radiation from linear tomographic and computer-assisted tomographic (CT) simulated dental implant radiographic examinations. The mean dose was determined for each anatomical site. Resulting dose measurements from linear tomography and computer-assisted tomography are compared with reported panoramic and intra-oral doses. CT examination delivered the greatest dose, while linear tomography was generally lowest. Panoramic and intra-oral doses were similar to those of linear tomography.

  19. [Occlusal evaluation and design of dental implant therapy in defect dentition].

    PubMed

    Li, Y

    2016-04-09

    Implant prosthesis of dentition defect is characteristic of remaining teeth and implants exist at the same time, so the remaining teeth occlusal conditions related to the final occlusal design is to maintain, adjust or re-establish the original dentition occlusion. Therefore, full evaluation of remaining teeth occlusion before restoration, clear prognosis, balancing the occlusal force distribution of natural teeth and implants, and carrying out the predictable occlusal design in the entire process of implant prosthesis can minimize the adverse events after implant prosthesis. Based on the typical cases in this paper, three occlusal design types of occlusal maintain-implant restoration, occlusal adjustment-implant restoration and occlusal reconstruction-implant restoration will be expounded respectively.

  20. In vitro and in vivo studies of ultrafine-grain Ti as dental implant material processed by ECAP.

    PubMed

    An, Baili; Li, Zhirui; Diao, Xiaoou; Xin, Haitao; Zhang, Qiang; Jia, Xiaorui; Wu, Yulu; Li, Kai; Guo, Yazhou

    2016-10-01

    The aim of this study was to investigate the surface characterization of ultrafine-grain pure titanium (UFG-Ti) after sandblasting and acid-etching (SLA) and to evaluate its biocompatibility as dental implant material in vitro and in vivo. UFG-Ti was produced by equal channel angular pressing (ECAP) using commercially pure titanium (CP-Ti). Microstructure and yield strength were investigated. The morphology, wettability and roughness of the specimens were analyzed after they were modified by SLA. MC3T3-E1 osteoblasts were seeded onto the specimens to evaluate its biocompatibility in vitro. For the in vivo study, UFG-Ti implants after SLA were embedded into the femurs of New Zealand rabbits. Osseointegration was investigated though micro-CT analysis, histological assessment and pull-out test. The control group was CP-Ti. UFG-Ti with enhanced mechanical properties was produced by four passes of ECAP in BC route at room temperature. After SLA modification, the hierarchical porous structure on its surface exhibited excellent wettability. The adhesion, proliferation and viability of cells cultured on the UFG-Ti were superior to that of CP-Ti. In the in vivo study, favorable osseointegration occurred between the implant and bone in CP and UFG-Ti groups. The combination intensity of UF- Ti with bone was higher according to the pull-out test. This study supports the claim that UFG-Ti has grain refinement with outstanding mechanical properties and, with its excellent biocompatibility, has potential for use as dental implant material.

  1. Evaluation of the peri-implant bone around parallel-walled dental implants with a condensing thread macrodesign and a self-tapping apex: a 10-year retrospective histological analysis.

    PubMed

    Degidi, Marco; Perrotti, Vittoria; Shibli, Jamil A; Mortellaro, Carmen; Piattelli, Adriano; Iezzi, Giovanna

    2014-05-01

    The long-term high percentages of survival and success of dental implants reported in the literature are related mainly to new, innovative implant and thread designs, and new implant surfaces that allow to obtain very good primary and secondary stability in most anatomical and clinical situations, even in low quality and quantity of bone, promoting a more rapid osseointegration. The aim of this retrospective study was a histological and histomorphometrical evaluation of the bone response around implants with a parallel-wall configuration, condensing thread macrodesign, and self-tapping apex, retrieved from man for different causes. A total of 10 implants were reported in the present study, and these implants had been retrieved after a loading period comprised between a few weeks to about 8 years. Mineralized newly formed bone was found at the interface of all the implants, in direct contact with the implant surface, with no gaps or connective fibrous tissue. This bone adapted very well to the microirregularities of the implant surface. Areas of bone remodeling were present in some regions of the interface, with many reversal lines. High bone-implant contact percentages were found. In conclusion, both the macrostructure and the microstructure of this specific type of implant could be very helpful in the long-term high survival and success implant percentages.

  2. Laser beam melting 3D printing of Ti6Al4V based porous structured dental implants: fabrication, biocompatibility analysis and photoelastic study.

    PubMed

    Yang, Fei; Chen, Chen; Zhou, QianRong; Gong, YiMing; Li, RuiXue; Li, ChiChi; Klämpfl, Florian; Freund, Sebastian; Wu, XingWen; Sun, Yang; Li, Xiang; Schmidt, Michael; Ma, Duan; Yu, YouCheng

    2017-03-28

    Fabricating Ti alloy based dental implants with defined porous scaffold structure is a promising strategy for improving the osteoinduction of implants. In this study, we use Laser Beam Melting (LBM) 3D printing technique to fabricate porous Ti6Al4V dental implant prototypes with three controlled pore sizes (200, 350 and 500 μm). The mechanical stress distribution in the surrounding bone tissue is characterized by photoelastography and associated finite element simulation. For in-vitro studies, experiments on implants' biocompatibility and osteogenic capability are conducted to evaluate the cellular response correlated to the porous structure. As the preliminary results, porous structured implants show a lower stress-shielding to the surrounding bone at the implant neck and a more densed distribution at the bottom site compared to the reference implant. From the cell proliferation tests and the immunofluorescence images, 350 and 500 μm pore sized implants demonstrate a better biocompatibility in terms of cell growth, migration and adhesion. Osteogenic genes expression of the 350 μm group is significantly increased alone with the ALP activity test. All these suggest that a pore size of 350 μm provides an optimal provides an optimal potential for improving the mechanical shielding to the surrounding bones and osteoinduction of the implant itself.

  3. Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part I: a Systematic Review of Surgical Techniques

    PubMed Central

    Juodzbalys, Gintaras

    2015-01-01

    ABSTRACT Objectives The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical techniques of the lateralization and transposition of the inferior alveolar nerve, followed by the placement of an implant in an edentulous atrophic posterior mandible. Material and Methods A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC database, academic sites and books. The articles were searched from January 1997 to July 2014 and comprised English-language articles that included adult patients between 18 and 80 years old with minimal residual bone above the mandibular canal who had undergone inferior alveolar nerve (IAN) repositioning with a minimum 6 months of follow-up. Results A total of 16 studies were included in this review. Nine were related to IAN transposition, 4 to IAN lateralization and 3 to both transposition and lateralization. Implant treatment results and complications were presented. Conclusions Inferior alveolar nerve lateralization and transposition in combination with the installation of dental implants is sometimes the only possible procedure to help patients to obtain a fixed prosthesis, in edentulous atrophic posterior mandibles. With careful pre-operative surgical and prosthetic planning, imaging, and extremely precise surgical technique, this procedure can be successfully used for implant placement in edentulous posterior mandibular segments. PMID:25937873

  4. Experimental and computational investigation of Morse taper conometric system reliability for the definition of fixed connections between dental implants and prostheses.

    PubMed

    Bressan, Eriberto; Lops, Diego; Tomasi, Cristiano; Ricci, Sara; Stocchero, Michele; Carniel, Emanuele Luigi

    2014-07-01

    Nowadays, dental implantology is a reliable technique for treatment of partially and completely edentulous patients. The achievement of stable dentition is ensured by implant-supported fixed dental prostheses. Morse taper conometric system may provide fixed retention between implants and dental prostheses. The aim of this study was to investigate retentive performance and mechanical strength of a Morse taper conometric system used as implant-supported fixed dental prostheses retention. Experimental and finite element investigations were performed. Experimental tests were achieved on a specific abutment-coping system, accounting for both cemented and non-cemented situations. The results from the experimental activities were processed to identify the mechanical behavior of the coping-abutment interface. Finally, the achieved information was applied to develop reliable finite element models of different abutment-coping systems. The analyses were developed accounting for different geometrical conformations of the abutment-coping system, such as different taper angle. The results showed that activation process, occurred through a suitable insertion force, could provide retentive performances equal to a cemented system without compromising the mechanical functionality of the system. These findings suggest that Morse taper conometrical system can provide a fixed connection between implants and dental prostheses if proper insertion force is applied. Activation process does not compromise the mechanical functionality of the system.

  5. Biomechanics and strain mapping in bone as related to immediately-loaded dental implants

    PubMed Central

    Du, Jing; Lee, Jihyun; Jang, Andrew; Gu, Allen; Hossaini-Zadeh, Mehran; Prevost, Richard; Curtis, Don; Ho, Sunita

    2015-01-01

    The effects of alveolar bone socket geometry and bone-implant contact on implant biomechanics, and resulting strain distributions in bone were investigated. Following extraction of lateral incisors on a cadaver mandible, immediate implants were placed and bone-implant contact area, stability and bone strain were measured. In situ biomechanical testing coupled with micro X-ray microscope (μ-XRM) illustrated less stiff bone-implant complexes (701-822 N/mm) compared with bone-periodontal ligament (PDL)-tooth complexes (791-913 N/mm). X-ray tomograms illustrated that the cause of reduced stiffness was due to reduced and limited bone-implant contact. Heterogeneous elemental composition of bone was identified by using energy dispersive X-ray spectroscopy (EDS). The novel aspect of this study was the application of a new experimental mechanics method, that is, digital volume correlation, which allowed mapping of strains in volumes of alveolar bone in contact with a loaded implant. The identified surface and subsurface strain concentrations were a manifestation of load transferred to bone through bone-implant contact based on bone-implant geometry, quality of bone, implant placement, and implant design. 3D strain mapping indicated that strain concentrations are not exclusive to the bone-implant contact regions, but also extend into bone not directly in contact with the implant. The implications of the observed strain concentrations are discussed in the context of mechanobiology. Although a plausible explanation of surgical complications for immediate implant treatment is provided, extrapolation of results is only warranted by future systematic studies on more cadaver specimens and/or in vivo small scale animal models. PMID:26162549

  6. State anxiety and depression as factors modulating and influencing postoperative pain in dental implant surgery. A prospective clinical survey

    PubMed Central

    Gómez-de Diego, Rafael; Cutando-Soriano, Antonio; Montero-Martín, Javier; Prados-Frutos, Juan C.

    2014-01-01

    Objetives: To determine whether preoperative state anxiety and depression modulate or influence objective and subjective postoperative pain following dental implant insertion. Study Design: Prospective, clinical study with 7-day follow-up of a sample of 105 subjects who preoperatively completed the state anxiety questionnaire (STAI-E) and Beck Depression Inventory (BDI) and postoperatively, at 2 and 7 days, recorded objective pain with the Semmes-Weinstein mechanical esthesiometer (SW test) and subjective pain with the Visual Analog Scale (VAS). Results: 85.6% and 81.5% of patients, respectively, recorded no signs of state anxiety or depression. The correlation between anxiety and depression for both maxillary bones was the lower (P=0.02). The correlation between subjective and objective pain at 2 and 7 days, and the anatomic regions intervened, was statistically significant in the mandible at day 7 (P<0.01), and highly significant (P<0.001) for the other variables. The correlation between state anxiety and objective pain at day 7 was nearly statistically significant (P=0.07). Conclusions: The correlation between state anxiety and depression, and objective and subjective pain at day 7 was not statistically significant. A strong correlation was found between objective and subjective pain in the immediate postoperative period. Key words:Anxiety, depression, postoperative pain, dental implants. PMID:24880447

  7. Dental Implants Fatigue as a Possible Failure of Implantologic Treatment: The Importance of Randomness in Fatigue Behaviour

    PubMed Central

    Prados-Privado, María; Prados-Frutos, Juan Carlos; Manchón, Ángel; Rojo, Rosa; Felice, Pietro; Bea, José Antonio

    2015-01-01

    Objective. To show how random variables concern fatigue behaviour by a probabilistic finite element method. Methods. Uncertainties on material properties due to the existence of defects that cause material elastic constant are not the same in the whole dental implant the dimensions of the structural element and load history have a decisive influence on the fatigue process and therefore on the life of a dental implant. In order to measure these uncertainties, we used a method based on Markoff chains, Bogdanoff and Kozin cumulative damage model, and probabilistic finite elements method. Results. The results have been obtained by conventional and probabilistic methods. Mathematical models obtained the same result regarding fatigue life; however, the probabilistic model obtained a greater mean life but with more information because of the cumulative probability function. Conclusions. The present paper introduces an improved procedure to study fatigue behaviour in order to know statistics of the fatigue life (mean and variance) and its probability of failure (fatigue life versus probability of failure). PMID:26583137

  8. Corrosion behavior of novel Ti-24Nb-4Zr-7.9Sn alloy for dental implant applications in vitro.

    PubMed

    Cheng, Yicheng; Hu, Jiang; Zhang, Chunbao; Wang, Zhongyi; Hao, Yulin; Gao, Bo

    2013-02-01

    Ti-24Nb-4Zr-7.9Sn (TNZS) alloy is a newly developed β-titanium alloy considered suitable for dental implant applications due to its low elastic modulus and high strength. The aim of this study was to investigate the corrosion behavior of TNZS alloy through a static immersion test in various simulated physiological solutions, namely, artificial saliva, lactic acid solution, fluoridated saliva, and fluoridated acidified saliva for 7 days. The corrosion behavior of commercially pure titanium and Ti-6Al-4V alloy were also examined for comparison. The elemental release was measured with inductively coupled plasma mass spectroscopy, and the changes of alloy surface were observed with scanning electron microscopy (SEM). The test results showed that the quantity of each metal element released from TNZS alloy into fluoridated solutions was much higher than the solutions without fluoride ions. It was highest in fluoridated acidified saliva and lowest in artificial saliva (p < 0.01). The total elemental release from TNZS alloy was lower than commercially pure titanium and Ti-6Al-4V alloy in the same solution (p < 0.01). SEM micrographs indicated that TNZS alloy possessed better corrosion resistant performance. It can be concluded that fluoridated solutions have a negative influence on the corrosion behavior of TNZS alloy. Compared with commercially pure titanium and Ti-6Al-4V alloy, TNZS alloy demonstrates better corrosion resistance in various simulated physiological solutions, so it has greater potential for dental implant applications.

  9. Bone response to dental implants after a 3- to 10-year loading period: a histologic and histomorphometric report of four cases.

    PubMed

    Iezzi, Giovanna; Degidi, Marco; Shibli, Jamil A; Vantaggiato, Giovanni; Piattelli, Adriano; Perrotti, Vittoria

    2013-01-01

    The aim of this study was to histologically and histomorphometrically analyze the peri-implant tissue reactions and the bone-titanium interface in loaded Ankylos implants retrieved after loading periods of longer than 1 year. The archives of the Implant Retrieval Center of the Dental School of the University of Chieti- Pescara were searched for Ankylos implants retrieved from humans after a loading period of longer than 1 year. A total of four implants were found: one had been retrieved after 3 years (Friadent plus surface), two after 3.5 years (Friadent plus surface), and one after 10 years (Deep Profile surface). All implants had been loaded; two had been loaded immediately. One implant was retrieved after fracture, one was retrieved after fracture of the superstructure, and the other two were retrieved because of bone resorption with or without infection. Compact bone with few small marrow spaces was present around the three implants retrieved after 3 and 3.5 years; trabecular bone was present around the implant retrieved after 10 years. The bone-implant contact of the three best threads was 35% for the implant retrieved after 10 years, 99% for the implant retrieved after 3 years, and 100% for the implants retrieved after 3.5 years. No untoward effects were present at the interface, and a high bone-implant contact was present around the implants with the microstructured surface. The data show that these implants had the potential to maintain osseointegration under long-term function with continuous and ongoing bone remodeling.

  10. Laser beam melting 3D printing of Ti6Al4V based porous structured dental implants: fabrication, biocompatibility analysis and photoelastic study

    PubMed Central

    Yang, Fei; Chen, Chen; Zhou, QianRong; Gong, YiMing; Li, RuiXue; Li, ChiChi; Klämpfl, Florian; Freund, Sebastian; Wu, XingWen; Sun, Yang; Li, Xiang; Schmidt, Michael; Ma, Duan; Yu, YouCheng

    2017-01-01

    Fabricating Ti alloy based dental implants with defined porous scaffold structure is a promising strategy for improving the osteoinduction of implants. In this study, we use Laser Beam Melting (LBM) 3D printing technique to fabricate porous Ti6Al4V dental implant prototypes with three controlled pore sizes (200, 350 and 500 μm). The mechanical stress distribution in the surrounding bone tissue is characterized by photoelastography and associated finite element simulation. For in-vitro studies, experiments on implants’ biocompatibility and osteogenic capability are conducted to evaluate the cellular response correlated to the porous structure. As the preliminary results, porous structured implants show a lower stress-shielding to the surrounding bone at the implant neck and a more densed distribution at the bottom site compared to the reference implant. From the cell proliferation tests and the immunofluorescence images, 350 and 500 μm pore sized implants demonstrate a better biocompatibility in terms of cell growth, migration and adhesion. Osteogenic genes expression of the 350 μm group is significantly increased alone with the ALP activity test. All these suggest that a pore size of 350 μm provides an optimal provides an optimal potential for improving the mechanical shielding to the surrounding bones and osteoinduction of the implant itself. PMID:28350007

  11. Long-term outcome of dental implants after maxillary augmentation with and without bone grafting

    PubMed Central

    Machuca-Ariza, Jesús; Ruiz-Martos, Alberto; Ramos-Robles, Mª-Carmen; Martínez-Lara, Ildefonso

    2016-01-01

    Background This study aims to evaluate the technique of sinus bone reformation, which consists of elevating the sinus membrane and placement the implant without bone graft, compared with the widely-used technique involving raising the maxillary sinus and grafting, using animal hydroxyapatite as the filler, while simultaneously fixing the implants. Material and Methods This is a retrospective study on two groups of patients who underwent elevation of the sinus membrane and simultaneous placement of the implant. The grafting technique was applied to one group, while the other had no graft. An alveolar ridge height of 4 to 7 mm was necessary. Radiological control was undertaken at 6 months and one year post-prosthetic loading. In each group 38 implants were placed. Results No significant behavioural differences were observed in the implants according to the Albrektsson success criteria. Implant failure was observed in 2 implants from the bone grafting group (success rate 93%) and in 1 implant from the reformation group (success rate 97%). In this group, bone formation was observed on both sides of each implant, the bone gain was measured using image management software (2.7±0.9mm mesial and 2.6±0.9mm distal). There was no correlation between mesial and distal bone gain and implant´s length. Conclusions The results indicate that bone reformation is a valid technique in cases involving atrophy of the posterior maxilla. Primary stability, maintenance of space by the implant, and the formation of a blood clot are crucial in this technique in order to achieve bone formation around the implant. It is an alternative to the conventional technique of sinus lift with filling material, and has several advantages over this procedure, including a lower infection risk, as it does not involve a biomaterial, reduced cost, a simpler technique, and better acceptance by the patient. Key words:Bone formation, sinus membrane elevation, maxillary sinus, bone grafting. PMID:26827071

  12. Measurement and image processing evaluation of surface modifications of dental implants G4 pure titanium created by different techniques

    NASA Astrophysics Data System (ADS)

    Bulutsuz, A. G.; Demircioglu, P.; Bogrekci, I.; Durakbasa, M. N.; Katiboglu, A. B.

    2015-03-01

    Foreign substances and organic tissue interaction placed into the jaw in order to eliminate tooth loss involves a highly complex process. Many biological reactions take place as well as the biomechanical forces that influence this formation. Osseointegration denotes to the direct structural and functional association between the living bone and the load-bearing artificial implant's surface. Taking into consideration of the requirements in the manufacturing processes of the implants, surface characterizations with high precise measurement techniques are investigated and thus long-term success of dental implant is emphasized on the importance of these processes in this study. In this research, the detailed surface characterization was performed to identify the dependence of the manufacturing techniques on the surface properties by using the image processing methods and using the scanning electron microscope (SEM) for morphological properties in 3D and Taylor Hobson stylus profilometer for roughness properties in 2D. Three implant surfaces fabricated by different manufacturing techniques were inspected, and a machined surface was included into the study as a reference specimen. The results indicated that different surface treatments were strongly influenced surface morphology. Thus 2D and 3D precise inspection techniques were highlighted on the importance for surface characterization. Different image analyses techniques such as Dark-light technique were used to verify the surface measurement results. The computational phase was performed using image processing toolbox in Matlab with precise evaluation of the roughness for the implant surfaces. The relationship between the number of black and white pixels and surface roughness is presented. FFT image processing and analyses results explicitly imply that the technique is useful in the determination of surface roughness. The results showed that the number of black pixels in the image increases with increase in surface

  13. Concentration- and time-dependent response of human gingival fibroblasts to fibroblast growth factor 2 immobilized on titanium dental implants

    PubMed Central

    Ma, Qianli; Wang, Wei; Chu, Paul K; Mei, Shenglin; Ji, Kun; Jin, Lei; Zhang, Yumei

    2012-01-01

    Background Titanium (Ti) implants are widely used clinically, but peri-implantitis remains one of the most common and serious complications. Healthy integration between gingival tissue and the implant surface is critical to long-term success in dental implant therapy. The objective of this study was to investigate how different concentrations of immobilized fibroblast growth factor 2 (FGF2) on the titania nanotubular surface influence the response of human gingival fibroblasts (HGFs). Methods Pure Ti metal was anodized at 20 V to form a vertically organized titanium dioxide nanotube array on which three concentrations of FGF2 (250 ng/mL, 500 ng/mL, or 1000 ng/mL) were immobilized by repeated lyophilization. Surface topography was observed and FGF2 elution was detected using enzyme-linked immunosorbent assay. The bioactivity changes of dissolvable immobilized FGF2 were measured by methyl-thiazolyl-tetrazolium assay. Behavior of HGFs was evaluated using adhesion and methyl-thiazolyl-tetrazolium bromide assays. Results The FGF2 remained for several days on the modified surface on which HGFs were cultured. Over 90% of the dissolvable immobilized FGF2 had been eluted by Day 9, whereas the FGF2 activity was found to diminish gradually from Day 1 to Day 9. The titania nanotubular surface with an optimal preparing concentration (500 ng/mL) of FGF2 immobilization exhibited improved HGF functions such as cellular attachment, proliferation, and extracellular matrix-related gene expression. Moreover, significant bidirectional as well as concentration- and time-dependent bioactivity was observed. Conclusion Synergism of the FGF2-impregnated titanium dioxide nanotubular surface revealed good gingival-implant integration, indicating that these materials might have promising applications in dentistry and other biomedical devices. PMID:22619534

  14. Measurement and image processing evaluation of surface modifications of dental implants G4 pure titanium created by different techniques

    SciTech Connect

    Bulutsuz, A. G.; Demircioglu, P. Bogrekci, I.; Durakbasa, M. N.

    2015-03-30

    Foreign substances and organic tissue interaction placed into the jaw in order to eliminate tooth loss involves a highly complex process. Many biological reactions take place as well as the biomechanical forces that influence this formation. Osseointegration denotes to the direct structural and functional association between the living bone and the load-bearing artificial implant's surface. Taking into consideration of the requirements in the manufacturing processes of the implants, surface characterizations with high precise measurement techniques are investigated and thus long-term success of dental implant is emphasized on the importance of these processes in this study. In this research, the detailed surface characterization was performed to identify the dependence of the manufacturing techniques on the surface properties by using the image processing methods and using the scanning electron microscope (SEM) for morphological properties in 3D and Taylor Hobson stylus profilometer for roughness properties in 2D. Three implant surfaces fabricated by different manufacturing techniques were inspected, and a machined surface was included into the study as a reference specimen. The results indicated that different surface treatments were strongly influenced surface morphology. Thus 2D and 3D precise inspection techniques were highlighted on the importance for surface characterization. Different image analyses techniques such as Dark-light technique were used to verify the surface measurement results. The computational phase was performed using image processing toolbox in Matlab with precise evaluation of the roughness for the implant surfaces. The relationship between the number of black and white pixels and surface roughness is presented. FFT image processing and analyses results explicitly imply that the technique is useful in the determination of surface roughness. The results showed that the number of black pixels in the image increases with increase in surface

  15. Influence of the ultimate torsion on the geometry of dental implants.

    PubMed

    Teixeira, Ana Beatriz V; Beja, Gabriela B S P; Shimano, Antônio Carlos; Macedo, Ana Paula; Oliscovicz, Nathalia Ferraz; Reis, Andréa C dos

    2013-01-01

    This study evaluated the profile of implants subjected to torsion test. Four types of implants (Conexão®) were analyzed: Master Porous (MP - external hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm), Master Screw (MS - external hexagon, cylindrical, machined implants; 11.5 X 3.75 mm), Conect Conic (CC - external hexagon, cylindrical, machined implants; 11.5 X 3.5 mm) and Master Conect AR (CA - internal hexagon, cylindrical, double-porous surface implants; 11.5 X 3.75 mm). The Nikon® model C profile projector was used for the analysis before and after torsion test with a Mackena® model MK-20XX digital torque meter. The measures analyzed in the profile of implants were: diameter and height of the platform, diameter of the screw/platform connection, angle of the screw/platform connection, external diameter, internal diameter, thread pitch, height and length of the thread. Statistical analysis was performed using ANOVA and Tukey test at 5% significance level. The torsion test caused a visible deformity on the external implant profile. There was a statistical difference among the implants before and after torsion (p<0.05) for the variables: platform diameter, platform height, diameter of the screw/platform connection and length. Changes were observed in platform height of CC and CA, fracture of CA implants, fracture of the MP and MS assembler/connectors, and internal thread stripping of CC. Thus, it was concluded that excessive or some unadvised torque by the manufacturer can lead to changes in different geometric measurements of implants.

  16. Beam hardening artifacts by dental implants: Comparison of cone-beam and 64-slice computed tomography scanners

    PubMed Central

    Esmaeili, Farzad; Johari, Masume; Haddadi, Pezhman

    2013-01-01

    Background: Cone beam computed tomography (CBCT) is an alternative to a computed tomography (CT) scan, which is appropriate for a wide range of craniomaxillofacial indications. The long-term use of metallic materials in dentistry means that artifacts caused by metallic restorations in the oral cavity should be taken into account when utilizing CBCT and CT scanners. The aim of this study was to quantitatively compare the beam hardening artifacts produced by dental implants between CBCT and a 64-Slice CT scanner. Materials and Methods: In this descriptive study, an implant drilling model similar to the human mandible was used in the present study. The implants (Dentis) were placed in the canine, premolar and molar areas. Three series of scans were provided from the implant areas using Somatom Sensation 64-slice and NewTom VGi (CBCT) CT scanners. Identical images were evaluated by three radiologists. The artifacts in each image were determined based on pre-determined criteria. Kruskal-Wallis test was used to compare mean values; Mann-Whitney U test was used for two-by-two comparisons when there was a statistical significance (P < 0.05). Results: The images of the two scanners had similar resolutions in axial sections (P = 0.299). In coronal sections, there were significant differences in the resolutions of the images produced by the two scanners (P < 0.001), with a higher resolution in the images produced by NewTom VGi scanner. On the whole, there were significant differences between the resolutions of the images produced by the two CT scanners (P < 0.001), with higher resolution in the images produced by NewTom VGi scanner in comparison to those of Somatom Sensation. Conclusion: Given the high quality of the images produced by NewTom VGi and the lower costs in comparison to CT, the use of the images of this scanner in dental procedures is recommended, especially in patients with extensive restorations, multiple prostheses and previous implants. PMID:24019808

  17. Effect of implant-supported prosthesis on the bite force and masticatory efficiency in subjects with shortened dental arches.

    PubMed

    Meena, A; Jain, V; Singh, N; Arora, N; Jha, R

    2014-02-01

    The aim of the study was to assess changes in bite force and masticatory efficiency in shortened dental arch (SDA) subjects rehabilitated with implant-supported restoration for 1st molar. Ten SDA subjects with bilaterally missing mandibular molars (experimental group) were recruited. In each subject, one tapered threaded implant was placed bilaterally in 1st mandibular molar region and restored. Masticatory efficiency was evaluated objectively by measuring the released dye from chewed raw carrots, with a 'spectrophotometer' at 530 nm preoperatively and at 3 months after restoration. Bite force was evaluated using 'bite force measuring appliance' preoperatively, at 6 weeks and at 3 months after restoration. Ten completely dentate-matched subjects (in terms of age, sex, height and weight) acted as control. The results revealed that as compared with the control group, the experimental group showed significantly less (P < 0.05) mean maximum bite force at pre-restoration and at 6 weeks after restoration. Although at 3 months the mean maximum bite force value was less than the control group but the mean difference was statistically insignificant. The mean difference of masticatory efficiency between control and experimental group was statistically significant (P < 0.05) before restoration, but was statistically insignificant at 3 months after restoration. Thus it was concluded that after the restoration of mandibular arch with implant-supported prosthesis, both bite force and masticatory efficiency of all SDA subjects increased and were comparable to that of matched completely dentate subjects after 3 months.

  18. Behavior of Dental/Implant Alloys in Commercial Mouthwash Solution Studied by Electrochemical Techniques

    NASA Astrophysics Data System (ADS)

    Mareci, Daniel; Strugaru, Sorin Iacob; Iacoban, Sorin; Bolat, Georgiana; Munteanu, Corneliu

    2013-03-01

    This study investigates the electrochemical behavior of the various dental materials: Paliag (Ag-Pd based), Wiron 99 (Ni-Cr based), Cp-Ti (commercial pure titanium), and experimental Ti12Mo5Ta alloy in commercial mouthwash solution with 500 ppm F- (Oral B®) and compares it with the behavior of the same dental materials in artificial saliva. Linear potentiodynamic polarization (LPP) and electrochemical impedance spectroscopy (EIS) are the electrochemical procedures of investigation. The passivation of all dental samples in artificial saliva and mouthwash solution occurred spontaneously at open circuit potential. The corrosion current density of all tested dental materials in mouthwash solution were low (1-2 μA/cm2). The results suggest a non-predominant fluoride effect on the passive layer formed on all samples at open circuit potential. No passivation could be established with Paliag alloy when polarized in mouthwash solution. The EIS results confirm that all dental sample exhibit passivity in mouthwash solution at open circuit potential (polarization resistance was around 5 × 105 Ω cm2). For Paliag alloy after LPP in mouthwash solution the protectiveness passive layer was no more present. The corrosion resistances of four dental materials in mouthwash solution are in the following order: Ti12Mo5Ta > Cp-Ti > Wiron 99 > Paliag.

  19. A Novel Scheme and Evaluations on a Long-Term and Continuous Biosensor Platform Integrated with a Dental Implant Fixture and Its Prosthetic Abutment

    PubMed Central

    Li, Yu-Jung; Lu, Chih-Cheng

    2015-01-01

    A miniature intra-oral dental implant system including a built-in biosensor device is proposed in this article. The dental implant system, or platform, is replaced over maxilla and allows relatively non-invasive procedures for a novel biosensing scheme for human blood analysis. Due to placement of the implant fixture, periodontal ligaments and the pulp structure, which are regarded as the main origin of pain, are thus removed, and long-term, continuous blood analysis and management through maxillary bone marrow becomes achievable through the dental implant platform. The new pathway of biological sensing is for the first time presented to realize an accurate and painless approach without injections. The dental implant system mainly consists of an implant fixture and a prosthetic abutment, a biosensor module, a bluetooth 4.0 wireless module and a dc button cell battery. The electrochemical biosensor possesses three electrodes, including working, reference and counter ones, which are arranged to pass through the titanium implant fixture below the biosensor module. The electrodes are exposed to the blood pool inside the maxillary bone marrow and perform oxidation/reduction reactions with the coating of biosensing enzyme. To prove the proposed platform, the immobilization process of glucose oxidase (GOD) enzyme and in vitro detections of glucose levels are successfully carried out, and proven sensitivity, linearity and repeatability of the glucose biosensor system are obtained. Moreover, a preliminary canine animal model adopting the new pathway shows significant consistency with the traditional method through dermal pricks for blood sugar detection. Despite the prospective results, further challenges in engineering implementation and clinical practices are addressed and discussed. In brief, the novel biosensing pathway and intra-oral biosensor platform may increasingly reveal their promising value and feasibilities in current bio-medical analysis, diagnosis, drug

  20. A Novel Scheme and Evaluations on a Long-Term and Continuous Biosensor Platform Integrated with a Dental Implant Fixture and Its Prosthetic Abutment.

    PubMed

    Li, Yu-Jung; Lu, Chih-Cheng

    2015-09-25

    A miniature intra-oral dental implant system including a built-in biosensor device is proposed in this article. The dental implant system, or platform, is replaced over maxilla and allows relatively non-invasive procedures for a novel biosensing scheme for human blood analysis. Due to placement of the implant fixture, periodontal ligaments and the pulp structure, which are regarded as the main origin of pain, are thus removed, and long-term, continuous blood analysis and management through maxillary bone marrow becomes achievable through the dental implant platform. The new pathway of biological sensing is for the first time presented to realize an accurate and painless approach without injections. The dental implant system mainly consists of an implant fixture and a prosthetic abutment, a biosensor module, a bluetooth 4.0 wireless module and a dc button cell battery. The electrochemical biosensor possesses three electrodes, including working, reference and counter ones, which are arranged to pass through the titanium implant fixture below the biosensor module. The electrodes are exposed to the blood pool inside the maxillary bone marrow and perform oxidation/reduction reactions with the coating of biosensing enzyme. To prove the proposed platform, the immobilization process of glucose oxidase (GOD) enzyme and in vitro detections of glucose levels are successfully carried out, and proven sensitivity, linearity and repeatability of the glucose biosensor system are obtained. Moreover, a preliminary canine animal model adopting the new pathway shows significant consistency with the traditional method through dermal pricks for blood sugar detection. Despite the prospective results, further challenges in engineering implementation and clinical practices are addressed and discussed. In brief, the novel biosensing pathway and intra-oral biosensor platform may increasingly reveal their promising value and feasibilities in current bio-medical analysis, diagnosis, drug

  1. Computed tomography-guided implant surgery for dental rehabilitation in mandible reconstructed with a fibular free flap: description of the technique.

    PubMed

    De Riu, Giacomo; Meloni, Silvio Mario; Pisano, Milena; Massarelli, Olindo; Tullio, Antonio

    2012-01-01

    The fibular free flap, with or without a cutaneous component, is the gold standard for reconstructing mandibular defects. Dental prosthetic rehabilitation is possible this way, even if the prosthesis-based implant is still a challenge because of the many anatomical and prosthetic problems. We think that complications can be overcome or reduced by adopting the new methods of computed tomography (CT)-assisted implant surgery (NobelGuide, Nobel Biocare AB, Goteborg, Sweden). Here we describe the possibility of using CT-guided implant surgery with a flapless approach and immediate loading in mandibles reconstructed with fibular free flaps.

  2. Stress Distribution Around Single Short Dental Implants: A Finite Element Study.

    PubMed

    Vidya Bhat, S; Premkumar, Priyanka; Kamalakanth Shenoy, K

    2014-12-01

    Bone height restrictions are more common in the posterior regions of the mandible, because of either bone resorption resulting from tooth loss or even anatomic limitations, such as the position of the inferior alveolar nerve. In situations where adequate bone height is not available in the posterior mandible region, smaller lengths of implants may have to be used but it has been reported that the use of long implants (length ≥10 mm) is a positive factor in osseointegration and authors have reported failures with short implants. Hence knowledge about the stress generated on the bone with different lengths of implants needs scientific evaluation. The purpose of this study was to compare and evaluate the influence of different lengths of implants on stress upon bone in mandibular posterior area. A 3 D finite element model was made of the posterior mandible using the details from a CT scan, using computer software (ANSYS 12). Four simulated implants with lengths 6 mm, 8 mm, 10 mm and 13 mm were placed in the centre of the bone. A static vertical force of 250 N and a static horizontal force of 100 N were applied. The stress generated in the cortical and cancellous bone around the implant were recorded and evaluated with the help of ANSYS. In this study, Von Mises stress on a 6 mm implant under a static vertical load of 250 N appeared to be almost in the same range of 8 and 10 mm implant which were more as compared to 13 mm implant. Von Mises stress on a 6mm implant under a static horizontal load of 100 N appeared to be less when compared to 8, 10 and 13 mm implants. From the results obtained it may be inferred that under static horizontal loading conditions, shorter implants receive lesser load and thus may tend to transfer more stresses to the surrounding bone. While under static vertical loading the shorter implants bear more loads and comparatively transmit lesser load to the surrounding bone.

  3. An image analysis approach for automatically re-orienteering CT images for dental implants.

    PubMed

    Cucchiara, Rita; Lamma, Evelina; Sansoni, Tommaso

    2004-06-01

    In the last decade, computerized tomography (CT) has become the most frequently used imaging modality to obtain a correct pre-operative implant planning. In this work, we present an image analysis and computer vision approach able to identify, from the reconstructed 3D data set, the optimal cutting plane specific to each implant to be planned, in order to obtain the best view of the implant site and to have correct measures. If the patient requires more implants, different cutting planes are automatically identified, and the axial and cross-sectional images can be re-oriented accordingly to each of them. In the paper, we describe the defined algorithms in order to recognize 3D markers (each one aligned with a missed tooth for which an implant has to be planned) in the 3D reconstructed space, and the results in processing real exams, in terms of effectiveness and precision and reproducibility of the measure.

  4. Conventional radiography and cross-sectional imaging when planning dental implants in the anterior edentulous mandible to support an overdenture: a systematic review.

    PubMed

    Shelley, A M; Glenny, A-M; Goodwin, M; Brunton, P; Horner, K

    2014-01-01

    The objectives for this systematic review were to determine if the pre-operative availability of cross-sectional imaging, such as cone beam CT, has a diagnostic impact, therapeutic impact or impact on patients' outcome when placing two dental implants in the anterior mandible to support an overdenture. The Cochrane Oral Health Group's Trials Register (CENTRAL), MEDLINE® and Embase were searched up to, and including, February 2013. Studies were considered eligible for inclusion if they compared the impact of conventional and cross-sectional imaging when placing dental implants in sites including the anterior mandible. An adapted quality assessment tool was used for the assessment of the risk of bias in included studies. Pooled quantitative analysis was not possible and, therefore, synthesis was qualitative. Of 2374 potentially eligible papers, 5 studies were included. Little can be determined from a synthesis of these studies because of their small number, clinical diversity and high risks of bias. Notwithstanding, it may be tentatively inferred that cross-sectional imaging has a therapeutic impact in the more challenging cases. In terms of impact, this review has found no evidence to support any specific imaging modality when planning dental implant placement in any region of the mouth. Therefore, those who argue that cross-sectional imaging should be used for the assessment of all dental implant sites are unsupported by evidence.

  5. Association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars: a long-term follow-up clinical and radiographic analysis

    PubMed Central

    2016-01-01

    Purpose The aim of this retrospective study was to determine the association between dental implants in the posterior region and traumatic occlusion in the adjacent premolars, using data collected during from 2002 to 2015. Methods Traumatic occlusion in the adjacent premolars was assessed by examining clinical parameters (bleeding on probing, probing pocket depth, fremitus, and tooth mobility) and radiographic parameters (loss of supporting bone and widening of the periodontal ligament space) over a mean follow-up of 5 years. Clinical factors (gender, age, implant type, maxillary or mandibular position, opposing teeth, and duration of functional loading) were evaluated statistically in order to characterize the relationship between implants in the posterior region and traumatic occlusion in the adjacent premolars. Results The study inclusion criteria were met by 283 patients, who had received 347 implants in the posterior region. The incidence of traumatic occlusion in the adjacent premolars was significantly higher for splinted implants (P=0.004), implants in the maxillary region (P<0.001), and when implants were present in the opposing teeth (P<0.001). The other clinical factors of gender, age, and duration of functional loading were not significantly associated with traumatic occlusion. Conclusions This study found that the risk of traumatic occlusion in the adjacent premolars increased when splinted implants were placed in the maxillary molar region and when the teeth opposing an implant also contained implants. PMID:28050317

  6. Influence of a micro-thread at cervical position and a cylindrical intermediate zone on the mechanical behaviour of dental implants: A three-dimensional finite element analysis.

    PubMed

    Garitaonaindia, Ugutz; Alcaraz, José Luis

    2015-09-01

    The purpose of this work is to analyse the influence on the biomechanical behaviour of dental implants of a micro-thread at their cervical part as well as of a cylindrical geometry at an intermediate zone. Stresses and strains in the elements involved, that is, bone, implant, screw and abutment, have to be considered in detail. Three different three-dimensional finite element models are generated to analyse the behaviour of the various components under the so-called tightening and operating conditions. For the modelling, material specifications for the cancellous bone and cortical bone, on one hand, and titanium properties for the implant, screw and abutment, on the other, are implemented. The tightening condition was fixed according to the stresses in the screw. The operating conditions were simulated by applying a force of 150 N, taking into account ISO 14801:2007 standard. The maximum stress under tightening conditions occurs always in the screw, while under operating conditions it is produced at the screw or the abutment, although considerable stress values are also present in the implant. In all the models, the maximum stress at the junction between the implant and the bone occurs within the cortical bone. Implants provided with micro-thread at the cervical position are advantageous over homogeneously threaded implants since lower stresses in both the implant and the adjacent bone are produced. A cylindrical intermediate portion on the implant surface does not present special advantage over the implants with continuous external thread under tightening and operating conditions.

  7. Finite element analysis of dental implant loading on atrophic and non-atrophic cancellous and cortical mandibular bone - a feasibility study.

    PubMed

    Marcián, Petr; Borák, Libor; Valášek, Jiří; Kaiser, Jozef; Florian, Zdeněk; Wolff, Jan

    2014-12-18

    The first aim of this study was to assess displacements and micro-strain induced on different grades of atrophic cortical and trabecular mandibular bone by axially loaded dental implants using finite element analysis (FEA). The second aim was to assess the micro-strain induced by different implant geometries and the levels of bone-to-implant contact (BIC) on the surrounding bone. Six mandibular bone segments demonstrating different grades of mandibular bone atrophy and various bone volume fractions (from 0.149 to 0.471) were imaged using a micro-CT device. The acquired bone STL models and implant (Brånemark, Straumann, Ankylos) were merged into a three-dimensional finite elements structure. The mean displacement value for all implants was 3.1 ±1.2 µm. Displacements were lower in the group with a strong BIC. The results indicated that the maximum strain values of cortical and cancellous bone increased with lower bone density. Strain distribution is the first and foremost dependent on the shape of bone and architecture of cancellous bone. The geometry of the implant, thread patterns, grade of bone atrophy and BIC all affect the displacement and micro-strain on the mandible bone. Preoperative finite element analysis could offer improved predictability in the long-term outlook of dental implant restorations.

  8. A Novel Multi-Phosphonate Surface Treatment of Titanium Dental Implants: A Study in Sheep

    PubMed Central

    von Salis-Soglio, Marcella; Stübinger, Stefan; Sidler, Michéle; Klein, Karina; Ferguson, Stephen J.; Kämpf, Käthi; Zlinszky, Katalin; Buchini, Sabrina; Curno, Richard; Péchy, Péter; Aronsson, Bjorn-Owe; von Rechenberg, Brigitte

    2014-01-01

    The aim of the present study was to evaluate a new multi-phosphonate surface treatment (SurfLink®) in an unloaded sheep model. Treated implants were compared to control implants in terms of bone to implant contact (BIC), bone formation, and biomechanical stability. The study used two types of implants (rough or machined surface finish) each with either the multi-phosphonate Wet or Dry treatment or no treatment (control) for a total of six groups. Animals were sacrificed after 2, 8, and 52 weeks. No adverse events were observed at any time point. At two weeks, removal torque showed significantly higher values for the multi-phosphonate treated rough surface (+32% and +29%, Dry and Wet, respectively) compared to rough control. At 52 weeks, a significantly higher removal torque was observed for the multi-phosphonate treated machined surfaces (+37% and 23%, Dry and Wet, respectively). The multi-phosphonate treated groups showed a positive tendency for higher BIC with time and increased new-old bone ratio at eight weeks. SEM images revealed greater amounts of organic materials on the multi-phosphonate treated compared to control implants, with the bone fracture (from the torque test) appearing within the bone rather than at the bone to implant interface as it occurred for control implants. PMID:25215424

  9. Alveolar bone density and its clinical implication in the placement of dental implants and orthodontic mini-implants

    PubMed Central

    Almasoud, Naif N.; Tanneru, Nagaraju; Marei, Hesham F.

    2016-01-01

    Objectives: To assess the bone density in maxilla and mandible in dentate and edentulous patients in Saudi population. Methods: This study involved a retrospective analysis of cone beam CT images of 100 patients (50 male and 50 female) who have come to College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia between January 2014 and 2015. Using the bone density option in the Simplant software, the Hounsfield unit (HU) was calculated at the edentulous sites. While for dentate sites, a region of interest was selected coronally at 3-5 mm to the root apex using I-CAT vision software. The densities of the buccal bone and cancellous bone were measured at interradicular areas of a specific teeth. Results: The highest bone density at the edentulous sites was at the mandibular anterior region (776.5 ± 65.7 HU), followed by the mandibular posterior region (502.2 ± 224.2 HU). Regarding the dentate sites, the highest bone density was at the buccal cortical plate of the lower incisor teeth (937.56 ± 176.92 HU) and the lowest bone density was at the cancellous bone around the posterior maxillary teeth (247.12 ± 46.75 HU). Conclusion: The alveolar bone density at dentate and edentulous sites in our population is generally lower than the norm reference density of other populations, which dictates the need for quantitative assessment of bone density before implants and mini-implants placement. PMID:27279516

  10. Rehabilitation of the severely atrophied dentoalveolar ridge in the aesthetic region with corticocancellous grafts from the iliac crest and dental implants