Hard tissue formation adjacent to implants of various size and configuration immediately placed into extraction sockets: an experimental study in dogs

Objectives To evaluate the influence of implant size and configuration on osseointegration in implants immediately placed into extraction sockets. Material and methods Implants were installed immediately into extraction sockets in the mandibles of six Labrador dogs. In the control sites, cylindrical transmucosal implants (3.3 mm diameter) were installed, while in the test sites, larger and conical (root formed, 5 mm diameter) implants were installed. After 4 months of healing, the resorptive patterns of the alveolar crest were evaluated histomorphometrically. Results With one exception, all implants were integrated in mineralized bone, mainly composed of mature lamellar bone. The alveolar crest underwent resorption at the control as well as at the test implants. This resorption was more pronounced at the buccal aspects and significantly greater at the test (2.7 +/- 0.4 mm) than at the control implants (1.5 +/- 0.6 mm). However, the control implants were associated with residual defects that were deeper at the lingual than at the buccal aspects, while these defects were virtually absent at test implants. Conclusions The installment of root formed wide implants immediately into extraction sockets will not prevent the resorption of the alveolar crest. In contrast, this resorption is more marked both at the buccal and lingual aspects of root formed wide than at standard cylindrical implants. To cite this article:Caneva M, Salata LA, de Souza SS, Bressan E, Botticelli D, Lang NP. Hard tissue formation adjacent to implants of various size and configuration immediately placed into extraction sockets: an experimental study in dogs.Clin. Oral Impl. Res. 21, 2010; 885-895.doi: 10.1111/j.1600-0501.2010.01931.x.

Collagen membranes at immediate implants: a histomorphometric study in dogs

Aim To evaluate the influence of resorbable membranes on hard tissue alterations and osseointegration at implants placed into extraction sockets in a dog model. Material and methods In the mandibular premolar region, implants were installed immediately into the extraction sockets of six Labrador dogs. Collagen-resorbable membranes were placed at the test sites, while the control sites were left uncovered. Implants were intended to heal in a submerged mode. After 4 months of healing, the animals were sacrificed, and ground sections were obtained for histomorphometric evaluation. Results After 4 months of healing, a control implant was not integrated (n=5). Both at the test and at the control sites, bone resorption occurred. While the most coronal bone-to-implant contact was similar between the test and the control sites, the alveolar bone crest outline was maintained to a higher degree at the buccal aspect of the test sites (loss: 1.7 mm) compared with the control sites (loss: 2.2 mm). Conclusions The use of collagen-resorbable membranes at implants immediately placed into extraction sockets contributed to a partial (23%) preservation of the buccal outline of the alveolar process. To cite this article:Caneva M, Botticelli D, Salata LA, Souza SLS, Carvalho Cardoso L, Lang NP. Collagen membranes at immediate implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 21, 2010; 891-897.doi: 10.1111/j.1600-0501.2010.01946.x.

Magnesium-enriched hydroxyapatite at immediate implants: a histomorphometric study in dogs

Aim To evaluate the influence of magnesium-enriched hydroxyapatite (MHA) (SintLife (R)) on bone contour preservation and osseointegration at implants placed immediately into extraction sockets. Material and methods In the mandibular pre-molar region, implants were installed immediately into extraction sockets of six Labrador dogs. MHA was placed at test sites, while the control sites did not receive augmentation materials. Implants were intended to heal in a submerged mode. After 4 months of healing, the animals were sacrificed, and ground sections were obtained for histomorphometric evaluation. Results After 4 months of healing, one control implant was not integrated leaving n=5 test and control implants for evaluation. Both at the test and the control sites, bone resorption occurred. While the most coronal bone-to-implant contact was similar between test and control sites, the alveolar bony crest outline was maintained to a higher degree at the buccal aspect of the test sites (loss: 0.7 mm) compared with the control sites (loss: 1.2 mm), even though this difference did not reach statistical significance. Conclusions The use of MHA to fill the defect around implants placed into the alveolus immediately after tooth extraction did not contribute significantly to the maintenance of the contours of the buccal alveolar bone crest. To cite this article:Caneva M, Botticelli D, Stellini E, Souza SLS, Salata LA, Lang NP. Magnesium-enriched hydroxyapatite at immediate implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 22, 2011; 512-517doi: 10.1111/j.1600-0501.2010.02040.x.

Flap vs. ""flapless"" surgical approach at immediate implants: a histomorphometric study in dogs

Aim To compare the remodeling of the alveolar process at implants installed immediately into extraction sockets by applying a flap or a ""flapless"" surgical approach in a dog model. Material and methods Implants were installed immediately into the distal alveoli of the second mandibular premolars of six Labrador dogs. In one side of the mandible, a full-thickness mucoperiosteal flap was elevated (control site), while contra-laterally, the mucosa was gently dislocated, but not elevated (test site) to disclose the alveolar crest. After 4 months of healing, the animals were sacrificed, ground sections were obtained and a histomorphometric analysis was performed. Results After 4 months of healing, all implants were integrated (n=6). Both at the test and at the control sites, bone resorption occurred with similar outcomes. The buccal bony crest resorption was 1.7 and 1.5 mm at the control and the test sites, respectively. Conclusions ""Flapless"" implant placement into extraction sockets did not result in the prevention of alveolar bone resorption and did not affect the dimensional changes of the alveolar process following tooth extraction when compared with the usual placement of implants raising mucoperiosteal flaps. To cite this article:Caneva M, Botticelli D, Salata LA, Souza SLS, Bressan E, Lang NP. Flap vs. ""flapless"" surgical approach at immediate implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 21, 2010; 1314-1319.doi: 10.1111/j.1600-0501.2009.01959.x.

A Prospective Follow-up Study of 44 Mandibular Immediately Loaded Implants Using Resonance Frequency Analysis: Preliminary 1-Year Results

Purpose: This clinical study aimed to evaluate initial, 4-months, and 1-year stability of immediately loaded dental implants inserted according to a protocol of lower rehabilitation with prefabricated bars. Materials and Methods: The sample was composed of 11 edentulous patients. In each patient, 4 interforaminal implants were inserted. Immediately after implant installation, resonance frequency analysis (RFA) for each fixation was registered as well as after 4 months and 1 year with the prosthetic bar removed as it is a screwed system. Results: The clinical implant survival rate was 100%. The RFA showed an increase in stability after 4 months from 64.09 +/- 648 to 64.31 +/- 4.96 and I year, 67.11 +/- 4.37. The analysis of variance showed a statistically significant result (P = 0.015) among implant stability quotient values for the different periods evaluated. Tukey test results showed statistically significant differences between 1-year results and the initial periods but there was no statistically significant difference between initial and 4-month results (P > 0.05). Conclusion: These preliminary 1-year results indicate that immediate loading of mandibular dental implants using the studied prefabricated bars protocol is a reliable treatment as it is in accordance with the results described in the literature for other similar techniques. (Implant Dent 2009; 18:530-538)

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.

Analysis of the effects of irradiation in osseointegrated dental implants

Objective: The purpose of the present study was to evaluate the influence of radiation in osseointegrated dental implants installed in tibiae of rats.Material and methods: Screw-shaped implants (2.5 mm diameter by 3.5 mm length) were custom made from commercially pure titanium bars. Titanium implants were blasted and sterilized before implantation. Animals were divided into two groups of 12 animals each and the rats were not paired after the groups' formation. The experimental group (group 1) received external irradiation 4 weeks after surgery while in the control group (group 2) animals were kept free of radiation. The shear strength required to detach the implant from bone was measured by push-out testing and osseointegration was histologically evaluated.Results: Results showed that the compressive strength of irradiated implants (33.49 MPa) was significantly lower than the compressive strength of non-irradiated implants (48.05 MPa).Conclusions: We concluded that the mechanical strength bonding between implants and host tissues decreased after irradiation.

Stability of cp-Ti and Ti-6Al-4V alloy for dental implants as a function of saliva pH - an electrochemical study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Radiographic assessment of bone density around integrated titanium implants after ovariectomy in rats

Objectives:This study evaluated the influence of ovariectomy 8 weeks after implant placement on bone integrated to titanium implants.Materials and methods:Thirty-eight female rats were submitted to a titanium implant at the tibiae proximal methaphysis. After a healing period of 8 weeks the animals were randomly divided into three groups: control (CTL-10 animals), sham-operated (SHAM-14 animals) and ovariectomy (OVX-14 animals). The CTL group was then sacrificed in order to confirm integration of the implant. The SHAM group was submitted to fictitious surgery and the OVX group was submitted to bilateral ovariectomy. After 12 weeks post-implant placement, the SHAM and OVX groups were sacrificed. In order to confirm the systemic osteopenia in rats, a dual-energy X-ray absorptiometry (DXA) was performed. For the evaluation of bone density, digital radiographs were taken. The grey level of the bone adjacent to implant was measured using image software and the bone density was calculated at six points on both sides of the implant.Results:Densitometry measurements of the femur confirmed systemic bone mass loss in the OVX group. Individualized bone analyses of different regions surrounding the implant showed a significantly lower radiographic bone density (P < 0.05) in the cancellous region of the OVX group (77.48 +/- 23.39 grey levels) when compared with the CTL and SHAM groups (91.61 +/- 32.10 and 102.57 +/- 32.50 grey levels, respectively).Conclusions:The present study showed a decrease of the radiographic bone density in the cancellous region of bone around titanium implants placed 8 weeks before ovariectomy in rats.

Influence of cyclosporin A on quality of bone around integrated dental implants: a radiographic study in rabbits

To evaluate the influence of cyclosporin A (CsA) administration on bone around integrated dental implants assessed by a bone quality index and by quantitative subtraction radiography.A total of 36 machine surface commercial implants were placed in 18 adult rabbits. After a 3-month healing period without any disturbance, the animals were randomly divided into three groups of six animals each. Group A was sacrificed at this time. CsA was injected subcutaneously in an immunosuppressive dose of 10 mg/kg/day in a test group (Group T), and a Group B served as a control, receiving only vehicle. After 3 months of cyclosporin administration, the animals of both Groups B and T were sacrificed. Radiographs were obtained at implant surgery and at the day of sacrifice with a CMOS sensor. Bone quality around the implants was compared between the groups using a bone quality index and quantitative subtraction radiography.The bone analysis showed that in Group T, the bone quality changed dramatically from a dense cortical to a loose trabecular bone structure (P < 0.0001, chi(2) test) while in Groups A and B there were no significant differences. Quantitative digital subtraction radiography showed significantly (P < 0.05) lower gray shade values (radiographic density) in a region of bone formation around the implants in Group T (118 +/- 12) than in Groups A (161 +/- 6) and B (186 +/- 10).Within the limits of this study, CsA administration has a negative effect on the quality of bone around integrated dental implant.

Influence of homeopathic treatment with comfrey on bone density around titanium implants. A digital subtraction radiography study in rats

Objective: The objective of this study was to evaluate the influence of homeopathic treatment with comfrey (Shymphytum officinalis 6CH) on radiographic bone density and area around titanium implants.Material and methods: Forty-eight rats were divided into two groups of 24 animals each: a control group (C) and a test group (SO). Each animal received one titanium micro-implant placed in the tibia. The animals in Group SO were subjected to 10 drops of comfrey 6CH per day mixed into their drinking water until the day of sacrifice. Eight animals of each group were sacrificed at 7, 14 and 28 days post-surgery, respectively.Standardized digital radiographs were obtained on the day of implant installation (baseline images) and on the day of sacrifice (final images). Digital subtraction of the two corresponding images was performed to evaluate changes in bone density and the area related to change around the implant between baseline and final images.Results: Subtraction images demonstrated that a significant difference existed in mean shade of gray at 14 days post-surgery between Group SO (mean 175.3 +/- 14.4) and Group C (mean 146.2 +/- 5.2). Regarding the area in pixels corresponding to the bone gain in Group SO, the differences observed between the sacrifice periods and groups were only significant at 7 days sacrifice between Group SO (mean 171.2 +/- 21.9) and Group C (mean 64.5 +/- 60.4).Conclusion: Within the limits of this study, comfrey administration promotes an increase in radiographic bone density around titanium implants in the initial period of bone healing.

Effect of diabetes mellitus and insulin therapy on bone density around osseointegrated dental implants: a digital subtraction radiography study in rats

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

The effect of oestrogen and alendronate therapies on postmenopausal bone loss around osseointegrated titanium implants

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

Effects of magnesium intake deficiency on bone metabolism and bone tissue around osseointegrated implants

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