Influence of implant diameter on surrounding bone

Objectives : Implant osseointegration is dependent upon various factors, such as bone quality and type of implant surface. It is also subject to adaptation in response to changes in bone metabolism or transmission of masticatory forces. Understanding of long-term physiologic adjustment is critical to prevention of potential loss of osseointegration, especially because excessive occlusal forces lead to failure. To address this issue, wide-diameter implants were introduced in part with the hope that greater total implant surface would offer mechanical resistance. Yet, there is little evidence that variation in diameter translates into a different bone response in the implant vicinity. Therefore, this study aimed at comparing the impact of implant diameter on surrounding bone. Material and methods : Twenty standard (3.75 mm) and 20 wide (5 mm) implants were placed using an animal model. Histomorphometry was performed to establish initial bone density (IBD), bone to implant contact (BIC) and adjacent bone density (ABD). Results : BIC was 71% and 73%, whereas ABD was 65% and 52%, for standard and wide implants, respectively. These differences were not statistically different ( P >0.05). Correlation with IBD was then investigated. BIC was not correlated with IBD. ABD was not correlated to IBD for standard implants ( r 2 =0.126), but it was correlated with wide implants ( r 2 =0.82). In addition, a 1 : 1 ratio between IBD and ABD was found for wide implants. It can be concluded, within the limits of this study, that ABD may be influenced by implant diameter, perhaps due to differences in force dissipation. To cite this article: Brink J, Meraw SJ, Sarment DP. Influence of implant diameter on surrounding bone. Clin. Oral Impl. Res. 18 , 2007; 563–568 doi: 10.1111/j.1600-0501.2007.01283.xPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75089/1/j.1600-0501.2007.01283.x.pd

Comparing the TiOblast and Osseospeed surfaces. Histomorphometric and histological analysis in humans

The aim of the present study was to compare two implant surfaces, the TiOblast (Astra Tech) surface, manufactured by blasting the surface and already present in literature and the Osseospeed (Astra Tech) surface, manufactured by blasting and treating the surface with fluoride ions and recently launched onto the market with the modified surfaces of the latest generation. This study is part of a more extensive research project whose protocol required the insertion of 10 couples of implants; thus in the present discussion partial data are being taken into consideration, with an eye at collecting more data in the future, regarding both microscopy and histomorphometric histological analysis on 5 couples of implants. The purpose of the study is to investigate how the modified surfaces of the latest generation can guarantee a greater osseointegration both from a qualitative and quantitative level compared to the surfaces presently used and that they may represent the first example of "bioactivity", that is, an active interaction with the processes of new bone formation and tissue healing

The Potential for Bonding Titanium Restorations

: The use of titanium for implants has shown the biological acceptance of the metal. Recently, methods of using titanium for restorations, crowns, and bridges have been introduced using both cast and spark erosion systems for fabrication. A potential also exists for using titanium for bonded (Maryland) bridges. Materials and Methods : In this study, the potential for bonding titanium was investigated by cementing with various adhesives: (A) metal to metal, (B) metal to enamel, and (C) comparing with a known procedure of bonding nickel-chromium. Truncated cones of pure titanium were fabricated with a 5-mm circular face for bonding to a larger titanium disc embedded in a plastic ring. A special jig was used to pull the bonded cone from the disc on an Instron tensile testing machine (Instron Corporation, Canton, MA). The resin-metal adhesives used were: (1) Infinity, (2) Metabond, (3) All-Bond 2, and (4) Panavia. These were compared with (5) nickel-chromium cones sandblasted and bonded to nickel-chromium with Panavia. Titanium cones were also bonded to human enamel with (6) Panavia and (7) Metabond. The 10 samples in each group were subjected to tensile force, and point of fracture was recorded. The data were subjected to an analysis of variance with a Scheffe F test at the 95% level of significance. Results : The results of tensile forces in MPa were (1) Infinity, 28.1 ± 3.6; (2) Metabond, 28.1 ± 1; (3) All-Bond 2, 49.5 ± 4.3; (4) Panavia, 57.9 ± 3.1; (5) Panavia to nickel-chromium, 42.9 ± 6.6; (6) Panavia to enamel, 18.5 ± 4.7; and (7) Metabond to enamel, 19.3 ± 3.5. Titanium was most effectively bonded with All-Bond 2 and Panavia, with Panavia samples significantly better than Panavia to nickel-chromium samples. Conclusions : It was concluded that titanium bonded restorations with certain adhesive cements were a definite possibility.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74888/1/j.1532-849X.1993.tb00399.x.pd

Strain driven fast osseointegration of implants

BACKGROUND: Although the bone's capability of dental implant osseointegration has clinically been utilised as early as in the Gallo-Roman population, the specific mechanisms for the emergence and maintenance of peri-implant bone under functional load have not been identified. Here we show that under immediate loading of specially designed dental implants with masticatory loads, osseointegration is rapidly achieved. METHODS: We examined the bone reaction around non- and immediately loaded dental implants inserted in the mandible of mature minipigs during the presently assumed time for osseointegration. We used threaded conical titanium implants containing a titanium2+ oxide surface, allowing direct bone contact after insertion. The external geometry was designed according to finite element analysis: the calculation showed that physiological amplitudes of strain (500–3,000 ustrain) generated through mastication were homogenously distributed in peri-implant bone. The strain-energy density (SED) rate under assessment of a 1 Hz loading cycle was 150 Jm-3 s-1, peak dislocations were lower then nm. RESULTS: Bone was in direct contact to the implant surface (bone/implant contact rate 90%) from day one of implant insertion, as quantified by undecalcified histological sections. This effect was substantiated by ultrastructural analysis of intimate osteoblast attachment and mature collagen mineralisation at the titanium surface. We detected no loss in the intimate bone/implant bond during the experimental period of either control or experimental animals, indicating that immediate load had no adverse effect on bone structure in peri-implant bone. CONCLUSION: In terms of clinical relevance, the load related bone reaction at the implant interface may in combination with substrate effects be responsible for an immediate osseointegration state

Soft and hard tissue assessment of immediate implant placement: a case series

Objectives : The aim of this prospective study was to evaluate clinically and radiographically the success and esthetic result of immediate implant placement at the time of extraction. Material and methods : Twelve patients with 14 titanium screw-shaped implants (13–16 mm length and 4.3 or 5 mm diameters) were placed in the extraction sockets. Defects after implant placement were recorded, and then filled up with deproteinized bovine bone mineral, bioabsorbable collagen membrane, and absorbable pins. The defect was again re-evaluated at second-stage surgery. Clinical and radiographic parameters of the peri-implant conditions were assessed at the moment of prosthesis placement and at 1-year follow-up. Results : The cumulative implant survival and success rate was 100% after a 1-year observation period. Analysis of the esthetic result showed that the mean pink esthetic score (PES) was 11.1 (SD 1.35) at 1-year follow-up. At 1 year, 64.3% papillae had a score of 2 and the remaining 35.7% score 3 according to the Jemt (1997) papillary index. Optimal value of width of the keratinized mucosa was recorded in 13 (92.9%) implant cases in both periods of follow-up. At 1-year follow-up, the linear distance between implant-shoulder to the bone peaks remains stable with a mean of 2.62±0.2 mm at the mesial and 2.9±0.58 mm at the distal aspect. Conclusion : Careful evaluation of potential extraction sites before immediate implant installation promotes optimal implant esthetics. To cite this article: Juodzbalys G, Wang H-L. Soft and hard tissue assessment of immediate implant placement: a case series. Clin. Oral Impl. Res. 18 , 2007; 237–243 doi:10.1111/j.1600-0501.2006.01312.xPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74957/1/j.1600-0501.2006.01312.x.pd

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

Background 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. Methods 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 Gottinger 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. Results 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. Conclusion The results of this study indicate similar osseointegration of zirconia and titanium implants at the ultrastructural level

Treatment of Peri‐Implant Defects With Combination Growth Factor Cement

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141685/1/jper0008.pd