Three-Dimensional Characterization of Pores in Ti-6Al-4V Alloy

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Inferior Alveolar Nerve Lateralization and Implant Placement in Atrophic Posterior Mandible

The aims of this article were to describe the surgical technique of the inferior alveolar nerve lateralization followed by implant installation by means of a clinical report and also to discuss the importance of an adequate surgical and prosthetic planning for atrophic posterior mandible rehabilitation.

Three-Dimensional Finite Element Analysis of Vertical and Angular Misfit in Implant-Supported Fixed Prostheses

Purpose: Three-dimensional finite element analysis was used to evaluate the effect of vertical and angular misfit in three-piece implant-supported screw-retained fixed prostheses on the biomechanical response in the peri-implant bone, implants, and prosthetic components. Materials and Methods: Four three-dimensional models were fabricated to represent a right posterior mandibular section with one implant in the region of the second premolar (2PM) and another in the region of the second molar (2M). The implants were splinted by a three-piece implant-supported metal-ceramic prosthesis and differed according to the type of misfit, as represented by four different models: Control = prosthesis with complete fit to the implants; UAM (unilateral angular misfit) = prosthesis presenting unilateral angular misfit of 100 pm in the mesial region of the 2M; UVM (unilateral vertical misfit) = prosthesis presenting unilateral vertical misfit of 100 pm in the mesial region of the 2M; and TVM (total vertical misfit) = prosthesis presenting total vertical misfit of 100 pm in the platform of the framework in the 2M. A vertical load of 400 N was distributed and applied on 12 centric points by the software Ansys, ie, a vertical load of 150 N was applied to each molar in the prosthesis and a vertical load of 100 N was applied at the 2PM. Results: The stress values and distribution in peri-implant bone tissue were similar for all groups. The models with misfit exhibited different distribution patterns and increased stress magnitude in comparison to the control. The highest stress values in group UAM were observed in the implant body and retention screw. The groups UVM and TVM exhibited high stress values in the platform of the framework and the implant hexagon, respectively. Conclusions: The three types of misfit influenced the magnitude and distribution of stresses. The influence of misfit on peri-implant bone tissue was modest. Each type of misfit increased the stress values in different regions of the system. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:788-796

Comparison of the biological behavior of wollastonite bioceramics prepared from synthetic and natural precursors

Wollastonite bioceramics prepared from synthetic and natural precursors were implanted in rats in bone and subcutaneous tissues. The implant sites were excised after 7, 30 and 120 days, fixed, dehydrated, embedded in paraffin wax for serial cutting and examined under transmitted light microscope. It was found a very similar behavior for both wollastonite bioceramics. They were biocompatible, bioactive and biodegradable when implanted in rat bone. The synthetic ceramic was more reabsorbable than the one from natural powder. When implanted in subcutaneous rat tissue, both materials elicited a mild initial inflammatory reaction that practically disappeared after 120 days. Both materials were encapsulated with a very thin fibrous capsule and slightly reabsorbed at their surfaces. None of the materials induced ectopic osteogenesis. According to the results, the studied materials seem to be able for manufacturing reabsorbable bone implants.

In vivo biological behavior of calcium phosphate cements with different Ca/P ratio

Bioceramics with different Ca/P ratio were prepared from a mechanical mixture of NaPO3, CaCO3, Ca(OH)2 and phosphate buffer solution and implanted in rats subcutaneous tissues. The cements were characterized by Thermo gravimetric analysis (TG-TDA), X-ray diffraction and 31P-NMR. The implant sites were excised after 1, 4 and 16 weeks, fixed, dehydrated, included in paraffin wax for serial cutting and examined under the light transmitted microscope. They were biocompatible and biodegradable when implanted in rat subcutaneous. None of the materials induced ectopic osteogenesis. According to the results, the studied materials seem to be able for manufacturing reabsorbable bone implants.

Efeito da deficiência de magnésio na dieta sobre a densidade e o metabolismo ósseo ao redor de implantes com osseointegração estabelecida: estudos em ratos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise de materiais para sistemas de fechamento ósseo através da caracterização superficial e comportamento mecânico

Pós-graduação em Engenharia Mecânica - FEB

Lack of influence of the Schneiderian membrane in forming new bone apical to implants simultaneously installed with sinus floor elevation: an experimental study in monkeys

Aim: To describe the early healing processes around the implants installed after elevation of the sinus mucosa applying the lateral access technique without the use of grafting material.Material and methods: Immediately after the elevation of the maxillary sinus Schneiderian membrane by the lateral approach in eight monkeys, implants were installed without the use of grafting material. The healing of the tissue around the implants was evaluated after 4, 10, 20 and 30 days. Ground sections were prepared and analyzed histologically.Results: After 4 days of healing, the formation of coagulum and provisional matrix was documented within the elevated area. At 10-day interval, sprouts of woven bone were in continuity with the parent bone, and partly in contact with the implant surface at the base of the augmented area. While bone-to-implant contact increased after 20 and 30 days, the area underneath the Schneiderian membrane appeared reduced in volume and condensed toward the apex of the implants. The sinus mucosa was to some extent collapsed onto the implant surface and on the newly formed bone.Conclusions: The void initially occupied by the coagulum after sinus membrane elevation shrank substantially during the observation period. A lack of influence of the Schneiderian membrane in bone formation apical to implants was documented in the early phase of healing.

Influence of microgap location and configuration on the periimplant bone morphology in submerged implants. An experimental study in dogs

Objectives: The vertical location of the implant-abutment connection influences the periimplant bone morphology. It is unknown, however, whether different microgap configurations cause different bone reactions. Therefore, in this study the bone morphologies of two different implant systems were compared.Material and methods: Three months after tooth extraction in eight mongrel dogs, two grit-blasted screw implants with internal Morse taper connection (ANK group) were placed on one side whereas the contralateral side received two oxidized screw implants with external hex (TIU group). One implant on each side was placed level with the bone (equicrestal), the second implant was inserted 1.5mm below bone level (subcrestal). After 3 months the implants were uncovered. Three months after stage two surgery, histometrical evaluations were performed in order to assess the periimplant bone levels (PBL), the first bone-to-implant contact points (BICP), the width (HBD) and the steepness (SLO) of the bone defect.Results: All implants osseointegrated clinically and histologically. Bone overgrowth of the microgap was seen in ANK implants only. No significant differences between ANK and TIU could be detected in neither vertical position for PBL and BICP. However, a tendency in favor of ANK was visible when the implants were placed subcrestally. In the parameters HBD (ANK equicrestal -0.23mm; TIU equicrestal -0.51mm; ANK subcrestal +0.19mm; TIU subcrestal -0.57mm) and SLO (ANK equicrestal 35.36 degrees; TIU equicrestal 63.22 degrees; ANK subcrestal 20.40 degrees; TIU subcrestal 44.43 degrees) more pronounced and significant differences were noted.Conclusions: Within the limits of this study, it is concluded that different microgap designs cause different shapes and sizes of the periimplant ('dish-shaped') bone defect in submerged implants both in equicrestal and subcrestal positions.

Influence of Microgap Location and Configuration on Radiographic Bone Loss Around Submerged Implants: An Experimental Study in Dogs

Purpose: The vertical location of the implant-abutment connection influences the subsequent reaction of the peri-implant bone. It is not known, however, whether any additional influence is exerted by different microgap configurations. Therefore, the radiographic bone reactions of two different implant systems were monitored for 6 months. Materials and Methods: In eight mongrel dogs, two implants with an internal Morse-taper connection (INT group) were placed on one side of the mandible; the contralateral side received two implants with an external-hex connection (EXT group). on each side, one implant was aligned at the bone level (equicrestal) and the second implant was placed 1.5 mm subcrestal. Healing abutments were placed 3 months after submerged healing, and the implants were maintained for another 3 months without prosthetic loading. At implant placement and after 1, 2, 3, 4, 5, and 6 months, standardized radiographs were obtained, and peri-implant bone levels were measured with regard to microgap location and evaluated statistically. Results: All implants osseointegrated clinically and radiographically. The overall mean bone loss was 0.68 +/- 0.59 mm in the equicrestal INT group, 1.32 +/- 0.49 mm in the equicrestal EXT group, 0.76 +/- 0.49 mm in the subcrestal INT group, and 1.88 +/- 0.81 mm in the subcrestal EXT group. The differences between the INT and EXT groups were statistically significant (paired t tests). The first significant differences between the internal and external groups were seen at month 1 in the subcrestal groups and at 3 months in the equicrestal groups. Bone loss was most pronounced in the subcrestal EXT group. Conclusions: Within the limits of this study, different microgap configurations can cause different amounts of bone loss, even before prosthetic loading. Subcrestal placement of a butt-joint microgap design may lead to more pronounced radiographic bone loss. INT J ORAL MAXILLOFAC IMPLANTS 2011;26:941-946

Digital Radiographic Evaluation of the Level of Alveolar Bone Crest in External Hexagon Implants Submitted to 2 Types of Implant Abutments Under Immediate Loading

Purpose: The aim of this study was to evaluate by means of digital radiography the behavior of the alveolar bone crest in external hexagon implants following the use of 2 different types of abutments, one for conventional cemented prosthesis and one for modified cemented prosthesis.Methods: Ten external hexagon implants (platform 4.1) were placed in 5 patients. Initial instrumentation was carried out to obtain primary stability of the temporary prostheses under immediate loading. Each patient received both abutments for conventional and modified cemented prosthesis. Standardized digital periapical radiographies were performed at times T0 (immediately after implant placement) and T1 (4 months after implant placement). A straight line was initially established from the implant platform to the distal and mesial periimplantar marginal bone tissue (immediately in contact with the implant) and measured by digital radiography, using Sidexis version 2.3 (Sirona Dental Systems GmbH, Bensheim, Germany) software. The data were submitted to paired-samples t-test analysis.Results: There was no significant difference between the conventional and modified cemented prosthesis. In both cases, t-test results were within the null hypothesis level.Conclusion: The abutment for the modified cemented prosthesis resulted in no significant radiographic difference of alveolar bone crest height, when compared with the conventional cemented prostheses.

Evaluation of Centrifuged Bone Marrow on Bone Regeneration Around Implants in Rabbit Tibia

Objective: To evaluate the bone regeneration of cervical defects produced around titanium implants filled with blood clot and filled with centrifuged bone marrow (CBM) by means of histomorphometric analysis.Materials and Methods: Twelve rabbits received 2 titanium implants in each right tibia, with the upper cortical prepared with a 5-mm drill and the lower cortex with a 3-mm-diameter drill. Euthanasia was performed to allow analysis at 7, 21, and 60 days after operation. The samples were embedded in light curing resin, cut and stained with alizarin red and Stevenel blue for a histomorphometric analysis of the bone-to-implant contact (BIC) and the bone area around implant (BA). The values obtained were statistically analyzed using the nonparametric Kruskal-Wallis test (P = 0.05).Results: At 60 days postoperation, the groups had their cervical defects completely filled by neo-formed bone tissue. There was no statistically significant difference between the groups regarding BIC and BA during the analyzed periods.Conclusion: There was no difference in the bone repair of periimplant cervical defects with or without the use of CBM. (Implant Dent 2012;21:481-485)

Influence of Microgap Location and Configuration on Radiographic Bone Loss in Nonsubmerged Implants: An Experimental Study in Dogs

Purpose: The implant-abutment connection (microgap) influences the pen-implant bone morphology. However, it is unclear if different microgap configurations additionally modify bone reactions. This preliminary study aimed to radiographically monitor pen-implant bone levels in two different microgap configurations during 3 months of nonsubmerged healing. Materials and Methods: Six dogs received two implants with internal Morse taper connection (INT group) on one side of the mandible and two implants with external-hex connection (EXT group) on the other side. One implant on each side was positioned at bone level (equicrestal); the second implant was inserted 1.5 mm below the bone crest (subcrestal). Healing abutments were attached directly after implant insertion, and the implants were maintained for 3 months without prosthetic loading. At implant placement and 1, 2, and 3 months, standardized radiographs were taken to monitor pen-implant bone levels. Results: All implants osseointegrated. A total bone loss of 0.48 +/- 0.66 mm was measured in the equicrestal INT group, 0.69 +/- 0.43 mm in the equicrestal EXT group, 0.79 +/- 0.93 mm in the subcrestal INT group, and 1.56 +/- 0.53 mm in the subcrestal EXT group (P>.05, paired t tests). Within the four groups, bone loss over time became significantly greater in the EXT groups than in the INT groups. The greatest bone loss was noted in the subcrestal EXT group. Conclusion: Within the limits of this animal study, it seems that even without prosthetic loading, different microgap configurations exhibit different patterns of bone loss during nonsubmerged healing. Subcrestal positioning of an external butt joint microgap may lead to faster radiographic bone loss. Int J Prosthodont 2011;24:445-452.

Maxillary Bone Defect Reconstruction Using Porous Polyethylene Implants

Purpose: The aim of this study was to evaluate the bone repair process in the maxillary sinus in monkeys treated with high-density porous polyethylene (Medpor)Methods: Four capuchin monkeys (Cebus apella) were submitted to bilateral horizontal osteotomies in the anterior wall of the maxillary sinus and divided into 2 groups: control group, left side with no implants, and porous polyethylene group, right side with Medpor. After a period of 145 days after implant placement, the maxillae were removed for histologic and histometric analyses.Results: Bone repair in osteotomized areas took place by connective tissue in 58.5% and 58.7% in the control group and the porous polyethylene group, respectively. In the contact surface with Medpor, bone repair occurred in 41.3%.Conclusions: Medpor was not reabsorbed within the period of this study and allowed bone repair surrounding it. The porous polyethylene constitutes a feasible alternative for bone defect reconstruction.

Influence of Microgap Location and Configuration on Peri-implant Bone Morphology in Nonsubmerged Implants: An Experimental Study in Dogs

Purpose: It is unknown whether different micro gap configurations can cause different pen-implant bone reactions. Therefore, this study sought to compare the peri-implant bone morphologies of two implant systems with different implant-abutment connections. Materials and Methods: Three months after mandibular tooth extractions in six mongrel dogs, two oxidized screw implants with an external-hex connection were inserted (hexed group) on one side, whereas on the contralateral side two grit-blasted screw implants with an internal Morse-taper connection (Morse group) were placed. on each side, one implant was inserted level with the bone (equicrestal) and the second implant was inserted 1.5 mm below the bony crest (subcrestal). Healing abutments were inserted immediately after implant placement. Three months later, the peri-implant bone levels, the first bone-to-implant contact points, and the width and steepness of the peri-implant bone defects were evaluated histometrically. Results: All 24 implants osseointegrated clinically and histologically. No statistically significant differences between the hexed group and Morse group were detected for either the vertical position for peri-implant bone levels (Morse equicrestal -0.16 mm, hexed equicrestal -0.22 mm, Morse subcrestal 1.50 mm, hexed subcrestal 0.94 mm) or for the first bone-to-implant contact points (Morse equicrestal -2.08 mm, hexed equicrestal -0.98 mm, Morse subcrestal -1.26 mm, hexed subcrestal -0.76 mm). For the parameters width (Morse equicrestal -0.15 mm, hexed equicrestal -0.59 mm, Morse subcrestal 0.28 mm, hexed subcrestal -0.70 mm) and steepness (Morse equicrestal 25.27 degree, hexed equicrestal 57.21 degree, Morse subcrestal 15.35 degree, hexed subcrestal 37.97 degree) of the pen-implant defect, highly significant differences were noted between the Morse group and the hexed group. Conclusion: Within the limits of this experiment, it can be concluded that different microgap configurations influence the size and shape of the peri-implant bone defect in nonsubmerged implants placed both at the crest and subcrestally. INT J ORAL MAXILLOFAC IMPLANTS 2010;25:540-547