Efficient cleaning of a macro-structured micro-rough dental implant shoulder with a new coronal vertical groove design: A technical note

This evaluation assessed the influence of a new implant shoulder design on cleanability using a now established in-vitro study model. Eight test (Botticelli, Di Meliora AG, Basel, Switzerland) and eight control implants (T3 Osseotite, ZimVie, Winterthur, Switzerland), were embedded in standardized defects in simulated bone. The implant surfaces were painted to be visually distinguishable and debrided with ultrasonic instruments (US) and an air powder waterjet device (AIR). Uncleaned implants served as positive controls. After the standardized cleaning, the implants were photographed and divided into three zones (upper marginal shoulder zone (A); lower marginal shoulder zone (B); fully threaded sub-shoulder zone (C)), and analyzed with an image processing software. On test implants, AIR was almost 100% efficacious compared to 80-90% with US, in both upper zones (A/B). In control implants, results of both AIR and US were almost 100% in zone A, but only 55-75% in zone B. In both implants, AIR showed statistically significant higher efficacy than US (P<0.05). Within the limitations of the present in-vitro model, a new macro-structured micro-rough dental implant shoulder with a new coronal vertical groove design shows similar cleanability in comparison to a smooth and machined surface

Healing of osteotomy sites applying either piezosurgery or two conventional saw blades: a pilot study in rabbits

Purpose: The purpose of this study was to compare bone healing of experimental osteotomies applying either piezosurgery or two different oscillating saw blades in a rabbit model. Methods: The 16 rabbits were randomly assigned into four groups to comply with observation periods of one, two, three and fiveweeks. In all animals, four osteotomy lines were performed on the left and right nasal bone using a conventional saw blade, a novel saw blade and piezosurgery. Results: All three osteotomy techniques revealed an advanced gap healing starting after oneweek. The most pronounced new bone formation took place between two and threeweeks, whereby piezoelectric surgery revealed a tendency to faster bone formation and remodelling. Yet, there were no significant differences between the three modalities. Conclusions: The use of a novel as well as the piezoelectric bone-cutting instrument revealed advanced bone healing with a favourable surgical performance compared to a traditional sa

Effects of Er:YAG laser on bacteria associated with titanium surfaces and cellular response in vitro

This in vitro study examined (a) the anti-bacterial efficacy of a pulsed erbium-doped yttrium aluminum garnet (Er:YAG) laser applied to Streptococcus sanguinis or Porphyromonas gingivalis adhered to either polished or microstructured titanium implant surfaces, (b) the response of osteoblast-like cells and (c) adhesion of oral bacteria to titanium surfaces after laser irradiation. Thereto, (a) bacteria adhered to titanium disks were irradiated with a pulsed Er:YAG laser (λ = 2,940nm) at two different power settings: a lower mode (12.74J/cm2 calculated energy density) and a higher mode (63.69J/cm2). (b) After laser irradiation with both settings of sterile titanium, disks were seeded with 104 MG-63 cells/cm2. Adhesion and proliferation were determined after 1, 4, and 24h by fluorescence microscopy and scanning electron microscopy. (c) Bacterial adhesion was also studied on irradiated (test) and non-irradiated (control) surfaces. Adhered P. gingivalis were effectively killed, even at the lower laser setting, independent of the material's surface. S. sanguinis cells adhered were effectively killed only at the higher setting of 63.69J/cm2. Laser irradiation of titanium surfaces had no significant effects on (b) adhesion or proliferation of osteoblast-like MG-63 cells or (c) adhesion of both oral bacterial species in comparison to untreated surfaces. An effective decontamination of polished and rough titanium implant surfaces with a Er:YAG laser could only be achieved with a fluence of 63.69J/cm2. Even though this setting may lead to certain surface alterations, no significant adverse effect on subsequent colonization and proliferation of MG-63 cells or increased bacterial adhesion was found in comparison to untreated control surfaces

Influence of gaseous ozone in peri-implantitis: bactericidal efficacy and cellular response. An in vitro study using titanium and zirconia

Dental implants are prone to bacterial colonization which may result in bone destruction and implant loss. Treatments of peri-implant disease aim to reduce bacterial adherence while leaving the implant surface intact for attachment of bone-regenerating host cells. The aims of this study were to investigate the antimicrobial efficacy of gaseous ozone on bacteria adhered to various titanium and zirconia surfaces and to evaluate adhesion of osteoblast-like MG-63 cells to ozone-treated surfaces. Saliva-coated titanium (SLA and polished) and zirconia (acid etched and polished) disks served as substrates for the adherence of Streptococcus sanguinis DSM20068 and Porphyromonas gingivalis ATCC33277. The test specimens were treated with gaseous ozone (140ppm; 33mL/s) for 6 and 24s. Bacteria were resuspended using ultrasonication, serially diluted and cultured. MG-63 cell adhesion was analyzed with reference to cell attachment, morphology, spreading, and proliferation. Surface topography as well as cell morphology of the test specimens were inspected by SEM. The highest bacterial adherence was found on titanium SLA whereas the other surfaces revealed 50-75% less adherent bacteria. P. gingivalis was eliminated by ozone from all surfaces within 24s to below the detection limit (≥99.94% reduction). S. sanguinis was more resistant and showed the highest reduction on zirconia substrates (>90% reduction). Ozone treatment did not affect the surface structures of the test specimens and did not influence osteoblastic cell adhesion and proliferation negatively. Titanium (polished) and zirconia (acid etched and polished) had a lower colonization potential and may be suitable material for implant abutments. Gaseous ozone showed selective efficacy to reduce adherent bacteria on titanium and zirconia without affecting adhesion and proliferation of osteoblastic cells. This in vitro study may provide a solid basis for clinical studies on gaseous ozone treatment of peri-implantitis and revealed an essential base for sufficient tissue regeneratio

Piezoelectric osteotomy in hand surgery: first experiences with a new technique

BACKGROUND: In hand and spinal surgery nerve lesions are feared complications with the use of standard oscillating saws. Oral surgeons have started using a newly developed ultrasound bone scalpel when performing precise osteotomies. By using a frequency of 25–29 kHz only mineralized tissue is cut, sparing the soft tissue. This reduces the risk of nerve lesions. As there is a lack of experience with this technique in the field of orthopaedic bone surgery, we performed the first ultrasound osteotomy in hand surgery. METHOD: While performing a correctional osteotomy of the 5th metacarpal bone we used the Piezosurgery(® )Device from Mectron [Italy] instead of the usual oscillating saw. We will report on our experience with one case, with a follow up time of one year. RESULTS: The cut was highly precise and there were no vibrations of the bone. The time needed for the operation was slightly longer than the time needed while using the usual saw. Bone healing was good and at no point were there any neurovascular disturbances. CONCLUSION: The Piezosurgery(® )Device is useful for small long bone osteotomies. Using the fine tip enables curved cutting and provides an opportunity for new osteotomy techniques. As the device selectively cuts bone we feel that this device has great potential in the field of hand- and spinal surgery

Hydrophilic implant surfaces – a clinical and scientific update (in German)

The modification of the implant surface influences implant osseointegration. A physico-chemical means to modify implant surfaces is the creation of hydrophilic surfaces. The aim is an accelerated osseointegration for earlier implant loading and possibly the increase of bone quantity and quality. This review gives an update on the current scientific knowledge on hydrophilic implant surfaces. In vitro, hydrophilic titanium surfaces exhibit different positive effects on hard and soft tissues with significant differences to hydrophobic surfaces. Several cell types and the initial wound healing phase are positively affected. In vivo, an increased osseointegration is detected in the early phase of wound healing. In later stages these significant differences are rarely detectable. Based on clinical trials, early implant loading of hydrophilic surfaces is considered safe and predictable. There is only few data on hydrophilic surfaces in areas of reduced bone quality or quality

The rabbit as experimental model for research in implant dentistry and related tissue regeneration

The use of rabbits for experimental research has a long historical tradition. The aim of this review consists in outlining the use of the rabbit for research in implant dentistry and related tissue regeneration. Rabbits appear as a first-hand choice for fundamental implant design studies because of their size, easy handling, short life span, and economical aspects in purchasing and sustaining. In the following, the various anatomical sites in the rabbit will be summarized to provide an overview of current possibilities and limitations of this model for bone research in oral implantology

Hydrophilic implant surfaces: A clinical and scientific update

Die Veränderung der Implantatoberfläche ist eine Möglichkeit zur Beeinflussung der Osseointegration. Eine Möglichkeit, die physikochemischen Eigenschaften von Implantatoberflächen zu ver- ändern, ist die Hydrophilisierung der Oberfläche. Ziel ist die beschleunigte periimplantäre Knochenbildung zur sicheren Frühbelastung. Im Weiteren ist von Interesse, ob eine qualitative und quanti- tative Steigerung der Knochenneubildung möglich ist. Dies könnte auch Vorteile im schwachen Knochenlager haben. Eine zunehmende Anzahl an Patienten leidet an chronischen Erkrankungen, erhält eine Strahlentherapie oder systemische medikamentöse Therapien mit Einfluss auf den Knochenstoffwechsel. Auch in diesen Fällen könn- ten sich Vorteile zeigen. Diese Übersichtsarbeit gibt ein Update zur aktuellen Studienlage zu hydrophilen Implantatoberflächen. In vitro zeigen hydrophile Titanoberflächen positive Eigenschaften auf das Hart- und Weichgewebe mit signifikanten Unterschieden zu hydrophoben Oberflächen. Hierbei werden verschiedene Zelltypen der initialen Heilungsphase positiv beeinflusst. In vivo zeigt sich in der frühen Einheilphase eine beschleunigte Osseointegration, in späteren Phasen sind diese signifikanten Unterschiede nur bedingt feststellbar. Frühbelastungskonzepte mit hydrophilen Oberflächen gelten auf Basis der bestehenden Studien als sicher und voraussagbar. Zur Osseointegration bei verminderter Knochenqualität liegen derzeit nur wenige Daten vor.The modification of the implant surface influences implant osseointegration. A physicochemical means to modify implant surfaces is the creation of hydrophilic surfaces. The aim is an accelerated osseointegration for earlier implant loading and possibly the increase of bone quantity and quality. This review gives an update on the current scientific knowledge on hydrophilic implant surfaces.In vitro, hydrophilic titanium surfaces exhibit different positive effects on hard and soft tissues with significant differences to hydrophobic surfaces. Several cell types and the initial wound healing phase are positively affected. In vivo, an increased osseointegration is detected in the early phase of wound healing. In later stages these significant differences are rarely detectable. Based on clinical trials, early im- plant loading of hydrophilic surfaces is considered safe and predictable. There is only few data on hydrophilic surfaces in areas of reduced bone quality or quality

The bone splitting stabilisation technique-a modified approach to prevent bone resorption of the buccal wall

The aim of this case series was to clinically demonstrate successful prevention of bone resorption of the buccal wall after alveolar bone splitting by additional stabilization of the lateral bone plate using a biphasic ceramic bone substitute. In three patients alveolar bone splitting was performed with a piezoelectric device. Clinical as well as radiological results after two and five years revealed stable hard and soft tissue conditions with no soft tissue recessions and peri-implant bone loss in three patients. The advantage of this one-stage procedure was the ability to insert dental implants into a very compromised bony site in a simultaneous procedure. Yet the bone splitting stabilisation technique appeared to be a more user-sensitive method