Influence of immediate loading on healing of implants installed with different insertion torques - an experimental study in dogs

Objective: To evaluate the influence of different insertion torques on healing of implants loaded immediately or left unloaded.Material and methods: In six Labrador dogs, all mandibular premolars and molars were extracted. After 4 months of healing, flaps were elevated, and two implant sites were prepared at each side of the mandible. The distal sites were prepared conventionally while the mesial sites were underprepared by 0.3 mm. As a consequence, different final insertion torques of about 30 Ncm at the distal and >70 Ncm at the mesial sites were recorded. Healing abutments were applied to the left and transmucosal abutments to the right side. Flaps were sutured, crown preparation of the upper right second and third premolars was performed, and impressions were taken. Within 24 h, crowns were cemented both to implants and teeth in the right side of the mouth. After 4 months, the animals were sacrificed and ground sections obtained for histological evaluation.Results: A higher buccal bony crestal resorption and a more apical position of the coronal level of osseointegration were found at the loaded compared with the unloaded sites. MBIC% and percentages of peri-implant mineralized tissue (MB%) were higher at the loaded compared with the unloaded sites. Moreover, a higher MBIC% was found at the lower compared with the higher final insertion torque.Conclusions: Immediate loading does not seem to have a negative effect on osseointegration. High torque values for the immediate loading procedures were not necessary. Probably, low torque values, were sufficient to obtain primary stability and hence may provide better osseointegration than high torque value.

Hard and soft tissue changes around implants installed in regular-sized and reduced alveolar bony ridges. An experimental study in dogs

Objective: To study bony and soft tissue changes at implants installed in alveolar bony ridges of different widths.Material and methods: In 6 Labrador dogs, the mandibular premolars and first molars were extracted, and a buccal defect was created in the left side at the third and fourth premolars by removing the buccal bone and the inter-radicular and interdental septa. Three months after tooth extraction, full-thickness mucoperiosteal flaps were elevated, and implants were installed, two at the reduced (test) and two at the regular-sized ridges (control). Narrow or wide abutments were affixed to the implants. After 3 months, biopsies were harvested, and ground sections prepared for histological evaluation.Results: A higher vertical buccal bony crest resorption was found at the test (1.5 +/- 0.7 mm and 1.0 +/- 0.7 mm) compared to the control implants (1.0 +/- 0.5 mm and 0.7 +/- 0.4 mm), for both wide and narrow abutment sites. A higher horizontal alveolar resorption was identified at the control compared to the test implants. The difference was significant for narrow abutment sites. The peri-implant mucosa was more coronally positioned at the narrow abutment, in the test sites, while for the control sites, the mucosal adaptation was more coronal at the wide abutment sites. These differences, however, did not reach statistical significance.Conclusions: Implants installed in regular-sized alveolar ridges had a higher horizontal, but a lower vertical buccal bony crest resorption compared to implants installed in reduced alveolar ridges. Narrow abutments in reduced ridges as well as wide abutments in regular-sized ridges yielded less soft tissue recession compared to their counterparts.

A digital evaluation of alveolar ridge preservation at implants placed immediately into extraction sockets: an experimental study in the dog

Objective: To compare with pristine sites bone resorption and soft tissue adaptation at implants placed immediately into extraction sockets (IPIES) in conjunction with deproteinized bovine bone mineral (DBBM) particles and a collagen membrane.Material and methods: The mesial root of the third premolar in the left side of the mandible was endodontically treated (Test). Flaps were elevated, the tooth hemi-sectioned, and the distal root removed to allow the immediate installation of an implant into the extraction socket in a lingual position. DBBM particles were placed into the defect and on the outer contour of the buccal bony ridge, concomitantly with the placement of a collagen membrane. A non-submerged healing was allowed. The premolar on the right side of the mandible was left in situ (control). Ground sections from the center of the implant as well as from the center of the distal root of the third premolar of the opposite side of the mandible were obtained. The histological image from the implant site was superimposed to that of the contralateral pristine distal alveolus, and dimensional variation evaluated for the hard tissue and the alveolar ridge.Results: After 3 months of healing, both histological and photographic evaluation revealed a reduction of hard and soft tissue dimensions.Conclusion: The contour augmentation performed with DBBM particles and a collagen membrane at the buccal aspects of implants placed IPIES was not able to maintain the tissue volume.

Calvarial Autogenous Bone Graft for Maxillary Ridge and Sinus Reconstruction for Rehabilitation With Dental Implants

Autogenous bone grafting is the gold-standard technique for bone augmentation procedures prior to implant placement. If the amount of available intraoral donor bone is insufficient, it is necessary to harvest bone graft from extraoral sites, such as calvaria. Although this technique is well established, only a few case reports show the histological analysis of the grafted bone at the moment of implant placement. This article reports the case of a 48-year-old female patient with a critical atrophic maxillary ridge reconstructed using autogenous calvarial bone graft prior to implant placement, with clinical and histological evaluation. Bone was collected under general anesthesia from the parietal bone. The outer cortical originated the bone blocks, and the medullar bone layer between was collected to be used in the sinus augmentation procedure, together with 5 of the bone blocks triturated. Six months after bone augmentation, 8 implants were placed in the grafted area and 2 biopsies were retrieved (anterior and the posterior regions), allowing the visualization of the bone-remodeling process in the grafted areas. The patient had a stable recovery. Our results showed that although necrotic bone could still be seen in the outer layer of the grafted area, the interface between this necrotic bone and the already remodeled bone was consistent with biocompatibility. Two-year radiographic evaluation showed success of the grafts and the implants in supporting an esthetic and functionally stable prosthesis. Summarizing, calvarial bone grafts are a viable alternative for the attainment of adequate bone volume prior to implant placement.

Crescimento de apatita na superfície da liga Ti-25Ta empregando dois tipos de tratamento de superfície: biomimético e deposição de polímero por eletrofiação

Titanium and its alloys has been widely used as materials for metallic biomaterials implants are usually employed to restore the hard tissue function, being used for artificial joints and bones, synthetic plates, crowns, dental implants and screws . Objective of this work was the surface modification of Ti-alloy 25Ta from biomimetic surface treatment of employment and deposition of polymer by electrospinning. The league was obtained from the fusion of the pure elements in the arc furnace with controlled atmosphere. The ingots were subjected to heat treatment, cold forged and sectioned discs with 13 mm diameter and 3 mm thick. Two surface treatments was evaluated, biomimetic and electrospinning with PCL fiber. The biomimetic treatment was performed involving alkaline treatment for three molarities 1.5M, 3M and 5M with immersion in SBF. The electrospinning was performed using PCL polymer alloy surface after the alkali treatment Ti25Ta 1M. For this group the polymer coated surfaces were immersed in calcium phosphate containing solution for immobilization of apatite. The results were compared with previous studies using surface treatment group to verify hydroxyapatite formation on the sample surface and it is concluded that the best condition is biomimetic treatment with 5M alkali treatment and heat treatment at 80 ° C for 72 hours

Analysis of implants with laser irradiated surface and silicate deposition

Objectives: the purpose of this study was to evaluate the surfaces of commercially pure titanium (cpTi) implants surface modified by laser beam (LS), by laser beam associated with sodium silicate deposition (SS) and compare them with surfaces modified by dual-acid etched (AS) and with machined surface (MS). Methods: thirty rabbits received two implants each (one for each tibia). After 30, 60 and 90 days postoperative, the implants were removed by reverse torque for biomechanical analysis and surfaces were analyzed by scanning electron microscopy (SEM) and X-ray energy dispersive spectroscopy (EDS). Results: the mean values of reverse torque at 30, 60 and 90 days postoperative were respectively 24.60, 43.60 e 60.40 N.cm to MS, 43.00, 68.20 e 63.80 N.cm to AS group, 59.80, 76.60 e 78.00 N.cm to LS group and 63.00, 75.40 e 76.60 N.cm to SS group. At 30 days, LS and SS groups showed statistically significant difference (p<0.05) compared to the other groups. At 60 days, LS and SS groups showed statistically significant difference (p<0.05) when compared to MS. Conclusions: it was concluded that SL and SS implants' biomechanical and topographical properties increased bone-implant interaction when compared to the AS and MS implants.

Longitudinal study on skeletal changes during and after bionator therapy using metallic implants

Aim: To demonstrate the magnitude and direction of skeletal changes in the maxilla and mandible during and after the use of bionator, as well as their rotations. Methods: Partial superimposition on the maxilla and mandible on the metallic implants and total superimposition on the cranial base were performed at three periods, T1 before bionator therapy, T2 after bionator therapy, and T3 5.68 years after T2. Results: There was total clockwise maxillary rotation and counterclockwise mandibular rotation, in the North American technique, throughout the study period, as well as extensive remodeling on the condylar region, especially in vertical direction and on the gonial region in horizontal direction. Conclusions: The total maxillary rotation seemed to be significantly affected by therapy than the mandible. There was a clear change in the direction of condylar remodeling compared to the period of bionator therapy and posterior bionator therapy. Considering the entire study period, it was observed that intra-matrix rotation of the maxilla and mandible masked their total rotation, causing minimum changes in the matrix rotation.

Bone-implant contact around crestal and subcrestal dental implants submitted to immediate and conventional loading

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Deproteinized Bovine Bone Mineral or Autologous Bone at Dehiscence Type Defects at Implants Installed Immediately into Extraction Sockets: An Experimental Study in Dogs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Bone apposition and surface treatment in dental implants: histomorphometric pilot evaluation in rabbits

The surface of dental implants is an important factor for osseointegration process and different methods of surface treatment have been described. Objective: To investigate the bone apposition in implant surface treated with sandblasting and acid-etching. Material and methods: Ten rabbits were selected and received one implant treated with method I in the left tibia and one implant treated with method II in the right tibia. Then, twenty implants were divided in two groups, according to methods of sandblasting and acid-etching (method I and method II). After 7, 14, 30, 45 and 60 days, tibias were retrieved and submitted to histotechnical procedures. The percentages of bone–implant contact (BIC) and bone area between threads (BABT) were determined throughout histomorphometric analysis and bone apposition was detected in implants of both groups. Results: In BABT measurements, an increase was observed after 45 and 60 days in the method II, compared to method I and no differences were found after 7, 14 and 30 days. In BIC measurements, an increase was detected with method II at 45 days when compared to method I. No differences between groups in BIC values were observed after 7, 14, 30 and 60 days. Conclusion: Our data demonstrated that implants treated with the method II presented increase in the contact between bone and implant after 45 days compared to method I. Moreover, with concern to bone area between threads, it was observed an increased in the method II after 45 and 60 days. However, both groups can be successfully used as a therapeutic strategy to rehabilitation of edentulous patients. Then, further experiments are needed to evaluate, in depth, the putative differential role of each surface treatment.

Relationship between the surface chemical composition of implants and contact with the substrate

The purpose of the study was to use scanning electron microscopy and energy dispersive x-ray spectrometry to assess possible morphologic and chemical changes after performing double-insertion and pullout tests of implants of different shapes and surface treatments. Four different types of implants were used—cylindrical machined-surface implants, cylindrical double-surface–treated porous implants, cylindrical surface-treated porous implants, and tapered surface-treated porous implants—representing a total of 32 screws. The implants were inserted into synthetic bone femurs, totaling 8 samples, before performing each insertion with standardized torque. After each pullout the implants were analyzed by scanning electron microscopy and energy dispersive x-ray spectrometry using a universal testing machine and magnified 35 times. No structural changes were detected on morphological surface characterization, only substrate accumulation. As for composition, there were concentration differences in the titanium, oxygen, and carbon elements. Implants with surface acid treatment undergo greater superficial changes in chemical composition than machined implants, that is, the greater the contact area of the implant with the substrate, the greater the oxide layer change. In addition, prior manipulation can alter the chemical composition of implants, typically to a greater degree in surface-treated implants.

Bacterial cellulose-hydroxyapatite composites with osteogenic growth peptide (OGP) or pentapeptide OGP on bone regeneration in critical-size calvarial defect model

This study aimed to evaluate the potential of bacterial cellulose-hydroxyapatite (BC-HA) composites associated with osteogenic growth peptide (OGP) or pentapeptide OGP(10–14) in bone regeneration in critical-size calvarial defects in mice. In this study, the BC-HA, BC-HA-OGP, and BC-HA-OGP(10–14) membranes were analyzed at 3, 7, 15, 30, 60, and 90 days. In each period, the specimens were evaluated by micro-computed tomography (µCT), descriptive histology, gene expression of bone biomarkers by qPCR and VEGFR-2 (vascular endothelial growth factor) quantification by ELISA. Three days post-operative, Runx2, Tnfrsf11b and Bglap bone biomarkers were upregulated mainly by BC-HA OGP and BC-HA OGP(10–14) membranes, suggesting an acceleration of the osteoblast differentiation/activity with the use of these biomaterials. At 60 and 90 days, a high percentage of bone formation was observed by µCT for BC-HA and BC-HA OGP(10–14) membranes. High expression of some bone biomarkers, such as Alpl, Spp1, and Tnfrsf11b, was also observed for the same membranes on days 60 and 90. In conclusion, the BC-HA membrane promoted a better bone formation in critical-size mice calvarial defects. Nevertheless, incorporation of the peptides at the concentration of 10−9 mol L−1 did not improve bone regeneration potential in the long-term.

Predictability of short dental implants: a literature review

Introduction: In clinical situations where severe bone resorption has occurred following tooth loss, implant treatment options may comprise either a previous bone reconstruction or only the use of short implants. Objective: This non-systematic review summarizes and discusses some aspects of the use of short implants, such as: biomechanical aspects, success rate, longevity and surgical-prosthetic planning. Literature review: Current and relevant references were selected in order to compare short dental implants to conventional ones. Several studies have highlighted the great importance of wide-diameter implants. Dental short implants have shown high predictability and success rates when some biomechanical aspects are taken into consideration. Conclusion: Placement of short dental implants is a viable treatment method for patients with decreased bone height.

Effect of the association between the tray and impression techniques on angulated implants using the All-on-Four system

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)