Buccal Bone Plate Remodeling After Immediate Implant Placement With and Without Synthetic Bone Grafting and Flapless Surgery: Radiographic Study in Dogs

Recent studies in animals have shown pronounced resorption of the buccal bone plate after immediate implantation. The use of flapless surgical procedures prior to the installation of immediate implants, as well as the use of synthetic bone graft in the gaps represent viable alternatives to minimize buccal bone resorption and to favor osseointegration. The aim of this study was to evaluate the healing of the buccal bone plate following immediate implantation using the flapless approach, and to compare this process with sites in which a synthetic bone graft was or was not inserted into the gap between the implant and the buccal bone plate. Lower bicuspids from 8 dogs were bilaterally extracted without the use of flaps, and 4 implants were installed in the alveoli in each side of the mandible and were positioned 2.0 mm from the buccal bone plate (gap). Four groups were devised: 2.0-mm subcrestal implants (3.3 x 8 mm) using bone grafts (SCTG), 2.0-mm subcrestal implants without bone grafts (SCCG), equicrestal implants (3.3 x 10 mm) with bone grafts (EGG), and equicrestal implants without bone grafts (ECCG). One week following the surgical procedures, metallic prostheses were installed, and within 12 weeks the dogs were sacrificed. The blocks containing the individual implants were turned sideways, and radiographic imaging was obtained to analyze the remodeling of the buccal bone plate. In the analysis of the resulting distance between the implant shoulder and the bone crest, statistically significant differences were found in the SCTG when compared to the ECTG (P = .02) and ECCG (P = .03). For mean value comparison of the resulting linear distance between the implant surface and the buccal plate, no statistically significant difference was found among all groups (P > .05). The same result was observed in the parameter for presence or absence of tissue formation between the implant surface and buccal plate. Equicrestally placed implants, in this methodology, presented little or no loss of the buccal bone. The subcrestally positioned implants presented loss of buccal bone, even though synthetic bone graft was used. The buccal bone, however, was always coronal to the implant shoulder.

Designing piezoresistive plate-based sensors with distribution of piezoresistive material using topology optimization

Piezoresistive sensors are commonly made of a piezoresistive membrane attached to a flexible substrate, a plate. They have been widely studied and used in several applications. It has been found that the size, position and geometry of the piezoresistive membrane may affect the performance of the sensors. Based on this remark, in this work, a topology optimization methodology for the design of piezoresistive plate-based sensors, for which both the piezoresistive membrane and the flexible substrate disposition can be optimized, is evaluated. Perfect coupling conditions between the substrate and the membrane based on the `layerwise' theory for laminated plates, and a material model for the piezoresistive membrane based on the solid isotropic material with penalization model, are employed. The design goal is to obtain the configuration of material that maximizes the sensor sensitivity to external loading, as well as the stiffness of the sensor to particular loads, which depend on the case (application) studied. The proposed approach is evaluated by studying two distinct examples: the optimization of an atomic force microscope probe and a pressure sensor. The results suggest that the performance of the sensors can be improved by using the proposed approach.