SEM and fractography analysis of screw thread loosening in dental implants.

Biological and technical failures of implants have already been reported. Mechanical factors are certainly of importance in implant failures, even if their exact nature has not yet been established. The abutment screw fracture or loosening represents a rare, but quite unpleasant failure. The aim of the present research is an analysis and structural examination of screw thread or abutment loosening compared with screw threads or abutment without loosening. The loosening of screw threads was compared to screw thread without loosening of three different implant systems; Branemark (Nobel Biocare, Gothenburg, Sweden), T.B.R. implant systems (Benax, Ancona, Italy) and Restore (Lifecore Biomedical, Chaska, Minnesota, USA). In this study broken screws were excluded. A total of 16 screw thread loosenings were observed (Group I) (4 Branemark, 4 T.B.R and 5 Restore), 10 screw threads without loosening were removed (Group II), and 6 screw threads as received by the manufacturer (unused) (Group III) were used as control (2 Branemark, 2 T.B.R and 2 Restore). The loosened abutment screws were retrieved and analyzed under SEM. Many alterations and deformations were present in concavities and convexities of screw threads in group I. No macroscopic alterations or deformations were observed in groups II and III. A statistical difference of the presence of microcracks were observed between screw threads with an abutment loosening and screw threads without an abutment loosening

Influence of Maxillary Sinus Width on New Bone Formation After Transcrestal Sinus Floor Elevation: A Proof-of-Concept Prospective Cohort Study

PURPOSE: Graft maturation in the maxillary sinus requires adequate angiogenesis and osteoprogenitor cells migration from the surrounding bony walls: the aim of this study was to analyze the correlation between sinus cavity dimensions and new bone formation after transcrestal sinus floor elevation (tSFE). METHODS: Patients needing maxillary sinus augmentation (residual crest height 64 4 mm) were treated with tSFE using xenogeneic granules. Six months later, bone-core biopsies were retrieved for histological analysis in the implant insertion sites. Buccopalatal sinus width (SW) was evaluated on cone beam computed tomography, and correlations between histomorphometric and anatomical parameters were quantified by means of linear regression analysis. RESULTS: Eight consecutive patients underwent tSFE procedures: at 6 months, average percentage of newly formed bone resulted 24.2% \ub1 7.9%. Statistical analysis showed a strong inverse correlation between SW and new bone formation (R = 0.88), and a strong direct correlation between the number of exposed bone walls and new bone formation (R = 0.82). CONCLUSION: Within the limitations of this proof-of-concept study, in which a restricted number of patients were analyzed, tSFE showed more predictable results in narrow than in large sinuses, in terms of new bone formation

Adhesion of human gingival fibroblasts/Streptococcus mitis co-culture on the nanocomposite system Chitlac-nAg

10noComposite materials are increasingly used as dental restoration. In the field of biomaterials, infections remain the main reason of dental devices failure. Silver, in the form of nanoparticles (AgNPs), ions and salt, well known for its antimicrobial properties, is used in several medical applications in order to avoid bacterial infection. To reduce both bacterial adhesion to dental devices and cytotoxicity against eukaryotic cells, we coated BisGMA/TEGDMA methacrylic thermosets with a new material, Chitlac-nAg, formed by stabilized AgNPs with a polyelectrolyte solution containing Chitlac. Here we analyzed the proliferative and adhesive ability of human gingival fibroblasts (HGFs) on BisGMA/TEGDMA thermosets uncoated and coated with AgNPs in a coculture model system with Streptococcus mitis. After 48 h, HGFs well adhered onto both surfaces, while S. mitis cytotoxic response was higher in the presence of AgNPs coated thermosets. After 24 h thermosets coated with Chitlac as well as those coated with Chitlac-nAg exerted a minimal cytotoxic effect on HGFs, while after 48 h LDH release raised up to 20 %. Moreover the presence of S. mitis reduced this release mainly when HGFs adhered to Chitlac-nAg coated thermosets. The reduced secretion of collagen type I was significant in the presence of both surfaces with the co-culture system even more when saliva is added. Integrin β1 localized closely to cell membranes onto Chitlac-nAg thermosets and PKCα translocated into nuclei. These data confirm that Chitlac-nAg have a promising utilization in the field of restorative dentistry exerting their antimicrobial activity due to AgNPs without cytotoxicity for eukaryotic cells.openopenCataldi, Amelia; Gallorini, Marialucia; Di Giulio, Mara; Guarnieri, Simone; Mariggiò, Maria Addolorata; Traini, Tonino; Di Pietro, Roberta; Cellini, Luigina; Marsich, Eleonora; Sancilio, SilviaCataldi, Amelia; Gallorini, Marialucia; Di Giulio, Mara; Guarnieri, Simone; Mariggiò, Maria Addolorata; Traini, Tonino; Di Pietro, Roberta; Cellini, Luigina; Marsich, Eleonora; Sancilio, Silvi

Sinus Membrane Elevation with Heterologous Cortical Lamina: A Randomized Study of a New Surgical Technique for Maxillary Sinus Floor Augmentation without Bone Graft

Background: The aim of this randomized controlled clinical trial was to compare the efficacy of two different techniques for maxillary sinus augmentation using a lateral window approach: Heterologous cortical lamina without any grafting material versus 100% collagenated granular collagen porcine bone. Methods: Twenty-three healthy patients with not relevant past medical history (14 women and 9 men, non-smokers, mean age 52 years, range 48–65 years) were included. In Group I, the sinus was filled with collagen porcine bone (Geno-os, OsteoBiol, Turin, Italy) and a collagen membrane (Evolution, OsteoBiol, Turin, Italy) was used to close the lateral window of the sinus. In Group II, the sinus was treated with heterologous cortical lamina only (Lamina, OsteoBiol, Turin, Italy). Results: There was a statistically significant difference in the surgical time required to complete the augmentation procedures: 18.3 ± 2.1 min for lamina treated sites versus 12.5 ± 3.1 min for porcine bone treated sites. In Group I, the mean volume of the graft was 3101 ± 321 mm3 in the immediate postoperative examination (5–7 days), while after a six-month healing period it was 2716.7 ± 432 mm3. Conclusion: This study demonstrates that the use of heterologous cortical lamina is a valid technique for the mechanical support of sinus membranes resulting in only bone tissue formation and not mixed with the graft. The graft material was biocompatible and not completely resorbed after six months, although the remains were integrated into the bone

Histologic and Histomorphometric Comparison between Sintered Nanohydroxyapatite and Anorganic Bovine Xenograft in Maxillary Sinus Grafting: A Split-Mouth Randomized Controlled Clinical Trial

The presence of vital bone after maxillary sinus augmentation is crucial to enhance the quality of bone-implant interface, ensuring predictable long-term results. The aims of this RCT with split-mouth design were the histologic and histomorphometric comparison of two different biomaterials in sinus elevation after 6 months of healing and the evaluation of the clinical outcomes of implants inserted in the augmented areas after 12 months of prosthetic loading. Twenty-eight patients (10 females, 18 males) were treated with bilateral sinus floor elevation with lateral approach. Pure sintered nanohydroxyapatite (NHA) and anorganic bovine bone (ABB) were used as test and active control, respectively. After six months, 52 bone biopsies were harvested from 26 patients, and 107 implants were inserted in the augmented areas. Histomorphometry showed that, in the two groups, vital bone percentages were 34.9±15% (NHA) and 38.5±17% (ABB) (p=0.428), marrow spaces percentages were 44.5±18% (NHA) and 43.5±23% (ABB) (p=0.866), and residual graft percentages were 20.6±13% (NHA) and 22.3±12% (ABB) (p=0.638). After 6 months of healing, no statistically significant difference was present in histomorphometric outcomes between NHA and ABB groups. Implant survival rate in NHA group after 12 months of loading was 96.4%, showing no statistically significant differences with ABB group