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Sample records for zirconia implants compared

  1. Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: a comparative in vitro study.

    PubMed

    Stimmelmayr, Michael; Edelhoff, Daniel; Güth, Jan-Frederik; Erdelt, Kurt; Happe, Arndt; Beuer, Florian

    2012-12-01

    The purpose of this study was to determine and measure the wear of the interface between titanium implants and one-piece zirconia abutments in comparison to titanium abutments. 6 implants were secured into epoxy resin blocks. The implant interface of these implants and 6 corresponding abutments (group Zr: three one-piece zirconia abutments; group Ti: three titanium abutments) were examined by a microscope and scanning electron micrograph (SEM). Also the implants and the abutments were scanned by 3D-Micro Computer Tomography (CT). The abutments were connected to the implants and cyclically loaded with 1,200,000 cycles at 100N in a two-axis fatigue testing machine. Afterwards, all specimens were unscrewed and the implants and abutments again were scanned by microscope, SEM and CT. The microscope and SEM images were compared, the CT data were superimposed and the wear was calculated by inspection software. The statistical analysis was carried out with an unpaired t-test. Abutment fracture or screw loosening was not observed during cyclical loading. Comparing the microscope and SEM images more wear was observed on the implants connected to zirconia abutments. The maximum wear on the implant shoulder calculated by the inspection software was 10.2μm for group Zr, and 0.7μm for group Ti. The influence of the abutment material on the measured wear was statistically significant (p≤0.001; Levene-test). Titanium implants showed higher wear at the implant interface following cyclic loading when connected to one-piece zirconia implant abutments compared to titanium abutments. The clinical relevance is not clear; hence damage of the internal implant connection could result in prosthetic failures up to the need of implant removal. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  2. Comparison of peri-implant bone formation around injection-molded and machined surface zirconia implants in rabbit tibiae

    PubMed Central

    Kim, Hong-Kyun; Woo, Kyung mi; Shon, Won-Jun; Ahn, Jin-Soo; Cha, Seunghee; Park, Young-Seok

    2017-01-01

    The aim of this study was to compare osseointegration and surface characteristics of zirconia implants made by the powder injection molding (PIM) technique and made by the conventional milling procedure in rabbit tibiae. Surface characteristics of 2 types of implant were evaluated. Sixteeen rabbits received 2 types of external hex implants with similar geometry, machined zirconia implants and PIM zirconia implants, in the tibiae. Removal torque tests and histomorphometric analyses were performed. The roughness of PIM zirconia implants was higher than that of machined zirconia implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined zirconia implants (P < 0.001). The osseointegration of the PIM zirconia implant is promising, and PIM, using the roughened mold etching technique, can produce substantially rough surfaces on zirconia implants. PMID:26235717

  3. Failure analysis of fractured dental zirconia implants.

    PubMed

    Gahlert, M; Burtscher, D; Grunert, I; Kniha, H; Steinhauser, E

    2012-03-01

    The purpose of the present study was the macroscopic and microscopic failure analysis of fractured zirconia dental implants. Thirteen fractured one-piece zirconia implants (Z-Look3) out of 170 inserted implants with an average in situ period of 36.75±5.34 months (range from 20 to 56 months, median 38 months) were prepared for macroscopic and microscopic (scanning electron microscopy [SEM]) failure analysis. These 170 implants were inserted in 79 patients. The patient histories were compared with fracture incidences to identify the reasons for the failure of the implants. Twelve of these fractured implants had a diameter of 3.25 mm and one implant had a diameter of 4 mm. All fractured implants were located in the anterior side of the maxilla and mandibula. The patient with the fracture of the 4 mm diameter implant was adversely affected by strong bruxism. By failure analysis (SEM), it could be demonstrated that in all cases, mechanical overloading caused the fracture of the implants. Inhomogeneities and internal defects of the ceramic material could be excluded, but notches and scratches due to sandblasting of the surface led to local stress concentrations that led to the mentioned mechanical overloading by bending loads. The present study identified a fracture rate of nearly 10% within a follow-up period of 36.75 months after prosthetic loading. Ninety-two per cent of the fractured implants were so-called diameter reduced implants (diameter 3.25 mm). These diameter reduced implants cannot be recommended for further clinical use. Improvement of the ceramic material and modification of the implant geometry has to be carried out to reduce the failure rate of small-sized ceramic implants. Nevertheless, due to the lack of appropriate laboratory testing, only clinical studies will demonstrate clearly whether and how far the failure rate can be reduced. © 2011 John Wiley & Sons A/S.

  4. 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

  5. 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. © International & American Associations for Dental

  6. Zirconia Dental Implants: Investigation of Clinical Parameters, Patient Satisfaction, and Microbial Contamination.

    PubMed

    Holländer, Jens; Lorenz, Jonas; Stübinger, Stefan; Hölscher, Werner; Heidemann, Detlef; Ghanaati, Shahram; Sader, Robert

    2016-01-01

    In recent years, dental implants made from zirconia have been further developed and are considered a reliable treatment method for replacing missing teeth. The aim of this study was to analyze dental implants made from zirconia regarding their clinical performance compared with natural teeth (control). One hundred six zirconia implants in 38 adults were analyzed in a clinical study after 1 year of loading. The plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), probing attachment level (PAL), and creeping or recession (CR/REC) of the gingiva were detected and compared with natural control teeth (CT). Furthermore, the papilla index (PAP), Periotest values (PTV), microbial colonization of the implant/dental sulcus fluid, and patient satisfaction were assessed. The survival rate was 100%. No statistical significance was observed between implants and teeth regarding BOP, PPD, and PAL. A statistical significance was detected regarding PI and CR/REC with significantly less plaque accumulation and recession in the study group. Mean PAP was 1.76 ± 0.55, whereas the mean PTV was -1.31 ± 2.24 (range from -5 to +6). A non-statistically significant higher colonization of periodontitis/peri-implantitis bacteria was observed in the implant group. The questionnaire showed that the majority of the patients were satisfied with the overall treatment. One-piece zirconia dental implants exhibited similar clinical results (BOP, PPD, and PAL) compared with natural teeth in regard to adhesion of plaque (PI) and creeping attachment (CR/REC); zirconia implants performed even better. The favorable results for PAL and CR/REC reflect the comparable low affinity of zirconia for plaque adhesion. Patient satisfaction indicated a high level of acceptance for zirconia implants. However, a long-term follow-up is needed to support these findings.

  7. Study on the neotype zirconia's implant coated nanometer hydroxyapatite ceramics

    NASA Astrophysics Data System (ADS)

    Zhu, J. W.; Yang, D. W.

    2007-07-01

    In recent years, biologic ceramics is a popular material of implants and bioactive surface modification of dental implant became a research emphasis, which aims to improve bioactivity of implants materials and acquire firmer implants-bone interface. The zirconia ceramic has excellent mechanical properties and nanometer HA ceramics is a bioceramic well known for its bioactivity, therefore, nanometer HA ceramics coating on zirconia, allows combining the excellent mechanical properties of zirconia substrates with its bioactivity. This paper shows a new method for implant shape design and bioactive modification of dental implants surface. Zirconia's implant substrate was prepared by sintered method, central and lateral tunnels were drilled in the zirconia hollow porous cylindrical implants by laser processing. The HA powders and needle-like HA crystals were made by a wet precipitation and calcining method. Its surface was coated with nanometer HA ceramics which was used brush HA slurry and vacuum sintering. Mechanical testing results revealed that the attachment strength of nanometer HA ceramics coated zirconia samples is high. SEM and interface observation after inserted experiment indicated that calcium and phosphor content increased and symmetrically around coated implant-bone tissue interface. A significantly higher affinity index was demonstrated in vivo by histomorphometric evaluation in coated versus uncoated implants. SEM analysis demonstrated better bone adhesion to the material in coated implant at any situation. In addition, the hollow porous cylindrical implant coated with nanometer HA ceramics increase the interaction of bone and implant, the new bone induced into the surface of hollow porous cylindrical implant and through the most tunnels filled into central hole. The branch-like structure makes the implant and bone a body, which increased the contact area and decreased elastic ratio. Therefore, the macroscopical and microcosmic nested structure of

  8. A comparison of fit of CNC-milled titanium and zirconia frameworks to implants.

    PubMed

    Abduo, Jaafar; Lyons, Karl; Waddell, Neil; Bennani, Vincent; Swain, Michael

    2012-05-01

    Computer numeric controlled (CNC) milling was proven to be predictable method to fabricate accurately fitting implant titanium frameworks. However, no data are available regarding the fit of CNC-milled implant zirconia frameworks. To compare the precision of fit of implant frameworks milled from titanium and zirconia and relate it to peri-implant strain development after framework fixation. A partially edentulous epoxy resin models received two Branemark implants in the areas of the lower left second premolar and second molar. From this model, 10 identical frameworks were fabricated by mean of CNC milling. Half of them were made from titanium and the other half from zirconia. Strain gauges were mounted close to the implants to qualitatively and quantitatively assess strain development as a result of framework fitting. In addition, the fit of the framework implant interface was measured using an optical microscope, when only one screw was tightened (passive fit) and when all screws were tightened (vertical fit). The data was statistically analyzed using the Mann-Whitney test. All frameworks produced measurable amounts of peri-implant strain. The zirconia frameworks produced significantly less strain than titanium. Combining the qualitative and quantitative information indicates that the implants were under vertical displacement rather than horizontal. The vertical fit was similar for zirconia (3.7 µm) and titanium (3.6 µm) frameworks; however, the zirconia frameworks exhibited a significantly finer passive fit (5.5 µm) than titanium frameworks (13.6 µm). CNC milling produced zirconia and titanium frameworks with high accuracy. The difference between the two materials in terms of fit is expected to be of minimal clinical significance. The strain developed around the implants was more related to the framework fit rather than framework material. © 2011 Wiley Periodicals, Inc.

  9. Comparison of mechanical and biological properties of zirconia and titanium alloy orthodontic micro-implants.

    PubMed

    Choi, Hae Won; Park, Young Seok; Chung, Shin Hye; Jung, Min Ho; Moon, Won; Rhee, Sang Hoon

    2017-07-01

    The aim of this study was to compare the initial stability as insertion and removal torque and the clinical applicability of novel orthodontic zirconia micro-implants made using a powder injection molding (PIM) technique with those parameters in conventional titanium micro-implants. Sixty zirconia and 60 titanium micro-implants of similar design (diameter, 1.6 mm; length, 8.0 mm) were inserted perpendicularly in solid polyurethane foam with varying densities of 20 pounds per cubic foot (pcf), 30 pcf, and 40 pcf. Primary stability was measured as maximum insertion torque (MIT) and maximum removal torque (MRT). To investigate clinical applicability, compressive and tensile forces were recorded at 0.01, 0.02, and 0.03 mm displacement of the implants at angles of 0°, 10°, 20°, 30°, and 40°. The biocompatibility of zirconia micro-implants was assessed via an experimental animal study. There were no statistically significant differences between zirconia micro-implants and titanium alloy implants with regard to MIT, MRT, or the amount of movement in the angulated lateral displacement test. As angulation increased, the mean compressive and tensile forces required to displace both types of micro-implants increased substantially at all distances. The average bone-to-implant contact ratio of prototype zirconia micro-implants was 56.88 ± 6.72%. Zirconia micro-implants showed initial stability and clinical applicability for diverse orthodontic treatments comparable to that of titanium micro-implants under compressive and tensile forces.

  10. Implant stability and marginal bone level of microgrooved zirconia dental implants: A 3-month experimental study on dogs.

    PubMed

    Delgado-Ruiz, Rafael Arcesio; Marković, Aleksa; Calvo-Guirado, José Luís; Lazić, Zoran; Piattelli, Adriano; Boticelli, Daniele; Maté-Sánchez, José Eduardo; Negri, Bruno; Ramírez-Fernández, María Piedad; Mišić, Tijana

    2014-05-01

    The modification of implant surfaces could affect mechanical implant stability as well as dynamics and quality of peri-implant bone healing. The aim of this 3-month experimental study in dogs was to investigate implant stability, marginal bone levels and bone tissue response to zirconia dental implants with two laser-micro-grooved intraosseous surfaces in comparison with nongrooved sandblasted zirconia and sandblasted, high-temperature etched titanium implants. Implant surface characterization was performed using optical interferometric profilometty and energy dispersive X-ray spectroscopy. A total of 96 implants (4 mm in diameter and 10 mm in length) were inserted randomly in both sides of the lower jaw of 12 Fox Hound dogs divided into groups of 24 each: the control (titanium), the group A (sandblasted zirconia), the group B (sandolasted zirconia plus microgrooved neck) and the group C (sandblasted zirconia plus all microgrooved). All the implants were immediately loaded. Insertion torque, periotest values, radiographic crestal bone level and removal torque were recorded during the 3-month follow-up. Qualitative scanning electon microscope (SEM) analysis of the bone-implant interfaces of each group was performed. Insertion torque values were higher in the group C and control implants (p < 0.05). Periotest values increased in all the periods in proportion to the extent of microgrooving as follows: the group C > the control > the group B > the group A (p < 0.05). Radiographic measurements showed minimal crestal bone loss at 3 months for microgrooved zirconia implants (groups C and B) and control implants compared with the group A implants (p < 0.05). The removal torque values increased with time for all the groups as follows: the group C > the control > the group B > the group A (p < 0.05). SEM showed that implant surfaces of the groups B and C had an extra bone growth inside the microgrooves that corresponded to the shape and direction of the microgrooves. The

  11. [Application of plasma sprayed zirconia coating in dental implant: study in implant].

    PubMed

    Huang, Z F; Wang, Z F; Li, C H; Hao, D; Lan, J

    2018-04-09

    Objective: To investigate the osseointegration of a novel coating-plasma-sprayed zirconia in dental implant. Methods: Zirconia coating on non-thread titanium implant was prepared using plasma spraying, the implant surface morphology, surface roughness and wettability were measured. In vivo , zirconia coated implants were inserted in rabbit tibia and animals were respectively sacrificed at 2, 4, 8 and 12 weeks after implantation. The bond strength between implant and bone was measured by push-out test. The osseointegration was observed by scanning electron microscopy (SEM), micro CT and histological analyses. Quantified parameters including removal torque, and bone-implant contact (BIC) percentage were calculated. Results: The surface roughness (1.6 µm) and wettability (54.6°) of zirconia coated implant was more suitable than those of titanium implant (0.6 µm and 74.4°) for osseointegration. At 12 weeks, the push-out value of zirconia coated implant and titanium implant were (64.9±3.0) and (50.4±2.9) N, and BIC value of these two groups were (54.7±3.6)% and (41.5±3.6)%. All these differences had statistical significance. Conclusions: The surface characters of zirconia coated implant were more suitable for osseointegration and present better osseointegration than smooth titanium implant in vivo , especially at early stage.

  12. Osseointegration of zirconia implants: an SEM observation of the bone-implant interface.

    PubMed

    Depprich, Rita; Zipprich, Holger; Ommerborn, Michelle; Mahn, Eduardo; Lammers, Lydia; Handschel, Jörg; Naujoks, Christian; Wiesmann, Hans-Peter; Kübler, Norbert R; Meyer, Ulrich

    2008-11-06

    The successful use of zirconia ceramics in orthopedic surgery led to a demand for dental zirconium-based implant systems. Because of its excellent biomechanical characteristics, biocompatibility, and bright tooth-like color, zirconia (zirconium dioxide, ZrO2) has the potential to become a substitute for titanium as dental implant material. The present study aimed at investigating the osseointegration of zirconia implants with modified ablative surface at an ultrastructural level. A total of 24 zirconia implants with modified ablative surfaces and 24 titanium implants all of similar shape and surface structure were inserted into the tibia of 12 Göttinger minipigs. Block biopsies were harvested 1 week, 4 weeks or 12 weeks (four animals each) after surgery. Scanning electron microscopy (SEM) analysis was performed at the bone implant interface. Remarkable bone attachment was already seen after 1 week which increased further to intimate bone contact after 4 weeks, observed on both zirconia and titanium implant surfaces. After 12 weeks, osseointegration without interposition of an interfacial layer was detected. At the ultrastructural level, there was no obvious difference between the osseointegration of zirconia implants with modified ablative surfaces and titanium implants with a similar surface topography. The results of this study indicate similar osseointegration of zirconia and titanium implants at the ultrastructural level.

  13. Experimental and numeric stress analysis of titanium and zirconia one-piece dental implants.

    PubMed

    Mobilio, Nicola; Stefanoni, Filippo; Contiero, Paolo; Mollica, Francesco; Catapano, Santo

    2013-01-01

    To compare the stress in bone around zirconia and titanium implants under loading. A one-piece zirconia implant and a replica of the same implant made of commercially pure titanium were embedded in two self-curing acrylic resin blocks. To measure strain, a strain gauge was applied on the surface of the two samples. Loads of 50, 100, and 150 N, with orientations of 30, 45, and 60 degrees with respect to the implant axis were applied on the implant. Strain under all loading conditions on both samples was measured. Three-dimensional virtual replicas of both the implants were reproduced using the finite element method and inserted into a virtual acrylic resin block. All the materials were considered isotropic, linear, and elastic. The same geometry and loading conditions of the experimental setup were used to realize two new models, with the implants embedded within a virtual bone block. Very close values of strain in the two implants embedded in acrylic resin were obtained both experimentally and numerically. The stress states generated by the implants embedded in virtual bone were also very similar, even if the two implants moved differently. Moreover, the stress levels were higher on cortical bone than on trabecular bone. The stress levels in bone, generated by the two implants, appeared to be very similar. From a mechanical point of view, zirconia is a feasible substitute for titanium.

  14. Loading capacity of zirconia implant supported hybrid ceramic crowns.

    PubMed

    Rohr, Nadja; Coldea, Andrea; Zitzmann, Nicola U; Fischer, Jens

    2015-12-01

    Recently a polymer infiltrated hybrid ceramic was developed, which is characterized by a low elastic modulus and therefore may be considered as potential material for implant supported single crowns. The purpose of the study was to evaluate the loading capacity of hybrid ceramic single crowns on one-piece zirconia implants with respect to the cement type. Fracture load tests were performed on standardized molar crowns milled from hybrid ceramic or feldspar ceramic, cemented to zirconia implants with either machined or etched intaglio surface using four different resin composite cements. Flexure strength, elastic modulus, indirect tensile strength and compressive strength of the cements were measured. Statistical analysis was performed using two-way ANOVA (p=0.05). The hybrid ceramic exhibited statistically significant higher fracture load values than the feldspar ceramic. Fracture load values and compressive strength values of the respective cements were correlated. Highest fracture load values were achieved with an adhesive cement (1253±148N). Etching of the intaglio surface did not improve the fracture load. Loading capacity of hybrid ceramic single crowns on one-piece zirconia implants is superior to that of feldspar ceramic. To achieve maximal loading capacity for permanent cementation of full-ceramic restorations on zirconia implants, self-adhesive or adhesive cements with a high compressive strength should be used. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  15. Titanium versus zirconia implants supporting maxillary overdentures: three-dimensional finite element analysis.

    PubMed

    Osman, Reham B; Elkhadem, Amr H; Ma, Sunyoung; Swain, Michael V

    2013-01-01

    The purpose of this study was to compare the stress and strain occurring in peri-implant bone and implants used to support maxillary overdentures. Three-dimensional finite element analysis (3D FEA) was used to compare one-piece zirconia and titanium implants. Two types of implants were simulated using a 3D FEA model: one-piece zirconia and titanium implants (diameter, 3.8 × 11.5 mm) with 2.25-mm diameter ball abutments. In each simulation four implants were placed bilaterally in the canine/premolar region of an edentulous maxillary model. Static loads were applied axially and 20 degrees buccolingually on the buccal slope of the lingual cusps of posterior teeth of the first quadrant. Von Mises stresses and equivalent strains generated in peri-implant bone and first principal stresses in the implants were calculated. Comparable stress and strain values were shown in the peri-implant bone for both types of implants. The maximum equivalent strain produced in the peri-implant region was mostly within the range for bone augmentation. Under oblique loading, maximum von Mises stresses and equivalent strain were more evident at the neck of the most distal implant on the loaded side. Under axial load, the stress and strain were transferred to the peri-implant bone around the apex of the implant. Maximum tensile stresses that developed for either material were well below their fracture strength. The highest stresses were mainly located at the distobuccal region of the neck for the two implant materials under both loading conditions. From a biomechanical point of view, ceramic implants made from yttrium-stabilized tetragonal polycrystalline zirconia may be a potential alternative to conventional titanium implants for the support of overdentures. This is particularly relevant for a select group of patients with a proven allergy to titanium. Prospective clinical studies are still required to confirm these in vitro results. Different simulations presenting various cortical bone

  16. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study.

    PubMed

    Siddiqi, A; Duncan, W J; De Silva, R K; Zafar, S

    2016-01-01

    Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control) and one Zr (test) implant were placed in the mandible, and one of each implant (Ti and Zr) was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9%) ( p = 0.002). Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3%) ( p = 0.087). High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions.

  17. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

    PubMed Central

    De Silva, R. K.; Zafar, S.

    2016-01-01

    Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control) and one Zr (test) implant were placed in the mandible, and one of each implant (Ti and Zr) was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9%) (p = 0.002). Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3%) (p = 0.087). High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions. PMID:28058261

  18. Evaluation of nano-technology-modified zirconia oral implants: a study in rabbits.

    PubMed

    Lee, Jaebum; Sieweke, Janet H; Rodriguez, Nancy A; Schüpbach, Peter; Lindström, Håkan; Susin, Cristiano; Wikesjö, Ulf M E

    2009-07-01

    The objective of this study was to screen candidate nano-technology-modified, micro-structured zirconia implant surfaces relative to local bone formation and osseointegration. Proprietary nano-technology surface-modified (calcium phosphate: CaP) micro-structured zirconia implants (A and C), control micro-structured zirconia implants (ZiUnite), and titanium porous oxide implants (TiUnite) were implanted into the femoral condyle in 40 adult male New Zealand White rabbits. Each animal received one implant in each hind leg; thus, 20 animals received A and C implants and 20 animals received ZiUnite and TiUnite implants in contralateral hind legs. Ten animals/group were euthanized at weeks 3 and 6 when biopsies of the implant sites were processed for histometric analysis using digital photomicrographs produced using backscatter scanning electron microscopy. The TiUnite surface demonstrated significantly greater bone-implant contact (BIC) (77.6+/-2.6%) compared with the A (64.6+/-3.6%) and C (62.2+/-3.1%) surfaces at 3 weeks (p<0.05). Numerical differences between ZiUnite (70.5+/-3.1%) and A and C surfaces did not reach statistical significance (p>0.05). Similarly, there were non-significant differences between the TiUnite and the ZiUnite surfaces (p>0.05). At 6 weeks, there were no significant differences in BIC between the TiUnite (67.1+/-4.2%), ZiUnite (69.7+/-5.7%), A (68.6+/-1.9%), and C (64.5+/-4.1%) surfaces (p>0.05). TiUnite and ZiUnite implant surfaces exhibit high levels of osseointegration that, in this model, confirm their advanced osteoconductive properties. Addition of CaP nano-technology to the ZiUnite surface does not enhance the already advanced osteoconductivity displayed by the TiUnite and ZiUnite implant surfaces.

  19. Displacement comparison of CAD-CAM titanium and zirconia abutments to implants with different conical connections.

    PubMed

    Yilmaz, Burak; Hashemzadeh, Shervin; Seidt, Jeremy D; Clelland, Nancy L

    2018-04-01

    To compare the displacements of CAD-CAM zirconia and titanium abutments into different internal connection systems after torquing. OsseoSpeed EV and OsseoSpeed TX implants (n=10) were placed in resin blocks. Zirconia and titanium abutments (n=5) were first hand tightened and then tightened to the recommended torque (20Ncm for TX and 25Ncm for EV). Displacements of abutments between screw tightening by hand and torque driver was measured using three-dimensional digital image correlation (3D DIC) technique. Displacements were measured in U (front/back), V (into/outward), W (right/left) directions and 3-dimensionally (3D). ANOVA with restricted maximum likelihood estimation method was used to analyze the data. Bonferroni-corrected t tests was used to determine the statistical differences (α=0.05). 3D displacement of zirconia and titanium abutments was significantly greater in OsseoSpeed EV implant (P<0.001). Displacement of zirconia and titanium abutments was not significantly different within implant systems, 3D (P≥0.386) and in each direction (P≥0.382). In U and V directions, zirconia and titanium abutments displaced significantly more towards negative in OsseoSpeed EV implant (P<0.019). Within the OsseoSpeed TX system, abutments displaced significantly more in V direction compared to the U and W (P≤0.005), and within the Osseospeed EV system, abutment displacements were significantly different amongst directions and displacements in V were the greatest (P<0.001). Abutments displaced more in the implant that required higher torque values to tighten the abutment. The amount of displacement in both systems was clinically small. Abutment material did not affect the magnitude of displacement. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  20. Fracture strength of zirconia implant abutments on narrow diameter implants with internal and external implant abutment connections: A study on the titanium resin base concept.

    PubMed

    Sailer, Irena; Asgeirsson, Asgeir G; Thoma, Daniel S; Fehmer, Vincent; Aspelund, Thor; Özcan, Mutlu; Pjetursson, Bjarni E

    2018-04-01

    There is limited knowledge regarding the strength of zirconia abutments with internal and external implant abutment connections and zirconia abutments supported by a titanium resin base (Variobase, Straumann) for narrow diameter implants. To compare the fracture strength of narrow diameter abutments with different types of implant abutment connections after chewing simulation. Hundred and twenty identical customized abutments with different materials and implant abutment connections were fabricated for five groups: 1-piece zirconia abutment with internal connection (T1, Cares-abutment-Straumann BL-NC implant, Straumann Switzerland), 1-piece zirconia abutment with external hex connection (T2, Procera abutment-Branemark NP implant, Nobel Biocare, Sweden), 2-piece zirconia abutments with metallic insert for internal connection (T3, Procera abutment-Replace NP implant, Nobel Biocare), 2-piece zirconia abutment on titanium resin base (T4, LavaPlus abutment-VarioBase-Straumann BL-NC implant, 3M ESPE, Germany) and 1-piece titanium abutment with internal connection (C, Cares-abutment-Straumann BL-NC implant, Straumann, Switzerland). All implants had a narrow diameter ranging from 3.3 to 3.5 mm. Sixty un-restored abutments and 60 abutments restored with glass-ceramic crowns were tested. Mean bending moments were compared using ANOVA with p-values adjusted for multiple comparisons using Tukey's procedure. The mean bending moments were 521 ± 33 Ncm (T4), 404 ± 36 Ncm (C), 311 ± 106 Ncm (T1) 265 ± 22 Ncm (T3) and 225 ± 29 (T2) for un-restored abutments and 278 ± 84 Ncm (T4), 302 ± 170 Ncm (C), 190 ± 55 Ncm (T1) 80 ± 102 Ncm (T3) and 125 ± 57 (T2) for restored abutments. For un-restored abutments, C and T4 had similar mean bending moments, significantly higher than those of the three other groups (p < .05). Titanium abutments (C) had significantly higher bending moments than identical zirconia abutments (T1) (p < .05). Zirconia

  1. Initial Bacterial Adhesion on Different Yttria-Stabilized Tetragonal Zirconia Implant Surfaces in Vitro

    PubMed Central

    Karygianni, Lamprini; Jähnig, Andrea; Schienle, Stefanie; Bernsmann, Falk; Adolfsson, Erik; Kohal, Ralf J.; Chevalier, Jérôme; Hellwig, Elmar; Al-Ahmad, Ali

    2013-01-01

    Bacterial adhesion to implant biomaterials constitutes a virulence factor leading to biofilm formation, infection and treatment failure. The aim of this study was to examine the initial bacterial adhesion on different implant materials in vitro. Four implant biomaterials were incubated with Enterococcus faecalis, Staphylococcus aureus and Candida albicans for 2 h: 3 mol % yttria-stabilized tetragonal zirconia polycrystal surface (B1a), B1a with zirconium oxide (ZrO2) coating (B2a), B1a with zirconia-based composite coating (B1b) and B1a with zirconia-based composite and ZrO2 coatings (B2b). Bovine enamel slabs (BES) served as control. The adherent microorganisms were quantified and visualized using scanning electron microscopy (SEM); DAPI and live/dead staining. The lowest bacterial count of E. faecalis was detected on BES and the highest on B1a. The fewest vital C. albicans strains (42.22%) were detected on B2a surfaces, while most E. faecalis and S. aureus strains (approximately 80%) were vital overall. Compared to BES; coated and uncoated zirconia substrata exhibited no anti-adhesive properties. Further improvement of the material surface characteristics is essential. PMID:28788415

  2. Initial Bacterial Adhesion on Different Yttria-Stabilized Tetragonal Zirconia Implant Surfaces in Vitro.

    PubMed

    Karygianni, Lamprini; Jähnig, Andrea; Schienle, Stefanie; Bernsmann, Falk; Adolfsson, Erik; Kohal, Ralf J; Chevalier, Jérôme; Hellwig, Elmar; Al-Ahmad, Ali

    2013-12-04

    Bacterial adhesion to implant biomaterials constitutes a virulence factor leading to biofilm formation, infection and treatment failure. The aim of this study was to examine the initial bacterial adhesion on different implant materials in vitro . Four implant biomaterials were incubated with Enterococcus faecalis , Staphylococcus aureus and Candida albicans for 2 h: 3 mol % yttria-stabilized tetragonal zirconia polycrystal surface (B1a), B1a with zirconium oxide (ZrO₂) coating (B2a), B1a with zirconia-based composite coating (B1b) and B1a with zirconia-based composite and ZrO₂ coatings (B2b). Bovine enamel slabs (BES) served as control. The adherent microorganisms were quantified and visualized using scanning electron microscopy (SEM); DAPI and live/dead staining. The lowest bacterial count of E. faecalis was detected on BES and the highest on B1a. The fewest vital C. albicans strains (42.22%) were detected on B2a surfaces, while most E. faecalis and S. aureus strains (approximately 80%) were vital overall. Compared to BES; coated and uncoated zirconia substrata exhibited no anti-adhesive properties. Further improvement of the material surface characteristics is essential.

  3. Peri-implant soft tissue colour around titanium and zirconia abutments: a prospective randomized controlled clinical study.

    PubMed

    Cosgarea, Raluca; Gasparik, Cristina; Dudea, Diana; Culic, Bogdan; Dannewitz, Bettina; Sculean, Anton

    2015-05-01

    To objectively determine the difference in colour between the peri-implant soft tissue at titanium and zirconia abutments. Eleven patients, each with two contralaterally inserted osteointegrated dental implants, were included in this study. The implants were restored either with titanium abutments and porcelain-fused-to-metal crowns, or with zirconia abutments and ceramic crowns. Prior and after crown cementation, multi-spectral images of the peri-implant soft tissues and the gingiva of the neighbouring teeth were taken with a colorimeter. The colour parameters L*, a*, b*, c* and the colour differences ΔE were calculated. Descriptive statistics, including non-parametric tests and correlation coefficients, were used for statistical analyses of the data. Compared to the gingiva of the neighbouring teeth, the peri-implant soft tissue around titanium and zirconia (test group), showed distinguishable ΔE both before and after crown cementation. Colour differences around titanium were statistically significant different (P = 0.01) only at 1 mm prior to crown cementation compared to zirconia. Compared to the gingiva of the neighbouring teeth, statistically significant (P < 0.01) differences were found for all colour parameter, either before or after crown cementation for both abutments; more significant differences were registered for titanium abutments. Tissue thickness correlated positively with c*-values for titanium at 1 mm and 2 mm from the gingival margin. Within their limits, the present data indicate that: (i) The peri-implant soft tissue around titanium and zirconia showed colour differences when compared to the soft tissue around natural teeth, and (ii) the peri-implant soft tissue around zirconia demonstrated a better colour match to the soft tissue at natural teeth than titanium. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Wear and Corrosion Interactions at the Titanium/Zirconia Interface: Dental Implant Application.

    PubMed

    Sikora, Craig L; Alfaro, Maria F; Yuan, Judy Chia-Chun; Barao, Valentim A; Sukotjo, Cortino; Mathew, Mathew T

    2018-03-09

    than the titanium couplings (p < 0.001). This study highlights the synergistic interaction between wear and corrosion, which occurs when masticatory forces combine with the salivary environment of the oral cavity. Overall, the zirconia groups outperformed the titanium groups. In fact, the titanium groups generated 5 to 6 times more wear to the implant alloys as compared with the zirconia counterparts. The best performing group was Zr/Ti, and the worst performing group was Ti/Ti. © 2018 by the American College of Prosthodontists.

  5. [Crown color match of implant-supported zirconia and porcelain-fused-to-metal restorations: a spectrophotometric comparison].

    PubMed

    Peng, Min; Fei, Wei; Hosseini, Mandana; Gotfredsen, Klaus

    2014-02-01

    This study aimed to compare the crown color match of implant-supported zirconia restorations and porcelain-fused-to-metal (PFM) restorations in the anterior maxillary region through spectrophotometric evaluation. Eighteen patients with 29 implant-supported single crowns in the anterior maxillary area were recruited. Eleven of the implant crowns were zirconia restorations and 18 were PFM restorations. Color matching of the implant crown with contra-lateral/ neighboring tooth at the position of body 1/3 of the crown was assessed using a spectrophotometer (SpectroShade) in CIE L* a* b* coordinates. Subjective crown color match scores were evaluated. Independent sample t test of SPSS 17.0 was used to compare the difference between zirconia restoration and PFM restoration. Spearman correlation was used to analyze the relationship between the spectrophotometric color difference and the subjective crown color match score. Descriptive statistics was used to analyze the distribution of color coordinates of natural anterial teeth. The crown color of the implant-supported zirconia restorations and PFM restorations were both lighter than that of natural teeth (delta L, 4.5 +/- 3.2, 1.0 +/- 2.6). The lightness difference induced by zirconia restorations was significantly larger than that induced by PFM restorations (P=0.004). The spectrophotometric crown color difference (delta E) induced by zirconia restorations (7.0 +/- 2.8) was significantly larger than that induced by PFM restorations (4.0 +/- 1.9) (P=0.002), and both values were beyond the clinical thresholds (3.7). The spectrophotometric crown color difference induced by zirconia restorations was significantly larger than that induced by PFM restorations. However, they were indistinguishable in subjective evaluation.

  6. 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

  7. 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.

  8. Stability of prototype two-piece zirconia and titanium implants after artificial aging: an in vitro pilot study.

    PubMed

    Kohal, Ralf-Joachim; Finke, Hans Christian; Klaus, Gerold

    2009-12-01

    270 and 393 N (mean: 325.1 N), for group 2 between 235 and 321 N (mean: 281.8 N), and between 474 and 765 N (mean: 595.2 N) for the titanium group. The failure mode during the fracture testing in the zirconia implant groups was a fracture of the implant head and a bending/fracture of the abutment screw in the titanium group. Within the limits of this pilot investigation, the biomechanical stability of all tested prototype implant groups seems to be - compared with the possibly exerted occlusal forces - borderline for clinical use. A high number of failures occurred already during the artificial loading in the titanium group at the abutment screw level. The zirconia implant groups showed irreparable implant head fractures at relatively low fracture loads. Therefore, the clinical use of the presented prototype implants has to be questioned.

  9. Fracture resistance of zirconia-based implant abutments after artificial long-term aging.

    PubMed

    Alsahhaf, Abdulaziz; Spies, Benedikt Christopher; Vach, Kirstin; Kohal, Ralf-Joachim

    2017-02-01

    To investigate the survival rate, fracture strength, bending moments, loading to fracture and fracture modes of different designs of zirconia abutments after dynamic loading with thermocycling, and compare these values to titanium abutments. A total of 80 abutment samples were divided into 5 test groups of 16 samples in each group. The study included the following groups, "Group 1" CAD/CAM produced all-zirconia abutments, "Group 2" titanium abutments, "Group 3" zirconia-abutments adhesively luted to a titanium base, "Group 4" prefabricated all-zirconia abutments and "Group 5" zirconia-abutments glass soldered to a titanium base. Half the number of samples in each group was exposed to 1.2 million loading cycles (5-years simulation) in the chewing simulator. The samples that survived the artificial aging were later tested for fracture strength in a universal testing machine. The remaining 8 samples of the group were directly tested for fracture strength. All samples exposed to the 5-years artificial aging survived except of six samples in one group (Group 1). The surviving samples were later fracture tested in the universal testing machine. The bending moments (Ncm) values were as follow: Exposed groups: "Group 1" 94.5Ncm; "Group 2" 599.2Ncm; "Group 3" 477.5Ncm; "Group 4" 314.4Ncm; "Group 5" 509.4Ncm. Non-exposed groups: "Group 1" 269.3Ncm; "Group 2" 474.2Ncm; "Group 3" 377.6Ncm; "Group 4" 265.4Ncm; "Group 5" 372.4Ncm. Except in Group 1, the values were higher in the exposed groups, although, statistically there was no difference (p>0.05). The one-piece ZrO2-abutment group (Group 1 and Group 4) exhibited lower values, while the two-piece ZrO2-abutment groups (Group 3 and Group 5) showed similar values and fracture modes like the titanium abutment group. The titanium abutment group showed the highest values of bending moments among all groups. The implant-abutment connection area appeared to influence the bending moment value and the fracture mode of the tested

  10. Discoloration of the Peri-implant Mucosa Caused by Zirconia and Titanium Implants.

    PubMed

    Thoma, Daniel S; Ioannidis, Alexis; Cathomen, Elena; Hämmerle, Christoph H F; Hüsler, Jürg; Jung, Ronald E

    2016-01-01

    The aim of the present study was to assess the discoloration of the peri-implant mucosa caused by zirconia (Zr) and titanium (Ti) dental implants with and without soft tissue grafting (STG). Zr and Ti implants were inserted in edentulous areas in pig maxillae. Spectrophotometric measurements were performed prior to and after the insertion of the implants, and following the placement of a STG on the buccal side. A significant discoloration of the mucosa was observed with a mean ΔE of 8.05 (± 2.51) (Ti) and 4.93 (± 3.18) (Zr). In conjunction with a STG, ΔE values amounted to 5.31 ± 3.50 (Ti) and 5.95 (± 3.68) (Zr). The placement of Zr implants led to less discoloration of the mucosa than Ti implants without STG.

  11. Peri-implant bone formation and surface characteristics of rough surface zirconia implants manufactured by powder injection molding technique in rabbit tibiae.

    PubMed

    Park, Young-Seok; Chung, Shin-Hye; Shon, Won-Jun

    2013-05-01

    To evaluate osseointegration in rabbit tibiae and to investigate surface characteristics of novel zirconia implants made by powder injection molding (PIM) technique, using molds with and without roughened inner surfaces. A total of 20 rabbits received three types of external hex implants with identical geometry on the tibiae: machined titanium implants, PIM zirconia implants without mold etching, and PIM zirconia implants with mold etching. Surface characteristics of the three types of implant were evaluated. Removal torque tests and histomorphometric analyses were performed. The roughness of PIM zirconia implants was higher than that of machined titanium implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined titanium implants (P < 0.001). The PIM zirconia implants using roughened mold showed significantly higher removal torque values than PIM zirconia implants without using roughened mold (P < 0.001). It is concluded that the osseointegration of PIM zirconia implant is promising and PIM using roughened mold etching technique can produce substantially rough surfaces on zirconia implants. © 2012 John Wiley & Sons A/S.

  12. 3D-printing zirconia implants; a dream or a reality? An in-vitro study evaluating the dimensional accuracy, surface topography and mechanical properties of printed zirconia implant and discs.

    PubMed

    Osman, Reham B; van der Veen, Albert J; Huiberts, Dennis; Wismeijer, Daniel; Alharbi, Nawal

    2017-11-01

    The aim of this study was to evaluate the dimensional accuracy, surface topography of a custom designed, 3D-printed zirconia dental implant and the mechanical properties of printed zirconia discs. A custom designed implant was 3D-printed in zirconia using digital light processing technique (DLP). The dimensional accuracy was assessed using the digital-subtraction technique. The mechanical properties were evaluated using biaxial flexure strength test. Three different build angles were adopted to print the specimens for the mechanical test; 0°(Vertical), 45° (Oblique) and 90°(Horizontal) angles. The surface topography, crystallographic phase structure and surface roughness were evaluated using scanning electron microscopy analysis (SEM), X-ray diffractometer and confocal microscopy respectively. The printed implant was dimensionally accurate with a root mean square (RMSE) value of 0.1mm. The Weibull analysis revealed a statistically significant higher characteristic strength (1006.6MPa) of 0° printed specimens compared to the other two groups and no significant difference between 45° (892.2MPa) and 90° (866.7MPa) build angles. SEM analysis revealed cracks, micro-porosities and interconnected pores ranging in size from 196nm to 3.3µm. The mean Ra (arithmetic mean roughness) value of 1.59µm (±0.41) and Rq (root mean squared roughness) value of 1.94µm (±0.47) was found. A crystallographic phase of primarily tetragonal zirconia typical of sintered Yttria tetragonal stabilized zirconia (Y-TZP) was detected. DLP prove to be efficient for printing customized zirconia dental implants with sufficient dimensional accuracy. The mechanical properties showed flexure strength close to those of conventionally produced ceramics. Optimization of the 3D-printing process parameters is still needed to improve the microstructure of the printed objects. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. A Critical Review of Dental Implant Materials with an Emphasis on Titanium versus Zirconia

    PubMed Central

    Osman, Reham B.; Swain, Michael V.

    2015-01-01

    The goal of the current publication is to provide a comprehensive literature review on the topic of dental implant materials. The following paper focuses on conventional titanium implants and more recently introduced and increasingly popular zirconia implants. Major subtopics include the material science and the clinical considerations involving both implant materials and the influence of their physical properties on the treatment outcome. Titanium remains the gold standard for the fabrication of oral implants, even though sensitivity does occur, though its clinical relevance is not yet clear. Zirconia implants may prove to be promising in the future; however, further in vitro and well-designed in vivo clinical studies are needed before such a recommendation can be made. Special considerations and technical experience are needed when dealing with zirconia implants to minimize the incidence of mechanical failure. PMID:28787980

  14. Fracture and Fatigue Resistance of Cemented versus Fused CAD-on Veneers over Customized Zirconia Implant Abutments.

    PubMed

    Nossair, Shereen Ahmed; Aboushelib, Moustafa N; Morsi, Tarek Salah

    2015-01-05

    To evaluate the fracture mechanics of cemented versus fused CAD-on veneers on customized zirconia implant abutments. Forty-five identical customized CAD/CAM zirconia implant abutments (0.5 mm thick) were prepared and seated on short titanium implant abutments (Ti base). A second scan was made to fabricate 45 CAD-on veneers (IPS Empress CAD, A2). Fifteen CAD-on veneers were cemented on the zirconia abutments (Panavia F2.0). Another 15 were fused to the zirconia abutments using low-fusing glass, while manually layered veneers served as control (n = 15). The restorations were subjected to artificial aging (3.2 million cycles between 5 and 10 kg in a water bath at 37°C) before being axially loaded to failure. Fractured specimens were examined using scanning electron microscopy to detect fracture origin, location, and size of critical crack. Stress at failure was calculated using fractography principles (alpha = 0.05). Cemented CAD-on restorations demonstrated significantly higher (F = 72, p < 0.001) fracture load compared to fused CAD-on and manually layered restorations. Fractographic analysis of fractured specimens indicated that cemented CAD-on veneers failed due to radial cracks originating from the veneer/resin interface. Branching of the critical crack was observed in the bulk of the veneer. Fused CAD-on veneers demonstrated cohesive fracture originating at the thickest part of the veneer ceramic, while manually layered veneers failed due to interfacial fracture at the zirconia/veneer interface. Within the limitations of this study, cemented CAD-on veneers on customized zirconia implant abutments demonstrated higher fracture than fused and manually layered veneers. © 2014 by the American College of Prosthodontists.

  15. Fracture load of implant-supported zirconia all-ceramic crowns luted with various cements.

    PubMed

    Lim, Hyun-Pil; Yoo, Jeong-Min; Park, Sang-Won; Yang, Hong-So

    2010-01-01

    This study compared the fracture load and failure types of implant-supported zirconia all-ceramic crowns cemented with various luting agents. The ceramic frameworks were fabricated from a presintered yttria-stabilized zirconium dioxide block using computer-aided design/computer-assisted manufacturing technology, and were then veneered with feldspathic porcelain. Three luting agents were used. Composite resin cement (1,560.78 +/- 39.43 N) showed the highest mean fracture load, followed by acrylic/urethane cement (1,116.20 +/- 77.32 N) and zinc oxide eugenol cement (741.21 +/- 41.95 N) (P < .05). The types of failure varied between groups.

  16. Stock Versus CAD/CAM Customized Zirconia Implant Abutments - Clinical and Patient-Based Outcomes in a Randomized Controlled Clinical Trial.

    PubMed

    Schepke, Ulf; Meijer, Henny J A; Kerdijk, Wouter; Raghoebar, Gerry M; Cune, Marco

    2017-02-01

    Single-tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the abutment remain unclear. This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant abutments with respect to preservation of marginal bone level and several clinical and patient-based outcome measures. Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Mölndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Mölndal, Sweden) zirconia abutment therapy. Peri-implant bone level (primary outcome), Plaque-index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. No implants were lost and no complications related to the abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia abutments could not be demonstrated for any of the operationalized variables. The use of a CAD/CAM customized zirconia abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia abutment. © 2016 The Authors. Clinical Implant Dentistry and Related Research Published by Wiley Periodicals, Inc.

  17. Dual jaw treatment of edentulism using implant-supported monolithic zirconia fixed prostheses.

    PubMed

    Altarawneh, Sandra; Limmer, Bryan; Reside, Glenn J; Cooper, Lyndon

    2015-01-01

    This case report describes restoration of the edentulous maxilla and mandible with implant supported fixed prostheses using monolithic zirconia, where the incisal edges and occluding surfaces were made of monolithic zirconia. Edentulism is a debilitating condition that can be treated with either a removable or fixed dental prosthesis. The most common type of implant-supported fixed prosthesis is the metal acrylic (hybrid), with ceramo-metal prostheses being used less commonly in complete edentulism. However, both of these prostheses designs are associated with reported complications of screw loosening or fracture and chipping of acrylic resin and porcelain. Monolithic zirconia implant-supported fixed prostheses have the potential for reduction of such complications. In this case, the CAD/CAM concept was utilized in fabrication of maxillary and mandibular screw-retained implant-supported fixed prostheses using monolithic zirconia. Proper treatment planning and execution coupled with utilizing advanced technologies contributes to highly esthetic results. However, long-term studies are required to guarantee a satisfactory long-term outcome of this modality of treatment. This case report describes the clinical and technical procedures involved in fabrication of maxillary and mandibular implant-supported fixed prostheses using monolithic zirconia as a treatment of edentulism, and proposes the possible advantages associated with using monolithic zirconia in eliminating dissimilar interfaces in such prostheses that are accountable for the most commonly occurring technical complication for these prostheses being chipping and fracture of the veneering material. © 2015 Wiley Periodicals, Inc.

  18. Marginal bone-level alterations of loaded zirconia and titanium dental implants: an experimental study in the dog mandible.

    PubMed

    Thoma, Daniel S; Benic, Goran I; Muñoz, Fernando; Kohal, Ralf; Sanz Martin, Ignacio; Cantalapiedra, Antonio G; Hämmerle, Christoph H F; Jung, Ronald E

    2016-04-01

    The aim was to test whether or not the marginal bone-level alterations of loaded zirconia implants are similar to the bone-level alterations of a grade 4 titanium one-piece dental implant. In six dogs, all premolars and the first molars were extracted in the mandible. Four months later, three zirconia implants (BPI, VC, ZD) and a control titanium one-piece (STM) implant were randomly placed in each hemimandible and left for transmucosal healing (baseline). Six months later, CAD/CAM crowns were cemented. Sacrifice was scheduled at 6-month postloading. Digital X-rays were taken at implant placement, crowns insertion, and sacrifice. Marginal bone-level alterations were calculated, and intra- and intergroup comparisons performed adjusted by confounding factors. Implants were successfully placed. Until crown insertion, two implants were fractured (one VC, one ZD). At sacrifice, 5 more implants were (partly) fractured (one BPI, four ZD), and one lost osseointegration (VC). No decementation of crowns occurred. All implant systems demonstrated a statistically significant (except VC) loss of marginal bone between baseline and crown insertion ranging from 0.29 mm (VC; P = 0.116) to 0.80 mm (ZD; P = 0.013). The estimated marginal bone loss between baseline and 6 months of loading ranged between 0.19 mm (BPI) and 1.11 mm (VC), being statistically significant for STM and VC only (P < 0.05). The changes in marginal bone levels were statistically significantly different between zirconia implants and control implants (STM vs. BPI P = 0.007; vs. VC P = 0.001; vs. ZD P = 0.011). Zirconia implants were more prone to fracture prior to and after loading with implant-supported crowns compared to titanium implants. Individual differences and variability in the extent of the bone-level changes during the 12-month study period were found between the different implant types and materials. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Distortion of CAD-CAM-fabricated implant-fixed titanium and zirconia complete dental prosthesis frameworks.

    PubMed

    Al-Meraikhi, Hadi; Yilmaz, Burak; McGlumphy, Edwin; Brantley, William A; Johnston, William M

    2018-01-01

    Computer-aided design and computer-aided manufacturing (CAD-CAM)-fabricated titanium and zirconia implant-supported fixed dental prostheses have become increasingly popular for restoring patients with complete edentulism. However, the distortion level of these frameworks is not well known. The purpose of this in vitro study was to compare the 3-dimensional (3D) distortion of CAD-CAM zirconia and titanium implant-fixed screw-retained complete dental prostheses. A master edentulous model with 4 implants at the positions of the maxillary first molars and canines was used. Multiunit abutments (Nobel Biocare) secured to the model were digitally scanned using scan bodies and a laboratory scanner (S600 ARTI; Zirkonzahn). Titanium (n=5) and zirconia (n=5) frameworks were milled using a CAD-CAM system (Zirkonzahn M1; Zirkonzahn). All frameworks were scanned using an industrial computed tomography (CT) scanner (Nikon/X-Tek XT H 225kV MCT Micro-Focus). The direct CT scans were reconstructed to generate standard tessellation language (STL) files. To calculate the 3D distortion of the frameworks, STL files of the CT scans were aligned to the CAD model using a sum of the least squares best-fit algorithm. Surface comparison points were placed on the CAD model on the midfacial aspect of all teeth. The 3D distortion of each direct scan to the CAD model was calculated. In addition, color maps of the scan-to-CAD comparison were constructed using a ±0.500 mm color scale range. Both materials exhibited distortion; however, no significant difference was found in the amount of distortion from the CAD model between the materials (P=.747). Absolute values of deviations from the CAD model were evident in the x and y plane and less so in the z direction. Zirconia and titanium frameworks showed similar 3D distortion compared with the CAD model for the tested CAD-CAM and implant systems. The distortion was more pronounced in the horizontal and sagittal plane than in the vertical plane

  20. Load to failure of different zirconia implant abutments with titanium components.

    PubMed

    Mascarenhas, Faye; Yilmaz, Burak; McGlumphy, Edwin; Clelland, Nancy; Seidt, Jeremy

    2017-06-01

    Abutments with a zirconia superstructure and a titanium insert have recently become popular. Although they have been tested under static load, their performance under simulated mastication is not well known. The purpose of this in vitro study was to compare the cyclic load to failure of 3 types of zirconia abutments with different mechanisms of retention of the zirconia to the titanium interface. Fifteen implants (n=5 per system) and abutments (3 groups: 5 friction fit [Frft]; 5 bonded; and 5 titanium ring friction fit [Ringfrft]) were used. Abutments were thermocycled in water between 5°C and 55°C for 15000 cycles and then cyclically loaded for 20000 cycles or until failure at a frequency of 2 Hz by using a sequentially increased loading protocol up to a maximum of 720 N. The load to failure for each group was recorded, and 1-way analysis of variance was performed. The mean load-to-failure values for the Frft group was 526 N, for the Bond group 605 N, and for the Ringfrft group 288 N. A statistically significant difference was found among all abutments tested (P<.05). Abutments with the bonded connection showed the highest load-to-failure value, and the abutment with the titanium ring friction fit connection showed the lowest load-to-failure value. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  1. Structural investigations in helium implanted cubic zirconia using grazing incidence XRD and EXAFS spectroscopy

    NASA Astrophysics Data System (ADS)

    Kuri, G.; Degueldre, C.; Bertsch, J.; Döbeli, M.

    2010-06-01

    The crystal structure and local atom arrangements surrounding Zr atoms were determined for a helium implanted cubic stabilized zirconia (CSZ) using X-ray diffraction (XRD) and extended X-ray absorption fine structure (EXAFS) spectroscopy, respectively, measured at glancing angles. The implanted specimen was prepared at a helium fluence of 2 × 10 16 cm -2 using He + beams at two energies (2.54 and 2.74 MeV) passing through a 8.0 μm Al absorber foil. XRD results identified the formation of a new rhombohedral phase in the helium embedded layer, attributed to internal stress as a result of expansion of the CSZ-lattice. Zr K-edge EXAFS data suggested loss of crystallinity in the implanted lattice and disorder of the Zr atoms environment. EXAFS Fourier transforms analysis showed that the average first-shell radius of the Zr sbnd O pair in the implanted sample was slightly larger than that of the CSZ standard. Common general disorder features were explained by rhombohedral type short-range ordered clusters. The average structural parameters estimated from the EXAFS data of unimplanted and implanted CSZ are compared and discussed. Potential of EXAFS as a local probe of atomic-scale structural modifications induced by helium implantation in CSZ is demonstrated.

  2. Fracture resistance of inter-joined zirconia abutment of dental implant system with injection molding technique.

    PubMed

    Yang, Jianjun; Wang, Ke; Liu, Guangyuan; Wang, Dashan

    2013-11-01

    Zirconia powder in nanometers can be fabricated into inter-joined abutment of dental implant system with the injection shaping technique. This study was to detect the resistance of inter-joined zirconia abutment with different angle loading for clinical applications. The inter-joined abutments were shaped with the technique of injection of zirconia powder in nanometers. Sixty Osstem GSII 5 × 10 mm implants were used with 30 zirconia abutments and 30 Osstem GSII titanium abutments for fixation using 40 N torque force. The loading applications included 90°, 30°, and 0° formed by the long axis of abutments and pressure head of universal test machine. The fracture resistances of zirconia and titanium abutments were documented and analyzed. The inter-joined zirconia abutments were assembled to the Osstem GSII implants successfully. In the 90° loading mode, the fracture resistance of zirconia abutment group and titanium abutment group were 301.5 ± 15.4 N and 736.4 ± 120.1 N, respectively. And those in the 30° groups were 434.7 ± 36.1 N and 1073.1 ± 74 N, correspondingly. Significant difference in the two groups was found using t-test and Wilcoxon test. No damage on the abutments of the two groups but S-shaped bending on the implants was found when the 0° loading was 1300-2000 N. Through the assembly of Zirconia abutments and implants, all the components presented sufficient resistance acquired for the clinical application under loadings with different angle. © 2012 John Wiley & Sons A/S.

  3. Stock Versus CAD/CAM Customized Zirconia Implant Abutments – Clinical and Patient‐Based Outcomes in a Randomized Controlled Clinical Trial

    PubMed Central

    Meijer, Henny J.A.; Kerdijk, Wouter; Raghoebar, Gerry M.; Cune, Marco

    2016-01-01

    Abstract Background Single‐tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the abutment remain unclear. Purpose This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant abutments with respect to preservation of marginal bone level and several clinical and patient‐based outcome measures. Material and Methods Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Mölndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Mölndal, Sweden) zirconia abutment therapy. Peri‐implant bone level (primary outcome), Plaque‐index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. Results No implants were lost and no complications related to the abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia abutments could not be demonstrated for any of the operationalized variables. Conclusion The use of a CAD/CAM customized zirconia abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia abutment. PMID:27476829

  4. A prospective, split-mouth study comparing tilted implants with angulated connection versus conventional implants with angulated abutment.

    PubMed

    Van Weehaeghe, Manú; De Bruyn, Hugo; Vandeweghe, Stefan

    2017-12-01

    An angulation of the implant connection could overcome the problems related to angulated abutments. This study compares conventional implants with angulated abutment to tilted implants with an angulated connection. Twenty patients were treated in the edentulous mandible. In the posterior jaw locations, one conventional tilted implant with angulated abutment and one angulated implant without abutment were placed. In the anterior jaw, two conventional implants were placed, one with and one without abutment. Implants were immediately loaded and 3 months later, the final bridge (PFM or monolithic zirconia) was placed. After a follow-up of 48 months, 17 patients were available for clinical examination. The mean overall marginal bone loss (MBL) was 1.26 mm. No significant differences in implant survival, MBL, periodontal indices, patients' satisfaction, or complications was found between implants restored on abutment or implant level, between the posteriorly located angulated implant nor angulated abutment, and between both anterior implants with or without abutment. The posterior implants demonstrated less MBL compared to the anterior implants (P < .001). There was no significant difference in MBL between the implants restored with zirconia or PFM bridges (P = .294). Overall mean pocket depth was 2.83 mm. More plaque was found in the PFM group compared to the full-zirconia group, at the bridge (P = .042) and the implants (P = .029). There was no difference between both materials in pocket depth (P = .635) or bleeding (P = .821). One zirconia bridge fractured, two angulated abutment were replaced and four loose bridge screws connected to the angulated abutments had to be tightened. Patients were overall satisfied (4.74/5). An implant with angulated connection may results in a stronger connection but does not affect the marginal bone loss. No difference in MBL was seen between implants restored on abutment or implant level. Zirconia seems to reduce

  5. Immediate, non-submerged, root-analogue zirconia implant in single tooth replacement.

    PubMed

    Pirker, W; Kocher, A

    2008-03-01

    This report demonstrates the successful clinical use of a modified root-analogue zirconia implant for immediate single tooth replacement. A right maxillary premolar was removed and a custom-made, root-analogue, roughened zirconia implant with macro-retentions in the interdental space was fabricated and placed into the extraction socket 4 days later. Four months after root implantation a composite crown was cemented. No complications occurred during the healing period. An excellent esthetic and functional result was achieved with the composite crown. No clinically noticeable bone resorption or soft-tissue recession was observed at 26 months follow up. Significant modifications such as macro-retentions seem to indicate that primary stability and excellent osseointegration of immediate root-analogue zirconia implants can be achieved, while preventing unesthetic bone resorption. The macro-retentions must be limited to the interdental space to avoid fracture of the thin buccal cortex. This successful case warrants further clinical research in well controlled trials.

  6. Biomechanical properties of polymer-infiltrated ceramic crowns on one-piece zirconia implants after long-term chewing simulation.

    PubMed

    Baumgart, Pia; Kirsten, Holger; Haak, Rainer; Olms, Constanze

    2018-05-23

    Implant and superstructure provide a complex system, which has to withstand oral conditions. Concerning the brittleness of many ceramics, fractures are a greatly feared issue. Therefore, polymer-infiltrated ceramic networks (PICNs) were developed. Because of its low Young's modulus and high elastic modulus, the PICN crown on a one-piece zirconia implant might absorb forces to prevent the system from fracturing in order to sustain oral forces. Recommendations for the material of superstructure on zirconia implants are lacking, and only one study investigates PICN crowns on these types of implants. Accordingly, this study aimed to examine PICN crowns on one-piece zirconia implants regarding bond strength and surface wear after long-term chewing simulation (CS). Twenty-five hybrid ceramic crowns (Vita Enamic, Vita Zahnfabrik) were produced using computer-aided design/computer-aided manufacturing (CAD/CAM) technology and adhesively bonded (RelyX™ Ultimate, 3M ESPE) to zirconia implants. Twenty of the specimens underwent simultaneous mechanical loading and thermocycling simulating a 5-year clinical situation (SD Mechatronik GmbH). Wear depth and wear volume, based on X-ray micro-computed tomography volume scans (Skyscan 1172-100-50, Bruker) before and after CS, were evaluated. All crowns were removed from the implants using a universal testing machine (Z010, Zwick GmbH&Co.KG). Subsequently, luting agent was light microscopically localized (Stemi 2000-C, Zeiss). With a scanning electron microscope (SEM, Phenom™ G2 pro, Phenom World), the area of abrasion was assessed. 1. After CS, none of the tested crowns were fractured or loosened. 2. The maximum vertical wear after CS was M = 0.31 ± 0.04 mm (mean ± standard deviation), and the surface wear was M = 0.74 ± 0.23 mm 3 . 3. The pull-off tests revealed a 1.8 times higher bond strength of the control group compared to the experimental group (t(23) = 8.69, p < 0.001). 4. Luting agent was

  7. In vitro comparison of fracture load of implant-supported, zirconia-based, porcelain- and composite-layered restorations after artificial aging.

    PubMed

    Komine, Futoshi; Taguchi, Kohei; Fushiki, Ryosuke; Kamio, Shingo; Iwasaki, Taro; Matsumura, Hideo

    2014-01-01

    This study evaluated fracture load of single-tooth, implant-supported, zirconia-based, porcelain- and indirect composite-layered restorations after artificial aging. Forty-four zirconia-based molar restorations were fabricated on implant abutments and divided into four groups, namely, zirconia-based all-ceramic restorations (ZAC group) and three types of zirconia-based composite-layered restorations (ZIC-P, ZIC-E, and ZIC groups). Before layering an indirect composite material, the zirconia copings in the ZIC-P and ZIC-E groups were primed with Clearfil Photo Bond and Estenia Opaque Primer, respectively. All restorations were cemented on the abutments with glass-ionomer cement and then subjected to thermal cycling and cyclic loading. All specimens survived thermal cycling and cyclic loading. The fracture load of the ZIC-P group (2.72 kN) was not significantly different from that of the ZAC group (3.05 kN). The fracture load of the zirconia-based composite-layered restoration primed with Clearfil Photo Bond (ZIC-P) was comparable to that of the zirconia-based all-ceramic restoration (ZAC) after artificial aging.

  8. Bending moments of zirconia and titanium implant abutments supporting all-ceramic crowns after aging.

    PubMed

    Mühlemann, Sven; Truninger, Thomas C; Stawarczyk, Bogna; Hämmerle, Christoph H F; Sailer, Irena

    2014-01-01

    To test the fracture load and fracture patterns of zirconia abutments restored with all-ceramic crowns after fatigue loading, exhibiting internal and external implant-abutment connections as compared to restored and internally fixed titanium abutments. A master abutment was used for the customization of 5 groups of zirconia abutments to a similar shape (test). The groups differed according to their implant-abutment connections: one-piece internal connection (BL; Straumann Bonelevel), two-piece internal connection (RS; Nobel Biocare ReplaceSelect), external connection (B; Branemark MkIII), two-piece internal connection (SP, Straumann StandardPlus) and one-piece internal connection (A; Astra Tech AB OsseoSpeed). Titanium abutments with internal implant-abutment connection (T; Straumann Bonelevel) served as control group. In each group, 12 abutments were fabricated, mounted to the respective implants and restored with glass-ceramic crowns. All samples were embedded in acrylic holders (ISO-Norm 14801). After aging by means of thermocycling in a chewing simulator, static load was applied until failure (ISO-Norm 14801). Fracture load was analyzed by calculating the bending moments. Values of all groups were compared with one-way ANOVA followed by Scheffé post hoc test (P-value<0.05). Failure mode was analyzed descriptively. The mean bending moments were 464.9 ± 106.6 N cm (BL), 581.8 ± 172.8 N cm (RS), 556.7 ± 128.4 N cm (B), 605.4 ± 54.7 N cm (SP), 216.4 ± 90.0 N cm (A) and 1042.0 ± 86.8 N cm (T). No difference of mean bending moments was found between groups BL, RS, B and SP. Test group A exhibited significantly lower mean bending moment than the other test groups. Control group T had significantly higher bending moments than all test groups. Failure due to fracture of the abutment and/or crown occurred in the test groups. In groups BL and A, fractures were located in the internal part of the connection, whereas in groups RS and SP, a partial

  9. Fracture of Reduced-Diameter Zirconia Dental Implants Following Repeated Insertion.

    PubMed

    Karl, Matthias; Scherg, Stefan; Grobecker-Karl, Tanja

    Achievement of high insertion torque values indicating good primary stability is a goal during dental implant placement. The objective of this study was to evaluate whether or not two-piece implants made from zirconia ceramic may be damaged as a result of torque application. A total of 10 two-piece zirconia implants were repeatedly inserted into polyurethane foam material with increasing density and decreasing osteotomy size. The insertion torque applied was measured, and implants were checked for fractures by applying the fluorescent penetrant method. Weibull probability of failure was calculated based on the recorded insertion torque values. Catastrophic failures could be seen in five of the implants from two different batches at insertion torques ranging from 46.0 to 70.5 Ncm, while the remaining implants (all belonging to one batch) survived. Weibull probability of failure seems to be low at the manufacturer-recommended maximum insertion torque of 35 Ncm. Chipping fractures at the thread tips as well as tool marks were the only otherwise observed irregularities. While high insertion torques may be desirable for immediate loading protocols, zirconia implants may fracture when manufacturer-recommended insertion torques are exceeded. Evaluating bone quality prior to implant insertion may be useful.

  10. 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

  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. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  12. Deformation characteristics of the near-surface layers of zirconia ceramics implanted with aluminum ions

    NASA Astrophysics Data System (ADS)

    Ghyngazov, S. A.; Vasiliev, I. P.; Frangulyan, T. S.; Chernyavski, A. V.

    2015-10-01

    The effect of ion treatment on the phase composition and mechanical properties of the near-surface layers of zirconium ceramic composition 97 ZrO2-3Y2O3 (mol%) was studied. Irradiation of the samples was carried out by accelerated ions of aluminum with using vacuum-arc source Mevva 5-Ru. Ion beam had the following parameters: the energy of the accelerated ions E = 78 keV, the pulse current density Ji = 4mA / cm2, current pulse duration equal τ = 250 mcs, pulse repetition frequency f = 5 Hz. Exposure doses (fluence) were 1016 и 1017 ion/cm2. The depth distribution implanted ions was studied by SIMS method. It is shown that the maximum projected range of the implanted ions is equal to 250 nm. Near-surface layers were investigated by X-ray diffraction (XRD) at fixed glancing incidence angle. It is shown that implantation of aluminum ions into the ceramics does not lead to a change in the phase composition of the near-surface layer. The influence of implanted ions on mechanical properties of ceramic near-surface layers was studied by the method of dynamic nanoindentation using small loads on the indenter P=300 mN. It is shown that in ion- implanted ceramic layer the processes of material recovery in the deformed region in the unloading mode proceeds with higher efficiency as compared with the initial material state. The deformation characteristics of samples before and after ion treatment have been determined from interpretation of the resulting P-h curves within the loading and unloading sections by the technique proposed by Oliver and Pharr. It was found that implantation of aluminum ions in the near-surface layer of zirconia ceramics increases nanohardness and reduces the Young's modulus.

  13. 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. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Novel Cranial Implants of Yttria-Stabilized Zirconia as Acoustic Windows for Ultrasonic Brain Therapy.

    PubMed

    Gutierrez, Mario I; Penilla, Elias H; Leija, Lorenzo; Vera, Arturo; Garay, Javier E; Aguilar, Guillermo

    2017-11-01

    Therapeutic ultrasound can induce changes in tissues by means of thermal and nonthermal effects. It is proposed for treatment of some brain pathologies such as Alzheimer's, Parkinson's, Huntington's diseases, and cancer. However, cranium highly absorbs ultrasound reducing transmission efficiency. There are clinical applications of transcranial focused ultrasound and implantable ultrasound transducers proposed to address this problem. In this paper, biocompatible materials are proposed for replacing part of the cranium (cranial implants) based on low porosity polycrystalline 8 mol% yttria-stabilized-zirconia (8YSZ) ceramics as acoustic windows for brain therapy. In order to assess the viability of 8YSZ implants to effectively transmit ultrasound, various 8YSZ ceramics with different porosity are tested; their acoustic properties are measured; and the results are validated using finite element models simulating wave propagation to brain tissue through 8YSZ windows. The ultrasound attenuation is found to be linearly dependent on ceramics' porosity. Results for the nearly pore-free case indicate that 8YSZ is highly effective in transmitting ultrasound, with overall maximum transmission efficiency of ≈81%, compared to near total absorption of cranial bone. These results suggest that 8YSZ polycrystals could be suitable acoustic windows for ultrasound brain therapy at 1 MHz. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Prosthodontic maintenance of overdentures on zirconia implants: 1-year results of a randomized controlled trial.

    PubMed

    Osman, Reham B; Ma, Sunyoung

    2014-01-01

    The purpose of this study was to determine the prosthodontic outcomes of one-piece zirconia implants and their attachment systems in edentulous participants with maxillary and mandibular overdentures after 1 year of a randomized controlled trial. Random allocation of 24 edentulous participants (age range: 45 to 86 years) into titanium (control) or zirconia (test) groups using onepiece implants and a planned unsplinted prosthodontic design was performed. Four maxillary implants (one midpalatal; three anterior crestal) and three mandibular implants (one midsymphyseal; two bilateral distal) were conventionally loaded with the overdentures. Similar attachment systems were used throughout: ball abutment-type patrices (diameter: 2.25 to 3.1 mm as part of the one-piece implants) and custommade plastic matrices (with or without metal housings depending on the patrix size). Prosthodontic outcomes were documented during the first year of the clinical trial. Following three deaths and two dropouts, there were 19 participants who were available at the 1-year recall. Of these participants, 3 had early maxillary implant failure and had to be converted to conventional maxillary complete dentures opposing mandibular implant overdentures. There were 79 maintenance events, 34 in the titanium (control) group and 45 in the zirconia (test) group. Patrix loss occurred as a result of three zirconia implant fractures (one mandibular and two crestal maxillary implants). Maintenance events were principally the replacement of matrices and overdenture fracture. Although relines and replacement overdentures also occurred, overall there were no significant differences in prosthodontic maintenance between the control and test groups. A six-field prosthodontic-success analysis table showed no statistically significant difference between the two groups; however, 50% of participants in each group were allocated to the retreatment (repair) field, which produced a low prosthodontic success rate

  16. Comparison of heat generated by alumina-toughened zirconia and stainless steel burs for implant placement.

    PubMed

    Pires, Luis Fernando S; Tandler, Bernard; Bissada, Nabil; Duarte, Sillas

    2012-01-01

    In current practice, two types of burs are typically used: stainless steel (SS) and alumina-toughened zirconia (ATZ). The present study evaluated the durability of these two burs in relation to osteotomy creation for implant placement. In addition, the effects of the two types of burs on a bone model were examined. SS and ATZ burs were compared under controlled conditions in a swine rib osteotomy. The heat generated and time necessary for perforation were measured and analyzed with repeated-measures one-way analysis of variance. The burs and bone samples were evaluated using scanning electron microscopy. New ATZ and SS burs showed greater bone disruption compared to burs that had been used 80 times. Brand new burs of either material showed small manufacturing defects, which increased in number with use. No clinically or statistically significant differences were found between burs with respect to temperature and time for perforation. SS and ATZ burs can be used several times for implant site preparation under controlled conditions without reaching a temperature that is harmful to the bone. Both burs wear under repeated use, but not to an excessive degree. The duller burs produced smoother perforations than did the new ones.

  17. Comparison of 3D displacements of screw-retained zirconia implant crowns into implants with different internal connections with respect to screw tightening.

    PubMed

    Rebeeah, Hanadi A; Yilmaz, Burak; Seidt, Jeremy D; McGlumphy, Edwin; Clelland, Nancy; Brantley, William

    2018-01-01

    Internal conical implant-abutment connections without horizontal platforms may lead to crown displacement during screw tightening and torque application. This displacement may affect the proximal contacts and occlusion of the definitive prosthesis. The purpose of this in vitro study was to evaluate the displacement of custom screw-retained zirconia single crowns into a recently introduced internal conical seal implant-abutment connection in 3D during hand and torque driver screw tightening. Stereolithic acrylic resin models were printed using computed tomography data from a patient missing the maxillary right central incisor. Two different internal connection implant systems (both ∼11.5 mm) were placed in the edentulous site in each model using a surgical guide. Five screw-retained single zirconia computer-aided design and computer-aided manufacturing (CAD-CAM) crowns were fabricated for each system. A pair of high-resolution digital cameras was used to record the relationship of the crown to the model. The crowns were tightened according to the manufacturers' specifications using a torque driver, and the cameras recorded their relative position again. Three-dimensional image correlation was used to measure and compare crown positions, first hand tightened and then torque driven. The displacement test was repeated 3 times for each crown. Commercial image correlation software was used to extract the data and compare the amount of displacement vertically, mesiodistally, and buccolingually. Repeated-measures ANOVA calculated the relative displacements for all 5 specimens for each implant for both crown screw hand tightening and after applied torque. A Student t test with Bonferroni correction was used for pairwise comparison of interest to determine statistical differences between the 2 implants (α=.05). The mean vertical displacements were statistically higher than the mean displacements in the mesiodistal and buccolingual directions for both implants (P<.001

  18. Zirconia-implant-supported all-ceramic crowns withstand long-term load: a pilot investigation.

    PubMed

    Kohal, Ralf-J; Klaus, Gerold; Strub, Jörg R

    2006-10-01

    The purpose of this pilot investigation was to test whether zirconia implants restored with different all-ceramic crowns would fulfill the biomechanical requirements for clinical use. Therefore, all-ceramic Empress-1 and Procera crowns were cemented on zirconia implants and exposed to the artificial mouth. Afterwards, the fracture strength of the all-ceramic implant-crown systems was evaluated. Conventional titanium implants restored with porcelain-fused-to-metal (PFM) crowns served as controls. Sixteen titanium implants with 16 PFM crowns and 32 zirconia implants with 16 Empress-1 crowns and 16 Procera crowns each--i.e., three implant-crown groups--were used in this investigation. The titanium implants were fabricated using the ReImplant system and the zirconia implants using the Celay system. The upper left central incisor served as a model for the fabrication of the implants and the crowns. Eight samples of each group were submitted to a long-term load test in the artificial mouth (1.2 million chewing cycles). Subsequently, a fracture strength test was performed with seven of the eight crowns. The remaining eight samples of each group were not submitted to the long-term load in the artificial mouth but were fracture-tested immediately. One loaded and one unloaded sample of each group were evaluated regarding the marginal fit of the crowns. All test samples survived the exposure to the artificial mouth. Three Empress-1 crowns showed cracks in the area of the loading steatite ball. The values for the fracture load in the titanium implant-PFM crown group without artificial loading ranged between 420 and 610 N (mean: 531.4 N), between 460 and 570 N (mean: 512.9 N) in the Empress-1 crown group, and in the Procera crown group the values were between 475 and 700 N (mean: 575.7 N) when not loaded artificially. The results when the specimens were loaded artificially with 1.2 million cycles were as follows: the titanium implant-PFM crowns fractured between 440 and 950 N

  19. Effects of framework design and layering material on fracture strength of implant-supported zirconia-based molar crowns.

    PubMed

    Kamio, Shingo; Komine, Futoshi; Taguchi, Kohei; Iwasaki, Taro; Blatz, Markus B; Matsumura, Hideo

    2015-12-01

    To evaluate the effects of framework design and layering material on the fracture strength of implant-supported zirconia-based molar crowns. Sixty-six titanium abutments (GingiHue Post) were tightened onto dental implants (Implant Lab Analog). These abutment-implant complexes were randomly divided into three groups (n = 22) according to the design of the zirconia framework (Katana), namely, uniform-thickness (UNI), anatomic (ANA), and supported anatomic (SUP) designs. The specimens in each design group were further divided into two subgroups (n = 11): zirconia-based all-ceramic restorations (ZAC group) and zirconia-based restorations with an indirect composite material (Estenia C&B) layered onto the zirconia framework (ZIC group). All crowns were cemented on implant abutments, after which the specimens were tested for fracture resistance. The data were analyzed with the Kruskal-Wallis test and the Mann-Whitney U-test with the Bonferroni correction (α = 0.05). The following mean fracture strength values (kN) were obtained in UNI design, ANA design, and SUP design, respectively: Group ZAC, 3.78, 6.01, 6.50 and Group ZIC, 3.15, 5.65, 5.83. In both the ZAC and ZIC groups, fracture strength was significantly lower for the UNI design than the other two framework designs (P = 0.001). Fracture strength did not significantly differ (P > 0.420) between identical framework designs in the ZAC and ZIC groups. A framework design with standardized layer thickness and adequate support of veneer by zirconia frameworks, as in the ANA and SUP designs, increases fracture resistance in implant-supported zirconia-based restorations under conditions of chewing attrition. Indirect composite material and porcelain perform similarly as layering materials on zirconia frameworks. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Evaluation of laser bacterial anti-fouling of transparent nanocrystalline yttria-stabilized-zirconia cranial implant.

    PubMed

    Damestani, Yasaman; De Howitt, Natalie; Halaney, David L; Garay, Javier E; Aguilar, Guillermo

    2016-10-01

    The development and feasibility of a novel nanocrystalline yttria-stabilized-zirconia (nc-YSZ) cranial implant has been recently established. The purpose of what we now call "window to the brain (WttB)" implant (or platform), is to improve patient care by providing a technique for delivery and/or collection of light into/from the brain, on demand, over large areas, and on a chronically recurring basis without the need for repeated craniotomies. WttB holds the transformative potential for enhancing light-based diagnosis and treatment of a wide variety of brain pathologies including cerebral edema, traumatic brain injury, stroke, glioma, and neurodegenerative diseases. However, bacterial adhesion to the cranial implant is the leading factor for biofilm formation (fouling), infection, and treatment failure. Escherichia coli (E. coli), in particular, is the most common isolate in gram-negative bacillary meningitis after cranial surgery or trauma. The transparency of our WttB implant may provide a unique opportunity for non-invasive treatment of bacterial infection under the implant using medical lasers. A drop of a diluted overnight culture of BL21-293 E. coli expressing luciferase was seeded between the nc-YSZ implant and the agar plate. This was followed by immediate irradiation with selected laser. After each laser treatment the nc-YSZ was removed, and cultures were incubated for 24 hours at 37 °C. The study examined continuous wave (CW) and pulsed wave (PW) modes of near-infrared (NIR) 810 nm laser wavelength with a power output ranging from 1 to 3 W. During irradiation, the temperature distribution of nc-YSZ surface was monitored using an infrared thermal camera. Relative luminescence unit (RLU) was used to evaluate the viability of bacteria after the NIR laser treatment. Analysis of RLU suggests that the viability of E. coli biofilm formation was reduced with NIR laser treatment when compared to the control group (P < 0.01) and loss of viability

  1. Complications and Clinical Considerations of the Implant-Retained Zirconia Complete-Arch Prosthesis with Various Opposing Dentitions.

    PubMed

    Gonzalez, Jorge; Triplett, Robert G

    To evaluate the performance of the implant-retained zirconia complete-arch prosthesis with various opposing dentitions. The 40 patients included in this retrospective case series study were treated with one or two implant-retained zirconia complete-arch prostheses (ZIRCAP) using the Zirkonzahn protocol. Prettau zirconia frames were created with strategic cutbacks in the structure to extend zirconia incisal coverage of the esthetic anterior sextants and complete monolithic zirconia in the molar areas; subsequent layers of porcelain were applied to nonfunctional and esthetic areas. Patients had three possible occlusal scenarios: (1) maxillary ZIRCAP and mandibular ZIRCAP, (2) maxillary ZIRCAP and mandibular natural dentition, and (3) maxillary ZIRCAP and mandibular conventional hybrid prosthesis. Complications were recorded during follow-up appointments 3, 6, and 12 months after definitive prosthesis delivery. The mean treatment observation period was 33 months. Eight prosthetic complications were noted for the 40 implant-retained zirconia complete-arch prostheses (18.18%), including six cases of minor porcelain chipping and two cases of debonding of the metal insert from the zirconia framework. Maxillary ZIRCAP opposing mandibular ZIRCAP and maxillary ZIRCAP opposing mandibular natural dentition occlusal scenarios presented the same complication ratio of 4. No complications were seen in the maxillary ZIRCAP opposing mandibular conventional hybrid prosthesis group, yet 16 complications were found as denture tooth fractures in 12 mandibular conventional hybrid prostheses (ratio of 0.75). The results indicate that the implant-retained zirconia complete-arch prosthesis offers acceptable performance for use as an alternative to the conventional titanium framework acrylic veneer prosthesis for complete edentulism with a lower incidence of prosthetic complications and fewer maintenance appointments. Chipping of veneering porcelain was the most common complication, but a

  2. Alumina-zirconia machinable abutments for implant-supported single-tooth anterior crowns.

    PubMed

    Sadoun, M; Perelmuter, S

    1997-01-01

    Innovative materials and application techniques are constantly being developed in the ongoing search for improved restorations. This article describes a new material and the fabrication process of aesthetic machinable ceramic anterior implant abutments. The ceramic material utilized is a mixture of alumina (aluminum oxide) and ceria (cerium oxide) with partially stabilized zirconia (zirconium oxide). The initial core material is a cylinder with a 9-mm diameter and a 15-mm height, obtained by ceramic injection and presintering processes. The resultant alumina-zirconia core is porous and readily machinable. It is secured to the analog, and its design is customized by machining the abutment to suit the particular clinical circumstances. The machining is followed by glass infiltration, and the crown is finalized. The learning objective of this article is to gain a basic knowledge of the fabrication and clinical application of the custom machinable abutments.

  3. 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. © 2012 by the American College of Prosthodontists.

  4. Effects of artificial aging conditions on yttria-stabilized zirconia implant abutments.

    PubMed

    Basílio, Mariana de Almeida; Cardoso, Kátia Vieira; Antonio, Selma Gutierrez; Rizkalla, Amin Sami; Santos Junior, Gildo Coelho; Arioli Filho, João Neudenir

    2016-08-01

    Most ceramic abutments are fabricated from yttria-stabilized tetragonal zirconia (Y-TZP). However, Y-TZP undergoes hydrothermal degradation, a process that is not well understood. The purpose of this in vitro study was to assess the effects of artificial aging conditions on the fracture load, phase stability, and surface microstructure of a Y-TZP abutment. Thirty-two prefabricated Y-TZP abutments were screwed and tightened down to external hexagon implants and divided into 4 groups (n = 8): C, control; MC, mechanical cycling (1×10(6) cycles; 10 Hz); AUT, autoclaving (134°C; 5 hours; 0.2 MPa); and TC, thermal cycling (10(4) cycles; 5°/55°C). A single-load-to-fracture test was performed at a crosshead speed of 0.5 mm/min to assess the assembly's resistance to fracture (ISO Norm 14801). X-ray diffraction (XRD) analysis was applied to observe and quantify the tetragonal-monoclinic (t-m) phase transformation. Representative abutments were examined with high-resolution scanning electron microscopy (SEM) to observe the surface characteristics of the abutments. Load-to-fracture test results (N) were compared by ANOVA and Tukey test (α=.05). XRD measurements revealed the monoclinic phase in some abutments after each aging condition. All the aging conditions reduced the fracture load significantly (P<.001). Mechanical cycling reduced the fracture load more than autoclaving (P=.034). No differences were found in the process of surface degradation among the groups; however, the SEM detected grinding-induced surface flaws and microcracks. The resistance to fracture and the phase stability of Y-TZP implant abutments were susceptible to hydrothermal and mechanical conditions. The surface microstructure of Y-TZP abutments did not change after aging conditions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  5. Comparative Evaluation of Fracture Resistance and Mode of Failure of Zirconia and Titanium Abutments with Different Diameters.

    PubMed

    Shabanpour, Reza; Mousavi, Niloufar; Ghodsi, Safoura; Alikhasi, Marzieh

    2015-08-01

    The purpose of the current study was to compare the fracture resistance and mode of failure of zirconia and titanium abutments with different diameters. Fourteen groups of abutments including prefabricated zirconia, copy-milled zirconia and titanium abutments of an implant system (XiVE, Dentsply) were prepared in different diameters. An increasing vertical load was applied to each specimen until failure occurred. Fracture resistance was measured in each group using the universal testing machine. Moreover, the failure modes were studied and categorized as abutment screw fracture, connection area fracture, abutment body fracture, abutment body distortion, screw distortion and connection area distortion. Groups were statistically compared using univariate and post-hoc tests. The level of statistical significance was set at 5%. Fabrication method (p = 0.03) and diameter (p < 0.001) had significant effect on the fracture resistance of abutments. Fracture resistance of abutments with 5.5 mm diameter was higher than other diameters (p < 0.001). The observed modes of failure were dependent on the abutment material as well. All of the prefabricated titanium abutments fractured within the abutment screw. Abutment screw distortion, connection area fracture, and abutment body fracture were the common failure type in other groups. Diameter had a significant effect on fracture resistance of implant abutments, as abutments with greater diameters were more resistant to static loads. Copy-milled abutments showed lower fracture resistance as compared to other experimental groups. Although zirconia abutments have received great popularity among clinicians and even patients selecting them for narrow implants should be with caution.

  6. Assessment and comparison of retention of zirconia copings luted with different cements onto zirconia and titanium abutments: An in vitro study

    PubMed Central

    Menon, Neelima Sreekumar; Kumar, G. P. Surendra; Jnanadev, K. R.; Satish Babu, C. L.; Shetty, Shilpa

    2016-01-01

    Aim: The purpose of this in vitro study was to assess and compare the retention of zirconia copings luted with different luting agents onto zirconia and titanium abutments. Materials and Methods: Titanium and zirconia abutments were torqued at 35 N/cm onto implant analogs. The samples were divided into two groups: Group A consisted of four titanium abutments and 32 zirconia copings and Group B consisted of four zirconia abutments and 32 zirconia copings and four luting agents were used. The cemented copings were subjected to tensile dislodgement forces and subjected to ANOVA test. Results: Zirconia abutments recorded a higher mean force compared to titanium. Among the luting agents, resin cement recorded the highest mean force followed by zinc phosphate, glass ionomer, and noneugenol zinc oxide cement, respectively. Conclusion: Highest mean retention was recorded for zirconia implant abutments compared to titanium abutments when luted with zirconia copings. PMID:27141162

  7. Dental implant customization using numerical optimization design and 3-dimensional printing fabrication of zirconia ceramic.

    PubMed

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

    2017-05-01

    This study proposes a new methodology for dental implant customization consisting of numerical geometric optimization and 3-dimensional printing fabrication of zirconia ceramic. In the numerical modeling, exogenous factors for implant shape include the thread pitch, thread depth, maximal diameter of implant neck, and body size. Endogenous factors are bone density, cortical bone thickness, and non-osseointegration. An integration procedure, including uniform design method, Kriging interpolation and genetic algorithm, is applied to optimize the geometry of dental implants. The threshold of minimal micromotion for optimization evaluation was 100 μm. The optimized model is imported to the 3-dimensional slurry printer to fabricate the zirconia green body (powder is bonded by polymer weakly) of the implant. The sintered implant is obtained using a 2-stage sintering process. Twelve models are constructed according to uniform design method and simulated the micromotion behavior using finite element modeling. The result of uniform design models yields a set of exogenous factors that can provide the minimal micromotion (30.61 μm), as a suitable model. Kriging interpolation and genetic algorithm modified the exogenous factor of the suitable model, resulting in 27.11 μm as an optimization model. Experimental results show that the 3-dimensional slurry printer successfully fabricated the green body of the optimization model, but the accuracy of sintered part still needs to be improved. In addition, the scanning electron microscopy morphology is a stabilized t-phase microstructure, and the average compressive strength of the sintered part is 632.1 MPa. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Hybrid micro/nano-topography of a TiO2 nanotube-coated commercial zirconia femoral knee implant promotes bone cell adhesion in vitro.

    PubMed

    Frandsen, Christine J; Noh, Kunbae; Brammer, Karla S; Johnston, Gary; Jin, Sungho

    2013-07-01

    Various approaches have been studied to engineer the implant surface to enhance bone in-growth properties, particularly using micro- and nano-topography. In this study, the behavior of osteoblast (bone) cells was analyzed in response to a titanium oxide (TiO2) nanotube-coated commercial zirconia femoral knee implant consisting of a combined surface structure of a micro-roughened surface with the nanotube coating. The osteoblast cells demonstrated high degrees of adhesion and integration into the surface of the nanotube-coated implant material, indicating preferential cell behavior on this surface when compared to the bare implant. The results of this brief study provide sufficient evidence to encourage future studies. The development of such hierarchical micro- and nano-topographical features, as demonstrated in this work, can provide insightful designs for advanced bone-inducing material coatings on ceramic orthopedic implant surfaces. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. On the bulk degradation of yttria-stabilized nanocrystalline zirconia dental implant abutments: an electron backscatter diffraction study.

    PubMed

    Ocelík, V; Schepke, U; Rasoul, H Haji; Cune, M S; De Hosson, J Th M

    2017-08-01

    Degradation of yttria-stabilized zirconia dental implants abutments due to the tetragonal to monoclinic phase transformation was studied in detail by microstructural characterization using Electron Back Scatter Diffraction (EBSD). The amount and distribution of the monoclinic phase, the grain-size distribution and crystallographic orientations between tetragonal and monoclinic crystals in 3 mol.% yttria-stabilized polycrystalline zirconia (3Y-TZP) were determined in two different types of nano-crystalline dental abutments, even for grains smaller than 400 nm. An important and novel conclusion is that no substantial bulk degradation of 3Y-TZP dental implant abutments was detected after 1 year of clinical use.

  10. Clinical outcome of double crown-retained implant overdentures with zirconia primary crowns

    PubMed Central

    Buergers, Ralf; Ziebolz, Dirk; Roediger, Matthias

    2015-01-01

    PURPOSE This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: 5.9 ± 2.2 years), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required. PMID:26330981

  11. Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns

    PubMed Central

    Kwon, Taek-Ka; Pak, Hyun-Soon; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun

    2013-01-01

    PURPOSE All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. MATERIALS AND METHODS Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. RESULTS The mean fracture strengths were as follows: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. CONCLUSION The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain. PMID:23755332

  12. Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns.

    PubMed

    Kwon, Taek-Ka; Pak, Hyun-Soon; Yang, Jae-Ho; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun; Yeo, In-Sung

    2013-05-01

    All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. THE MEAN FRACTURE STRENGTHS WERE AS FOLLOWS: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain.

  13. An investigation of heat transfer to the implant-bone interface when drilling through a zirconia crown attached to a titanium or zirconia abutment.

    PubMed

    Mason, Amy G; Sutton, Alan; Turkyilmaz, Ilser

    2014-11-01

    Thermal injury to the implant-bone interface may lead to bone necrosis and loss of osseointegration. This is a concern during manipulation of the implant throughout the restorative phase of treatment. The risk of heat transfer to the implant-bone interface during abutment preparation or prosthesis removal should be considered. The purpose of the study was to examine the amount of heat transferred to the implant-bone interface when a zirconia crown is drilled to access the screw channel or section a crown with a high-speed dental handpiece. Of the 64 ceramic-veneered zirconia crowns fabricated, 32 had a coping thickness of 0.5 mm and 32 had a coping thickness of 1.0 mm. The crowns were cemented on either titanium stock abutments or zirconia stock abutments. Each group was further subdivided to evaluate heat transfer when the screw channel was accessed or the crown was sectioned with a high-speed handpiece with or without irrigation. Temperature change was recorded for each specimen at the cervical and apical aspect of the implant with thermocouples and a logging thermometer. ANOVA was used to assess the statistical significance in temperature change between the test combinations, and nonparametric Mann-Whitney U tests were used to evaluate the findings. The use of irrigation during both crown removal processes yielded an average temperature increase of 3.59 ±0.35°C. Crown removal in the absence of irrigation yielded an average temperature increase of 18.76 ±3.09°C. When all parameter combinations in the presence of irrigation were evaluated, the maximum temperature change was below the threshold of thermal injury to bone. The maximum temperature change was above the threshold for thermal injury at the coronal aspect of the implant and below the threshold at the apical aspect in the absence of irrigation. Within the limitations of this investigation, the use of irrigation with a high-speed dental handpiece to remove a ceramic-veneered zirconia crown results in

  14. Zirconia removable telescopic dentures retained on teeth or implants for maxilla rehabilitation. Three-year observation of three cases.

    PubMed

    Zafiropoulos, Gregory-George; Rebbe, Jochen; Thielen, Ulrich; Deli, Giorgio; Beaumont, Christian; Hoffmann, Oliver

    2010-01-01

    This report addresses maxillary restoration with removable telescopic crown-retained palatal free dentures. One patient with 7 natural teeth (PERIO), a second patient with 6 dental implants (IMPL), and a third patient with 2 natural teeth and 4 dental implants (IMPL-PERIO) were treated. Zirconia copings for natural teeth and individual zirconia implant abutments were fabricated in CAD/CAM and used as primary crowns. Electroformed gold copings were used as secondary telescopes. All maxilla supraconstructions were fabricated with zirconia and CAD/CAM. Patients were monitored during a 3-year period; all teeth and implants survived, and no biological or mechanical complications occurred. The peri-implant and periodontal conditions were healthy. While recognizing the limitations of this report, results showed that fabricating removable zirconia structures by means of CAD/CAM can yield highly functional and esthetic results. Galvanoforming technology is the preferable means of fabricating secondary crowns. The combination of these techniques and materials results in a prosthetic reconstruction of high quality, good fit, and biocompatibility. Long-term studies of large populations are necessary to investigate the clinical properties of the material utilized in this type of construction.

  15. Selective etching of injection molded zirconia-toughened alumina: Towards osseointegrated and antibacterial ceramic implants.

    PubMed

    Flamant, Quentin; Caravaca, Carlos; Meille, Sylvain; Gremillard, Laurent; Chevalier, Jérôme; Biotteau-Deheuvels, Katia; Kuntz, Meinhard; Chandrawati, Rona; Herrmann, Inge K; Spicer, Christopher D; Stevens, Molly M; Anglada, Marc

    2016-12-01

    Due to their outstanding mechanical properties and excellent biocompatibility, zirconia-toughened alumina (ZTA) ceramics have become the gold standard in orthopedics for the fabrication of ceramic bearing components over the last decade. However, ZTA is bioinert, which hampers its implantation in direct contact with bone. Furthermore, periprosthetic joint infections are now the leading cause of failure for joint arthroplasty prostheses. To address both issues, an improved surface design is required: a controlled micro- and nano-roughness can promote osseointegration and limit bacterial adhesion whereas surface porosity allows loading and delivery of antibacterial compounds. In this work, we developed an integrated strategy aiming to provide both osseointegrative and antibacterial properties to ZTA surfaces. The micro-topography was controlled by injection molding. Meanwhile a novel process involving the selective dissolution of zirconia (selective etching) was used to produce nano-roughness and interconnected nanoporosity. Potential utilization of the porosity for loading and delivery of antibiotic molecules was demonstrated, and the impact of selective etching on mechanical properties and hydrothermal stability was shown to be limited. The combination of injection molding and selective etching thus appears promising for fabricating a new generation of ZTA components implantable in direct contact with bone. Zirconia-toughened alumina (ZTA) is the current gold standard for the fabrication of orthopedic ceramic components. In the present work, we propose an innovative strategy to provide both osseointegrative and antibacterial properties to ZTA surfaces: we demonstrate that injection molding allows a flexible design of surface micro-topography and can be combined with selective etching, a novel process that induces nano-roughness and surface interconnected porosity without the need for coating, avoiding reliability issues. These surface modifications have the

  16. Study of iodine migration in zirconia using stable and radioactive ion implantation

    NASA Astrophysics Data System (ADS)

    Chevarier, N.; Brossard, F.; Chevarier, A.; Crusset, D.; Moncoffre, N.

    1998-03-01

    The large uranium fission cross section leading to iodine and the behaviour of this element in the cladding tube during energy production and afterwards during waste storage is a crucial problem, especially for 129I which is a very long half-life isotope ( T = 1.59 × 10 7yr). Since a combined external and internal oxidation of the zircaloy cladding tube occurs during the reactor processing, iodine diffusion parameters in zirconia are needed. In order to obtain these data, stable iodine atoms were first introduced by ion implantation into zirconia with an energy of 200 keV and a dose equal to 8 × 10 15at cm -2. Diffusion profiles were measured using 3 MeV alpha-particle Rutherford Backscattering Spectrometry at each step of the annealing procedure between 700°C and 900°C. In such experiments a reduced iodine concentration was observed, which correlated to a diffusion-like process. Similar analysis has been performed using radioactive 131I implanted at a very low dose of 10 9 at cm -2. In this case the iodine release is deduced from gamma-ray spectroscopy measurements. The results are discussed in this paper.

  17. Comparison of surface modified zirconia implants with commercially available zirconium and titanium implants: a histological study in pigs.

    PubMed

    Gredes, Tomasz; Kubasiewicz-Ross, Pawel; Gedrange, Tomasz; Dominiak, Marzena; Kunert-Keil, Christiane

    2014-08-01

    New biomaterials and their various surface modifications should undergo in vitro and in vivo evaluation before clinical trials. The objective of our in vivo study was to evaluate the biocompatibility of newly created zirconium implant surfaces after implantation in the lower jaw of pigs and compare the osseointegration of these dental implants with commercially available zirconium and titanium implants. After a healing period of 12 weeks, a histological analysis of the soft and hard tissues and a histomorphometric analysis of the bone-implant contact (BIC) were performed. The implant surfaces showed an intimate connection to the adjacent bone for all tested implants. The 3 newly created zirconium implant surfaces achieved a BIC of 45% on average in comparison with a BIC of 56% from the reference zirconium implants and 35% from titanium implants. Furthermore, the new zirconium implants had a better attachment to gingival and bone tissues in the range of implant necks as compared with the reference implants. The results suggest that the new implants comparably osseointegrate within the healing period, and they have a good in vivo biocompatibility.

  18. Immediate Functional Loading of One-Piece Zirconia Implants in a Full-Arch Maxillary Restoration: A Five-Year Case Report.

    PubMed

    Peter, Burghard

    Immediate loading has proven to be a predictable modality for restorations with titanium dental implants. An increasing number of articles indicate that zirconia implants might osseointegrate to a similar extent in this context. This 5-year case report describes an outpatient maxillary restoration with eight immediately loaded zirconia implants. Implantation followed extensive bone augmentation. At the 5-year follow-up, all implants were still well osseointegrated clinically and radiologically. No major bone loss or peri-implantitis had occurred in spite of temporary insufficient patient compliance. More research and studies are needed to confirm these results.

  19. Zirconia dental implants degradation by confocal Raman microspectroscopy: analytical simulation and experiments

    PubMed Central

    Djaker, Nadia; Wulfman, Claudine; Sadoun, Michaël; Lamy de la Chapelle, Marc

    2013-01-01

    Subsurface hydrothermal degradation of yttria stabilized tetragonal zirconia polycrystals (3Y-TZP) is presented. Evaluation of low temperature degradation (LTD) phase transformation induced by aging in 3Y-TZP is experimentally studied by Raman confocal microspectroscopy. A non-linear distribution of monoclinic volume fraction is determined in depth by using different pinhole sizes. A theoretical simulation is proposed based on the convolution of the excitation intensity profile and the Beer-Lambert law (optical properties of zirconia) to compare between experiment and theory. The calculated theoretical degradation curves matche closely to the experimental ones. Surface transformation (V0) and transformation factor in depth (T) are obtained by comparing simulation and experience for each sample with nondestructive optical sectioning. PMID:23667788

  20. [Effect of zirconia abutment angulation on stress distribution in the abutment and the bone around implant: a finite element study].

    PubMed

    Yang, Yan-zhong; Tian, Xiao-hua; Zhou, Yan-min

    2015-08-01

    To investigate the effect of three different zirconia angular abutments on the stress distribution in bone and abutment using three-dimensional finite element analysis, and provide instruction for clinical application. Finite element analysis (FEA) was applied to analyze the stress distribution of three different zirconia/titanium angular abutments and bone around implant. The maximum Von Minses stress that existed in abutment, bolt and bone of the angular abutment model was significantly higher than that existed in the straight abutment model. The maximum Von Minses stress that existed in abutment, bolt and bone of the 20 ° angular abutment model was significantly higher than that existed in 15 ° angular abutment model. There was no significant difference between zirconia abutment model and titanium abutment model. The abutment angulation has a significant influence on the stress distribution in the abutment, bolt and bone, and exacerbates as the angulation increases, which suggest that we should take more attention to the implant orientation and use straight abutment or little angular abutment. The zirconia abutment can be used safely, and there is no noticeable difference between zirconia abutment and titanium abutment on stress distribution.

  1. Fracture resistance of implant- supported monolithic crowns cemented to zirconia hybrid-abutments: zirconia-based crowns vs. lithium disilicate crowns

    PubMed Central

    Nawafleh, Noor; Öchsner, Andreas; George, Roy

    2018-01-01

    PURPOSE The aim of this in vitro study was to investigate the fracture resistance under chewing simulation of implant-supported posterior restorations (crowns cemented to hybrid-abutments) made of different all-ceramic materials. MATERIALS AND METHODS Monolithic zirconia (MZr) and monolithic lithium disilicate (MLD) crowns for mandibular first molar were fabricated using computer-aided design/computer-aided manufacturing technology and then cemented to zirconia hybrid-abutments (Ti-based). Each group was divided into two subgroups (n=10): (A) control group, crowns were subjected to single load to fracture; (B) test group, crowns underwent chewing simulation using multiple loads for 1.2 million cycles at 1.2 Hz with simultaneous thermocycling between 5℃ and 55℃. Data was statistically analyzed with one-way ANOVA and a Post-Hoc test. RESULTS All tested crowns survived chewing simulation resulting in 100% survival rate. However, wear facets were observed on all the crowns at the occlusal contact point. Fracture load of monolithic lithium disilicate crowns was statistically significantly lower than that of monolithic zirconia crowns. Also, fracture load was significantly reduced in both of the all-ceramic materials after exposure to chewing simulation and thermocycling. Crowns of all test groups exhibited cohesive fracture within the monolithic crown structure only, and no abutment fractures or screw loosening were observed. CONCLUSION When supported by implants, monolithic zirconia restorations cemented to hybrid abutments withstand masticatory forces. Also, fatigue loading accompanied by simultaneous thermocycling significantly reduces the strength of both of the all-ceramic materials. Moreover, further research is needed to define potentials, limits, and long-term serviceability of the materials and hybrid abutments. PMID:29503716

  2. Effect of geometry on deformation of anterior implant-supported zirconia frameworks: An in vitro study using digital image correlation.

    PubMed

    Calha, Nuno; Messias, Ana; Guerra, Fernando; Martinho, Beatriz; Neto, Maria Augusta; Nicolau, Pedro

    2017-04-01

    To evaluate the effect of geometry on the displacement and the strain distribution of anterior implant-supported zirconia frameworks under static load using the 3D digital image correlation method. Two groups (n=5) of 4-unit zirconia frameworks were produced by CAD/CAM for the implant-abutment assembly. Group 1 comprised five straight configuration frameworks and group 2 consisted of five curved configuration frameworks. Specimens were cemented and submitted to static load up to 200N. Displacements were captured with two high-speed photographic cameras and analyzed with video correlation system in three spacial axes U, V, W. Statistical analysis was made using the nonparametric Mann-Whitney test. Up to 150N loads, the vertical displacements (V axis) were statistically higher for curved frameworks (-267.83±23.76μm), when compared to the straight frameworks (-120.73±36.17μm) (p=0.008), as well as anterior displacements in the W transformed axis (589.55±64.51μm vs 224.29±50.38μm for the curved and straight frameworks), respectively (p=0.008). The mean von Mises strains over the surface frameworks were statistically higher for the curved frameworks under any load. Within the limitations of this in vitro study, it is possible to conclude that the geometric configuration influences the deformation of 4-unit anterior frameworks under static load. The higher strain distribution and micro-movements of the curved frameworks reflect less rigidity and increased risk of fractures associated to FPDs. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  3. Effect of modifying the screw access channels of zirconia implant abutment on the cement flow pattern and retention of zirconia restorations.

    PubMed

    Wadhwani, Chandur; Chung, Kwok-Hung

    2014-07-01

    The effect of managing the screw access channels of zirconia implant abutments in the esthetic zone has not been extensively evaluated. The purpose of this study was to determine the effect of an insert placed within the screw access channel of an anterior zirconia implant abutment on the amount of cement retained within the restoration-abutment system and on the dislodging force. Thirty-six paired zirconia abutments and restorations were fabricated by computer-aided design and computer-aided manufacturing and were divided into 3 groups: open abutment, with the screw access channel unfilled; closed abutment, with the screw access channel sealed; and insert abutment, with a thin, tubular metal insert projection continuous with the screw head and placed into the abutment screw access channel. The restorations were cemented to the abutments with preweighed eugenol-free zinc oxide cement (TempBond NE). Excess cement was removed, and the weight of the cement that remained in the restoration-abutment system was measured. Vertical tensile dislodging forces were recorded at a crosshead speed of 5 mm/min after incubation in a 37°C water bath for 24 hours. The specimens were examined for the cement flow pattern into the screw access channel after dislodgement. Data were analyzed with ANOVA, followed by multiple comparisons by using the Tukey honestly significant difference test (α = .05). The mean (standard deviation) of retentive force values ranged from 108.1 ± 29.9 N to 148.3 ± 21.0 N. The retentive force values differed significantly between the insert abutment and both the open abutment (P < .05) and closed abutment groups (P < .01). Distinct patterns of cement failure were noted. The weight of the cement that remained in the system differed significantly, with both open abutment and insert abutment being greater than closed abutment (P < .05). Modifying the internal configuration of the screw access channel of an esthetic zirconia implant abutment with a metal

  4. Biomechanical investigation of thread designs and interface conditions of zirconia and titanium dental implants with bone: three-dimensional numeric analysis.

    PubMed

    Fuh, Lih-Jyh; Hsu, Jui-Ting; Huang, Heng-Li; Chen, Michael Y C; Shen, Yen-Wen

    2013-01-01

    Bone stress and interfacial sliding at the bone-implant interface (BII) were analyzed in zirconia and titanium implants with various thread designs and interface conditions (bonded BII and contact BIIs with different frictional coefficients) for both conventional and immediately loaded treatments. A total of 18 finite element models comprising two implant materials (zirconia and titanium), three thread designs (different shapes and pitches), and three interface conditions (bonded and contact BIIs) were analyzed to assess the effects on bone stresses and on sliding at the BII. The material properties of the bone model were anisotropic, and a lateral force of 130 N was applied as the loading condition. In the immediately loaded implant, the stress was highly concentrated at one site of the peri-implant bone. The peak bone stress was more than 20% lower in zirconia implants than in titanium implants for a bonded BII and 14% to 20% lower for a contact BII. The bone stresses did not differ significantly between implants with V-shaped threads and square threads. However, sliding at the BII was more than 25% lower with square-thread implants than with V-shaped-thread implants for titanium implants and 36% lower for zirconia implants. Reducing the thread size and pitch in cortical bone (via two V-shaped threads with different pitches) decreased the bone stress by 13%. Increasing the frictional coefficient reduced sliding at the BII in both zirconia and titanium implants. As an implant material, zirconia can reduce the bone stress in the crestal cortical region. Bone stress and sliding at the BII are heavily dependent on the thread design and the frictional coefficient at the BII of immediately loaded implants.

  5. [Failure of zirconia-based prostheses on natural teeth and implants: focus on risk factors].

    PubMed

    Dupont, N; Koenig, V; Vanheusden, A; Mainjot, A

    2014-01-01

    Cohesive fracture of the veneering ceramic (chipping) is the first cause of failure of zirconia-based prostheses on natural teeth and implants. Besides risk factors related to the material (thermal stresses generated during the manufacturing process, framework inappropriate design), there are some clinical risk factors, which can influence the restoration prognosis. Indeed, unfavorable occlusal relationships and/or the presence of parafunctions such as bruxism and clenching, which are frequent pathologies, engender significant overloading. A retrospective study was performed at the University Hospital Center (CHU) of Liege on 147 dental and implants prostheses, placed between May 2003 and January 2012. This study highlighted a significant correlation between chipping and the absence of an occlusal nightguard (p = 0.0048), the presence of a ceramic restoration as an antagonist (p = 0.013), the presence of occlusal parafunctions (p = 0.018), and the presence of implants as support of the restorations (p = 0.026). These results underline the importance of external stress and occlusal risk factors diagnosis, as the need to perform an occlusal nightguard to patients with parafunctions.

  6. Comparison of fracture resistance of pressable metal ceramic custom implant abutment with a commercially fabricated CAD/CAM zirconia implant abutment.

    PubMed

    Protopapadaki, Maria; Monaco, Edward A; Kim, Hyeong-Il; Davis, Elaine L

    2013-11-01

    The predictable nature of the hot pressing ceramic technique has several applications, but no study was identified that evaluated its application to the fabrication of custom implant abutments. The purpose of this study was to compare the fracture resistance of an experimentally designed pressable metal ceramic custom implant abutment (PR) with that of a duplicate zirconia abutment (ZR). Two groups of narrow platform (NP) (Nobel Replace) implant abutment specimens were fabricated (n=10). The experimental abutment (PR) had a metal substructure cast with ceramic alloy (Lodestar) and veneered with leucite pressable glass ceramic (InLine PoM). Each PR abutment was individually scanned and 10 duplicate CAD/CAM ZR abutments were fabricated for the control group. Ceramic crowns (n=20) with the average dimensions of a human lateral incisor were pressed with lithium disilicate glass ceramic (IPS e.max Press) and bonded on the abutments with a resin luting agent (Multilink Automix). The specimens were subjected to thermocycling, cyclic loading, and finally static loading to failure with a computer-controlled Universal Testing Machine. An independent t test (1 sided) determined whether the mean values of the fracture load differed significantly (α=.05) between the 2 groups. No specimen failed during cyclic loading. Upon static loading, the mean (SD) load to failure was significantly higher for the PR group (525.89 [143.547] N) than for the ZR group (413.70 [35.515] N) for internal connection narrow platform bone-level implants (P=.025). Failure was initiated at the screw and internal connection level for both groups. It is possible to fabricate PR abutments that are stronger than ZR abutments for Nobel Biocare internal connection NP bone-level implants. The screw and the internal connection are the weak links for both groups. Copyright © 2013 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  7. Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A Randomized, Multicenter Clinical Trial.

    PubMed

    Wittneben, J G; Gavric, J; Belser, U C; Bornstein, M M; Joda, T; Chappuis, V; Sailer, I; Brägger, U

    2017-02-01

    Patients' esthetic expectations are increasing, and the options of the prosthetic pathways are currently evolving. The objective of this randomized multicenter clinical trial was to assess and compare the esthetic outcome and clinical performance of anterior maxillary all-ceramic implant crowns (ICs) based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with hand buildup technique. The null hypothesis was that there is no statistically significant difference between the 2 groups. Forty implants were inserted in sites 14 to 24 (FDI) in 40 patients in 2 centers, the Universities of Bern and Geneva, Switzerland. After final impression, 20 patients were randomized into group A, restored with a 1-piece screw-retained single crown made of a prefabricated zirconia abutment with pressed ceramic as the veneering material using the cut-back technique, or group B using an individualized CAD/CAM zirconia abutment (CARES abutment; Institut Straumann AG) with a hand buildup technique. At baseline, 6 mo, and 1 y clinical, esthetic and radiographic parameters were assessed. Group A exhibited 1 dropout patient and 1 failure, resulting in a survival rate of 94.7% after 1 y, in comparison to 100% for group B. No other complications occurred. Clinical parameters presented stable and healthy peri-implant soft tissues. Overall, no or only minimal crestal bone changes were observed with a mean DIB (distance from the implant shoulder to the first bone-to-implant contact) of -0.15 mm (group A) and 0.12 mm (group B) at 1 y. There were no significant differences at baseline, 6 mo, and 1 y for DIB values between the 2 groups. Pink esthetic score (PES) and white esthetic score (WES) values at all 3 examinations indicated stability over time for both groups and pleasing esthetic outcomes. Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of single ICs in the anterior maxilla

  8. Towards long lasting zirconia-based composites for dental implants: Transformation induced plasticity and its consequence on ceramic reliability.

    PubMed

    Reveron, Helen; Fornabaio, Marta; Palmero, Paola; Fürderer, Tobias; Adolfsson, Erik; Lughi, Vanni; Bonifacio, Alois; Sergo, Valter; Montanaro, Laura; Chevalier, Jérôme

    2017-01-15

    Zirconia-based composites were developed through an innovative processing route able to tune compositional and microstructural features very precisely. Fully-dense ceria-stabilized zirconia ceramics (84vol% Ce-TZP) containing equiaxed alumina (8vol%Al 2 O 3 ) and elongated strontium hexa-aluminate (8vol% SrAl 12 O 19 ) second phases were obtained by conventional sintering. This work deals with the effect of the zirconia stabilization degree (CeO 2 in the range 10.0-11.5mol%) on the transformability and mechanical properties of Ce-TZP-Al 2 O 3 -SrAl 12 O 19 materials. Vickers hardness, biaxial flexural strength and Single-edge V-notched beam tests revealed a strong influence of ceria content on the mechanical properties. Composites with 11.0mol% CeO 2 or above exhibited the classical behaviour of brittle ceramics, with no apparent plasticity and very low strain to failure. On the contrary, composites with 10.5mol% CeO 2 or less showed large transformation-induced plasticity and almost no dispersion in strength data. Materials with 10.5mol% of ceria showed the highest values in terms of biaxial bending strength (up to 1.1GPa) and fracture toughness (>10MPa√m). In these ceramics, as zirconia transformation precedes failure, the Weibull modulus was exceptionally high and reached a value of 60, which is in the range typically reported for metals. The results achieved demonstrate the high potential of using these new strong, tough and stable zirconia-based composites in structural biomedical applications. Yttria-stabilized (Y-TZP) zirconia ceramics are increasingly used for developing metal-free restorations and dental implants. Despite their success related to their excellent mechanical resistance, Y-TZP can undergo Low Temperature Degradation which could be responsible for restoration damage or even worst the failure of the implant. Current research is focusing on strategies to improve the LTD resistance of Y-TZP or to develop alternative composites with better

  9. Effect of feldspathic porcelain layering on the marginal fit of zirconia and titanium complete-arch fixed implant-supported frameworks.

    PubMed

    Yilmaz, Burak; Alshahrani, Faris A; Kale, Ediz; Johnston, William M

    2018-02-06

    Veneering with porcelain may adversely affect the marginal fit of long-span computer-aided design and computer-aided manufacturing (CAD-CAM) implant-supported fixed prostheses. Moreover, data regarding the precision of fit of CAD-CAM-fabricated implant-supported complete zirconia fixed dental prostheses (FDPs) before and after porcelain layering are limited. The purpose of this in vitro study was to evaluate the effect of porcelain layering on the marginal fit of CAD-CAM-fabricated complete-arch implant-supported, screw-retained FDPs with presintered zirconia frameworks compared with titanium. An autopolymerizing acrylic resin-fixed complete denture framework prototype was fabricated on an edentulous typodont master model (all-on-4 concept; Nobel Biocare) with 2 straight in the anterior and 2 distally tilted internal-hexagon dental implants in the posterior with multiunit abutments bilaterally in canine and first molar locations. A 3-dimensional (3D) laser scanner (S600 ARTI; Zirkonzahn) was used to digitize the prototype and the master model by using scan bodies to generate a virtual 3D CAD framework. Five presintered zirconia (ICE Zirkon Translucent - 95H16; Zirkonzahn) and 5 titanium (Titan 5 - 95H14; Zirkonzahn) frameworks were fabricated using the CAM milling unit (M1 Wet Heavy Metal Milling Unit; Zirkonzahn).The 1-screw test was applied by fixing the frameworks at the location of the maxillary left first molar abutment, and an industrial computed tomography (CT) scanner (XT H 225 - Basic Configuration; Nikon) was used to scan the framework-model complex to evaluate the passive fit of the frameworks on the master model. The scanned data were transported in standard tessellation language (STL) from Volume Graphics analysis software to PolyWorks analysis software by using the maximum-fit algorithm to fit scanned planes in order to mimic the mating surfaces in the best way. 3D virtual assessment of the marginal fit was performed at the abutment

  10. The Impact of In Vitro Accelerated Aging, Approximating 30 and 60 Years In Vivo, on Commercially Available Zirconia Dental Implants.

    PubMed

    Monzavi, Mona; Noumbissi, Sammy; Nowzari, Hessam

    2017-04-01

    Despite increased popularity of Zirconia dental implants, concerns have been raised regarding low temperature degradation (LTD) and its effect on micro-structural integrity. This study evaluated the effect of LTD on four types of Zirconia dental implants at 0, 30, and 60 years of artificial aging. The impact of aging on t-m transformation and micro crack formation was measured. Accelerated aging at 15 and 30 hours, approximating 30 and 60 years in vivo, aged 36 Zirconia dental implants: Z systems ® (A), Straumann ® (B), Ceraroot ® (C), and Zeramex ® (D). Focused ion beam-scanning electron microscopic analysis determined the micro structural features, phase transformation, and the formation of micro cracks. At 15 hours, type A implant presented with micro cracks and t-m transformation of 0.9 µm and 3.1 µm, respectively. At 30 hours, micro cracks remained shallow (1 µm). At 15 hours, type B implant presented micro cracks (0.7 µm) and grain transformation (1.2 µm). At 30 hours, these features remained superficial at 0.6 and 1.5 µm, respectively. Type C implant presented surface micro cracks of 0.3 µm at 15 hours. The depth of t-m transformation slightly increased to 1.4 µm. At 30 hours, number of micro cracks increased at the surface to an average depth of 1.5 µm. Depth of t-m transformation increased to an average of 2.5 µm. At 15 hours, micro cracks remained superficial (0.8 µm) for type D implant and depth of t-m transformation increased to 2.3 µm. At 30 hours, the depth of micro cracks increased to an average of 1.3 µm followed by increased t-m transformation to a depth of 4.1 µm. Depth of grain transformation remained within 1-4 µm from the surface. The effect of aging was minimal for all Zirconia implants. © 2016 Wiley Periodicals, Inc.

  11. The effect of zirconia or titanium as abutment material on soft peri-implant tissues: a systematic review and meta-analysis.

    PubMed

    Linkevicius, Tomas; Vaitelis, Julius

    2015-09-01

    The objective of this review was to analyze research with regard to the effect of zirconia or titanium as abutment material on soft peri-implant tissues. Clinical studies were selected via electronic and hand searches in English language journals until December 1, 2014. Only randomized clinical trials (RCTs) and prospective controlled clinical trials (CCTs) showing direct comparison between zirconia (Zr) and titanium (Ti) abutments in the same patient were considered. The outcome measures were (1) soft tissue color, (2) soft tissue recession, (3) peri-implant probing, (4) bleeding on probing, (5) esthetic indexes, (6) patient-reported outcome, (7) marginal bone level, and (8) biological complications. Nine relevant studies (11 papers) were identified: 4 RCTs and 5 CCTs. Due to heterogeneity in the study design, statistical methods, and reported results, a meta-analysis of the data was feasible only for soft tissue color. The outcome was found to be significantly superior for Zr abutments. For the other outcome measures, a qualitative analysis of the selected articles was performed. The studies did not show any statistically significant differences between Zr and Ti abutments on soft tissue recession, probing depths, bleeding on probing, marginal bone level, and patient-reported outcome. One study reported significantly higher pink esthetic score (PES) scores at Zr implants with Zr abutments, compared to metal implants and Ti abutments. Overall, the research does not support any obvious advantage of Ti or Zr abutments over each other. However, there is a significant tendency in Zr abutments evoking better color response of peri-implant mucosa and superior esthetic outcome measured by PES score. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Retention Forces between Titanium and Zirconia Components of Two-Part Implant Abutments with Different Techniques of Surface Modification.

    PubMed

    von Maltzahn, Nadine Freifrau; Holstermann, Jan; Kohorst, Philipp

    2016-08-01

    The adhesive connection between titanium base and zirconia coping of two-part abutments may be responsible for the failure rate. A high mechanical stability between both components is essential for the long-term success. The aim of the present in-vitro study was to evaluate the influence of different surface modification techniques and resin-based luting agents on the retention forces between titanium and zirconia components in two-part implant abutments. A total of 120 abutments with a titanium base bonded to a zirconia coping were investigated. Two different resin-based luting agents (Panavia F 2.0 and RelyX Unicem) and six different surface modifications were used to fix these components, resulting in 12 test groups (n = 10). The surface of the test specimens was mechanically pretreated with aluminium oxide blasting in combination with application of two surface activating primers (Alloy Primer, Clearfil Ceramic Primer) or a tribological conditioning (Rocatec), respectively. All specimens underwent 10,000 thermal cycles between 5°C and 55°C in a moist environment. A pull-off test was then conducted to determine retention forces between the titanium and zirconia components, and statistical analysis was performed (two-way anova). Finally, fracture surfaces were analyzed by light and scanning electron microscopy. No significant differences were found between Panavia F 2.0 and RelyX Unicem. However, the retention forces were significantly influenced by the surface modification technique used (p < 0.001). For both luting agents, the highest retention forces were found when adhesion surfaces of both the titanium bases and the zirconia copings were pretreated with aluminium oxide blasting, and with the application of Clearfil Ceramic Primer. Surface modification techniques crucially influence the retention forces between titanium and zirconia components in two-part implant abutments. All adhesion surfaces should be pretreated by sandblasting. Moreover, a

  13. Comparative study of new bone formation capability of zirconia bone graft material in rabbit calvarial.

    PubMed

    Kim, Ik-Jung; Shin, Soo-Yeon

    2018-06-01

    The purpose of this study was to compare the new bone formation capability of zirconia with those of other synthetic bone grafts. Twelve rabbits were used and four 6-mm diameter transcortical defects were formed on each calvaria. Each defect was filled with Osteon II (Os), Tigran PTG (Ti), and zirconia (Zi) bone grafts. For the control group, the defects were left unfilled. The rabbits were sacrificed at 2, 4, and 8 weeks. Specimens were analyzed through micro computed tomography (CT) and histomorphometric analysis. The Ti and Zi groups showed significant differences in the amount of newly formed bone between 2 and 4 weeks and between 2 and 8 weeks ( P <.05). The measurements of total bone using micro CT showed significant differences between the Os and Ti groups and between the Os and Zi groups at 2 and 8 weeks ( P <.05). Comparing by week in each group, the Ti group showed a significant difference between 4 and 8 weeks. Histomorphometric analysis also showed significant differences in new bone formation between the control group and the experimental groups at 2, 4, and 8 weeks ( P <.05). In the comparison of newly formed bone, significant differences were observed between 2 and 4 weeks and between 2 and 8 weeks ( P <.05) in all groups. Zirconia bone graft material showed satisfactory results in new bone formation and zirconia could be used as a new synthetic bone graft material.

  14. Comparisons of maximum deformation and failure forces at the implant–abutment interface of titanium implants between titanium-alloy and zirconia abutments with two levels of marginal bone loss

    PubMed Central

    2013-01-01

    Background Zirconia materials are known for their optimal aesthetics, but they are brittle, and concerns remain about whether their mechanical properties are sufficient for withstanding the forces exerted in the oral cavity. Therefore, this study compared the maximum deformation and failure forces of titanium implants between titanium-alloy and zirconia abutments under oblique compressive forces in the presence of two levels of marginal bone loss. Methods Twenty implants were divided into Groups A and B, with simulated bone losses of 3.0 and 1.5 mm, respectively. Groups A and B were also each divided into two subgroups with five implants each: (1) titanium implants connected to titanium-alloy abutments and (2) titanium implants connected to zirconia abutments. The maximum deformation and failure forces of each sample was determined using a universal testing machine. The data were analyzed using the nonparametric Mann–Whitney test. Results The mean maximum deformation and failure forces obtained the subgroups were as follows: A1 (simulated bone loss of 3.0 mm, titanium-alloy abutment) = 540.6 N and 656.9 N, respectively; A2 (simulated bone loss of 3.0 mm, zirconia abutment) = 531.8 N and 852.7 N; B1 (simulated bone loss of 1.5 mm, titanium-alloy abutment) = 1070.9 N and 1260.2 N; and B2 (simulated bone loss of 1.5 mm, zirconia abutment) = 907.3 N and 1182.8 N. The maximum deformation force differed significantly between Groups B1 and B2 but not between Groups A1 and A2. The failure force did not differ between Groups A1 and A2 or between Groups B1 and B2. The maximum deformation and failure forces differed significantly between Groups A1 and B1 and between Groups A2 and B2. Conclusions Based on this experimental study, the maximum deformation and failure forces are lower for implants with a marginal bone loss of 3.0 mm than of 1.5 mm. Zirconia abutments can withstand physiological occlusal forces applied in the anterior region. PMID

  15. Evaluation of the sealing capability of implants to titanium and zirconia abutments against Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum under different screw torque values.

    PubMed

    Smith, Nicole A; Turkyilmaz, Ilser

    2014-09-01

    When evaluating long-term implant success, clinicians have always been concerned with the gap at the implant-abutment junction, where bacteria can accumulate and cause marginal bone loss. However, little information regarding bacterial leakage at the implant-abutment junction, or microgap, is available. The purpose of this study was to evaluate sealing at 2 different implant-abutment interfaces under different screw torque values. Twenty sterile zirconia abutments and 20 sterile titanium abutments were screwed into 40 sterile implants and placed in test tubes. The ability of a bacterial mixture of Prevotella intermedia, Porphyromonas gingivalis, and Fusobacterium nucleatum to leak through an implant-titanium abutment seal under 20 and 35 Ncm torque values and an implant-zirconia abutment seal under 20 and 35 Ncm torque values was evaluated daily until leakage was noted. Once a unit demonstrated leakage, a specimen was plated. After 4 days, the number of colonies on each plate was counted with an electronic colony counter. Plating was used to verify whether or not bacterial leakage occurred and when leakage first occurred. The implant-abutment units were removed and rinsed with phosphate buffered saline solution and evaluated with a stereomicroscope. The marginal gap between the implant and the abutment was measured and correlated with the amount of bacterial leakage. The data were analyzed with ANOVA. Bacterial leakage was noted in all specimens, regardless of material or screw torque value. With titanium abutments, changing the screw torque value from 20 to 35 Ncm did not significantly affect the amount of bacterial leakage. However, with zirconia abutments, changing the screw torque value from 20 to 35 Ncm was statistically significant (P<.017). Overall, the marginal gap noted was larger at the zirconia-abutment interface (5.25 ±1.99 μm) than the titanium-abutment interface (12.38 ±3.73 μm), irrespective of the screw torque value. Stereomicroscopy revealed a

  16. Assessment of the primary stability of root analog zirconia implants designed using cone beam computed tomography software by means of the Periotest® device: An ex vivo study. A preliminary report.

    PubMed

    Matys, Jacek; Świder, Katarzyna; Flieger, Rafał; Dominiak, Marzena

    2017-08-01

    The implant primary stability is a fundamental prerequisite for a success of osseointegration process which determines the prosthetic reconstruction time. The aim of the present study was to assess the quality and precision of modern conical bone computer tomography (CBCT) software in preparing root analog zirconia implants (RAZIs) by measuring its primary stability by means of the Periotest device. Thirteen pig jaws with proper erupted first premolar (P1) teeth were used in the study. The CBCT examination was conducted in the area of the P1 tooth in each mandible. The 3-dimensional (3D) view of each tooth was designed from CBCT scan. The created 3D images were used to prepare root analog zirconia implants milled from a medical-grade zirconia block by means of laboratory milling. The RAZIs and titanium implants were placed into an alveolar socket after the tooth had been removed. The primary stability of the teeth before their extraction (G1), RAZIs (G2) and titanium implants (G3) were checked by Periotest devices. The mean results in PTV were: 15.9, 3.35, 12.7 for G1, G2 and G3 group, respectively. RAZIs during immediate loading achieved a significantly higher primary stability (lower Periotest value) as compared to the teeth and implants. The modern CBCT device allows us to design a precise image of an extracted tooth for the purpose of manufacturing a root analog implant. The additional feature of the surgical protocol using RAZI is the possibility of avoiding the augmentation procedure, which reduces the whole cost of the treatment.

  17. Complications and patient-centered outcomes with an implant-supported monolithic zirconia fixed dental prosthesis: 1 year results.

    PubMed

    Limmer, Bryan; Sanders, Anne E; Reside, Glenn; Cooper, Lyndon F

    2014-06-01

    To characterize the number and type of complications that occur with a monolithic zirconia fixed dental prosthesis (MZ-FDP) supported by four endosseous implants in the edentulous mandible over time and to quantify the impact of treatment on oral health quality of life (OHQoL). Seventeen edentulous participants were enrolled. New conventional dentures were fabricated for each participant. Four Astra Tech Osseospeed TX implants (Dentsply) were then placed in the parasymphyseal mandible, and after a period of healing, a full-arch monolithic zirconia prosthesis (Zirkonzahn) was inserted. Complication data were recorded and OHQoL was evaluated using the Oral Health Impact Profile (OHIP-49), administered on four occasions: enrollment; implant surgery; and 6- and 12-month recalls. Sixty-eight implants were placed in 17 edentulous individuals aged 30 to 78 (mean 57.9 years). Implant survival was 94% from the subject perspective and 99% from the implant perspective. Prosthesis survival was 88%. Twelve complications occurred in ten participants, whereas seven participants remained complication free. Both OHIP-49 severity and extent scores decreased significantly between enrollment and 12-month recall (p < 0.001). The mean OHIP-49 severity score at baseline was 94.8 (95% confidence interval [CI]: 73.9, 115.8) and declined an average of 76.8 (95% CI: -91.3, -62.3) units per participant. The mean OHIP-49 extent score at baseline was 17.2 (95% CI: 10.8, 23.6) and declined 16.3 (95% CI: -20.2, -12.4) units per participant on average. Implant survival was high, and few complications related to the MZ-FDP were observed. The most common prosthetic complication was tooth chipping in the opposing maxillary denture, which accounted for 50% of all complication events. Substantial and clinically important improvements in OHQoL were achieved with both conventional dentures and the implant-supported MZ-FDP. The data of this short-term study indicate that the implant-supported MZ-FDP is a

  18. Microbial adhesion on novel yttria-stabilized tetragonal zirconia (Y-TZP) implant surfaces with nitrogen-doped hydrogenated amorphous carbon (a-C:H:N) coatings.

    PubMed

    Schienle, Stefanie; Al-Ahmad, Ali; Kohal, Ralf Joachim; Bernsmann, Falk; Adolfsson, Erik; Montanaro, Laura; Palmero, Paola; Fürderer, Tobias; Chevalier, Jérôme; Hellwig, Elmar; Karygianni, Lamprini

    2016-09-01

    Biomaterial surfaces are at high risk for initial microbial colonization, persistence, and concomitant infection. The rationale of this study was to assess the initial adhesion on novel implant surfaces of Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans upon incubation. The tested samples were 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) samples with nitrogen-doped hydrogenated amorphous carbon (a-C:H:N) coating (A) and 3Y-TZP samples coated with ceria-stabilized zirconia-based (Ce-TZP) composite and a-C:H:N (B). Uncoated 3Y-TZP samples (C) and bovine enamel slabs (BES) served as controls. Once the surface was characterized, the adherent microorganisms were quantified by estimating the colony-forming units (CFUs). Microbial vitality was assessed by live/dead staining, and microbial-biomaterial surface topography was visualized by scanning electron microscopy (SEM). Overall, A and B presented the lowest CFU values for all microorganisms, while C sheltered significantly less E. faecalis, P. aeruginosa, and C. albicans than BES. Compared to the controls, B demonstrated the lowest vitality values for E. coli (54.12 %) and C. albicans (67.99 %). Interestingly, A (29.24 %) exhibited higher eradication rates for S. aureus than B (13.95 %). Within the limitations of this study, a-C:H:N-coated 3Y-TZP surfaces tended to harbor less initially adherent microorganisms and selectively interfered with their vitality. This could enable further investigation of the new multi-functional zirconia surfaces to confirm their favorable antimicrobial properties in vivo.

  19. [Influence of different designs and porcelain/glaze firing on the marginal and internal fit of implant-supported zirconia crowns].

    PubMed

    Cuiling, Liu; Xu, Gao; Yuping, Qi; Liyuan, Yang

    2016-02-01

    This study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns. Three groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0. HMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05). The marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.

  20. Evaluation of removal forces of implant-supported zirconia copings depending on abutment geometry, luting agent and cleaning method during re-cementation

    PubMed Central

    Rödiger, Matthias; Rinke, Sven; Ehret-Kleinau, Fenja; Pohlmeyer, Franziska; Lange, Katharina; Bürgers, Ralf

    2014-01-01

    PURPOSE To evaluate the effects of different abutment geometries in combination with varying luting agents and the effectiveness of different cleaning methods (prior to re-cementation) regarding the retentiveness of zirconia copings on implants. MATERIALS AND METHODS Implants were embedded in resin blocks. Three groups of titanium abutments (pre-fabricated, height: 7.5 mm, taper: 5.7°; customized-long, height: 6.79 mm, taper: 4.8°; customized-short, height: 4.31 mm, taper: 4.8°) were used for luting of CAD/CAM-fabricated zirconia copings with a semi-permanent (Telio CS) and a provisional cement (TempBond NE). Retention forces were evaluated using a universal testing machine. Furthermore, the influence of cleaning methods (manually, manually in combination with ultrasonic bath or sandblasting) prior to re-cementation with a provisional cement (TempBond NE) was investigated with the pre-fabricated titanium abutments (height: 7.5 mm, taper: 5.7°) and SEM-analysis of inner surfaces of the copings was performed. Significant differences were determined via two-way ANOVA. RESULTS Significant interactions between abutment geometry and luting agent were observed. TempBond NE showed the highest level of retentiveness on customized-long abutments, but was negatively affected by other abutment geometries. In contrast, luting with Telio CS demonstrated consistent results irrespective of the varying abutment geometries. Manual cleaning in combination with an ultrasonic bath was the only cleaning method tested prior to re-cementation that revealed retentiveness levels not inferior to primary cementation. CONCLUSION No superiority for one of the two cements could be demonstrated because their influences on retentive strength are also depending on abutment geometry. Only manual cleaning in combination with an ultrasonic bath offers retentiveness levels after re-cementation comparable to those of primary luting. PMID:25006388

  1. Influence of artificial aging on the load-bearing capability of straight or angulated zirconia abutments in implant/tooth-supported fixed partial dentures.

    PubMed

    Nothdurft, Frank P; Doppler, Klaus E; Erdelt, Kurt J; Knauber, Andreas W; Pospiech, Peter R

    2010-01-01

    The aim of the study was to evaluate the influence of artificial aging on the fracture behavior of straight and angulated zirconia implant abutments used in ZirDesign (Astra Tech) implant/tooth-supported fixed partial dentures (FPDs) in the maxilla. Four different test groups (n = 8) representing anterior implant/tooth-supported FPDs were prepared. Groups 1 and 2 simulated a clinical situation with an ideal implant position (maxillary left central incisor) from a prosthetic point of view, which allowed for the use of a straight, prefabricated zirconia abutment. Groups 3 and 4 simulated a situation with a compromised implant position that required an angulated (20-degree) abutment. OsseoSpeed implants (4.5 3 13 mm, Astra Tech) as well as metal tooth analogs (maxillary right lateral incisor) with simulated periodontal mobility were mounted in polymethyl methacrylate. The FPDs (chromium-cobalt alloy) were cemented with glass ionomer. Groups 2 and 4 were thermomechanically loaded and subjected to static loading until failure. Statistical analysis of force data at the fracture site was performed using nonparametric tests. All samples survived thermomechanical loading. Artificial aging did not lead to a significant decrease in load-bearing capacity in either the straight abutments or the angulated abutments. The restorations that used angulated abutments exhibited higher fracture loads than the restorations with straight abutments (group 1: 209.13 ± 39.11 N; group 2: 233.63 ± 30.68 N; group 3: 324.62 ± 108.07 N; group 4: 361.75 ± 73.82 N). This difference in load-bearing performance was statistically significant, both with and without artificial aging. All abutment fractures occurred below the implant shoulder. Compensation for angulated implant positions with an angulated zirconia abutment is possible without reducing the load-bearing capacity of implant/tooth-supported anterior FPDs.

  2. Marginal and Internal Adaptation of Zirconia Crowns: A Comparative Study of Assessment Methods.

    PubMed

    Cunali, Rafael Schlögel; Saab, Rafaella Caramori; Correr, Gisele Maria; Cunha, Leonardo Fernandes da; Ornaghi, Bárbara Pick; Ritter, André V; Gonzaga, Carla Castiglia

    2017-01-01

    Marginal and internal adaptation is critical for the success of indirect restorations. New imaging systems make it possible to evaluate these parameters with precision and non-destructively. This study evaluated the marginal and internal adaptation of zirconia copings fabricated with two different systems using both silicone replica and microcomputed tomography (micro-CT) assessment methods. A metal master model, representing a preparation for an all-ceramic full crown, was digitally scanned and polycrystalline zirconia copings were fabricated with either Ceramill Zi (Amann-Girrbach) or inCoris Zi (Dentslpy-Sirona), n=10. For each coping, marginal and internal gaps were evaluated by silicone replica and micro-CT assessment methods. Four assessment points of each replica cross-section and micro-CT image were evaluated using imaging software: marginal gap (MG), axial wall (AW), axio-occlusal angle (AO) and mid-occlusal wall (MO). Data were statistically analyzed by factorial ANOVA and Tukey test (a=0.05). There was no statistically significant difference between the methods for MG and AW. For AO, there were significant differences between methods for Amann copings, while for Dentsply-Sirona copings similar values were observed. For MO, both methods presented statistically significant differences. A positive correlation was observed determined by the two assessment methods for MG values. In conclusion, the assessment method influenced the evaluation of marginal and internal adaptation of zirconia copings. Micro-CT showed lower marginal and internal gap values when compared to the silicone replica technique, although the difference was not always statistically significant. Marginal gap and axial wall assessment points showed the lower gap values, regardless of ceramic system and assessment method used.

  3. Immediate, single stage, truly anatomic zirconia implant in lower molar replacement: a case report with 2.5 years follow-up.

    PubMed

    Pirker, W; Wiedemann, D; Lidauer, A; Kocher, A A

    2011-02-01

    This report demonstrates the clinical use of a modified, truly anatomic, root-analogue zirconia implant for immediate replacement of a two-rooted, left first mandibular molar. A 50-year-old female patient with chronic apical periodontitis of the left mandibulary first molar was referred and the tooth was extracted. The mesial root had to be removed surgically due to a root fracture. A truly anatomical, root identical, roughened zirconia implant modified by macro-retentions was manufactured and placed into the extraction socket by tapping 7 days later. After 4 months a composite crown was cemented in place. No complications occurred during the healing period. A good functional and aesthetic result was achieved with minimal bone resorption and soft tissue recession at 30 months follow-up. This report describes the successful clinical use of an immediate, single stage, truly anatomical root-analogue zirconia implant for replacement of a two-rooted tooth. Significant modifications such as macro-retentions yielded primary stability and excellent osseointegration. This novel approach is minimally invasive, respects the underlying anatomy, aids socket prevention, is time- and cost-saving with good patient acceptance as there is no need for bone drilling, sinus lift, bone augmentation or other traumatic procedures. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Zirconia in biomedical applications.

    PubMed

    Chen, Yen-Wei; Moussi, Joelle; Drury, Jeanie L; Wataha, John C

    2016-10-01

    The use of zirconia in medicine and dentistry has rapidly expanded over the past decade, driven by its advantageous physical, biological, esthetic, and corrosion properties. Zirconia orthopedic hip replacements have shown superior wear-resistance over other systems; however, risk of catastrophic fracture remains a concern. In dentistry, zirconia has been widely adopted for endosseous implants, implant abutments, and all-ceramic crowns. Because of an increasing demand for esthetically pleasing dental restorations, zirconia-based ceramic restorations have become one of the dominant restorative choices. Areas covered: This review provides an updated overview of the applications of zirconia in medicine and dentistry with a focus on dental applications. The MEDLINE electronic database (via PubMed) was searched, and relevant original and review articles from 2010 to 2016 were included. Expert commentary: Recent data suggest that zirconia performs favorably in both orthopedic and dental applications, but quality long-term clinical data remain scarce. Concerns about the effects of wear, crystalline degradation, crack propagation, and catastrophic fracture are still debated. The future of zirconia in biomedical applications will depend on the generation of these data to resolve concerns.

  5. Preparation and characterization of TiO2 and Si-doped octacalcium phosphate composite coatings on zirconia ceramics (Y-TZP) for dental implant applications

    NASA Astrophysics Data System (ADS)

    Bao, Lei; Liu, Jingxiao; Shi, Fei; Jiang, Yanyan; Liu, Guishan

    2014-01-01

    In order to prevent the low temperature degradation and improve the bioactivity of zirconia ceramic implants, TiO2 and Si-doped octacalcium phosphate composite coating was prepared on zirconia substrate. The preventive effect on low temperature degradation and surface morphology of the TiO2 layer were studied. Meanwhile, the structure and property changes of the bioactive coating after doping Si were discussed. The results indicate that the dense TiO2 layer, in spite of some microcracks, inhibited the direct contact of the water vapor with the sample's surface and thus prevented the low temperature degradation of zirconia substrates. The acceleration aging test shows that the ratio of the monoclinic phase transition decreased from 10% for the original zirconia substrate to 4% for the TiO2-coated substrate. As to the Si-doped octacalcium phosphate coating prepared by biomimetic method, the main phase composition of the coating was octacalcium phosphate. The morphology of the coating was lamellar-like, and the surface was uniform and continuous with no cracks being observed. It is suggested that Si was added into the coating both through substituting for PO43- and doping as NaSiO3.

  6. Wear at the Implant-Abutment Interface of Zirconia Abutments Manufactured by Three CAD/CAM Systems.

    PubMed

    Pinheiro Tannure, Ana Luiza; Cunha, Alfredo Gonçalves; Borges Junior, Luiz Antônio; da Silva Concílio, Laís Regiane; Claro Neves, Ana Christina

    To evaluate the changes in the external-hexagon surface of the titanium (Ti) implant before and after mechanical cycling, when coupled with zirconia (Zr) abutments (A) manufactured by three computer-aided design/computer-aided manufacturing (CAD/CAM) systems (Neodent Digital, Zirkonzahn, and AmannGirrbach) and the ZrTi abutment manufactured by Neodent. Four groups were formed (n = 6): titanium implant with Zr AmannGirrbach abutment (AZrAG), with Zr Zirkonzahn abutment (AZrZ), with Zr Neodent abutment (AZrN), and with Zr abutment with infrastructure in Ti Neodent (AZrTiN). Standardized abutments were made from three identical abutments milled in wax. Images of the surface of each side of the hexagons of the implant were obtained by scanning electron microscopy, before and after mechanical cycling, to evaluate the parameters: (1) scratches in the hexagon face; (2) hexagon superior shoulder kneading; (3) hexagon shoulder wear; (4) alterations on the hexagon base; and (5) scratches on the hexagon top. The abutments were coupled with the implants, and Cr-Co crowns were cemented. The implant/abutment/crown assemblies were submitted to mechanical cycling (400 N, 8.0 Hz) for 1 million cycles. The observed changes were classified as follows: absence (0), mild (1), moderate (2), and severe (3). The results were analyzed using the Mann-Whitney, Kruskal-Wallis, and Dunn tests (P < .05). For parameter 1, a significant difference (P = .008) was observed between AZrZ and AZrAG, with more scratches in AZrZ; and between AZrN and AZrTiN (P = .006), with more scratches in AZrN. For parameter 2, a significant difference (P < .05) was observed between AZrZ and AZrAG and between AZrZ and AZrN, with greater kneading in AZrZ; among AZrN and AZrTiN, there was no significant difference (P = .103). For parameter 3, a significant difference (P < .05) was observed between AZrZ and the other groups of Zr, with more wear in AZrZ; between AZrN and AZrTiN, there was no significant difference (P

  7. Misfit and fracture load of implant-supported monolithic crowns in zirconia-reinforced lithium silicate

    PubMed Central

    GOMES, Rafael Soares; de SOUZA, Caroline Mathias Carvalho; BERGAMO, Edmara Tatiely Pedroso; BORDIN, Dimorvan; DEL BEL CURY, Altair Antoninha

    2017-01-01

    Abstract Zirconia-reinforced lithium silicate (ZLS) is a ceramic that promises to have better mechanical properties than other materials with the same indications as well as improved adaptation and fracture strength. Objective In this study, marginal and internal misfit and fracture load with and without thermal-mechanical aging (TMA) of monolithic ZLS and lithium disilicate (LDS) crowns were evaluated. Material and methods Crowns were milled using a computer-aided design/computer-aided manufacturing system. Marginal gaps (MGs), absolute marginal discrepancy (AMD), axial gaps, and occlusal gaps were measured by X-ray microtomography (n=8). For fracture load testing, crowns were cemented in a universal abutment, and divided into four groups: ZLS without TMA, ZLS with TMA, LDS without TMA, and LDS with TMA (n=10). TMA groups were subjected to 10,000 thermal cycles (5-55°C) and 1,000,000 mechanical cycles (200 N, 3.8 Hz). All groups were subjected to compressive strength testing in a universal testing machine at a crosshead speed of 1 mm/min until failure. Student’s t-test was used to examine misfit, two-way analysis of variance was used to analyze fracture load, and Pearson’s correlation coefficients for misfit and fracture load were calculated (α=0.05). The materials were analyzed according to Weibull distribution, with 95% confidence intervals. Results Average MG (p<0.001) and AMD (p=0.003) values were greater in ZLS than in LDS crowns. TMA did not affect the fracture load of either material. However, fracture loads of ZLS crowns were lower than those of LDS crowns (p<0.001). Fracture load was moderately correlated with MG (r=-0.553) and AMD (r=-0.497). ZLS with TMA was least reliable, according to Weibull probability. Conclusion Within the limitations of this study, ZLS crowns had lower fracture load values and greater marginal misfit than did LDS crowns, although these values were within acceptable limits. PMID:28678947

  8. Osteogenic Responses to Zirconia with Hydroxyapatite Coating by Aerosol Deposition

    PubMed Central

    Cho, Y.; Hong, J.; Ryoo, H.; Kim, D.; Park, J.

    2015-01-01

    Previously, we found that osteogenic responses to zirconia co-doped with niobium oxide (Nb2O5) or tantalum oxide (Ta2O5) are comparable with responses to titanium, which is widely used as a dental implant material. The present study aimed to evaluate the in vitro osteogenic potential of hydroxyapatite (HA)-coated zirconia by an aerosol deposition method for improved osseointegration. Surface analysis by scanning electron microscopy and x-ray diffraction proved that a thin as-deposited HA film on zirconia showed a shallow, regular, crater-like surface. Deposition of dense and uniform HA films was measured by SEM, and the contact angle test demonstrated improved wettability of the HA-coated surface. Confocal laser scanning microscopy indicated that MC3T3-E1 pre-osteoblast attachment did not differ notably between the titanium and zirconia surfaces; however, cells on the HA-coated zirconia exhibited a lower proliferation than those on the uncoated zirconia late in the culture. Nevertheless, ALP, alizarin red S staining, and bone marker gene expression analysis indicated good osteogenic responses on HA-coated zirconia. Our results suggest that HA-coating by aerosol deposition improves the quality of surface modification and is favorable to osteogenesis. PMID:25586588

  9. Comparison of fit accuracy and torque maintenance of zirconia and titanium abutments for internal tri-channel and external-hex implant connections

    PubMed Central

    Siadat, Hakimeh; Beyabanaki, Elaheh; Mousavi, Niloufar

    2017-01-01

    PURPOSE This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. MATERIALS AND METHODS Two regular platform dental implants, one with external connection (Brånemark, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at α=0.05 of significance. RESULTS There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups (P<.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom (P<.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments (P<.001). However, neither connection type (P=.15) nor abutment material (P=.38) affected torque loss. CONCLUSION Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values. PMID:28874994

  10. Comparison of fit accuracy and torque maintenance of zirconia and titanium abutments for internal tri-channel and external-hex implant connections.

    PubMed

    Siadat, Hakimeh; Beyabanaki, Elaheh; Mousavi, Niloufar; Alikhasi, Marzieh

    2017-08-01

    This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. Two regular platform dental implants, one with external connection (Brånemark, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at α=0.05 of significance. There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups ( P <.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom ( P <.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments ( P <.001). However, neither connection type ( P =.15) nor abutment material ( P =.38) affected torque loss. Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values.

  11. [Rehabilitation of a periodontally compromised dentition with implant-supported zirconia bridges. Case report].

    PubMed

    Balmer, Sacha; Mericske-Stern, Regina

    2009-01-01

    Clinical aspects of reconstruction with fix prosthesis and dental implants in a patient with a history of periodontitis is shown. A successful stabilization and rehabilitation of the periodontally involved dentition can be achieved with tooth-worn crown and bridge reconstructions. From a functional and aesthetic point of view the result may not be satisfying due to mobility and overlength of the teeth and open approximal spaces. Today, dentist and patient have often to weigh if teeth shall be maintained or replaced by dental implants. Thereby, both must be aware of the fact that in complex cases long-term success and aesthetic outcome may be difficult to predict. An intense discussion with the patient on his expectations, invasive treatment, risks with regard to biologic and prosthetic aspects is mandatory and must be based on the best scientific evidence available. The present case report shows different considerations and describes a radical solution which meets the patient's needs and is based on modern CAD-CAM technology.

  12. Prosthetically guided bone sculpturing for a maxillary complete-arch implant-supported monolithic zirconia fixed prosthesis based on a digital smile design: A clinical report.

    PubMed

    Rojas-Vizcaya, Fernando

    2017-11-01

    A digital smile design was used to create an average smile and to develop a removable interim restoration for an edentulous patient with a high smile line and different bone levels in the maxilla. The interim restoration was used as a guide to perform bone sculpturing to create space for the biological width and to restore a monolithic zirconia implant-supported fixed restoration. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  13. Bi-layered zirconia/fluor-apatite bridges supported by ceramic dental implants: a prospective case series after thirty months of observation.

    PubMed

    Spies, Benedikt Christopher; Witkowski, Siegbert; Butz, Frank; Vach, Kirstin; Kohal, Ralf-Joachim

    2016-10-01

    The aim of this study was to determine the success and survival rate of all-ceramic bi-layered implant-supported three-unit fixed dental prostheses (IS-FDPs) 3 years after implant placement. Thirteen patients (seven males, six females; age: 41-78 years) received two one-piece ceramic implants (alumina-toughened zirconia) each in the region of the premolars or the first molar and were finally restored with adhesively cemented bi-layered zirconia-based IS-FDPs (3 in the maxilla, 10 in the mandible) composed of CAD/CAM-fabricated zirconia frameworks pressed-over with fluor-apatite glass-ceramic ingots. At prosthetic delivery and the follow-ups after 1, 2 and 3 years, the restorations were evaluated using modified United States Public Health Service (USPHS) criteria. Restorations with minor veneer chippings, a small-area occlusal roughness, slightly soundable restoration margins, minimal contour deficiencies and tolerable color deviations were regarded as success. In case of more distinct defects that could, however, be repaired to a clinically acceptable level, IS-FDPs were regarded as surviving. Kaplan-Meier plots were used for the success/survival analyses. To verify an impact on subjective patients' perceptions, satisfaction was evaluated by visual analog scales (VAS). All patients were seen 3 years after implant installation. No IS-FDP had to be replaced, resulting in 100% survival after a mean observation period of 29.5 months (median: 30.7). At the 3-year follow-up, 7/13 IS-FDPs showed a veneer chipping, 13/13 an occlusal roughness and 12/13 minimal deficiencies of contour/color. Since six restorations showed a major chipping and/or a major occlusal roughness, the Kaplan-Meier success rate was 53.8%. However, patients' significantly improved perceptions of function, esthetics, sense, and speech at prosthetic delivery remained stable over time. Bi-layered zirconia/fluor-apatite IS-FDPs entirely survived the observation period but showed a high frequency of

  14. Release of zirconia nanoparticles at the metal stem-bone cement interface in implant loosening of total hip replacements.

    PubMed

    Schunck, Antje; Kronz, Andreas; Fischer, Cornelius; Buchhorn, Gottfried Hans

    2016-02-01

    In a previous failure analysis performed on femoral components of cemented total hip replacements, we determined high volumes of abraded bone cement. Here, we describe the topography of the polished surface of polymethyl methacrylate (PMMA) bone cement containing zirconia radiopacifier, analyzed by scanning electron microscopy and vertical scanning interferometry. Zirconia spikes protruded about 300nm from the PMMA matrix, with pits of former crystal deposition measuring about 400nm in depth. We deduced that the characteristically mulberry-shaped agglomerates of zirconia crystals are ground and truncated into flat surfaces and finally torn out of the PMMA matrix. Additionally, evaluation of in vitro PMMA-on-PMMA articulation confirmed that crystal agglomerations of zirconia were exposed to grain pullout, fatigue, and abrasion. In great quantities, micron-sized PMMA wear and zirconia nanoparticles accumulate in the cement-bone interface and capsular tissues, thereby contributing to osteolysis. Dissemination of nanoparticles to distant lymph nodes and organs of storage has been reported. As sufficient information is lacking, foreign body reactions to accumulated nanosized zirconia in places of long-term storage should be investigated. The production of wear particles of PMMA bone cement in the interface to joint replacement devices, presents a local challenge. The presence of zirconia particles results in frustrated digestion attempts by macrophages, liberation of inflammatory mediators, and necrosis leading to aseptic inflammation and osteolyses. Attempts to minimize wear of articulating joints reduced the attention to the deterioration of cement cuffs. We therefore investigated polished surfaces of retrieved cuffs to demonstrate their morphology and to measure surface roughness. Industrially admixed agglomerates of the radiopacifier are abraded to micron and nano-meter sized particles. The dissemination of zirconia particles in the reticulo-endothelial system to

  15. Computer-assisted design/computer-assisted manufacturing zirconia implant fixed complete prostheses: clinical results and technical complications up to 4 years of function.

    PubMed

    Papaspyridakos, Panos; Lal, Kunal

    2013-06-01

    To report the clinical results and technical complications with computer-assisted design/computer-assisted manufacturing (CAD/CAM) zirconia, implant fixed complete dental prostheses (IFCDPs) after 2-4 years in function. Fourteen consecutive edentulous patients (16 edentulous arches) were included in this study. Ten of the patients were women and four were men, with an average age of 58 years (range: 35-71). Ten mandibular and six maxillary arches were restored with porcelain fused to zirconia (PFZ) IFCDPs. Of the 16 arches, 14 received one-piece and 2 received segmented two-piece IFCDPs, respectively. The mean clinical follow-up period was 3 years (range: 2-4). At the last recall appointment, biological and technical parameters of dental implant treatment were evaluated. The implant and prosthesis survival rate following prosthesis insertion was 100% up to 4-year follow-up. The prostheses in 11 of the 16 restored arches were structurally sound, exhibited favorable soft tissue response, esthetics, and patient satisfaction. Five IFCDPs (31.25%) in four patients exhibited porcelain veneer chipping. Chipping was minor in three prostheses (three patients) and was addressed intraorally with polishing (one prosthesis) or composite resin (two prostheses). One patient with maxillary and mandibular zirconia IFCDP exhibited major porcelain chipping fractures which had to be repaired in the laboratory. Function, esthetics, and patient satisfaction were not affected in three of the four fracture incidents. Median crestal bone loss was 0.1 mm (0.01-0.2 mm). The presence of parafunctional activity, the IFCDP as opposing dentition, and the absence of occlusal night guard were associated with all the incidents of ceramic chipping. CAD/CAM zirconia IFCDPs are viable prosthetic treatment after 2-4 years in function, but not without complications. The porcelain chipping/fracture was the most frequent technical complication, with a 31.25% chipping rate at the prosthesis level

  16. Comparative analysis of two measurement methods for marginal fit in metal-ceramic and zirconia posterior FPDs.

    PubMed

    Gonzalo, Esther; Suárez, María J; Serrano, Benjamin; Lozano, José F L

    2009-01-01

    The purpose of this study was to compare two measurement methods for the external marginal fit of zirconia posterior fixed partial dentures (FPDs) fabricated using computer-aided design/manufacturing technology and metal-ceramic posterior FPDs fabricated using the conventional lost-wax technique. The null hypothesis was that there would be no differences between the measurement methods. Forty standardized steel specimens were prepared to receive posterior three-unit FPDs. Specimens were divided into four groups (n = 10): (1) metal-ceramic, (2) Procera Bridge Zirconia, (3) Lava AllCeramic System, and (4) Vita In-Ceram YZ 2000. All FPDs were luted with glass-ionomer cement (Ketac Cem EasyMix, 3M ESPE). Two measurement methods were used to analyze marginal fit: an image analysis (IA) program and a scanning electron microscope (SEM) (JEOL JSM-6400) with magnifications of 340 and 31,000, respectively. Marginal fit was measured at the same point on each abutment. Significant interaction was observed between measurement method and material (P = .0019). Therefore, the measurement method is not independent of the restoration material. Differences among groups were observed for IA (P = .0001) and SEM (P = .0013). Significant differences were observed for the Procera (P = .0050) and metal-ceramic (P = .0039) specimen groups when both measurement methods were evaluated separately. Accuracy of fit achieved by the four groups analyzed was within the range of clinical acceptance, yielding Procera Bridge Zirconia to have the best marginal fit using both measurement methods.

  17. All-Ceramic Single Crown Restauration of Zirconia Oral Implants and Its Influence on Fracture Resistance: An Investigation in the Artificial Mouth

    PubMed Central

    Kohal, Ralf-Joachim; Kilian, Jolanta Bernadette; Stampf, Susanne; Spies, Benedikt Christopher

    2015-01-01

    The aim of the current investigation was to evaluate the fracture resistance of one-piece zirconia oral implants with and without all-ceramic incisor crowns after long-term thermomechanical cycling. A total of 48 implants were evaluated. The groups with crowns (C, 24 samples) and without crowns (N, 24 samples) were subdivided according to the loading protocol, resulting in three groups of 8 samples each: Group “0” was not exposed to cyclic loading, whereas groups “5” and “10” were loaded with 5 and 10 million chewing cycles, respectively. This resulted in 6 different groups: C0/N0, C5/N5 and C10/N10. Subsequently, all 48 implants were statically loaded to fracture and bending moments were calculated. All implants survived the artificial aging. For the static loading the following average bending moments were calculated: C0: 326 Ncm; C5: 339 Ncm; C10: 369 Ncm; N0: 339 Ncm; N5: 398 Ncm and N10: 355 Ncm. To a certain extent, thermomechanical cycling resulted in an increase of fracture resistance which did not prove to be statistically significant. Regarding its fracture resistance, the evaluated ceramic implant system made of Y-TZP seems to be able to resist physiological chewing forces long-term. Restauration with all-ceramic single crowns showed no negative influence on fracture resistance. PMID:28788018

  18. Densification kinetics of nanocrystalline zirconia powder using microwave and spark plasma sintering--a comparative study.

    PubMed

    Vasylkiv, Oleg; Demirskyi, Dmytro; Sakka, Yoshio; Ragulya, Andrey; Borodianska, Hanna

    2012-06-01

    Two-stage densification process of nanosized 3 mol% yttria-stabilized zirconia (3Y-SZ) polycrystalline compacts during consolidation via microwave and spark-plasma sintering have been observed. The values of activation energies obtained for microwave and spark-plasma sintering 260-275 kJ x mol(-1) are quite similar to that of conventional sintering of zirconia, suggesting that densification during initial stage is controlled by the grain-boundary diffusion mechanism. The sintering behavior during microwave sintering was significantly affected by preliminary pressing conditions, as the surface diffusion mechanism (230 kJ x mol(-1)) is active in case of cold-isostatic pressing procedure was applied.

  19. In vivo evaluation of zirconia ceramic in the DexAide right ventricular assist device journal bearing.

    PubMed

    Saeed, Diyar; Shalli, Shanaz; Fumoto, Hideyuki; Ootaki, Yoshio; Horai, Tetsuya; Anzai, Tomohiro; Zahr, Roula; Horvath, David J; Massiello, Alex L; Chen, Ji-Feng; Dessoffy, Raymond; Catanese, Jacquelyn; Benefit, Stephen; Golding, Leonard A R; Fukamachi, Kiyotaka

    2010-06-01

    Zirconia is a ceramic with material properties ideal for journal bearing applications. The purpose of this study was to evaluate the use of zirconium oxide (zirconia) as a blood journal bearing material in the DexAide right ventricular assist device. Zirconia ceramic was used instead of titanium to manufacture the DexAide stator housing without changing the stator geometry or the remaining pump hardware components. Pump hydraulic performance, journal bearing reliability, biocompatibility, and motor efficiency data of the zirconia stator were evaluated in six chronic bovine experiments for 14-91 days and compared with data from chronic experiments using the titanium stator. Pump performance data including average in vivo pump flows and speeds using a zirconia stator showed no statistically significant difference to the average values for 16 prior titanium stator in vivo studies, with the exception of a 19% reduction in power consumption. Indices of hemolysis were comparable for both stator types. Results of coagulation assays and platelet aggregation tests for the zirconia stator implants showed no device-induced increase in platelet activation. Postexplant evaluation of the zirconia journal bearing surfaces showed no biologic deposition in any of the implants. In conclusion, zirconia ceramic can be used as a hemocompatible material to improve motor efficiency while maintaining hydraulic performance in a blood journal bearing application.

  20. [Comparative study of bond strength between zirconia ceramics and 4 luting cements].

    PubMed

    Zheng, Hu; Zhang, Xian-Fang; Han, Dong-Wei

    2007-02-01

    To study the bonding strength of zirconia ceramics with 4 kinds of luting cement materials. Blocks of sintered zirconia ceramics were cut and randomly divided into 4 groups with 16 slices in each group. They were treated with sandblasting and bonded with 4 kinds of luting cements respectively. After preserved in 37 degrees C distilled-water for 24 hours and 30 days, the shear bonding strength of these specimens was tested and the data were analyzed by SAS6.12 software package and bond section were observed by scanning electron microscope. Two-way ANOVA revealed that the group of PanaviaF could attain the highest shear bonding strength: (34.7+/-3.44) MPa (after 24 hours), (31.5+/-3.44) MPa (after 1 month), which was significantly different from other treatment methods (P<0.01). The initial shear bonding strength of the groups of resin-reinforced glass ionomer was (15.5+/-2.71) MPa, (16.0+/-1.77) MPa (after 24 hours) but dropped markedly to (6.80+/-1.24) MPa, (3.38+/-2.32) MPa after 30 days (P<0.05). Resin luting cement containing phosphate monomer (MDP) can provide zirconia ceramics a strong and long-lasting bonding. Resin-reinforced glass ionomer can get good bonding strength too, but can't last long.

  1. Incidence of undetected cement on CAD/CAM monolithic zirconia crowns and customized CAD/CAM implant abutments. A prospective case series.

    PubMed

    Wasiluk, Grzegorz; Chomik, Ewa; Gehrke, Peter; Pietruska, Małgorzata; Skurska, Anna; Pietruski, Jan

    2017-07-01

    The aim of this study was to assess the frequency of cement residues after cementation of CAD/CAM monolithic zirconia crowns on customized CAD/CAM titanium abutments. Sixty premolars and molars were restored on Astra Tech Osseospeed TX ™ implants using single monolithic zirconia crowns fixed on two types of custom-made abutments: Atlantis ™ titanium or Atlantis ™ Gold Hue. Occlusal openings providing access to the abutment screws were designed for retrievability of the crown/abutment connection. After fixation with glass ionomer cement, the crown/abutment units were unscrewed to evaluate the presence of residual cement. Dichotomous assessment of the presence or absence of cement at the crown/abutment unit and peri-implant tissues was performed. Clinically undetected cement excess was visible on 44 of 60 restorations (73.3%). There was no interdependency between residual cement presence and implant location or diameter. However, a dependency between the presence of residual cement and the aspect of the abutment/crown connection could be noted. The majority of the residues were observed on the distal (17.9%) and mesial (15%) aspects. While on the palatal/lingual aspect, the cement was visible in 8.8%; only 3.4% of all surfaces displayed cement residues. Within the limitations of the study, it can be concluded that the use of customized CAD/CAM abutments do not guarantee avoidance of subgingival cement residues after crown cementation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Comparative silicone breast implant evaluation using mammography, sonography, and magnetic resonance imaging: experience with 59 implants.

    PubMed

    Ahn, C Y; DeBruhl, N D; Gorczyca, D P; Shaw, W W; Bassett, L W

    1994-10-01

    With the current controversy regarding the safety of silicone implants, the detection and evaluation of implant rupture are causing concern for both plastic surgeons and patients. Our study obtained comparative value analysis of mammography, sonography, and magnetic resonance imaging (MRI) in the detection of silicone implant rupture. Twenty-nine symptomatic patients (total of 59 silicone implants) were entered into the study. Intraoperative findings revealed 21 ruptured implants (36 percent). During physical examination, a positive "squeeze test" was highly suggestive of implant rupture. Mammograms were obtained of 51 implants (sensitivity 11 percent, specificity 89 percent). Sonography was performed on 57 implants (sensitivity 70 percent, specificity 92 percent). MRI was performed on 55 implants (sensitivity 81 percent, specificity 92 percent). Sonographically, implant rupture is demonstrated by the "stepladder sign." Double-lumen implants may appear as false-positive results for rupture on sonography. On MRI, the "linguine sign" represents disrupted fragments of a ruptured implant. The most reliable imaging modality for implant rupture detection is MRI, followed by sonogram. Mammogram is the least reliable. Our study supports the clinical indication and diagnostic value of sonogram and MRI in the evaluation of symptomatic breast implant patients.

  3. Towards long lasting zirconia-based composites for dental implants. Part I: innovative synthesis, microstructural characterization and in vitro stability.

    PubMed

    Palmero, Paola; Fornabaio, Marta; Montanaro, Laura; Reveron, Helen; Esnouf, Claude; Chevalier, Jérôme

    2015-05-01

    In order to fulfill the clinical requirements for strong, tough and stable ceramics used in dental applications, we designed and developed innovative zirconia-based composites, in which equiaxial α-Al2O3 and elongated SrAl12O19 phases are dispersed in a ceria-stabilized zirconia matrix. The composite powders were prepared by an innovative surface coating route, in which commercial zirconia powders were coated by inorganic precursors of the second phases, which crystallize on the zirconia particles surface under proper thermal treatment. Samples containing four different ceria contents (in the range 10.0-11.5 mol%) were prepared by carefully tailoring the amount of the cerium precursor during the elaboration process. Slip cast green bodies were sintered at 1450 °C for 1 h, leading to fully dense materials. Characterization of composites by SEM and TEM analyses showed highly homogeneous microstructures with an even distribution of both equiaxial and elongated-shape grains inside a very fine zirconia matrix. Ce content plays a major role on aging kinetics, and should be carefully controlled: sample with 10 mol% of ceria were transformable, whereas above 10.5 mol% there is negligible or no transformation during autoclave treatment. Thus, in this paper we show the potential of the innovative surface coating route, which allows a perfect tailoring of the microstructural, morphological and compositional features of the composites; moreover, its processing costs and environmental impacts are limited, which is beneficial for further scale-up and real use in the biomedical field. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. [Influence of coping material selection and porcelain firing on marginal and internal fit of computer-aided design/computer- aided manufacturing of zirconia and titanium ceramic implant-supported crowns].

    PubMed

    Cuiling, Liu; Liyuan, Yang; Xu, Gao; Hong, Shang

    2016-06-01

    This study aimed to investigate the influence of coping material and porcelain firing on the marginal and internal fit of computer-aided design/computer-aided manufacturing (CAD/CAM) of zirconia ceramic implant- and titanium ceramic implant-supported crowns. Zirconia ceramic implant (group A, n = 8) and titanium metal ceramic implant-supported crowns (group B, n = 8) were produced from copings using the CAD/CAM system. The marginal and internal gaps of the copings and crowns were measured by using a light-body silicone replica technique combined with micro-computed tomography scanning to obtain a three-dimensional image. Marginal gap (MG), horizontal marginal discrepancy (HMD), and axial wall (AW) were measured. Statistical analyses were performed using SPSS 17.0. Prior to porcelain firing, the measurements for MG, HMD, and AW of copings in group A were significantly larger than those in group B (P < 0.05). After porcelain firing, the measurements for MG of crowns in group A were smaller than those in group B (P < 0.05), whereas HMD and AW showed no significant difference between the two groups (P > 0.05). Porcelain firing significantly reduced MG (P < 0.05) in group A but significantly increased MG, HMD, and AW in group B (P < 0.05) HMD and AW were not influenced by porcelain firing in group A (P > 0.05). The marginal fits of CAD/CAM zirconia ceramic implant-supported crowns were superior to those of CAD/CAM titanium ceramic-supported crowns. The fits of both the CAD/CAM zirconia ceramic implant- and titanium ceramic implant-supported crowns were obviously influenced by porcelain firing.

  5. Fracture loads and failure modes of customized and non-customized zirconia abutments.

    PubMed

    Moris, Izabela Cristina Maurício; Chen, Yung-Chung; Faria, Adriana Cláudia Lapria; Ribeiro, Ricardo Faria; Fok, Alex Sui-Lun; Rodrigues, Renata Cristina Silveira

    2018-05-05

    This study aimed to evaluate the fracture load and pattern of customized and non-customized zirconia abutments with Morse-taper connection. 18 implants were divided into 3 groups according to the abutments used: Zr - with non-customized zirconia abutments; Zrc - with customized zirconia abutments; and Ti - with titanium abutments. To test their load capacity, a universal test machine with a 500-kgf load cell and a 0.5-mm/min speed were used. After, one implant-abutment assembly from each group was analyzed by Scanning Electron Microscopy (SEM). For fractographic analysis, the specimens were transversely sectioned above the threads of the abutment screw in order to examine their fracture surfaces using SEM. A significant difference was noted between the groups (Zr=573.7±11.66N, Zrc=768.0±8.72N and Ti=659.1±7.70N). Also, the zirconia abutments fractured while the titanium abutments deformed plastically. Zrc presented fracture loads significantly higher than Zr (p=0.009). All the zirconia abutments fractured below the implant platform, starting from the area of contact between the abutment and implant and propagating to the internal surface of the abutment. All the zirconia abutments presented complete cleavage in the mechanical test. Fractography detected differences in the position and pattern of fracture between the two groups with zirconia abutments, probably because of the different diameters in the transmucosal region. Customization of zirconia abutments did not affect their fracture loads, which were comparable to that of titanium and much higher than the maximum physiological limit for the anterior region of the maxilla. Copyright © 2018 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

  6. Long-term stability of peri-implant tissues after bone or soft tissue augmentation. Effect of zirconia or titanium abutments on peri-implant soft tissues. Summary and consensus statements. The 4th EAO Consensus Conference 2015.

    PubMed

    Sicilia, Alberto; Quirynen, Marc; Fontolliet, Alain; Francisco, Helena; Friedman, Anton; Linkevicius, Tomas; Lutz, Rainer; Meijer, Henny J; Rompen, Eric; Rotundo, Roberto; Schwarz, Frank; Simion, Massimo; Teughels, Wim; Wennerberg, Ann; Zuhr, Otto

    2015-09-01

    Several surgical techniques and prosthetic devices have been developed in the last decades, aiming to improve aesthetic, hygienic and functional outcomes that may affect the peri-implant tissues, such as procedures of bone and soft tissue augmentation and the use of custom-made abutments of titanium and zirconium. Three systematic reviews, based on randomized clinical trials and prospective studies covering the above reported topics were analysed, and the detected evidence was exposed to interactive experts' discussion during the group's and general assembly's meetings of the 4th EAO Consensus Conference. The results are reported using the following abbreviations: S-T: short-term evidence, M-T: medium-term evidence; L-T: long-term evidence; LE: limited evidence. Soft tissue augmentation procedures may be indicated for the increase of soft tissue thickness and keratinized tissue, the reduction of interproximal peri-implant bone loss, and the coverage of shallow peri-implant soft tissue recessions (S-T, LE), L-T is lacking. Guided bone regeneration approaches (GBR) showed efficacy when used for ridge reconstruction after the complete healing of the soft tissues (S-T & L-T), and the stability of the augmented bone may play a role in the maintenance of the soft tissue position and dimensions (LE). No significant differences were observed between titanium and zirconia abutments when evaluating probing pocket depth, bleeding on probing, marginal bone levels and mucosal recessions. Zirconia abutments were associated with more biological complications but demonstrated superiority in terms of achieving natural soft tissue colour (S-T). © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Effect of Porosity of Alumina and Zirconia Ceramics toward Pre-Osteoblast Response

    PubMed Central

    Hadjicharalambous, Chrystalleni; Prymak, Oleg; Loza, Kateryna; Buyakov, Ales; Kulkov, Sergei; Chatzinikolaidou, Maria

    2015-01-01

    It is acknowledged that cellular responses are highly affected by biomaterial porosity. The investigation of this effect is important for the development of implanted biomaterials that integrate with bone tissue. Zirconia and alumina ceramics exhibit outstanding mechanical properties and are among the most popular implant materials used in orthopedics, but few data exist regarding the effect of porosity on cellular responses to these materials. The present study investigates the effect of porosity on the attachment and proliferation of pre-osteoblastic cells on zirconia and alumina. For each composition, ceramics of three different porosities are fabricated by sintering, and characterized using scanning electron microscopy, energy dispersive X-ray spectroscopy and X-ray powder diffraction. Cell proliferation is quantified, and microscopy is employed to qualitatively support the proliferation results and evaluate cell morphology. Cell adhesion and metabolic activity are found comparable among low porosity zirconia and alumina. In contrast, higher porosity favors better cell spreading on zirconia and improves growth, but does not significantly affect cell response on alumina. Between the highest porosity materials, cell response on zirconia is found superior to alumina. Results show that an average pore size of ~150 μm and ~50% porosity can be considered beneficial to cellular growth on zirconia ceramics. PMID:26579516

  8. Zirconia in dental implantology: A review

    PubMed Central

    Apratim, Abhishek; Eachempati, Prashanti; Krishnappa Salian, Kiran Kumar; Singh, Vijendra; Chhabra, Saurabh; Shah, Sanket

    2015-01-01

    Background: Titanium has been the most popular material of choice for dental implantology over the past few decades. Its properties have been found to be most suitable for the success of implant treatment. But recently, zirconia is slowly emerging as one of the materials which might replace the gold standard of dental implant, i.e., titanium. Materials and Methods: Literature was searched to retrieve information about zirconia dental implant and studies were critically analyzed. PubMed database was searched for information about zirconia dental implant regarding mechanical properties, osseointegration, surface roughness, biocompatibility, and soft tissue health around it. The literature search was limited to English language articles published from 1975 to 2015. Results: A total of 45 papers met the inclusion criteria for this review, among the relevant search in the database. Conclusion: Literature search showed that some of the properties of zirconia seem to be suitable for making it an ideal dental implant, such as biocompatibility, osseointegration, favourable soft tissue response and aesthetics due to light transmission and its color. At the same time, some studies also point out its drawbacks. It was also found that most of the studies on zirconia dental implants are short-term studies and there is a need for more long-term clinical trials to prove that zirconia is worth enough to replace titanium as a biomaterial in dental implantology. PMID:26236672

  9. Comparative bone tissue integration of nanostructured and microroughened dental implants.

    PubMed

    Salou, Laëtitia; Hoornaert, Alain; Stanovici, Julien; Briand, Sylvain; Louarn, Guy; Layrolle, Pierre

    2015-01-01

    The aim was to compare osteointegration of nanostructured implants to a microsurface widely used for titanium dental implants. Commercial titanium dental implants with smooth or microroughened surfaces were nanostructured. Implants were inserted into the femoral condyles of rabbits. After 2 and 4 weeks, histomorphometry calculation was performed. Nanotubes measuring 60 nm in diameter were observed on both S-NANO (roughness: 0.05 μm) and R-NANO (roughness: 0.40 μm) surfaces. The MICRO surface exhibited typical random cavities (roughness: 2.09 μm). At 4 weeks, bone-to-implant contact values were significantly higher for the R-NANO than for the MICRO surface while no differences were observed at 2 weeks. Overall, this study shows that the nanostructured surfaces improved osteointegration similar or higher than the MICRO.

  10. Osseointegration of implants with dendrimers surface characteristics installed conventionally or with Piezosurgery®. A comparative study in the dog.

    PubMed

    Bengazi, Franco; Lang, Niklaus P; Canciani, Elena; Viganò, Paolo; Velez, Joaquin Urbizo; Botticelli, Daniele

    2014-01-01

    The first aim of the present experiment was to compare bone healing at implants installed in recipient sites prepared with conventional drills or a piezoelectric device. The second aim was to compare implant osseointegration onto surfaces with and without dendrimers coatings. Six Beagles dogs were used in this study. Five implants with two different surfaces, three with a ZirTi(®) surface (zirconia sand blasted, acid etched), and two with a ZirTi(®)-modified surface with dendrimers of phosphoserine and polylysine were installed in the right side of the mandible. In the most anterior region (P2, P3), two recipient sites were prepared with drills, and one implant ZirTi(®) surface and one coated with dendrimers implants were installed at random. In the posterior region (P4 and M1), three recipient sites were randomly prepared: two sites with a Piezosurgery(®) instrument and one site with drill and two ZirTi(®) surface and one coated with dendrimers implants installed. Three months after the surgery, the animals were sacrificed for histological analysis. No complications occurred during the healing period. Three implants were found not integrated and were excluded from analysis. However, n = 6 was obtained. The distance IS-B at the buccal aspect was 2.2 ± 0.8 and 1.8 ± 0.5 mm, while IS-C was 1.5 ± 0.9 and 1.4 ± 0.6 mm at the Piezosurgery(®) and drill groups, respectively. Similar values were obtained between the dendrimers-coated and ZirTi(®) surface implants. The BIC% values were higher at the drill (72%) compared to the Piezosurgery(®) (67%) sites. The BIC% were also found to be higher at the ZirTi(®) (74%) compared to the dendrimers-coated (65%) implants, the difference being statistically significant. This study has revealed that oral implants may osseointegrate equally well irrespective of whether their bed was prepared utilizing conventional drills with abundant cooling or Piezosurgery(®). Moreover, the surface coating of implants with dendrimers

  11. To Evaluate Effect of Airborne Particle Abrasion using Different Abrasives Particles and Compare Two Commercial Available Zirconia on Flexural Strength on Heat Treatment.

    PubMed

    Prasad, Hari A; Pasha, Naveed; Hilal, Mohammed; Amarnath, G S; Kundapur, Vinaya; Anand, M; Singh, Sumeet

    2017-06-01

    airborne-particle abrasion using 50 µm Al 2 O 3 particles and 50 µm silica coated Al 2 O 3 are applied to the upper and lower surfaces of the specimens. Each specimen is held under a pressure of 30 psi for 15 seconds at a direction perpendicular to the surface and at a distance of 30mm with an airborne particle abrasion device for the specimens in the airborne particle abraded groups. Heat treatments were performed at a starting temperature of 500°C, heating rate of 100°c/ min, ending at a temperature of 1000°C and 15 minutes holding time without vacuum for the specimens in the group 4, 5, 9 and 10. Airborne-particle abrasion mimicking the preparation for cementation was applied to the lower surfaces with 50 µm alumina and silica coated alumina particles for the specimens in the groups 6, 7, 8, 9 and 10. The specimens were cleaned for 15 minutes in an ultrasonic bath containing distilled water. To determine the fracture strength, a disc of 10 mm diameter was used to place 3 hardened steel balls of 3 mm diameter separated each other by 120 degrees (described in the ISO standard 6872 for dental ceramics). Each specimen was centrally placed on this disc. The lower surface mimicking the internal surface of zirconia was the tension side, facing the supporting device testing, while the upper surface mimicking the external surface of the zirconia core was loaded with a flat punch (1 mm in diameter). A universal testing machine was used to perform the test at a cross head speed of 1mm/min. The failure stress was calculated with the equation listed in ISO 6872. The results were then statistically analyzed. A post hoc test was used for pair wise comparisons. The mean fracture strength of commercially available Zirconia Ceramill (AMANNGIRBACH) showed a significant higher value compared to the ZR-White (UPCERA) Zirconia ( P <0.001), Airborne abrasion treatment to the specimens showed a significant difference between the abraded groups and the control group ( P <0.001); further

  12. To Evaluate Effect of Airborne Particle Abrasion using Different Abrasives Particles and Compare Two Commercial Available Zirconia on Flexural Strength on Heat Treatment

    PubMed Central

    Prasad, Hari A.; Pasha, Naveed; Hilal, Mohammed; Amarnath, G. S.; Kundapur, Vinaya; Anand, M; Singh, Sumeet

    2017-01-01

    specimens each. Heat treatment after airborne-particle abrasion using 50 µm Al2O3 particles and 50 µm silica coated Al2O3 are applied to the upper and lower surfaces of the specimens. Each specimen is held under a pressure of 30 psi for 15 seconds at a direction perpendicular to the surface and at a distance of 30mm with an airborne particle abrasion device for the specimens in the airborne particle abraded groups. Heat treatments were performed at a starting temperature of 500°C, heating rate of 100°c/ min, ending at a temperature of 1000°C and 15 minutes holding time without vacuum for the specimens in the group 4, 5, 9 and 10. Airborne-particle abrasion mimicking the preparation for cementation was applied to the lower surfaces with 50 µm alumina and silica coated alumina particles for the specimens in the groups 6, 7, 8, 9 and 10. The specimens were cleaned for 15 minutes in an ultrasonic bath containing distilled water. To determine the fracture strength, a disc of 10 mm diameter was used to place 3 hardened steel balls of 3 mm diameter separated each other by 120 degrees (described in the ISO standard 6872 for dental ceramics). Each specimen was centrally placed on this disc. The lower surface mimicking the internal surface of zirconia was the tension side, facing the supporting device testing, while the upper surface mimicking the external surface of the zirconia core was loaded with a flat punch (1 mm in diameter). A universal testing machine was used to perform the test at a cross head speed of 1mm/min. The failure stress was calculated with the equation listed in ISO 6872. The results were then statistically analyzed. A post hoc test was used for pair wise comparisons. Result: The mean fracture strength of commercially available Zirconia Ceramill (AMANNGIRBACH) showed a significant higher value compared to the ZR-White (UPCERA) Zirconia (P<0.001), Airborne abrasion treatment to the specimens showed a significant difference between the abraded groups and the

  13. [Comparative study of 4 types of luting cements on shear bond strength of Zirconia ceramics to dentin].

    PubMed

    Yin, Bao-di; Zhang, Xian-fang; Zheng, Hu; Han, Dong-wei

    2010-04-01

    To investigate the adequate luting cements for zirconia ceramics to dentin. Blocks of sintered zirconia ceramics were randomly divided into 4 groups with 8 slices in each. After saliva immersion,airborne-particle abraded ceramic specimens were cleaned with phosphoric acid gel(containing 35% phosphoric acid) and then bonded to dentin with these four kinds of luting cements. After preserved in 37 degrees centigrade distilled water for 24 hours, the shear bonding strength of these specimens was tested and the data was analyzed with SPSS12.0 software package. The Multilink Automix could attain the highest shear bonding strength and the 3M RelyXTM Unicem AplicapTM could attain higher shear bonding strength, which were both significantly higher than in the Tokuso Ionomer and Shofu Polycarboxylate Cement groups(P<0.05). Total etching resin luting cement is an ideal option to the bonding of zirconia ceramics and can provide a strong bonding.

  14. Comparing polymethylmethacrylate implant with collagen implant in deep sclerectomy: a randomized controlled trial.

    PubMed

    Mansouri, Kaweh; Shaarawy, Tarek; Wedrich, Andreas; Mermoud, André

    2006-06-01

    To compare the intraocular pressure (IOP) lowering effect and safety of a new rigid, nonabsorbable polymethylmethacrylate implant (PMMA) with the commercially available cylindrical collagen implant used in deep sclerectomy procedure. Nonpenetrating deep sclerectomy was performed on all patients. Patients were randomly assigned to receive either a PMMA implant or a collagen implant. The trial involved 60 patients (60 eyes) with medically uncontrolled primary and secondary open-angle glaucoma who were randomized to receive either a PMMA implant (30 eyes) or the collagen implant (30 eyes). The patients were examined before and after the operation 1 day before surgery and at day 1; weeks 1, 2 and 3; and months 1, 2, 3, 6, 9, 12, 18, 24, and 30. At each visit, the following examinations were performed: slit lamp examination, tonometry, visual acuity, and fundoscopy. The mean follow-up period was 20.4 (SD 12.4) months (PMMA) and 15.1 (SD 7.7) months (collagen) (P=NS). The mean preoperative IOP was 21.4 (SD 7.1) mm Hg (PMMA) and 21.0 mm Hg (SD 5.4) (collagen). The mean postoperative IOP was 7.4 (SD 4.5) mm Hg (PMMA) and 5.4 (SD 4.4) mm Hg (collagen) at day 1 (P=NS), 15.7 (SD 5.0) mm Hg (PMMA) and 14.7 (SD 5.0) mm Hg (collagen) at month 1 (P=NS), and 13.8 (SD 4.8) mm Hg (PMMA) and 13.3 (SD 2.4) mm Hg (collagen) at month 12 (P=NS). Seven patients had perforations of the trabeculo-Descemet membrane and were excluded from the analysis. At the last follow-up visit, 42% of PMMA patients and 44% of collagen patients achieved an IOP of 21 mm Hg or less without medication (P=NS). The number of medications was reduced from 2.4 (SD 1.0) to 0.6 (SD 0.6) (P<0.001) in the PMMA group, and from 2.4 (SD 1.1) to 0.7 (SD 0.8) (P<0.001) in the collagen group. There were no significant differences between the 2 groups in postoperative and transient complications. The new PMMA implant offered success and complication rates equal to those of the collagen implant. The new PMMA implant could

  15. Fracture Resistance and Mode of Failure of Ceramic versus Titanium Implant Abutments and Single Implant-Supported Restorations.

    PubMed

    Sghaireen, Mohd G

    2015-06-01

    The material of choice for implant-supported restorations is affected by esthetic requirements and type of abutment. This study compares the fracture resistance of different types of implant abutments and implant-supported restorations and their mode of failure. Forty-five Oraltronics Pitt-Easy implants (Oraltronics Dental Implant Technology GmbH, Bremen, Germany) (4 mm diameter, 10 mm length) were embedded in clear autopolymerizing acrylic resin. The implants were randomly divided into three groups, A, B and C, of 15 implants each. In group A, titanium abutments and metal-ceramic crowns were used. In group B, zirconia ceramic abutments and In-Ceram Alumina crowns were used. In group C, zirconia ceramic abutments and IPS Empress Esthetic crowns were used. Specimens were tested to failure by applying load at 130° from horizontal plane using an Instron Universal Testing Machine. Subsequently, the mode of failure of each specimen was identified. Fracture resistance was significantly different between groups (p < .05). The highest fracture loads were associated with metal-ceramic crowns supported by titanium abutments (p = .000). IPS Empress crowns supported by zirconia abutments had the lowest fracture loads (p = .000). Fracture modes of metal-ceramic crowns supported by titanium abutments included screw fracture and screw bending. Fracture of both crown and abutment was the dominant mode of failure of In-Ceram/IPS Empress crowns supported by zirconia abutments. Metal-ceramic crowns supported by titanium abutments were more resistant to fracture than In-Ceram crowns supported by zirconia abutments, which in turn were more resistant to fracture than IPS Empress crowns supported by zirconia abutments. In addition, failure modes of restorations supported by zirconia abutments were more catastrophic than those for restorations supported by titanium abutments. © 2013 Wiley Periodicals, Inc.

  16. Scalloped Implant-Abutment Connection Compared to Conventional Flat Implant-Abutment Connection: a Systematic Review and Meta-Analysis

    PubMed Central

    Christensen, Ann-Eva; Lorenzen, Henning

    2017-01-01

    ABSTRACT Objectives The objective was to test the hypothesis of no difference in implant treatment outcome after installation of implants with a scalloped implant-abutment connection compared to a flat implant-abutment connection. Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. No language or year of publication restriction was applied. Results The search provided 298 titles. Three studies fulfilled the inclusion criteria. The included studies were characterized by low or moderate risk of bias. Survival of suprastructures has never been compared within the same study. High implant survival rate was reported in all the included studies. Significantly more peri-implant marginal bone loss, higher probing depth score, bleeding score and gingival score was observed around implants with a scalloped implant-abutment connection. There were no significant differences between the two treatment modalities regarding professional or patient-reported outcome measures. Meta-analysis disclosed a mean difference of peri-implant marginal bone loss of 1.56 mm (confidence interval: 0.87 to 2.25), indicating significant more bone loss around implants with a scalloped implant-abutment connection. Conclusions A scalloped implant-abutment connection seems to be associated with higher peri-implant marginal bone loss compared to a flat implant-abutment connection. Therefore, the hypothesis of the present systematic review must be rejected. However, further long-term randomized controlled trials assessing implant treatment outcome with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of implants with a scalloped implant-abutment connection on preservation of the peri-implant marginal bone level. PMID:28496962

  17. Scalloped Implant-Abutment Connection Compared to Conventional Flat Implant-Abutment Connection: a Systematic Review and Meta-Analysis.

    PubMed

    Starch-Jensen, Thomas; Christensen, Ann-Eva; Lorenzen, Henning

    2017-01-01

    The objective was to test the hypothesis of no difference in implant treatment outcome after installation of implants with a scalloped implant-abutment connection compared to a flat implant-abutment connection. A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. No language or year of publication restriction was applied. The search provided 298 titles. Three studies fulfilled the inclusion criteria. The included studies were characterized by low or moderate risk of bias. Survival of suprastructures has never been compared within the same study. High implant survival rate was reported in all the included studies. Significantly more peri-implant marginal bone loss, higher probing depth score, bleeding score and gingival score was observed around implants with a scalloped implant-abutment connection. There were no significant differences between the two treatment modalities regarding professional or patient-reported outcome measures. Meta-analysis disclosed a mean difference of peri-implant marginal bone loss of 1.56 mm (confidence interval: 0.87 to 2.25), indicating significant more bone loss around implants with a scalloped implant-abutment connection. A scalloped implant-abutment connection seems to be associated with higher peri-implant marginal bone loss compared to a flat implant-abutment connection. Therefore, the hypothesis of the present systematic review must be rejected. However, further long-term randomized controlled trials assessing implant treatment outcome with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of implants with a scalloped implant-abutment connection on preservation of the peri-implant marginal bone level.

  18. Comparing Short Dental Implants to Standard Dental Implants: Protocol for a Systematic Review.

    PubMed

    Rokn, Amir Reza; Keshtkar, Abbasali; Monzavi, Abbas; Hashemi, Kazem; Bitaraf, Tahereh

    2018-01-18

    Short dental implants have been proposed as a simpler, cheaper, and faster alternative for the rehabilitation of atrophic edentulous areas to avoid the disadvantages of surgical techniques for increasing bone volume. This review will compare short implants (4 to 8 mm) to standard implants (larger than 8 mm) in edentulous jaws, evaluating on the basis of marginal bone loss (MBL), survival rate, complications, and prosthesis failure. We will electronically search for randomized controlled trials comparing short dental implants to standard dental implants in the following databases: PubMed, Web of Science, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov with English language restrictions. We will manually search the reference lists of relevant reviews and the included articles in this review. The following journals will also be searched: European Journal of Oral Implantology, Clinical Oral Implants Research, and Clinical Implant Dentistry and Related Research. Two reviewers will independently perform the study selection, data extraction and quality assessment (using the Cochrane Collaboration tool) of included studies. All meta-analysis procedures including appropriate effect size combination, sub-group analysis, meta-regression, assessing publication or reporting bias will be performed using Stata (Statacorp, TEXAS) version 12.1. Short implant effectiveness will be assessed using the mean difference of MBL in terms of weighted mean difference (WMD) and standardized mean difference (SMD) using Cohen's method. The combined effect size measures in addition to the related 95% confidence intervals will be estimated by a fixed effect model. The heterogeneity of the related effect size will be assessed using a Q Cochrane test and I2 measure. The MBL will be presented by a standardized mean difference with a 95% confidence interval. The survival rate of implants, prostheses failures, and complications will be reported using a risk

  19. Comparing the Quality of Life of Patients Requesting Dental Implants Before and After Implant.

    PubMed

    Sargozaie, Naser; Moeintaghavi, Amir; Shojaie, Hamid

    2017-01-01

    Tooth loss is a serious life event that impairs two important functions, namely, eating and speaking, and has significant side effects on different aspects of quality of life. These effects are internalized by the individual. The present study aimed to compare the quality of life (QOL) of patients requesting dental implants before and after implant. This analytical cross-sectional study was conducted on patients referred to the Mashhad faculty of Dentistry and private clinics with dental implants in 2015. Patient Quality Of Life (QOL) was assessed using the Oral Impact on Daily Practice (OIDP) questionnaire. Data were analyzed using SPSS software. In this study, the most common problems reported by patients were eating (78%), smiling, laughing, and embarrassment (53%) before surgery. The quality of life associated with eating; speaking clearly; clean teeth or dentures; light physical activities, such as working at home, going out to work or meeting others; smiling; laughing; showing teeth without discomfort and embarrassment; emotional conditions, such as becoming upset quicker than usual, enjoying communication with others ( i.e. , friends, relatives and neighbors); and job-related activities significantly increased after surgery, but QOL associated with the amount of sleep and resting did not improve. No significant association was noted between quality of life after implantation and place of residence, education and gender. In this study, implants had a favorable impact on a patient's quality of life.

  20. A comparative study between titania and zirconia as material for scattering layer in dye-sensitized solar cells

    NASA Astrophysics Data System (ADS)

    Nursam, N. M.; Hidayat, J.; Shobih; Rosa, E. S.; Pranoto, L. M.

    2018-04-01

    The photoanode of dye-sensitized solar cells (DSSC) is typically composed of nanocrystalline titania (TiO2) layer that has been sensitized with light-absorbing dye molecules. Large portion of the light, however, could not be efficiently absorbed due to some physical reasons, such as TiO2 crystal size (typically 10-25 nm) that makes the photoanode remains partially transparent to the visible region in the solar spectrum. One of the ways to improve the light harvesting efficiency in DSSC could be achieved by employing an additional scattering layer over the TiO2 electron transport material. In this contribution, we evaluate the effect of light scattering properties on the performance of DSSC. Specifically, the light scattering properties provided from two different scattering materials, i.e. additional TiO2 scattering layer and zirconia (ZrO2) scattering layer, were compared. Both layers were deposited using screen printing technique under the same condition on top of 8 µm thick TiO2 photoanode layer. All samples subsequently received the same thermal annealing treatment at 500 °C and sensitized with ruthenium-based synthetic dyes. Our results revealed that the thickness of the scattering layer for both TiO2 and ZrO2 had a significant effect on the solar cell performance. The best photoconversion efficiency was achieved by samples that were coated with one screen-printing cycle, giving an overall efficiency of 3.50 % and 4.02% for TiO2 and ZrO2, respectively.

  1. Trabeculectomy with Ex-PRESS implant versus Ahmed glaucoma valve implantation-a comparative study

    PubMed Central

    Waisbourd, Michael; Fischer, Naomi; Shalev, Hadas; Spierer, Oriel; Ben Artsi, Elad; Rachmiel, Rony; Shemesh, Gabi; Kurtz, Shimon

    2016-01-01

    AIM To compare the surgical outcomes of trabeculectomy with Ex-PRESS implant and Ahmed glaucoma valve (AGV) implantation. METHODS Patients who underwent trabeculectomy with Ex-PRESS implants or AGV implantation separately were included in this retrospective chart review. Main outcome measures were surgical failure and complications. Failure was defined as intraocular pressure (IOP) >21 mm Hg or <5 mm Hg on two consecutive visits after 3mo, reoperation for glaucoma, or loss of light perception. Eyes that had not failed were considered as complete success if they did not required supplemental medical therapy. RESULTS A total of 64 eyes from 57 patients were included: 31 eyes in the Ex-PRESS group and 33 eyes in the AGV group. The mean follow-up time was 2.6±1.1y and 3.3±1.6y, respectively. Patients in the AGV group had significantly higher baseline mean IOP (P=0.005), lower baseline mean visual acuity (VA) (P=0.02), and higher proportion of patients with history of previous trabeculectomy (P<0.0001). Crude failure rates were 16.1%, n=5/31 in the Ex-PRESS group and 24.2%, n=8/33 in the AGV group. The cumulative proportion of failure was similar between the groups, P=0.696. The proportion of eyes that experienced postoperative complications was 32.3% in the Ex-PRESS group and 60.1% in the AGV group (P=0.0229). CONCLUSION Trabeculectomy with Ex-PRESS implant and AGV implantation had comparable failure rates. The AGV group had more post-operative complications, but also included more complex cases with higher baseline mean IOP, worse baseline mean VA, and more previous glaucoma surgeries. Therefore, the results are limited to the cohort included in this study. PMID:27803857

  2. Implant Mandibular Overdentures Retained by Immediately Loaded Implants: A 1-Year Randomized Trial Comparing the Clinical and Radiographic Outcomes Between Mini Dental Implants and Standard-Sized Implants.

    PubMed

    Zygogiannis, Kostas; Aartman, Irene Ha; Parsa, Azin; Tahmaseb, Ali; Wismeijer, Daniel

    The aim of this 1-year randomized trial was to evaluate and compare the clinical and radiographic performance of four immediately loaded mini dental implants (MDIs) and two immediately loaded standard-sized tissue-level (STL) implants, placed in the interforaminal region of the mandible and used to retain mandibular overdentures (IODs) in completely edentulous patients. A total of 50 completely edentulous patients wearing conventional maxillary dentures and complaining about insufficient retention of their mandibular dentures were divided into two groups; 25 patients received four MDIs and 25 patients received two STL implants. The marginal bone loss (MBL) at the mesial and distal sides of each implant was assessed by means of standardized intraoral radiographs after a period of 1 year. Implant success and survival rates were also calculated. Immediate loading was possible for all patients in the first group. In the second group, an immediate loading protocol could not be applied for 10 patients. These patients were treated with a delayed loading protocol. A mean MBL of 0.42 ± 0.56 mm for the MDIs and 0.54 ± 0.49 mm for the immediately loaded STL implants was recorded at the end of the evaluation period. There was no statistically significant difference between the MDIs and the immediately loaded STL implants. Two MDIs failed, resulting in a survival rate of 98%. The success rate was 91%. For the immediately loaded conventional implants, the survival rate was 100% and the success rate 96.7% after 1 year of function. However, in 10 patients, the immediate loading protocol could not be followed. Considering the limitations of this short-term clinical study, immediate loading of four unsplinted MDIs or two splinted STL implants to retain mandibular overdentures seems to be a feasible treatment option. The marginal bone level changes around the MDIs were well within the clinically acceptable range.

  3. Phase Stabilization of Zirconia.

    DTIC Science & Technology

    1997-01-30

    preparing stabilized zirconia pursuant to this disclosure, an insoluble alumina powder is mixed with zirconia powder using a liquid dispersant, such...in a drying oven or a furnace. When mixing the alumina and zirconia powders , it is not necessary to have zirconia in any particular phase to achieve...phase stabilization, as disclosed herein. When mixed with alumina powder, zirconia powder can be in cubic, tetragonal or 20 monoclinic phases

  4. Positron annihilation studies of zirconia doped with metal cations of different valence

    NASA Astrophysics Data System (ADS)

    Prochazka, I.; Cizek, J.; Melikhova, O.; Konstantinova, T. E.; Danilenko, I. A.; Yashchishyn, I. A.; Anwand, W.; Brauer, G.

    2013-06-01

    New results obtained by applying positron annihilation spectroscopy to the investigation of zirconia-based nanomaterials doped with metal cations of different valence are reported. The slow-positron implantation spectroscopy combined with Doppler broadening measurements was employed to study the sintering of pressure-compacted nanopowders of tetragonal yttria-stabilised zirconia (t-YSZ) and t-YSZ with chromia additive. Positronium (Ps) formation in t-YSZ was proven by detecting 3γ-annihilations of ortho-Ps and was found to gradually decrease with increasing sintering temperature. A subsurface layer with enhanced 3γ-annihilations, compared to the deeper regions, could be identified. Addition of chromia was found to inhibit Ps formation. In addition, first results of positron lifetime measurements on nanopowders of zirconia phase-stabilised with MgO and CeO2 are presented.

  5. Comparative analysis of anchorage systems for micro implant orthodontics.

    PubMed

    Favero, Lorenzo; Giagnorio, Costantino; Cocilovo, Francesco

    2010-01-01

    The study analysed twelve anchorage systems based on micro implants in terms of their bio-mechanical properties and appraised their actual clinical effectiveness. The analysed micro implants had data provided by the manufacturers or extracted from articles published in specialised journals. The parameters taken into account were: material, surface treatment, head type, length, diameter, neck length, filleted self drilling or self tapping surface, applicable orthodontic forces, possibility of immediate loading, and device removal. Material Grade 5 titanium, titanium alloy (TiAl6V4), surgical steel; surfaces: smooth, sand-blasted and acid etched; head type: bracket, conic with button, round, hexagonal, button with cross cuts, double melted sphere; lengths: between 8.0 to 14 mm; diameters: between 1.2 to 2.0 mms; neck lengths: inferior to 1.5mm and superior to 2.0mm; filleted portion: self tapping and/or self drilling; applicable orthodontic forces: up to 500 g, possibility of immediate loading, device removal, possibility to use in growing patients. The most widely used material was TiAl6V4; most of the surfaces were smooth; the most commonly used head type was the bracket; the most often produced length was the "short" one (8.0-9.9 mm), the most demanded diameter the "smaller" one (1.2-1.4 mms); six systems out of eleven had micro implants with "extra" and "standard" necks; only 3 systems out of eleven produced "non self drilling"devices; all the micro implants analysed were able to withstand orthodontic forces between 150 g and 350 g; all devices were suitable for "immediate loading"; all micro implants had to be removed; all micro implants could be used in growing patients. The comparative analysis showed that micro implants could be used as valid anchorage systems, if dental anchorage was insufficient either in qualitative terms (i.e. parodontal problems) or in quantitative terms (i.e. few dental elements remaining), and in all those situations of limited patient

  6. Evaluation of porous gradient hydroxyapatite/zirconia composites for repair of lumbar vertebra defect in dogs.

    PubMed

    Shao, Rong-Xue; Quan, Ren-Fu; Huang, Xiao-Long; Wang, Tuo; Xie, Shang-Ju; Gao, Huan-Huan; Wei, Xi-Cheng; Yang, Di-Sheng

    2016-04-01

    To evaluate the effects of porous gradient composites with hydroxyapatite/zirconia and autologous iliac in repair of lumbar vertebra body defects in dogs. (1) New porous gradient hydroxyapatite/zirconia composites were prepared using foam immersion, gradient compound and high temperature sintering; (2) A total of 18 adult beagle dogs, aged five to eight months and weighted 10-13 kg, were randomly assigned into two subgroups, which were implanted with new porous gradient hydroxyapatite/zirconia composites (subgroup A in 12) or autologous iliac bone (subgroup B in 6); (3) The post-operative data were analyzed and compared between the subgroups to repair the vertebral body defect by roentgenoscopy, morphology and biomechanics. The porosity of new porous gradient hydroxyapatite/zirconia composites is at 25 poles per inch, and the size of pores is at between 150 and 300 µm. The post-operative roentgenoscopy displayed that new-bone formation is increased gradually, and the interface between composites and host-bone becomes became blur, and the new-bone around the composites were integrated into host-bone at 24 weeks postoperatively in subgroup A. As to subgroup B, the resorption and restructure were found at six weeks after the surgery, and the graft-bone and host-bone have been integrated completely without obvious boundary at 24 weeks postoperatively. Histomorphologic study showed that the amount of bone within pores of the porous gradient hydroxyapatite/zirconia composites increased continuously with a prolonged implantation time, and that partial composites were degradated and replaced by new-bone trabeculae. There was no significant difference between subgroups (P > 0.05) in the ultimate compressive strengths. New porous gradient hydroxyapatite/zirconia composites can promote the repair of bony defect, and induce bone tissue to ingrow into the pores, which may be applied widely to the treatment of bony defect in the future. © The Author(s) 2016.

  7. Comparative Clinical Study of Conventional Dental Implants and Mini Dental Implants for Mandibular Overdentures: A Randomized Clinical Trial.

    PubMed

    Aunmeungtong, Weerapan; Kumchai, Thongnard; Strietzel, Frank P; Reichart, Peter A; Khongkhunthian, Pathawee

    2017-04-01

    Dental implant-retained overdentures have been chosen as the treatment of choice for complete mandibular removable dentures. Dental implants, such as mini dental implants, and components for retaining overdentures, are commercially available. However, comparative clinical studies comparing mini dental implants and conventional dental implants using different attachment for implant-retained overdentures have not been well documented. To compare the clinical outcomes of using two mini dental implants with Equator ® attachments, four mini dental implants with Equator attachments, or two conventional dental implants with ball attachments, by means of a randomized clinical trial. Sixty patients received implant-retained mandibular overdentures in the interforaminal region. The patients were divided into three groups. In Groups 1 and 2, two and four mini dental implants, respectively, were placed and immediately loaded by overdentures, using Equator ® attachments. In Group 3, conventional implants were placed. After osseointegration, the implants were loaded by overdentures, using ball attachments. The study distribution was randomized and double-blinded. Outcome measures included changes in radiological peri-implant bone level from surgery to 12 months postinsertion, prosthodontic complications and patient satisfaction. The cumulative survival rate in the three clinical groups after one year was 100%. There was no significant difference (p < 0.05) in clinical results regarding the number (two or four) of mini dental implants with Equator attachments. However, there was a significant difference in marginal bone loss and patient satisfaction between those receiving mini dental implants with Equator attachments and conventional dental implants with ball attachments. The marginal bone resorption in Group 3 was significantly higher than in Groups 1 and 2 (p < 0.05); there were no significant differences between Groups 1 and 2. There was no significant difference in

  8. Influence of Ar-ion implantation on the structural and mechanical properties of zirconia as studied by Raman spectroscopy and nanoindentation techniques

    NASA Astrophysics Data System (ADS)

    Kurpaska, L.; Jasinski, J.; Wyszkowska, E.; Nowakowska-Langier, K.; Sitarz, M.

    2018-04-01

    In this study, structural and nanomechanical properties of zirconia polymorphs induced by ion irradiation were investigated by means of Raman spectroscopy and nanoindentation techniques. The zirconia layer have been produced by high temperature oxidation of pure zirconium at 600 °C for 5 h at normal atmospheric pressure. In order to distinguish between the internal and external parts of zirconia, the spherical metallographic sections have been prepared. The samples were irradiated at room temperature with 150 keV Ar+ ions at fluences ranging from 1 × 1015 to 1 × 1017 ions/cm2. The main objective of this study was to distinguish and confirm different structural and mechanical properties between the interface layer and fully developed scale in the internal/external part of the oxide. Conducted studies suggest that increasing ion fluence impacts Raman bands positions (especially characteristic for tetragonal phase) and increases the nanohardness and Young's modulus of individual phases. This phenomenon has been examined from the point of view of stress-induced hardening effect and classical monoclinic → tetragonal (m → t) martensitic phase transformation.

  9. A 5-year randomized trial to compare 1 or 2 implants for implant overdentures.

    PubMed

    Bryant, S R; Walton, J N; MacEntee, M I

    2015-01-01

    The hypothesis of this 5-y randomized clinical trial was that there would be no significant difference in the satisfaction of edentulous participants with removable complete overdentures attached to 1 or 2 mandibular implants. Secondary aims were to test changes in satisfaction between and within the groups from baseline to 5 y and differences between the groups in implant survival and prosthodontic maintenance over 5 y. Each of the 86 participants (mean age, 67 y) was randomly allocated to receive either 1 implant in the midline (group 1) or 2 implants in the canine areas (group 2) attached to a mandibular overdenture opposing a maxillary complete denture. Satisfaction was self-assessed by participants on a visual analog scale at baseline prior to implants, as well as at 2 mo and 1, 3, and 5 y with implant overdentures, whereas implant survival and prosthodontic maintenance were assessed by clinical examination. After 5 y, 29 participants in group 1 and 33 in group 2 were available, with most dropouts due to death. Satisfaction with the implant denture after 5 y was significantly (P < 0.001) higher than at baseline in both groups and remained with no significant difference (P = 0.32) between the groups. No implants failed in group 1 but 5 failed before loading in 4 participants in group 2. Most participants required maintenance or occasionally denture replacement, and although differences between the groups were not statistically significant, group 1 experienced almost twice as many fractured dentures usually adjacent to the implant attachment. We conclude that there were no significant differences after 5 y in satisfaction or survival of implants with mandibular overdentures retained by 1 implant or 2 implants. Additional research is required to confirm long-term treatment effectiveness of single-implant dentures and the implications of prosthetic maintenance with implant overdentures (ClinicalTrials.gov: NCT02117856). © International & American Associations for

  10. An overview of zirconia ceramics: basic properties and clinical applications.

    PubMed

    Manicone, Paolo Francesco; Rossi Iommetti, Pierfrancesco; Raffaelli, Luca

    2007-11-01

    Zirconia (ZrO2) is a ceramic material with adequate mechanical properties for manufacturing of medical devices. Zirconia stabilized with Y2O3 has the best properties for these applications. When a stress occurs on a ZrO2 surface, a crystalline modification opposes the propagation of cracks. Compression resistance of ZrO2 is about 2000 MPa. Orthopedic research led to this material being proposed for the manufacture of hip head prostheses. Prior to this, zirconia biocompatibility had been studied in vivo; no adverse responses were reported following the insertion of ZrO2 samples into bone or muscle. In vitro experimentation showed absence of mutations and good viability of cells cultured on this material. Zirconia cores for fixed partial dentures (FPD) on anterior and posterior teeth and on implants are now available. Clinical evaluation of abutments and periodontal tissue must be performed prior to their use. Zirconia opacity is very useful in adverse clinical situations, for example, for masking of dischromic abutment teeth. Radiopacity can aid evaluation during radiographic controls. Zirconia frameworks are realized by using computer-aided design/manufacturing (CAD/CAM) technology. Cementation of Zr-ceramic restorations can be performed with adhesive luting. Mechanical properties of zirconium oxide FPDs have proved superior to those of other metal-free restorations. Clinical evaluations, which have been ongoing for 3 years, indicate a good success rate for zirconia FPDs. Zirconia implant abutments can also be used to improve the aesthetic outcome of implant-supported rehabilitations. Newly proposed zirconia implants seem to have good biological and mechanical properties; further studies are needed to validate their application.

  11. Finite element analysis of a novel implant distribution to support maxillary overdentures.

    PubMed

    Osman, Reham B; Elkhadem, Amr H; Ma, Sunyoung; Swain, Michael V

    2013-01-01

    To evaluate the biomechanics of a novel implant placement distribution and compare it with that of conventional maxillary overdenture support using three-dimensional finite element analysis (FEA). The application of zirconia implants in the context of this novel design was also evaluated. Detailed FEA models were created to analyze the loading responses of two different distributions of implants to support maxillary overdentures. The two implant distributions were as follows: the conventional design (D1) included four unsplinted implants in the premolar regions, whereas the novel design (D2) included one midpalatal implant, bilateral canine/premolar implants, and one anterior off-center crestal implant. Anatomical models were created with computed tomographic data and static loads were applied axially and obliquely. Von Mises stresses and equivalent strains generated in peri-implant bone and first principal stresses in the implants were calculated, including any denture displacement. Comparable stress and strain values were seen in the peri-implant bone for both designs. A significant decrease in the first principal stresses of D2 implants was observed with oblique loads. The maximum equivalent strain produced in the peri-implant region was mostly within the range for bone augmentation. D2 displayed lower maximum displacement values than D1. Maximum tensile stresses in the zirconia implants for either design were well below their fracture strength. A novel four-implant distribution involving midpalatal and crestal implants may be an alternative to the conventional design used for maxillary overdentures. This is particularly relevant when anatomical considerations prevent the placement of four anterior crestal implants. Zirconia implants may also be a valid option for a selected group of patients or for those requesting metal-free restorations. Prospective clinical studies are required to confirm these in vitro results.

  12. Innovations in bonding to zirconia-based materials: Part I.

    PubMed

    Aboushelib, Moustafa N; Matinlinna, Jukka P; Salameh, Ziad; Ounsi, Hani

    2008-09-01

    Establishing a reliable bond to zirconia-based materials has proven to be difficult which is the major limitation against fabricating adhesive zirconia restorations. This bond could be improved using novel selective infiltration etching conditioning in combination with engineered zirconia primers. Aim of the work was to evaluate resin-to-zirconia bond strength using selective infiltration etching and novel silane-based zirconia primers. Zirconia discs (Procera Zirconia) received selective infiltration etching surface treatment followed by coating with either of five especially engineered experimental zirconia primers. Pre-aged resin-composite discs (Tetric Ivo Ceram) were bonded to the treated surface using an MDP-containing resin-composite (Panavia F 2.0). The bilayered specimens were cut into microbars and the microtensile bond strength (MTBS) was evaluated. 'As-sintered' zirconia discs served as a control (alpha=0.05). The broken microbars were examined using a scanning electron microscope (SEM). The combination of selective infiltration etching with experimental zirconia primers significantly improved (F=3805, P<0.0001) the MTBS values (41+/-5.8 MPa) compared to the 'as-sintered' surface using the same primers which demonstrated spontaneous failure and very low bond strength values (2.6+/-3.1 MPa). SEM analysis revealed that selective infiltration etching surface treatment resulted in a nano-retentive surface where the zirconia primers were able to penetrate and interlock which explained the higher MTBS values observed for the treated specimens.

  13. Immediate vs non-immediate loading post-extractive implants: a comparative study of implant stability quotient (ISQ)

    PubMed Central

    MILILLO, L.; FIANDACA, C.; GIANNOULIS, F.; OTTRIA, L.; LUCCHESE, A.; SILVESTRE, F.; PETRUZZI, M.

    2016-01-01

    SUMMARY Purpose This study aims to evaluate differences in implant stability between post-extractive implants vs immediately placed post-extractive implants by resonance frequency analysis (RFA). Materials and methods Patients were grouped into two different categories. In Group A 10 patients had an immediate post-extractive implant, then a provisional, acrylic resin crown was placed (immediate loading). In Group B (control group) 10 patients only had an immediate post-extractive implant. Both upper and lower premolars were chosen as post-extractive sites. Implant Stability Quotient (ISQ) was measured thanks to RFA measurements (Osstell®). Five intervals were considered: immediately after surgery (T0) and every four weeks, until five months after implant placement (T1, T2, T3, T4,T5). A statistical analysis by means of Student’s T-test (significance set at p<0.05) for independent sample was carried out in order to compare Groups A and B. Results The ISQ value between the two groups showed a statistically significant difference (p<0.02) at T1. No statistically significant difference in ISQ was assessed at T0, T2, T3, T4 and T5. Conclusions After clinical assessment it is possible to confirm that provisional and immediate prosthetic surgery in post-extraction sites with cone-shaped implants, platform-switching abutment and bioactive surface can facilitate osseointegration, reducing healing time. PMID:28042440

  14. Time-Efficiency Analysis Comparing Digital and Conventional Workflows for Implant Crowns: A Prospective Clinical Crossover Trial.

    PubMed

    Joda, Tim; Brägger, Urs

    2015-01-01

    To compare time-efficiency in the production of implant crowns using a digital workflow versus the conventional pathway. This prospective clinical study used a crossover design that included 20 study participants receiving single-tooth replacements in posterior sites. Each patient received a customized titanium abutment plus a computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia suprastructure (for those in the test group, using digital workflow) and a standardized titanium abutment plus a porcelain-fused-to-metal crown (for those in the control group, using a conventional pathway). The start of the implant prosthetic treatment was established as the baseline. Time-efficiency analysis was defined as the primary outcome, and was measured for every single clinical and laboratory work step in minutes. Statistical analysis was calculated with the Wilcoxon rank sum test. All crowns could be provided within two clinical appointments, independent of the manufacturing process. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different. The mean ± standard deviation (SD) time was 185.4 ± 17.9 minutes for the digital workflow process and 223.0 ± 26.2 minutes for the conventional pathway (P = .0001). Therefore, digital processing for overall treatment was 16% faster. Detailed analysis for the clinical treatment revealed a significantly reduced mean ± SD chair time of 27.3 ± 3.4 minutes for the test group compared with 33.2 ± 4.9 minutes for the control group (P = .0001). Similar results were found for the mean laboratory work time, with a significant decrease of 158.1 ± 17.2 minutes for the test group vs 189.8 ± 25.3 minutes for the control group (P = .0001). Only a few studies have investigated efficiency parameters of digital workflows compared with conventional pathways in implant dental medicine. This investigation shows that the digital workflow seems to be more time-efficient than the

  15. Surface crystalline phases and nanoindentation hardness of explanted zirconia femoral heads.

    PubMed

    Catledge, Shane A; Cook, Monique; Vohra, Yogesh K; Santos, Erick M; McClenny, Michelle D; David Moore, K

    2003-10-01

    One new and nine explanted zirconia femoral heads were studied using glancing angle X-ray diffraction, scanning electron microscopy, and nanoindentation hardness techniques. All starting zirconia implants consisted only of tetragonal zirconia polycrystals (TZP). For comparison, one explanted alumina femoral head was also studied. Evidence for a surface tetragonal-to-monoclinic zirconia phase transformation was observed in some implants, the extent of which was varied for different in-service conditions. A strong correlation was found between increasing transformation to the monoclinic phase and decreasing surface hardness. Microscopic investigations of some of the explanted femoral heads revealed ultra high molecular weight polyethylene and metallic transfer wear debris.

  16. Two-body wear comparison of zirconia crown, gold crown, and enamel against zirconia.

    PubMed

    Kwon, Min-Seok; Oh, Sang-Yeob; Cho, Sung-Am

    2015-07-01

    Full zirconia crowns have recently been used for dental restorations because of their mechanical properties. However, there is little information about their wear characteristics against enamel, gold, and full zirconia crowns. The purpose of this study was to compare the wear rate of enamel, gold crowns, and zirconia crowns against zirconia blocks using an in vitro wear test. Upper specimens were divided into three groups: 10 enamels (group 1), 10 gold crowns (group 2, Type III gold), and 10 zirconia crowns (group 3, Prettau(®)Zirkon 9H, Zirkonzahn, Italy). Each of these specimens was wear tested against a zirconia block (40×30×3mm(3)) as a lower specimen (30 total zirconia blocks). Each specimen of the groups was abraded against the zirconia block for 600 cycles at 1Hz with 15mm front-to-back movement on an abrading machine. Moreover, the load applied during the abrading test was 50N, and the test was performed in a normal saline emulsion for 10min. Three-dimensional images were taken before and after the test, and the statistical analysis was performed using the Krushal-Wallis test and Mann-Whitney test (p=0.05). The mean volume loss of group 1 was 0.47mm(3), while that of group 2 and group 3 was 0.01mm(3). The wear volume loss of enamels against zirconia was higher than that of gold and zirconia crowns. Moreover, according to this result, zirconia crowns are not recommended for heavy bruxers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Grinding model and material removal mechanism of medical nanometer zirconia ceramics.

    PubMed

    Zhang, Dongkun; Li, Changhe; Jia, Dongzhou; Wang, Sheng; Li, Runze; Qi, Xiaoxiao

    2014-01-01

    Many patents have been devoted to developing medical nanometer zirconia ceramic grinding techniques that can significantly improve both workpiece surface integrity and grinding quality. Among these patents is a process for preparing ceramic dental implants with a surface for improving osseo-integration by sand abrasive finishing under a jet pressure of 1.5 bar to 8.0 bar and with a grain size of 30 µm to 250 µm. Compared with other materials, nano-zirconia ceramics exhibit unmatched biomedical performance and excellent mechanical properties as medical bone tissue and dentures. The removal mechanism of nano-zirconia materials includes brittle fracture and plastic removal. Brittle fracture involves crack formation, extension, peeling, and chipping to completely remove debris. Plastic removal is similar to chip formation in metal grinding, including rubbing, ploughing, and the formation of grinding debris. The materials are removed in shearing and chipping. During brittle fracture, the grinding-led transverse and radial extension of cracks further generate local peeling of blocks of the material. In material peeling and removal, the mechanical strength and surface quality of the workpiece are also greatly reduced because of crack extension. When grinding occurs in the plastic region, plastic removal is performed, and surface grinding does not generate grinding fissures and surface fracture, producing clinically satisfactory grinding quality. With certain grinding conditions, medical nanometer zirconia ceramics can be removed through plastic flow in ductile regime. In this study, we analyzed the critical conditions for the transfer of brittle and plastic removal in nano-zirconia ceramic grinding as well as the high-quality surface grinding of medical nanometer zirconia ceramics by ELID grinding.

  18. Periotest values of implants placed in sockets augmented with calcium phosphosilicate putty graft: a comparative analysis against implants placed in naturally healed sockets.

    PubMed

    Mahesh, Lanka; Narayan, Tv; Kostakis, Georgios; Shukla, Sagrika

    2014-03-01

    To measure implant stability using periotest values of implants placed in sockets augmented with calcium phospho-silicate putty (CPS Putty) as compared with implant stability in naturally healed sockets. Twenty two sockets were implanted with CPS Putty immediately after extraction. The sockets were re-entered after a healing period at 5 to 6 months (average 5.3 months) for implant placement. Periotest values were recorded during implant insertion to assess primary stability. These were compared with the Periotest values of 26 implants placed in 22 patients, with naturally healed sockets. Periotest values were significantly lower in the grafted group, indicating better implant stability in sites grafted with CPS putty. Implant stability seems to be significantly higher in sockets augmented using CPS putty when compared to nongrafted sites. This suggests that socket grafting with CPS putty may enhance the quality of available bone for implantation.

  19. Evaluation of mandibular posterior single implants with two different surfaces: a 5-year comparative study.

    PubMed

    Jung, Ui-Won; Choi, Jung-Yoo; Kim, Chang-Sung; Cho, Kyoo-Sung; Chai, Jung-Kiu; Kim, Chong-Kwan; Choi, Seong-Ho

    2008-10-01

    Anatomic and biomechanical limitations can jeopardize successful single implantation in the mandibular posterior area. To overcome the limitations, the design and the surface of the fixtures were modified. This study evaluated the cumulative survival rate (CSR) of mandibular molars replaced with a sand-blasted, large-grit, acid-etched (SLA) single implant or an anodized (ANO) single implant and examined associated factors, such as the surface treatment, position, and length and diameter of the implants. One hundred ninety-three single implants restored with an SLA implant and 112 single implants restored with an ANO implant in the mandibular molar area were selected from subjects who had visited the Department of Periodontology, Dental Hospital of Yonsei University, from March 2001 through June 2006. In the SLA group, 123 and 70 implants were placed in the first and second molar area, respectively. In the ANO group, 55 and 57 implants were placed in the first and second molar area, respectively. The 1- to 6-year CSR of the SLA and ANO groups was calculated using the life-table analysis. In addition, associated factors, such as the surface treatment, position, and length and diameter of the implants, were compared and analyzed using the chi(2) test (P <0.05). Two of 193 implants in the SLA group failed, giving a CSR of 98.96%; four of 112 ANO implants failed, giving a CSR of 96.43%. There were no significant differences with regard to the surface treatment, position, and length and diameter of the implants. Despite the anatomic and biomechanical limitation in the mandibular posterior area, mandibular posterior single implants showed a high CSR during the observation period. Mandibular posterior single implants can be an effective and reliable treatment modality that is not affected by the surface treatment, position, or length and diameter of the implant.

  20. In Vitro versus In Vivo Phase Instability of Zirconia-Toughened Alumina Femoral Heads: A Critical Comparative Assessment

    PubMed Central

    Pezzotti, Giuseppe; Affatato, Saverio; Rondinella, Alfredo; Yorifuji, Makiko; Marin, Elia; Zhu, Wenliang; McEntire, Bryan; Bal, Sonny B.; Yamamoto, Kengo

    2017-01-01

    A clear discrepancy between predicted in vitro and actual in vivo surface phase stability of BIOLOX®delta zirconia-toughened alumina (ZTA) femoral heads has been demonstrated by several independent research groups. Data from retrievals challenge the validity of the standard method currently utilized in evaluating surface stability and raise a series of important questions: (1) Why do in vitro hydrothermal aging treatments conspicuously fail to model actual results from the in vivo environment? (2) What is the preponderant microscopic phenomenon triggering the accelerated transformation in vivo? (3) Ultimately, what revisions of the current in vitro standard are needed in order to obtain consistent predictions of ZTA transformation kinetics in vivo? Reported in this paper is a new in toto method for visualizing the surface stability of femoral heads. It is based on CAD-assisted Raman spectroscopy to quantitatively assess the phase transformation observed in ZTA retrievals. Using a series of independent analytical probes, an evaluation of the microscopic mechanisms responsible for the polymorphic transformation is also provided. An outline is given of the possible ways in which the current hydrothermal simulation standard for artificial joints can be improved in an attempt to reduce the gap between in vitro simulation and reality. PMID:28772828

  1. Fracture strength of lithium disilicate crowns compared to polymer-infiltrated ceramic-network and zirconia reinforced lithium silicate crowns.

    PubMed

    Sieper, Kim; Wille, Sebastian; Kern, Matthias

    2017-10-01

    The aim of this study was to evaluate the fracture strength of crowns made from current CAD/CAM materials. In addition the influence of crown thickness and chewing simulation on the fracture strength was evaluated. Crowns were fabricated from lithium disilicate, zirconia reinforced lithium silicate (ZLS-ceramic) and a polymer-infiltrated ceramic-network (PICN) with an occlusal thickness of 1.0mm or 1.5mm, respectively (n=16). Crowns were cemented on composite dies. Subgroups of eight specimens were loaded with 5kg in a chewing simulator for 1,200,000 cycles with thermal cycling. Finally, all specimens were loaded until fracture in a universal testing machine. Three-way ANOVA was used to detect statistical interaction. Differences regarding the materials were tested with two-way ANOVA, following one-way ANOVA and a post-hoc Tukey's-Test. All crowns survived the chewing simulation. The material had a significant influence on the fracture resistance (p≤0.05). Lithium disilicate achieved the highest values of fracture strength in almost all groups followed by ZLS-ceramic. PICN achieved the lowest values of fracture strength. Chewing simulation increased the fracture strength of thick lithium disilicate crown significantly. Greater occlusal thickness of all crown materials resulted in higher crown fracture strength before chewing simulation. After chewing simulation occlusal thickness of lithium disilicate and PICN crowns had no significant influence on the fracture strength. All crowns revealed fracture strength above the clinically expected loading forces. Therefore the durability of the tested CAD/CAM materials seems promising also in an occlusal thickness of 1.0mm. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Sol-gel derived bioactive coating on zirconia: Effect on flexural strength and cell proliferation.

    PubMed

    Shahramian, Khalil; Leminen, Heidi; Meretoja, Ville; Linderbäck, Paula; Kangasniemi, Ilkka; Lassila, Lippo; Abdulmajeed, Aous; Närhi, Timo

    2017-11-01

    The purpose of this study was to evaluate the effect of sol-gel derived bioactive coatings on the biaxial flexural strength and fibroblast proliferation of zirconia, aimed to be used as an implant abutment material. Yttrium stabilized zirconia disc-shaped specimens were cut, ground, sintered, and finally cleansed ultrasonically in each of acetone and ethanol for 5 minutes. Three experimental groups (n = 15) were fabricated, zirconia with sol-gel derived titania (TiO 2 ) coating, zirconia with sol-gel derived zirconia (ZrO 2 ) coating, and non-coated zirconia as a control. The surfaces of the specimens were analyzed through images taken using a scanning electron microscope (SEM), and a non-contact tapping mode atomic force microscope (AFM) was used to record the surface topography and roughness of the coated specimens. Biaxial flexural strength values were determined using the piston-on-three ball technique. Human gingival fibroblast proliferation on the surface of the specimens was evaluated using AlamarBlue assay™. Data were analyzed using a one-way analysis of variance (ANOVA) followed by Tukey's post-hoc test. Additionally, the biaxial flexural strength data was also statistically analyzed with the Weibull distribution. The biaxial flexural strength of zirconia specimens was unaffected (p > 0.05). Weibull modulus of TiO 2 coated and ZrO 2 coated groups (5.7 and 5.4, respectively) were lower than the control (8.0). Specimens coated with ZrO 2 showed significantly lower fibroblast proliferation compared to other groups (p < 0.05). In conclusion, sol-gel derived coatings have no influence on the flexural strength of zirconia. ZrO 2 coated specimens showed significantly lower cell proliferation after 12 days than TiO 2 coated or non-coated control. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2401-2407, 2017. © 2016 Wiley Periodicals, Inc.

  3. Nanosilica coating for bonding improvements to zirconia.

    PubMed

    Chen, Chen; Chen, Gang; Xie, Haifeng; Dai, Wenyong; Zhang, Feimin

    2013-01-01

    Resin bonding to zirconia cannot be established from standard methods that are currently utilized in conventional silica-based dental ceramics. The solution-gelatin (sol-gel) process is a well developed silica-coating technique used to modify the surface of nonsilica-based ceramics. Here, we use this technique to improve resin bonding to zirconia, which we compared to zirconia surfaces treated with alumina sandblasting and tribochemical silica coating. We used the shear bond strength test to examine the effect of the various coatings on the short-term resin bonding of zirconia. Furthermore, we employed field emission scanning electron microscopy, energy-dispersive X-ray spectroscopy, atomic force microscopy, and Fourier transform infrared spectroscopy to characterize the zirconia surfaces. Water-mist spraying was used to evaluate the durability of the coatings. To evaluate the biological safety of the experimental sol-gel silica coating, we conducted an in vitro Salmonella typhimurium reverse mutation assay (Ames mutagenicity test), cytotoxicity tests, and in vivo oral mucous membrane irritation tests. When compared to the conventional tribochemical silica coating, the experimental sol-gel silica coating provided the same shear bond strength, higher silicon contents, and better durability. Moreover, we observed no apparent mutagenicity, cytotoxicity, or irritation in this study. Therefore, the sol-gel technique represents a promising method for producing silica coatings on zirconia.

  4. Nanosilica coating for bonding improvements to zirconia

    PubMed Central

    Chen, Chen; Chen, Gang; Xie, Haifeng; Dai, Wenyong; Zhang, Feimin

    2013-01-01

    Resin bonding to zirconia cannot be established from standard methods that are currently utilized in conventional silica-based dental ceramics. The solution–gelatin (sol–gel) process is a well developed silica-coating technique used to modify the surface of nonsilica-based ceramics. Here, we use this technique to improve resin bonding to zirconia, which we compared to zirconia surfaces treated with alumina sandblasting and tribochemical silica coating. We used the shear bond strength test to examine the effect of the various coatings on the short-term resin bonding of zirconia. Furthermore, we employed field emission scanning electron microscopy, energy-dispersive X-ray spectroscopy, atomic force microscopy, and Fourier transform infrared spectroscopy to characterize the zirconia surfaces. Water–mist spraying was used to evaluate the durability of the coatings. To evaluate the biological safety of the experimental sol–gel silica coating, we conducted an in vitro Salmonella typhimurium reverse mutation assay (Ames mutagenicity test), cytotoxicity tests, and in vivo oral mucous membrane irritation tests. When compared to the conventional tribochemical silica coating, the experimental sol–gel silica coating provided the same shear bond strength, higher silicon contents, and better durability. Moreover, we observed no apparent mutagenicity, cytotoxicity, or irritation in this study. Therefore, the sol–gel technique represents a promising method for producing silica coatings on zirconia. PMID:24179333

  5. Do textured breast implants decrease the rate of capsular contracture compared to smooth implants?

    PubMed

    Cifuentes, Ignacio; Dagnino, Bruno; Rada, Gabriel

    2017-08-31

    The use of breast implants for aesthetic and reconstructive purposes has become one of the most common procedures performed by plastic surgeons. Several breast implants models exist. They differ in their size, filling, shape and characteristic of the shell, which can be smooth or textured. Capsular contracture is one of the main complications of breast implants. It has been suggested that the use of textured implants could reduce the incidence of capsular contracture. To answer this question, we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We identified 15 studies overall, of which 13 were randomized trials relevant for the question of interest. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded the use of textured breast implants probably decreases the risk of capsular contracture, however, they might be associated to an increased risk of anaplastic large cell lymphoma.

  6. Comparative analysis of stress in a new proposal of dental implants.

    PubMed

    Valente, Mariana Lima da Costa; de Castro, Denise Tornavoi; Macedo, Ana Paula; Shimano, Antonio Carlos; Dos Reis, Andréa Cândido

    2017-08-01

    The purpose of this study was to compare, through photoelastic analysis, the stress distribution around conventional and modified external hexagon (EH) and morse taper (MT) dental implant connections. Four photoelastic models were prepared (n=1): Model 1 - conventional EH cylindrical implant (Ø 4.0mm×11mm - Neodent®), Model 2 - modified EH cylindrical implant, Model 3 - conventional MT Conical implant (Ø 4.3mm×10mm - Neodent®) and Model 4 - modified MT conical implant. 100 and 150N axial and oblique loads (30° tilt) were applied in the devices coupled to the implants. A plane transmission polariscope was used in the analysis of fringes and each position of interest was recorded by a digital camera. The Tardy method was used to quantify the fringe order (n), that calculates the maximum shear stress (τ) value in each selected point. The results showed lower stress concentration in the modified cylindrical implant (EH) compared to the conventional model, with application of 150N axial and 100N oblique loads. Lower stress was observed for the modified conical (MT) implant with the application of 100 and 150N oblique loads, which was not observed for the conventional implant model. The comparative analysis of the models showed that the new design proposal generates good stress distribution, especially in the cervical third, suggesting the preservation of bone tissue in the bone crest region. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Efficacy and safety of a diode laser in second-stage implant surgery: a comparative study.

    PubMed

    El-Kholey, K E

    2014-05-01

    For more than a decade, peri-implant tissues have been treated with soft tissue lasers to create a bloodless flap for implant placement and to uncover implants with minimal bleeding, trauma, and anaesthesia. This study was designed to assess if dental implant uncovering is possible with a diode laser without anaesthesia, and to compare its performance with traditional cold scalpel surgery. Thirty patients with a total of 45 completely osseointegrated implants participated in this study. Patients were divided into two groups. For the study group, second-stage implant surgery was done with a 970nm diode laser. For the control group, the implants were exposed with a surgical blade. Certain parameters were used for evaluation of the two techniques. The use of the diode laser obviated the need for local anaesthesia; there was a significant difference between the two groups regarding the need for anaesthesia (P<0.0001). However, there were no significant differences between the two techniques regarding duration of surgery, postoperative pain, time for healing, and success of the implants. The diode laser can be used effectively for second-stage implant surgery, providing both the dentist and the patient with additional advantages over the conventional methods used for implant exposure. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Experimental research on the relationship between fit accuracy and fracture resistance of zirconia abutments.

    PubMed

    Sui, Xinxin; Wei, Huasha; Wang, Dashan; Han, Yan; Deng, Jing; Wang, Yongliang; Wang, Junjun; Yang, Jianjun

    2014-10-01

    The purpose of the study was to investigate the correlation between fit accuracy and fracture resistance of zirconia abutments, as well as its feasibility for clinical applications. Twenty self-made zirconia abutments were tested with 30 Osstem GSII implants. First, 10 Osstem GSII implants were cut into two parts along the long axis and assembled with the zirconia abutments. The microgaps between the implants and the zirconia abutments were measured under a scanning electron microscope. Second, the zirconia abutments were assembled with 20 un-cut implants and photographed before and after being fixed with a central screw of 30-Ncm torque. The dental films were measured by Digora for Windows 2.6 software. Then the fracture resistance of zirconia abutments was measured using the universal testing machine at 90°. All results were analyzed using SPSS13.0 software. The average internal-hexagon microgaps between the implants and zirconia abutments were 19.38±1.34μm. The average Morse taper microgap in the implant-abutment interface was 17.55±1.68μm. The dental film showed that the Morse taper gap in the implant-abutment interface disappeared after being fixed with a central screw of 30-Ncm torque, and the average moving distance of the zirconia abutments to the implants was 0.19±0.02mm. The average fracture resistance of zirconia abutments was 282.93±17.28N. The internal-hexagon microgap between the implants and zirconia abutments was negatively related to the fracture resistance of the abutments (r1=-0.97, p<0.01). The Morse taper microgap in the implant-abutment interface was negatively related to the fracture resistance of the abutments (r2=-0.84, p<0.01). The microgap between implant and abutment was negatively related to the fracture resistance of the abutment, while the internal-hexagon microgap has better correlation than the Morse taper microgap. The closure of microgap is helpful to improve the fracture resistance of zirconia abutments. The fracture

  9. Traditional Postextractive Implant Site Preparation Compared with Pre-extractive Interradicular Implant Bed Preparation in the Mandibular Molar Region, Using an Ultrasonic Device: A Randomized Pilot Study.

    PubMed

    Scarano, Antonio

    The immediate placement of single postextractive implants is increasing in the everyday clinical practice. Due to insufficient bone tissue volume, proper primary stability, essential for subsequent osseointegration, is sometimes not reached. The aim of this work was to compare two different approaches: implant bed preparation before and after root extraction. Twenty-two patients of both sexes were selected who needed an implant-prosthetic rehabilitation of the fractured first mandibular molar or presented an untreatable endodontic pathology. The sites were randomly assigned to the test group (treated with implant bed preparation before molar extractions) or control group (treated with implant bed preparation after molar extractions) by a computer-generated table. All implants were placed by the same operator, who was experienced in both traditional and ultrasonic techniques. The implant stability quotient (ISQ) and the position of the implant were evaluated. Statistical analysis was carried out. In the control group, three implants were placed in the central portion of the bone septum, while eight implants were placed with a tilted axis in relation to the septum; in the test group, all implants were placed in ideal positions within the root extraction sockets. The different position of the implants between the two procedures was statistically significant. This work presented an innovative approach for implant placement at the time of mandibular molar extraction. Preparing the implant bed with an ultrasonic device before root extraction is a simple technique and also allows greater stability to be reached in a selective case.

  10. Are marginal bone levels and implant stability/mobility affected by single-stage platform switched dental implants? A comparative clinical study.

    PubMed

    Dursun, Erhan; Tulunoglu, Ibrahim; Canpınar, Pınar; Uysal, Serdar; Akalın, Ferda Alev; Tözüm, Tolga F

    2012-10-01

    The aim of this study was to evaluate short-term bone level and stability/mobility measurement alterations at platform switched (PS) and standard platform (SP) implants placed in mandibular premolar/molar regions using a single-stage protocol. Sixteen PS and 16 SP implants restorated with fixed prosthesis were included. Standard implant dimensions were used for both implant systems. After 3 months of osseointegration, implants were connected to abutments and final restorations were performed. Marginal bone loss was measured by standardized periapical radiographs. Implant stability/mobility was determined by resonance frequency analysis (RFA) and mobility measuring (MM) device values. Peri-implant parameters were evaluated with clinical periodontal indices and all parameters were assessed at baseline, 1, 3, and 6 months after the surgery. After 6 months, all implants showed uneventful healing. Radiographic evaluation showed a mean bone loss of 0.72 mm for PS and 0.56 mm for SP implants, and there were no significant differences between implant types. At 6 months, mean implant stability quotient (ISQ) values were 73.38 and 77 for PS and SP implants, respectively. Mean MM values were -4.75 for PS and -6.38 for SP implants. Mean MM values were lower for SP implants compared to PS implants at all time points. No significant differences were detected between implant types according to clinical peri-implant parameters. The micro-gap at crestal level which immediately exposed to the oral cavity in non-submerged two part implants seems to have adverse influence on the marginal bone level. © 2011 John Wiley & Sons A/S.

  11. A comparative study of zirconium and titanium implants in rat: osseointegration and bone material quality.

    PubMed

    Hoerth, Rebecca M; Katunar, María R; Gomez Sanchez, Andrea; Orellano, Juan C; Ceré, Silvia M; Wagermaier, Wolfgang; Ballarre, Josefina

    2014-02-01

    Permanent metal implants are widely used in human medical treatments and orthopedics, for example as hip joint replacements. They are commonly made of titanium alloys and beyond the optimization of this established material, it is also essential to explore alternative implant materials in view of improved osseointegration. The aim of our study was to characterize the implant performance of zirconium in comparison to titanium implants. Zirconium implants have been characterized in a previous study concerning material properties and surface characteristics in vitro, such as oxide layer thickness and surface roughness. In the present study, we compare bone material quality around zirconium and titanium implants in terms of osseointegration and therefore characterized bone material properties in a rat model using a multi-method approach. We used light and electron microscopy, micro Raman spectroscopy, micro X-ray fluorescence and X-ray scattering techniques to investigate the osseointegration in terms of compositional and structural properties of the newly formed bone. Regarding the mineralization level, the mineral composition, and the alignment and order of the mineral particles, our results show that the maturity of the newly formed bone after 8 weeks of implantation is already very high. In conclusion, the bone material quality obtained for zirconium implants is at least as good as for titanium. It seems that the zirconium implants can be a good candidate for using as permanent metal prosthesis for orthopedic treatments.

  12. Outcomes of cochlear implantation in deaf children of deaf parents: comparative study.

    PubMed

    Hassanzadeh, S

    2012-10-01

    This retrospective study compared the cochlear implantation outcomes of first- and second-generation deaf children. The study group consisted of seven deaf, cochlear-implanted children with deaf parents. An equal number of deaf children with normal-hearing parents were selected by matched sampling as a reference group. Participants were matched based on onset and severity of deafness, duration of deafness, age at cochlear implantation, duration of cochlear implantation, gender, and cochlear implant model. We used the Persian Auditory Perception Test for the Hearing Impaired, the Speech Intelligibility Rating scale, and the Sentence Imitation Test, in order to measure participants' speech perception, speech production and language development, respectively. Both groups of children showed auditory and speech development. However, the second-generation deaf children (i.e. deaf children of deaf parents) exceeded the cochlear implantation performance of the deaf children with hearing parents. This study confirms that second-generation deaf children exceed deaf children of hearing parents in terms of cochlear implantation performance. Encouraging deaf children to communicate in sign language from a very early age, before cochlear implantation, appears to improve their ability to learn spoken language after cochlear implantation.

  13. Prospective assessment of CAD/CAM zirconia abutment and lithium disilicate crown restorations: 2.4 year results.

    PubMed

    Cooper, Lyndon F; Stanford, Clark; Feine, Jocelyne; McGuire, Michael

    2016-07-01

    Single-tooth implant restorations are commonly used to replace anterior maxillary teeth. The esthetic, functional, and biologic outcomes are, in part, a function of the abutment and crown. The purpose of this clinical study was to describe the implant, abutment, and crown survival and complication rates for CAD/CAM zirconia abutment and lithium disilicate crown restorations for single-tooth implants. As part of a broader prospective investigation that enrolled and treated 141 participants comparing tissue responses at the conical interface (CI; AstraTech OsseoSpeed), flat-to-flat interface (FI; NobelSpeedy), and platform-switch interface (PS; NanoTite Certain Prevail) of single-tooth implants, computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia abutments (ATLANTIS Abutment) and cemented lithium disilicate (e.max) crowns were used in the restoration of all implants. After 2.4 years in function (3 years after implant placement), the implant, abutment, and crown of 110 participants were evaluated. Technical and biologic complications were recorded. Demographic results were tabulated as percentages with mean values and standard deviations. Abutment survival was calculated with the Kaplan-Meier method. After 2.4 years, no abutments or crowns had been lost. Abutment complications (screw loosening, screw fracture, fracture) were absent for all 3 implant groups. Crown complications were limited to 2 crowns debonding and 1 with excess cement (2.5%). Five biological complications (4.0%) were recorded. The overall complication rate was 6.5%. CAD/CAM zirconia abutments restored with cemented lithium disilicate crowns demonstrated high survival on 3 different implant-abutment interface designs. No abutment or abutment screw fracture occurred. The technical complications observed after 2.4 years were minor and reversible. The use of CAD/CAM zirconia abutments with cemented lithium disilicate crowns is associated with high technical and biologic success at 2

  14. Bilateral and Unilateral Cochlear Implant Users Compared on Speech Perception in Noise

    PubMed Central

    Dunn, Camille C.; Noble, William; Tyler, Richard S.; Kordus, Monika; Gantz, Bruce J.; Ji, Haihong

    2009-01-01

    Objective Compare speech performance in noise with matched bilateral (CICI) and unilateral (CI-Only) cochlear implant users. Design Thirty CICI and 30 CI-Only subjects were tested on a battery of speech perception tests in noise that utilize an 8-loudspeaker array. Results On average, CICI subject's performance with speech in noise was significantly better than the CI-Only subjects. Conclusion The CICI group showed significantly better performance on speech perception in noise compared to the CI-Only subjects, supporting the hypothesis that bilateral cochlear implantation is more beneficial than unilateral implantation. PMID:19858720

  15. Randomized controlled clinical trial comparing two dental implants with different neck configurations.

    PubMed

    Sanz-Martín, Ignacio; Sanz-Sánchez, Ignacio; Noguerol, Fernando; Cok, Susy; Ortiz-Vigón, Alberto; Sanz, Mariano

    2017-06-01

    Peri-implant bone levels can vary according to the implant neck macro-design and the implant-abutment interface. To compare the changes in soft and hard tissues when using a one-piece implant with a machined collar (TG) versus a two-piece implant with a progressive platform widening and a platform switching connection (SP). Partially edentulous patients willing to receive one or two implants in the posterior maxilla or mandible were randomized to the control (TG) or to the test group (SP). Final prostheses were delivered after 12 months. Radiographic measurements of interproximal bone levels (primary outcome) were assessed at implant loading and 1-year postloading. Clinical, patient related outcomes and adverse events were assessed at loading and after 6 and 12 months. Sixty-one implants were placed in 47 patients, 37 patients (18 in the TG group and 19 in the SP group), and 47 implants (23 TG and 24 SP) completed the 24-months follow up. At the patient level, a significantly greater bone resorption from baseline to implant loading was observed in the SP group (-0.42 ± 0.45 vs -0.07 ± 0.45; P = .001*), while from loading to the final visit, the TG group had significantly greater bone loss than the SP group (-0.26 ± 0.22 vs -0.11 ± 0.2; P = .020*). At 24 months after surgery, there were no significant differences between both groups (control: 0.33 ± 0.49 vs test: 0.53 ± 0.53; P = .230). Similarly, no significant differences were observed for the secondary outcomes. Both types of implant reported high survival rates and similar bone level changes, clinical parameters, and patient related outcomes after 12 months of loading. © 2017 Wiley Periodicals, Inc.

  16. Bone healing response in cyclically loaded implants: Comparing zero, one, and two loading sessions per day.

    PubMed

    de Barros E Lima Bueno, Renan; Dias, Ana Paula; Ponce, Katia J; Wazen, Rima; Brunski, John B; Nanci, Antonio

    2018-05-31

    When bone implants are loaded, they are inevitably subjected to displacement relative to bone. Such micromotion generates stress/strain states at the interface that can cause beneficial or detrimental sequels. The objective of this study is to better understand the mechanobiology of bone healing at the tissue-implant interface during repeated loading. Machined screw shaped Ti implants were placed in rat tibiae in a hole slightly bigger than the implant diameter. Implants were held stable by a specially-designed bone plate that permits controlled loading. Three loading regimens were applied, (a) zero loading, (b) one daily loading session of 60 cycles with an axial force of 1.5 N/cycle for 7 days, and (c) two such daily sessions with the same axial force also for 7 days. Finite element analysis was used to characterize the mechanobiological conditions produced by the loading sessions. After 7 days, the implants with surrounding interfacial tissue were harvested and processed for histological, histomorphometric and DNA microarray analyses. Histomorphometric analyses revealed that the group subjected to repeated loading sessions exhibited a significant decrease in bone-implant contact and increase in bone-implant distance, as compared to unloaded implants and those subjected to only one loading session. Gene expression profiles differed during osseointegration between all groups mainly with respect to inflammatory and unidentified gene categories. The results indicate that increasing the daily cyclic loading of implants induces deleterious changes in the bone healing response, most likely due to the accumulation of tissue damage and associated inflammatory reaction at the bone-implant interface. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Synthesis and characterization of nanocrystalline mesoporous zirconia using supercritical drying.

    PubMed

    Tyagi, Beena; Sidhpuria, Kalpesh; Shaik, Basha; Jasra, Raksh Vir

    2006-06-01

    Synthesis of nano-crystalline zirconia aerogel was done by sol-gel technique and supercritical drying using n-propanol solvent at and above supercritical temperature (235-280 degrees C) and pressure (48-52 bar) of n-propanol. Zirconia xerogel samples have also been prepared by conventional thermal drying method to compare with the super critically dried samples. Crystalline phase, crystallite size, surface area, pore volume, and pore size distribution were determined for all the samples in detail to understand the effect of gel drying methods on these properties. Supercritical drying of zirconia gel was observed to give thermally stable, nano-crystalline, tetragonal zirconia aerogels having high specific surface area and porosity with narrow and uniform pore size distribution as compared to thermally dried zirconia. With supercritical drying, zirconia samples show the formation of only mesopores whereas in thermally dried samples, substantial amount of micropores are observed along with mesopores. The samples prepared using supercritical drying yield nano-crystalline zirconia with smaller crystallite size (4-6 nm) as compared to higher crystallite size (13-20 nm) observed with thermally dried zirconia.

  18. Comparative Microstrain Study of Internal Hexagon and Plateau Design of Short Implants Under Vertical Loading.

    PubMed

    Nishioka, Renato Sussumu; Rodrigues, Vinicius Anéas; De Santis, Leandro Ruivo; Nishioka, Gabriela Nogueira De Melo; Santos, Vivian Mayumi Miyazaki; Souza, Francisley Ávila

    2016-02-01

    To quantify microstrain development during axial loading using strain gauge analysis for short implants, varying the type of fixture-abutment joint and thread design. An internal hexagon implant (4 × 8 mm) and a plateau design implant (4 × 8 mm) were embedded on the center of 10 polyurethane blocks with dimensions of 190 × 30 × 12 mm. The respective abutments were screwed onto the implants. Four strain gauges (SGs) were bonded onto the surface of each block, and 4 vertical SGs were bonded onto the side of each block. Axial load of 30 kgf was applied for 10 seconds in the center of each implant. The data were analyzed statistically by analysis of variance for repeated measures and Tukey test (P < 0.05). The interaction between implant and region factors have been statistically significant (P = 0.0259). Tukey test revealed a difference on plateau's horizontal region. The cervical region presented higher microstrain values, when compared with the medium and apical regions of the implants. Within the purpose of the study, the type of fixture-abutment joint is a relevant factor to affect the amount of stress/strain in bone simulation. The microstrain development was concentrated on the cervical region of the implant.

  19. Comparative evaluation of the effectiveness of the implantation in the lateral part of the mandible between short tissue level (TE) and bone level (BL) implant systems.

    PubMed

    Hadzik, Jakub; Botzenhart, Ute; Krawiec, Maciej; Gedrange, Tomasz; Heinemann, Friedhelm; Vegh, Andras; Dominiak, Marzena

    2017-09-01

    Short dental implants can be an alternative method of treatment to a vertical bone augmentation procedure at sites of reduced alveolar height. However, for successful treatment, an implant system that causes a minimal marginal bone loss (MBL) should be taken into consideration. The aim of the study has been to evaluate implantation effectiveness for bone level and tissue level short implants provided in lateral aspects of partially edentulous mandible and limited alveolar ridge height. The MBL and primary as well as secondary implant stability were determined in the study. Patients were randomly divided into two groups according to the method of treatment provided. Sixteen short Bone Level Implants (OsseoSpeed TX, Astra tech) and 16 short Tissue Level Implants (RN SLActive ® , Straumann) were successfully placed in the edentulous part of the mandible. The determination of the marginal bone level was based on radiographic evaluation after 12 and 36 weeks. Implant stability was measured immediately after insertion and after 12 weeks. The marginal bone level of Bone Level Implants was significantly lower compared to Tissue Level Implants. Furthermore, the Bone Level Implants had greater primary and secondary stability in comparison with Tissue Level Implants (Primary: 77.8 ISQ versus 66.5 ISQ; Secondary: 78.9 ISQ versus 73.9 ISQ, respectively). Since short Bone Level Implants showed a significantly decreased MBL 12 and 36 weeks after implantation as well as better results for the primary stability compared to Tissue Level Implants, they should preferentially be used for this mentioned indication. Copyright © 2017 Elsevier GmbH. All rights reserved.

  20. Shear bond strength between resin cement and colored zirconia made with metal chlorides.

    PubMed

    Kim, Ga-Hyun; Park, Sang-Won; Lee, Kwangmin; Oh, Gye-Jeong; Lim, Hyun-Pil

    2015-06-01

    Although the application of zirconia in esthetic prostheses has increased, the shear bond strength (SBS) between colored zirconia and resin cement has not been investigated. The purpose of this study was to compare the SBS between resin cement and colored zirconia made with metal chlorides. Sixty-four zirconia specimens were divided into 2 groups: one in which the specimens were bonded with resin cement, including 4-META (4-methacryloxyethyl trimellitic anhydride), and one in which the specimens were bonded with resin cement (SEcure, Sun Medical) after being processed with zirconia primer (Zirconia Liner), including 4-META. Each group was then divided into 4 subgroups depending on the coloring liquid. The subgroups were noncolored (control), commercial coloring liquid VITA In-Ceram 2000 YZ LL1, aqueous chromium chloride solution 0.1 wt%, and aqueous molybdenum chloride solution 0.1 wt%. Composite resin cylinders (Filtek Z250, 3M ESPE) were fabricated and bonded to the surface of the zirconia specimen with resin cement (SEcure). All specimens were stored in 37°C distilled water for 24 hours, and the SBS was measured with a universal testing machine. All data were analyzed statistically with 2-way ANOVA and tested post hoc with the Tukey test (α=.05). Significant differences were observed among the SBS values of the colored zirconia depending on the coloring liquid (P<.001) and whether they were processed with zirconia primer (P<.001). The SBS between colored zirconia and resin cement was significantly higher than that of noncolored zirconia and resin cement in groups processed with zirconia primer (P<.05). Colored zirconia immersed in aqueous molybdenum chloride solution showed a significantly higher SBS. Coloring liquid enhanced the SBS between resin cement and zirconia processed with zirconia primer. In particular, colored zirconia immersed in aqueous molybdenum chloride solution showed the highest SBS. Copyright © 2015 Editorial Council for the Journal of

  1. Histopathological comparative analysis of peri-implant soft tissue response after dental implant placement with flap and flapless surgical technique. Experimental study in pigs.

    PubMed

    Vlahovic, Zoran; Markovic, Aleksa; Golubovic, Mileta; Scepanovic, Miodrag; Kalanovic, Milena; Djinic, Ana

    2015-11-01

    The aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis. The experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90 days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3. In the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants. Flapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Accuracy of Digital vs Conventional Implant Impression Approach: A Three-Dimensional Comparative In Vitro Analysis.

    PubMed

    Basaki, Kinga; Alkumru, Hasan; De Souza, Grace; Finer, Yoav

    To assess the three-dimensional (3D) accuracy and clinical acceptability of implant definitive casts fabricated using a digital impression approach and to compare the results with those of a conventional impression method in a partially edentulous condition. A mandibular reference model was fabricated with implants in the first premolar and molar positions to simulate a patient with bilateral posterior edentulism. Ten implant-level impressions per method were made using either an intraoral scanner with scanning abutments for the digital approach or an open-tray technique and polyvinylsiloxane material for the conventional approach. 3D analysis and comparison of implant location on resultant definitive casts were performed using laser scanner and quality control software. The inter-implant distances and interimplant angulations for each implant pair were measured for the reference model and for each definitive cast (n = 20 per group); these measurements were compared to calculate the magnitude of error in 3D for each definitive cast. The influence of implant angulation on definitive cast accuracy was evaluated for both digital and conventional approaches. Statistical analysis was performed using t test (α = .05) for implant position and angulation. Clinical qualitative assessment of accuracy was done via the assessment of the passivity of a master verification stent for each implant pair, and significance was analyzed using chi-square test (α = .05). A 3D error of implant positioning was observed for the two impression techniques vs the reference model, with mean ± standard deviation (SD) error of 116 ± 94 μm and 56 ± 29 μm for the digital and conventional approaches, respectively (P = .01). In contrast, the inter-implant angulation errors were not significantly different between the two techniques (P = .83). Implant angulation did not have a significant influence on definitive cast accuracy within either technique (P = .64). The verification stent

  3. Magnetic resonance imaging screening results compared with explantation results in poly implant prothèse silicone breast implants, recalled from the European market in 2010.

    PubMed

    Maijers, Maria C; Niessen, Francisus B; Veldhuizen, Jacob F H; Ritt, Marco J P F; Manoliu, Radu A

    2014-02-01

    In a prospective cohort study, the authors followed 112 women whose Poly Implant Prothèse silicone breast implants were recalled. Magnetic resonance imaging results and clinical consequences were previously published. The authors compared magnetic resonance imaging screening with explantation results to study the diagnostic value of magnetic resonance imaging in this unique unselected and nonbiased group. women with 224 proven Poly Implant Prothèse implants after a mean implantation time of 10 years were enrolled in 2011. All women underwent magnetic resonance imaging screening and were offered explantation. The explantation details of 107 women could be compared with magnetic resonance imaging results. Of 107 women, 29 (27 percent) had at least one ruptured implant at explantation, and 44 of 214 explanted implants (21 percent) were ruptured. The magnetic resonance imaging results correctly diagnosed 154 intact and 35 ruptured implants. Sensitivity and specificity were 80 percent and 91 percent, respectively. The positive predictive value was 69 percent, and the negative predictive value was 95 percent. The accuracy of magnetic resonance imaging is comparable to previously published data from other manufacturers of modern silicone implants but lower than that of some recent validation studies in selected symptomatic women. The authors believe that this study is representative of common daily practice as they followed normal day-to-day magnetic resonance imaging protocol without using multiple independent readers. The authors hope that this study will contribute to the ongoing discussion to screen asymptomatic women with modern silicone breast implants. Diagnostic, II.

  4. Comparative analysis of numerical and experimental data of orthodontic mini-implants.

    PubMed

    Chatzigianni, Athina; Keilig, Ludger; Duschner, Heinz; Götz, Hermann; Eliades, Theodore; Bourauel, Christoph

    2011-10-01

    The purpose of this study was to compare numerical simulation data derived from finite element analysis (FEA) to experimental data on mini-implant loading. Nine finite element (FE) models of mini-implants and surrounding bone were derived from corresponding experimental specimens. The animal bone in the experiment consisted of bovine rib. The experimental groups were based on implant type, length, diameter, and angle of insertion. One experimental specimen was randomly selected from each group and was digitized in a microCT scanner. The FE models consisted of bone pieces containing Aarhus mini-implants with dimensions 1.5 × 7 mm and 1.5 × 9 mm or LOMAS mini-implants (dimensions 1.5 × 7 mm, 1.5 × 9 mm, and 2 × 7 mm). Mini-implants were inserted in two different ways, perpendicular to the bone surface or at 45 degrees to the direction of the applied load. Loading and boundary conditions in the FE models were adjusted to match the experimental situation, with the force applied on the neck of the mini-implants, along the mesio-distal direction up to a maximum of 0.5 N. Displacement and rotation of mini-implants after force application calculated by FEA were compared to previously recorded experimental deflections of the same mini-implants. Analysis of data with the Altman-Bland test and the Youden plot demonstrated good agreement between numerical and experimental findings (P = not significant) for the models selected. This study provides further evidence of the appropriateness of the FEA as an investigational tool in relevant research.

  5. Strain analysis of 9 different abutments for cement-retained crowns on an internal hexagonal implant.

    PubMed

    Salaita, Louai G; Yilmaz, Burak; Seidt, Jeremy D; Clelland, Nancy L; Chien, Hua-Hong; McGlumphy, Edwin A

    2017-08-01

    Many aftermarket abutments for cement-retained crowns are available for the tapered screw-vent implant. Aftermarket abutments vary widely, from stock to custom abutments and in materials such as zirconia, titanium, or a combination of the two. How these aftermarket abutments perform under occlusal loads with regard to strain distribution is not clear. The purpose of this in vitro study was to measure and compare the different strains placed upon the bone around implants by 9 different abutments for cement-retained crowns on an implant with an internal hexagonal platform. Nine 4.1×11.5-mm tapered screw-vent implants were placed into a 305×51×8-mm resin block for strain measurements. Five abutment specimens of each of the 9 different abutments (N=45) were evaluated with 1 of the 9 implants. Monolithic zirconia crowns were then fabricated for each of the 9 different abutments, the crowns were cyclically loaded (maximum force 225 N) at 30 degrees, twice at a frequency of 2 Hz, and the strain was measured and recorded. The strain to the resin block was determined using a 3-dimensional digital image correlation (3D DIC) technique. Commercial image correlation software was used to analyze the strain around the implants. Data for maximal and minimal principal strains were compared using analysis of variance with a Tukey-Kramer post hoc test (α=.05). Strain measurements showed no significant differences among any of the abutments for minimal (compression) principal strains (P>.05). For maximal (tensile) principal strains, the zirconia abutment showed the highest, and the patient-specific abutment showed the second-highest strain around the implant, with the zirconia being significantly greater than all abutments, with the exception of the patient-specific abutment, and the patient-specific abutment being significantly greater than the straight contoured abutment in titanium and also zirconia (P<.05). The name brand patient specific titanium and Atlantis zirconia

  6. Comparative Evaluation of a Four-Implant-Supported Polyetherketoneketone Framework Prosthesis: A Three-Dimensional Finite Element Analysis Based on Cone Beam Computed Tomography and Computer-Aided Design.

    PubMed

    Lee, Ki-Sun; Shin, Sang-Wan; Lee, Sang-Pyo; Kim, Jong-Eun; Kim, Jee-Hwan; Lee, Jeong-Yol

    The purpose of this pilot study was to evaluate and compare polyetherketoneketone (PEKK) with different framework materials for implant-supported prostheses by means of a three-dimensional finite element analysis (3D-FEA) based on cone beam computed tomography (CBCT) and computer-aided design (CAD) data. A geometric model that consisted of four maxillary implants supporting a prosthesis framework was constructed from CBCT and CAD data of a treated patient. Three different materials (zirconia, titanium, and PEKK) were selected, and their material properties were simulated using FEA software in the generated geometric model. In the PEKK framework (ie, low elastic modulus) group, the stress transferred to the implant and simulated adjacent tissue was reduced when compressive stress was dominant, but increased when tensile stress was dominant. This study suggests that the shock-absorbing effects of a resilient implant-supported framework are limited in some areas and that rigid framework material shows a favorable stress distribution and safety of overall components of the prosthesis.

  7. Biofilm removal from implants supported restoration using different instruments: a 6-month comparative multicenter clinical study.

    PubMed

    Blasi, Andrea; Iorio-Siciliano, Vincenzo; Pacenza, Carina; Pomingi, Francesca; Matarasso, Sergio; Rasperini, Giulio

    2016-02-01

    The aim of this study was to compare the efficacy of different instruments on biofilm removal from implant supported restorations. The study was designed as comparative multicenter clinical study including patients proceeding from the Milan, Naples, and Buenos Aires, with a peri-implant mucositis. Implants enrolled for the study were allocated in 4 groups and treated with ultrasonic scalers with plastic tips, with titanium curettes, with airflow with glycine powder, and with rubber cup and polishing paste, respectively. mPI was assessed at baseline, immediately after therapy, at 1, 3, and 6 months. mBI, PD, and REC were assessed at baseline, 1, 3, and 6 months. All parameters were recorded on six sites per implant. Kruskal-Wallis and Mann-Whitney tests were used to compare groups and centers. A generalized linear model for repeated measures was chosen for inter-group comparison. An intra-group comparison was performed with repeated measure ANOVA test to assess differences between baseline and recalls. A total of 89 patients (39 males, 50 females) were enrolled in the study, and 141 implants were available for the analysis. 55 implants were enrolled in University of Buenos Aires, 32 in University of Milan, and 54 in University of Naples. There were no significant differences between the four groups in inflammatory status reduction of peri-implant mucosa. Non-surgical therapy is effective in reducing peri-implant mucositis. Sonic scaler with plastic tip and rubber cup with polishing paste showed higher efficacy when compared with titanium curettes or airflow with glycine powder. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Comparative assessment of implantable hip devices with different bearing surfaces: systematic appraisal of evidence.

    PubMed

    Sedrakyan, Art; Normand, Sharon-Lise T; Dabic, Stefan; Jacobs, Samantha; Graves, Stephen; Marinac-Dabic, Danica

    2011-11-29

    To determine comparative safety and effectiveness of combinations of bearing surfaces of hip implants. Systematic review of clinical trials, observational studies, and registries. Medline, Embase, Cochrane Controlled Trials Register, reference lists of articles, annual reports of major registries, summaries of safety and effectiveness for pre-market application and mandated post-market studies at the United States Food and Drug Administration. Criteria for inclusion were comparative studies in adults reporting information for various combinations of bearings (such as metal on metal and ceramic on ceramic). Data search, abstraction, and analyses were independently performed and confirmed by at least two authors. Qualitative data syntheses were performed. There were 3139 patients and 3404 hips enrolled in 18 comparative studies and over 830 000 operations in national registries. The mean age range in the trials was 42-71, and 26-88% were women. Disease specific functional outcomes and general quality of life scores were no different or they favoured patients receiving metal on polyethylene rather than metal on metal in the trials. While one clinical study reported fewer dislocations associated with metal on metal implants, in the three largest national registries there was evidence of higher rates of implant revision associated with metal on metal implants compared with metal on polyethylene. One trial reported fewer revisions with ceramic on ceramic compared with metal on polyethylene implants, but data from national registries did not support this finding. There is limited evidence regarding comparative effectiveness of various hip implant bearings. Results do not indicate any advantage for metal on metal or ceramic on ceramic implants compared with traditional metal on polyethylene or ceramic on polyethylene bearings.

  9. Do Breast Implants Influence Breastfeeding? A Meta-Analysis of Comparative Studies.

    PubMed

    Cheng, Fengrui; Dai, Shuiping; Wang, Chiyi; Zeng, Shaoxue; Chen, Junjie; Cen, Ying

    2018-06-01

    Aesthetic breast implant augmentation surgery is the most popular plastic surgery worldwide. Many women choose to receive breast implants during their reproductive ages, although the long-term effects are still controversial. Research aim: We conducted a meta-analysis to assess the influence of aesthetic breast augmentation on breastfeeding. We also compared the exclusive breastfeeding rates of periareolar versus inframammary incision. A systematic search for comparative studies about breast implants and breastfeeding was performed in PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, Scopus, and Web of Science through May 2018. Meta-analysis was conducted with a random-effects model (or fixed effects, if heterogeneity was absent). Four cohorts and one cross-sectional study were included. There was a significant reduction in the exclusive breastfeeding rate for women with breast implants compared with women without implants, pooled relative risk = 0.63, 95% confidence interval [0.46, 0.86], as well as the breastfeeding rate, pooled relative risk = 0.88, 95% confidence interval [0.81, 0.95]. There was no evidence that periareolar incision was associated with a reduction in the exclusive breastfeeding rate, pooled relative risk = 0.84, 95% confidence interval [0.45, 1.58]. Participants with breast implants are less likely to establish breastfeeding, especially exclusive breastfeeding. Periareolar incision does not appear to reduce the exclusive breastfeeding rate.

  10. Alumina additions may improve the damage tolerance of soft machined zirconia-based ceramics.

    PubMed

    Oilo, Marit; Tvinnereim, Helene M; Gjerdet, Nils Roar

    2011-01-01

    The aim of this study was to evaluate the damage tolerance of different zirconia-based materials. Bars of one hard machined and one soft machined dental zirconia and an experimental 95% zirconia 5% alumina ceramic were subjected to 100,000 stress cycles (n = 10), indented to provoke cracks on the tensile stress side (n = 10), and left untreated as controls (n = 10). The experimental material demonstrated a higher relative damage tolerance, with a 40% reduction compared to 68% for the hard machined zirconia and 84% for the soft machined zirconia.

  11. Zirconia based dental ceramics: structure, mechanical properties, biocompatibility and applications.

    PubMed

    Gautam, Chandkiram; Joyner, Jarin; Gautam, Amarendra; Rao, Jitendra; Vajtai, Robert

    2016-12-06

    Zirconia (ZrO 2 ) based dental ceramics have been considered to be advantageous materials with adequate mechanical properties for the manufacturing of medical devices. Due to its very high compression strength of 2000 MPa, ZrO 2 can resist differing mechanical environments. During the crack propagation on the application of stress on the surface of ZrO 2 , a crystalline modification diminishes the propagation of cracks. In addition, zirconia's biocompatibility has been studied in vivo, leading to the observation of no adverse response upon the insertion of ZrO 2 samples into the bone or muscle. In vitro experimentation has exhibited the absence of mutations and good viability of cells cultured on this material leading to the use of ZrO 2 in the manufacturing of hip head prostheses. The mechanical properties of zirconia fixed partial dentures (FPDs) have proven to be superior to other ceramic/composite restorations and hence leading to their significant applications in implant supported rehabilitations. Recent developments were focused on the synthesis of zirconia based dental materials. More recently, zirconia has been introduced in prosthetic dentistry for the fabrication of crowns and fixed partial dentures in combination with computer aided design/computer aided manufacturing (CAD/CAM) techniques. This systematic review covers the results of past as well as recent scientific studies on the properties of zirconia based ceramics such as their specific compositions, microstructures, mechanical strength, biocompatibility and other applications in dentistry.

  12. Zirconia in dentistry: part 2. Evidence-based clinical breakthrough.

    PubMed

    Koutayas, Spiridon Oumvertos; Vagkopoulou, Thaleia; Pelekanos, Stavros; Koidis, Petros; Strub, Jörg Rudolf

    2009-01-01

    An ideal all-ceramic restoration that conforms well and demonstrates enhanced biocompatibility, strength, fit, and esthetics has always been desirable in clinical dentistry. However, the inherent brittleness, low flexural strength, and fracture toughness of conventional glass and alumina ceramics have been the main obstacles for extensive use. The recent introduction of zirconia-based ceramics as a restorative dental material has generated considerable interest in the dental community, which has been expressed with extensive industrial, clinical, and research activity. Contemporary zirconia powder technology contributes to the fabrication of new biocompatible all-ceramic restorations with improved physical properties for a wide range of promising clinical applications. Especially with the development of computer-aided design (CAD)/computer-aided manufacturing (CAM) systems, high-strength zirconia frameworks can be viable for the fabrication of full and partial coverage crowns, fixed partial dentures, veneers, posts and/or cores, primary double crowns, implant abutments, and implants. Data from laboratory and clinical studies are promising regarding their performance and survival. However, clinical data are considered insufficient and the identified premature complications should guide future research. In addition, different zirconia-based dental auxiliary components (i.e., cutting burs and surgical drills, extra-coronal attachments and orthodontic brackets) can also be technologically feasible. This review aims to present and discuss zirconia manufacturing methods and their potential for successful clinical application in dentistry.

  13. Primary stability of a hybrid self-tapping implant compared to a cylindrical non-self-tapping implant with respect to drilling protocols in an ex vivo model.

    PubMed

    Toyoshima, Takeshi; Wagner, Wilfried; Klein, Marcus Oliver; Stender, Elmar; Wieland, Marco; Al-Nawas, Bilal

    2011-03-01

    Modifications of implant design have been intending to improve primary stability. However, little is known about investigation of a hybrid self-tapping implant on primary stability. The aims of this study were to evaluate the primary stability of two hybrid self-tapping implants compared to one cylindrical non-self-tapping implant, and to elucidate the relevance of drilling protocols on primary stability in an ex vivo model. Two types of hybrid self-tapping implants (Straumann® Bone Level implant [BL], Straumann® Tapered Effect implant [TE]) and one type of cylindrical non-self-tapping implant (Straumann® Standard Plus implant [SP]) were investigated in the study. In porcine iliac cancellous bones, 10 implants each were inserted either using standard drilling or under-dimensioned drilling protocol. The evaluation of implant-bone interface stability was carried out by records of maximum insertion torque, the Periotest® (Siemens, Bensheim, Germany), the resonance frequency analysis (RFA), and the push-out test. In each drilling group, the maximum insertion torque values of BL and TE were significantly higher than SP (p=.014 and p=.047, respectively). In each group, the Periotest values of TE were significantly lower than SP (p=.036 and p=.033, respectively). The Periotest values of BL and TE were significantly lower in the group of under-dimensioned drilling than standard drilling (p=.002 and p=.02, respectively). In the RFA, no statistical significances were found in implants between two groups and between implants in each group. In each group, the push-out values of BL and TE were significantly higher than SP (p=.006 and p=.049, respectively). Hybrid self-tapping implants could achieve a high primary stability which predicts them for use in low-density bone. However, there is still a debate to clarify the influence of under-dimensioned drilling on primary stability. © 2009, Copyright the Authors. Journal Compilation © 2011, Wiley Periodicals, Inc.

  14. Patients' preferences when comparing analogue implant impressions using a polyether impression material versus digital impressions (Intraoral Scan) of dental implants.

    PubMed

    Wismeijer, Daniel; Mans, Ronny; van Genuchten, Michiel; Reijers, Hajo A

    2014-10-01

    The primary objective of this clinical study was to assess the patients' perception of the difference between an analogue impression approach on the one hand and an intra-oral scan (IO scan) on the other when restoring implants in the non-aesthetic zone. A second objective was to analyse the difference in time needed to perform these two procedures. Thirty consecutive patients who had received 41 implants (Straumann tissue level) in the non-aesthetic zone in an implant-based referral practice setting in the Netherlands. As they were to receive crown and or bridge work on the implants, in one session, the final impressions were taken with both an analogue technique and with an intraoral scan. Patients were also asked if, directly after the treatment was carried out, they would be prepared to fill out a questionnaire on their perception of both techniques. The time involved following these two procedures was also recorded. The preparatory activities of the treatment, the taste of the impression material and the overall preference of the patients were significantly in favour of the IO scan. The bite registration, the scan head and gag reflex positively tended to the IO scan, but none of these effects were significant. The overall time involved with the IO scan was more negatively perceived than the analogue impression. Overall less time was involved when following the analogue impression technique than with the IO scan. The overall preference of the patients in our sample is significantly in favour of the approach using the IO scan. This preference relates mainly to the differences between the compared approaches with respect to taste effects and their preparatory activities. The patients did perceive the duration of IO scan more negatively than the analogue impression approach. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Naltrexone implants compared to methadone: outcomes six months after prison release.

    PubMed

    Lobmaier, Philipp P; Kunøe, Nikolaj; Gossop, Michael; Katevoll, Tormod; Waal, Helge

    2010-01-01

    After prison release, offenders with heroin use problems are at high risk of relapse and overdose death. There is a particular need for treatments that can be initiated in prison and continued after release into the community. Methadone maintenance treatment has been shown to reduce heroin use, criminality and mortality. Naltrexone implant treatment has not previously been evaluated in prison settings. This study compares the effects of naltrexone implants and methadone treatment on heroin and other illicit drug use, and criminality among heroin-dependent inmates after release from prison. Forty-six volunteers were randomly allocated to naltrexone implants or methadone before release. Intention-to-treat analyses showed reductions in both groups in frequency of use of heroin and benzodiazepines, as well as criminality, 6 months after prison release. Naltrexone implants may be a valuable treatment option in prison settings. 2010 S. Karger AG, Basel.

  16. Effect of Clinically Relevant CAD/CAM Zirconia Polishing on Gingival Fibroblast Proliferation and Focal Adhesions

    PubMed Central

    Fischer, Nicholas G.; Wong, Jeffrey; Cerutis, D. Roselyn

    2017-01-01

    Mucosal seal formation around dental abutments is critical to the successful integration of dental implants into the human oral cavity. No information exists for how clinically relevant polishing procedures for computer-aided design and computer-aided manufactured (CAD/CAM) zirconia abutments affects cellular responses important to mucosal seal formation. CAD/CAM zirconia was divided into four groups for clinically relevant polishing utilizing commercial polishing heads: control, coarse, coarse plus medium, and coarse plus medium plus fine. Surfaces were analyzed with scanning electron microscopy (SEM), atomic force microscopy (AFM), and optical profilometry (OP). Subsequently, human gingival fibroblasts (HGFs) were seeded onto the zirconia surfaces. Proliferation was measured via a quantitative SEM technique and focal adhesion kinase (FAK) phosphorylation status was measured by an enzyme-linked immunosorbent assay (ELISA). Results showed an increase in proliferation on all polished surfaces as compared to the control. Phosphorylation of FAK at tyrosine 397 (Y397) was up-modulated on the control surfaces. The associated cell adaptation is discussed. In all cases, FAK phosphorylation was greater at 24 h than 48 h. These results suggest that clinicians should be mindful of the effects of abutment polishing methodology, as this may have an impact on early mucosal seal formation. PMID:29186907

  17. A 12-month multicenter, randomized study comparing the levonorgestrel intrauterine system with the etonogestrel subdermal implant.

    PubMed

    Apter, Dan; Briggs, Paula; Tuppurainen, Marjo; Grunert, Julia; Lukkari-Lax, Eeva; Rybowski, Sarah; Gemzell-Danielsson, Kristina

    2016-07-01

    To compare the levonorgestrel intrauterine system (LNG-IUS 8), which has an average levonorgestrel release rate of ∼8 μg/24 hours during the first year (total levonorgestrel content 13.5 mg; Jaydess/Skyla), with the etonogestrel (ENG) subdermal implant (total content, 68 mg) with regard to the 12-month discontinuation rate (primary outcome). Randomized, open-label, phase III study. Thirty-eight centers in six European countries. Study population of 766 healthy nulliparous and parous women aged 18-35 years. The LNG-IUS 8 or the ENG implant. Discontinuation rate, by treatment group, at Month 12. The 12-month discontinuation rates were 19.6% and 26.8% in the LNG-IUS 8 and ENG implant groups, respectively. The -7.2% difference was statistically significant (95% confidence interval -13.2%, -1.2%). Fewer women in the LNG-IUS 8 group than in the ENG implant group discontinued because of increased bleeding (3.2% vs. 11.3%) or adverse events (14.3% vs. 21.8%). At 12 months, more women in the LNG-IUS 8 group than in the ENG implant group were "very/somewhat satisfied" with their bleeding pattern (60.9% vs. 33.6%) and reported a preference to use their study treatment after study completion (70.1% vs. 58.5%). The LNG-IUS 8 was associated with a significantly lower 12-month discontinuation rate compared with the ENG implant; mainly because ENG implant users frequently discontinued due to increased bleeding. More LNG-IUS 8 users than ENG implant users reported being "very/somewhat satisfied" with their bleeding pattern, and reported a preference to continue using their study treatment after the study. NCT01397097. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Impact of crestal and subcrestal implant placement in peri-implant bone: A prospective comparative study

    PubMed Central

    Pellicer-Chover, Hilario; Peñarrocha-Diago, María; Peñarrocha-Oltra, David; Gomar-Vercher, Sonia; Agustín-Panadero, Rubén

    2016-01-01

    Background To assess the influence of the crestal or subcrestal placement of implants upon peri-implant bone loss over 12 months of follow-up. Material and Methods Twenty-six patients with a single hopeless tooth were recruited in the Oral Surgery Unit (Valencia University, Valencia, Spain). The patients were randomized into two treatment groups: group A (implants placed at crestal level) or group B (implants placed at subcrestal level). Control visits were conducted by a trained clinician at the time of implant placement and 12 months after loading. A previously established standard protocol was used to compile general data on all patients (sex and age, implant length and diameter, and brushing frequency). Implant success rate, peri-implant bone loss and the treatment of the exposed implant surface were studied. The level of statistical significance was defined as 5% (α=0.05). Results Twenty-three patients (8 males and 15 females, mean age 49.8±11.6 years, range 28-75 years) were included in the final data analyses, while three were excluded. All the included subjects were nonsmokers with a brushing frequency of up to twice a day in 85.7% of the cases. The 23 implants comprised 10 crestal implants and 13 subcrestal implants. After implant placement, the mean bone position with respect to the implant platform in group A was 0.0 mm versus 2.16±0.88 mm in group B. After 12 months of follow-up, the mean bone positions were -0.06±1.11 mm and 0.95±1.50 mm, respectively - this representing a bone loss of 0.06±1.11 mm in the case of the crestal implants and of 1.22±1.06 mm in the case of the subcrestal implants (p=0.014). Four crestal implants and 5 subcrestal implants presented peri-implant bone levels below the platform, leaving a mean exposed treated surface of 1.13 mm and 0.57 mm, respectively. The implant osseointegration success rate at 12 months was 100% in both groups. Conclusions Within the limitations of this study, bone loss was found to be greater in

  19. CAD/CAM ZIRCONIA VS. SLIP-CAST GLASS-INFILTRATED ALUMINA/ZIRCONIA ALL-CERAMIC CROWNS: 2-YEAR RESULTS OF A RANDOMIZED CONTROLLED CLINICAL TRIAL

    PubMed Central

    Çehreli, Murat Cavit; Kökat, Ali Murat; Akça, Kivanç

    2009-01-01

    The aim of this randomized controlled clinical trial was to compare the early clinical outcome of slip-cast glass-infiltrated Alumina/Zirconia and CAD/CAM Zirconia all-ceramic crowns. A total of 30 InCeram® Zirconia and Cercon® Zirconia crowns were fabricated and cemented with a glass ionomer cement in 20 patients. At baseline, 6-month, 1-year, and 2-year recall appointments, Californian Dental Association (CDA) quality evaluation system was used to evaluate the prosthetic replacements, and plaque and gingival index scores were used to explore the periodontal outcome of the treatments. No clinical sign of marginal discoloration, persistent pain and secondary caries was detected in any of the restorations. All InCeram® Zirconia crowns survived during the 2-year period, although one nonvital tooth experienced root fracture coupled with the fracture of the veneering porcelain of the restoration. One Cercon® Zirconia restoration fractured and was replaced. According to the CDA criteria, marginal integrity was rated excellent for InCeram® Zirconia (73%) and Cercon® Zirconia (80%) restorations, respectively. Slight color mismatch rate was higher for InCeram® Zirconia restorations (66%) than Cercon® Zirconia (26%) restorations. Plaque and gingival index scores were mostly zero and almost constant over time. Time-dependent changes in plaque and gingival index scores within and between groups were statistically similar (p>0.05). This clinical study demonstrates that single-tooth InCeram® Zirconia and Cercon® Zirconia crowns have comparable early clinical outcome, both seem as acceptable treatment modalities, and most importantly, all-ceramic alumina crowns strengthened by 25% zirconia can sufficiently withstand functional load in the posterior zone. PMID:19148406

  20. Comparative study of encapsulated blebs following Ahmed glaucoma valve implantation and trabeculectomy with mitomycin-C.

    PubMed

    Bae, Kunho; Suh, Wool; Kee, Changwon

    2012-08-01

    To compare the histopathologic and morphologic findings of encapsulated blebs following Ahmed glaucoma valve implantation and primary standard trabeculectomy with mitomycin-C. We reviewed the records of patients with otherwise uncontrollable glaucoma who had undergone Ahmed glaucoma valve implantation or trabeculectomy with mitomycin-C. Five eyes that underwent Ahmed valve implantation and three eyes that underwent trabeculectomy needed surgical revision of the initial surgery due to encapsulated bleb development with total loss of function. The surgically removed encapsulated blebs were analyzed macroscopically and microscopically. Removal of the encapsulated bleb was performed at a mean follow-up time of 26.6 ± 19.4 weeks in the Ahmed valve implantation group and 12.0 ± 11.4 weeks in the trabeculectomy group. The fibrotic wall of the encapsulated blebs had an overall thickness of 2.48 ± 0.42 mm in the Ahmed valve implantation group and 1.62 ± 0.37 mm in the trabeculectomy group. Macroscopically, the coconut flesh-like smooth surface was split into two layers, and the wall of the capsule was thicker in the Ahmed valve implantation group than in the trabeculectomy group. Histopathologically, the fibrotic capsule was composed of an inner fibrodegenerative layer and an outer fibrovascular layer, and there were no histopathological differences between the two groups. The fibrotic capsule wall was thicker in the Ahmed valve group, but there were no differences in histological findings between the two groups.

  1. [Navigated implantation of total knee endoprostheses--a comparative study with conventional instrumentation].

    PubMed

    Jenny, J Y; Boeri, C

    2001-01-01

    A navigation system should improve the quality of a total knee prosthesis implantation in comparison to the classical, surgeon-controlled operative technique. The authors have implanted 40 knee total prostheses with an optical infrared navigation system (Orthopilot AESCULAP, Tuttlingen--group A). The quality of implantation was studied on postoperative long leg AP and lateral X-rays, and compared to a control group of 40 computer-paired total knee prostheses o the same model (Search Prosthesis, AESCULAP, Tuttlingen) implanted with a classical, surgeon-controlled technique (group B). An optimal mechanical femorotibial angle (3 degrees valgus to 3 degrees varus) was obtained by 33 cases in group A and 31 cases in group B (p > 0.05). Better results were seen for the coronal and sagittal orientation of both tibial and femoral components in group A. Globally, 26 cases of the group A and 12 cases of the group B were implanted in an optimal manner for all studied criteria (p < 0.01). The used navigation system allows a significant improvement of the quality of implantation of a knee total prosthesis in comparison to a classical, surgeon-controlled instrumentation. Long-term outcome could be consequently improved.

  2. Bilateral and unilateral cochlear implant users compared on speech perception in noise.

    PubMed

    Dunn, Camille C; Noble, William; Tyler, Richard S; Kordus, Monika; Gantz, Bruce J; Ji, Haihong

    2010-04-01

    Compare speech performance in noise with matched bilateral cochlear implant (CICI) and unilateral cochlear implant (CI only) users. Thirty CICI and 30 CI-only subjects were tested on a battery of speech perception tests in noise that use an eight-loudspeaker array. On average, CICI subject's performance with speech in noise was significantly better than the CI-only subjects. The CICI group showed significantly better performance on speech perception in noise compared with the CI-only subjects, supporting the hypothesis that CICI is more beneficial than CI only.

  3. A comparative evaluation of the tissue responses associated with polymeric implants in the rat and mouse.

    PubMed

    Kidd, Kameha R; Dal Ponte, Donny B; Kellar, Robert S; Williams, Stuart K

    2002-03-15

    End product application is an important consideration when evaluating a material in an in vivo setting (Didisheim, Cardiovasc Pathol 1993;2:1S-2S). Small animal models allow high through-put evaluation of biocompatability. Previous preclinical evaluations have often used a rat subcutaneous model for the characterization of material-tissue interaction. Recent advances in genetic manipulation have provided mouse models with selective expression of a wide range of critical proteins. The rat model does not have many of the resources (i.e., knockouts, SCID, nude) that are present in mouse strains. The availability of these mice provides a resource to delineate the mechanisms regulating the healing associated with implants. However, before the mouse models can be used, they must be validated with respect to their ability to accurately assess tissue responses to materials. In this study the tissue responses after the implantation of expanded polytetrafluoroethylene (ePTFE) were compared between rat and mouse. Discs of ePTFE (30-microm internodal distance) were implanted in subcutaneous and epididymal fat tissue of rats (Sprague-Dawley) and mice (129-SVJ). After 5 weeks the samples were removed and evaluated for vascular density, inflammation, and fibrous encapsulation. No difference in the vessel density was observed within the peri-implant subcutaneous and adipose tissue or within the porous material. However, a significant difference was found in the number of activated macrophages and giant cells between these two species. Implants in the rat exhibited greater numbers of activated inflammatory cells in the peri-implant tissue. The data indicate that the mouse and rat provide a comparable model for evaluating angiogenesis and neovascularization associated with synthetic porous implants. Copyright 2001 John Wiley & Sons, Inc. J Biomed Mater Res 59: 682-689, 2002

  4. Nerve damage assessment following implant placement in human cadaver jaws: an ex vivo comparative study.

    PubMed

    Murat, Sema; Kamburoğlu, Kıvanç; Kılıç, Cenk; Ozen, Tuncer; Gurbuz, Ayhan

    2014-02-01

    The present study compared the use of cone beam computerized tomography (CBCT) images and intra-oral radiographs in the placement of final implant drills in terms of nerve damage to cadaver mandibles. Twelve cadaver hemimandibles obtained from 6 cadavers were used. Right hemimandibles were imaged using peri-apical radiography and left hemimandibles using CBCT, and the images obtained were used in treatment planning for the placement of implant drills (22 for each modality, for a total of 44 final drills). Specimens were dissected, and the distances between the apex of the final implant drill and the inferior alveolar neurovascular bundle and incisive nerve were measured using a digital calliper. Nerves were assessed as damaged or not damaged, and the Chi-square test was used to compare nerve damage between modalities (P < 0.05). Nerve damage occurred with 7 final drills placed based on peri-apical radiography (31.8%) and 1 final drill placed using CBCT images (4.5%). The difference in nerve damage between imaging modalities was statistically significant (P = 0.023), with CBCT outperforming intraoral film in the placement of final implant drills ex vivo. In order to prevent nerve damage, CBCT is recommended as the principal imaging modality for pre-implant assessment.

  5. Comparative ex vivo evaluation of two electronic percussive testing devices measuring the stability of dental implants.

    PubMed

    Geckili, Onur; Bilhan, Hakan; Cilingir, Altug; Bilmenoglu, Caglar; Ates, Gokcen; Urgun, Aliye Ceren; Bural, Canan

    2014-12-01

    A comparative ex vivo study was performed to determine electronic percussive test values (PTVs) measured by cabled and wireless electronic percussive testing (EPT) devices and to evaluate the intra- and interobserver reliability of the wireless EPT device. Forty implants were inserted into the vertebrae and forty into the pelvis of a steer, a safe distance apart. The implants were all 4.3 mm wide and 13 mm long, from the same manufacturer. PTV of each implant was measured by four different examiners, using both EPT devices, and compared. Additionally, the intra- and interobserver reliability of the wireless EPT device was evaluated. Statistically significant differences (P <0.05) were observed between PTVs made by the two EPT devices. PTVs measured by the wireless EPT device were significantly higher than the cabled EPT device (P <0.05), indicating lower implant stability. The intraobserver reliability of the wireless EPT device was evaluated as excellent for the measurements in type II bone and good-to-excellent in type IV bone; interobserver reliability was evaluated as fair-to-good in both bone types. The wireless EPT device gives PTVs higher than the cabled EPT device, indicating lower implant stability, and its inter- and intraobserver reliability is good and acceptable.

  6. Evaluation of translucency of monolithic zirconia and framework zirconia materials

    PubMed Central

    Tuncel, İlkin; Üşümez, Aslıhan

    2016-01-01

    PURPOSE The opacity of zirconia is an esthetic disadvantage that hinders achieving natural and shade-matched restorations. The aim of this study was to evaluate the translucency of non-colored and colored framework zirconia and monolithic zirconia. MATERIALS AND METHODS The three groups tested were: non-colored framework zirconia, colored framework zirconia with the A3 shade according to Vita Classic Scale, and monolithic zirconia (n=5). The specimens were fabricated in the dimensions of 15×12×0.5 mm. A spectrophotometer was used to measure the contrast ratio, which is indicative of translucency. Three measurements were made to obtain the contrast ratios of the materials over a white background (L*w) and a black background (L*b). The data were analyzed using the one-way analysis of variance and Tukey HSD tests. One specimen from each group was chosen for scanning electron microscope analysis. The determined areas of the SEM images were divided by the number of grains in order to calculate the mean grain size. RESULTS Statistically significant differences were observed among all groups (P<.05). Non-colored zirconia had the highest translucency with a contrast ratio of 0.75, while monolithic zirconia had the lowest translucency with a contrast ratio of 0.8. The mean grain sizes of the non-colored, colored, and monolithic zirconia were 233, 256, and 361 nm, respectively. CONCLUSION The translucency of the zirconia was affected by the coloring procedure and the grain size. Although monolithic zirconia may not be the best esthetic material for the anterior region, it may serve as an alternative in the posterior region for the bilayered zirconia restorations. PMID:27350851

  7. Breast Reduction versus Breast Reduction Plus Implants: A Comparative Study with Measurements and Outcomes

    PubMed Central

    2014-01-01

    Background: Breast reduction is well-known to provide an improvement in physical symptoms. However, measurements show that this procedure is less effective in restoring upper-pole fullness. Breast implants effectively augment the upper pole. This study was undertaken to determine the effectiveness and safety of this treatment combination. Methods: This retrospective study consists of 3 parts: (1) a clinical study, (2) breast measurements, and (3) an outcome study. Eighty consecutive women undergoing breast reduction (n = 56) or breast reduction plus implants (n = 24) were evaluated. All breast implants were inserted submuscularly. All patients were treated with the same vertical reduction technique, using a medially based pedicle and intraoperative nipple positioning. Measurements were compared between preoperative photographs and photographs taken at least 3 months after surgery (n = 51). Patient surveys (n= 56) were evaluated. Results: There was no significant difference in complication or reoperation rates between groups. Both procedures elevated the breast mound and lower-pole level and increased the breast parenchymal ratio (upper-pole area/lower-pole area). Breast implants significantly increased upper-pole projection (P < 0.01). All surveyed patients who had simultaneous implants reported that they were pleased with their decision. Physical symptoms were reduced in both groups. Patient satisfaction was 92.5% for breast reduction and 93.8% for breast reduction plus implants. Both groups reported an improvement in quality of life. Conclusions: Vertical breast reduction with a medial pedicle may be combined safely and effectively with breast implants in patients who desire upper-pole fullness. PMID:25587515

  8. Aesthetic outcome of single-tooth implant restorations following early implant placement and guided bone regeneration: crown and soft tissue dimensions compared with contralateral teeth.

    PubMed

    Cosyn, Jan; De Rouck, Tim

    2009-10-01

    The aim of this study was to compare crown and soft tissue dimensions of single-tooth implant restorations following early implant placement and guided bone regeneration (GBR) with contralateral non-restored teeth. Twenty-seven patients treated by one and the same surgeon and prosthodontist to restore a single-tooth gap with a class I bone defect in the premaxilla by means of an implant-supported restoration were reviewed. Patients were examined at least 6 months following placement of the crown. All implants had been inserted 6-8 weeks following tooth extraction in conjunction with GBR. At evaluation, crown dimensions, soft tissue dimensions, clinical conditions and patients' aesthetic satisfaction were assessed by one clinician who had not been involved in the treatment. Implant-supported crowns were not significantly longer than contralateral teeth and midfacial soft tissues showed comparable levels after on average 21 months of function. Our data also indicated significant papilla loss especially at the distal aspect of the implants. As the patient's aesthetic appreciation was favourable in 88% of the cases, this appeared to be of trivial importance. Favourable aesthetics may be achieved for single-tooth implant restorations following early implant placement and GBR. The impact of the latter on papilla levels, however, remains to be determined in longitudinal studies.

  9. Surface roughness of zirconia for full-contour crowns after clinically simulated grinding and polishing.

    PubMed

    Hmaidouch, Rim; Müller, Wolf-Dieter; Lauer, Hans-Christoph; Weigl, Paul

    2014-12-01

    The aim of this study was to evaluate the effect of controlled intraoral grinding and polishing on the roughness of full-contour zirconia compared to classical veneered zirconia. Thirty bar-shaped zirconia specimens were fabricated and divided into two groups (n=15). Fifteen specimens (group 1) were glazed and 15 specimens (group 2) were veneered with feldspathic ceramic and then glazed. Prior to grinding, maximum roughness depth (Rmax) values were measured using a profilometer, 5 times per specimen. Simulated clinical grinding and polishing were performed on the specimens under water coolant for 15 s and 2 N pressure. For grinding, NTI diamonds burs with grain sizes of 20 µm, 10 µm, and 7.5 µm were used sequentially. The ground surfaces were polished using NTI kits with coarse, medium and fine polishers. After each step, Rmax values were determined. Differences between groups were examined using one-way analysis of variance (ANOVA). The roughness of group 1 was significantly lower than that of group 2. The roughness increased significantly after coarse grinding in both groups. The results after glazing were similar to those obtained after fine grinding for non-veneered zirconia. However, fine-ground veneered zirconia had significantly higher roughness than venerred, glazed zirconia. No significant difference was found between fine-polished and glazed zirconia, but after the fine polishing of veneered zirconia, the roughness was significantly higher than after glazing. It can be concluded that for full-contour zirconia, fewer defects and lower roughness values resulted after grinding and polishing compared to veneered zirconia. After polishing zirconia, lower roughness values were achieved compared to glazing; more interesting was that the grinding of glazed zirconia using the NTI three-step system could deliver smooth surfaces comparable to untreated glazed zirconia surfaces.

  10. Surface roughness of zirconia for full-contour crowns after clinically simulated grinding and polishing

    PubMed Central

    Hmaidouch, Rim; Müller, Wolf-Dieter; Lauer, Hans-Christoph; Weigl, Paul

    2014-01-01

    The aim of this study was to evaluate the effect of controlled intraoral grinding and polishing on the roughness of full-contour zirconia compared to classical veneered zirconia. Thirty bar-shaped zirconia specimens were fabricated and divided into two groups (n=15). Fifteen specimens (group 1) were glazed and 15 specimens (group 2) were veneered with feldspathic ceramic and then glazed. Prior to grinding, maximum roughness depth (Rmax) values were measured using a profilometer, 5 times per specimen. Simulated clinical grinding and polishing were performed on the specimens under water coolant for 15 s and 2 N pressure. For grinding, NTI diamonds burs with grain sizes of 20 µm, 10 µm, and 7.5 µm were used sequentially. The ground surfaces were polished using NTI kits with coarse, medium and fine polishers. After each step, Rmax values were determined. Differences between groups were examined using one-way analysis of variance (ANOVA). The roughness of group 1 was significantly lower than that of group 2. The roughness increased significantly after coarse grinding in both groups. The results after glazing were similar to those obtained after fine grinding for non-veneered zirconia. However, fine-ground veneered zirconia had significantly higher roughness than venerred, glazed zirconia. No significant difference was found between fine-polished and glazed zirconia, but after the fine polishing of veneered zirconia, the roughness was significantly higher than after glazing. It can be concluded that for full-contour zirconia, fewer defects and lower roughness values resulted after grinding and polishing compared to veneered zirconia. After polishing zirconia, lower roughness values were achieved compared to glazing; more interesting was that the grinding of glazed zirconia using the NTI three-step system could deliver smooth surfaces comparable to untreated glazed zirconia surfaces. PMID:25059249

  11. Systematic review of the effectiveness of polyurethane-coated compared with textured silicone implants in breast surgery.

    PubMed

    Duxbury, Paula J; Harvey, James R

    2016-04-01

    Silicone gel implants are used worldwide for breast augmentation and breast reconstruction. Textured silicone implants are the most commonly placed implant, but polyurethane-coated implants are increasingly being used in an attempt to ameliorate the long-term complications associated with implant insertion. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Electronic searches of MEDLINE, EMBASE, the Cochrane Library and www.ClinicalTrials.gov were undertaken in March 2014 using keywords. Following data extraction, 18 studies were included in the review, including four core studies of textured silicone implants and five studies reporting outcomes for polyurethane-coated silicone implants. There are no clear data reporting revision rates in patients treated with polyurethane implants. In the primary reconstructive setting, capsular contracture rates with silicone implants are 10-15% at 6 years, whilst studies of polyurethane implants report rates of 1.8-3.4%. In the primary augmentation setting, core studies show a capsular contracture rate of 2-15% at 6 years compared with 0.4-1% in polyurethane-coated implants; however, the polyurethane studies are limited by their design and poor follow-up. The use of polyurethane implants should be considered a safe alternative to textured silicone implants. It is likely that an implant surface does influence short- and long-term outcomes; however, the extent of any benefit cannot be determined from the available evidence base. Future implant studies should target the short- and long-term benefits of implant surfacing by procedure with defined outcome measures; a head-to-head comparison would help clarify outcomes. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Finite element analysis to compare complete denture and implant-retained overdentures with different attachment systems.

    PubMed

    Barão, Valentim Adelino Ricardo; Assunção, Wirley Gonçalves; Tabata, Lucas Fernando; Delben, Juliana Aparecida; Gomes, Erica Alves; de Sousa, Edson Antonio Capello; Rocha, Eduardo Passos

    2009-07-01

    This finite element analysis compared stress distribution on complete dentures and implant-retained overdentures with different attachment systems. Four models of edentulous mandible were constructed: group A (control), complete denture; group B, overdenture retained by 2 splinted implants with bar-clip system; group C, overdenture retained by 2 unsplinted implants with o'ring system; and group D, overdenture retained by 2 splinted implants with bar-clip and 2 distally placed o'ring system. Evaluation was performed on Ansys software, with 100-N vertical load applied on central incisive teeth. The lowest maximum general stress value (in megapascal) was observed in group A (64.305) followed by groups C (119.006), D (258.650), and B (349.873). The same trend occurred in supporting tissues with the highest stress value for cortical bone. Unsplinted implants associated with the o'ring attachment system showed the lowest maximum stress values among all overdenture groups. Furthermore, o'ring system also improved stress distribution when associated with bar-clip system.

  13. In vitro assessment of cutting efficiency and durability of zirconia removal diamond rotary instruments.

    PubMed

    Kim, Joon-Soo; Bae, Ji-Hyeon; Yun, Mi-Jung; Huh, Jung-Bo

    2017-06-01

    Recently, zirconia removal diamond rotary instruments have become commercially available for efficient cutting of zirconia. However, research of cutting efficiency and the cutting characteristics of zirconia removal diamond rotary instruments is limited. The purpose of this in vitro study was to assess and compare the cutting efficiency, durability, and diamond rotary instrument wear pattern of zirconia diamond removal rotary instruments with those of conventional diamond rotary instruments. In addition, the surface characteristics of the cut zirconia were assessed. Block specimens of 3 mol% yttrium cation-doped tetragonal zirconia polycrystal were machined 10 times for 1 minute each using a high-speed handpiece with 6 types of diamond rotary instrument from 2 manufacturers at a constant force of 2 N (n=5). An electronic scale was used to measure the lost weight after each cut in order to evaluate the cutting efficiency. Field emission scanning electron microscopy was used to evaluate diamond rotary instrument wear patterns and machined zirconia block surface characteristics. Data were statistically analyzed using the Kruskal-Wallis test, followed by the Mann-Whitney U test (α=.05). Zirconia removal fine grit diamond rotary instruments showed cutting efficiency that was reduced compared with conventional fine grit diamond rotary instruments. Diamond grit fracture was the most dominant diamond rotary instrument wear pattern in all groups. All machined zirconia surfaces were primarily subjected to plastic deformation, which is evidence of ductile cutting. Zirconia blocks machined with zirconia removal fine grit diamond rotary instruments showed the least incidence of surface flaws. Although zirconia removal diamond rotary instruments did not show improved cutting efficiency compared with conventional diamond rotary instruments, the machined zirconia surface showed smoother furrows of plastic deformation and fewer surface flaws. Copyright © 2016 Editorial Council

  14. Densification of Zirconia with Borates.

    DTIC Science & Technology

    1980-01-24

    solid electrolytes for fuel cell and oxygen sensor applications.1 ’ 2 The sintering temperatures for commercial quality stabilized zirconia powders are...in the temperature range 1450-1500C). A few studies were also made using a much coarser particle size (- 1-2 pm ave.) cubic stabilized zirconia ... powder , "Zircoa B" [Zirconia Corp. of America]. The additives used as sintering aids were reagent grade horic anhydride, calcium metaborate and calcium

  15. Histological evaluations and inflammatory responses of different dental implant abutment materials: A human histology pilot study.

    PubMed

    Sampatanukul, Teeratida; Serichetaphongse, Pravej; Pimkhaokham, Atiphan

    2018-04-01

    Improvements of soft tissue to the abutment surface results in more stable peri-implant conditions, however, few human histological studies have compared soft tissue responses around different abutment materials. To describe the peri-implant tissue around 3 abutment materials; titanium, zirconia, and gold alloy, over an 8-week healing period. Fifteen edentulous sites were treated with implants. Eight weeks later, peri-implant tissue was harvested and processed using a nonseparation resin embedded technique. The tissue attachment characteristics were assessed at clinical stages using the gingival index (GI) score, surgical stage (surgical score), and histological stage (histological attachment percentage). Additionally, the inflammatory responses were evaluated using inflammatory extent and inflammatory cellularity grades. Nonparametrical statistics were used to describe the GI and surgical scores, and analytical statistics were used to analyze the histological attachment percentages as well as the inflammatory extent and cellularity grades amongst the 3 groups. There were no statistically significant differences among the groups for GI score (P = .071) and surgical score (P = .262). Titanium and zirconia exhibited nearly similar mean histological attachment percentages while gold alloy had a significantly lower percentage (P = .004). For the inflammatory extent and cellularity grades, the odds of being one grade higher for gold alloy abutment was 5.18 and 17.8 times that of titanium abutment, respectively. However, for the zirconia abutment, the odds were 0.87 and 7.5 times higher than the titanium group. The tissue around the gold alloy abutments resulted in worse attachment conditions compared with the titanium and zirconia abutments. Inflammation tended to be higher in the tissue around the gold alloy abutments than the titanium and zirconia abutments. © 2017 Wiley Periodicals, Inc.

  16. COMPARATIVE STUDY BETWEEN OSTEOSYNTHESIS IN CONVENTIONAL AND BIOABSORBABLE IMPLANTS IN ANKLE FRACTURES

    PubMed Central

    Gaiarsa, Guilherme Pelosini; dos Reis, Paulo Roberto; Mattar, Rames; Silva, Jorge dos Santos; Fernandez, Túlio Diniz

    2015-01-01

    ABSTRACT Objective: To compare the functional results of ankle fractures treated with metallic and absorbable plates. Twenty patients were randomized into two groups (metallic and absorbable implant groups) and followed prospectively. In the immediate postoperative period, patients were immobilized with plaster casts for one week, which was replaced by a removable cast for another four weeks. Partial weight-bearing was allowed after three weeks, and full weight-bearing after six weeks. Functional recovery was similar in both groups. At six months, three patients in the metallic group complained of local pain, and had their implants removed. One patient in the absorbable group exhibited early dehiscence of the suture and underwent debridement and suturing with good evolution. The American Orthopaedic Foot and Ankle Society (AOFAS) score was similar between the two groups after six and nine months of follow-up. The absorbable implants showed clinical and functional results that were similar to those of metallic implants. Level of Evidence II, Prospective Comparative Study. PMID:26981035

  17. Osseointegration and biocompatibility of different metal implants - a comparative experimental investigation in sheep

    PubMed Central

    2012-01-01

    Background In the present study, 4 different metallic implant materials, either partly coated or polished, were tested for their osseointegration and biocompatibility in a pelvic implantation model in sheep. Methods Materials to be evaluated were: Cobalt-Chrome (CC), Cobalt-Chrome/Titanium coating (CCTC), Cobalt-Chrome/Zirconium/Titanium coating (CCZTC), Pure Titanium Standard (PTST), Steel, TAN Standard (TANST) and TAN new finish (TANNEW). Surgery was performed on 7 sheep, with 18 implants per sheep, for a total of 63 implants. After 8 weeks, the specimens were harvested and evaluated macroscopically, radiologically, biomechanically (removal torque), histomorphometrically and histologically. Results Cobalt-Chrome screws showed significantly (p = 0.031) lower removal torque values than pure titanium screws and also a tendency towards lower values compared to the other materials, except for steel. Steel screws showed no significant differences, in comparison to cobalt-chrome and TANST, however also a trend towards lower torque values than the remaining materials. The results of the fluorescence sections agreed with those of the biomechanical test. Histomorphometrically, there were no significant differences of bone area between the groups. The BIC (bone-to-implant-contact), used for the assessment of the osseointegration, was significantly lower for cobalt-chrome, compared to steel (p = 0.001). Steel again showed a lower ratio (p = 0.0001) compared to the other materials. Conclusion This study demonstrated that cobalt-chrome and steel show less osseointegration than the other metals and metal-alloys. However, osseointegration of cobalt-chrome was improved by zirconium and/or titanium based coatings (CCTC, TANST, TAN, TANNEW) being similar as pure titanium in their osseointegrative behavior. PMID:22400715

  18. A Clinical Comparative Study of 3-Dimensional Accuracy between Digital and Conventional Implant Impression Techniques.

    PubMed

    Alsharbaty, Mohammed Hussein M; Alikhasi, Marzieh; Zarrati, Simindokht; Shamshiri, Ahmed Reza

    2018-02-09

    To evaluate the accuracy of a digital implant impression technique using a TRIOS 3Shape intraoral scanner (IOS) compared to conventional implant impression techniques (pick-up and transfer) in clinical situations. Thirty-six patients who had two implants (Implantium, internal connection) ranging in diameter between 3.8 and 4.8 mm in posterior regions participated in this study after signing a consent form. Thirty-six reference models (RM) were fabricated by attaching two impression copings intraorally, splinted with autopolymerizing acrylic resin, verified by sectioning through the middle of the index, and rejoined again with freshly mixed autopolymerizing acrylic resin pattern (Pattern Resin) with the brush bead method. After that, the splinted assemblies were attached to implant analogs (DANSE) and impressed with type III dental stone (Gypsum Microstone) in standard plastic die lock trays. Thirty-six working casts were fabricated for each conventional impression technique (i.e., pick-up and transfer). Thirty-six digital impressions were made with a TRIOS 3Shape IOS. Eight of the digitally scanned files were damaged; 28 digital scan files were retrieved to STL format. A coordinate-measuring machine (CMM) was used to record linear displacement measurements (x, y, and z-coordinates), interimplant distances, and angular displacements for the RMs and conventionally fabricated working casts. CATIA 3D evaluation software was used to assess the digital STL files for the same variables as the CMM measurements. CMM measurements made on the RMs and conventionally fabricated working casts were compared with 3D software measurements made on the digitally scanned files. Data were statistically analyzed using the generalized estimating equation (GEE) with an exchangeable correlation matrix and linear method, followed by the Bonferroni method for pairwise comparisons (α = 0.05). The results showed significant differences between the pick-up and digital groups in all of the

  19. Accuracy of impression scanning compared with stone casts of implant impressions.

    PubMed

    Matta, Ragai Edward; Adler, Werner; Wichmann, Manfred; Heckmann, Siegfried Martin

    2017-04-01

    Accurate virtual implant models are a necessity for the fabrication of precisely fitting superstructures. The purpose of this in vitro study was to evaluate different methods with which to build an accurate virtual model of a 3-dimensional implant in the oral cavity; this model would then be used for iterative computer-aided design and computer-aided manufacturing (CAD-CAM) procedures. A titanium master model with 3 rigidly connected implants was manufactured and digitized with a noncontact industrial scanner to obtain a virtual master model. Impressions of the master model with the implant position locators (IPL) were made using vinyl siloxanether material. The impressions were scanned (Impression scanning technique group). For the transfer technique and pick-up technique groups (each group n=20), implant analogs were inserted into the impression copings, impressions were made using polyether, and casts were poured in Type 4 gypsum. The IPLs were screwed into the analogs and scanned. To compare the virtual master model with each virtual test model, a CAD interactive software, ATOS professional, was applied. The Kruskal-Wallis test was subsequently used to determine the overall difference between groups, with the Mann-Whitney U test used for pairwise comparisons. Through Bonferroni correction, the α-level was set to .017. The outcome revealed a significant difference among the 3 groups (P<.01) in terms of accuracy. With regard to total deviation, for all axes, the transfer technique generated the greatest divergence, 0.078 mm (±0.022), compared with the master model. Deviation with the pick-up technique was 0.041 mm (±0.009), with impression scanning generating the most accurate models with a deviation of 0.022 mm (±0.007). The impression scanning method improved the precision of CAD-CAM-fabricated superstructures. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  20. Survival of anterior cantilevered all-ceramic resin-bonded fixed dental prostheses made from zirconia ceramic.

    PubMed

    Sasse, Martin; Kern, Matthias

    2014-06-01

    This study evaluated the clinical outcome of all-ceramic resin-bonded fixed dental prostheses (RBFDPs) with a cantilevered single-retainer design made from zirconia ceramic. Forty-two anterior RBFDPs with a cantilevered single-retainer design were made from yttrium oxide-stabilized zirconium oxide ceramic. RBFDPs were inserted using Panavia 21 TC as luting agent after air-abrasion of the ceramic bonding surface. During a mean observation time of 61.8 months two debondings occurred. Both RBFDPs were rebonded using Panavia 21 TC and are still in function. A caries lesion was detected at one abutment tooth during recall and was treated with a composite filling. Therefore, the overall six-year failure-free rate according to Kaplan-Meier was 91.1%. If only debonding was defined as failure the survival rate increased to 95.2%. Since all RBFDPs are still in function the overall survival rate was 100% after six years. Cantilevered zirconia ceramic RBFDPs showed promising results within the observation period. Single-retainer resin-bonded fixed dental prostheses made from zirconia ceramic show very good mid-term clinical survival rates. They should therefore be considered as a viable treatment alternative for the replacement of single missing anterior teeth especially as compared to an implant therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Optical properties of pre-colored dental monolithic zirconia ceramics.

    PubMed

    Kim, Hee-Kyung; Kim, Sung-Hun

    2016-12-01

    The purposes of this study were to evaluate the optical properties of recently marketed pre-colored monolithic zirconia ceramics and to compare with those of veneered zirconia and lithium disilicate glass ceramics. Various shades of pre-colored monolithic zirconia, veneered zirconia, and lithium disilicate glass ceramic specimens were tested (17.0×17.0×1.5mm, n=5). CIELab color coordinates were obtained against white, black, and grey backgrounds with a spectrophotometer. Color differences of the specimen pairs were calculated by using the CIEDE2000 (ΔE 00 ) formula. The translucency parameter (TP) was derived from ΔE 00 of the specimen against a white and a black background. X-ray diffraction was used to determine the crystalline phases of monolithic zirconia specimens. Data were analyzed with 1-way ANOVA, Scheffé post hoc, and Pearson correlation testing (α=0.05). For different shades of the same ceramic brand, there were significant differences in L * , a * , b * , and TP values in most ceramic brands. With the same nominal shade (A2), statistically significant differences were observed in L * , a * , b * , and TP values among different ceramic brands and systems (P<0.001). The color differences between pre-colored monolithic zirconia and veneered zirconia or lithium disilicate glass ceramics of the corresponding nominal shades ranged beyond the acceptability threshold. Due to the high L * values and low a * and b * values, pre-colored monolithic zirconia ceramics can be used with additional staining to match neighboring restorations or natural teeth. Due to their high value and low chroma, unacceptable color mismatch with adjacent ceramic restorations might be expected. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Tooth movement using palatal implant supported anchorage compared to conventional dental anchorage.

    PubMed

    Borsos, Gabriella; Vokó, Zoltan; Gredes, Tomasz; Kunert-Keil, Christiane; Vegh, Andras

    2012-11-01

    Tooth stability is one of the most changing parameters in age. The aim of the present study has been to clarify the therapeutic benefit of the osseointegrated palatal implant (PI) supported anchorage in adolescents compared with conventional dental anchorage (DA) in extraction cases requiring 'maximum anchorage' in growing patients following the post pubertal growth spurt. Thirty patients (14.22±1.37 years) selected with homogeneous facial skeletal characteristics were divided in two groups. In the PI group, Orthosystem(®) implants were placed into the palate for anchorage and the transpalatal arch (TPA) was fixed to the implant and to the molar bands. In the DA group maximal anchorage was provided by a TPA and a utility arch. Super-elastic spring was used for canine- and contraction arch for incisor retraction. An insignificant difference was observed between the groups as to the duration of the canine retraction. In the PI group, the duration of the front retraction and the total treatment time was shorter compared to the DA group (P<0.05). No significant difference in molar mesial movement was found during canine retraction, but during front retraction, there was significantly less mesial molar movement in the PI group compared to the DA group (P<0.05). The use of palatal implant-based anchorage does not offer a shorter canine retraction period, but resulted in a significant shortening of the front-retraction phase and a total treatment time shortened by 5 months on average. The tooth stability in adolescent patients is adequate for tooth movements using both methods. Copyright © 2012 Elsevier GmbH. All rights reserved.

  3. Comparative evaluation of topographical data of dental implant surfaces applying optical interferometry and scanning electron microscopy.

    PubMed

    Kournetas, N; Spintzyk, S; Schweizer, E; Sawada, T; Said, F; Schmid, P; Geis-Gerstorfer, J; Eliades, G; Rupp, F

    2017-08-01

    Comparability of topographical data of implant surfaces in literature is low and their clinical relevance often equivocal. The aim of this study was to investigate the ability of scanning electron microscopy and optical interferometry to assess statistically similar 3-dimensional roughness parameter results and to evaluate these data based on predefined criteria regarded relevant for a favorable biological response. Four different commercial dental screw-type implants (NanoTite Certain Prevail, TiUnite Brånemark Mk III, XiVE S Plus and SLA Standard Plus) were analyzed by stereo scanning electron microscopy and white light interferometry. Surface height, spatial and hybrid roughness parameters (Sa, Sz, Ssk, Sku, Sal, Str, Sdr) were assessed from raw and filtered data (Gaussian 50μm and 5μm cut-off-filters), respectively. Data were statistically compared by one-way ANOVA and Tukey-Kramer post-hoc test. For a clinically relevant interpretation, a categorizing evaluation approach was used based on predefined threshold criteria for each roughness parameter. The two methods exhibited predominantly statistical differences. Dependent on roughness parameters and filter settings, both methods showed variations in rankings of the implant surfaces and differed in their ability to discriminate the different topographies. Overall, the analyses revealed scale-dependent roughness data. Compared to the pure statistical approach, the categorizing evaluation resulted in much more similarities between the two methods. This study suggests to reconsider current approaches for the topographical evaluation of implant surfaces and to further seek after proper experimental settings. Furthermore, the specific role of different roughness parameters for the bioresponse has to be studied in detail in order to better define clinically relevant, scale-dependent and parameter-specific thresholds and ranges. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights

  4. Digital vs. conventional full-arch implant impressions: a comparative study.

    PubMed

    Amin, Sarah; Weber, Hans Peter; Finkelman, Matthew; El Rafie, Khaled; Kudara, Yukio; Papaspyridakos, Panos

    2017-11-01

    To test whether or not digital full-arch implant impressions with two different intra-oral scanners (CEREC Omnicam and True Definition) have the same accuracy as conventional ones. The hypothesis was that the splinted open-tray impressions would be more accurate than digital full-arch impressions. A stone master cast representing an edentulous mandible using five internal connection implant analogs (Straumann Bone Level RC, Basel, Switzerland) was fabricated. The three median implants were parallel to each other, the far left implant had 10°, and the far right had 15° distal angulation. A splinted open-tray technique was used for the conventional polyether impressions (n = 10) for Group 1. Digital impressions (n = 10) were taken with two intra-oral optical scanners (CEREC Omnicam and 3M True Definition) after connecting polymer scan bodies to the master cast for groups 2 and 3. Master cast and conventional impression test casts were digitized with a high-resolution reference scanner (Activity 880 scanner; Smart Optics, Bochum, Germany) to obtain digital files. Standard tessellation language (STL) datasets from the three test groups of digital and conventional impressions were superimposed with the STL dataset from the master cast to assess the 3D deviations. Deviations were recorded as root-mean-square error. To compare the master cast with conventional and digital impressions at the implant level, Welch's F-test was used together with Games-Howell post hoc test. Group I had a mean value of 167.93 μm (SD 50.37); Group II (Omnicam) had a mean value of 46.41 μm (SD 7.34); Group III (True Definition) had a mean value of 19.32 μm (SD 2.77). Welch's F-test was used together with the Games-Howell test for post hoc comparisons. Welch's F-test showed a significant difference between the groups (P < 0.001). The Games-Howell test showed statistically significant 3D deviations for all three groups (P < 0.001). Full-arch digital implant impressions using True

  5. Novel Zirconia Surface Treatments for Enhanced Osseointegration: Laboratory Characterization

    PubMed Central

    Ewais, Ola H.; Al Abbassy, Fayza; Ghoneim, Mona M.; Aboushelib, Moustafa N.

    2014-01-01

    Purpose. The aim of this study was to evaluate three novel surface treatments intended to improve osseointegration of zirconia implants: selective infiltration etching treatment (SIE), fusion sputtering (FS), and low pressure particle abrasion (LPPA). The effects of surface treatments on roughness, topography, hardness, and porosity of implants were also assessed. Materials and Methods. 45 zirconia discs (19 mm in diameter × 3 mm in thickness) received 3 different surface treatments: selective infiltration etching, low pressure particle abrasion with 30 µm alumina, and fusion sputtering while nontreated surface served as control. Surface roughness was evaluated quantitatively using profilometery, porosity was evaluated using mercury prosimetry, and Vickers microhardness was used to assess surface hardness. Surface topography was analyzed using scanning and atomic force microscopy (α = 0.05). Results. There were significant differences between all groups regarding surface roughness (F = 1678, P < 0.001), porosity (F = 3278, P < 0.001), and hardness (F = 1106.158, P < 0.001). Scanning and atomic force microscopy revealed a nanoporous surface characteristic of SIE, and FS resulted in the creation of surface microbeads, while LPPA resulted in limited abrasion of the surface. Conclusion. Within the limitations of the study, changes in surface characteristics and topography of zirconia implants have been observed after different surface treatment approaches. Thus possibilities for enhanced osseointegration could be additionally offered. PMID:25349610

  6. Bisphenyl-Polymer/Carbon-Fiber-Reinforced Composite Compared to Titanium Alloy Bone Implant

    PubMed Central

    Petersen, Richard C.

    2014-01-01

    Aerospace/aeronautical thermoset bisphenyl-polymer/carbon-fiber-reinforced composites are considered as new advanced materials to replace metal bone implants. In addition to well-recognized nonpolar chemistry with related bisphenol-polymer estrogenic factors, carbon-fiber-reinforced composites can offer densities and electrical conductivity/resistivity properties close to bone with strengths much higher than metals on a per-weight basis. In vivo bone-marrow tests with Sprague-Dawley rats revealed far-reaching significant osseoconductivity increases from bisphenyl-polymer/carbon-fiber composites when compared to state-of-the-art titanium-6-4 alloy controls. Midtibial percent bone area measured from the implant surface increased when comparing the titanium alloy to the polymer composite from 10.5% to 41.6% at 0.8 mm, P < 10−4, and 19.3% to 77.7% at 0.1 mm, P < 10−8. Carbon-fiber fragments planned to occur in the test designs, instead of producing an inflammation, stimulated bone formation and increased bone integration to the implant. In addition, low-thermal polymer processing allows incorporation of minerals and pharmaceuticals for future major tissue-engineering potential. PMID:25553057

  7. Bisphenyl-Polymer/Carbon-Fiber-Reinforced Composite Compared to Titanium Alloy Bone Implant.

    PubMed

    Petersen, Richard C

    2011-05-03

    Aerospace/aeronautical thermoset bisphenyl-polymer/carbon-fiber-reinforced composites are considered as new advanced materials to replace metal bone implants. In addition to well-recognized nonpolar chemistry with related bisphenol-polymer estrogenic factors, carbon-fiber-reinforced composites can offer densities and electrical conductivity/resistivity properties close to bone with strengths much higher than metals on a per-weight basis. In vivo bone-marrow tests with Sprague-Dawley rats revealed far-reaching significant osseoconductivity increases from bisphenyl-polymer/carbon-fiber composites when compared to state-of-the-art titanium-6-4 alloy controls. Midtibial percent bone area measured from the implant surface increased when comparing the titanium alloy to the polymer composite from 10.5% to 41.6% at 0.8 mm, P < 10 -4 , and 19.3% to 77.7% at 0.1 mm, P < 10 -8 . Carbon-fiber fragments planned to occur in the test designs, instead of producing an inflammation, stimulated bone formation and increased bone integration to the implant. In addition, low-thermal polymer processing allows incorporation of minerals and pharmaceuticals for future major tissue-engineering potential.

  8. Light transmittance of zirconia as a function of thickness and microhardness of resin cements under different thicknesses of zirconia

    PubMed Central

    Egilmez, Ferhan; Ergun, Gulfem; Kaya, Bekir M.

    2013-01-01

    Objective: The objective of this study was to compare microhardness of resin cements under different thicknesses of zirconia and the light transmittance of zirconia as a function of thickness. Study design: A total of 126 disc-shaped specimens (2 mm in height and 5 mm in diameter) were prepared from dual-cured resin cements (RelyX Unicem, Panavia F and Clearfil SA cement). Photoactivation was performed by using quartz tungsten halogen and light emitting diode light curing units under different thicknesses of zirconia. Then the specimens (n=7/per group) were stored in dry conditions in total dark at 37°C for 24 h. The Vicker’s hardness test was performed on the resin cement layer with a microhardness tester. Statistical significance was determined using multifactorial analysis of variance (ANOVA) (alpha=.05). Light transmittance of different thicknesses of zirconia (0.3, 0.5 and 0.8 mm) was measured using a hand-held radiometer (Demetron, Kerr). Data were analyzed using one-way ANOVA test (alpha=.05). Results: ANOVA revealed that resin cement and light curing unit had significant effects on microhardness (p < 0.001). Additionally, greater zirconia thickness resulted in lower transmittance. There was no correlation between the amount of light transmitted and microhardness of dual-cured resin cements (r = 0.073, p = 0.295). Conclusion: Although different zirconia thicknesses might result in insufficient light transmission, dual-cured resin cements under zirconia restorations could have adequate microhardness. Key words:Zirconia, microhardness, light transmittance, resin cement. PMID:23385497

  9. Peri-Implant Tissue Findings in Bone Grafted Oral Cancer Patients Compared to non Bone Grafted Patients without Oral Cancer

    PubMed Central

    Agata, Hideki; Sándor, George K.; Haimi, Suvi

    2011-01-01

    ABSTRACT Objectives The aim of this study was to compare microbiological, histological, and mechanical findings from tissues around osseointergrated dental implants in patients who had undergone tumour resection and subsequent bone grafting with non bone grafted patients without a history of oral cancer and to develop an effective tool for the monitoring of the peri-implant tissues. A third aim was to assess and compare the masticatory function of the two patient groups after reconstruction with dental implants. Material and Methods A total of 20 patients were divided into 2 groups. The first group was edentulous and treated with dental implants without the need for bone grafting. The second edentulous group, with a history of oral cancer involving the mandible, received onlay bone grafts with concurrent placement of dental implants. Microbiological, histological, mechanical and biochemical assessment methods, crevicular fluid flow rate, hygiene-index, implant mobility, and the masticatory function were analysed and compared in both patient groups. Results The microbiological examinations showed no evidence of the three most common pathogenic bacteria: Porphyromonas gingivalis, Prevotella intermedius, Actinobacillus actinomycetencomitans. A causal relationship between specific microbes and peri-implant inflammation could not be found. All biopsies in both patient groups revealed early signs of soft tissue peri-implant inflammation. Conclusions The crevicular fluid volume and grade of gingival inflammation around the dental implants were related. Peri-implant tissue findings were similar in the two patient groups despite the history of oral cancer and the need for bone grafting at the time of dental implant placement. PMID:24421999

  10. A comparative study of gold UCLA-type and CAD/CAM titanium implant abutments

    PubMed Central

    Park, Ji-Man; Lee, Jai-Bong; Heo, Seong-Joo

    2014-01-01

    PURPOSE The aim of this study was to evaluate the interface accuracy of computer-assisted designed and manufactured (CAD/CAM) titanium abutments and implant fixture compared to gold-cast UCLA abutments. MATERIALS AND METHODS An external connection implant system (Mark III, n=10) and an internal connection implant system (Replace Select, n=10) were used, 5 of each group were connected to milled titanium abutment and the rest were connected to the gold-cast UCLA abutments. The implant fixture and abutment were tightened to torque of 35 Ncm using a digital torque gauge, and initial detorque values were measured 10 minutes after tightening. To mimic the mastication, a cyclic loading was applied at 14 Hz for one million cycles, with the stress amplitude range being within 0 N to 100 N. After the cyclic loading, detorque values were measured again. The fixture-abutment gaps were measured under a microscope and recorded with an accuracy of ±0.1 µm at 50 points. RESULTS Initial detorque values of milled abutment were significantly higher than those of cast abutment (P<.05). Detorque values after one million dynamic cyclic loadings were not significantly different (P>.05). After cyclic loading, detorque values of cast abutment increased, but those of milled abutment decreased (P<.05). There was no significant difference of gap dimension between the milled abutment group and the cast abutment group after cyclic loading. CONCLUSION In conclusion, CAD/CAM milled titanium abutment can be fabricated with sufficient accuracy to permit screw joint stability between abutment and fixture comparable to that of the traditional gold cast UCLA abutment. PMID:24605206

  11. Evaluation of intensity of artefacts in CBCT by radio-opacity of composite simulation models of implants in vitro

    PubMed Central

    Kuusisto, N; Vallittu, P K; Lassila, L V J

    2015-01-01

    Objectives: The aim was to compare the intensity of artefacts in CBCT images caused by different percentages of radio-opacifying material in composite simulation models of implants. Titanium and zirconia models of implants were used as a reference for the evaluation of the intensity of artefacts. Methods: Seven different percentages of radio-opacifying BaAlSiO2 fillers were added to composite resin to fabricate seven step wedges and simulation models of implants. Titanium and zirconia simulation models of implants were also fabricated. Aluminium step wedge was used as a reference for the measurement of grey values in intraoral radiographs. Step wedges were exposed with a Planmeca Intra X-ray machine (Planmeca Oy, Helsinki, Finland). All composite, titanium and zirconia simulation models of implants were exposed with a SCANORA® 3D dental X-ray machine (Soredex, Tuusula, Finland). Images and grey values were analysed with ImageJ software (National Institutes of Health, Bethesda, MD). To demonstrate possible artefacts between all the simulation models of implants, the images were also visually compared with each other using ImageJ software. Results: Artefacts were clearly present in CBCT images caused by titanium and zirconia and when the composite material consisted at least 20% BaAlSiO2. The intensity of artefacts increased when the radio-opacity of the composite material increased. Conclusions: Materials containing less radio-opacity produce less pronounced artefacts. The cut-off point for artefacts is at 20% radio-opaque filling material in composite material. PMID:25283364

  12. Phonon anharmonicity of monoclinic zirconia and yttrium-stabilized zirconia

    SciT

    Li, Chen W.; Smith, Hillary L.; Lan, Tian

    2015-04-13

    Inelastic neutron scattering measurements on monoclinic zirconia (ZrO 2) and 8 mol% yttrium-stabilized zirconia were performed at temperatures from 300 to 1373 ωK. We reported temperature-dependent phonon densities of states (DOS) and Raman spectra obtained at elevated temperatures. First-principles lattice dynamics calculations with density functional theory gave total and partial phonon DOS curves and mode Grüneisen parameters. These mode Grüneisen parameters were used to predict the experimental temperature dependence of the phonon DOS with partial success. However, substantial anharmonicity was found at elevated temperatures, especially for phonon modes dominated by the motions of oxygen atoms. Yttrium-stabilized zirconia (YSZ) was somewhatmore » more anharmonic and had a broader phonon spectrum at low temperatures, owing in part to defects in its structure. YSZ also has a larger vibrational entropy than monoclinic zirconia.« less

  13. Comparing Binaural Pre-processing Strategies II: Speech Intelligibility of Bilateral Cochlear Implant Users.

    PubMed

    Baumgärtel, Regina M; Hu, Hongmei; Krawczyk-Becker, Martin; Marquardt, Daniel; Herzke, Tobias; Coleman, Graham; Adiloğlu, Kamil; Bomke, Katrin; Plotz, Karsten; Gerkmann, Timo; Doclo, Simon; Kollmeier, Birger; Hohmann, Volker; Dietz, Mathias

    2015-12-30

    Several binaural audio signal enhancement algorithms were evaluated with respect to their potential to improve speech intelligibility in noise for users of bilateral cochlear implants (CIs). 50% speech reception thresholds (SRT50) were assessed using an adaptive procedure in three distinct, realistic noise scenarios. All scenarios were highly nonstationary, complex, and included a significant amount of reverberation. Other aspects, such as the perfectly frontal target position, were idealized laboratory settings, allowing the algorithms to perform better than in corresponding real-world conditions. Eight bilaterally implanted CI users, wearing devices from three manufacturers, participated in the study. In all noise conditions, a substantial improvement in SRT50 compared to the unprocessed signal was observed for most of the algorithms tested, with the largest improvements generally provided by binaural minimum variance distortionless response (MVDR) beamforming algorithms. The largest overall improvement in speech intelligibility was achieved by an adaptive binaural MVDR in a spatially separated, single competing talker noise scenario. A no-pre-processing condition and adaptive differential microphones without a binaural link served as the two baseline conditions. SRT50 improvements provided by the binaural MVDR beamformers surpassed the performance of the adaptive differential microphones in most cases. Speech intelligibility improvements predicted by instrumental measures were shown to account for some but not all aspects of the perceptually obtained SRT50 improvements measured in bilaterally implanted CI users. © The Author(s) 2015.

  14. Thermal Changes During Guided Flapless Implant Site Preparation: A Comparative Study.

    PubMed

    Sannino, Gianpaolo; Gherlone, Enrico F

    To compare intrabony thermal changes induced by two different protocols for guided implant surgery during the whole drilling procedure. Two protocols for guided implant placement were evaluated in vitro using artificial bone cylinders. The control protocol provided traditional metal sleeves and a standard drilling sequence composed of four cylindrical triflute drills (cutting surface length = 16 mm). The test protocol provided a three-slot polyurethane sleeve and two cylindrical drills (second drill cutting surface length = 4 mm). Forty automated intermittent and graduated osteotomies (depth = 14 mm) were performed under external irrigation. Temperatures were measured in real time by three sensors at different depths (2, 8, and 13 mm). The temperature changes generated by the final drill of each protocol during the shearing and withdrawing processes were recorded as experimental results and subjected to the Student t test. Maximum temperature increases were recorded during the process of withdrawing in both protocols. In the control group, the mean thermal changes were 10.18°C, 8.61°C, and 5.78°C at depths of 2, 8, and 13 mm, respectively. In the test group, the mean thermal changes were 1.44°C, 4.46°C, and 3.58°C at depths of 2, 8, and 13 mm, respectively. The control group revealed statistically significantly (P < .0001) higher thermal changes than the test group, both in the superficial and deeper bone areas. An appropriate irrigation system could be crucial for thermal lowering during a guided implant osteotomy mainly in the coronal and middle third of the implant site. Copious irrigation should be provided during the withdrawing process since greater thermal increases could be expected. Lower temperature increases could be achieved, reducing drill-to-bone contact, ie, cutting surface length, due to short frictional force exposure.

  15. A preliminary randomized clinical trial comparing diode laser and scalpel periosteal incision during implant surgery: impact on postoperative morbidity and implant survival.

    PubMed

    Shahnaz, Aysan; Jamali, Raika; Mohammadi, Farnush; Khorsand, Afshin; Moslemi, Neda; Fekrazad, Reza

    2018-01-01

    The aim of this preliminary randomized clinical trial was to compare: (1) post-operative morbidity after application of laser or scalpel incision for flap advancement during implant surgery and bone grafting and (2) implant survival rate following flap advancement with laser or scalpel incision after 6 months of loading. Eighteen patients who were scheduled for dental implant placement and simultaneous bone grafting were randomly assigned to test or control groups. Diode laser (810 nm, 2 W, pulse interval 200 μs; pulse length 100 μs, 400-μm initiated fiber tip), or scalpel (control) was used to sever the periosteum to create a tension-free flap. Visual analogue scale (VAS) pain score, rate of nonsteroid anti-inflammatory drug (NSAID) consumption, intensity of swelling, and ecchymosis were measured for the six postsurgical days. Six months after loading, implant survival was assessed. VAS pain score (during the first four postoperative days), rate of NSAID consumption (during the first three postoperative days), and intensity of swelling (during the first five postoperative days) were significantly lower in the test group compared to the control group (All P values < 0.05). One patient in the control group experienced ecchymosis. All implants were successful in function. Application of laser for performing periosteal releasing incision reduced the incidence and severity of postoperative morbidity of the patients undergone implant surgery in conjunction with bone augmentation procedure. We did not find any detrimental effect of laser incision on the implant survival within 6 months of loading.

  16. Adhesion/cementation to zirconia and other non-silicate ceramics: Where are we now?

    PubMed Central

    Thompson, Jeffrey Y; Stoner, Brian R.; Piascik, Jeffrey R.; Smith, Robert

    2010-01-01

    Non-silicate ceramics, especially zirconia, have become a topic of great interest in the field of prosthetic and implant dentistry. A clinical problem with use of zirconia-based components is the difficulty in achieving suitable adhesion with intended synthetic substrates or natural tissues. Traditional adhesive techniques used with silica-based ceramics do not work effectively with zirconia. Currently, several technologies are being utilized clinically to address this problem, and other approaches are under investigation. Most focus on surface modification of the inert surfaces of high strength ceramics. The ability to chemically functionalize the surface of zirconia appears to be critical in achieving adhesive bonding. This review will focus on currently available approaches as well as new advanced technologies to address this problem. PMID:21094526

  17. Patient-centered outcomes comparing digital and conventional implant impression procedures: a randomized crossover trial.

    PubMed

    Joda, Tim; Brägger, Urs

    2016-12-01

    The aim of this randomized controlled trial was to compare patient-centered outcomes during digital and conventional implant impressions. In a crossover study design, intraoral scanning (IOS) [test] as well as classical polyether impressions [control] were both performed on 20 patients for single-tooth replacement with implant-supported crowns. The sequential distribution of either starting with the test or the control procedure was randomly selected. Patients' perception and satisfaction on the level of convenience-related factors were assessed with visual analogue scale (VAS) questionnaires. In addition, clinical work time was separately recorded for test and control procedures. Statistical analyses were performed with Wilcoxon signed-rank tests and corrected for multiple testing by the method of Holm. On VAS ranging from 0 to 100, patients scored a mean convenience level of 78.6 (SD ± 14.0) in favor of IOS compared to conventional impressions with 53.6 (SD ± 15.4) [P = 0.0001]. All included patients would prefer the digital workflow if in the future they could choose between the two techniques. Secondary, IOS was significantly faster with 14.8 min (SD ± 2.2) compared to the conventional approach with 17.9 min (SD ± 1.1) [P = 0.0001]. Based on the findings of this investigation, both impression protocols worked successfully for all study participants capturing the 3D implant positions. However, the digital technique emerges as the most preferred one according to patient-centered outcomes and was more time-effective compared to conventional impressions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. [Comparative evaluation of two kinds of micro-implant system with different size].

    PubMed

    Wang, Zhen-Dong; Li, Qing-Yi; Wang, Lin; Gu, Yong-Jia

    2009-04-01

    To offer some reference for micro-implant's development and population by analyzing clinical application of two kinds of micro-implant systems. 38 patients treated with MIA (micro-implant anchorage) and 28 patients treated with SDIA (self-driven titanium implant for orthodontic anchorage) were included. Analyzing the rate of lost implants, the gum's reactivity and the efficiency of moving teeth summarized the excellences and shortcomings of two systems. 1) Six of MIA implants fell off after being inserted. Seven of SDIA implants lost when they had been implanted for a month. But they were stable after being inserted again. 2) The gum around 12 SDIA implants got inflammation symptom, but the gum around MIA implants was normal. 3) Both MIA implants and SDIA implants could move teeth effectively and persistently when they were stable. When we apply micro-implant in clinic, we should prevent it from closing roots of teeth and choose the small tip micro-implant. The embedded position should be in area of attachment gum. At the same time, the areas around the tip of micro-implant should be keeping clean.

  19. New bone formation and trabecular bone microarchitecture of highly porous tantalum compared to titanium implant threads: A pilot canine study.

    PubMed

    Lee, Jin Whan; Wen, Hai Bo; Gubbi, Prabhu; Romanos, Georgios E

    2018-02-01

    This study evaluated new bone formation activities and trabecular bone microarchitecture within the highly porous region of Trabecular Metal™ Dental Implants (TM) and between the threads of Tapered Screw-Vent® Dental Implants (TSV) in fresh canine extraction sockets. Eight partially edentulated dogs received four implants (4.1 mmD × 13 mmL) bilaterally in mandibular fresh extraction sockets (32 TM, 32 TSV implants), and allowed to heal for 2, 4, 8, and 12 weeks. Calcein was administered to label mineralizing bone at 11 and 4 days before euthanasia for dogs undergoing all four healing periods. Biopsies taken at each time interval were examined histologically. Histomorphometric assay was conducted for 64 unstained and 64 stained slides at the region of interest (ROI) (6 mm long × 0.35 mm deep) in the midsections of the implants. Topographical and chemical analyses were also performed. Histomorphometry revealed significantly more new bone in the TM than in the TSV implants at each healing time (p = .0014, .0084, .0218, and .0251). Calcein-labeled data showed more newly mineralized bone in the TM group than in the TSV group at 2, 8, and 12 weeks (p = .045, .028, .002, respectively) but not at 4 weeks (p = .081). Histologically TM implants exhibited more bone growth and dominant new immature woven bone at an earlier time point than TSV implants. The parameters representing trabecular bone microarchitecture corroborated faster new bone formation in the TM implants when compared to the TSV implants. TM exhibited an irregular faceted topography compared to a relatively uniform microtextured surface for TSV. Chemical analysis showed peaks associated with each implant's composition material, and TSV also showed peaks reflecting the elements of the calcium phosphate blasting media. Results suggest that the healing pathway associated with the highly porous midsection of TM dental implant could enable faster and stronger secondary implant stability than

  20. Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.

    PubMed

    Jalbert, Jessica J; Ritchey, Mary Elizabeth; Mi, Xiaojuan; Chen, Chih-Ying; Hammill, Bradley G; Curtis, Lesley H; Setoguchi, Soko

    2014-11-01

    Medical devices play a vital role in diagnosing, treating, and preventing diseases and are an integral part of the health-care system. Many devices, including implantable medical devices, enter the market through a regulatory pathway that was not designed to assure safety and effectiveness. Several recent studies and high-profile device recalls have demonstrated the need for well-designed, valid postmarketing studies of medical devices. Medical device epidemiology is a relatively new field compared with pharmacoepidemiology, which for decades has been developed to assess the safety and effectiveness of medications. Many methodological considerations in pharmacoepidemiology apply to medical device epidemiology. Fundamental differences in mechanisms of action and use and in how exposure data are captured mean that comparative effectiveness studies of medical devices often necessitate additional and different considerations. In this paper, we discuss some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. We discuss special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Translucency of Zirconia Ceramics before and after Artificial Aging.

    PubMed

    Walczak, Katarzyna; Meißner, Heike; Range, Ursula; Sakkas, Andreas; Boening, Klaus; Wieckiewicz, Mieszko; Konstantinidis, Ioannis

    2018-03-11

    The aging of zirconia ceramics (Y-TZP) is associated with tetragonal to monoclinic phase transformation. This change in microstructure may affect the optical properties of the ceramic. This study examines the effect of aging on the translucency of different zirconia materials. 120 disc-shaped specimens were fabricated from four zirconia materials: Cercon ht white, BruxZir Solid Zirconia, Zenostar T0, Lava Plus (n = 30 per group). Accelerated aging was performed in a steam autoclave (134°C, 0.2 MPa, 5 hours). CIELab coordinates (L*, a*, b*) and luminous reflectance (Y) were measured with a spectrophotometer before and after aging. Contrast ratio (CR) and translucency parameter (TP) were calculated from the L*, a*, b*, and Y tristimulus values. The general linear model (Bonferroni adjusted) was used to compare both parameters before and after aging, as well as between the different zirconia materials (p ≤ 0.05). CR and TP differed significantly before and after aging in all groups tested. Before aging, Zenostar T showed the highest and Lava Plus showed the lowest translucency. After aging, Cercon ht and Zenostar T showed the highest and BruxZir and Lava Plus the lowest translucency. Aging reduced the translucency in all specimens tested. Furthermore, translucency differed between the zirconia brands tested. Nevertheless, the differences were below the detectability threshold of the human eye. The aging process can influence the translucency and thus the esthetic outcome of zirconia restorations; however, the changes in translucency were minimal and probably undetectable by the human eye. © 2018 by the American College of Prosthodontists.

  2. Shear bond strength of veneering porcelain to zirconia: Effect of surface treatment by CNC-milling and composite layer deposition on zirconia.

    PubMed

    Santos, R L P; Silva, F S; Nascimento, R M; Souza, J C M; Motta, F V; Carvalho, O; Henriques, B

    2016-07-01

    The purpose of this study was to evaluate the shear bond strength of veneering feldspathic porcelain to zirconia substrates modified by CNC-milling process or by coating zirconia with a composite interlayer. Four types of zirconia-porcelain interface configurations were tested: RZ - porcelain bonded to rough zirconia substrate (n=16); PZ - porcelain bonded to zirconia substrate with surface holes (n=16); RZI - application of a composite interlayer between the veneering porcelain and the rough zirconia substrate (n=16); PZI - application of a composite interlayer between the porcelain and the zirconia substrate treated by CNC-milling (n=16). The composite interlayer was composed of zirconia particles reinforced porcelain (30%, vol%). The mechanical properties of the ceramic composite have been determined. The shear bond strength test was performed at 0.5mm/min using a universal testing machine. The interfaces of fractured and untested specimens were examined by FEG-SEM/EDS. Data was analyzed with Shapiro-Wilk test to test the assumption of normality. The one-way ANOVA followed by Tukey HSD multiple comparison test was used to compare shear bond strength results (α=0.05). The shear bond strength of PZ (100±15MPa) and RZI (96±11MPa) specimens were higher than that recorded for RZ (control group) specimens (89±15MPa), although not significantly (p>0.05). The highest shear bond strength values were recorded for PZI specimens (138±19MPa), yielding a significant improvement of 55% relative to RZ specimens (p<0.05). This study shows that it is possible to highly enhance the zirconia-porcelain bond strength - even by ~55% - by combining surface holes in zirconia frameworks and the application of a proper ceramic composite interlayer. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Psychophysical Map Stability in Bilateral Sequential Cochlear Implantation: Comparing Current Audiology Methods to a New Statistical Definition.

    PubMed

    Domville-Lewis, Chloe; Santa Maria, Peter L; Upson, Gemma; Chester-Browne, Ronel; Atlas, Marcus D

    2015-01-01

    The purpose of this study was to establish a statistical definition for stability in cochlear implant maps. Once defined, this study aimed to compare the duration taken to achieve a stable map in first and second implants in patients who underwent sequential bilateral cochlear implantation. This article also sought to evaluate a number of factors that potentially affect map stability. A retrospective cohort study of 33 patients with sensorineural hearing loss who received sequential bilateral cochlear implantation (Cochlear, Sydney, Australia), performed by the senior author. Psychophysical parameters of hearing threshold scores, comfort scores, and the dynamic range were measured for the apical, medial, and basal portions of the cochlear implant electrode at a range of intervals postimplantation. Stability was defined statistically as a less than 10% difference in threshold, comfort, and dynamic range scores over three consecutive mapping sessions. A senior cochlear implant audiologist, blinded to implant order and the statistical results, separately analyzed these psychophysical map parameters using current assessment methods. First and second implants were compared for duration to achieve stability, age, gender, the duration of deafness, etiology of deafness, time between the insertion of the first and second implant, and the presence or absence of preoperative hearing aids were evaluated and its relationship to stability. Statistical analysis included performing a two-tailed Student's t tests and least squares regression analysis, with a statistical significance set at p ≤ 0.05. There was a significant positive correlation between the devised statistical definition and the current audiology methods for assessing stability, with a Pearson correlation coefficient r = 0.36 and a least squares regression slope (b) of 0.41, df(58), 95% confidence interval 0.07 to 0.55 (p = 0.004). The average duration from device switch on to stability in the first implant was 87

  4. Comparative experimental re-evaluation of the two implanting methods of silicone gel testicular prostheses in beagle dogs

    PubMed Central

    2011-01-01

    Background Testicular prosthesis has been applied clinically for decades, and implantation of testis prosthesis under the tunica albuginea has been considered to be the standard method in the most of the reports. However, postoperative scrotal appearance, the mobilization and the palpitation of the prosthesis are not always satisfactory to all the patients. Modifications in surgical techniques might be necessary to bring improvements to the clinical outcomes in testicular prosthesis implantation. Findings In a group of 9 beagle dogs in this study, an orchiectomy succeeded with a testicular prosthesis implantation under the tunica vaginalis, and a complete mechanical denudation of the testicular parenchyma succeeded with an implantation under the tunica albuginea were performed, respectively. Histopathological evaluations of the scrotal tissues and the implants, which were made at the end of the follow-up, showed that all the tested animals lived uneventful lives during the follow-up period, and no rejections or infections were found. Prostheses implanted under the tunica vaginalis showed a more satisfying mobilization and palpation than those implanted under the tunica albuginea. Chronic inflammation in the para-prosthesis tissues with vascular proliferation and fibrinogenesis were more common in the "under tunica albuginea" group than that in the "under tunica vaginalis" group, although differences in fibrinogenesis between the two groups were found to be statistically insignificant. Conclusions In this comparative study, we have re-evaluated the two most popular implantation methods of testicular prosthesis, the "under the tunica albuginea" and the "under the tunica vaginalis" pathways, in animal models. We found that the testicular prosthesis were all well tolerated, but the prosthesis implanted under the tunica vaginalis showed a more satisfying result concerning appearance, palpability, and histopathological findings than that of the "under the tunica

  5. Resin adhesion strengths to zirconia ceramics after primer treatment with silane coupling monomer or oligomer.

    PubMed

    Okada, Masahiro; Inoue, Kazusa; Irie, Masao; Taketa, Hiroaki; Torii, Yasuhiro; Matsumoto, Takuya

    2017-09-26

    Resin bonding to zirconia ceramics is difficult to achieve using the standard methods for conventional silica-based dental ceramics, which employ silane coupling monomers as primers. The hypothesis in this study was that a silane coupling oligomer -a condensed product of silane coupling monomers- would be a more suitable primer for zirconia. To prove this hypothesis, the shear bond strengths between a composite resin and zirconia were compared after applying either a silane coupling monomer or oligomer. The shear bond strength increased after applying a non-activated ethanol solution of the silane coupling oligomer compared with that achieved when applying the monomer. Thermal treatment of the zirconia at 110°C after application of the silane coupling agents was essential to improve the shear bond strength between the composite resin cement and zirconia.

  6. Proximal humerus fractures: a comparative biomechanical analysis of intra and extramedullary implants.

    PubMed

    Füchtmeier, B; May, R; Hente, R; Maghsudi, M; Völk, M; Hammer, J; Nerlich, M; Prantl, L

    2007-08-01

    The biomechanical stability of a newly developed humerus nail (Sirustrade mark) for the treatment of fractures of the proximal humerus was analyzed in comparison to established systems. In total, three randomized groups were formed (n = 4 pairs) from 12 matched pairs of human cadaver humeri. All intact bones were mechanically characterized by five subsequent load cycles under bending and torsional loading. The bending moment at the osteotomy was 7.5 N m the torsional moment was 8.3 N m over the hole specimen length. Loading was consistently initiated at the distal epiphysis and the deformation at the distal epiphysis was continuously recorded. Prior to implant reinforcement, a defect of 5 mm was created to simulate an unstable subcapital humerus fracture. For paired comparison, one humerus of each pair was stabilized with the Sirus proximal humerus nail while the counterpart was stabilized by a reference implant. In detail, the following groups were created: Sirus versus Proximal humerus nail (PHN) with spiral blade (group I); Sirus versus PHILOS plate (group II); Sirus versus 4.5 mm AO T-plate (group III). The Sirus nail demonstrated significantly higher stiffness values compared to the reference implants for both bending and torsional loading. The following distal epiphyseal displacements were recorded for a bending moment of 7.5 N m at the osteotomy: Sirus I: 8.8 mm, II: 8.4 mm, III: 7.7 mm (range 6.9-10.9), PHN 21.1 mm (range 15.7-25.2) (P = 0.005), PHILOS plate 27.5 mm (range 21.6-35.8) (P < 0.001), 4.5 AO T-plate 26.3 mm (range 24.3-33.9) (P = 0.01). The rotations corresponding to 8.3 N m torsional moment were: Sirus I: 9.1 degrees , II: 9.3 degrees , III: 10.6 degrees (range 7.5-12.2), PHN 13.5 degrees (range 10.3-15.6) (P = 0.158), PHILOS plate 15.6 degrees (range 13.7-20.8) (P = 0.007), 4.5 AO T-Platte 14.1 degrees (range 11.5-19.7) (P = 0.158). The intramedullary load carriers were biomechanically superior when compared to the plating systems in the

  7. Assessment of Myeloperoxidase and Nitric Levels around Dental Implants and Natural Teeth as a Marker of Inflammation: A Comparative Study.

    PubMed

    Kulkarni, Gayithri H; Jadhav, Prashant; Kulkarni, Kiran; Shinde, Sachin V; Patil, Yojana B; Kumar, Manish

    2016-11-01

    Dental implants form the mainstay of dental treatment involving rehabilitation of missing teeth. One of the major concerns for the clinicians doing dental implants is the postsurgical failure of dental implants. Success of dental implants is dependent upon the skills of the surgeon and the amount and quality of the bone remaining at the edentulous area where dental implant has to be placed. Myeloperoxidase (MPO) and nitrites are few of the enzymes and molecules which are said to be altered in inflammation. However, their exact role in the inflammatory processes around natural tooth and dental implant is still unclear. Hence we comparatively evaluated the levels of MPO and nitrites in the areas around the dental implants and natural teeth. The present study comprises 42 patients who underwent prosthetic rehabilitation by dental implants from 2011 to 2014. Depth of probing value (DP), score of plaque index (SPI), gingival index (GI), and index of gingival bleeding time (GBT) were evaluated for the assessment of the periimplant soft tissue changes. Assessment of inflammation around the dental implant surface and around natural tooth was done based on the readings of these parameters. For the measurement of the MPO levels, spectrophotometric MPO assay was used. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. The mean plaque index values were 1.56 and 0.97 in periodontitis cases of natural teeth and inflamed cases of dental implants respectively. While comparing mean plaque index, mean probing depth, and mean gingival bleeding index in between the two groups, significant difference was obtained. Mean MPO concentration in periodontitis and gingivitis cases in natural teeth were 0.683 and 0.875 U/μL, while in inflamed dental implant cases, the mean value was 0.622 U/μL. While comparing the total MPO levels, total nitrite levels, and total nitrite concentration in between two study groups, significant difference was obtained

  8. Continuous corticosterone delivery via the drinking water or pellet implantation: A comparative study in mice.

    PubMed

    Gasparini, Sylvia J; Weber, Marie-Christin; Henneicke, Holger; Kim, Sarah; Zhou, Hong; Seibel, Markus J

    2016-12-01

    In order to investigate the effects of glucocorticoid excess in rodent models, reliable methods of continuous glucocorticoid delivery are essential. The current study compares two methods of corticosterone (CS) delivery in regards to their ability to induce typical adverse outcomes such as fat accrual, insulin resistance, sarcopenia and bone loss. Eight-week-old mice received CS for 4weeks either via the drinking water (25-100μgCS/mL) or through weekly surgical implantation of slow release pellets containing 1.5mg CS. Both methods induced abnormal fat mass accrual, inhibited lean mass accretion and bone expansion, suppressed serum osteocalcin levels and induced severe insulin resistance. There was a clear dose dependant relationship between the CS concentrations in the drinking water and the severity of the phenotype, with a concentration of 50μg CS/mL drinking water most closely matching the metabolic changes induced by weekly pellet implantations. In contrast to pellets, however, delivery of CS via the drinking water resulted in a consistent diurnal exposure pattern, closely mimicking the kinetics of clinical glucocorticoid therapy. In addition, the method is safe, inexpensive, easily adjustable, non-invasive and avoids operative stress to the animals. Our data demonstrate that delivery of CS via the drinking water has advantages over weekly implantations of slow-release pellets. A dose of 50μg CS/mL drinking water is appropriate for the investigation of chronic glucocorticoid excess in mice. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  9. Removal torque of zirconia abutment screws under dry and wet conditions.

    PubMed

    Nigro, Frederico; Sendyk, Claudio L; Francischone, Carlos Eduardo; Francischone, Carlos Eduardo

    2010-01-01

    The aim of this study was to verify whether screw abutment lubrication can generate higher preload values compared to non-lubricated screws, a titanium abutment was screwed onto an implant analog and scanned with the Procera System to generate 20 zirconia abutments. MKIII Brånemark implants were clamped to a precision torque device, and the abutments were distributed in dry and wet groups with 10 specimens each. In the wet groups, the inner threads of the implants were filled with artificial saliva. All abutments were fastened with a Torqtite screw under 32 Ncm. Ten detorque measurements were performed per group pushing the reverse button of the Torque controller soon after screw tightening with values registered. The mean detorque values were calculated and compared by a Student's t test (α=0.05). The wet condition presented significantly higher mean detorque than the dry condition (31.5 ± 1.2 versus 27.5 ± 1.5 Ncm, respectively; p=0.0000024). In conclusion, there was always a loss in the initial torque values when the removal torque was measured under both conditions. The wet condition presented higher mean torque than the dry condition. Better preload values were established in the wet group, suggesting that the abutment screw must be lubricated in saliva to avoid further loosening.

  10. A comparative study of the accuracy between plastic and metal impression transfer copings for implant restorations.

    PubMed

    Fernandez, Monica A; Paez de Mendoza, Carmen Y; Platt, Jeffrey A; Levon, John A; Hovijitra, Suteera T; Nimmo, Arthur

    2013-07-01

    A precise transfer of the position and orientation of the antirotational mechanism of an implant to the working cast is particularly important to achieve optimal fit of the final restoration. This study evaluated and compared the accuracy of metal and plastic impression copings for use in a full-arch mandibular edentulous simulation with four implants. Metal and plastic impression transfer copings for two implant systems, Nobel Biocare™ Replace and Straumann SynOcta®, were assessed on a laboratory model to simulate clinical practice. The accuracy of producing stone casts using these plastic and metal impression transfer copings was measured against a standard prosthetic framework consisting of a cast gold bar. A total of 20 casts from the four combinations were obtained. The fit of the framework on the cast was tested by a noncontact surface profilometer, the Proscan 3D 2000 A, using the one-screw test. The effects of implant/system and impression/coping material on gap measurements were analyzed using repeated measures ANOVA. The findings of this in vitro study were as follows: plastic copings demonstrated significantly larger average gaps than metal for Straumann (p = 0.001). Plastic and metal copings were not significantly different for Nobel (p = 0.302). Nobel had significantly larger average gaps than Straumann for metal copings (p = 0.003). Nobel had marginally smaller average gaps than Straumann (p = 0.096) for plastic copings. The system-by-screw location interaction was significant as well (p < 0.001), indicating significant differences among the four screw locations, but the location differences were not the same for the two systems. A rank transformation of the data was necessary due to the nonnormal distribution of the gap measurements. No adjustments were made for multiple comparisons. The metal impression copings were more accurate than plastic copings when using the Straumann system, and there was no difference between metal and plastic copings

  11. A comparative biomechanical analysis of implants for the stabilization of proximal humerus fractures.

    PubMed

    Füchtmeier, B; May, R; Fierlbeck, J; Hammer, J; Nerlich, M

    2006-01-01

    A new humerus nail (Sirus) has become available for the treatment of fractures of the proximal humerus. The aim of the study was the biomechanical comparison of this implant with established systems. 12 matched pairs of human humeri were employed for testing. Three randomized groups were formed (n = 4 pairs). A bending moment of 7.5 Nm and a torsional moment of 8.3 Nm were applied in a test of five loading cycles to all intact bones. Loading was consistently initiated at the distal epiphysis. The consequent deformation at the distal epiphysis was continuously recorded. Then an osteotomy with a defect of 5 mm was created to simulate an unstable subcapital humerus fracture. For paired comparison, one of each pair was stabilized with the Sirus proximal humerus nail. The other side was fixed with a reference implant. The following groups were created.: Group I: Sirus versus Proximal humerus nail (PHN) with spiral blade. Group II: Sirus versus PHILOS plate. Group III: Sirus versus 4.5 mm AO T-plate. The proximal humerus nail (Sirus) demonstrated significantly higher stiffness values than the reference implants for both bending and torsional load. The following values were recorded at a bending moment of 7.5 Nm: Sirus 14.2 mm, PHN 20.7 mm, PHILOS plate 28.1 mm, 4.5 AO T-plate 29.3 mm p < 0.0012). The values at 8.3 Nm torsional moment were: Sirus 8.5 degrees , PHN 12.3 degrees , PHILOS plate 16.4 degrees , 4.5 AO T-Platte 15.6 degrees (p < 0.002). The intramedullary load carriers were biomechanically superior when compared to the plating systems in the fracture model presented here. Supplementary, the Sirus Nail showed higher stiffness values than the PHN. However, the latter are gaining in importance due to the possibility of minimal invasive implantation. Whether this will be associated with functional advantages requires further clinical investigation.

  12. Combined Glaucoma Tube Shunt (Ahmed) and Fluocinolone Acetonide (Retisert™) Implantation Compared to Ahmed Alone in Uveitic Glaucoma.

    PubMed

    Zivney, Mark; Lin, Phoebe; Edmunds, Beth; Parikh, Mansi; Takusagawa, Hana; Tehrani, Shandiz

    2016-12-01

    Glaucoma is a known complication of uveitis, and may require glaucoma tube shunt implantation for intraocular pressure (IOP) control. The success of glaucoma tube shunt implantation in the setting of a local ocular steroid depot in uveitic glaucoma remains unknown. The purpose of this study was to determine whether patients who underwent combined glaucoma tube shunt (Ahmed) and fluocinolone acetonide (Retisert™, Bausch + Lomb, Bridgewater, NJ, USA) implantation have superior outcomes compared to patients with Ahmed implants only in the setting of uveitic glaucoma. All participants were studied retrospectively and underwent Ahmed implantation alone or with existing/concurrent Retisert implantation (combined group) at a single academic institution. The main outcome measures were IOP, visual acuity (VA), number of IOP-lowering medications, and adverse events at 6 months after Ahmed implantation. Secondary outcome measures included adverse events and surgical success at 6 months after Ahmed implantation. Mean IOP at 6 months after Ahmed implantation was 15.3 ± 4.8 and 15.1 ± 4.9 mm Hg in the Ahmed only group (n = 17) and the combined group (n = 17), respectively (p = 0.89). The mean number of IOP-lowering medications at 6 months after Ahmed implantation was 1.7 ± 1.0 and 1.8 ± 1.0 in the Ahmed only group and the combined group, respectively (p = 0.86). Mean VA at 6 months after Ahmed implantation was 0.35 ± 0.29 and 0.42 ± 0.33 log mean angle of resolution in the Ahmed only group and the combined group, respectively (p = 0.50). No significant differences in surgical success or adverse events were noted between the two groups. At 6 months, no significant differences in mean IOP, mean number of IOP-lowering medications, VA, surgical success, or adverse events were noted between Ahmed implantation alone or combined Ahmed and Retisert implantation in patients with uveitic glaucoma.

  13. Multinuclear NMR study of silica fiberglass modified with zirconia.

    PubMed

    Lapina, O B; Khabibulin, D F; Terskikh, V V

    2011-01-01

    Silica fiberglass textiles are emerging as uniquely suited supports in catalysis, which offer unprecedented flexibility in designing advanced catalytic systems for chemical and auto industries. During manufacturing fiberglass materials are often modified with additives of various nature to improve glass properties. Glass network formers, such as zirconia and alumina, are known to provide the glass fibers with higher strength and to slow down undesirable devitrification processes. In this work multinuclear (1)H, (23)Na, (29)Si, and (91)Zr NMR spectroscopy was used to characterize the effect of zirconia on the molecular-level fiberglass structure. (29)Si NMR results help in understanding why zirconia-modified fiberglass is more stable towards devitrification comparing with pure silica glass. Internal void spaces formed in zirconia-silica glass fibers after acidic leaching correlate with sodium and water distributions in the starting bulk glass as probed by (23)Na and (1)H NMR. These voids spaces are important for stabilization of catalytically active species in the supported catalysts. Potentials of high-field (91)Zr NMR spectroscopy to study zirconia-containing glasses and similarly disordered systems are illustrated. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Shear bond strength of indirect composite material to monolithic zirconia.

    PubMed

    Sari, Fatih; Secilmis, Asli; Simsek, Irfan; Ozsevik, Semih

    2016-08-01

    This study aimed to evaluate the effect of surface treatments on bond strength of indirect composite material (Tescera Indirect Composite System) to monolithic zirconia (inCoris TZI). Partially stabilized monolithic zirconia blocks were cut into with 2.0 mm thickness. Sintered zirconia specimens were divided into different surface treatment groups: no treatment (control), sandblasting, glaze layer & hydrofluoric acid application, and sandblasting + glaze layer & hydrofluoric acid application. The indirect composite material was applied to the surface of the monolithic zirconia specimens. Shear bond strength value of each specimen was evaluated after thermocycling. The fractured surface of each specimen was examined with a stereomicroscope and a scanning electron microscope to assess the failure types. The data were analyzed using one-way analysis of variance (ANOVA) and Tukey LSD tests (α=.05). Bond strength was significantly lower in untreated specimens than in sandblasted specimens (P<.05). No difference between the glaze layer and hydrofluoric acid application treated groups were observed. However, bond strength for these groups were significantly higher as compared with the other two groups (P<.05). Combined use of glaze layer & hydrofluoric acid application and silanization are reliable for strong and durable bonding between indirect composite material and monolithic zirconia.

  15. Shear bond strength of indirect composite material to monolithic zirconia

    PubMed Central

    2016-01-01

    PURPOSE This study aimed to evaluate the effect of surface treatments on bond strength of indirect composite material (Tescera Indirect Composite System) to monolithic zirconia (inCoris TZI). MATERIALS AND METHODS Partially stabilized monolithic zirconia blocks were cut into with 2.0 mm thickness. Sintered zirconia specimens were divided into different surface treatment groups: no treatment (control), sandblasting, glaze layer & hydrofluoric acid application, and sandblasting + glaze layer & hydrofluoric acid application. The indirect composite material was applied to the surface of the monolithic zirconia specimens. Shear bond strength value of each specimen was evaluated after thermocycling. The fractured surface of each specimen was examined with a stereomicroscope and a scanning electron microscope to assess the failure types. The data were analyzed using one-way analysis of variance (ANOVA) and Tukey LSD tests (α=.05). RESULTS Bond strength was significantly lower in untreated specimens than in sandblasted specimens (P<.05). No difference between the glaze layer and hydrofluoric acid application treated groups were observed. However, bond strength for these groups were significantly higher as compared with the other two groups (P<.05). CONCLUSION Combined use of glaze layer & hydrofluoric acid application and silanization are reliable for strong and durable bonding between indirect composite material and monolithic zirconia. PMID:27555895

  16. Influence of implant location on the clinical outcomes of implant abutments: a systematic review and meta-analysis

    PubMed Central

    ElHoussiney, Amr G; Zhang, He; Song, Jinlin; Ji, Ping; Wang, Lu; Yang, Sheng

    2018-01-01

    Purpose To compare the failure events and incidence of complications of different abutment materials in anterior and posterior regions. Failure was defined as complete loss of the abutment requiring replacement by a new abutment. Materials and methods Electronic searches using PubMed/Medline and Google Scholar complemented with manual searches were performed with specific search terms. Searches were restricted to publications in English between January 2006 and March 2016. Results A total of 863 and 1,264 implants were inserted in the anterior and posterior regions, respectively, in a total of 1,529 patients. No titanium abutments failed in anterior or posterior regions. On the other hand, 1.6% of zirconia abutments failed in the anterior region and 1.5% failed in the posterior region. Technical complications occurred mostly in the posterior region and mostly involved zirconia abutment. Meta-analysis was possible only for zirconia-abutment failure, due to considerable heterogeneity of studies and outcome variables. No significant difference in failure rate was found between anterior and posterior zirconia abutments (risk ratio 1.53, 95% CI 0.49–4.77; P=0.47). Conclusion This systematic review and meta-analysis showed similar outcomes of different abutment materials when used in anterior and posterior regions in terms of failure events and biological and aesthetic complications. The only significant finding was the increased incidence of technical complications in the posterior region, mostly involving zirconia abutments. Abutment-screw loosening was the most common technical complication. PMID:29520162

  17. Clinical Performance of One-Piece, Screw-Retained Implant Crowns Based on Hand-Veneered CAD/CAM Zirconia Abutments After a Mean Follow-up Period of 2.3 Years.

    PubMed

    Schnider, Nicole; Forrer, Fiona Alena; Brägger, Urs; Hicklin, Stefan Paul

    The aim of this study was to evaluate the clinical performance of one-piece, screw-retained implant crowns based on hand-veneered computer-aided design/computer-aided manufacture (CAD/CAM) zirconium dioxide abutments with a crossfit connection at least 1 year after insertion of the crown. Consecutive patients who had received at least one Straumann bone level implant and one-piece, screw-retained implant crowns fabricated with CARES zirconium dioxide abutments were reexamined. Patient satisfaction, occlusal and peri-implant parameters, mechanical and biologic complications, radiologic parameters, and esthetics were recorded. A total of 50 implant crowns in the anterior and premolar region were examined in 41 patients. The follow-up period of the definitive reconstructions ranged from 1.1 to 3.8 years. No technical and no biologic complications had occurred. At the reexamination, 100% of the implants and reconstructions were in situ. Radiographic evaluation revealed a mean distance from the implant shoulder to the first visible bone-to-implant contact of 0.06 mm at the follow-up examination. Screw-retained crowns based on veneered CAD/CAM zirconium dioxide abutments with a crossfit connection seem to be a promising way to replace missing teeth in the anterior and premolar region. In the short term, neither failures of components nor complications were noted, and the clinical and radiographic data revealed stable hard and soft tissue conditions.

  18. The Application of a Novel Ceramic Liner Improves Bonding between Zirconia and Veneering Porcelain

    PubMed Central

    Lee, Hee-Sung

    2017-01-01

    The adhesion of porcelain to zirconia is a key factor in the success of bilayered restorations. In this study, the efficacy of a novel experimental liner (EL) containing zirconia for improved bonding between zirconia and veneering porcelain was tested. Four ELs containing various concentrations (0, 3.0, 6.0, and 9.0 wt %) of zirconia were prepared. Testing determined the most effective EL (EL3 containing 3.0 wt % zirconia) in terms of shear bond strength value (n = 15). Three different bar-shaped zirconia/porcelain bilayer specimens were prepared for a three-point flexural strength (TPFS) test (n = 15): no-liner (NL), commercial liner (CL), and EL3. Specimens were tested for TPFS with the porcelain under tension and the maximum load was measured at the first sign of fracture. The strength data were analyzed using one-way ANOVA and Tukey’s test (α = 0.05) as well as Weibull distribution. When compared to NL, the CL application had no effect, while the EL3 application had a significant positive effect (p < 0.001) on the flexural strength. Weibull analysis also revealed the highest shape and scale parameters for group EL3. Within the limitations of this study, the novel ceramic liner containing 3.0 wt % zirconia (EL3) significantly enhanced the zirconia/porcelain interfacial bonding. PMID:28869512

  19. In vivo study comparing an X-shaped polymethylmethacrylate and a cylindrical collagen implant for deep sclerectomy.

    PubMed

    Codreanu, Andrea; Tran, Hoai V; Wiaux, Christophe; Mansouri, Kaweh; Roy, Sylvain; Mermoud, Andre; Schnyder, Corinne

    2011-03-01

    Study in vivo characteristics of a polymethylmethacrylate (PMMA) implant compared to the standard cylindrical collagen implant for deep sclerectomy (DS). Six-month comparative study. Twenty eyes of ten rabbits. Eyes were randomized to have DS with PMMA implant in one eye and collagen implant in the opposite eye. The growth of the new subconjunctival drainage vessels was assessed by combined fluorescein and indocyanin green anterior segment angiography; intrascleral and subconjunctival blebs were imaged by ultrasound biomicroscopy (UBM). At six months, outflow facility (C) was measured by anterior chamber perfusion and portions of one side of the DS were compared to portions on the 180° opposite side and native sclera on histology. The mean IOP preoperatively and at one, four, twelve, and twenty-four weeks was comparable in both groups (P > 0.1). UBM showed a statistically insignificant quicker regression of the subconjunctival bleb as well as a durable intrascleral lake in the PMMA group (P > 0.05). New drainage vessels were initially observed one month after surgery; they were more numerous in the PMMA group on angiographic and histological findings at 6 months (P < 0.05). The mean C increased significantly after surgery compared to preoperative values (P < 0.05) and no difference was observed between the implants (0.24 ± 0.06 µl/min/mmHg [PMMA] and 0.23 ± 0.07 µl/min/mmHg [collagen implant]) (P = 0.39). Deep sclerectomy performed with PMMA or collagen implants showed similar IOP lowering effects, outflow facility increase, and degree of inflammatory reaction. © 2010 The Authors. Clinical and Experimental Ophthalmology © 2010 Royal Australian and New Zealand College of Ophthalmologists.

  20. A Comparative Analysis on Two Types of Oral Implants, Bone-Level and Tissue-Level, with Different Cantilever Lengths of Fixed Prosthesis.

    PubMed

    Mosavar, Alireza; Nili, Monireh; Hashemi, Sayed Raouf; Kadkhodaei, Mahmoud

    2017-06-01

    Depending on esthetic, anatomical, and functional aspects, in implant-prosthetic restoration of a completely edentulous jaw, the selection of implant type is highly important; however, bone- and tissue-level implants and their stress distribution in bone have not yet been comparatively investigated. Hence, finite element analysis was used to study the influence of cantilever length in a fixed prosthesis on stress distribution in peri-implant bone around these two types of oral implants. A 3D edentulous mandible was modeled. In simulations, a framework with four posterior cantilever lengths and two types of implants, bone-level and tissue-level, was considered. A compressive load was applied to the distal regions of the cantilevers, and the von-Mises stress of peri-implant bone was investigated. The independent t-test and the Pearson correlation coefficient analyzed the results (α = 0.05). Stresses in the cortical bone around the bone-level implants were greater than those in the tissue-level implants with the same cantilever length. In addition, by extending the cantilever length, the stress values in peri-implant bone increased. Therefore, when the cantilever was at its maximum length, the maximum stress was in cortical bone and around the bone-level distal implants. The results of the present study indicate that treatment with tissue-level implants is potentially more advantageous than with bone-level implants for implant-supported fixed prostheses. © 2015 by the American College of Prosthodontists.

  1. Comparative study between conventional en-masse retraction (sliding mechanics) and en-masse retraction using orthodontic micro implant.

    PubMed

    Basha, Asim Ghouse; Shantaraj, Ravi; Mogegowda, Shivalinga B

    2010-04-01

    The purpose of this study was to measure and compare the difference between rate of en-masse retraction with mini-implant and molar anchorage. A comparative study consisting of 14 patients (all females) randomized into 2 groups. Seven in group I (nonimplant) molar was used as anchor for en-masse retraction of anterior teeth (mean age 16 years SD +/- 1.41). In group II (implant), mini-implant was used as anchorage to retract the anterior teeth (mean age 17.36 SD +/- 1.35). In both groups, all first premolars were extracted. After leveling and aligning, surgical steel mini-implant of 1.3 mm in diameter and 8 mm in length were placed between the roots of second premolar and first molar in the maxilla in the implant group. Implants were immediately loaded with 2 N of force. In nonimplant group molar was used as anchorage. The retraction and postretraction lateral cephalograms were taken. Rate of retraction and anchor loss were measured by using pterygoid vertical in maxilla. Four implants became loose during the treatment, which were subsequently replaced. The stability of surgical steel in this study was 71.4%. Student t test were used to analyze the treatment charges in 2 groups. Mean anchor loss in maxilla in nonimplant group. No differences in the mean rate of retraction time were noted in both groups. Mini-implants provided absolute anchorage in patients requiring maximum anterior retraction. No differences in the mean retraction time were noted between 2 groups.

  2. Impact of abutment material on peri-implant soft tissue color. An in vitro study.

    PubMed

    Sala, Leticia; Bascones-Martínez, Antonio; Carrillo-de-Albornoz, Ana

    2017-09-01

    The objectives of the present study is to determine the differences in peri-implant soft tissue color with the utilization of titanium, titanium gold-plated, white zirconia, Vita Classical (VC) A4-shaded zirconia, and fluorescent white zirconia abutments and to establish the influence of gingival thickness on the resulting color. Four implants were contralaterally inserted in 19 fresh pig mandibles, and the color of the peri-implant mucosa with the different abutments was spectrophotometrically measured at 1-, 2-, and 3-mm height from the margin. At 1-mm height, titanium significantly differed from all zirconia abutments in lightness (L*), chroma along red axis (a*), and chroma along yellow-blue axis (b*) parameters. At 2 mm, all zirconia abutments differed from titanium in b* but only fluorescent zirconia in a*. At 3 mm, titanium differed from VC A4-shaded and fluorescent zirconia abutments in b*. At soft tissue thicknesses <1 and 1-2 mm, titanium differed from fluorescent zirconia in a* and b* and from VC A4-shaded zirconia in b*; at thickness >2 mm, no differences were found among abutments. All abutments differed from natural teeth in a* and b* at all heights and thicknesses except for fluorescent zirconia at thickness >2 mm. The Euclidean distance (ΔΕ) differed between titanium abutments and gold, VC A4, and fluorescent zirconia at <1- and 1-2-mm thicknesses. The natural gingival color was not reproduced with any abutment at gingival thicknesses <2 mm. The worst color match was with titanium abutments and the best with fluorescent zirconia, followed by VC A4-shaded zirconia. At gingival thicknesses >2 mm, no differences were detected among abutments. This study demonstrates that the type of abutment and the gingival thickness affect the resulting peri-implant gingival color.

  3. How to treat two adjacent missing teeth with dental implants. A systematic review on single implant-supported two-unit cantilever FDP's and results of a 5-year prospective comparative study in the aesthetic zone.

    PubMed

    Van Nimwegen, W G; Raghoebar, G M; Tymstra, N; Vissink, A; Meijer, H J A

    2017-06-01

    To conduct a systematic review on the clinical outcome of single implant-supported two-unit cantilever FDP's and to conduct a 5-year prospective comparative pilot study of patients with a missing central and lateral upper incisor treated with either a single implant-supported two-unit cantilever FDP or two implants with solitary implant crowns in the aesthetic zone. Medline, Embase and the Cochrane Central Register of Controlled Trials were searched (last search 1 August 2016) for eligible studies. In the comparative pilot study, an implant-cantilever group of five patients with a single implant-supported two-unit cantilever FDP (NobelReplace Groovy Regular Platform) was compared with an implant-implant group of five patients with two adjacent single implant-supported crowns (NobelReplace Groovy Regular Platform) in the aesthetic zone. Implant survival, marginal bone level (MBL) changes, pocket probing depth, papilla index and patient satisfaction were assessed during a 5-year follow-up period. Five of 276 articles were considered eligible for data extraction. Implant survival ranged from 96·6% to 100%. Marginal bone level changes were higher in the anterior region than in the posterior region. Technical complications occurred more often in the posterior than anterior region. In the 5-year comparative pilot study, no clinically significant differences in hard and soft peri-implant tissue levels occurred between both groups. Single implant-supported two-unit cantilever FDP's can be a viable alternative to the placement of two adjacent single implant crowns in the aesthetic zone. Due to technical complications, placement of two-unit cantilever crowns in the posterior region can be considered unwise. © 2017 John Wiley & Sons Ltd.

  4. Biological Evaluation of Implant Drill Made from Zirconium Dioxide.

    PubMed

    Akiba, Yosuke; Eguchi, Kaori; Akiba, Nami; Uoshima, Katsumi

    2017-04-01

    Zirconia is a good candidate material in the dental field. In this study, we evaluated biological responses against a zirconia drill using a bone cavity healing model. Zirconia drills, stainless steel drills, and the drilled bone surface were observed by scanning electron microscopy (SEM), before and after cavity preparation. For the bone cavity healing model, the upper first and second molars of Wistar rats were extracted. After 4 weeks, cavities were prepared with zirconia drills on the left side. As a control, a stainless steel drill was used on the right side. At 3, 7, and 14 days after surgery, micro-CT images were taken. Samples were prepared for histological staining. SEM images revealed that zirconia drills maintained sharpness even after 30 drilling procedures. The bone surface was smoother with the zirconia drill. Micro-CT images showed faster and earlier bone healing in the zirconia drill cavity. On H-E staining, at 7 days, the zirconia drill defect had a smaller blank lacunae area. At 14 days, the zirconia drill defect was filled with newly formed bone. The zirconia drill induces less damage during cavity preparation and is advantageous for bone healing. (197 words). © 2016 The Authors Clinical Implant Dentistry and Related Research Published by Wiley Periodicals, Inc.

  5. A computational method for comparing the behavior and possible failure of prosthetic implants

    SciT

    Nielsen, C.; Hollerbach, K.; Perfect, S.

    1995-05-01

    Prosthetic joint implants currently in use exhibit high Realistic computer modeling of prosthetic implants provides an opportunity for orthopedic biomechanics researchers and physicians to understand possible in vivo failure modes, without having to resort to lengthy and costly clinical trials. The research presented here is part of a larger effort to develop realistic models of implanted joint prostheses. The example used here is the thumb carpo-metacarpal (cmc) joint. The work, however, can be applied to any other human joints for which prosthetic implants have been designed. Preliminary results of prosthetic joint loading, without surrounding human tissue (i.e., simulating conditions undermore » which the prosthetic joint has not yet been implanted into the human joint), are presented, based on a three-dimensional, nonlinear finite element analysis of three different joint implant designs.« less

  6. A Comparative Study of Defibrillator Leads at a Large-Volume Implanting Hospital: Results From the Pacemaker and Implantable Defibrillator Leads Survival Study ("PAIDLESS").

    PubMed

    Cohen, Todd J; Asheld, Wilbur J; Germano, Joseph; Islam, Shahidul; Patel, Dhimesh

    2015-06-01

    The purpose of the study was to examine survival in the implantable defibrillator subset of implanted leads at a large-volume implanting hospital. Implantable lead survival has been the subject of many multicenter studies over the past decade. Fewer large implanting volume single-hospital studies have examined defibrillator lead failure as it relates to patient survival and lead construction. This investigator-initiated retrospective study examined defibrillator lead failure in those who underwent implantation of a defibrillator between February 1, 1996 and December 31, 2011. Lead failure was defined as: failure to capture/sense, abnormal pacing and/or defibrillator impedance, visual insulation defect or lead fracture, extracardiac stimulation, cardiac perforation, tricuspid valve entrapment, lead tip fracture and/or lead dislodgment. Patient characteristics, implant approach, lead manufacturers, lead models, recalled status, patient mortality, and core lead design elements were compared using methods that include Kaplan Meier analysis, univariate and multivariable Cox regression models. A total of 4078 defibrillator leads were implanted in 3802 patients (74% male; n = 2812) with a mean age of 70 ± 13 years at Winthrop University Hospital. Lead manufacturers included: Medtronic: [n = 1834; 801 recalled]; St. Jude Medical: [n = 1707; 703 recalled]; Boston Scientific: [n = 537; 0 recalled]. Kaplan-Meier analysis adjusted for multiple comparisons revealed that both Boston Scientific's and St. Jude Medical's leads had better survival than Medtronic's leads (P<.001 and P=.01, respectively). Lead survival was comparable between Boston Scientific and St. Jude Medical (P=.80). A total of 153 leads failed (3.5% of all leads) during the study. There were 99 lead failures from Medtronic (5.4% failure rate); 56 were recalled Sprint Fidelis leads. There were 36 lead failures from St. Jude (2.1% failure rate); 20 were recalled Riata or Riata ST leads. There were 18 lead

  7. A multicenter comparative study on the efficacy, safety, and acceptability of the contraceptive subdermal implants Norplant and Norplant-II.

    PubMed

    del Carmen Cravioto, M; Alvarado, G; Canto-de-Cetina, T; Bassol, S; Oropeza, G; Santos-Yung, R; Valencia, J; Palma, Y; Fuziwara, J L; Navarrete, T; Garza-Flores, J; Pérez-Palacios, G

    1997-06-01

    In order to assess efficacy, safety, and acceptability of the contraceptive subdermal implants Norplant and Norplant-II in Mexican women, a comparative phase III clinical trial was undertaken in eight clinics across the country. The study involved 1052 women who were followed-up trimonthly for three years. Cumulative pregnancy rates were 0.29% and 0.34% for Norplant and Norplant-II implants, respectively. Similar overall cumulative discontinuation rates were observed at three years: 50.38% for Norplant capsules, and 50.44% for Norplant-II rods. The main method-related reason for termination was endometrial bleeding irregularity which led to discontinuation rates of 11.94% and 11.62% for Norplant and Norplant-II contraceptive systems, respectively. In 15,279 woman-months of experience accumulated with Norplant implants and 14,092 with Norplant-II implants, there were few adverse events reported. No difference was found between the two groups in either difficulty for implants placement and removal or women's discomfort, even though the time required for insertion and removal of Norplant capsules was longer than for Norplant-II rods. It is concluded that during the first three years of use, both implants systems are equally effective, safe, and acceptable.

  8. Time efficiency, difficulty, and operator's preference comparing digital and conventional implant impressions: a randomized controlled trial.

    PubMed

    Joda, Tim; Lenherr, Patrik; Dedem, Philipp; Kovaltschuk, Irina; Bragger, Urs; Zitzmann, Nicola U

    2017-10-01

    The aim of this randomized controlled trial was to analyze implant impression techniques applying intraoral scanning (IOS) and the conventional method according to time efficiency, difficulty, and operator's preference. One hundred participants (n = 100) with diverse levels of dental experience were included and randomly assigned to Group A performing digital scanning (TRIOS Pod) first or Group B conducting conventional impression (open tray with elastomer) first, while the second method was performed consecutively. A customized maxillary model with a bone-level-type implant in the right canine position (FDI-position 13) was mounted on a phantom training unit realizing a standardized situation for all participants. Outcome parameter was time efficiency, and potential influence of clinical experience, operator's perception of level of difficulty, applicability of each method, and subjective preferences were analyzed with Wilcoxon -Mann-Whitney and Kruskal-Wallis tests. Mean total work time varied between 5.01 ± 1.56 min (students) and 4.53 ± 1.34 min (dentists) for IOS, and between 12.03 ± 2.00 min (students) and 10.09 ± 1.15 min (dentists) for conventional impressions with significant differences between the two methods. Neither assignment to Group A or B, nor gender nor number of impression-taking procedures did influence working time. Difficulty and applicability of IOS was perceived more favorable compared to conventional impressions, and effectiveness of IOS was rated better by the majority of students (88%) and dentists (64%). While 76% of the students preferred IOS, 48% of the dentists were favoring conventional impressions, and 26% each IOS and either technique. For single-implant sites, the quadrant-like intraoral scanning (IOS) was more time efficient than the conventional full-arch impression technique in a phantom head simulating standardized optimal conditions. A high level of acceptance for IOS was observed among students and

  9. Microbiology and Biofilm Trends of Silicone Lacrimal Implants: Comparing Infected Versus Routinely Removed Stents.

    PubMed

    Samimi, David B; Ediriwickrema, Lilangi S; Bielory, Brett P; Miller, Darlene; Lee, Wendy; Johnson, Thomas E

    To investigate the pathogens and biofilms responsible for clinically significant infection of silicone stents implanted within the lacrimal system. Retrospective review of culture results and patient demographics for all silicone lacrimal stents removed early for clinically significant infection and sent to the Bascom Palmer Microbiology Laboratory through the end of year 2010. As a control, routinely removed, clinically noninfected stents from the same institution were prospectively sent for culture over a 6-month period. Four clinically infected and 6 clinically noninfected stents showing mucus within the lumen at removal were sent for scanning electron microscopy. Images were randomized and graded by a microbiologist for the presence of organisms, matrix deposits, organisms within matrix, and overall impression of significant biofilm formation. Nineteen stents were included in the study; 100% of clinically infected (n = 10) and noninfected (n = 9) stents were culture positive. Culture positivity for nontuberculous mycobacterium was found in 90% of infected stents and none of the noninfected stents (p < 0.001). Of infected stents, 50% grew Gram-positive organisms compared with 89% of noninfected stents (p = 0.07). Fifty percent of infected versus 67% of noninfected stents were culture positive for Gram-negative organisms (p = 0.46). Electron microscopy of stents revealed organisms consistent with culture results (size, shape) in planktonic and biofilm form. Masked observer image grading revealed a statistically significant higher amount of organism and biofilm on infected versus noninfected specimen. Nontuberculous mycobacteria comprise the primary pathogens responsible for clinically significant infection of silicone stents in the lacrimal system in South Florida. Robust biofilm production by this organism likely plays a role in pathogenesis. Further research into biofilm-related lacrimal implant infection may aid in the development of useful prevention and

  10. CNC-milled titanium frameworks supported by implants in the edentulous jaw: a 10-year comparative clinical study.

    PubMed

    Örtorp, Anders; Jemt, Torsten

    2012-03-01

    No long-term clinical studies covering more than 5 years are available on Computer Numeric Controlled (CNC) milled titanium frameworks. To evaluate and compare the clinical and radiographic performance of implant-supported prostheses provided with CNC titanium frameworks in the edentulous jaw with prostheses with cast gold-alloy frameworks during the first 10 years of function. Altogether, 126 edentulous patients were by random provided with 67 prostheses with titanium frameworks (test) in 23 maxillas and 44 mandibles, and with 62 prostheses with gold-alloy castings (control) in 31 maxillas and 31 mandibles. Clinical and radiographic 10-year data were collected for the groups and statistically compared on patient level. The 10-year prosthesis and implant cumulative survival rate was 95.6% compared with 98.3%, and 95.0% compared with 97.9% for test and control groups, respectively (p > .05). No implants were lost after 5 years of follow-up. Smokers lost more implants than nonsmokers after 5 years of follow-up (p < .01). Mean marginal bone loss in the test group was 0.7 mm (SD 0.61) and 0.7 mm (SD 0.85) in the maxilla and mandible, with similar pattern in the control group (p > .05), respectively. One prosthesis was lost in each group due to loss of implants, and one prosthesis failed due to framework fracture in the test group. Two metal fractures were registered in each group. More appointments of maintenance were needed for the prostheses in the maxilla compared with those in the mandible (p < .001). The frequency of complications was low with similar clinical and radiological performance for both groups during 10 years. CNC-milled titanium frameworks are a viable alternative to gold-alloy castings for restoring patients with implant-supported prostheses in the edentulous jaw. © 2009 Wiley Periodicals, Inc.

  11. Thermal conductivity of zirconia thermal barrier coatings

    NASA Technical Reports Server (NTRS)

    Dinwiddie, R. B.; Beecher, S. C.; Nagaraj, B. A.; Moore, C. S.

    1995-01-01

    Thermal barrier coatings (TBC's) applied to the hot gas components of turbine engines lead to enhanced fuel efficiency and component reliability. Understanding the mechanisms which control the thermal transport behavior of the TBC's is of primary importance. Physical vapor description (PVD) and plasma spraying (PS) are the two most commonly used coating techniques. These techniques produce coatings with unique microstructures which control their performance and stability. The PS coatings were applied with either standard power or hollow sphere particles. The hollow sphere particles yielded a lower density and lower thermal conductivity coating. The thermal conductivity of both fully and partially stabilized zirconia, before and after thermal aging, will be compared. The thermal conductivity of the coatings permanently increase upon being exposed to high temperatures. These increases are attributed to microstructural changes within the coatings. Sintering of the as fabricated plasma sprayed lamellar structure is observed by scanning electron microscopy of coatings isothermally heat treated at temperatures greater than 1100 C. During this sintering process the planar porosity between lamella is converted to a series of small spherical pores. The change in pore morphology is the primary reason for the observed increase in thermal conductivity. This increase in thermal conductivity can be modeled using a relationship which depends on both the temperature and time of exposure. Although the PVD coatings are less susceptible to thermal aging effects, preliminary results suggest that they have a higher thermal conductivity than PS coatings, both before and after thermal aging. The increases in thermal conductivity due to thermal aging for partially stabilized plasma sprayed zirconia have been found to be less than for fully stabilized plasma sprayed zirconia coatings. The high temperature thermal diffusivity data indicates that if these coatings reach a temperature above

  12. Thermal conductivity of zirconia thermal barrier coatings

    NASA Technical Reports Server (NTRS)

    Dinwiddie, R. B.; Beecher, S. C.; Nagaraj, B. A.; Moore, C. S.

    1995-01-01

    Thermal barrier coatings (TBC's) applied to the hot gas components of turbine engines lead to enhanced fuel efficiency and component reliability. Understanding the mechanisms which control the thermal transport behavior of the TBC's is of primary importance. Physical vapor deposition (PVD) and plasma spraying (PS) are the two most commonly used coating techniques. These techniques produce coatings with unique microstructures which control their performance and stability. The PS coatings were applied with either standard powder or hollow sphere particles. The hollow sphere particles yielded a lower density and lower thermal conductivity coating. The thermal conductivity of both fully and partially stabilized zirconia, before and after thermal aging, will be compared. The thermal conductivity of the coatings permanently increases upon exposed to high temperatures. These increases are attributed to microstructural changes within the coatings. Sintering of the as-fabricated plasma sprayed lamellar structure is observed by scanning electron microscopy of coatings isothermally heat treated at temperatures greater than 1100 C. During this sintering process the planar porosity between lamella is converted to a series of small spherical pores. The change in pore morphology is the primary reason for the observed increase in thermal conductivity. This increase in thermal conductivity can be modeled using a relationship which depends on both the temperature and time of exposure. Although the PVD coatings are less susceptible to thermal aging effects, preliminary results suggest that they have a higher thermal conductivity than PS coatings, both before and after thermal aging. The increases in thermal conductivity due to thermal aging for partially stabilized plasma sprayed zirconia have been found to be less than for fully stabilized plasma sprayed zirconia coatings. The high temperature thermal diffusivity data indicate that if these coatings reach a temperature above 1100 C

  13. Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive.

    PubMed

    Lee, Ji-Yeon; Ahn, Jaechan; An, Sang In; Park, Jeong-Won

    2018-02-01

    The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive. Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al 2 O 3 for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test ( p = 0.05). Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 ( p < 0.05). Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used.

  14. Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive

    PubMed Central

    2018-01-01

    Objectives The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive. Materials and Methods Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al2O3 for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test (p = 0.05). Results Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 (p < 0.05). Conclusions Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used. PMID:29487838

  15. [Effect of a chemical primer on the bond strength of a zirconia ceramic with self-adhesive resin cement].

    PubMed

    Zhang, Hong; Jing, Ye; Nie, Rongrong; Meng, Xiangfeng

    2015-10-01

    To evaluate the bond strength and durability of a self-adhesive resin cement with a zirconia ceramic pretreated by a zirconia primer. Zirconia ceramic (Vita Inceram YZ) plates with a thickness of 2.5 mm were fired, polished, and then cleaned. Half of the polished ceramic plates were sandblasted with 50 μm alumina particles at 0.3 MPa for 20 s. The surface compound weight ratios were measured via X-ray fluorescence microscopy. The polished and sandblasted ceramic plates were directly bonded with self-adhesive resin cement (Biscem) or were pretreated by a zirconia primer (Z Primer Plus) before bonding with Biscem. The specimens of each test group were divided into two subgroups (n=10) and subjected to the shear test after 0 and 10,000 thermal cycles. The data were analyzed via three-way ANOVA. After air abrasion, 8.27% weight ratio of alumina attached to the zirconia surface. Compared with air abrasion, primer treatment more significantly improved the primary resin bond strength of the zirconia ceramic. The primary resin bond strength of the zirconia ceramic with no primer treatment was not affected by thermocycling (P>0.05). However, the primary resin bond strength of the zirconia ceramic with primer treatment was significantly decreased by thermocycling (P<0.05). Primer treatment can improve the primary resin bond strengths of zirconia ceramics. However, the bond interface of the primer is not stable and rapidly degraded during thermocycling.

  16. Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types.

    PubMed

    Meisberger, Eric W; Bakker, Sjoerd J G; Cune, Marco S

    2015-12-01

    Ultrasonic instrumentation under magnification may facilitate mobilization of screw remnants but may induce heat trauma to surrounding bone. An increase of 5°C is considered detrimental to osseointegration. The objective of this investigation was to examine the rise in temperature of the outer implant body after 30 s of ultrasonic instrumentation to the inner part, in relation to implant type, type of ultrasonic equipment, and the use of coolants in vitro. Two ultrasonic devices (Satelec Suprasson T Max and Electro Medical Systems (EMS) miniMaster) were used on five different implant types that were provided with a thermo couple (Astra 3.5 mm, bone level Regular CrossFit (RC) 4.1 mm, bone level Narrow CrossFit (NC) 3.3 mm, Straumann tissue level regular body regular neck 3.3 mm, and Straumann tissue level wide body regular neck 4.8 mm), either with or without cooling during 30 s. Temperature rise at this point in time is the primary outcome measure. In addition, the mean maximum rise in temperature (all implants combined) was assessed and statistically compared among devices, implant systems, and cooling mode (independent t-tests, ANOVA, and post hoc analysis). The Satelec device without cooling induces the highest temperature change of up to 13°C, particularly in both bone level implants (p < 0.05) but appears safe for approximately 10 s of continuous instrumentation, after which a cooling down period is rational. Cooling is effective for both devices. However, when the Satelec device is used with coolant for a longer period of time, a rise in temperature must be anticipated after cessation of instrumentation, and post-operational cooling is advised. The in vitro setup used in this experiment implies that care should be taken when translating the observations to clinical recommendations, but it is carefully suggested that the EMS device causes limited rise in temperature, even without coolant.

  17. Sintering behavior and mechanical properties of zirconia compacts fabricated by uniaxial press forming.

    PubMed

    Oh, Gye-Jeong; Yun, Kwi-Dug; Lee, Kwang-Min; Lim, Hyun-Pil; Park, Sang-Won

    2010-09-01

    The purpose of this study was to compare the linear sintering behavior of presintered zirconia blocks of various densities. The mechanical properties of the resulting sintered zirconia blocks were then analyzed. Three experimental groups of dental zirconia blocks, with a different presintering density each, were designed in the present study. Kavo Everest® ZS blanks (Kavo, Biberach, Germany) were used as a control group. The experimental group blocks were fabricated from commercial yttria-stabilized tetragonal zirconia powder (KZ-3YF (SD) Type A, KCM. Corporation, Nagoya, Japan). The biaxial flexural strengths, microhardnesses, and microstructures of the sintered blocks were then investigated. The linear sintering shrinkages of blocks were calculated and compared. Despite their different presintered densities, the sintered blocks of the control and experimental groups showed similar mechanical properties. However, the sintered block had different linear sintering shrinkage rate depending on the density of the presintered block. As the density of the presintered block increased, the linear sintering shrinkage decreased. In the experimental blocks, the three sectioned pieces of each block showed the different linear shrinkage depending on the area. The tops of the experimental blocks showed the lowest linear sintering shrinkage, whereas the bottoms of the experimental blocks showed the highest linear sintering shrinkage. Within the limitations of this study, the density difference of the presintered zirconia block did not affect the mechanical properties of the sintered zirconia block, but affected the linear sintering shrinkage of the zirconia block.

  18. Sintering behavior and mechanical properties of zirconia compacts fabricated by uniaxial press forming

    PubMed Central

    Oh, Gye-Jeong; Yun, Kwi-Dug; Lee, Kwang-Min; Lim, Hyun-Pil

    2010-01-01

    PURPOSE The purpose of this study was to compare the linear sintering behavior of presintered zirconia blocks of various densities. The mechanical properties of the resulting sintered zirconia blocks were then analyzed. MATERIALS AND METHODS Three experimental groups of dental zirconia blocks, with a different presintering density each, were designed in the present study. Kavo Everest® ZS blanks (Kavo, Biberach, Germany) were used as a control group. The experimental group blocks were fabricated from commercial yttria-stabilized tetragonal zirconia powder (KZ-3YF (SD) Type A, KCM. Corporation, Nagoya, Japan). The biaxial flexural strengths, microhardnesses, and microstructures of the sintered blocks were then investigated. The linear sintering shrinkages of blocks were calculated and compared. RESULTS Despite their different presintered densities, the sintered blocks of the control and experimental groups showed similar mechanical properties. However, the sintered block had different linear sintering shrinkage rate depending on the density of the presintered block. As the density of the presintered block increased, the linear sintering shrinkage decreased. In the experimental blocks, the three sectioned pieces of each block showed the different linear shrinkage depending on the area. The tops of the experimental blocks showed the lowest linear sintering shrinkage, whereas the bottoms of the experimental blocks showed the highest linear sintering shrinkage. CONCLUSION Within the limitations of this study, the density difference of the presintered zirconia block did not affect the mechanical properties of the sintered zirconia block, but affected the linear sintering shrinkage of the zirconia block. PMID:21165274

  19. Zirconia-Polyurethane Aneurysm Clip.

    PubMed

    Cho, Won-Sang; Cho, Kyung-Il; Kim, Jeong Eun; Jang, Tae-Sik; Ha, Eun Jin; Kang, Hyun-Seung; Son, Young-Je; Choi, Seung Hong; Lee, Seunghyun; Kim, Chong-Chan; Sun, Jeong-Yun; Kim, Hyoun-Ee

    2018-03-27

    Susceptibility artifacts from metal clips in magnetic resonance (MR) imaging present an obstacle to evaluating the status of clipped aneurysms, parent arteries and adjacent brain parenchyma. We aimed to develop MR-compatible aneurysm clips. Considering the mechanical and biological properties, and MR compatibility of candidate materials, a prototype clip with a zirconia body and a polyurethane head spring (ZC, straight, 9-mm long) was developed. The closing forces, opening width of blades, and in vitro and in vivo artifact volumes in 3 tesla MR imaging were compared among the prototype and commercial metal clips such as a Yasargil ® clip (YC, curved type, 8.3-mm long) and a Sugita ® clip (SC, straight type, 10-mm long). An in vivo animal study was performed with a canine venous pouch aneurysm model. The closing forces (N) at 1 and 8 mm from the blade tip were 2.09 and 3.77 in YC, 1.85 and 3.04 in SC, and 2.05 and 4.60 in ZC. The maximum opening widths (mm) was 6.8, 9.0, and 3.0 in YC, SC, and ZC, respectively. The in vitro artifact volumes of YC, SC and ZC in time-of-flight MR imaging were 26.9, 29.7 and 1.9 times larger than the respective real volumes. The in vivo artifact volumes of YC, SC, and ZC were respectively 21.4, 29.4, and 2.6 times larger than real ones. ZC showed the smallest susceptibility artifacts and satisfactory closing forces. However, the narrow opening width of the blades was a weak point. Copyright © 2018. Published by Elsevier Inc.

  20. Fracture Strength of Three-Unit Implant Supported Fixed Partial Dentures with Excessive Crown Height Fabricated from Different Materials.

    PubMed

    Nazari, Vahideh; Ghodsi, Safoura; Alikhasi, Marzieh; Sahebi, Majid; Shamshiri, Ahmad Reza

    2016-11-01

    Fracture strength is an important factor influencing the clinical long-term success of implant-supported prostheses especially in high stress situations like excessive crown height space (CHS). The purpose of this study was to compare the fracture strength of implant-supported fixed partial dentures (FPDs) with excessive crown height, fabricated from three different materials. Two implants with corresponding abutments were mounted in a metal model that simulated mandibular second premolar and second molar. Thirty 3-unit frameworks with supportive anatomical design were fabricated using zirconia, nickel-chromium alloy (Ni-Cr), and polyetheretherketone (PEEK) (n=10). After veneering, the CHS was equal to 15mm. Then; samples were axially loaded on the center of pontics until fracture in a universal testing machine at a crosshead speed of 0.5 mm/minute. The failure load data were analyzed by one-way ANOVA and Games-Howell tests at significance level of 0.05. The mean failure loads for zirconia, Ni-Cr and PEEK restorations were 2086±362N, 5591±1200N and 1430±262N, respectively. There were significant differences in the mean failure loads of the three groups (P<0.001). The fracture modes in zirconia, metal ceramic and PEEK restorations were cohesive, mixed and adhesive type, respectively. According to the findings of this study, all implant supported three-unit FPDs fabricated of zirconia, metal ceramic and PEEK materials are capable to withstand bite force (even para-functions) in the molar region with excessive CHS.

  1. Reduction in mean deviation values in automated perimetry in eyes with multifocal compared to monofocal intraocular lens implants.

    PubMed

    Farid, Marjan; Chak, Garrick; Garg, Sumit; Steinert, Roger F

    2014-08-01

    To evaluate differences in mean deviation values in automated perimetry in healthy eyes with multifocal compared to monofocal intraocular lens (IOL) implants. Prospective, age-matched, comparative analysis. Single-center, tertiary referral academic practice. A total of 37 healthy eyes in 37 patients with bilateral multifocal (n=22) or monofocal (n=15) IOL implants were studied. INTERVENTION/OBSERVATION PROCEDURE: Humphrey Visual Field 10-2 testing was performed on all patients. Mean deviation (MD) and pattern standard deviation (PSD) numerical values were evaluated and compared between groups. The average MD was -2.84 dB (SD 2.32) for the multifocal IOL group and -0.97 dB (SD 1.58) for the monofocal IOL group (P=.006). There was no significant difference in PSD between the 2 groups (P=.99). Eyes that had the visual field 10-2 testing≥6 months from time of IOL placement showed no improvement in MD when compared to eyes that were tested within 6 months from IOL placement. Multifocal IOL implants cause significant nonspecific reduction in MD values on Humphrey Visual Field 10-2 testing that does not improve with time or neuroadaptation. Multifocal IOL implants may be inadvisable in patients where central visual field reduction may not be tolerated, such as macular degeneration, retinal pigment epithelium changes, and glaucoma. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Calcium aluminate coated and uncoated free form fabricated CoCr implants: a comparative study in rabbit.

    PubMed

    Palmquist, A; Jarmar, T; Hermansson, L; Emanuelsson, L; Taylor, A; Taylor, M; Engqvist, H; Thomsen, P

    2009-10-01

    The purpose of this study was to compare the integration in bone of uncoated free form fabricated cobalt chromium (CoCr) implants to the same implant with a calcium aluminate coating. The implants of cylindrical design with a pyramidal surface structure were press-fit into the limbs of New Zealand white rabbits. After 6 weeks, the rabbits were sacrificed, and samples were retrieved and embedded. Ground sections were subjected to histological analysis and histomorphometry. The section counter part was used for preparing an electron transparent transmission electron microscopy sample by focused ion beam milling. Calcium aluminate dip coating provided a significantly greater degree of bone contact than that of the native CoCr. The gibbsite hydrate formed in the hardening reaction of the calcium aluminate was found to be the exclusive crystalline phase material in direct contact with bone. (c) 2009 Wiley Periodicals, Inc.

  3. Clinical Outcome of Hydroxyapatite Coated, Bioactive Glass Coated, and Machined Ti6Al4V Threaded Dental Implant in Human Jaws: A Short-Term Comparative Study.

    PubMed

    Mistry, Surajit; Roy, Rajiv; Kundu, Biswanath; Datta, Someswar; Kumar, Manoj; Chanda, Abhijit; Kundu, Debabrata

    2016-04-01

    Growing aspect of endosseous implant research is focused on surface modification of dental implants for the purpose of improving osseointegration. The aim of this study was to evaluate and compare the clinical outcome (ie, osseointegration) of hydroxyapatite coated, bioactive glass coated and machined titanium alloy threaded dental implants in human jaw bone after implantation. One hundred twenty-six implants (45 hydroxyapatite coated, 41 bioactive glass coated, and 40 machined titanium implants) have been placed in incisor areas of 62 adult patients. Outcome was assessed up to 12 months after prosthetic rehabilitation using different clinical and radiological parameters. Surface roughness of failed implants was analyzed by laser profilometer. Hydroxyapatite and bioactive glass coating materials were nontoxic and biocompatible. Least marginal bone loss in radiograph, significantly higher (P < 0.05) interface radiodensity, and less interfacial gaps were observed in computed tomography with bioactive glass coated implants at anterior maxilla compared to other 2 types. Bioactive glass coated implants are equally safe and effective as hydroxyapatite coated and machined titanium implants in achieving osseointegration; therefore, can be effectively used as an alternative coating material for dental implants.

  4. Evaluating the Safety Profile of Non-Active Implantable Medical Devices Compared with Medicines.

    PubMed

    Pane, Josep; Coloma, Preciosa M; Verhamme, Katia M C; Sturkenboom, Miriam C J M; Rebollo, Irene

    2017-01-01

    Recent safety issues involving non-active implantable medical devices (NAIMDs) have highlighted the need for better pre-market and post-market evaluation. Some stakeholders have argued that certain features of medicine safety evaluation should also be applied to medical devices. Our objectives were to compare the current processes and methodologies for the assessment of NAIMD safety profiles with those for medicines, identify potential gaps, and make recommendations for the adoption of new methodologies for the ongoing benefit-risk monitoring of these devices throughout their entire life cycle. A literature review served to examine the current tools for the safety evaluation of NAIMDs and those for medicines. We searched MEDLINE using these two categories. We supplemented this search with Google searches using the same key terms used in the MEDLINE search. Using a comparative approach, we summarized the new product design, development cycle (preclinical and clinical phases), and post-market phases for NAIMDs and drugs. We also evaluated and compared the respective processes to integrate and assess safety data during the life cycle of the products, including signal detection, signal management, and subsequent potential regulatory actions. The search identified a gap in NAIMD safety signal generation: no global program exists that collects and analyzes adverse events and product quality issues. Data sources in real-world settings, such as electronic health records, need to be effectively identified and explored as additional sources of safety information, particularly in some areas such as the EU and USA where there are plans to implement the unique device identifier (UDI). The UDI and other initiatives will enable more robust follow-up and assessment of long-term patient outcomes. The safety evaluation system for NAIMDs differs in many ways from those for drugs, but both systems face analogous challenges with respect to monitoring real-world usage. Certain features

  5. Comparative Effectiveness of Cardiac Resynchronization Therapy Defibrillators Versus Standard Implantable Defibrillators in Medicare Patients.

    PubMed

    Zusterzeel, Robbert; Caños, Daniel A; Sanders, William E; Silverman, Henry; MaCurdy, Thomas E; Worrall, Christopher M; Kelman, Jeffrey; Marinac-Dabic, Danica; Strauss, David G

    2015-07-01

    Previous analyses have shown that there is lower mortality with cardiac resynchronization therapy defibrillators (CRT-D) in patients with left bundle branch block (LBBB) but demonstrated mixed results in patients without LBBB. We evaluated the comparative effectiveness of CRT-D versus standard implantable defibrillators (ICDs) separately in patients with LBBB and right bundle branch block (RBBB) using Medicare claims data. Medicare records from CRT-D and ICD recipients from 2002 to 2009 that were followed up for up to 48 months were analyzed. We used propensity scores to match patients with ICD to those with CRT-D. In LBBB, 1:1 matching with replacement resulted in 54,218 patients with CRT-D and 20,763 with ICD, and in RBBB, 1:1 matching resulted in 7,298 patients with CRT-D and 7,298 with ICD. In LBBB, CRT-D had a 12% lower risk of heart failure hospitalization or death (hazard ratio [HR] 0.88, 95% confidence interval 0.86 to 0.90) and 5% lower death risk (HR 0.95, 0.92 to 0.97) compared with ICD. In RBBB, CRT-D had a 15% higher risk of heart failure hospitalization or death (HR 1.15, 1.10 to 1.20) and 13% higher death risk (HR 1.13, 1.07 to 1.18). Sensitivity analysis revealed that accounting for covariates not captured in the Medicare database may lead to increased benefit with CRT-D in LBBB and no difference in RBBB. In conclusion, in a large Medicare population, CRT-D was associated with lower mortality in LBBB but higher mortality in RBBB. The absence of certain covariates, in particular those that determine treatment selection, may affect the results of comparative effectiveness studies using claims data. Published by Elsevier Inc.

  6. Comparing spatial tuning curves, spectral ripple resolution, and speech perception in cochlear implant users.

    PubMed

    Anderson, Elizabeth S; Nelson, David A; Kreft, Heather; Nelson, Peggy B; Oxenham, Andrew J

    2011-07-01

    Spectral ripple discrimination thresholds were measured in 15 cochlear-implant users with broadband (350-5600 Hz) and octave-band noise stimuli. The results were compared with spatial tuning curve (STC) bandwidths previously obtained from the same subjects. Spatial tuning curve bandwidths did not correlate significantly with broadband spectral ripple discrimination thresholds but did correlate significantly with ripple discrimination thresholds when the rippled noise was confined to an octave-wide passband, centered on the STC's probe electrode frequency allocation. Ripple discrimination thresholds were also measured for octave-band stimuli in four contiguous octaves, with center frequencies from 500 Hz to 4000 Hz. Substantial variations in thresholds with center frequency were found in individuals, but no general trends of increasing or decreasing resolution from apex to base were observed in the pooled data. Neither ripple nor STC measures correlated consistently with speech measures in noise and quiet in the sample of subjects in this study. Overall, the results suggest that spectral ripple discrimination measures provide a reasonable measure of spectral resolution that correlates well with more direct, but more time-consuming, measures of spectral resolution, but that such measures do not always provide a clear and robust predictor of performance in speech perception tasks. © 2011 Acoustical Society of America

  7. Comparing spatial tuning curves, spectral ripple resolution, and speech perception in cochlear implant users

    PubMed Central

    Anderson, Elizabeth S.; Nelson, David A.; Kreft, Heather; Nelson, Peggy B.; Oxenham, Andrew J.

    2011-01-01

    Spectral ripple discrimination thresholds were measured in 15 cochlear-implant users with broadband (350–5600 Hz) and octave-band noise stimuli. The results were compared with spatial tuning curve (STC) bandwidths previously obtained from the same subjects. Spatial tuning curve bandwidths did not correlate significantly with broadband spectral ripple discrimination thresholds but did correlate significantly with ripple discrimination thresholds when the rippled noise was confined to an octave-wide passband, centered on the STC’s probe electrode frequency allocation. Ripple discrimination thresholds were also measured for octave-band stimuli in four contiguous octaves, with center frequencies from 500 Hz to 4000 Hz. Substantial variations in thresholds with center frequency were found in individuals, but no general trends of increasing or decreasing resolution from apex to base were observed in the pooled data. Neither ripple nor STC measures correlated consistently with speech measures in noise and quiet in the sample of subjects in this study. Overall, the results suggest that spectral ripple discrimination measures provide a reasonable measure of spectral resolution that correlates well with more direct, but more time-consuming, measures of spectral resolution, but that such measures do not always provide a clear and robust predictor of performance in speech perception tasks. PMID:21786905

  8. Comparative study on stress distribution around internal tapered connection implants according to fit of cement- and screw-retained prostheses.

    PubMed

    Lee, Mi-Young; Heo, Seong-Joo; Park, Eun-Jin; Park, Ji-Man

    2013-08-01

    The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of α=.05. The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 µm/m at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit.

  9. Hybrid cochlear implantation: quality of life, quality of hearing, and working performance compared to patients with conventional unilateral or bilateral cochlear implantation.

    PubMed

    Härkönen, Kati; Kivekäs, Ilkka; Kotti, Voitto; Sivonen, Ville; Vasama, Juha-Pekka

    2017-10-01

    The objective of the present study is to evaluate the effect of hybrid cochlear implantation (hCI) on quality of life (QoL), quality of hearing (QoH), and working performance in adult patients, and to compare the long-term results of patients with hCI to those of patients with conventional unilateral cochlear implantation (CI), bilateral CI, and single-sided deafness (SSD) with CI. Sound localization accuracy and speech-in-noise test were also compared between these groups. Eight patients with high-frequency sensorineural hearing loss of unknown etiology were selected in the study. Patients with hCI had better long-term speech perception in noise than uni- or bilateral CI patients, but the difference was not statistically significant. The sound localization accuracy was equal in the hCI, bilateral CI, and SSD patients. QoH was statistically significantly better in bilateral CI patients than in the others. In hCI patients, residual hearing was preserved in all patients after the surgery. During the 3.6-year follow-up, the mean hearing threshold at 125-500 Hz decreased on average by 15 dB HL in the implanted ear. QoL and working performance improved significantly in all CI patients. Hearing outcomes with hCI are comparable to the results of bilateral CI or CI with SSD, but hearing in noise and sound localization are statistically significantly better than with unilateral CI. Interestingly, the impact of CI on QoL, QoH, and working performance was similar in all groups.

  10. Synthesis and characterization of mesoporous zirconia and aluminated mesoporous zirconia

    NASA Astrophysics Data System (ADS)

    Zhao, Elizabeth Sun

    Synthesis of mesoporous zirconia has been performed by slowly hydrolyzing zirconium propoxide in the presence of anionic surfactants: namely, dodecyl phosphate or sulfate (P12 and Sf12) and hexadecyl sulfonate (So16) The zirconia. outgassed at 140--150°C has T-plot surface areas higher than 400 M2/g. This outgassing does not remove the surfactant. After calcination in air at 500°C and combustion of the surfactant, the mesoporous volume is reduced by a factor of about 2, whereas the pore wall material crystallizes in the tetragonal phase. The high-resolution electron microscopic study reveals the presence of a disorganized network of polygonal pores structure. It is suggested that the chemistry of the hydrolysis solution is instrumental in determining the pore structure. A schematic model in which the surfactant is a scaffold component is suggested in order to explain these results and the fixation of PO4, or SO4 in the walls may help to preserve the porous structure. It is very different from the templating mechanism. From the density obtained from phase transition temperature, and from the mesoporous volume (N2 adsorption), the thickness of the wall can be calculated as well as the pseudo-length of the pores. From the thickness, the T-plot area can be recalculated and agrees well with the measured T-plot surface area for the sample calcined at 500°C. Around 900°C, the walls become thicker and crystallizes into monoclinic zirconia without pore structure. In order to try to modify, the acidity of the mesoporous sulfated and oxo-phosphated zirconia, they were doped with aluminum. The sulfated zirconia only has a coating layer of amorphous alumina, while the phosphated zirconia has aluminum in the lattice and the alumina coat. A maximum ratio of Al/Zr ˜ 0.04 can be reached in the lattice. The introduction of aluminum into the lattice prevents the crystallization of the oxo-phosphate at 900°C, and helps to preserve the surface area and porosity of the sulfated

  11. Evaluation of experimental coating to improve the zirconia-veneering ceramic bond strength.

    PubMed

    Matani, Jay D; Kheur, Mohit; Jambhekar, Shantanu Subhashchandra; Bhargava, Parag; Londhe, Aditya

    2014-12-01

    To evaluate the shear bond strength (SBS) between zirconia and veneering ceramic following different surface treatments of zirconia. The efficacy of an experimental zirconia coating to improve the bond strength was also evaluated. Zirconia strips were fabricated and were divided into four groups as per their surface treatment: polished (control), airborne-particle abrasion, laser irradiation, and application of the experimental coating. The surface roughness and the residual monoclinic content were evaluated before and after the respective surface treatments. A scanning electron microscope (SEM) analysis of the experimental surfaces was performed. All specimens were subjected to shear force in a universal testing machine. The SBS values were analyzed with one-way ANOVA followed by Bonferroni post hoc for groupwise comparisons. The fractured specimens were examined to observe the failure mode. The SBS (29.17 MPa) and roughness values (0.80) of the experimental coating group were the highest among the groups. The residual monoclinic content was minimal (0.32) when compared to the remaining test groups. SEM analysis revealed a homogenous surface well adhered to an undamaged zirconia base. The other test groups showed destruction of the zirconia surface. The analysis of failure following bond strength testing showed entirely cohesive failures in the veneering ceramic in all study groups. The experimental zirconia surface coating is a simple technique to increase the microroughness of the zirconia surface, and thereby improve the SBS to the veneering ceramic. It results in the least monoclinic content and produces no structural damage to the zirconia substructure. © 2014 by the American College of Prosthodontists.

  12. Numerical simulation of left ventricular assist device implantations: comparing the ascending and the descending aorta cannulations.

    PubMed

    Bonnemain, Jean; Malossi, A Cristiano I; Lesinigo, Matteo; Deparis, Simone; Quarteroni, Alfio; von Segesser, Ludwig K

    2013-10-01

    In this work we present numerical simulations of continuous flow left ventricle assist device implantation with the aim of comparing difference in flow rates and pressure patterns depending on the location of the anastomosis and the rotational speed of the device. Despite the fact that the descending aorta anastomosis approach is less invasive, since it does not require a sternotomy and a cardiopulmonary bypass, its benefits are still controversial. Moreover, the device rotational speed should be correctly chosen to avoid anomalous flow rates and pressure distribution in specific location of the cardiovascular tree. With the aim of assessing the differences between these two approaches and device rotational speed in terms of flow rate and pressure waveforms, we set up numerical simulations of network of one-dimensional models where we account for the presence of an outflow cannula anastomosed to different locations of the aorta. Then, we use the resulting network to compare the results of the two different cannulations for several stages of heart failure and different rotational speed of the device. The inflow boundary data for the heart and the cannulas are obtained from a lumped parameters model of the entire circulatory system with an assist device, which is validated with clinical data. The results show that ascending and descending aorta cannulations lead to similar waveforms and mean flow rate in all the considered cases. Moreover, regardless of the anastomosis region, the rotational speed of the device has an important impact on wave profiles; this effect is more pronounced at high RPM. Copyright © 2013 IPEM. Published by Elsevier Ltd. All rights reserved.

  13. Enhanced structural stability of nanoporous zirconia under irradiation of He

    SciT

    Yang, Tengfei; Huang, Xuejun; Wang, Chenxu

    2012-01-01

    This work reports a greatly enhanced tolerance for He irradiation-induced swelling in nanocrystalline zirconia film with interconnected nanoporous structure (hereinafter referred as to NC-C). Compared to bulk yttria-stabilized zirconia (YSZ) and another nanocrystalline zirconia film only with discrete nano voids (hereinafter referred as to NC-V), the NC-C film reveals good tolerance for irradiation of high-fluence He. No appreciable surface blistering can be found even at the highest fluence of 6 1017 cm2 in NCC film. From TEM analysis of as-irradiated samples, the enhanced tolerance for volume swelling in NCC film is attributed to the enhanced diffusion mechanism of deposited Hemore » via widely distributed nano channels. Furthermore, the growth of grain size is quite small for both nanocrystalline zirconia films after irradiation, which is ascribed to the decreasing of area of grain boundary due to loose structure and low energy of primary knock-on atoms for He ions.« less

  14. Fracture resistance and reliability of new zirconia posts.

    PubMed

    Oblak, Cedomir; Jevnikar, Peter; Kosmac, Tomaz; Funduk, Nenad; Marion, Ljubo

    2004-04-01

    The radicular portion of zirconia endodontic posts often need to be reshaped to achieve a definitive form and may be airborne-particle abraded to improve adhesion during luting. Therefore, the surface of the tetragonal zirconia ceramics may be transformed and damaged, influencing the mechanical properties of the material. This study compared the fracture resistance of prefabricated zirconia posts with a new retentive post-head after different surface treatments. Experimental zirconia posts of 2 different diameters, 1.3 mm and 1.5 mm, were produced from commercially available zirconia powder. A cylindro-conical outline form was used for the root portion of the system and a post-head with 3 retentive rings was designed. Sixty posts of each diameter were divided into 3 groups (n=20). Group 1 was ground with a coarse grit diamond bur; Group 2 was airborne-particle abraded with 110-microm fused alumina particles, and Group 3 was left as-received (controls). Posts were luted into the root-shaped artificial canals with the Clearfil adhesive system and Panavia 21 adhesive resin luting agent. The posts were loaded in a universal testing machine at an inclination of 45 degrees with the constant cross-head speed of 1 mm/min. The fracture load (N) necessary to cause post fracture was recorded, and the statistical significance of differences among groups was analyzed with 1-way ANOVA followed by the Fischer LSD test (alpha=.05). The variability was analyzed using Weibull statistics. Load to fracture values of all zirconia posts depended primarily on post diameter. Mean fracture loads (SD) in Newtons were 518.4 (+/-101.3), 993.6 (+/-224.1), and 622.7 (+/-110.3) for Groups 1 through 3, respectively, for thicker posts, and 385.9 (+/-110.3), 627.0 (+/-115.1), and 451.2 (+/-81.4) for Groups 1 through 3, respectively, for thinner posts. Airborne-particle-abraded posts exhibited significantly higher resistance to fracture (P<.05) than those in the other 2 groups for diameters 1.3 mm

  15. Adhesion, proliferation and differentiation of osteoblasts on zirconia films prepared by cathodic arc deposition.

    PubMed

    Zhang, Shailin; Sun, Junying; Xu, Ying; Qian, Shi; Wang, Bing; Liu, Fei; Liu, Xuanyong

    2013-01-01

    Zirconia films were prepared on titanium by cathodic arc deposition technique. The surface topography and element composition of the films were characterized by scanning electron microscopy and X-ray photoelectron spectroscopy, respectively. Osteoblast-like MG63 cells were cultured on the surface of the zirconia films in vitro, and cell behaviour was investigated, with titanium as control. The results obtained from scanning electron microscopy and immunofluorescence studies showed that the MG63 cells on ZrO2 films spread better than those on Ti. The CCK8 assay indicated that the zirconia films promoted the proliferation of MG63 cells. The results of alkaline phosphatase (ALP) activity test and the expression of osteogenic marker genes, such as ALP, collagen I and osteocalcin, demonstrated that the differentiation of MG63 cells might be enhanced by zirconia films. In addition, the zirconia films possibly regulated osteoclastogenic gene expression by stimulating the expression of osteoprotegerin and reducing the expression of receptor activator of nuclear factor-kappaB ligand. The present work suggests that the ZrO2 film is worth further consideration for orthopedic implant applications.

  16. Comparative Impacts of Scala Vestibuli Versus Scala Tympani Cochlear Implantation on Auditory Performances and Programming Parameters in Partially Ossified Cochleae.

    PubMed

    Trudel, Mathieu; Côté, Mathieu; Philippon, Daniel; Simonyan, David; Villemure-Poliquin, Noémie; Bussières, Richard

    2018-07-01

    To compare scala vestibuli versus scala tympani cochlear implantation in terms of postoperative auditory performances and programming parameters in patients with severe scala tympani ossification. Retrospective case-control study. Tertiary referral center. One hundred three pediatric and adult patients who underwent cochlear implant surgery between 2000 and 2016. Three groups were formed: a scala vestibuli group, a scala tympani with ossification group, and a scala tympani without ossification group. Patients were matched based on their age, sex, duration of deafness, and side of implantation (ratio of 1:2:2). Postoperative evaluation of auditory performances and programming parameters following intensive functional rehabilitation program completion. Multimedia adaptive test (MAT), hearing in noise test (HINT SNR +10 dB, HINT SNR +5 dB, and HINT SNR +0 dB), impedances, neural response telemetry thresholds (NRT), neural response imaging thresholds (NRI), comfortable levels (C-levels), and threshold levels (T-levels) were compared between groups. Twenty-one patients underwent scala vestibuli cochlear implantation: 19 adults and two children. Auditory performances were similar between groups, although sentence recognition in a noisy environment was slightly higher in the scala vestibuli group. Impedance values were also higher in the scala vestibuli group, but all other programming parameters were similar between groups. We present the largest series of patients with scala vestibuli cochlear implantation. This approach provides at least comparable auditory performances without having any deleterious effects on programming parameters. This viable and useful insertion route might be the primary surgical alternative when facing partial cochlear ossification.

  17. Alumina-Reinforced Zirconia Composites

    NASA Technical Reports Server (NTRS)

    Choi, Sung R.; Bansal, Narottam P.

    2003-01-01

    Alumina-reinforced zirconia composites, used as electrolyte materials for solid oxide fuel cells, were fabricated by hot pressing 10 mol percent yttria-stabilized zirconia (10-YSZ) reinforced with two different forms of alumina particulates and platelets each containing 0 to 30 mol percent alumina. Major mechanical and physical properties of both particulate and platelet composites including flexure strength, fracture toughness, slow crack growth, elastic modulus, density, Vickers microhardness, thermal conductivity, and microstructures were determined as a function of alumina content either at 25 C or at both 25 and 1000 C. Flexure strength and fracture toughness at 1000 C were maximized with 30 particulate and 30 mol percent platelet composites, respectively, while resistance to slow crack growth at 1000 C in air was greater for 30 mol percent platelet composite than for 30 mol percent particulate composites.

  18. Comparative effectiveness and cost-effectiveness of the implantable miniature telescope.

    PubMed

    Brown, Gary C; Brown, Melissa M; Lieske, Heidi B; Lieske, Philip A; Brown, Kathryn S; Lane, Stephen S

    2011-09-01

    To assess the preference-based comparative effectiveness (human value gain) and the cost-utility (cost-effectiveness) of a telescope prosthesis (implantable miniature telescope) for the treatment of end-stage, age-related macular degeneration (AMD). A value-based medicine, second-eye model, cost-utility analysis was performed to quantify the comparative effectiveness and cost-effectiveness of therapy with the telescope prosthesis. Published, evidence-based data from the IMT002 Study Group clinical trial. Ophthalmic utilities were obtained from a validated cohort of >1000 patients with ocular diseases. Comparative effectiveness data were converted from visual acuity to utility (value-based) format. The incremental costs (Medicare) of therapy versus no therapy were integrated with the value gain conferred by the telescope prosthesis to assess its average cost-utility. The incremental value gains and incremental costs of therapy referent to (1) a fellow eye cohort and (2) a fellow eye cohort of those who underwent intra-study cataract surgery were integrated in incremental cost-utility analyses. All value outcomes and costs were discounted at a 3% annual rate, as per the Panel on Cost-Effectiveness in Health and Medicine. Comparative effectiveness was quantified using the (1) quality-adjusted life-year (QALY) gain and (2) percent human value gain (improvement in quality of life). The QALY gain was integrated with incremental costs into the cost-utility ratio ($/QALY, or US dollars expended per QALY gained). The mean, discounted QALY gain associated with use of the telescope prosthesis over 12 years was 0.7577. When the QALY loss of 0.0004 attributable to the adverse events was factored into the model, the final QALY gain was 0.7573. This resulted in a 12.5% quality of life gain for the average patient during the 12 years of the model. The average cost-utility versus no therapy for use of the telescope prosthesis was $14389/QALY. The incremental cost-utility referent

  19. Comparative evaluation of the oral tactile function by means of teeth or implant-supported prostheses.

    PubMed

    Jacobs, R; van Steenberghe, D

    1991-01-01

    To clarify more of the tactile function of oral implants, both an interocclusal thickness detection and discrimination task were carried out in 4 different test conditions on 37 patients: t (tooth)/t, i (implant)/t, i/i and d (denture)/o (overdenture supported by implants). For the interocclusal detection of steel foils, the 50% detection threshold level (RL) in the 4 conditions was 20, 48, 64 and 108 microns, respectively, which indicates significant differences. The ability to discriminate interdental thickness differences was tested with a 0.2 and 1.0 mm standard. It was evaluated as the 75% discrimination level (DL). In the 0.2 mm discrimination task, corresponding DL-values for the t/t, i/t, i/i and d/o condition were 25, 55, 66 and 134 microns, whereas the 1.0 mm standard gave values of 193, 293, 336 and 348 microns, respectively. All results differed significantly from each other (p less than 0.05) except for the i/i-d/o comparison of the 1.0 mm discrimination task where the difference was negligible. The present findings indicate that the tactile sensibility of implants is reduced with regard to natural teeth. Remaining receptors of the peri-implant tissues might play a compensatory role in the decreased exteroceptive function.

  20. Measurement of the rotational misfit and implant-abutment gap of all-ceramic abutments.

    PubMed

    Garine, Wael N; Funkenbusch, Paul D; Ercoli, Carlo; Wodenscheck, Joseph; Murphy, William C

    2007-01-01

    The specific aims of this study were to measure the implant and abutment hexagonal dimensions, to measure the rotational misfit between implant and abutments, and to correlate the dimension of the gap present between the abutment and implant hexagons with the rotational misfit of 5 abutment-implant combinations from 2 manufacturers. Twenty new externally hexed implants (n = 10 for Nobel Biocare; n = 10 for Biomet/3i) and 50 new abutments were used (n = 10; Procera Zirconia; Procera Alumina; Esthetic Ceramic Abutment; ZiReal; and GingiHue post ZR Zero Rotation abutments). The mating surfaces of all implants and abutments were imaged with a scanning electron microscope before and after rotational misfit measurements. The distances between the corners and center of the implant and abutment hexagon were calculated by entering their x and y coordinates, measured on a measuring microscope, into Pythagoras' theorem. The dimensional difference between abutment and implant hexagons was calculated and correlated with the rotational misfit, which was recorded using a precision optical encoder. Each abutment was rotated (3 times/session) clockwise and counterclockwise until binding. Analysis of variance and Student-Newman-Keuls tests were used to compare rotational misfit among groups (alpha = .05). With respect to rotational misfit, the abutment groups were significantly different from one another (P < .001), with the exception of the Procera Zirconia and Esthetic Ceramic groups (P = .4). The mean rotational misfits in degrees were 4.13 +/- 0.68 for the Procera Zirconia group, 3.92 +/- 0.62 for the Procera Alumina group, 4.10 +/- 0.67 for the Esthetic Ceramic group, 3.48 +/- 0.40 for the ZiReal group, and 1.61 +/- 0.24 for the GingiHue post ZR group. There was no correlation between the mean implant-abutment gap and rotational misfit. Within the limits of this study, machining inconsistencies of the hexagons were found for all implants and abutments tested. The GingiHue Post

  1. Zirconia-molybdenum disilicide composites

    DOEpatents

    Petrovic, John J.; Honnell, Richard E.

    1991-01-01

    Compositions of matter comprised of molybdenum disilicide and zirconium oxide in one of three forms: pure, partially stabilized, or fully stabilized and methods of making the compositions. The stabilized zirconia is crystallographically stabilized by mixing it with yttrium oxide, calcium oxide, cerium oxide, or magnesium oxide and it may be partially stabilized or fully stabilized depending on the amount of stabilizing agent in the mixture.

  2. Retrospective comparative analysis of cardiovascular implantable electronic device infections with and without the use of antibacterial envelopes.

    PubMed

    Hassoun, A; Thottacherry, E D; Raja, M; Scully, M; Azarbal, A

    2017-03-01

    Cardiovascular implantable electronic device (CIED) infections are associated with morbidity and mortality. Peri-operative systemic intravenous antibiotic prophylaxis reduces the rate of CIED infections. AIGIS Rx , a polymer envelope implanted with the CIED, releases minocycline and rifampin, and has been introduced to reduce infections. Retrospective review of 184 patients who underwent CIED implantation was conducted. Ninety-two patients were implanted with an AIGIS Rx envelope (AIGIS Rx group) and 92 patients were not implanted with an AIGIS Rx envelope (control group). Data were collected on demographics and risk factors for CIED infections (i.e. congestive heart failure, renal insufficiency, chronic kidney disease, oral anticoagulant use, chronic steroid use, need for lead replacement or revision, temporary pacing, early re-intervention, and having more than two leads in place). Rates of implantation success, major infections and mortality were compared between the AIGIS Rx group and the control group. The AIGIS Rx group had longer hospitalizations (6.8±10.7 days vs 3.1±5.2 days; P=0.001), higher chronic corticosteroid use, higher rates of replacement or revision (51.1% vs 8.7%; P=0.001), and a greater proportion of devices with more than two intracardiac leads (42.4% vs 29.3%; P=0.03) than the control group. Successful implantation occurred in 97% of patients in both groups. Major infection was seen in 5.4% of cases in the AIGIS Rx group and 1.1% of cases in the control group (P=0.048). Device removal was conducted in 3.3% of cases in the AIGIS Rx group compared with 1.1% of cases in the control group (P=0.16). There were two deaths in the AIGIS Rx group. Organisms cultured were meticillin-resistant Staphylococcus aureus, meticillin-susceptible S. aureus and Enterococcus faecalis. The AIGIS Rx group had higher rates of major infection but also higher risk factors compared with the control group. The rate of device extraction and CIED-related mortality was

  3. Comparative study of the failure rates among 3 implantable defibrillator leads.

    PubMed

    van Malderen, Sophie C H; Szili-Torok, Tamas; Yap, Sing C; Hoeks, Sanne E; Zijlstra, Felix; Theuns, Dominic A M J

    2016-12-01

    After the introduction of the Biotronik Linox S/SD high-voltage lead, several cases of early failure have been observed. The purpose of this article was to assess the performance of the Linox S/SD lead in comparison to 2 other contemporary leads. We used the prospective Erasmus MC ICD registry to identify all implanted Linox S/SD (n = 408), Durata (St. Jude Medical, model 7122) (n = 340), and Endotak Reliance (Boston Scientific, models 0155, 0138, and 0158) (n = 343) leads. Lead failure was defined by low- or high-voltage impedance, failure to capture, sense or defibrillate, or the presence of nonphysiological signals not due to external interference. During a median follow-up of 5.1 years, 24 Linox (5.9%), 5 Endotak (1.5%), and 5 Durata (1.5%) leads failed. At 5-year follow-up, the cumulative failure rate of Linox leads (6.4%) was higher than that of Endotak (0.4%; P < .0001) and Durata (2.0%; P = .003) leads. The incidence rate was higher in Linox leads (1.3 per 100 patient-years) than in Endotak and Durata leads (0.2 and 0.3 per 100 patient-years, respectively; P < .001). A log-log analysis of the cumulative hazard for Linox leads functioning at 3-year follow-up revealed a stable failure rate of 3% per year. The majority of failures consisted of noise (62.5%) and abnormal impedance (33.3%). This study demonstrates a higher failure rate of Linox S/SD high-voltage leads compared to contemporary leads. Although the mechanism of lead failure is unclear, the majority presents with abnormal electrical parameters. Comprehensive monitoring of Linox S/SD high-voltage leads includes remote monitoring to facilitate early detection of lead failure. Copyright © 2016. Published by Elsevier Inc.

  4. Comparative study of manufacturing condyle implant using rapid prototyping and CNC machining

    NASA Astrophysics Data System (ADS)

    Bojanampati, S.; Karthikeyan, R.; Islam, MD; Venugopal, S.

    2018-04-01

    Injuries to the cranio-maxillofacial area caused by road traffic accidents (RTAs), fall from heights, birth defects, metabolic disorders and tumors affect a rising number of patients in the United Arab Emirates (UAE), and require maxillofacial surgery. Mandibular reconstruction poses a specific challenge in both functionality and aesthetics, and involves replacement of the damaged bone by a custom made implant. Due to material, design cycle time and manufacturing process time, such implants are in many instances not affordable to patients. In this paper, the feasibility of designing and manufacturing low-cost, custom made condyle implant is assessed using two different approaches, consisting of rapid prototyping and three-axis computer numerically controlled (CNC) machining. Two candidate rapid prototyping techniques are considered, namely fused deposition modeling (FDM) and three-dimensional printing followed by sand casting The feasibility of the proposed manufacturing processes is evaluated based on manufacturing time, cost, quality, and reliability.

  5. Mastectomy Skin Necrosis After Breast Reconstruction: A Comparative Analysis Between Autologous Reconstruction and Implant-Based Reconstruction.

    PubMed

    Sue, Gloria R; Lee, Gordon K

    2018-05-01

    Mastectomy skin necrosis is a significant problem after breast reconstruction. We sought to perform a comparative analysis on this complication between patients undergoing autologous breast reconstruction and patients undergoing 2-stage expander implant breast reconstruction. A retrospective review was performed on consecutive patients undergoing autologous breast reconstruction or 2-stage expander implant breast reconstruction by the senior author from 2006 through 2015. Patient demographic factors including age, body mass index, history of diabetes, history of smoking, and history of radiation to the breast were collected. Our primary outcome measure was mastectomy skin necrosis. Fisher exact test was used for statistical analysis between the 2 patient cohorts. The treatment patterns of mastectomy skin necrosis were then analyzed. We identified 204 patients who underwent autologous breast reconstruction and 293 patients who underwent 2-stage expander implant breast reconstruction. Patients undergoing autologous breast reconstruction were older, heavier, more likely to have diabetes, and more likely to have had prior radiation to the breast compared with patients undergoing implant-based reconstruction. The incidence of mastectomy skin necrosis was 30.4% of patients in the autologous group compared with only 10.6% of patients in the tissue expander group (P < 0.001). The treatment of this complication differed between these 2 patient groups. In general, those with autologous reconstructions were treated with more conservative means. Although 37.1% of patients were treated successfully with local wound care in the autologous group, only 3.2% were treated with local wound care in the tissue expander group (P < 0.001). Less than half (29.0%) of patients in the autologous group were treated with an operative intervention for this complication compared with 41.9% in the implant-based group (P = 0.25). Mastectomy skin necrosis is significantly more likely to occur after

  6. Comparative 3D micro-CT and 2D histomorphometry analysis of dental implant osseointegration in the maxilla of minipigs.

    PubMed

    Bissinger, Oliver; Probst, Florian Andreas; Wolff, Klaus-Dietrich; Jeschke, Anke; Weitz, Jochen; Deppe, Herbert; Kolk, Andreas

    2017-04-01

    The bone implant contact (BIC) has traditionally been evaluated with histological methods. Thereupon, strong correlations of two-dimensional (2D) BIC have been detected between μCT and destructive histology. However, due to the high intra-sample variability in BIC values, one histological slice is not sufficient to represent 3D BIC. Therefore, our aim has been to correlate the averaged values of 3-4 histological sections to 3D μCT. Fifty-four implants inserted into the maxilla of 14 minipigs were evaluated. Two different time points were selected to assess the 3D BIC (distance to implant: 2-5 voxels), an inner ring (6-30 voxels) and an outer ring (55-100 voxels) using μCT (voxel size: 10 μm) and to correlate the values to histomorphometry. Strong correlations (p < 0.0001; 28 days, 56 days, total) were seen between μCT and histomorphometry concerning BIC (r = 0.84, r = 0.85, r = 0.83), the inner ring (r = 0.87, r = 0.87, r = 0.88) and the outer ring (r = 0.85, r = 0.85, r = 0.88). Closer to the implant, μCT values were higher compared with histomorphometry. Although 3-4 histological slices per implant seem to predict the 3D BIC, μCT might be advantageous because of its non-destructive 3D character. The healing time may not impact on the comparability. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Findings from the experience with the punch technique for auditory osseointegrated implants: A retrospective single center comparative study.

    PubMed

    Bonilla, Alfonso; Magri, Carlos; Juan, Eulalia

    To compare the punch technique and linear incision with soft tissue reduction for the placement of auditory osseointegrated implants (AOI) and analyze results of osseointegration obtained with the punch technique as measured with the Implant Stability Quotient (ISQ). Case review of 34 patients who received auditory osseointegrated implants between January 2010 and July 2015 and were divided into two groups according to the surgical technique: 18 with the punch technique (PT) and 16 with the linear incision technique (LI). Minimum follow-up was four months (mean: 24 months; range 4-64 months). Included in the analysis were patient profiles and records of the demographic data, surgical indications, surgical technique, implant placement, surgical time, intraoperative complications, as well as postsurgical complications (Holgers classification) and implant stability quotients (ISQ). Use of larger abutments was significantly greater in the PT group (PT, 10mm; LI, 6mm, p<0.001). The PT technique resulted in a shorter procedure than the LI (PT, 20min; LI, 45min, p<0.001). Holgers classification scores identified significantly fewer skin complications one week after surgery for the PT group; however, only small differences were seen between the two groups at the one- and three-month control visits. As shown for our cohort, the punch technique for surgical placement of AOI is faster and presents fewer immediate postoperative complications when compared to the linear incision technique. The clinical application of the ISQ is a useful, easy method to demonstrate the status of osseointegration and, thus, the stability of the device. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  8. [Comparing the anchorage effects of micro-implant and J hook on treating patients with maxillary protrusion].

    PubMed

    Wu, Xin; Liu, Guo-yuan; Jiang, Yong-lian

    2015-10-01

    To investigate the differences in anchorage effects between micro-implants and J hook in treating patients with Class II division 1 maxillary protrusion. Thirty-one cases of adult patients with Class II division 1 maxillary protrusion were treated. They were divided into 2 groups depending on their selection. The first group included 17 patients for micro-implant anchorage, who adopted micro-implant and sliding mechanism to close maxillary extraction space and depress the mandibular molar. The second group encompassed 14 cases for J hook, who adopted sliding mechanism, J hooks in high traction and Class II intermaxillary traction to close extraction space. X-ray lateral cephalometric radiographs were measured before and after treatment, and SPSS16.0 software package was employed to compare the differences in soft and hard tissue changes before and after treatment between 2 groups. There were statistically significant differences in SNB, ANB, MP-FH, U1-Y, U6-Y, L6-MP, NLA, and UL-Y between the 2 groups before and after treatment, while there was no significant difference in SNA, U1-SN, U1-X, and U6-X between the 2 groups. In treating patients with Class II division 1 maxillary protrusion, micro-implant has stronger anchorage effects than J hook, while at the same time depressing the mandibular molars, and making it more favorable to improve Class II faces.

  9. Precision Fit of Screw-Retained Implant-Supported Fixed Dental Prostheses Fabricated by CAD/CAM, Copy-Milling, and Conventional Methods.

    PubMed

    de França, Danilo Gonzaga; Morais, Maria Helena; das Neves, Flávio D; Carreiro, Adriana Fonte; Barbosa, Gustavo As

    The aim of this study was to evaluate the effectiveness of fabrication methods (computer-aided design/computer-aided manufacture [CAD/CAM], copy-milling, and conventional casting) in the fit accuracy of three-unit, screw-retained fixed dental prostheses. Sixteen three-unit implant-supported screw-retained frameworks were fabricated to fit an in vitro model. Eight frameworks were fabricated using the CAD/CAM system, four in zirconia and four in cobalt-chromium. Four zirconia frameworks were fabricated using the copy-milled system, and four were cast in cobalt-chromium using conventional casting with premachined abutments. The vertical and horizontal misfit at the implant-framework interface was measured using scanning electron microscopy at ×250. The results for vertical misfit were analyzed using Kruskal-Wallis and Mann-Whitney tests. The horizontal misfits were categorized as underextended, equally extended, or overextended. Statistical analysis established differences between groups according to the chi-square test (α = .05). The mean vertical misfit was 5.9 ± 3.6 μm for CAD/CAM-fabricated zirconia, 1.2 ± 2.2 μm for CAD/CAM-fabricated cobalt-chromium frameworks, 7.6 ± 9.2 μm for copy-milling-fabricated zirconia frameworks, and 11.8 (9.8) μm for conventionally fabricated frameworks. The Mann-Whitney test revealed significant differences between all but the zirconia-fabricated frameworks. A significant association was observed between the horizontal misfits and the fabrication method. The percentage of horizontal misfits that were underextended and overextended was higher in milled zirconia (83.3%), CAD/CAM cobaltchromium (66.7%), cast cobalt-chromium (58.3%), and CAD/CAM zirconia (33.3%) frameworks. CAD/CAM-fabricated frameworks exhibit better vertical misfit and low variability compared with copy-milled and conventionally fabricated frameworks. The percentage of interfaces equally extended was higher when CAD/CAM and zirconia were used.

  10. Ion beam synthesis of ZrC{sub x}O{sub y} nanoparticles in cubic zirconia

    SciT

    Velişa, Gihan, E-mail: gihan@tandem.nipne.ro; Horia Hulubei National Institute for Physics and Nuclear Engineering, P.O.B. MG-6, 077125 Magurele; Mylonas, Stamatis

    2016-04-28

    {110}-oriented yttria-stabilized zirconia single crystals have been implanted with low-energy C ions in an axial direction, at room temperature and at 550 °C. Room temperature ion implantation generated a damage layer that contains the expected dislocation loop clusters. Strikingly, the high temperature implantation produced zirconium oxycarbide nanoparticles (ZrC{sub x}O{sub y}) at a shallow depth in the yttria-stabilized cubic zirconia crystal, with a diameter in the range of 4–10 nm. Moreover, in the high concentration region of implanted C ions, between 100 and 150 nm below the surface, a number of large precipitates, up to 20 nm, were observed.

  11. Randomized clinical study of wear of enamel antagonists against polished monolithic zirconia crowns

    PubMed Central

    Esquivel-Upshaw, J.F.; Kim, M.J.; Hsu, S.M.; Abdulhameed, N.; Jenkins, R.; Neal, D.; Ren, F.; Clark, A.E.

    2018-01-01

    Objectives To test the hypothesis that there is no difference in the in vivo maximum wear of enamel opposing monolithic zirconia crowns, enamel opposing porcelain fused to metal crowns and enamel opposing enamel. Methods Thirty patients needing single crowns were randomized to receive either a monolithic zirconia or metal-ceramic crown. Two non-restored opposing teeth in the same quadrants were identified to serve as enamel controls. After cementation, quadrants were scanned for baseline data. Polyvinylsiloxane impressions were obtained and poured in white stone. Patients were recalled at six-months and one-year for re-impression. Stone models were scanned using a tabletop laserscanner to determine maximum wear. Statistical analysis was performed using Mann-Whitney U to determine any significant differences between the wear of enamel against zirconia and metal-ceramic crowns. Results Sixteen zirconia and 14 metal-ceramic crowns were delivered. There were no statistical differences in mean wear of crown types (p = 0.165); enamel antagonists (p = 0.235) and enamel controls (p = 0.843) after one year. Conclusion Monolithic zirconia exhibited comparable wear of enamel compared with metal-ceramic crowns and control enamel after one year. Significance This study is clinically significant because the use of polished monolithic zirconia demonstrated comparable wear of opposing enamel to metal-ceramic and enamel antagonists. PMID:29042241

  12. Influence of low temperature ageing on optical and mechanical properties of transparent yittria stabilized-zirconia cranial prosthesis

    NASA Astrophysics Data System (ADS)

    Davoodzadeh, Nami; Uahengo, Gottlieb; Halaney, David; Garay, Javier E.; Aguilar, Guillermo

    2018-02-01

    Laser-based diagnostics and therapeutics show promise for many neurological disorders. However, the poor transparency of cranial bone limits the spatial resolution and interaction depth that can be achieved. We addressed this limitation previously, by introducing a novel cranial prosthesis made of a transparent nanocrystalline yttria-stabilized zirconia (nc-YSZ) which aims to enhance the diagnosis and treatment of neurological diseases by providing chronic optical access to the brain. By using optical coherence tomography, we have demonstrated the initial feasibility of ncYSZ implants for cortical imaging in an acute murine model. Although zirconia-based implants have been known for their excellent mechanical properties, the in vivo application was found to be affected by long-term failures, due to low temperature degradation. Accelerated aging simulations in humid environments at slightly elevated temperatures and over long periods typically transforms the ceramic surface into a monoclinic structure through a stress-corrosion-type mechanism. It was expected that the new nc-YSZ would show sufficient resistance to humid environments in comparison to the conventional zirconia implant. However, even a modest amount of transformation can change optical characteristics such as transparency. Herein we present the results of a simulated ageing study following the guidelines from the ISO 13356:2008 on aging of surgical zirconia ceramics. Comparison of %monoclinic transformation, optical transparency and mechanical hardness of nc-YSZ samples at baseline and following 25 and 100 h hydrothermal treatments shows our implant can withstand these extended ageing treatments.

  13. A comparative study on the stress distribution around dental implants in three arch form models for replacing six implants using finite element analysis.

    PubMed

    Zarei, Maryam; Jahangirnezhad, Mahmoud; Yousefimanesh, Hojatollah; Robati, Maryam; Robati, Hossein

    2018-01-01

    Dental implant is a method to replacement of missing teeth. It is important for replacing the missed anterior teeth. In vitro method is a safe method for evaluation of stress distribution. Finite element analysis as an in vitro method evaluated stress distribution around replacement of six maxillary anterior teeth implants in three models of maxillary arch. In this in vitro study, using ABAQUS software (Simulia Corporation, Vélizy-Villacoublay, France), implant simulation was performed for reconstruction of six maxillary anterior teeth in three models. Two implants were placed on both sides of the canine tooth region (A model); two implants on both sides of the canine tooth region and another on one side of the central incisor region (B model); and two implants on both sides of the canine tooth region and two implants in the central incisor area (C model). All implants evaluated in three arch forms (tapered, ovoid, and square). Data were analyzed by finite analysis software. Von Mises stress by increasing of implant number was reduced. In a comparison of A model in each maxillary arch, the stress created in the cortical and cancellous bones in the square arch was less than ovoid and tapered arches. The stress created in implants and cortical and cancellous bones in C model was less than A and B models. The C model (four-implant) reduced the stress distribution in cortical and cancellous bones, but this pattern must be evaluated according to arch form and cost benefit of patients.

  14. Comparative study of irradiated and hydrogen implantation damaged German RPV steels from PAS point of view

    NASA Astrophysics Data System (ADS)

    Pecko, Stanislav; Sojak, Stanislav; Slugeň, Vladimír

    2014-09-01

    Commercial German reactor pressure vessel (RPV) steels were studied by positron annihilation lifetime spectroscopy (PALS). This unique non-destructive method can be effectively applied for the evaluation of microstructural changes and for the analysis of degradation of reactor steels due to neutron irradiation and proton implantation. Studied specimens of German reactor pressure vessel steels are originally from CARINA/CARISMA program. Eight specimens were measured in as-received state and two specimens were irradiated by neutrons in German experimental reactor VAK (Versuchsatomkraftwerk Kahl) in the 1980s. One of the specimens which was also in as-received and neutron irradiated condition was also used for simulation of neutron damage by hydrogen nuclei implantation. Defects with the size of about 1-2 vacancies with relatively small contribution (with intensity on the level of 20-40%) were observed in "as-received" steels. A significant increase in the size of the induced defects due to neutron damage was observed at a level of 2-3 vacancies in the irradiated specimens. The size and intensity of defects reached a similar level as in the specimens irradiated in nuclear reactor due to hydrogen ions implantation with energy of 100 keV (up to the depth <500 nm). This could confirm the ability to simulate neutron damage by ion implantation.

  15. A comparative evaluation of mandibular finite element models with different lengths and elements for implant biomechanics.

    PubMed

    Teixeira, E R; Sato, Y; Akagawa, Y; Shindoi, N

    1998-04-01

    Further validity of finite element analysis (FEA) in implant biomechanics requires an increase of modelled range and mesh refinement, and a consequent increase in element number and calculation time. To develop a new method that allows a decrease of the modelled range and element number (along with less calculation time and less computer memory), 10 FEA models of the mandible with different mesio-distal lengths and elements were constructed based on three-dimensional graphic data of the bone structure around an osseointegrated implant. Analysis of stress distribution followed by 100 N loading with the fixation of the most external planes of the models indicated that a minimal bone length of 4.2 mm of the mesial and distal sides was acceptable for FEA representation. Moreover, unification of elements located far away from the implant surface did not affect stress distribution. These results suggest that it may be possible to develop a replica FEA implant model of the mandible with less range and fewer elements without altering stress distribution.

  16. Increasing synthetic serum substitute (SSS) concentrations in P1 glucose/phosphate-free medium improves implantation rate: a comparative study.

    PubMed

    Ben-Yosef, D; Yovel, I; Schwartz, T; Azem, F; Lessing, J B; Amit, A

    2001-11-01

    To assess the comparative efficacy of IVF medium (MediCult, with 5.2 mM glucose) and a glucose/phosphate-free medium, P1 (Irvine Scientific), and to investigate the influence of increasing the serum supplementation (synthetic serum substitute; SSS; Irvine Scientific) to P1 on embryo development and implantation. Patients were randomly assigned to IVF medium (Group 1, cycles n = 172) or P1 supplemented with 10% SSS (Group 2, cycles n = 229) according to the medium scheduled for use on the day of oocyte retrieval. Another 555 IVF consequent cycles (Group 3) were performed using increased SSS concentrations (20%) in P1 medium. In this large series of IVF cycles, we herein demonstrate that significantly higher pregnancy and implantation rates were found when embryos were cultured in glucose/phosphate-free medium P1 supplemented with 20% SSS compared to supplementation with the lower SSS concentration and with IVF medium.

  17. Implant Supported Distal Extension over Denture Retained by Two Types of Attachments. A Comparative Radiographic Study by Cone Beam Computed Tomography

    PubMed Central

    Mahrous, Ahmed I; Aldawash, Hussien A; Soliman, Tarek A; Banasr, Fahad H; Abdelwahed, Ahmed

    2015-01-01

    Background: This study was conducted to compare and evaluate the effect of two different attachments (locator attachment and ball and socket [B&S] attachment) on implants and natural abutments supporting structures, in cases of limited inter-arch spaces in mandibular Kennedy Class I implant supported removable partial over dentures by measuring the bone height changes through the cone beam radiographic technology. Materials and Methods: Two implants were positioned in the first or second molar area following the two-stage surgical protocol. Two equal groups were divided ten for each: Group I: Sides were the placed implants restored by the locator attachment. Group II: The other sides, implants were restored by B&S attachment. Evaluation of the implants and main abutments supporting structures of each group was done at the time of removable partial over denture insertion, 6, 12 and 18 months by measuring the bone height changes using cone beam computed tomography. Results: Implants with locator attachment showed marginal bone height better effects on implants and main abutments supporting structures. Conclusion: Implants restored by locator attachment shows better effects on bone of both main natural abutments and implant than those restored with ball and socket. PMID:26028894

  18. SEM evaluation of human gingival fibroblasts growth onto CAD/CAM zirconia and veneering ceramic for zirconia

    PubMed Central

    Zizzari, Vincenzo; Borelli, Bruna; De Colli, Marianna; Tumedei, Margherita; Di Iorio, Donato; Zara, Susi; Sorrentino, Roberto; Cataldi, Amelia; Gherlone, Enrico Felice; Zarone, Fernando; Tetè, Stefano

    2013-01-01

    Summary Aim To evaluate the growth of Human Gingival Fibroblasts (HGFs) cultured onto sample discs of CAD/CAM zirconia and veneering ceramic for zirconia by means of Scanning Electron Microscope (SEM) analysis at different experimental times. Methods A total of 26 experimental discs, divided into 2 groups, were used: Group A) CAD/CAM zirconia (3Y-TZP) discs (n=13); Group B) veneering ceramic for zirconia discs (n=13). HGFs were obtained from human gingival biopsies, isolated and placed in culture plates. Subsequently, cells were seeded on experimental discs at 7,5×103/cm2 concentration and cultured for a total of 7 days. Discs were processed for SEM observation at 3h, 24h, 72h and 7 days. Results In Group A, after 3h, HGFs were adherent to the surface and showed a flattened profile. The disc surface covered by HGFs resulted to be wider in Group A than in Group B samples. At SEM observation, after 24h and 72h, differences in cell attachment were slightly noticeable between the groups, with an evident flattening of HGFs on both surfaces. All differences between Group A and group B became less significant after 7 days of culture in vitro. Conclusions SEM analysis of HGFs showed differences in terms of cell adhesion and proliferation, especially in the early hours of culture. Results showed a better adhesion and cell growth in Group A than in Group B, especially up to 72h in vitro. Differences decreased after 7 days, probably because of the rougher surface of CAD/CAM zirconia, promoting better cell adhesion, compared to the smoother surface of veneering ceramic. PMID:24611089

  19. Zirconia in fixed prosthesis. A literature review

    PubMed Central

    Román-Rodríguez, Juan L.; Ferreiroa, Alberto; Solá-Ruíz, María F.; Fons-Font, Antonio

    2014-01-01

    Statement of problem: Evidence is limited on the efficacy of zirconia-based fixed dental prostheses. Objective: To carry out a literature review of the behavior of zirconium oxide dental restorations. Material and Methods: This literature review searched the Pubmed, Scopus, Medline and Cochrane Library databases using key search words “zirconium oxide,” “zirconia,” “non-metal restorations,” “ceramic oxides,” “veneering ceramic,” “zirconia-based fixed dental prostheses”. Both in vivo and in vitro studies into zirconia-based prosthodontic restoration behavior were included. Results: Clinical studies have revealed a high rate of fracture for porcelain-veneered zirconia-based restorations that varies between 6% and 15% over a 3- to 5-year period, while for ceramo-metallic restorations the fracture rate ranges between 4 and 10% over ten years. These results provoke uncertainty as to the long-term prognosis for this material in the oral medium. The cause of veneering porcelain fractures is unknown but hypothetically they could be associated with bond failure between the veneer material and the zirconia sub-structure. Key words:Veneering ceramic, zirconia-based ceramic restoration, crown, zirconia, tooth-supported fixed prosthesis. PMID:24596638

  20. Totally implantable venous access devices: evaluation of complications and a prospective comparative study of two different port systems.

    PubMed

    Hartkamp, A; van Boxtel, A J; Zonnenberg, B A; Witteveen, P O

    2000-12-01

    Totally implantable venous access devices (TIVADs) are valuable instruments in case prolonged intravenous therapy is required, but implantation and use of these devices are associated with complications. The purpose of this study was to evaluate perioperative and long-term complications associated with TIVADs. In addition, we compared two different types of TIVADs with respect to implantation, care protocol and patients' comfort. In a retrospective study perioperative and long-term complications in a general oncology population were analysed. In a prospective randomized study comparison of two types of TIVADs was carried out. Perioperative complications occurred in 27 (21.4%) of 126 implanted TIVADs: catheter malposition (16.7%) in 21 patients, pneumothorax (0.8%) in one and haemorrhage (4.0%) in five. Long-term complications appeared in 31 (25.2%) out of 123 TIVADs: thrombosis in 9 (7.3%), especially associated with malposition of the tip of the catheter; infection in 10 (8.1%); extravasation in 2 (1.6%); migration of the catheter tip in 6 (4.8%); pain at reservoir in 3 (2.4%) and inaccessibility of the port in 1 (0.8%). No significant differences were found with respect to implantation, care accessibility and patients' comfort between the two TIVADs. The use of TIVADs is associated with some risk of serious perioperative and long-term complications. In case of thrombotic complications these systems can be saved with appropriate treatment. Correct positioning of the catheter tip is essential to prevent thrombotic complications. In case of TIVAD-related infectious complications, the possibility of saving the TIVAD depends on the causative microorganism and type of infection. Furthermore, to increase patients' satisfaction with TIVADs they should be well informed about the surgical procedure and possible disadvantages of these devices.

  1. SU-E-T-12: A Comparative Dosimetric Study of Pre and Post Prostate Iodine-125 Permanent Seed Implants

    SciT

    Liu, X; Rahimian, J; Goy, B

    Purpose: Post-implant dosimetry has become the gold standard for prostate implant evaluation. The goal of this research is to compare the dosimetry between pre-plan and post-plan in permanent prostate seed implant brachytherapy. Methods: A retrospective study of 91 patients treated with Iodine-125 prostate seed implant between year 2012∼2014 were performed. All plans were created using a VariSeed 8.0 planning system. Pre-plan ultrasound images were acquired using 0.5 cm slice thickness. Post-plan CT images acquired about 1–4 weeks after implant, fused with the preplan ultrasound images. The prostate and urethra contours were generated using the fusion of ultrasound and CT images.more » Iodine-125 seed source activities varied between 0.382 to 0.414 mCi per seed. The loading patterns varied slightly between patients depending on the prostate size. Statistical analysis of pre and post plans for prostate and urethra volumes, V100%, V150% and D90, and urethra D10 were performed and reported. Results: The pre and post implant average prostate size was 36.90cc vs. 38.58cc; V100% was 98.33% vs. 96.89%; V150% was 47.09% vs. 56.95%; D90 was 116.35Gy vs. 116.12Gy, urethra volume was 1.72cc vs. 1.85cc, urethra D10% was 122.0% vs. 135.35%, respectively. There was no statistically significant difference between the pre and post-plan values for D90(p-value=0.43). However, there are significant differences between other parameters most likely due to post surgical edema; prostate size (p-value= 0.00015); V100% (p-value=3.7803E-07); V150% (p-value=1.49E-09); urethra volume (p-value= 2.77E-06); Urethra D10 (p-value=7.37E-11). Conclusion: The post-plan dosimetry using CT image set showed similar D90 dose coverage to the pre-plan using the ultrasound image dataset. The study showed that our prostate seed implants have consistently delivered adequate therapeutic dose to the prostate while sparing urethra. Future studies to correlate dose versus biochemical response using

  2. Penile prosthesis implantation compares favorably in malpractice outcomes to other common urological procedures: findings from a malpractice insurance database.

    PubMed

    Chason, Juddson; Sausville, Justin; Kramer, Andrew C

    2009-08-01

    Some urologists choose not to offer penile prostheses because of concern over malpractice liability. The aim of this study was to assess whether urologists performing penile prosthesis surgery are placed at a greater malpractice risk. Percentage of malpractice suits from prosthesis surgery and other urological procedures that result in payment, average resulting payout from these cases, and category of legal issue that ultimately resulted in payout. A database from the Physician Insurers Association of America, an association of malpractice insurance companies covering physicians in North America, was analyzed to quantitatively compare penile implant surgery to other urological procedures in medicolegal terms. Compared to other common urological procedures, penile implant is comparable and on the lower end of the spectrum in terms of both the percentage of malpractice suits that result in payment and the amount ultimately paid in indemnity from those cases. Additionally, issues of informed consent play the largest role in indemnities for all urological procedures, whereas surgical technique is the most important issue for prosthesis surgery. Urologists who are adequately trained in prosthetic surgery should not avoid penile implant procedures for fear of malpractice suits. A focus on communication and informed consent can greatly reduce malpractice risk for urological procedures.

  3. Shear bond strength between an indirect composite layering material and feldspathic porcelain-coated zirconia ceramics.

    PubMed

    Fushiki, Ryosuke; Komine, Futoshi; Blatz, Markus B; Koizuka, Mai; Taguchi, Kohei; Matsumura, Hideo

    2012-10-01

    This study aims to evaluate the effect of both feldspathic porcelain coating of zirconia frameworks and priming agents on shear bond strength between an indirect composite material and zirconia frameworks. A total of 462 airborne-particle-abraded zirconia disks were divided into three groups: untreated disks (ZR-AB), airborne-particle-abraded zirconia disks coated with feldspathic porcelain, (ZR-PO-AB), and hydrofluoric acid-etched zirconia disks coated with feldspathic porcelain (ZR-PO-HF). Indirect composite (Estenia C&B) was bonded to zirconia specimens with no (CON) or one of four priming agents--Clearfil Photo Bond (CPB), Clearfil Photo Bond with Clearfil Porcelain Bond Activator (CPB + activator), Estenia Opaque primer, or Porcelain Liner M Liquid B (PLB)--with or without an opaque material (Estenia C&B Opaque). All specimens were tested for shear bond strength before and after 20,000 thermocycles. The Steel-Dwass test and Mann-Whitney U test were used to compare shear bond strength. In ZR-AB specimens, the initial bond strength of the CPB and CPB + Activator groups was significantly higher as compared with the other three groups (P < 0.05), whereas the PLB and CPB + Activator groups had the highest pre- and post-thermocycling bond strengths in ZR-PO-AB and ZR-PO-HF specimens. Among CON disks without opaque material, bond strength was significantly lower in ZR-AB specimens than in ZR-PO-AB and ZR-PO-HF specimens (P < 0.05). Feldspathic porcelain coating of a Katana zirconia framework enhanced the bond strength of Estenia C&B indirect composite to zirconia independent of surface treatment. The use of a silane coupling agent and opaque material yields durable bond strength between the indirect composite and feldspathic-porcelain-coated zirconia. The results of the present study suggest that feldspathic porcelain coating of zirconia frameworks is an effective method to obtain clinically acceptable bond strengths of a layering indirect

  4. Titanium hydride and hydrogen concentration in acid-etched commercially pure titanium and titanium alloy implants: a comparative analysis of five implant systems.

    PubMed

    Szmukler-Moncler, S; Bischof, M; Nedir, R; Ermrich, M

    2010-09-01

    Acid etching is a popular method to texture the surface of dental implants. During etching, the titanium oxide protective layer is dissolved and small native hydrogen ions diffuse into the unprotected implant surface. They enrich the implant surface with hydrogen and precipitate into titanium hydride (TiH). The aim of this study was to measure the concentration of TiH at the implant surface and the total concentration of Hydrogen at five commercially available implant systems, made of either commercially pure (cp) titanium or titanium alloy. X-Ray diffraction (XRD) was conducted on each implant system to determine the compounds present at the implant surface. Following a TiH(2)/Ti calibration curve, the concentration of TiH was determined. Concentration of hydrogen in the implants was measured by the inert gas fusion thermal conductivity/infrared detection method. XRD data showed that TiH was present on all cp titanium implants but not on the alloyed implants. TiH concentration varied between 5% and 37%. Hydrogen concentration varied between 43 and 108 ppm, no difference in uptake was found between the cp titanium and alloyed implants. Low solubility of hydrogen in alpha-titanium is responsible for precipitation into TiH. Stronger etching conditions led to higher concentration of TiH2-x. High solubility of hydrogen in the beta-phase of the alloy is preventing hydrogen from precipitating into TiH. All implants, even those lacking TiH at the surface, were enriched with hydrogen. In all implants, hydrogen concentration was within the normative limit of 130 ppm.

  5. Fracture mode during cyclic loading of implant-supported single-tooth restorations.

    PubMed

    Hosseini, Mandana; Kleven, Erik; Gotfredsen, Klaus

    2012-08-01

    Fracture of veneering ceramics in zirconia-based restorations has frequently been reported. Investigation of the fracture mode of implant-supported ceramic restorations by using clinically relevant laboratory protocols is needed. This study compared the mode of fracture and number of cyclic loads until veneering fracture when ceramic and metal ceramic restorations with different veneering ceramics were supported by implants. Thirty-two implant-supported single-tooth restorations were fabricated. The test group was composed of 16 ceramic restorations of zirconia abutment-retained crowns with zirconia copings veneered with glass-ceramics (n=8) and feldspathic ceramics (n=8). The control group was composed of 16 metal ceramic restorations of titanium abutment-retained crowns with gold alloy copings veneered with glass (n=8) and feldspathic ceramics (n=8). The palatal surfaces of the crowns were exposed to cyclic loading of 800 N with a frequency of 2 Hz, which continued to 4.2 million cycles or until fracture of the copings, abutments, or implants. The number of cycles and the fracture modes were recorded. The fracture modes were analyzed by descriptive analysis and the Mann-Whitney test (α=.05). The differences in loading cycles until veneering fracture were estimated with the Cox proportional hazards analysis. Veneering fracture was the most frequently observed fracture mode. The severity of fractures was significantly more in ceramic restorations than in metal ceramic restorations. Significantly more loading cycles until veneering fracture were estimated with metal ceramic restorations veneered with glass-ceramics than with other restorations. The metal ceramic restorations demonstrated fewer and less severe fractures and resisted more cyclic loads than the ceramic restorations, particularly when the metal ceramic crowns were veneered with glass-ceramics. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All

  6. Comparative analysis between endometrial proteomes of pregnant and non-pregnant ewes during the peri-implantation period.

    PubMed

    Zhao, Haichao; Sui, Linlin; Miao, Kai; An, Lei; Wang, Dong; Hou, Zhuocheng; Wang, Rui; Guo, Min; Wang, Zhilong; Xu, Jiqiang; Wu, Zhonghong; Tian, Jianhui

    2015-01-01

    Early pregnancy failure has a profound impact on both human reproductive health and animal production. 2/3 pregnancy failures occur during the peri-implantation period; however, the underlying mechanism(s) remains unclear. Well-organized modification of the endometrium to a receptive state is critical to establish pregnancy. Aberrant endometrial modification during implantation is thought to be largely responsible for early pregnancy loss. In this study, using well-managed recipient ewes that received embryo transfer as model, we compared the endometrial proteome between pregnant and non-pregnant ewes during implantation period. After embryo transfer, recipients were assigned as pregnant or non-pregnant ewes according to the presence or absence of an elongated conceptus at Day 17 of pregnancy. By comparing the endometrial proteomic profiles between pregnant and non-pregnant ewes, we identified 94 and 257 differentially expressed proteins (DEPs) in the endometrial caruncular and intercaruncular areas, respectively. Functional analysis showed that the DEPs were mainly associated with immune response, nutrient transport and utilization, as well as proteasome-mediated proteolysis. These analysis imply that dysfunction of these biological processes or pathways of DEP in the endometrium is highly associated with early pregnancy loss. In addition, many proteins that are essential for the establishment of pregnancy showed dysregulation in the endometrium of non-pregnant ewes. These proteins, as potential candidates, may contribute to early pregnancy loss.

  7. Strengths and difficulties in children with cochlear implants--comparing self-reports with reports from parents and teachers.

    PubMed

    Anmyr, Lena; Larsson, Kjerstin; Olsson, Mariann; Freijd, Anders

    2012-08-01

    The aim was to explore and compare how children with cochlear implants, their parents, and their teachers perceive the children's mental health in terms of emotional and behavioral strengths and difficulties. The self-report, parents', and teachers' versions of the Strengths and Difficulties Questionnaire (SDQ) were used to assess the mental health of 22 children with cochlear implants. The children's assessments were then compared to the parents' and 17 teachers' assessments. The data were analyzed using the SPSS software package. Total difficulties (p=.000), emotional symptoms (p=.000), and conduct problems (p=.007) were greater according to the children than according to parents and teachers. Younger children (9 years, n=12) reported more emotional symptoms than older children (12 and 15 years, n=10). Almost a quarter of the children rated themselves in a way indicating mental ill-health. Parents and teachers each indicated mental ill-health for one child. Children with cochlear implants express greater concerns about their mental health than their parents and teachers do. This is important knowledge for adults in families, schools, and health care in order to support these children and offer treatment when needed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Effect of coping thickness and background type on the masking ability of a zirconia ceramic.

    PubMed

    Tabatabaian, Farhad; Taghizade, Fateme; Namdari, Mahshid

    2018-01-01

    The masking ability of zirconia ceramics as copings is unclear. The purpose of this in vitro study was to evaluate the effect of coping thickness and background type on the masking ability of a zirconia ceramic and to determine zirconia coping thickness cut offs for masking the backgrounds investigated. Thirty zirconia disks in 3 thickness groups of 0.4, 0.6, and 0.8 mm were placed on 9 backgrounds to measure CIELab color attributes using a spectrophotometer. The backgrounds included A1, A2, and A3.5 shade composite resin, A3 shade zirconia, nickel-chromium alloy, nonprecious gold-colored alloy, amalgam, black, and white. ΔE values were measured to determine color differences between the specimens on the A2 shade composite resin background and the same specimens on the other backgrounds. The color change (ΔE) values were compared with threshold values for acceptability (ΔE=5.5) and perceptibility (ΔE=2.6). Repeated measures ANOVA, the Bonferroni test, and 1-sample t tests were used to analyze data (α=.05). Mean ΔE values ranged between 1.44 and 7.88. The zirconia coping thickness, the background type, and their interaction affected the CIELab and ΔE values (P<.001). To achieve ideal masking, the minimum thickness of a zirconia coping should be 0.4 mm for A1 and A3.5 shade composite resin, A3 shade zirconia, and nonprecious gold-colored alloy, 0.6 mm for amalgam, and 0.8 mm for nickel-chromium alloy. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  9. Bonding of Resin Cement to Zirconia with High Pressure Primer Coating

    PubMed Central

    Wang, Ying-jie; Jiao, Kai; Liu, Yan; Zhou, Wei; Shen, Li-juan; Fang, Ming; Li, Meng; Zhang, Xiang; Tay, Franklin R.; Chen, Ji-hua

    2014-01-01

    Objectives To investigate the effect of air-drying pressure during ceramic primer coating on zirconia/resin bonding and the surface characteristics of the primed zirconia. Methods Two ceramic primers (Clearfil Ceramic Primer, CCP, Kuraray Medical Inc. and Z-Prime Plus, ZPP, Bisco Inc.) were applied on the surface of air-abraded zirconia (Katana zirconia, Noritake) and dried at 4 different air pressures (0.1–0.4 MPa). The primed zirconia ceramic specimens were bonded with a resin-based luting agent (SA Luting Cement, Kuraray). Micro-shear bond strengths of the bonded specimens were tested after 3 days of water storage or 5,000× thermocycling (n = 12). Failure modes of the fractured specimens were examined with scanning electron miscopy. The effects of air pressure on the thickness of the primer layers and the surface roughness (Sa) of primed zirconia were evaluated using spectroscopic ellipsometry (n = 6), optical profilometry and environmental scanning electron microscopy (ESEM) (n = 6), respectively. Results Clearfil Ceramic Primer air-dried at 0.3 and 0.4 MPa, yielding significantly higher µSBS than gentle air-drying subgroups (p<0.05). Compared to vigorous drying conditions, Z-Prime Plus air-dried at 0.2 MPa exhibited significantly higher µSBS (p<0.05). Increasing air-drying pressure reduced the film thickness for both primers. Profilometry measurements and ESEM showed rougher surfaces in the high pressure subgroups of CCP and intermediate pressure subgroup of ZPP. Conclusion Air-drying pressure influences resin/zirconia bond strength and durability significantly. Higher air-drying pressure (0.3-0.4 MPa) for CCP and intermediate pressure (0.2 MPa) for ZPP are recommended to produce strong, durable bonds between resin cement and zirconia ceramics. PMID:24992678

  10. Photoelastic analysis to compare implant-retained and conventional obturator dentures

    NASA Astrophysics Data System (ADS)

    Goiato, Marcelo Coelho; Prado Ribeiro, Paula do; Pellizzer, Eduardo Piza; Pesqueira, Aldiéris Alves; Haddad, Marcela Filiè; dos Santos, Daniela Micheline; Moreno, Amália

    2012-06-01

    The use of photoelastic analysis contributes to the rehabilitation of patients with oral-sinus-nasal sequelae, which in turn affect important functions such as chewing, swallowing, and speech. The prosthetic rehabilitation with implant-retained dentures is a suitable treatment option. The purpose of this study was to verify, by using a photoelastic analysis, the stress distribution in implant-retained palatal obturator dentures (relined or not) associated with different attachment systems (O-ring, bar-clip, and bar-clip associated with distally placed O-rings). Two photoelastic models were obtained from an experimental maxillary cast presenting an oral-nasal communication. One model had two 13-mm length implants placed on the left region. A total of eight colorless maxillary obturators were fabricated and subsequently four of them were relined with soft silicone soft, and three had attachment systems associated. The assembly (model/attachment system/prosthesis) was positioned in a circular polariscope and a 100-N load was applied at 10 mm/s. The results showed that the denture relining influenced the distribution and amount of stress on the models. The O-ring group displayed the lowest stress levels, followed by bar-clip system associated with distally placed O-rings and bar-clip groups.

  11. Posterior chamber phakic intraocular lens implantation: comparative, multicentre study in 351 eyes with low-to-moderate or high myopia.

    PubMed

    Kamiya, Kazutaka; Shimizu, Kimiya; Igarashi, Akihito; Kitazawa, Yoshihiro; Kojima, Takashi; Nakamura, Tomoaki; Oka, Yoshitaka; Matsumoto, Rei

    2018-02-01

    To compare the clinical outcomes of posterior chamber phakic intraocular lens implantation with a central hole (Hole Implantable Collamer Lens (ICL), STAAR Surgical) for low-to-moderate myopia and for high myopia. This multicentre retrospective case series comprised 351 eyes of 351 consecutive patients undergoing ICL implantation. Eyes were divided into groups based on preoperative degree of myopia: group 1; 57 eyes, manifest spherical equivalent less than -6 dioptres (D), and group 2; 294 eyes, -6 D or more. Safety, efficacy, predictability, stability and adverse events were compared preoperatively; and at 1 day, 1 week and 1, 3, 6 and 12 months postoperatively, RESULTS: Uncorrected and corrected visual acuities were -0.17±0.14 and -0.21±0.10 logMAR in group 1, and -0.16±0.09 and -0.21±0.08 logMAR in group 2, 1 year postoperatively. In groups 1 and 2, 98% and 99% of eyes were within 1.0 D of the targeted correction. Manifest refraction changes of -0.12±0.34 D (group 1) and -0.18±0.43 D (group 2) occurred from 1 day to 1 year. ICL exchanges were necessary in two eyes (0.7%) in group 2. No vision-threatening complications occurred at any time. The ICL performed well for the correction of both low-to-moderate myopia and high myopia throughout the 1-year observation period. The clinical outcomes of ICL implantation for low-to-moderate myopia are essentially equivalent to those for high myopia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Auditory, speech and language development in young children with cochlear implants compared with children with normal hearing.

    PubMed

    Schramm, Bianka; Bohnert, Andrea; Keilmann, Annerose

    2010-07-01

    This study had two aims: (1) to document the auditory and lexical development of children who are deaf and received the first cochlear implant (CI) by the age of 16 months and the second CI by the age of 31 months and (2) to compare these children's results with those of children with normal hearing (NH). This longitudinal study included five children with NH and five with sensorineural deafness. All children of the second group were observed for 36 months after the first fitting of the device (cochlear implant). The auditory development of the CI group was documented every 3 months up to the age of two years in hearing age and chronological age and for the NH group in chronological age. The language development of each NH child was assessed at 12, 18, 24 and 36 months of chronological age. Children with CIs were examined at the same age intervals at chronological and hearing age. In both groups, children showed individual patterns of auditory and language development. The children with CIs developed differently in the amount of receptive and expressive vocabulary compared with the NH control group. Three children in the CI group needed almost 6 months to make gains in speech development that were consistent with what would be expected for their chronological age. Overall, the receptive and expressive development in all children of the implanted group increased with their hearing age. These results indicate that early identification and early implantation is advisable to give children with sensorineural hearing loss a realistic chance to develop satisfactory expressive and receptive vocabulary and also to develop stable phonological, morphological and syntactical skills for school life. On the basis of these longitudinal data, we will be able to develop new diagnostic tools that enable clinicians to assess child's progress in hearing and speech development. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  13. In vitro fracture resistance of three commercially available zirconia crowns for primary molars.

    PubMed

    Townsend, Janice A; Knoell, Patrick; Yu, Qingzhao; Zhang, Jian-Feng; Wang, Yapin; Zhu, Han; Beattie, Sean; Xu, Xiaoming

    2014-01-01

    The purpose of this study was to measure the fracture resistance of primary mandibular first molar zirconia crowns from three different manufacturers-EZ Pedo (EZP), NuSmile (NSZ), and Kinder Krowns (KK)-and compare it with the thickness of the zirconia crowns and the measured fracture resistance of preveneered stainless steel crowns (SSCs). The thickness of 20 zirconia crowns from three manufacturers were measured. The mean force required to fracture the crowns was determined. Preveneered NuSmile (NSW) SSCs were tested as a control. EZP crowns were significantly thicker in three of the six measured locations. The force required to fracture the EZP crown was significantly higher than that required for NSZ and KK. There was a positive correlation between fracture resistance and crown thickness in the mesial, distal, mesioocclusal, and distoocclusal dimensions. None of the zirconia crowns proved to be as resistant to fracture as the preveneered SSCs. Statistically significant differences were found among the forces required to fracture zirconia crowns by three different manufacturers. The increase in force correlated with crown thickness. The forces required to fracture the preveneered stainless steel crowns were greater than the forces required to fracture all manufacturers' zirconia crowns.

  14. A Randomized Case-Series Study Comparing the Stability of Implant with Two Different Surfaces Placed in Fresh Extraction Sockets and Immediately Loaded

    PubMed Central

    Vanden Bogaerde, Leonardo; Sennerby, Lars

    2016-01-01

    Background. Hydrophilic and moderately rough implant surfaces have been proposed to enhance the osseointegration response. Aim. The aim of this study was to compare early changes of stability for two implants with identical macrodesign but with different surface topographies. Materials and Methods. In 11 patients, a total of 22 implants (11 bimodal (minimally rough, control) and 11 proactive (moderately rough and hydrophilic, test), Neoss Ltd., Harrogate, UK) were immediately placed into fresh extraction sockets and immediately loaded. The peak insertion torque (IT) was measured in Ncm at placement. Resonance Frequency Analysis (RFA) measurements were made at baseline and 2, 4, 6, and 12 weeks after surgery. Results. The two implant types showed similar IT and RFA values at placement (NS). A dip of RFA values after 2 weeks followed by an increase was observed, where the test implant showed a less pronounced decrease and a more rapid recovery than the control implant. The test implants were significantly more stable than the control ones after 12 weeks. Conclusions. The results from the present study indicated that the hydrophilic and rougher test implant was more resistant to immediate loading and showed a significantly higher stability than the smoother control implant after 12 weeks. PMID:27042180

  15. Machined versus roughened immediately loaded and finally restored single implants inserted flapless: Preliminary 6-month data from a split- mouth randomised controlled trial.

    PubMed

    Cannizzaro, Gioacchino; Felice, Pietro; Loi, Ignazio; Viola, Paolo; Ferri, Vittorio; Leone, Michele; Lazzarini, Matteo; Trullenque-Eriksson, Anna; Esposito, Marco

    To compare the outcome of immediately loaded single implants with a machined or a roughened surface. Fifty patients had two implant sites randomly allocated to receive flaplessplaced single Syra implants (Sweden & Martina), one with a machined and one with a roughened surface (sand-blasted with zirconia powder and acid etched), according to a split-mouth design. To be loaded immediately, implants had to be inserted with a torque superior to 50 Ncm. Implants were restored with definitive crowns in direct occlusal contact within 48 h. Patients were followed for 6 months after loading. Outcome measures were prosthetic and implant failures and complications. Two machined implants and four roughened implants were not loaded immediately. Six months after loading no dropout occurred. One implant loaded late, which had a rough implant surface, failed 20 days after loading (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). Three crowns had to be remade on machined implants and four on roughened implants (P (McNemar test) = 1.000; difference in proportions = -0.02; 95% CI: -0.12 to 0.08). Three machined and five roughened implants experienced complications (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). There were no statistically significant differences between groups for crown and implant losses as well as complications. Up to 6 months after loading both machined and roughened flapless-placed and immediately loaded single implants provided good and similar results, however, longer follow-ups are needed to evaluate the long-term prognosis of implants with different surfaces.

  16. Fabrication and Characterization of Nanoporous Niobia, and Nanotubular Tantala, Titania and Zirconia via Anodization

    PubMed Central

    Minagar, Sepideh; Berndt, Christopher C.; Wen, Cuie

    2015-01-01

    Valve metals such as titanium (Ti), zirconium (Zr), niobium (Nb) and tantalum (Ta) that confer a stable oxide layer on their surfaces are commonly used as implant materials or alloying elements for titanium-based implants, due to their exceptional high corrosion resistance and excellent biocompatibility. The aim of this study was to investigate the bioactivity of the nanostructures of tantala (Ta2O5), niobia (Nb2O5), zirconia (ZrO2) and titania (TiO2) in accordance to their roughness and wettability. Therefore, four kinds of metal oxide nanoporous and nanotubular Ta2O5, Nb2O5, ZrO2 and TiO2 were fabricated via anodization. The nanosize distribution, morphology and the physical and chemical properties of the nanolayers and their surface energies and bioactivities were investigated using SEM-EDS, X-ray diffraction (XRD) analysis and 3D profilometer. It was found that the nanoporous Ta2O5 exhibited an irregular porous structure, high roughness and high surface energy as compared to bare tantalum metal; and exhibited the most superior bioactivity after annealing among the four kinds of nanoporous structures. The nanoporous Nb2O5 showed a uniform porous structure and low roughness, but no bioactivity before annealing. Overall, the nanoporous and nanotubular layers of Ta2O5, Nb2O5, ZrO2 and TiO2 demonstrated promising potential for enhanced bioactivity to improve their biomedical application alone or to improve the usage in other biocompatible metal implants. PMID:25837724

  17. A 5- to 8-year retrospective study comparing the clinical results of implant-supported telescopic crown versus bar overdentures in patients with edentulous maxillae.

    PubMed

    Zou, Duohong; Wu, Yiqun; Huang, Wei; Zhang, Zhiyong; Zhang, Zhiyuan

    2013-01-01

    The objective of this study was to compare implant survival and success rates, peri-implant parameters, and prosthodontic maintenance efforts for implant-supported telescopic crown overdentures and bar overdentures to restore maxillary edentulism. This retrospective clinical study involved patients with maxillary edentulism who were fitted with implant-supported overdentures from January 2004 to June 2007. During a 5- to 8-year follow-up period, the implant survival and success rates, biologic and mechanical complications, prosthodontic maintenance, and patient satisfaction were retrospectively analyzed. The data were evaluated statistically and P < .05 was considered to be statistically significant. Forty-four patients with maxillary edentulism received implant-supported removable overdentures. Twenty-one patients chose telescopic crown overdentures and 23 patients chose bar overdentures. A total of 41 patients and 201 implants were available for follow-up. The implant survival and success rates, average bone resorption, and subjective patient satisfaction scores showed no difference between the telescopic crown and the bar overdenture group at follow-up. However, there were higher values for Plaque and Calculus Indexes in the bar group compared with the telescopic crown group, and these values showed a statistically significant difference annually from the 3-year follow-up (P < .05). Each year, the number of prosthodontics maintenance procedures per patient did not significantly differ between the telescopic crown (approximately 0.36 to 0.58) and bar groups (approximately 0.30 to 0.49) (P = .16). Although there were higher plaque and calculus levels in the bar group and more maintenance was required for the telescopic crown group, overdentures provided a healthy peri-implant structure for implants in both groups. Implant-supported telescopic crown or bar overdentures can provide a good treatment option for patients with edentulous maxillae.

  18. Comparative evaluation of anchorage reinforcement between orthodontic implants and conventional anchorage in orthodontic management of bimaxillary dentoalveolar protrusion.

    PubMed

    Chopra, S S; Mukherjee, Manish; Mitra, Rajat; Kochar, Gagan Deep; Kadu, Abhijeet

    2017-04-01

    Increased upper lip procumbency is commonly associated with maxillary dentoalveolar protrusion with the major goal of reducing maxillary dentoalveolar protrusion. The treatment plan usually includes extraction of the maxillary first premolars, followed by retraction of anterior teeth with maximum anchorage. Dental implants have been widely accepted as successful adjuncts for obtaining maximum anchorage in orthodontic treatment. 50 subjects between the ages of 13 and 17 years having bimaxillary dentoalveolar protrusion were included in the study. The patients were divided into two groups. Both groups received treatment with 0.022″ MBT prescription preadjusted edgewise appliance system. In addition, subjects of Group 'I' received the Nance button and lingual arch as anchorage reinforcement in the upper and lower arches, respectively. Subjects of Group 'II' received self-drilling titanium OI for anchorage reinforcement. Significant retraction was achieved in all cases with good vertical control. Anchor loss was observed in both groups. Anchor loss was much higher in Group I compared to Group II, and an intergroup comparison for anchor loss was highly significant. Implants as anchorage, for en masse retraction, can be incorporated into orthodontic practice. The use of orthodontic implants for anchorage is a viable alternative to conventional molar anchorage.

  19. Oral tactile sensibility recorded in overdenture wearers with implants or natural roots: a comparative study. Part 2.

    PubMed

    Mericske-Stern, R

    1994-01-01

    The capacity of dentate subjects to discriminate the thickness of objects placed between the teeth seems to depend on receptors in the periodontal ligament and muscles. The compensatory mechanism of ankylotic implants for the function of missing periodontal ligaments is not yet known. To investigate this question in overdenture wearers, 26 patients with ITI implants and 20 patients with natural roots were selected. According to the experimental protocol, the discriminatory ability was recorded with 10 steel foils (thickness ranging from 10 to 100 microns) placed between the premolars. Each thickness was tested 10 times and the test subjects were required to distinguish whether foil was positioned between the teeth. A maximum of 100 correct or 100 incorrect answers was possible. The average number of incorrect answers was significantly higher in test subjects with implants. The 50% limit (ie, the tested thickness recorded with at least 5 wrong answers) was established, but no statistically significant difference was found. In both groups, the critical tactile threshold of perceived thickness was 30 to 40 microns, with 2 being the average number of incorrect assessments. When comparing the minimal thickness, which was recorded without incorrect assessment, a significantly lower threshold was observed on patients with natural roots. Thus, active tactile sensibility appears to depend on the receptors in the periodontal ligament. However, wearing of removable prostheses is a modifying factor and may influence the oral tactile sensibility for both groups.

  20. Consecutive unsplinted implant-supported restorations to replace lost multiple adjacent posterior teeth: A 4-year prospective cohort study.

    PubMed

    Lee, Jung-Tae; Lee, Hyo-Jung; Park, Shin-Young; Kim, Hae-Young; Yeo, In-Sung

    2015-08-01

    The aim of this study was to investigate the various events occurring in unsplinted implant restoration in posterior jaws during a period of 4 years. From August 2008 to April 2009, eight volunteers (three men and five women) who had two or more consecutively missing teeth received 20 implants in posterior maxillae and mandibles. Unsplinted single crowns were delivered to each implant. For the 4-year follow-up periods, patients were enrolled in a maintenance schedule at 1, 3, 6, 12, 24, 36 and 48 months. The data, including a questionnaire, radiography, mobility and probing were recorded on regular check-ups. A total of 20 implants in eight patients were followed up for 48 months, showing a 100% survival rate. Mean marginal bone loss around implants was 0.26 mm. Statistical analysis revealed insignificant correlation between metal-ceramic and zirconia-ceramic crowns and among implant lengths (8.5 mm, 10 mm and 11.5 mm). Mean probing depths were similar or insignificantly different, regardless of the materials used or length of implants. The most frequent complications, in decreasing order, were food impaction (65%) and porcelain chipping (45%), sensitivity (25%), pain (20%) and loose contact (15%). Compared with metal-ceramic crowns, zirconia-ceramic crowns showed more unfavorable cases of porcelain chipping (p=0.017), pain (p=0.007) and loose contact with an adjacent crown (p=0.031). Within the limits of the sample size, this study showed that unsplinted implant-supported single restorations to replace consecutive posterior missing teeth may function well.

  1. [Ambulatory Essure implant placement sterilization procedure for women: prospective study comparing general anesthesia versus hypnosis combined with sedation].

    PubMed

    Musellec, H; Bernard, F; Houssel, P; Guillou, N; Hugot, P; Martin, L; Hamelin, H; Lanchou, J; Gentili, M-E; Devins, C; Virot, C

    2010-12-01

    implant placement Essure, sterilization procedure for women, were performed under hypnosedation (HYP) and compared to the operative anxiety and analgesia of 12 patients operated-on under general anesthesia (GA). prospective and comparative group study. two groups of twelve patients were matched and compared based on the choice of anesthetic technique: hypnotics (HYP) with possible additional sedation by propofol and remifentanil or GA involving propofol, sevoflurane and remifentanil. The assessment of anxiety and pain based on a visual analogy scale (0-10) and use of analgesics were studied in the recovery room and at discharge of hospital. The statistical analysis relies on nonparametric tests for paired data (Wilcoxon test). all patients were operated. The two groups are statistically comparable. The preoperative anxiety before premedication is lower in the HYP group (p<0.05). No conversion to general anaesthesia is necessary in the HYP group, but five patients were using sedatives drugs but doses are very low compared to general anaesthesia. The analgesic consumption was equivalent in both groups. we conclude that hypnosedation is a valuable alternative to traditional anesthetic techniques for ambulatory Essure implant. The use of hypnotic tool is an interesting alternative for the management of patients during invasive medical procedures or surgical, providing psychological benefits to the patient. 2010. Published by Elsevier SAS.

  2. Synthesis of zirconia monoliths for chromatographic separations.

    PubMed

    Randon, Jérôme; Huguet, Samuel; Piram, Anne; Puy, Guillaume; Demesmay, Claire; Rocca, Jean-Louis

    2006-03-17

    The aim of this work is to join the advantages of two different kinds of stationary phases: monolithic columns and zirconia-based supports. On the one hand, silica monolithic columns allow a higher efficiency with a lower back-pressure than traditional packed columns. On the other hand, chromatographic stationary phases based on zirconia have a higher thermal and chemical stability and specific surface properties. Combining these advantages, a zirconia monolith with a macroporous framework could be a real improvement in separation sciences. Two main strategies can be used in order to obtain a zirconia surface on a monolithic skeleton: coating or direct synthesis. The coverage by a zirconia layer of the surface of a silica-based monolith can be performed using the chemical properties of the silanol surface groups. We realized this coverage using zirconium alkoxide and we further grafted n-dodecyl groups using phosphate derivatives. Any loss of efficiency was observed and fast separations have been achieved. The main advance reported in this paper is related to the preparation of zirconia monoliths by a sol-gel process starting from zirconium alkoxide. The synthesis parameters (hydrolysis ratio, porogen type, precursor concentration, drying step, etc.) were defined in order to produce a macroporous zirconia monoliths usable in separation techniques. We produced various homogeneous structures: zirconia rod 2 cm long with a diameter of 2.3 mm, and zirconia monolith inside fused silica capillaries with a 75 microm I.D. These monoliths have a skeleton size of 2 microm and have an average through pore size of 6 microm. Several separations have been reported.

  3. Comparative Matched-Pair Analysis of the Injection Versus Implantation of Mesenchymal Stem Cells for Knee Osteoarthritis.

    PubMed

    Kim, Yong Sang; Kwon, Oh Ryong; Choi, Yun Jin; Suh, Dong Suk; Heo, Dong Beom; Koh, Yong Gon

    2015-11-01

    The mesenchymal stem cell (MSC)-based tissue engineering approach has been developed to address the problem of articular cartilage repair in knee osteoarthritis (OA). However, the most effective method of MSC application has not yet been established. To compare the injection and implantation of MSCs in patients with knee OA in terms of clinical and second-look arthroscopic outcomes. Cohort study; Level of evidence, 3. Among 182 patients treated with arthroscopic surgery using MSCs for knee OA from October 2010 to August 2012, patients treated with an injection of MSCs in combination with platelet-rich plasma (injection group; n = 20) were pair-matched with patients who underwent MSC implantation on a fibrin glue scaffold (implantation group; n = 20) based on sex, age, and lesion size. Clinical outcomes were evaluated using the International Knee Documentation Committee (IKDC) score and Tegner activity scale, and cartilage repair was assessed arthroscopically with the International Cartilage Repair Society (ICRS) grading system. The mean (±SD) IKDC and Tegner activity scores significantly improved from 38.5 ± 9.2 to 55.2 ± 15.0 and from 2.5 ± 1.2 to 3.5 ± 1.2, respectively, in the injection group and from 36.6 ± 4.9 to 62.7 ± 14.1 and from 2.3 ± 0.9 to 3.6 ± 1.1, respectively, in the implantation group at the time of second-look arthroscopic surgery (mean, 12.6 months postoperatively) (P < .001 in all cases). At final follow-up (mean, 28.6 months postoperatively), the mean IKDC and Tegner activity scores in the implantation group had improved further to 64.8 ± 13.4 and 3.9 ± 1.0, respectively (P < .001 and P = .035, respectively), while no significant improvements were found in the injection group (P = .130 and P = .655, respectively). At final follow-up, there was a significant difference in the mean IKDC score between groups (P = .049). Significant correlations between the number of administered MSCs and the postoperative clinical outcomes were found

  4. Abutment Material Effect on Peri-implant Soft Tissue Color and Perceived Esthetics.

    PubMed

    Kim, Aram; Campbell, Stephen D; Viana, Marlos A G; Knoernschild, Kent L

    2016-12-01

    The purpose of this study was to evaluate the effect of implant abutment material on peri-implant soft tissue color using intraoral spectrophotometric analysis and to compare the clinical outcomes with patient and clinician perception and satisfaction. Thirty patients and four prosthodontic faculty members participated. Abutments were zirconia, gold-hued titanium, and titanium. Peri-implant mucosa color of a single anterior implant restoration was compared to the patient's control tooth. Spectrophotometric analysis using SpectroShade TM Micro data determined the color difference (ΔE, ΔL*, Δa*, Δb*) between the midfacial peri-implant soft tissue for each abutment material and the marginal gingiva of the control tooth. Color difference values of the abutment groups were compared using ANOVA (α = 0.05). Patient and clinician satisfaction surveys were also conducted using a color-correcting light source. The results of each patient and clinician survey question were compared using chi-square analysis (α = 0.05). Pearson correlation analyses identified the relationship between the total color difference (ΔE) and the patient/clinician perception and satisfaction, as well as between ΔE and tissue thickness. Zirconia abutments displayed significantly smaller spectrophotometric gingival color difference (ΔE) compared to titanium and gold-hued titanium abutments (respectively, 3.98 ± 0.99; 7.22 ± 3.31; 5.65 ± 2.11; p < 0.05). Among ΔL*, Δa*, and Δb*, only Δa* (red-green spectrum) showed significant difference between groups. There was no significant correlation between measured soft tissue thickness and ΔE, but thick gingival phenotype, determined by a probe test, demonstrated a smaller ΔE than thin phenotype (4.82 ± 1.49; 6.41 ± 3.27; p = 0.097). There was no statistical difference in patient or clinician satisfaction among abutment materials, and no correlation between ΔE and the patient and clinician satisfaction. Patient satisfaction was

  5. Comparative treatment and mortality correlates and adverse event profile of implant naltrexone and sublingual buprenorphine.

    PubMed

    Reece, Albert Stuart

    2009-10-01

    There is increasing interest in the use of implantable naltrexone as a new treatment for opiate dependence. This center has been one of the leaders in this form of treatment in Australia and has recently completed a registry-controlled review of our mortality data. As part of the study of the safety profile of this therapy, we were interested to review both the treatment correlates of previously presented mortality data and of adverse events. A total of 255 naltrexone implant therapy (NIT) and 2,518 buprenorphine (BUP) patients were followed for 1,322.22 and 8,030.02 patient-years, respectively. NIT patients had significantly longer days in treatment per episode (mean +/- standard deviation, 238.32 +/- 110.11 vs. 46.96 +/- 109.79), total treatment duration (371.21 +/- 284.64 vs. 162.50 +/- 245.76), and mean treatment times but fewer treatment episodes than BUP (all p < .0001). Serious local tissue reaction or infection each occurred in 1% of 200 NIT episodes. These data show that NIT economizes treatment resources without compromising safety concerns.

  6. Comparing the performance plateau in adult cochlear implant patients using HINT and AzBio.

    PubMed

    Massa, Sean T; Ruckenstein, Michael J

    2014-04-01

    This study aims to characterize the performance plateau in adult cochlear implant recipients after the initial postimplantation increase by using word recognition testing and an explicit definition of performance plateau. Retrospective review. Urban, tertiary referral center. One hundred twenty-five patients with 138 devices tested with AzBio were matched to 130 patients with 138 devices tested with HINT based on performed on CNC monosyllable tests. Patient's performance was measured overtime using AzBio and HINT tests to determine when and at what score their performance reached a plateau. Time from implantation to reach a performance plateau and plateau score with each test. Thirty-four devices reached a HINT plateau and 30 devices reached an AzBio plateau. Patients reached plateaus at similar times postoperatively using HINT and AzBio, 18.8 and 16.5 weeks, respectively (p = 0.476). Five patients tested with HINT plateaued at scores of 99% to 100%, whereas no patients plateaued above 92% with AzBio. Patients reached a plateau in performance at similar median times using AzBio and HINT, despite the ceiling effect of HINT in some patients. Most patients who reach a plateau did so within 4 months, but exactly when and if a patient's performance plateaus varies significantly among individuals. Further study is required to determine which test best reflects when a patient reaches his or her maximal performance in natural listening conditions.

  7. Comparative Evaluation of Cell Viability Immediately After Osteotomy for Implants With Drills and Piezosurgery: Immunohistochemistry Analysis.

    PubMed

    Pereira, Cassiano Costa Silva; Batista, Fábio Roberto de Souza; Jacob, Ricardo Garcia Mureb; Nogueira, Lamis Meorin; Carvalho, Abrahão Cavalcante Gomes de Souza; Gealh, Walter Cristiano; Garcia-Júnior, Idelmo Rangel; Okamoto, Roberta

    2018-05-08

    To evaluate the effect of reusing drills and piezosurgery tips during implant osteotomy on immediate bone cell viability through immunohistochemical analysis. Six male rabbits were divided into 2 groups and then divided into 5 subgroups-correspond to drills and tips used 10, 20, 30, 40, and 50 times, respectively. All animals received 10 osteotomies in each tibia, by use of the classic drilling procedure in one group (G1) and the piezosurgery device in the other group (G2). For immunohistochemical technique were utilized the osteoprotegerin, RANKL, osteocalcin, and caspase 3. Control procedures were performed by omitting the primary antibodies (negative control). Bone formation and resorption responses presented in more intense way during the piezosurgery. The expression of osteocalcin had become quite intense in piezosurgery groups, but with reduced immunostaining from the 30th osteotomy. The caspase 3 showed the viability of the osteoblast from the 20th osteotomy with piezosurgery and remained constant until the 50th. Piezosurgery provides greater osteoblastic cell viability than the system of conventional drilling. This study will provide data so that the authors can recycle the drills and tips for implant placement, thus enabling a better cell viability for osseointegration.

  8. Investigation of hydrogen interaction with defects in zirconia

    NASA Astrophysics Data System (ADS)

    Melikhova, O.; Kuriplach, J.; Čížek, J.; Procházka, I.; Brauer, G.; Anwand, W.

    2010-04-01

    Defect studies of a ZrO2 + 9 mol. % Y2O3 single crystal were performed in this work using a high resolution positron lifetime spectroscopy combined with slow positron implantation spectroscopy. In order to elucidate the nature of positron trapping sites observed experimentally, the structural relaxations of several types of vacancy-like defects in zirconia were performed and positron characteristics for them were calculated. Relaxed atomic configurations of studied defects were obtained by means of ab initio pseudopotential method within the supercell approach. Theoretical calculations indicated that neither oxygen vacancies nor their neutral complexes with substitute yttrium atoms are capable of positron trapping. On the other hand, zirconium vacancies are deep positron traps and are most probably responsible for the saturated positron trapping observed in yttria stabilized zirconia single crystals. However, the calculated positron lifetime for zirconium vacancy is apparently longer than the experimental value corresponding to a single-component spectrum measured for the cubic ZrO2 + 9 mol. % Y2O3 single crystal. It was demonstrated that this effect can be explained by hydrogen trapped in zirconium vacancies. On the basis of structure relaxations, we found that zirconium vacancy - hydrogen complexes represent deep positron traps with the calculated lifetime close to the experimental one. In zirconium vacancy - hydrogen complexes the hydrogen atom forms an O-H bond with one of the nearest neighbour oxygen atoms. The calculated bond length is close to 1 Å.

  9. Randomized controlled multicenter study comparing short dental implants (6 mm) versus longer dental implants (11-15 mm) in combination with sinus floor elevation procedures. Part 2: clinical and radiographic outcomes at 1 year of loading.

    PubMed

    Schincaglia, Gian Pietro; Thoma, Daniel S; Haas, Robert; Tutak, Marcin; Garcia, Abel; Taylor, Thomas D; Hämmerle, Christoph H F

    2015-11-01

    To compare, clinically and radiographically, short dental implants (6 mm) to long implants (11-15 mm) placed with sinus grafting. Participants with 5-7 mm of bone height in the posterior maxilla were randomly allocated to receive short implants (GS) or long implants with sinus grafting (GG). Implants were loaded with single crowns 6 months after placement (PR). Patients were re-evaluated 12 months after loading (FU-1). Outcome variables included: Implant survival rate (CSR), marginal bone level alteration (MBL), periodontal probing depth (PPD), bleeding on probing (BoP), plaque control record (PCR) and crown-to-implant ratios (C/I). Statistical analysis was performed using parametric tests. In 97 subjects, 132 implants were re-evaluated at FU-1. The CSR was 100%. The MBL from implant placement (IP) to (PR) was -0.22 ± 0.4 mm for GG and -0.3 ± 0.45 mm for GS (p < 0.001). MBL from IP to FU-1 was -0.37 ± 0.59 mm for GG and -0.22 ± 0.3 mm for GS (p < 0.001). Intergroup comparisons showed non-significant differences for MBL (p > 0.05), PPD (p = 1) and PCR (p = 0.09). BoP was higher in the GS (p = 0.04). The C/I was 0.99 ± 0.17 for GG and 1.86 ± 0.23 for GS (p < 0.001). No correlation was observed between C/I and MBL, (GG: p = 0.13; GS: p = 0.38). Both treatment modalities provided similar outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Assessment of the post-implant final left ventricular lead position: a comparative study between radiographic and angiographic modalities.

    PubMed

    Kumar, Prabhat; Blendea, Dan; Nandigam, Veena; Moore, Stephanie A; Heist, E Kevin; Singh, Jagmeet P

    2010-10-01

    Post-implant lateral and postero-anterior chest X-rays (CXR) are often utilized to determine the final LV lead tip position after cardiac resynchronization therapy (CRT). This study sought to compare post-implant standard CXRs with intra-procedural rotational coronary venous angiography (RCVA) to localize the final LV lead position. Sixty-four patients undergoing CRT (69.2 ± 11.4 years; males 68.7%; ischemic cardiomyopathy 59.4%; NYHA class 2.9 ± 0.5 and LV ejection fraction 24% ± 9%) were included in the study. RCVA was done by recording a rapid 4-second isocentric cine-loop from RAO 55° to LAO 55° (120 frames). Conventional CXR method (CC) and a composite CXR strategy (CM) based on two-view CXR were separately compared with RCVA. The most common pacing site was lateral (64.1%), followed by postero-lateral (23.4%) and antero-lateral (10.9%). In 73.4% (47) cases, the LV lead position was misclassified by CC as compared to RCVA. Among the 47 (73.4%) cases misclassified by CC approach, 35 had lateral LV lead position misclassified by CC as postero-lateral (77%), posterior (20%) and antero-lateral (3%). On the other hand, CM strategy classified the LV lead position correctly in 46 (71.9%) of the patients (p < 0.0001). The composite CXR strategy is a useful method for post-procedure LV lead localization. Due to its simplicity, it can be widely applied in post-implant evaluation of LV lead position in CRT patients.

  11. Comparing the influence of crestal cortical bone and sinus floor cortical bone in posterior maxilla bi-cortical dental implantation: a three-dimensional finite element analysis.

    PubMed

    Yan, Xu; Zhang, Xinwen; Chi, Weichao; Ai, Hongjun; Wu, Lin

    2015-05-01

    This study aimed to compare the influence of alveolar ridge cortical bone and sinus floor cortical bone in sinus areabi-cortical dental implantation by means of 3D finite element analysis. Three-dimensional finite element (FE) models in a posterior maxillary region with sinus membrane and the same height of alveolar ridge of 10 mm were generated according to the anatomical data of the sinus area. They were either with fixed thickness of crestal cortical bone and variable thickness of sinus floor cortical bone or vice versa. Ten models were assumed to be under immediate loading or conventional loading. The standard implant model based on the Nobel Biocare implant system was created via computer-aided design software. All materials were assumed to be isotropic and linearly elastic. An inclined force of 129 N was applied. Von Mises stress mainly concentrated on the surface of crestal cortical bone around the implant neck. For all the models, both the axial and buccolingual resonance frequencies of conventional loading were higher than those of immediate loading; however, the difference is less than 5%. The results showed that bi-cortical implant in sinus area increased the stability of the implant, especially for immediately loading implantation. The thickness of both crestal cortical bone and sinus floor cortical bone influenced implant micromotion and stress distribution; however, crestal cortical bone may be more important than sinus floor cortical bone.

  12. Strain characteristics of Marburg double crown-retained implant overdentures compared with bar and ball-retained implant overdentures, with and without a rigid major connector.

    PubMed

    Kazokoğlu, F Şehnaz; Akaltan, Funda

    2014-12-01

    It is hard to identify the most favorable retainer type and the denture design when considering strain levels around implants and in edentulous ridges for implant overdentures (IOVD). The purpose of this study was to evaluate the strain transmitted to the implants and edentulous ridges by Marburg double crown (MDC)-retained IOVD as opposed to bar and ball-retained IOVD and the efficiency of a rigid major connector in the maxilla. An in vitro maxillary model was prepared with 4 implants, with strain gauges placed distally to each implant and also in the anterior and posterior edentulous ridges. Five overdentures were fabricated for each MDC and each ball and bar attachment retainers. Vertical loads of 280 N were applied bilaterally on the first molar region. Then the palatal bars of each IOVD were disconnected, and loading procedures were repeated for the prostheses. No significant difference was observed among the MDC and the bar and ball-retained IOVD, with and without a rigid bar according to the data taken from both the implants and edentulous ridges. However, when the strain values attained from each strain gauge separately were considered, a slight difference was observed around the implants of ball-retained overdentures and in the edentulous ridges of MDC-retained overdentures. Within the limitations of this in vitro study, MDC-retained maxillary overdentures with 4 parallel and symmetrically placed implants can be used safely without a rigid major connector as with bar and ball-retained IOVD with regard to the strains generated in the edentulous ridge and around implants. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  13. In Vitro Microbiological Analysis of Bacterial Seal in Hybrid Zirconia Abutment Tapered Connection.

    PubMed

    Harlos, Maurício Marcelo; Bezerra da Silva, Thiago; Peruzzo, Daiane C; Napimoga, Marcelo H; Joly, Julio Cesar; Martinez, Elizabeth F

    2017-04-01

    The aim of this study was to evaluate the bacterial seal at the implant-hybrid zirconia abutment interface and Morse taper-type connections through in vitro microbiological analysis. Sixteen implants and their respective abutments were divided into 3 groups: test (10 sets), positive control (3 sets), and negative control (3 sets). In the test group, 10 implants were contaminated with Escherichia coli using a sterile inoculating loop to the inner portion of the implants, followed by torque application to the abutment (30 N·cm). The positive controls were also contaminated, but no torque was applied to the abutment screw. The negative control consisted of uncontaminated sets. All specimens were immersed in test tubes containing 5 mL brain heart infusion (BHI) broth, maintained in a microbiological incubator for 14 days at 37°C under aerobic conditions, and monitored every 24 hours for evidence of bacterial growth. During the 14 days of incubation, no significant increase in the number of cloudy culture media was observed in the test group (P = 0.448). No significant difference in broth turbidity ratio was observed (P > 0.05). Hybrid zirconia abutments can create an effective seal at the tapered abutment-implant interface with a 30-N·cm installation torque.

  14. Post-thermocycling shear bond strength of a gingiva-colored indirect composite layering material to three implant framework materials.

    PubMed

    Komine, Futoshi; Koizuka, Mai; Fushiki, Ryosuke; Taguchi, Kohei; Kamio, Shingo; Matsumura, Hideo

    2013-09-01

    To evaluate shear bond strength of a gingiva-colored indirect composite to three implant framework materials, before and after thermocycling, and verify the effect of surface pre-treatment for each framework. Commercially pure titanium (CP-Ti), American Dental Association (ADA) type 4 casting gold alloy (Type IV) and zirconia ceramics (Zirconia) were assessed. For each substrate, 96 disks were divided into six groups and primed with one of the following primers: Alloy Primer (ALP), Clearfil Photo Bond (CPB), Clearfil Photo Bond with Clearfil Porcelain Bond Activator (CPB+Activator), Estenia Opaque Primer (EOP), Metal Link (MLP) and V-Primer (VPR). The specimens were then bonded to a gingiva-colored indirect composite (Ceramage Concentrate GUM-D). Shear bond strengths were measured at 0 and 20 000 thermocycles and data were analyzed with the Steel-Dwass test and Mann-Whitney U-test. Shear bond strengths were significantly lower after thermocycling, with the exception of Type IV specimens primed with CPB (p = 0.092) or MLP (p = 0.112). For CP-Ti and Zirconia specimens, priming with CPB or CPB+Activator produced significantly higher bond strengths at 0 and 20 000 thermocycles, as compared with the other groups. For Type IV specimens, priming with ALP or MLP produced higher bond strengths at 0 and 20 000 thermocycles. Shear bond strength of a gingiva-colored indirect composite to CP-Ti, gold alloy and zirconia ceramics was generally lower after thermocycling. Application of a hydrophobic phosphate monomer and polymerization initiator was effective in maintaining bond strength of CP-Ti and zirconia ceramics. Combined use of a thione monomer and phosphoric monomer enhanced the durable bond strength of gold alloy.

  15. Influence of full-contour zirconia surface roughness on wear of glass-ceramics.

    PubMed

    Luangruangrong, Palika; Cook, N Blaine; Sabrah, Alaa H; Hara, Anderson T; Bottino, Marco C

    2014-04-01

    The purpose of this study was to evaluate the influence of full-contour (Y-TZP) zirconia surface roughness (glazed vs. as-machined) on the wear behavior of glass-ceramics. Thirty-two full contour Y-TZP (Diazir®) specimens (hereafter referred to as zirconia sliders) (ϕ = 2 mm, 1.5 mm in height) were fabricated using CAD/CAM and sintered according to the manufacturer's instructions. Zirconia sliders were embedded in brass holders using acrylic resin and then randomly assigned (n = 16) according to the surface treatment received, that is, as-machined or glazed. Glass-ceramic antagonists, Empress/EMP and e.max/EX, were cut into tabs (13 × 13 × 2 mm(3) ), wet-finished, and similarly embedded in brass holders. Two-body pin-on-disk wear testing was performed at 1.2 Hz for 25,000 cycles under a 3 kg load. Noncontact profilometry was used to measure antagonist height (μm) and volume loss (mm(3) ). Qualitative data of the zirconia testing surfaces and wear tracks were obtained using SEM. Statistics were performed using ANOVA with a significance level of 0.05. As-machined yielded significantly higher mean roughness values (Ra = 0.83 μm, Rq = 1.09 μm) than glazed zirconia (Ra = 0.53 μm, Rq = 0.78 μm). Regarding glass-ceramic antagonist loss, as-machined zirconia caused significantly less mean height and volume loss (68.4 μm, 7.6 mm(3) ) for EMP than the glazed group (84.9 μm, 9.9 mm(3) ), while no significant differences were found for EX. Moreover, EMP showed significantly lower mean height and volume loss than EX (p < 0.0001). SEM revealed differences on wear characteristics between the glass-ceramics tested. e.max wear was not affected by zirconia surface roughness; however, Empress wear was greater when opposing glazed zirconia. Overall, surface glazing on full-contour zirconia did not minimize glass-ceramic wear when compared with as-machined zirconia. © 2013 by the American College of Prosthodontists.

  16. Porous zirconia ceramic as an alternative to dentin for in vitro dentin barriers cytotoxicity test.

    PubMed

    Hu, Meng-Long; Lin, Hong; Jiang, Ruo-Dan; Dong, Li-Min; Huang, Lin; Zheng, Gang

    2018-06-01

    This study assessed the potential of porous zirconia ceramic as an alternative to dentin via an in vitro dentin barrier cytotoxicity test. The permeability of dentin and porous zirconia ceramic was measured using a hydraulic-conductance system, and their permeability was divided into two groups: high and low. Using an in vitro dentin barrier test, the cytotoxicity of dental materials by dentin and porous zirconia ceramic was compared within the same permeability group. The L-929 cell viability was assessed by MTT assay. The mean (SD) permeability of the high and low group for dentin was 0.334 (0.0873) and 0.147 (0.0377) μl min -1  cm -2  cm H 2 O -1 and for zirconia porous ceramic was 0.336 (0.0609) and 0.146 (0.0340) μl min -1  cm -2  cm H 2 O -1 . The cell viability of experimental groups which are the low permeability group was higher than that of the high permeability group for both dentin and porous zirconia ceramic as a barrier except for Maxcem Elite ™ by porous zirconia ceramic. There was no significant difference between dentin and porous zirconia ceramic in cell viability, within either the high or low permeability group for all materials. The SD for cell viability of the porous zirconia ceramic was less than that of the dentin, across all materials within each permeability group, except for Maxcem Elite ™ in the high permeability group. Porous zirconia ceramic, having similar permeability to dentin at the same thickness, can be used as an alternative to dentin for in vitro dentin barrier cytotoxicity tests. In vitro dentin barrier cytotoxicity tests when a standardized porous zirconia ceramic was used as a barrier could be useful for assessing the potential toxicity of new dental materials applied to dentin before applying in clinical and may resolve the issue of procuring human teeth when testing proceeds.

  17. Laser-welded titanium frameworks supported by implants in the partially edentulous mandible: a 10-year comparative follow-up study.

    PubMed

    Ortorp, Anders; Jemt, Torsten

    2008-09-01

    Comparative long-term knowledge of different framework materials in the partially edentulous implant patient is not available. To report and compare 10-year data on free-standing implant-supported partial prostheses with laser-welded titanium (test) and conventional gold alloy (control) frameworks. Altogether, 52 partially edentulous patients were consecutively provided with laser-welded prostheses (n = 60) in the partially edentulous lower jaw (test group). A control group of 52 randomly selected patients with gold alloy castings (n = 60) was used for comparison. Clinical and radiographic 10-year data were retrospectively collected and evaluated for both groups. The overall 10-year implant cumulative survival rate (CSR) was 93.0% (loaded implants, 96.4%), with a 10-year implant CSR of 91.5 and 94.7% for test and control implants, respectively (p > .05). Out of a total of 22 lost implants, 17 implants (77.3%) were shorter than 10 mm. The overall 10-year prosthesis CSR was 93.7%, with a corresponding 10-year CSR of 88.4 and 100% for test and control groups, respectively (p < .05). Average 10-year bone loss was 0.46 mm (SD 0.47) and 0.69 mm (SD 0.53) for the test and control groups (p < .001), respectively. Only 1% of the implants had >3 mm accumulated bone loss after 10 years. Altogether, 10 of the prostheses in both groups had implant component mechanical problems (8.3%). None of the frameworks or implants fractured, but more fractures of porcelain veneers were observed in the test group (p < .05). The protocol of implant treatment in the partially edentulous jaw functioned well during 10 years, although prosthodontic maintenance was required. However, laser-welded titanium frameworks presented more problems as compared with gold alloy frameworks. More loaded implants were lost (p < .05), and higher incidence of porcelain chipping was noted in the test group (p < .05). However, bone loss was on an average lower for the test group during the 10 years of follow-up (p

  18. Intricate Assessment and Evaluation of Effect of Bruxism on Long-term Survival and Failure of Dental Implants: A Comparative Study.

    PubMed

    Yadav, Kajal; Nagpal, Abhishek; Agarwal, S K; Kochhar, Aarti

    2016-08-01

    Dental implants are one of the common lines of treatment used for the treatment of missing tooth. Various risk factors are responsible for the failure of the dental implants and occurrence of postoperative complications. Bruxism is one such factor responsible for the failure of the dental implants. The actual relation between bruxism and dental implants is a subject of long-term controversy. Hence, we carried out this retrospective analysis to assess the complications occurring in dental implants in patients with and without bruxism. The present study included 1100 patients which were treated for rehabilitation by dental implant procedure at 21 dental offices of Ghaziabad (India) from 2004 to 2014. Analyzing the clinical records of the patients along with assessing the photographs of the patients was done for confirming the diagnosis of bruxism. Clinical re-evaluation of the patients, who came back for follow-up, was done to confirm the diagnosis of bruxism. Systemic questionnaires as used by previous workers were used to evaluate the patients about the self-conscience of the condition. Estimation of the mechanical complications was done only in those cases which occurred on the surfaces of the restoration of the dental implants. All the results were analyzed by Statistical Package for Social Sciences (SPSS) software. Student's t-test and Pearson's chi-square test were used to evaluate the level of significance. In both bruxer and non-bruxers, maximum number of dental implants was placed in anterior maxillary region. Significant difference was obtained while comparing the two groups for dimensions of the dental implants used. On comparing the total implant failed cases between bruxers and non-bruxers group, statistically significant result was obtained. Statistically significant difference was obtained while comparing the two study groups based on the health parameters, namely hypertension, diabetes, and smoking habit. Success of dental implant is significantly

  19. Mechanical properties of zirconia reinforced lithium silicate glass-ceramic.

    PubMed

    Elsaka, Shaymaa E; Elnaghy, Amr M

    2016-07-01

    The aim of this study was to assess the mechanical properties of recently introduced zirconia reinforced lithium silicate glass-ceramic. Two types of CAD/CAM glass-ceramics (Vita Suprinity (VS); zirconia reinforced lithium silicate and IPS e.max CAD (IC); lithium disilicate) were used. Fracture toughness, flexural strength, elastic modulus, hardness, brittleness index, and microstructures were evaluated. Data were analyzed using independent t tests. Weibull analysis of flexural strength data was also performed. VS had significantly higher fracture toughness (2.31±0.17MPam(0.5)), flexural strength (443.63±38.90MPa), elastic modulus (70.44±1.97GPa), and hardness (6.53±0.49GPa) than IC (P<0.001). On the other hand, VS glass-ceramic revealed significantly a higher brittleness index (2.84±0.26μm(-1/2)) (lower machinability) than IC glass-ceramic (P<0.05). VS demonstrated a homogeneous fine crystalline structure while, IC revealed a structure with needle-shaped fine-grained crystals embedded in a glassy matrix. The VS glass-ceramic revealed a lower probability of failure and a higher strength than IC glass-ceramic according to Weibull analysis. The VS zirconia reinforced lithium silicate glass-ceramic revealed higher mechanical properties compared with IC lithium disilicate glass-ceramic. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  20. On the interfacial fracture resistance of resin-bonded zirconia and glass-infiltrated graded zirconia

    PubMed Central

    Chai, Herzl; Kaizer, Marina; Chughtai, Asima; Tong, Hui; Tanaka, Carina; Zhang, Yu

    2015-01-01

    Objective A major limiting factor for the widespread use of zirconia in prosthetic dentistry is its poor resin-cement bonding capabilities. We show that this deficiency can be overcome by infiltrating the zirconia cementation surface with glass. Current methods for assessing the fracture resistance of resin-ceramic bonds are marred by uneven stress distribution at the interface, which may result in erroneous interfacial fracture resistance values. We have applied a wedge-loaded double-cantilever-beam testing approach to accurately measure the interfacial fracture resistance of adhesively bonded zirconia-based restorative materials. Methods The interfacial fracture energy GC was determined for adhesively bonded zirconia, graded zirconia and feldspathic ceramic bars. The bonding surfaces were subjected to sandblasting or acid etching treatments. Baseline GC was measured for bonded specimens subjected to 7 days hydration at 37 °C. Long-term GC was determined for specimens exposed to 20,000 thermal cycles between 5 and 55 °C followed by 2-month aging at 37 °C in water. The test data were interpreted with the aid of a 2D finite element fracture analysis. Results The baseline and long-term GC for graded zirconia was 2–3 and 8 times that for zirconia, respectively. More significantly, both the baseline and long-term GC of graded zirconia were similar to those for feldspathic ceramic. Significance The interfacial fracture energy of feldspathic ceramic and graded zirconia was controlled by the fracture energy of the resin cement while that of zirconia by the interface. GC for the graded zirconia was as large as for feldspathic ceramic, making it an attractive material for use in dentistry. PMID:26365987

  1. Cell Attachment Following Instrumentation with Titanium and Plastic Instruments, Diode Laser, and Titanium Brush on Titanium, Titanium-Zirconium, and Zirconia Surfaces.

    PubMed

    Lang, Melissa S; Cerutis, D Roselyn; Miyamoto, Takanari; Nunn, Martha E

    2016-01-01

    The aim of this study was to evaluate the surface characteristics and gingival fibroblast adhesion of disks composed of implant and abutment materials following brief and repeated instrumentation with instruments commonly used in procedures for implant maintenance, stage-two implant surgery, and periimplantitis treatment. One hundred twenty disks (40 titanium, 40 titaniumzirconium, 40 zirconia) were grouped into treatment categories of instrumentation by plastic curette, titanium curette, diode microlaser, rotary titanium brush, and no treatment. Twenty strokes were applied to half of the disks in the plastic and titanium curette treatment categories, while half of the disks received 100 strokes each to simulate implant maintenance occurring on a repetitive basis. Following analysis of the disks by optical laser profilometry, disks were cultured with human gingival fibroblasts. Cell counts were conducted from scanning electron microscopy (SEM) images. Differences in surface roughness across all instruments tested for zirconia disks were negligible, while both titanium disks and titaniumzirconium disks showed large differences in surface roughness across the spectrum of instruments tested. The rotary titanium brush and the titanium curette yielded the greatest overall mean surface roughness, while the plastic curette yielded the lowest mean surface roughness. The greatest mean cell counts for each disk type were as follows: titanium disks with plastic curettes, titanium-zirconium disks with titanium curettes, and zirconia disks with the diode microlaser. Repeated instrumentation did not result in cumulative changes in surface roughness of implant materials made of titanium, titanium-zirconium, or zirconia. Instrumentation with plastic implant curettes on titanium and zirconia surfaces appeared to be more favorable than titanium implant curettes in terms of gingival fibroblast attachment on these surfaces.

  2. A review of engineered zirconia surfaces in biomedical applications

    PubMed Central

    Yin, Ling; Nakanishi, Yoshitaka; Alao, Abdur-Rasheed; Song, Xiao-Fei; Abduo, Jaafar; Zhang, Yu

    2017-01-01

    Zirconia is widely used for load-bearing functional structures in medicine and dentistry. The quality of engineered zirconia surfaces determines not only the fracture and fatigue behaviour but also the low temperature degradation (ageing sensitivity), bacterial colonization and bonding strength of zirconia devices. This paper reviews the current manufacturing techniques for fabrication of zirconia surfaces in biomedical applications, particularly, in tooth and joint replacements, and influences of the zirconia surface quality on their functional behaviours. It discusses emerging manufacturing techniques and challenges for fabrication of zirconia surfaces in biomedical applications. PMID:29130030

  3. Mesoporous silica templated zirconia nanoparticles

    NASA Astrophysics Data System (ADS)

    Ballem, Mohamed A.; Córdoba, José M.; Odén, Magnus

    2011-07-01

    Nanoparticles of zirconium oxide (ZrO2) were synthesized by infiltration of a zirconia precursor (ZrOCl2·8H2O) into a SBA-15 mesoporous silica mold using a wet-impregnation technique. X-ray diffractometry and high-resolution transmission electron microscopy show formation of stable ZrO2 nanoparticles inside the silica pores after a thermal treatment at 550 °C. Subsequent leaching out of the silica template by NaOH resulted in well-dispersed ZrO2 nanoparticles with an average diameter of 4 nm. The formed single crystal nanoparticles are faceted with 110 surfaces termination suggesting it to be the preferred growth orientation. A growth model of these nanoparticles is also suggested.

  4. The educational settings of profoundly deaf children with cochlear implants compared with age-matched peers with hearing aids: implications for management.

    PubMed

    Archbold, Sue M; Nikolopoulos, Thomas P; Lutman, Mark E; O'Donoghue, Gerard M

    2002-04-01

    The educational settings of 42 implanted profoundly deaf children 3 years after implantation were compared with the respective settings of 635 age-matched severely deaf and 511 profoundly deaf children with hearing aids. All implanted children received their implants before beginning school. The results revealed that 3 years after implantation. 38% (16 children) of the implanted profoundly deaf children attended mainstream schools, whereas 57% (24 children) were in a unit, or special class, in a mainstream school, and 5% (two children) were in schools for the deaf. With regard to the age-matched profoundly deaf children with hearing aids, 12% (63 children) attended mainstream schools, whereas 55% (281 children) were in a unit of a mainstream school, and 33% (167 children) were in schools for the deaf. In the group of age-matched severely deaf children, 38% (239 children) attended mainstream schools, whereas 51% (326 children) were in a unit of a mainstream school, and 11% (70 children) were in schools for the deaf. Statistical analysis revealed a highly significant difference between the educational placement of implanted children and hearing-aided profoundly deaf children (p<0.00001), whereas there was no statistically significant difference between implanted children and hearing-aided severely deaf children. In conclusion, implanted profoundly deaf children who have received their implants before beginning school have the same profile of educational placement as aided severely deaf children rather than aided profoundly deaf children of the same age in the UK. This is likely to have significant implications for the future management of profoundly deaf children and to influence future planning of educational support services.

  5. Off the ear with no loss in speech understanding: comparing the RONDO and the OPUS 2 cochlear implant audio processors.

    PubMed

    Dazert, Stefan; Thomas, Jan Peter; Büchner, Andreas; Müller, Joachim; Hempel, John Martin; Löwenheim, Hubert; Mlynski, Robert

    2017-03-01

    The RONDO is a single-unit cochlear implant audio processor, which omits the need for a behind-the-ear (BTE) audio processor. The primary aim was to compare speech perception results in quiet and in noise with the RONDO and the OPUS 2, a BTE audio processor. Secondary aims were to determine subjects' self-assessed levels of sound quality and gather subjective feedback on RONDO use. All speech perception tests were performed with the RONDO and the OPUS 2 behind-the-ear audio processor at 3 test intervals. Subjects were required to use the RONDO between test intervals. Subjects were tested at upgrade from the OPUS 2 to the RONDO and at 1 and 6 months after upgrade. Speech perception was determined using the Freiburg Monosyllables in quiet test and the Oldenburg Sentence Test (OLSA) in noise. Subjective perception was determined using the Hearing Implant Sound Quality Index (HISQUI 19 ), and a RONDO device-specific questionnaire. 50 subjects participated in the study. Neither speech perception scores nor self-perceived sound quality scores were significantly different at any interval between the RONDO and the OPUS 2. Subjects reported high levels of satisfaction with the RONDO. The RONDO provides comparable speech perception to the OPUS 2 while providing users with high levels of satisfaction and comfort without increasing health risk. The RONDO is a suitable and safe alternative to traditional BTE audio processors.

  6. Comparison of shear bond strength of orthodontic brackets using various zirconia primers.

    PubMed

    Lee, Ji-Yeon; Kim, Jin-Seok; Hwang, Chung-Ju

    2015-07-01

    The aim of this study was to compare the shear bond strength (SBS) of orthodontic brackets bonded to zirconia surfaces using three different zirconia primers and one silane primer, and subjected to thermocycling. We designed 10 experimental groups following the surface treatment and thermocycling. The surface was treated with one of the following method: no-primer (NP), Porcelain Conditioner (PC), Z-PRIME Plus (ZP), Monobond Plus (MP) and Zirconia Liner Premium (ZL) (n=20). Then each group was subdivided to non-thermocycled and thermocycled groups (NPT, PC, ZPT, MPT, ZLT) (n=10). Orthodontic brackets were bonded to the specimens using Transbond™ XT Paste and light cured for 15 s at 1,100 mW/cm(2). The SBS was measured at a 1 mm/min crosshead speed. The failure mode was assessed by examination with a stereomicroscope and the amount of bonding resin remaining on the zirconia surface was scored using the modified adhesive remnant index (ARI). The SBS of all experimental groups decreased after thermocycling. Before thermocycling, the SBS was ZL, ZP ≥ MP ≥ PC > NP but after thermocycling, the SBS was ZLT ≥ MPT ≥ ZPT > PCT = NPT (p > 0.05). For the ARI score, both of the groups lacking primer (NP and NPT) displayed adhesive failure modes, but the groups with zirconia primers (ZP, ZPT, MP, MPT, ZL, and ZLT) were associated with mixed failure modes. Surface treatment with a zirconia primer increases the SBS relative to no-primer or silane primer application between orthodontic brackets and zirconia prostheses.

  7. Alkaline nanoparticle coatings improve resin bonding of 10-methacryloyloxydecyldihydrogenphosphate-conditioned zirconia.

    PubMed

    Qian, Mengke; Lu, Zhicen; Chen, Chen; Zhang, Huaiqin; Xie, Haifeng

    Creating an alkaline environment prior to 10-methacryloyloxydecyldihydrogenphosphate (MDP) conditioning improves the resin bonding of zirconia. The present study evaluated the effects of four alkaline coatings with different water solubilities and pH values on resin bonding of MDP-conditioned zirconia. Two alkaline nanoparticle coatings were studied in particular. Thermodynamics calculations were performed to evaluate the strengths of MDP-tetragonal phase zirconia chemical bonds at different pH values. Zirconia surfaces with and without alkaline coatings were characterized by scanning electron microscope (SEM)/energy dispersive spectrometer and Fourier transform infrared spectroscopy; alkaline coatings included NaOH, Ca(OH) 2 , nano-MgO, and nano-Zr(OH) 4 . A shear bond strength (SBS) test was performed to evaluate the effects of the four alkaline coatings on bonding; the alkaline coatings were applied to the surfaces prior to conditioning the zirconia with MDP-containing primers. Gibbs free energies of the MDP-tetragonal zirconia crystal model coordination reaction in different pH environments were -583.892 (NaOH), -569.048 [Ca(OH) 2 ], -547.393 (MgO), and -530.279 kJ/mol [Zr(OH) 4 ]. Thermodynamic calculations indicated that the alkaline coatings improved bonding in the following order: NaOH > Ca(OH) 2 > MgO > Zr(OH) 4 . Statistical analysis of SBS tests showed a different result. SBSs were significantly different in groups that had different alkaline coatings, but it was not influenced by different primers. All four alkaline coatings increased SBS compared to control groups. Of the four coatings, nano-Zr(OH) 4 and -MgO showed higher SBS. Therefore, preparing nano-Zr(OH) 4 or -MgO coatings prior to conditioning with MDP-containing primers may potentially improve resin bonding of zirconia in the clinic.

  8. The bending stress distribution in bilayered and graded zirconia-based dental ceramics

    PubMed Central

    Fabris, Douglas; Souza, Júlio C.M.; Silva, Filipe S.; Fredel, Márcio; Mesquita-Guimarães, Joana; Zhang, Yu; Henriques, Bruno

    2016-01-01

    The purpose of this study was to evaluate the biaxial flexural stresses in classic bilayered and in graded zirconia-feldspathic porcelain composites. A finite element method and an analytical model were used to simulate the piston-on-ring test and to predict the biaxial stress distributions across the thickness of the bilayer and graded zirconia-feldspathic porcelain discs. An axisymmetric model and a flexure formula of Hsueh et al. were used in the FEM and analytical analysis, respectively. Four porcelain thicknesses were tested in the bilayered discs. In graded discs, continuous and stepwise transitions from the bottom zirconia layer to the top porcelain layer were studied. The resulting stresses across the thickness, measured along the central axis of the disc, for the bilayered and graded discs were compared. In bilayered discs, the maximum tensile stress decreased while the stress mismatch (at the interface) increased with the porcelain layer thickness. The optimized balance between both variables is achieved for a porcelain thickness ratio in the range of 0.30–0.35. In graded discs, the highest tensile stresses were registered for porcelain rich interlayers (p=0.25) whereas the zirconia rich ones (p=8) yield the lowest tensile stresses. In addition, the maximum stresses in a graded structure can be tailored by altering compositional gradients. A decrease in maximum stresses with increasing values of p (a scaling exponent in the power law function) was observed. Our findings showed a good agreement between the analytical and simulated models, particularly in the tensile region of the disc. Graded zirconia-feldspathic porcelain composites exhibited a more favourable stress distribution relative to conventional bilayered systems. This fact can significantly impact the clinical performance of zirconia-feldspathic porcelain prostheses, namely reducing the fracture incidence of zirconia and the chipping and delamination of porcelain. PMID:28104926

  9. Alkaline nanoparticle coatings improve resin bonding of 10-methacryloyloxydecyldihydrogenphosphate-conditioned zirconia

    PubMed Central

    Qian, Mengke; Lu, Zhicen; Chen, Chen; Zhang, Huaiqin; Xie, Haifeng

    2016-01-01

    Creating an alkaline environment prior to 10-methacryloyloxydecyldihydrogenphosphate (MDP) conditioning improves the resin bonding of zirconia. The present study evaluated the effects of four alkaline coatings with different water solubilities and pH values on resin bonding of MDP-conditioned zirconia. Two alkaline nanoparticle coatings were studied in particular. Thermodynamics calculations were performed to evaluate the strengths of MDP-tetragonal phase zirconia chemical bonds at different pH values. Zirconia surfaces with and without alkaline coatings were characterized by scanning electron microscope (SEM)/energy dispersive spectrometer and Fourier transform infrared spectroscopy; alkaline coatings included NaOH, Ca(OH)2, nano-MgO, and nano-Zr(OH)4. A shear bond strength (SBS) test was performed to evaluate the effects of the four alkaline coatings on bonding; the alkaline coatings were applied to the surfaces prior to conditioning the zirconia with MDP-containing primers. Gibbs free energies of the MDP-tetragonal zirconia crystal model coordination reaction in different pH environments were −583.892 (NaOH), −569.048 [Ca(OH)2], −547.393 (MgO), and −530.279 kJ/mol [Zr(OH)4]. Thermodynamic calculations indicated that the alkaline coatings improved bonding in the following order: NaOH > Ca(OH)2 > MgO > Zr(OH)4. Statistical analysis of SBS tests showed a different result. SBSs were significantly different in groups that had different alkaline coatings, but it was not influenced by different primers. All four alkaline coatings increased SBS compared to control groups. Of the four coatings, nano-Zr(OH)4 and -MgO showed higher SBS. Therefore, preparing nano-Zr(OH)4 or -MgO coatings prior to conditioning with MDP-containing primers may potentially improve resin bonding of zirconia in the clinic. PMID:27785013

  10. Esthetic Evaluation of Anterior Single-Tooth Implants with Different Abutment Designs-Patients' Satisfaction Compared to Dentists' Observations.

    PubMed

    Patil, Ratnadeep; Gresnigt, Marco M M; Mahesh, Kavita; Dilbaghi, Anjali; Cune, Marco S

    2017-07-01

    To correlate patients' satisfaction and dentists' observations regarding two abutment designs used for single crowns in the esthetic zone: a divergent one (control) and a curved one (experimental), with special emphasis on muco-gingival esthetics. Twenty-six patients with nonadjacent missing teeth in the esthetic zone were enrolled in a randomized clinical trial (within-subject comparison). Two implants placed in each were restored using abutments of different geometry. Patients' appreciation was assessed on a visual analog scale (VAS) by recording answers to three questions, and dentists' appreciation was determined by means of the Pink Esthetic Score (PES) at T0 (crown cementation, baseline) and at T12 (1 year post-cementation). ANOVA with post hoc analysis was used to identify differences between groups and at different moments in time. Pearson correlations were calculated between all variables, both at T0 and at T12. No statistically significant differences were found at any time between the control and experimental abutment design, either for the PES or for the VAS score. PES slightly improved after 1 year, as did the VAS rating related to functioning with the implant-crown compared to the natural teeth. All PES and VAS scores demonstrated highly significant correlation. Both patient satisfaction and professional appreciation of muco-gingival conditions after single implant treatment in the esthetic zone were high; however, the curved, experimental abutment design performed no better than the conventional, divergent type. Curved abutment design does not significantly impact crown or gingival esthetics as assessed by PES and VAS scored by dentists and patients, respectively. © 2016 by the American College of Prosthodontists.

  11. A prospective study comparing endoscopic subcutaneous mastectomy plus immediate reconstruction with implants and breast conserving surgery for breast cancer.

    PubMed

    Fan, Lin-Jun; Jiang, Jun; Yang, Xin-Hua; Zhang, Yi; Li, Xing-Gang; Chen, Xian-Chun; Zhong, Ling

    2009-12-20

    Breast conserving surgery (BCS) has been the standard surgical procedure for the treatment of early breast cancer. Endoscopic subcutaneous mastectomy (ESM) plus immediate reconstruction with implants is an emerging procedure. The objective of this prospective study was to evaluate the clinical outcomes of these two surgical procedures in our clinical setting. From March 2004 to October 2007, 43 patients with breast cancer underwent ESM plus axillary lymph node dissection and immediate reconstruction with implants, while 54 patients underwent BCS. The clinical and pathological characteristics, surgical safety, and therapeutic effects were compared between the two groups. There were no significant differences in the age, clinical stage, histopathologic type of tumor, operative blood loss, postoperative drainage time, and postoperative complications between the two groups (P > 0.05). The postoperative complications were partial necrosis of the nipple and superficial skin flap in the ESM patients, and hydrops in the axilla and residual cavity in the BCS patients. There was no significant difference in the rate of satisfactory postoperative cosmetic outcomes between the ESM (88.4%, 38/43) and BCS (92.6%, 50/54) patients (P > 0.05). During follow-up of 6 months to 4 years, all patients treated with ESM were disease-free, but 3 patients who underwent BCS had metastasis or recurrence -one of these patients died of multiple organ metastasis. After considering the wide indications for use, high surgical safety, and favorable cosmetic outcomes, we conclude that ESM plus axillary lymph node dissection and immediate reconstruction with implants - the new surgery of choice for breast cancer - warrants serious consideration as the prospective next standard surgical procedure.

  12. A Meta-analysis of Studies Comparing Outcomes of Diverse Acellular Dermal Matrices for Implant-Based Breast Reconstruction.

    PubMed

    Lee, Kyeong-Tae; Mun, Goo-Hyun

    2017-07-01

    The current diversity of the available acellular dermal matrix (ADM) materials for implant-based breast reconstruction raises the issue of whether there are any differences in postoperative outcomes according to the kind of ADM used. The present meta-analysis aimed to investigate whether choice of ADM products can affect outcomes. Studies that used multiple kinds of ADM products for implant-based breast reconstruction and compared outcomes between them were searched. Outcomes of interest were rates of postoperative complications: infection, seroma, mastectomy flap necrosis, reconstruction failure, and overall complications. A total of 17 studies met the selection criteria. There was only 1 randomized controlled trial, and the other 16 studies had retrospective designs. Comparison of FlexHD, DermaMatrix, and ready-to-use AlloDerm with freeze-dried AlloDerm was conducted in multiple studies and could be meta-analyzed, in which 12 studies participated. In the meta-analysis comparing FlexHD and freeze-dried AlloDerm, using the results of 6 studies, both products showed similar pooled risks for all kinds of complications. When comparing DermaMatrix and freeze-dried AlloDerm with the results from 4 studies, there were also no differences between the pooled risks of complications of the two. Similarly, the meta-analysis of 4 studies comparing ready-to-use and freeze-dried AlloDerm demonstrated that the pooled risks for the complications did not differ. This meta-analysis demonstrates that the 3 recently invented, human cadaveric skin-based products of FlexHD, DermaMatrix, and ready-to-use AlloDerm have similar risks of complications compared with those of freeze-dried AlloDerm, which has been used for longer. However, as most studies had low levels of evidence, further investigations are needed.

  13. Comparing the spelling and reading abilities of students with cochlear implants and students with typical hearing.

    PubMed

    Apel, Kenn; Masterson, Julie J

    2015-04-01

    The purpose of this study was to determine whether students with and without hearing loss (HL) differed in their spelling abilities and, specifically, in the underlying linguistic awareness skills that support spelling ability. Furthermore, we examined whether there were differences between the two groups in the relationship between reading and spelling. We assessed the spelling, word-level reading, and reading comprehension skills of nine students with cochlear implants and nine students with typical hearing who were matched for reading age. The students' spellings were analyzed to determine whether the misspellings were due to errors with phonemic awareness, orthographic pattern or morphological awareness, or poor mental graphemic representations. The students with HL demonstrated markedly less advanced spelling abilities than the students with typical hearing. For the students with HL, the misspellings were primarily due to deficiencies in orthographic pattern and morphological awareness. Correlations between measures of spelling and both real word reading and reading comprehension were lower for the students with HL. With additional investigations using a similar approach to spelling analysis that captures the underlying causes for spelling errors, researchers will better understand the linguistic awareness abilities that students with HL bring to the task of reading and spelling. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Effect of Steam Autoclaving on the Tensile Strength of Resin Cements Used for Bonding Two-Piece Zirconia Abutments.

    PubMed

    Fadanelli, Marcos Alexandre; Amaral, Flávia Lucisano Botelho do; Basting, Roberta Tarkany; Turssi, Cecilia Pedroso; Sotto-Maior, Bruno Salles; França, Fabiana Mantovani Gomes

    2017-04-01

    The purpose of this study was to evaluate the effects of steam autoclave sterilization on the tensile strength of two types of resin cements used to bond customized CAD/CAM zirconia abutments onto titanium bases. Forty sets of zirconia abutments cemented to screwed titanium bases of implants analogs were divided into 4 groups (n = 10). Two groups were treated with a conventional chemically activated resin cement (ML, Multilink Ivoclar Vivadent) and the other two groups with a self-adhesive dual resin cement (RelyX U200, 3M ESPE). One group from each cement was submitted to steam autoclaving. The autoclave sterilization cycle was performed after 72 hours of cementation for 15 minutes at 121°C and 2.1 Kgf/cm 2 . The samples were subjected to tensile strength testing in a universal testing machine (200 Kgf, 0.5 mm/min), from which the means and standard deviations were obtained in Newtons. Results showed (via ANOVA and Tukey's test; α = 0.05) that in the absence of steam autoclaving, no difference was observed in tensile strength between the cements tested: ML: 344.87 (93.79) and U200: 280 (92.42) (P = .314). Steam autoclaving, however, significantly increased tensile strength for the ML: 465.42 (87.87) compared to U200: 289.10 (49.02) (P < .001). Despite the significant increase in the ML samples (P = .013), autoclaving did not affect the tensile strength of the U200 samples (P > 0.05). The authors concluded that steam autoclaving increases the mean tensile strength of the chemically activated cement compared to the dual-cure self-adhesive cement. The performance of both cements evaluated was similar if the sterilization step was disconsidered.

  15. Free form fabricated features on CoCr implants with and without hydroxyapatite coating in vivo: a comparative study of bone contact and bone growth induction.

    PubMed

    Grandfield, Kathryn; Palmquist, Anders; Gonçalves, Stéphane; Taylor, Andy; Taylor, Mark; Emanuelsson, Lena; Thomsen, Peter; Engqvist, Håkan

    2011-04-01

    The current study evaluates the in vivo response to free form fabricated cobalt chromium (CoCr) implants with and without hydroxyapatite (HA) plasma sprayed coatings. The free form fabrication method allowed for integration of complicated pyramidal surface structures on the cylindrical implant. Implants were press fit into the tibial metaphysis of nine New Zealand white rabbits. Animals were sacrificed and implants were removed and embedded. Histological analysis, histomorphometry and electron microscopy studies were performed. Focused ion beam was used to prepare thin sections for high-resolution transmission electron microscopy examination. The fabricated features allowed for effective bone in-growth and firm fixation after 6 weeks. Transmission electron microscopy investigations revealed intimate bone-implant integration at the nanometre scale for the HA coated samples. In addition, histomorphometry revealed a significantly higher bone contact on HA coated implants compared to native CoCr implants. It is concluded that free form fabrication in combination with HA coating improves the early fixation in bone under experimental conditions.

  16. Comparative Evaluation of Four Risk Scores for Predicting Mortality in Patients With Implantable Cardioverter-defibrillator for Primary Prevention.

    PubMed

    Rodríguez-Mañero, Moisés; Abu Assi, Emad; Sánchez-Gómez, Juan Miguel; Fernández-Armenta, Juan; Díaz-Infante, Ernesto; García-Bolao, Ignacio; Benezet-Mazuecos, Juan; Andrés Lahuerta, Ana; Expósito-García, Víctor; Bertomeu-González, Vicente; Arce-León, Álvaro; Barrio-López, María Teresa; Peinado, Rafael; Martínez-Sande, Luis; Arias, Miguel A

    2016-11-01

    Several clinical risk scores have been developed to identify patients at high risk of all-cause mortality despite implantation of an implantable cardioverter-defibrillator. We aimed to examine and compare the predictive capacity of 4 simple scoring systems (MADIT-II, FADES, PACE and SHOCKED) for predicting mortality after defibrillator implantation for primary prevention of sudden cardiac death in a Mediterranean country. A multicenter retrospective study was performed in 15 Spanish hospitals. Consecutive patients referred for defibrillator implantation between January 2010 and December 2011 were included. A total of 916 patients with ischemic and nonischemic heart disease were included (mean age, 62 ± 11 years, 81.4% male). Over 33.4 ± 12.9 months, 113 (12.3%) patients died (cardiovascular origin in 86 [9.4%] patients). At 12, 24, 36, and 48 months, mortality rates were 4.5%, 7.6%, 10.8%, and 12.3% respectively. All the risk scores showed a stepwise increase in the risk of death throughout the scoring system of each of the scores and all 4 scores identified patients at greater risk of mortality. The scores were significantly associated with all-cause mortality throughout the follow-up period. PACE displayed the lowest c-index value regardless of whether the population had heart disease of ischemic (c-statistic = 0.61) or nonischemic origin (c-statistic = 0.61), whereas MADIT-II (c-statistic = 0.67 and 0.65 in ischemic and nonischemic cardiomyopathy, respectively), SHOCKED (c-statistic = 0.68 and 0.66, respectively), and FADES (c-statistic = 0.66 and 0.60) provided similar c-statistic values (P ≥ .09). In this nontrial-based cohort of Mediterranean patients, the 4 evaluated risk scores showed a significant stepwise increase in the risk of death. Among the currently available risk scores, MADIT-II, FADES, and SHOCKED provide slightly better performance than PACE. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All

  17. Pulsewidth dependence of laser-induced periodic surface structure formed on yttria-stabilized zirconia polycrystal

    NASA Astrophysics Data System (ADS)

    Kakehata, Masayuki; Yashiro, Hidehiko; Oyane, Ayako; Ito, Atsuo; Torizuka, Kenji

    2016-03-01

    Three-mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) is a fine engineering ceramic that offers high fracture resistance and flexural strength. Thus, it is often applied in mechanical components and medical implants. The surface roughness can be controlled to improve the device characters in some applications. Ultrashort pulse lasers can form laser-induced periodic surface structures (LIPSS) on 3Y-TZP, which have never been investigated in detail. Therefore, this paper reports the formation and characteristics of LIPSS formed on 3Y-TZP, focusing on the pulsewidth dependence. The LIPSS was formed by a Ti:sapphire chirped-pulse amplification system, which generates 810 nmcentered 80-fs pulses at a 570 Hz repetition rate. The measured ablation threshold peak fluence was ~1.5 J/cm2 and the LIPSS was formed at the peak fluence of 2.7-7.7 J/cm2. For linearly polarized pulses, the lines of the LIPSS were oriented parallel to the polarization direction, and their period was comparable to or larger than the center wavelength of the laser. These characteristics differ from the reported characteristics of LIPSS on metals and dielectrics. The pulsewidth dependence of the ablation and LIPSS was investigated for different pulsewidths and signs of chirp. Under the investigated fluence condition, the LIPSS period increased with increasing pulsewidth for both signs of chirp. Similar pulsewidth dependencies were observed for circularly polarized pulses.

  18. Functionally graded bioactive glass coating on magnesia partially stabilized zirconia (Mg-PSZ) for enhanced biocompatibility.

    PubMed

    Rahaman, Mohamed N; Li, Yadong; Bal, B Sonny; Huang, Wenhai

    2008-06-01

    The coating of magnesia partially stabilized zirconia (Mg-PSZ) with a bioactive glass was investigated for enhancing the bioactivity and bone-bonding ability of Mg-PSZ orthopedic implants. Individual coatings of three different bioactive glasses were prepared by depositing a concentrated suspension of the glass particles on Mg-PSZ substrates, followed by sintering at temperatures between 750 degrees C and 850 degrees C. Two silicate-based glass compositions (designated 13-93 and 6P68), and a borosilicate glass composition (H12) were investigated. The microstructure and adhesive strength of the coatings were characterized, and the in vitro bioactivity of the glasses was compared by measuring their conversion kinetics to hydroxyapatite in an aqueous phosphate solution at 37 degrees C. The 6P68 glass provided the highest adhesive strength (40 +/- 2 MPa) but showed very limited bioactivity, whereas the H12 glass had lower adhesive strength (18 +/- 2 MPa) but the highest bioactivity. A functionally graded coating, consisting of a 6P68 interfacial layer and an H12 surface layer, was developed to provide a coating with high adhesive strength coupled with rapid in vitro bioactivity.

  19. Short Implants: New Horizon in Implant Dentistry.

    PubMed

    Jain, Neha; Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-09-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration.

  20. Short Implants: New Horizon in Implant Dentistry

    PubMed Central

    Gulati, Manisha; Garg, Meenu; Pathak, Chetan

    2016-01-01

    The choice of implant length is an essential factor in deciding the survival rates of these implants and the overall success of the prosthesis. Placing an implant in the posterior part of the maxilla and mandible has always been very critical due to poor bone quality and quantity. Long implants can be placed in association with complex surgical procedures such as sinus lift and bone augmentation. These techniques are associated with higher cost, increased treatment time and greater morbidity. Hence, there is need for a less invasive treatment option in areas of poor bone quantity and quality. Data related to survival rates of short implants, their design and prosthetic considerations has been compiled and structured in this manuscript with emphasis on the indications, advantages of short implants and critical biomechanical factors to be taken into consideration when choosing to place them. Studies have shown that comparable success rates can be achieved with short implants as those with long implants by decreasing the lateral forces to the prosthesis, eliminating cantilevers, increasing implant surface area and improving implant to abutment connection. Short implants can be considered as an effective treatment alternative in resorbed ridges. Short implants can be considered as a viable treatment option in atrophic ridge cases in order to avoid complex surgical procedures required to place long implants. With improvement in the implant surface geometry and surface texture, there is an increase in the bone implant contact area which provides a good primary stability during osseo-integration. PMID:27790598

  1. Concomitant tricuspid valve repair or replacement during left ventricular assist device implant demonstrates comparable outcomes in the long term.

    PubMed

    Deo, Salil V; Hasin, Tal; Altarabsheh, Salah E; McKellar, Stephen H; Shah, Ishan K; Durham, Lucian; Stulak, John M; Daly, Richard C; Park, Soon J; Joyce, Lyle D

    2012-11-01

    Severe tricuspid regurgitation (TR) is present in nearly half the patients undergoing implant of a left ventricular assist device (LVAD) and its correction confers better long-term outcome. To compare the early and late results of tricuspid valve repair (TVrpr) or replacement (TVR) with LVAD implant. Sixty-four from a cohort of 126 patients had a concomitant tricuspid valve procedure; 48 (75%) underwent a TVrpr whereas 16 (25%) had TVR. All preoperative hemodynamic parameters including the mean TR grade (TVrpr; 3.6 vs. TVR; 3.7) were comparable (p = 0.7). The mean TR grade was 1.6 ± 1.5 for the remaining 62 patients who did not have a concomitant tricuspid valve procedure, with 4/62 (6%) having severe TR (p < 0.0001). Cardiopulmonary bypass time was longer for patients undergoing TVR (p = 0.01). There was a significant reduction in right atrial pressure for the entire cohort (p < 0.01) and the postoperative right atrial pressure was not statistically different between TVrpr (13.6 ± 4.6) and TVR (11.6 ± 4.3; p = 0.6. Postoperative intensive care unit stay was comparable as was the duration of inotropic support (p = 0.5) or need for temporary right ventricular mechanical support. In-hospital mortality (12%) was not different between groups. The mean time for LVAD support was 12.3 ± 9.71 months and the last transthoracic echocardiographic examination was performed at mean intervals of 13.8 ± 10.8 months (TVrpr) and 11.8 ± 7.6 months (TVR; p = 0.47). Reduction in TR grade was similar between groups (p = 0.27). Late mortality (p = 1.00) was comparable in both groups. Using log-rank analysis, there was no significant difference in the estimated survival between TVrpr and TVR (p = 0.88). TVrpr repair at the time of LVAD implant is effective in correcting TR even at the end of one year of follow-up. The choice to repair or replace does not affect the clinical outcome. © 2012 Wiley Periodicals, Inc.

  2. Surface Modifications of Dental Ceramic Implants with Different Glass Solder Matrices: In Vitro Analyses with Human Primary Osteoblasts and Epithelial Cells

    PubMed Central

    Mick, Enrico

    2014-01-01

    Ceramic materials show excellent esthetic behavior, along with an absence of hypersensitivity, making them a possible alternative implant material in dental surgery. However, their surface properties enable only limited osseointegration compared to titanium implants. Within this study, a novel surface coating technique for enhanced osseointegration was investigated biologically and mechanically. Specimens of tetragonal zirconia polycrystal (TZP) and aluminum toughened zirconia (ATZ) were modified with glass solder matrices in two configurations which mainly consisted of SiO2, Al2O3, K2O, and Na2O. The influence on human osteoblastic and epithelial cell viability was examined by means of a WST-1 assay as well as live/dead staining. A C1CP-ELISA was carried out to verify procollagen type I production. Uncoated/sandblasted ceramic specimens and sandblasted titanium surfaces were investigated as a reference. Furthermore, mechanical investigations of bilaterally coated pellets were conducted with respect to surface roughness and adhesive strength of the different coatings. These tests could demonstrate a mechanically stable implant coating with glass solder matrices. The coated ceramic specimens show enhanced osteoblastic and partly epithelial viability and matrix production compared to the titanium control. Hence, the new glass solder matrix coating could improve bone cell growth as a prerequisite for enhanced osseointegration of ceramic implants. PMID:25295270

  3. Surface modifications of dental ceramic implants with different glass solder matrices: in vitro analyses with human primary osteoblasts and epithelial cells.

    PubMed

    Markhoff, Jana; Mick, Enrico; Mitrovic, Aurica; Pasold, Juliane; Wegner, Katharina; Bader, Rainer

    2014-01-01

    Ceramic materials show excellent esthetic behavior, along with an absence of hypersensitivity, making them a possible alternative implant material in dental surgery. However, their surface properties enable only limited osseointegration compared to titanium implants. Within this study, a novel surface coating technique for enhanced osseointegration was investigated biologically and mechanically. Specimens of tetragonal zirconia polycrystal (TZP) and aluminum toughened zirconia (ATZ) were modified with glass solder matrices in two configurations which mainly consisted of SiO2, Al2O3, K2O, and Na2O. The influence on human osteoblastic and epithelial cell viability was examined by means of a WST-1 assay as well as live/dead staining. A C1CP-ELISA was carried out to verify procollagen type I production. Uncoated/sandblasted ceramic specimens and sandblasted titanium surfaces were investigated as a reference. Furthermore, mechanical investigations of bilaterally coated pellets were conducted with respect to surface roughness and adhesive strength of the different coatings. These tests could demonstrate a mechanically stable implant coating with glass solder matrices. The coated ceramic specimens show enhanced osteoblastic and partly epithelial viability and matrix production compared to the titanium control. Hence, the new glass solder matrix coating could improve bone cell growth as a prerequisite for enhanced osseointegration of ceramic implants.

  4. Phase field modeling of tetragonal to monoclinic phase transformation in zirconia

    NASA Astrophysics Data System (ADS)

    Mamivand, Mahmood

    Zirconia based ceramics are strong, hard, inert, and smooth, with low thermal conductivity and good biocompatibility. Such properties made zirconia ceramics an ideal material for different applications form thermal barrier coatings (TBCs) to biomedicine applications like femoral implants and dental bridges. However, this unusual versatility of excellent properties would be mediated by the metastable tetragonal (or cubic) transformation to the stable monoclinic phase after a certain exposure at service temperatures. This transformation from tetragonal to monoclinic, known as LTD (low temperature degradation) in biomedical application, proceeds by propagation of martensite, which corresponds to transformation twinning. As such, tetragonal to monoclinic transformation is highly sensitive to mechanical and chemomechanical stresses. It is known in fact that this transformation is the source of the fracture toughening in stabilized zirconia as it occurs at the stress concentration regions ahead of the crack tip. This dissertation is an attempt to provide a kinetic-based model for tetragonal to monoclinic transformation in zirconia. We used the phase field technique to capture the temporal and spatial evolution of monoclinic phase. In addition to morphological patterns, we were able to calculate the developed internal stresses during tetragonal to monoclinic transformation. The model was started form the two dimensional single crystal then was expanded to the two dimensional polycrystalline and finally to the three dimensional single crystal. The model is able to predict the most physical properties associated with tetragonal to monoclinic transformation in zirconia including: morphological patterns, transformation toughening, shape memory effect, pseudoelasticity, surface uplift, and variants impingement. The model was benched marked with several experimental works. The good agreements between simulation results and experimental data, make the model a reliable tool for

  5. Towards more physiological manipulations of hormones in field studies: comparing the release dynamics of three kinds of testosterone implants, silastic tubing, time-release pellets and beeswax.

    PubMed

    Quispe, Rene; Trappschuh, Monika; Gahr, Manfred; Goymann, Wolfgang

    2015-02-01

    Hormone manipulations are of increasing interest in the areas of physiological ecology and evolution, because hormones are mediators of complex phenotypic changes. Often, however, hormone manipulations in field settings follow the approaches that have been used in classical endocrinology, potentially using supra-physiological doses. To answer ecological and evolutionary questions, it may be important to manipulate hormones within their physiological range. We compare the release dynamics of three kinds of implants, silastic tubing, time-release pellets, and beeswax pellets, each containing 3mg of testosterone. These implants were placed into female Japanese quail, and plasma levels of testosterone measured over a period of 30 days. Testosterone in silastic tubing led to supraphysiological levels. Also, testosterone concentrations were highly variable between individuals. Time-release pellets led to levels of testosterone that were slightly supraphysiological during the first days. Over the period of 30 days, however, testosterone concentrations were more consistent. Beeswax implants led to a physiological increase in testosterone and a relatively constant release. The study demonstrated that hormone implants in 10mm silastic tubing led to a supraphysiological peak in female quail. Thus, the use of similar-sized or even larger silastic implants in males or in other smaller vertebrates needs careful assessment. Time-release pellets and beeswax implants provide a more controlled release and degrade within the body. Thus, it is not necessary to recapture the animal to remove the implant. We propose beeswax implants as an appropriate procedure to manipulate testosterone levels within the physiological range. Hence, such implants may be an effective alternative for field studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Comparative study between the effects of photodynamic therapy and conventional therapy on microbial reduction in ligature-induced peri-implantitis in dogs.

    PubMed

    Hayek, Ricardo R A; Araújo, Ney S; Gioso, Marco A; Ferreira, Jonathan; Baptista-Sobrinho, Carlos A; Yamada, Aécio M; Ribeiro, Martha S

    2005-08-01

    Progressive peri-implant bone losses, which are accompanied by inflammatory lesions in the soft tissues, are referred to as peri-implantitis. The aim of this study was to compare the effects of photodynamic therapy (PDT) and conventional technique on microbial reduction in ligature-induced peri-implantitis in dogs. Eighteen third premolars from nine Labrador retriever dogs were extracted and the implants were submerged. After osseointegration, peri-implantitis was induced. After 4 months, ligature was removed and natural bacterial plaque was allowed to form for another 4 months. The animals were then randomly divided into two groups. In the conventional group, they were treated using mucoperiosteal flaps for scaling the implant surface and chlorexidine (conventional) irrigation. In the PDT group, only mucoperiosteal scaling was carried out before photodynamic therapy. Inside the peri-implant pocket, a paste-based azulene photosensitizer was placed and then a GaAlAs low-power laser (lambda=660 nm, P=40 mW, E=7.2 J for 3 minutes) was used. Microbiological samples were obtained before and immediately after treatment. Before treatment, one implant was removed and analyzed by scanning electron microscopy to validate the contamination. The results of this study showed that Prevotella sp., Fusobacterium sp., and S. Beta-haemolyticus were significantly reduced for both groups. After treatment, no significant differences were observed between the groups. These findings suggest that photodynamic therapy is a non-invasive method that could be used to reduce microorganisms in peri-implantitis. J Periodontol 2005;76:1275-1281.

  7. The effect of different surface treatments on the bond strength of a gingiva-colored indirect composite veneering material to three implant framework materials.

    PubMed

    Koizuka, Mai; Komine, Futoshi; Blatz, Markus B; Fushiki, Ryosuke; Taguchi, Kohei; Matsumura, Hideo

    2013-09-01

    To evaluate and compare the shear-bond strength of a gingiva-colored indirect composite material to three different implant framework materials (zirconia ceramics, gold alloy, and titanium), and to investigate the effect of surface pretreatment by air-particle abrasion and four priming agents. A gingiva-colored indirect composite (Ceramage) was bonded to three framework materials (n = 80): commercially pure titanium (CP- Ti ), ADA (American Dental Association)-type 4 casting gold alloy (Type IV), and zirconia ceramics (Zirconia) with or without airborne-particle abrasion. Before bonding, the surface of the specimens was treated using no (control) or one of four priming agents: Alloy Primer (ALP), Estenia Opaque Primer (EOP), Metal Link Primer (MLP), and V-Primer (VPR). Shear-bond strength was determined after 24-h wet storage. Data were analyzed using Steel-Dwass for multiple comparisons, and Mann-Whitney U-test (P = 0.05). For both CP- Ti and Zirconia substrates, three groups, ALP, EOP, and MLP, showed significantly higher bond strengths (P < 0.05) than the other groups with or without airborne-particle abrasion. For Type IV substrates, significantly higher bond strengths were obtained in ALP and MLP groups (P < 0.01) compared with the other groups with airborne-particle abrasion. Application of priming agents containing specific phosphoric ester groups significantly enhances the bond strength of a gingiva-colored composite material to commercially pure titanium and zirconia frameworks. Combined use of a thione monomer with a phosphoric monomer enhances the bond strengths to airborne-particle abraded type IV gold alloy. © 2012 John Wiley & Sons A/S.

  8. SU-F-T-39: Comparing Nomograms for Ordering of Palladium-103 Seeds for Dynamic Intraoperative Prostate Seed Implantation

    SciT

    Taylor, P; Wang, L; Riegel, A

    Purpose: Several nomograms exist for the purpose of ordering palladium- 103 seeds for permanent prostate seed implants. Excess seeds pose additional radiation safety risks and increase the cost of care. This study compared three seed ordering nomograms with seed counts from dynamic intra-operative PSI to determine (1) the cause of excess seeds and (2) the optimal nomogram for our institution. Methods: Pre-operative and intra-operative clinical data were collected for 100 Gy (n=151) and 125 Gy (n=224) prostate seed implants. The number of implanted seeds which would have given D90=100% was normalized to that criteria and seed strength of 2U. Thismore » was plotted against intra-operative prostate volume and compared to two previously published nomograms and an in-house nomogram. A linear fit was produced and confidence intervals were calculated. The causes of excess seeds were assessed by comparing pre- and intra-operative prostate volumes, variability of D90 around 100%, and variance of seed strength from 2U. Results: Of the 375 total cases, 97.6% had excess seeds. On average, 27.17±12.91% of ordered seeds were wasted. Of this percentage, 6.98±5.47% of excess seeds were due to overestimation of pre-operative prostate volume, 1.10±0.88% were due to D90<100%, 1.17±0.67% were due to seed strength over 2U, and 17.36±7.79% could not be directly attributed to a specific reason. The latter percentage may be due to overestimation of the in-house nomogram. Two of three nomograms substantially overestimated the number of seeds required. The third nomogram underestimated the required seed number for smaller prostate treatment volume. A linear fit to the clinical data was derived and 99.9% confidence intervals were calculated. Conclusion: Over 85% of clinical cases wasted over 15% of ordered seeds. Two of three nomograms overestimated the required number of seeds. The upper 99.9% C.I. of the clinical data may provide a more reasonable nomogram for Pd-103 seed ordering.« less

  9. The effect of silica-coating by sol-gel process on resin-zirconia bonding.

    PubMed

    Lung, Christie Ying Kei; Kukk, Edwin; Matinlinna, Jukka Pekka

    2013-01-01

    The effect of silica-coating by sol-gel process on the bond strength of resin composite to zirconia was evaluated and compared against the sandblasting method. Four groups of zirconia samples were silica-coated by sol-gel process under varied reagent ratios of ethanol, water, ammonia and tetraethyl orthosilicate and for different deposition times. One control group of zirconia samples were treated with sandblasting. Within each of these five groups, one subgroup of samples was kept in dry storage while another subgroup was aged by thermocycling for 6,000 times. Besides shear bond testing, the surface topography and surface elemental composition of silica-coated zirconia samples were also examined using scanning electron microscopy and X-ray photoelectron spectroscopy. Comparison of silica coating methods revealed significant differences in bond strength among the Dry groups (p<0.001) and Thermocycled groups (p<0.001). Comparison of sol-gel deposition times also revealed significant differences in bond strength among the Dry groups (p<0.01) and Thermocycled groups (p<0.001). Highest bond strengths were obtained after 141-h deposition: Dry (7.97±3.72 MPa); Thermocycled (2.33±0.79 MPa). It was concluded that silica-coating of zirconia by sol-gel process resulted in weaker resin bonding than by sandblasting.

  10. Surface fluorination of zirconia: adhesive bond strength comparison to commercial primers.

    PubMed

    Piascik, Jeffrey R; Swift, Edward J; Braswell, Krista; Stoner, Brian R

    2012-06-01

    This study evaluated contact angle and shear bond strength of three commercial zirconia primers and compared them to a recently developed fluorination pre-treatment. Earlier investigations reported that plasma fluorinated zirconia modifies the chemical bonding structure creating a more reactive surface. Yttria-stabilized zirconia (LAVA, 3M ESPE) plates were highly polished using 3μm diamond paste (R(a) ∼200nm) prior to pretreatments. After primer and fluorination treatment, contact angles were measured to quantify surface hydrophobicity before and after ethanol clean. Additionally, simple shear bond tests were performed to measure the adhesion strength to a composite resin. Plasma fluorination produced the lowest contact angle (7.8°) and the highest shear bond strength (37.3MPa) suggesting this pretreatment facilitates a more "chemically" active surface for adhesive bonding. It is hypothesized that plasma fluorination increase hydroxylation at the surface, making it more reactive, thus allowing for covalent bonding between zirconia surface and resin cement. A strong correlation was observed between contact angle and adhesion strength for all specimens; a relationship which may help understand the frequency and modes of failures, clinically. It is also believed that this surface treatment can increase long-term viability of zirconia restorations over other adhesive techniques. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  11. Hydroxyapatite coating on PEEK implants: biomechanical and histological study in a rabbit model

    PubMed Central

    Durham, John W.; Montelongo, Sergio A.; Ong, Joo L.; Guda, Teja; Allen, Matthew J.; Rabiei, Afsaneh

    2016-01-01

    A bioactive two-layer coating consisting of hydroxyapatite (HA) and yttria-stabilized zirconia (YSZ) was investigated on cylindrical polyether ether ketone (PEEK) implants using ion beam assisted deposition (IBAD). Post-deposition heat treatments via variable frequency microwave annealing with and without subsequent autoclaving were used to crystallize the as-deposited amorphous HA layer. Microstructural analysis, performed by TEM and EDS, showed that these methods were capable of crystallizing HA coating on PEEK. The in vivo response to cylindrical PEEK samples with and without coating was studied by implanting uncoated PEEK and coated PEEK implants in the lateral femoral condyle of 18 rabbits. Animals were studied in two groups 9 for observation at 6 or 18 weeks post surgery. MicroCT analysis, histology, and mechanical pull-out tests were performed to determine the effect of the coating on osseointegration. The heat-treated HA/YSZ coatings showed improved implant fixation as well as higher bone regeneration and bone-implant contact area compared to uncoated PEEK. The study offers a novel method to coat PEEK implants with improved osseointegration. PMID:27524073

  12. Hydroxyapatite coating on PEEK implants: Biomechanical and histological study in a rabbit model.

    PubMed

    Durham, John W; Montelongo, Sergio A; Ong, Joo L; Guda, Teja; Allen, Matthew J; Rabiei, Afsaneh

    2016-11-01

    A bioactive two-layer coating consisting of hydroxyapatite (HA) and yttria-stabilized zirconia (YSZ) was investigated on cylindrical polyetheretherketone (PEEK) implants using ion beam assisted deposition (IBAD). Post-deposition heat treatments via variable frequency microwave annealing with and without subsequent autoclaving were used to crystallize the as-deposited amorphous HA layer. Microstructural analysis, performed by TEM and EDS, showed that these methods were capable of crystallizing HA coating on PEEK. The in vivo response to cylindrical PEEK samples with and without coating was studied by implanting uncoated PEEK and coated PEEK implants in the lateral femoral condyle of 18 rabbits. Animals were studied in two groups of 9 for observation at 6 or 18weeks post surgery. Micro-CT analysis, histology, and mechanical pull-out tests were performed to determine the effect of the coating on osseointegration. The heat-treated HA/YSZ coatings showed improved implant fixation as well as higher bone regeneration and bone-implant contact area compared to uncoated PEEK. The study offers a novel method to coat PEEK implants with improved osseointegration. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Comparative study between unilateral and bilateral cochlear implantation in children of 1 and 2 years of age.

    PubMed

    Escorihuela García, Vicente; Pitarch Ribas, María Ignacia; Llópez Carratalá, Ignacio; Latorre Monteagudo, Emilia; Morant Ventura, Antonio; Marco Algarra, Jaime

    2016-01-01

    The studies that have evaluated the effectiveness of bilateral cochlear implantation in children suggest an improvement in hearing about sound localization and speech discrimination. In this paper we show the differences in audio-linguistic achievements with early bilateral cochlear implantation versus unilateral, and differences between simultaneous and sequential bilateral implantation. We present 88 children with bilateral profound sensorineural hearing loss, treated with bilateral cochlear implantation in 32 cases and unilateral in 56 cases, during the first 12 months (27 children) of life and between 12 and 24 months (61 children). We conducted a statistical comparison of both groups in the audiometry, IT-Mais, Nottingham, LittlEars scales and verbal tests. No significant differences in hearing thresholds and questionnaires between unilateral and bilateral implantation were detected in either the first or second year. Verbal tests do show statistically significant differences: children with bilateral cochlear implant obtain 100% recognition of disyllabic and phrases within 2-3 years after implantation whilst children with one implant do not obtain those results at 5 years after surgery. No differences between simultaneous and sequential bilateral implantation were detected. We emphasize the importance of ensuring good early audiological screening, to carry out an early and bilateral cochlear implantation with the consequent development of audio-language skills similar to normal hearing children. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  14. Comparative histomorphometry and resonance frequency analysis of implants with moderately rough surfaces in a loaded animal model.

    PubMed

    Al-Nawas, B; Groetz, K A; Goetz, H; Duschner, H; Wagner, W

    2008-01-01

    Test of favourable conditions for osseointegration with respect to optimum bone-implant contact (BIC) in a loaded animal model. The varied parameters were surface roughness and surface topography of commercially available dental implants. Thirty-two implants of six types of macro and microstructure were included in the study (total 196). The different types were: minimally rough control: Branemark machined Mk III; oxidized surface: TiUnite MkIII and MkIV; ZL Ticer; blasted and etched surface: Straumann SLA; rough control: titanium plasma sprayed (TPS). Sixteen beagle dogs were implanted with the whole set of the above implants. After a healing period of 8 weeks, implants were loaded for 3 months. For the evaluation of the BIC areas, adequately sectioned biopsies were visualized by subsurface scans with confocal laser scanning microscopy (CLSM). The primary statistical analysis testing BIC of the moderately rough implants (mean 56.1+/-13.0%) vs. the minimally rough and the rough controls (mean 53.9+/-11.2%) does not reveal a significant difference (P=0.57). Mean values of 50-70% BIC were found for all implant types. Moderately rough oxidized implants show a median BIC, which is 8% higher than their minimally rough turned counterpart. The intraindividual difference between the TPS and the blasted and etched counterparts revealed no significant difference. The turned and the oxidized implants show median values of the resonance frequency [implant stability quotients (ISQ)] over 60; the nonself-tapping blasted and etched and TPS implants show median values below 60. In conclusion, the benefit of rough surfaces relative to minimally rough ones in this loaded animal model was confirmed histologically. The comparison of different surface treatment modalities revealed no significant differences between the modern moderately rough surfaces. Resonance frequency analysis seems to be influenced in a major part by the transducer used, thus prohibiting the comparison of

  15. Optical properties and light irradiance of monolithic zirconia at variable thicknesses.

    PubMed

    Sulaiman, Taiseer A; Abdulmajeed, Aous A; Donovan, Terrence E; Ritter, André V; Vallittu, Pekka K; Närhi, Timo O; Lassila, Lippo V

    2015-10-01

    The aims of this study were to: (1) estimate the effect of polishing on the surface gloss of monolithic zirconia, (2) measure and compare the translucency of monolithic zirconia at variable thicknesses, and (3) determine the effect of zirconia thickness on irradiance and total irradiant energy. Four monolithic partially stabilized zirconia (PSZ) brands; Prettau® (PRT, Zirkonzahn), Bruxzir® (BRX, Glidewell), Zenostar® (ZEN, Wieland), Katana® (KAT, Noritake), and one fully stabilized zirconia (FSZ); Prettau Anterior® (PRTA, Zirkonzahn) were used to fabricate specimens (n=5/subgroup) with different thicknesses (0.5, 0.7, 1.0, 1.2, 1.5, and 2.0mm). Zirconia core material ICE® Zircon (ICE, Zirkonzahn) was used as a control. Surface gloss and translucency were evaluated using a reflection spectrophotometer. Irradiance and total irradiant energy transmitted through each specimen was quantified using MARC® Resin Calibrator. All specimens were then subjected to a standardized polishing method and the surface gloss, translucency, irradia