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Osseointegration

Distribution by Scientific Domains
Medical Sciences92%
3 Other Domains8%
Distribution within Medical Sciences
Implant Dentistry75%
Periodontology18%
4 Other Subdomains7%

Kinds of Osseointegration

  • implant osseointegration
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    Selected Abstracts

    A Computational Approach on the Osseointegration of Bone Implants Based on a Bio-Active Interface Theory

    GAMM - MITTEILUNGEN, Issue 2 2009
    André Lutz
    Abstract In this presentation an integrated approach on the simulation of osseointegration in the boneimplant interface is outlined. Besides the consistent combination of computational bone remodelling simulation and established medical imaging techniques, a new model refinement in terms of a bioactive interface theory is introduced, which enables the simulation of bone ingrowth in rough coated uncemented implants. Under consideration of seven physiological loads of daily motion the bone-implant relative micromotion in a soft tissue region around the endoprosthesis is investigated. As the micromotions are an important factor for osseointegration, because excessive micromotion leads to apposition of fibrous tissue, they are considered for the simulation of osseointegration. Results for different parameter constellations, regarding thickness and stiffness of bone-implant interface layer, are compared and the ingrowth for different configurations is predicted. With these results conclusions can be made about the stability of prosthesis in the host bone, which is an important factor for the clinical success of the treatment (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

    Early healing of implants placed into fresh extraction sockets: an experimental study in the beagle dog.

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2009
    De novo bone formation
    Abstract Objectives: Describe the early phases of tissue integration in implants placed into fresh extraction sockets and test whether a new implant surface nano-topography (DCD nano-particles, NanotiteÔ) promotes early osseointegration when compared with minimally rough surface implants (DAE, Osseotite®). Material and Methods: Sixteen beagle dogs received 64 test and control implants randomly installed into the distal socket of 3P3 and 4P4. Histomorphometric analysis of bone to implant contact (BIC) and bone area was performed at 4 h, 1, 2, 4 and 8 weeks. Results: Wound healing initiated with a coagulum that was substituted by a provisional matrix at 1 week. Bone formation started concomitant to a marked bone resorption. At 2 weeks, woven bone formation was evident and gradually remodelled into lamellar bone at 4 and 8 weeks. BIC increased similarly throughout the study in both groups with a tendency to higher percentages for the test devices at 2 and 4 weeks. The influence of the DCD nano-particles was more evident at the fourth premolar site. Conclusion: Osseointegration occurred similarly at both implant groups, although the socket dimension appeared to influence bone healing. It is suggested that the enhanced nano-topography has a limited effect in the immediate implant surgical protocol. [source]

    The Effect of a Constant Electrical Field on Osseointegration after Immediate Implantation in Dog Mandibles: A Preliminary Study

    JOURNAL OF PROSTHODONTICS, Issue 5 2007
    Yadollah Soleymani Shayesteh DDS
    Purpose: The long time span between insertion of implants and functional rehabilitation often inconveniences patients. Accelerating bone growth around dental implants can shorten this time span. This in vivo study evaluated the effect of a constant electrical field on bone growth around dental implants. Materials and Methods: Four mongrel dogs were used in this study. Sixteen dental implants were placed immediately after extraction of the first premolar and molar teeth. A constant electrical field (CEF) generator was placed in the mucoperiostal pouch created from the subperiostral dissection under the inferior border of the dog's mandible and connected to the experiment side fixtures. CEF provided 3 V of electrical potential during osseointegration. Histologic sections were stained with hematoxylin,eosin and observed under light microscopy. The sections were analyzed histomorphometrically to calculate the amount of newly formed bone. Statistical analysis was performed with SPSS 11.0 computer software (,= 0.05). Results: At the end of the first stage of the osseointegration (90 days) CEF group sections showed enhanced growth of the trabeculae compared with the control group. Statistical analysis revealed significant differences between experimental and control groups. Bone contact ratio was statistically significant in the experimental group (p= 0.001). An increase in the local bone formation and bone contact ratio was observed with direct electrical stimulation of the implant and the bone area around the implant. Conclusion: Minimal direct electrical current, which can produce an electrical field around the implant, can increase the amount of bone formation and decrease the time of osseointegration. [source]

    Dental implants: Maintenance, care and treatment of peri-implant infection

    AUSTRALIAN DENTAL JOURNAL, Issue 4 2003
    S. Chen
    Abstract Osseointegration is becoming increasingly routine in the rehabilitation of partially or fully edentulous patients. However, the surrounding tissues may be subject to inflammatory conditions similar to periodontal disease and so require maintenance. This article discusses the background, aetiology, diagnosis of peri-implant diseases, and the maintenance, care and treatment of peri-implant infection in osseointegrated implants. Three case studies are presented to illustrate points in the care of implants. [source]

    Parameters for Successful Implant Integration Revisited Part I: Immediate Loading Considered in Light of the Original Prerequisites for Osseointegration

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2010
    FACD, Oded Bahat BDS
    ABSTRACT Purpose: With the increasing popularity and publication of loading implants at the time of placement, including at time of dental extraction and simultaneous with reconstructive procedures, the objective was to evaluate known variables identified for a traditional unloaded healing period and determine the applicability of these variables to immediate loading. Materials: A total of 124 published reports available as of January 2008 that contained information about loading from the time of surgery up to 3 months postsurgically were examined in light of published variables affecting osseointegration based on a 2 stage surgical approach. Methods: The articles were examined to differentiate between immediate loading (within the initial 48 hours) and early/delayed loading of implants. Success or survival criteria were noted, and where reasons for failure were available, categorized according to six variables considered as determinants for maintaining a long-term bone-to-implant contact. Results: Approximately 60 of the 124 reports described immediately loading implants within 48 with single-tooth, partial, and full-arch restorations, as well as implant overdentures. The implant success or survival rates ranged from 70.8% to 100%. Most studies considered implant survival to be the only criterion for success. Conclusions: Of six parameters identified in 1981 as influencing osseointegration, two parameters (the status of the bone/implant site and implant loading conditions) appear to have diagnostic implications, whereas three (implant design, surgical technique, and implant finish) may affect immediate loading positively or adversely. [source]

    rhBMP-2/,BSM® Induces Significant Vertical Alveolar Ridge Augmentation and Dental Implant Osseointegration

    CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 4 2002
    Ulf M.E. Wikesjö DDS
    ABSTRACT Background: Recombinant human bone morphogenetic protein 2 (rhBMP-2) in a carrier has been shown to induce significant bone formation. Several candidate carriers, however, lack structural integrity to offset compressive forces that may compromise rhBMP-2 bone induction, in particular, for challenging onlay indications such as alveolar ridge augmentation. Purpose: The objective of this study was to evaluate rhBMP-2 in a calcium-phosphate cement carrier, ,BSM, for vertical alveolar ridge augmentation and immediate dental implant Osseointegration. Materials and Methods: Six adult Hound Labrador mongrels with 5 mm critical size supra-alveolar peri-implant defects were used. Three animals received rhBMP-2/,BSM (rhBMP-2 at 0.40 and 0.75 mg/mL) in contralateral jaw quadrants (total implant volume/defect , 1.5 mL). Three animals received ,BSM without rhBMP-2 (control group). The animals were euthanized at 16 weeks post surgery, and block biopsies were processed for histologie and histometric analysis. Results: rhBMP-2/,BSM induced substantial augmentation of the alveolar ridge. Control sites exhibited limited new bone formation. Vertical bone augmentation averaged (SD) 4.9 ± 1.0 mm (rhBMP-2 at 0.40 mg/mL), 5.3 ± 0.3 mm (rhBMP-2 at 0.75 mg/mL), and 0.4 ± 0.4 mm (control); new bone area 8.5 ± 4.2 mm 2, 9.0 ± 1.9 mm 2, and 0.5 ± 0.4 mm 2; new bone density 55.1 ± 6.4%, 61.1 ± 6.0%, and 67.7 ± 9.5%; and new bone-implant contact 26.9 ± 17.5%, 28.5 ± 1.4%, and 24.6 ± 16.1%, respectively. Residual ,BSM comprised 1% of the new bone. Bone density for the contiguous resident bone ranged from 65 to 71%, and bone-implant contact ranged from 49 to 64%. Conclusions: Surgical implantation of rhBMP-2/,BSM appears an effective protocol for vertical alveolar ridge augmentation procedures and immediate dental implant Osseointegration and for onlay indications of lesser complexity. [source]

    Histomorphologic and histomorphometric evaluation of various endosseous implant healing chamber configurations at early implantation times: a study in dogs

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2010
    Charles Marin
    Abstract Aim: The objective of this study was to evaluate the early healing of endosseous implants presenting various healing chamber configurations in a beagle dog mandible model. Methods: The four premolars of 12 beagle dogs were extracted and allowed to heal for a period of 8 weeks. Implants allowing six different healing chamber configurations were placed in each dog (three per side, six configurations per dog). The animals were sacrificed after 3 and 5 weeks in vivo (n=6 per time in vivo), and the implants were non-decalcified processed to slides of ,30 ,m thickness. Bone-to-implant contact (BIC) and bone area fraction occupied (BAFO) within the healing chamber were quantified. Statistical analysis was performed by a GLM ANOVA model at 5% significance level. Results: Osseointegration and healing with woven bone filling throughout all healing chambers was observed. Replacement of woven bone by lamellar bone showing primary osteonic structures was observed at 5 weeks. BIC was significantly affected by healing chamber configuration (P<0.001) and was not affected by time in vivo (P>0.42) at 3 and 5 weeks in vivo. BAFO was not affected by healing chamber configuration (P>0.14) however significantly increased over implantation time (P<0.001). Conclusion: Regardless of healing chamber design and dimensions considered, healing allowed the devices osseointegration. However, healing chamber configuration significantly affected osseointegration measurable parameters such as BIC. To cite this article: Marin C, Granato R, Suzuki M, Gil JN, Janal, MN Coelho PG. Histomorhpologic and histomorphometric evaluation of various endosseous implant healing chamber configurations at early implantation times: a study in dogs. Clin. Oral Impl. Res. 21, 2010; 577,583. doi: 10.1111/j.1600-0501.2009.01853.x [source]

    Osseointegration of titanium alloy and HA-coated implants in healthy and ovariectomized animals: a histomorphometric study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 11 2009
    Guaracilei Maciel Vidigal Jr
    Abstract Objectives: The objective of the present study is to evaluate the response to dental implants in healthy and osteoporotic bone. Materials and methods: Ten ovariectomized (OVX) New Zealand rabbits submitted to a hypocalcic diet and 10 sham-aged rabbits were used. All animals were submitted to bone mineral density (BMD) measurements before ovariectomy, and also 4 months afterwards, using dual energy X-ray absorptiometry. The BMD measurements showed a significant loss of bone mass, between the first and second examinations, only in the experimental group (P<0.05). After the bone mass loss induction period, three different implants were installed in the proximal tibia metaphisis of each animal: a titanium alloy implant (Ti), a plasma-spray hydroxyapatite-coated implant (HA-PS), and another implant coated with hydroxyapatite with the biomimetic process (HA-B). Results: After 3 months, histomorphometry showed a bone-to-implant contact (BIC) for Ti implants of 73.09±13.74% in healthy and 66.09±30.01% in OVX animals. The BIC for the HA-PS was 64.83±15.65% and 90.17±8.14% for healthy and OVX animals, respectively, and 88.66±5.30% and 87.96±10.71% for the HA-B implants placed in the same conditions. The differences between the implants in healthy and OVX conditions were not statistically significant (P>0.05). The only significant difference within groups was observed in the healthy animals between HA-B and Ti implants (P<0.06). Conclusion: Within the parameters used in this animal model it was not possible to observe BIC differences between osteoporotic and healthy animals. [source]

    Orthodontic loading of titanium miniplates in dogs: microradiographic and histological evaluation

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 10 2008
    M. A. Cornelis
    Abstract Objectives: The objectives of this animal study were to evaluate if orthodontic loading has an impact on osseointegration of screws supporting miniplates, and to describe the histological components of the bone,screw interface. Materials and methods: Eighty orthodontic miniplates were placed in the jaws of 10 dogs. After 2 weeks, a 125 g force was applied between the miniplates of one upper quadrant of each dog and between those of the controlateral lower quadrant. The others, nonloaded miniplates, were considered as controls. Five dogs were sacrificed 7 weeks after implantation and the remaining five dogs after 29 weeks [Short Term (ST) and Long Term (LT) groups, respectively]. Fluorochromes were injected at implantation and at sacrifice. Jaw quadrants were dissected, embedded, cut into undecalcified transverse sections through the screws and finally submitted to microradiographic analysis to allow assessment of bone,implant contact (BIC) and bone volume/total volume (BV/TV). The sections were observed under UV light and stained in order to examine them under ordinary light. Results: Osseointegration occurred around 90/160 screws and consisted mainly in limited repair and remodelling processes of lamellar bone, without inflammation. Wide variations were observed in BIC and BV/TV, but without any significant difference, neither between the loaded and the nonloaded screws, nor according to the direction of load, whereas they were significantly higher in the LT than in the ST group. Nonosseointegrated screws were surrounded by fibrous tissue. Osteoblastic activity, when present in front of these screws, was not sufficient to achieve stability. Conclusions: Osseointegration underlying orthodontic anchorage was not affected by loading. BIC increased with time and varied according to implantation site. Particularly the tight-fitting screw insertion appeared crucial in determining the appropriate bone healing response. [source]

    Osseointegration of Osseotite® and machined-surfaced titanium implants in membrane-covered critical-sized defects: a histologic and histometric study in dogs

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2007
    Alexander A. Veis
    Abstract: The texture of an implant's surface can influence the rate and extent of bone fixation as expressed by the amount of linear bone-to-implant contact (BIC). The purpose of this study was to compare the bone density and linear BIC between Osseotite® and machined-surface implants placed in bony defects without graft material and covered by a membrane. Thirty 2 mm diameter, 10 mm length custom implants were prepared for this study having a ,split surface,' with one side having the acid-etched surface and the opposite side having a machined surface. Defects were created in the iliac wing of three adult mongrel dogs where a 6-mm-diameter drill was used to generate a 5-mm-deep defect. The implants were inserted into the center of the defect with 5 mm secured into the bone leaving 5 mm free in the defect with a 2 mm gap between the implant and surrounding bone. Expanded polytetrafluroethelyene membranes were placed over the defect sites stabilized with Biotack® pins. The healing times were 2, 3, and 5 months. Histologic and histometric analysis showed significantly lower BIC in the defect region as compared with the portion of implant placed into native bone for both implant surfaces in all groups. There was no difference in BIC values at 2- and 5-month periods between the two surfaces in the regenerated area, while BIC values for Osseotite® surfaces were significantly higher than the machined surfaces at 3 months' healing time. Changes in bone density, observed between the three groups, affected correspondingly the BIC values in both implant surfaces, the effect being more pronounced in the Osseotite® surface. [source]

    Predicting osseointegration by means of implant primary stability

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2004
    A resonance-frequency analysis study with delayed, immediately loaded ITI SLA implants
    Abstract: The purpose of the present clinical study was (1) to evaluate the Osstell as a diagnostic tool capable of differentiating between stable and mobile ITI implants, (2) to evaluate a cut-off threshold implant stability quotient (ISQ) value obtained at implant placement (ISQitv) that might be predictive of osseointegration, (3) to compare the predictive ISQitv of immediately loaded (IL) implants and implants loaded after 3 months (DL). Two patient groups were enrolled, 18 patients received 63 IL implants and 18 patients were treated with 43 DL implants. The ISQ was recorded at implant placement, after 1, 2, 4, 6, 8, 10 and 12 weeks. All implants passed the 1-year loading control. Two implants failed, one DL implant with ISQ at placement (ISQi) of 48 and one IL implant with ISQi of 53. The resonance-frequency analysis (RFA) method was not a reliable diagnostic tool to identify mobile implants. However, implant stability could be reliably determined for implants displaying an ISQ,47. After 1 year of loading, all DL implants with an ISQi,49 and all IL implants with an ISQi,54 achieved and maintained osseointegration. By the end of 3 months, implants with ISQi<60 had an increase of stability. Implants with ISQi 60,69 had their stability decrease during 8 weeks before returning to their initial values. Implants with ISQ>69 had their stability decrease during the first 4 weeks before remaining stable. Although preliminary, these data might orient the practitioner to choose among various loading protocols and to selectively monitor implants during the healing phase. Résumé Le but de l'étude clinique présente a été 1) d'évaluer l'Osstell comme machine de diagnostic capable de différencier l'implant ITI stable et du mobile, 2) d'évaluer un niveau seuil de la valeur du quotient de stabilité implantaire obtenue lors du placement de l'implant (ISQitv) qui pourrait être prophétique pour l'ostéoïntégration, 3) de comparer le jugement ISQitv d'implants immédiatement mis en charge (IL) et d'implants chargés trois mois après leur placement(DL). Deux groupes de patients ont participéà cette étude : 18 patients ont reçu 63 implants IL et 18 autres ont été traités avec 43 implants DL. Le ISQ a été enregistré lors du placement de l'implant et après 1, 2, 4, 6, 8, 10 et 12 semaines. Tous les implants ont passé le contrôle de mise en charge d'une année. Deux implants ont échoué, un DL avec un ISQ lors de son placement de 48 et un implant IL avec un ISQi de 53 lors de son placement. La méthode RFA n'était pas un outil de diagnostic fiable pour identifier les implants mobiles. Cependant la stabilité implantaire pouvait être déterminée de manière sûre pour les implants qui avaient un ISQi 47. Après une année de mise en charge, tous les implants DL avec un ISQi 49 et tous les implants IL avec un ISQi 54 atteignaient et maintenaient l'ostéoïntégration. Après trois mois, les implants avec ISQi 60 montraient une augmentation de stabilité. Les implants avec ISQi de 60 à 69 avaient une diminution de la stabilité durant huit semaines avant de revenir à leur valeur initiale. Les implants avec ISQ>69 voyaient leur stabilité diminuée durant les premières quatre semaines avant de rester stables. Bien que préliminaires, ces données peuvent orienter le praticien pour choisir parmi différents protocoles de mise en charge et de suivre de manière sélective les implants durant la phase de guérison. Zusammenfassung Das Ziel dieser klinischen Studie war, 1) das Osstell als diagnostisches Werkzeug zur Unterscheidung von stabilen und beweglichen ITI-Implantaten zu untersuchen, 2) einen verbindlichen Grenzwert zu bestimmen, der in Form eines Implantatstabilitätsquotienten zum Zeitpunkt der Implantation (ISQitv) erhoben wird, und der als Voraussagewert für die Osseointegration dienen könnte, 3) den ISQitv von sofortbelasteten Implantaten (IL) und von erst nach 3 Monaten belasteten Implantaten (DL) zu vergleichen. Es waren zwei Patientengruppen beteiligt, 18 Patienten erhielten 63 IL-Implantate und 18 Patienten wurden mit 43 DL-Implantaten behandelt. Den ISQ-Wert bestimmte man sofort nach der Implantation, sowie nach 1, 2, 4, 6, 8, 10 und 12 Wochen. Alle Implantate konnten nach einem Jahr überprüft und kontrolliert werden. 2 Implantate gingen verloren, ein DL-Implantat mit einem ISQ bei der Implantation (ISQi) von 48 und ein IL-Implantat mit einem ISQi von 53. Die RFA-Methode war kein verlässliches diagnostisches Werkzeug, um bewegliche Implantate zu erkennen. Man konnte aber für Implantate mit einem ISQ von>47 die Implantatstabilität verlässlich bestimmen. Nach einer Belastung über ein Jahr erreichten alle DL-Implantate mit einem ISQi von>49 und alle IL-Implantate mit einem ISQi von>54 eine stabile Osseointegration. Nach 3 Monaten, erreichten Implantate mit einem ISQi von<60 eine zunehmende Stabilität. Implantate mit einem ISQi von 60-69 verloren in den ersten 8 Wochen einen Teil ihrer Stabilität, bevor sie wieder zu den Anfangswerten zurückkehrten. Implantate mit einem ISQ>69 hatten ihre Stabilitätsabnahme in den ersten 4 Wochen, bevor sie wiederum dauerhaft stabil wurden. Obwohl es erste Daten sind, können sie dem Praktiker helfen, um zwischen den verschiedenen Belastungsprotokollen zu wählen, und um die Implantate ganz individuell durch die Heilungsphase hindurch zu betreuen. Resumen El propósito del presente estudio fue, 1) evaluar el Osstell como herramienta diagnóstica capaz de de diferenciar entre implantes ITI estables y móviles, 2) evaluar un valor de cociente de umbral de corte de estabilidad de implante obtenido al colocar el implante (ISQitv) que pueda ser predictivo de osteointegración, 3) comparar la predictibilidad del ISQitv de los implantes de carga inmediata (IL) e implantes cargados tras 3 meses (DL). Se enroló a dos grupos de pacientes, 18 pacientes recibieron 63 implantes IL y 18 pacientes se trataron con 43 implantes DL. Se recogieron los ISQ al colocar los implantes, tras 1, 2, 4, 6, 8, 10 y 12 semanas. Todos los implantes superaron el control del año. 2 implantes fracasaron, un implante DL con un ISQ al colocarlo (ISQi) de 48 y un implante IL con un ISQi de 53. El método RFA no fue una herramienta fiable para identificar implantes móviles. De todos modos, la estabilidad de los implantes pudo ser determinada con fiabilidad para los implantes que mostraron un ISQ,47. Tras 1 año de carga, todos los implantes DL con un ISQi,49 y todos los IL con ISQi,54 lograron y mantuvieron la osteointegración. Al final de los 3 meses, los implantes con ISQ<60 tuvieron un incremento en la estabilidad. Los implantes con un ISQi de 60-69 tuvieron un descenso de la estabilidad durante 8 semanas antes de volver a sus valores iniciales. Los implantes con ISQ>69 tuvieron un descenso de la estabilidad durante la primeras 4 semanas antes de estabilizarse. Aunque preliminares, estos datos pueden orientar al clínico a escoger entre varios protocolos de carga y monitorizar selectivamente los implantes durante la fase de cicatrización. [source]

    Clinical outcome of 103 consecutive zygomatic implants: a 6,48 months follow-up study

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2004
    Chantal Malevez
    Abstract: The purpose of this study was to evaluate retrospectively, after a period of 6,48 months follow-up of prosthetic loading, the survival rate of 103 zygomatic implants inserted in 55 totally edentulous severely resorbed upper jaws. Fifty-five consecutive patients, 41 females and 14 males, with severe maxillary bone resorption were rehabilitated by means of a fixed prosthesis supported by either 1 or 2 zygomatic implants, and 2,6 maxillary implants. This retrospective study calculated success and survival rates at both the prosthetic and implant levels. Out of 55 prostheses, 52 were screwed on top of the implants, while 3 were modified due to the loss of standard additional implants and transformed in semimovable prosthesis. Although osseointegration in the zygomatic region is difficult to evaluate, no zygomatic implant was considered fibrously encapsulated and they are all still in function. This study confirms that the zygoma bone can offer a predictable anchorage and support function for a fixed prosthesis in severely resorbed maxillae. Résumé Le but de cette étude a été d'évaluer rétrospectivement, après une période de six à 48 mois après la mise en charge prothétique, le taux de survie de 103 implants zygomatiques insérés chez 55 édentés complets avec mâchoires supérieures extrêmement résorbées. Cinquante-cinq patients (41 femmes et quatorze hommes) avec une résorption osseuse maxillaire très sévère ont été soignés à l'aide d'une prothèse fixée supportée par un ou deux implants zygomatique et deux à six implants maxillaires. Cette étude rétrospective a calculé le taux de survie et le taux de succès tant au niveau prothétique et qu'implantaire. Des 55 prothèses, 52 ont été vissées sur les implants tandis que trois ont été modifiées vu la perte d'implants standards supplémentaires et transformées en prothèses semi-amovibles. Bien que l'ostéoïntégration dans la région zygomatique soit difficile àévaluer, aucun implant zygomatique n'a été considéré comme encapsulé fibreusement et ils sont encore tous en fonction. Cette étude confirme que l'os zygomatique peut offrir un ancrage prévisible et unun support de support pour une prothèse fixée dans les cas de maxillaires fortement résorbés. Zusammenfassung Die klinischen Ergebnisse von 103 Implantaten im Jochbein. Eine Langzeitstudie über 6,48 Monate. Das Ziel dieser Studie war es, bei 55 vollständig zahnlosen und massiv resorbierten Oberkiefern die Überlebensrate von 103 Implantaten im Jochbein retrospektiv zu untersuchen. Die Beobachtungszeit betrug 6,48 Monate nach prothetischer Versorgung. 55 Patienten, 41 Frauen und 14 Männer, die eine ausgedehnte Knochenresorption des Oberkiefers zeigten, wurden mit einer festsitzenden Brücke versorgt, die von 1,2 Implantaten im Jochbein und 2,6 weiteren Oberkieferimplantaten getragen wurde. Diese retrospektive Studie errechnete Erfolgsrate und Überlebensrate sowohl der prothetischen Rekonstruktion, wie auch der Implantate. Von den 55 Brücken waren 52 auf den Implantaten verschraubt, und 3 infolge Verlust von Standardimplantaten zu bedingt abnehmbaren Brücken umgebaut. Obwohl die Osseointegration in der Region des Jochbeins schwierig zu beurteilen ist, musste keines dieser Implantate als bindegewebig eingeheilt bezeichnet werden und alle sind immer noch in Funktion. Diese Arbeit belegt, dass der Knochen des Jochbeins ein voraussagbare Verankerung und Haltefunktion für eine festsitzende Brücke bei massiv resorbierten Oberkiefern liefern kann. Resumen La intención de este estudio fue evaluar retrospectivamente, tras un periodo de 6,48 meses de seguimiento de carga prostética, el índice se supervivencia de 103 implantes zigomáticos insertados en 55 maxilares superiores edéntulos severamente reabsorbidos. Se rehabilitaron 55 pacientes consecutivos, 41 mujeres y 14 hombres, con reabsorción ósea severa del maxilar, por medio de una prótesis fija soportada por 1 o 2 implantes zigomáticos, y de 2 a 6 implantes maxilares. Este estudio retrospectivo calculó los índices de éxito y supervivencia tanto a nivel de la prótesis como del implante. De las 55 prótesis, 52 se atornillaron sobre los implantes mientras que 3 se modificaron debido a la perdida de implantes estándar adicionales y se transformaron en prótesis semimóviles. Aunque la osteointegración en la región zigomática es difícil de evaluar, no se consideró a ningún implante zigomático como fibrosamente encapsulado y están aún en función. Este estudio confirma que el hueso zigomático pude ofrecer un anclaje predecible y función de soporte para una prótesis fija en el maxilar severamente reabsorbido. [source]

    Tissue response to titanium implantation in the rat maxilla, with special reference to the effects of surface conditions on bone formation

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2003
    Masaki Shirakura
    Abstract: Tissue responses to titanium implantation with two different surface conditions in our established implantation model in rat maxillae were investigated by light and transmission electron microscopy and by histochemistry for tartrate-resistant acid phosphatase (TRAPase) activity. Here we used two types of implants with different surface qualities: titanium implants sandblasted with Al2O3 (SA-group) and implants coated with hydroxyapatite (HA-group). In both groups, bone formation had begun by 5 days postimplantation when the inflammatory reaction had almost disappeared in the prepared bone cavity. In the SA-group, however, the bone formation process in the bone cavity was almost identical to that shown in our previous report using smooth surfaced implants (Futami et al. 2000): new bone formation, which occurred from the pre-existing bone toward the implant, was preceded by active bone resorption in the lateral area with a narrow gap, but not so in the base area with a wide gap. In the HA-group, direct bone formation from the implant toward the pre-existing bone was recognizable in both lateral and base areas. Many TRAPase-reactive cells were found near the implant surface. On the pre-existing bone, new bone formation occurred with bone resorption by typical osteoclasts. Osseointegration around the implants was achieved by postoperative day 28 in both SA- and HA-groups except for the lateral area, where the implant had been installed close to the cavity margin. These findings indicate that ossification around the titanium implants progresses in different patterns, probably dependent on surface properties and quality. Résumé Les réponses tissulaires à l'implantation du titane avec deux conditions de surfaces différentes dans le maxillaire du rat ont étéétudiées par microscopie optique et électronique à transmission et par histochimie pour l'activité de l'acide phosphatase résistant au tartrate (TRAPase). Deux types d'implants avec différentes qualité de surface ont été utilisés : des implants en titane sablés par du AL2O3 (groupe SA) et des implants couverts par de l'hydroxyapatite (groupe HA). Dans les deux groupes la formation osseuse avait démarré cinq jours après l'implantation, lorsque la réaction inflammatoire avait presque disparue de la cavité osseuse préparée. Cependant, dans le groupe SA le processus de formation osseuse de la cavité osseuse était quasi identique à celle montrée dans un rapport précédent utilisant des implants à surface lisse (Futami et al., 2000) : la néoformation osseuse qui démarre de l'os préexistant vers l'implant, était précédée par une résorption osseuse active dans l'aire latérale avec une brèche étroite, mais pas dans l'aire de base avec un espace large. Dans le groupe HA, une formation osseuse directe de l'implant vers l'os préexistant était reconnaissable tant dans les aires latérales qu'au niveau de la base. Beaucoup de cellules réactives au TRAPase ont été trouvées près de la surface de l'implant. Sur l'os préexistant une néoformation osseuse est apparue avec une résorption osseuse par des ostéoclastes typiques. L'ostéoïntégration autour des implants a été achevée au jour 28 après l'opération tant dans le groupe SA que HA excepté pour l'aire latérale où l'implant avait été inséré près du rebord de la cavité. Ces découvertes indiquent que l'ossification autour des implants en titane progresse de manière différente dépendant probablement de la qualité et des propriétés de surface. Zusammenfassung Die Gewebsantwort auf implantiertes Titan in einem Rattenoberkiefer. Spezielles Augenmerk auf die Einflüsse der Oberflächenbeschaffenheit auf die Knochenbildung. An unserem etablierten Implantationsmodell am Rattenoberkiefer wurde die Gewebsantwort nach der Titanimplantation von zwei Prüfkörpern mit verschiedener Oberfläche mit Hilfe der Licht- und Transmissionselektronenmikroskopie, sowie mittels Histochemie zum Aktivitätsnachweis der tartratresitenten sauren Phosphatase (TRAPase) untersucht. Wir benutzten hier zwei Implantattypen mit verschiedenen Oberflächen: Mit Al2O3 sandgestrahlte Titanimplantate (SA-Gruppe) und mit Hydroxylapatit beschichtete Implantate (HA-Gruppe). Bei beiden Gruppen begann die Knochenbildung 5 Tage nach der Implantation, sobald die Entzündungsreaktion im präparierten Knochenbett am verschwinden war. In der SA-Gruppe aber, zeigte sich im präparierten Implantatbett ein beinahe gleicher Knochenbildungsvorgang, wie in unseren früheren Berichten für glatte Implantatoberflächen beschrieben (Futami et al., 2000): Die vom bereits vorhandenen Knochen ausgehende Knochenneubildung gegen das Implantat hin erfolgte erst nach einer aktiven Knochenresorption im lateralen Bereich. Es entstand eine minime Spalte zwischen Knochen und Implantat, währenddem im apicalen Bereich eine breitere Spalte entstand. In der HA-Gruppe konnte man sowohl im lateralen, wie auch im apicalen Bereich eine direkt vom Implantat ausgehende Knochenbildung in Richtung des vorhandenen Knochens feststellen. In der Nähe der Implantatoberfläche fand man viele TRAPase-reaktive Zellen. Beim vorhandenen Knochen erfolgte die Knochenneubildung gleichzeitig mit der Knochenresorption durch typische Osteoklasten. Die Osseointegration rund um die Implantate herum erreichte man, ausser im lateralen Bereich gegen den Rand des Implantatbettes hin, in der SA-und der HA-Gruppe am 28igsten postoperativen Tag. Diese Ergebnisse zeigen, dass die Ossifikation um Titanimplantate in verschiedenen Mustern abläuft, wahrscheindlich in Abhängigkeit von der Oberflächeneigenschaft und -qualität. Resumen Se investigó las respuestas tisulares a la implantación con titanio con dos condiciones diferentes de superficie en nuestro modelo establecido de implantación en el maxilar de la rata por medio de microscopía óptica y electrónica de transmisión y por medio de histoquímica para la actividad de fosfatasa alcalina tartrato resistente (TRAPase). Hemos usado aquí dos tipos de implantes con diferentes calidades de superficies: Implantes de titanio pulverizados con Al2O3 (grupo-SA), e implantes cubiertos con hidroxiapatita (grupo-HA). En ambos grupos la formación de hueso comenzó a los 5 días de la implantación cuando la reacción inflamatoria hubo casi desaparecido en la cavidad ósea preparada. De todos modos, en el grupo SA, el proceso de formación de hueso en la cavidad ósea fue casi idéntico a aquel mostrado en nuestro informe previo usando implantes de superficies lisas (Futami et al., 2000): neoformación de hueso, que tuvo lugar desde el hueso preexistente hacia el implante, siendo precedida por reabsorción ósea activa en el área lateral con un espacio estrecho, pero no así en el área basal con espacio ancho. Se encontraron muchas células TRAPase reactivas cerca de la superficie del implante. En el hueso preexistente, la neoformación ósea tuvo lugar con reabsorción ósea con osteoclastos típicos. La osteointegración alrededor de los implantes se logró al día 28 tras la operación en ambos grupos SA y HA excepto para el área lateral, donde el implante se instaló cerca del margen de la cavidad. Estos hallazgos indican que la osificación alrededor de los implantes de titanio progresa con patrones diferentes, probablemente dependiendo de las propiedades y las calidades de la superficie. [source]

    Histomorphological evaluation of loaded plate-form and root-form implants in Macaca mulatta monkeys

    CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2002
    Michael McCracken
    Abstract: As part of a long-term evaluation of endosteal dental implants in primates, this paper describes the histological response to plate-form and root-form implants. Thirty-six primates received 48 mandibular distal abutment implants. After healing, the implants were restored with fixed partial dentures, which remained in function for two years. A subset of the group was ligated at the gingival sulcus to biologically stress tissues supporting the implants. Crestal bone height around implants was quantified using digital subtraction radiographic techniques. The ligated implants lost more crestal bone than non-ligated implants, as shown by ANOVA (P < 0.05). After retrieval, implants were embedded and sectioned for histomorphometric analysis including measurement of per cent osseointegration. Both plate-form and root-form non-ligated implants demonstrated about 60% osseointegration. When ligated, plate-form implants dropped to an average integration of only 34%, while root-form implants maintained 62% integration, a significant difference. These data show that in this primate model, plate-form and root-form implants maintained integration while in function for two years. When stressed with ligation, root-form implants maintained relative amounts of osseointegration, while per cent osseointegration of plate-form implants decreased. Résumé Ce manuscript décrit la réponse histologique à long terme au niveau des implants-plateau ou racine. Trente-six primates ont reçu 48 implants comme pilier distal au niveau de la mandibule. Après guérison, les implants ont été chargés avec des prothèses partielles fixées qui sont restées en fonction durant deux années. Un sous-groupe a été ligaturé au niveau des sulci gingivaux afin d'augmenter l'accumulation de plaque dentaire au niveau de ces implants. La hauteur osseuse crestale autour des implants a été quantifée en utilisant des techniques de soustraction radiologique. Les implants ligaturés ont perdu davantage d'os crestal que les non-ligaturés (ANOVA: P<0.05). Après leur avulsion les implants ont été enfouis dans des blocs et découpés pour une analyse histomorphométrique évaluant la mesure de l'ostéointégration. Les deux types d'implant avaient une ostéintégration d'environ 60%. Lorsqu'il y avait une ligature, les implants-plateau avaient une diminution de l'intégration allant jusqu'à 34% tandis que ceux en forme racine maintenaient une intégration de 62%. Ces données ont montré que dans ce modèle de primate, les implants-plateau et -racine maintenaient une intégration durant leur mise en fonction de deux années. Lorsqu'une ligature était placée les implants-racine maintenaient une bonne quantité d'ostéo?ntégration tandis que cette dernière était significativement inférieure lorsque les implants-plateau étaient utilisés. Zusammenfassung Diese Arbeit ist Teil einer Langzeitstudie über enossale Zahnimplantaten an Primaten und beschreibt die histologische Antwort auf scheiben- und wurzelförmige ?mplantate. 36 Primaten erhielten 48 seitliche Unterkieferimplantate. Nach der Heilphase wurden die ?mplantate mit festsitzenden Teilprothesen versorgt, die während zwei Jahren in Funktion verblieben. Ein Teil der Gruppe erhielt im den Sulcus eine Ligatur, um die dem ?mplantat angrenzendenden Gewebe einer biologischen Stressituation auszusetzen. Die Höhe des Alveolarknochens um die ?mplantate wurde mit Hilfe der digitalen Subtraktionsradiographie quantitativ erfasst. Die ?mplantate mit einer Ligatur verloren mehr Alveolarknochen als die nichtligierten ?mplantate (ANOVA; P<0.05). Nach der Entnahme wurden die ?mplantate eingebettet und histologische Schnitte angefertigt. Diese dienten der histomorphometrischen Analyse und der Bestimmung des Osseointegrationsgrades in Prozenten. Sowohl die scheiben-, wie auch die wurzelförmigen ?mplantate zeigten ohne Ligaturen eine 60%-ige Osseointegration. Wurden aber Ligaturen angelegt, so reduzierte sich der Grad der Osseointegration bei den scheibenförmigen ?mplantaten auf 34%, bei den wurzelförmigen ?mplantate auf 62%, es handelte sich um einen signifikanten Unterschied. Die Resultate dieses Primatenmodells zeigen, dass die scheiben- und wurzelförmigen ?mplantate während einer Funktionszeit von zwei Jahren ihre Osseointegration beibehalten. Werden die Gewebe aber mit Ligaturen zur experimentellen Entzündung gebracht, können die wurzelförmigen ?mplantate ihren Osseontegrationsgrad beibehalten, bei den scheibenförmigen ?mplantaten nahm er ab. Resumen Como parte de una evaluación a largo plazo de implantes dentales endoóseos en primates, este trabajo describe la respuesta histológica a implantes con forma de placa y con forma de raíz. Treinta y seis primates recibieron 48 implantes distales mandibulares con pilar. Tras la cicatrización, los implates se restauraron con dentaduras parciales fijas, que permanecieron en functión durante 2 años. A un subconjunto del grupo se les colocó una ligadura en el surco gingival para estresar los tejidos que soportan los implantes. Se cuantificó la altura de la cresta ósea alrededor de los implantes usando técnicas radiográficas de sustracción digital. Los implantes ligados perdieron mas hueso crestal que los implantes no ligados, como se muestra en ANOVA (P<0.05). Tras la retirada, los implantes se embebieron y seccionaron para análisis histomorfométrico incluyendo mediciones del porcentaje de osteointegración. Tanto los implantes con forma de placa como los de forma de raíz no ligados mostraron un 60 por ciento de osteointegración. Cuando se ligaron, los implantes con forma de placa bajaron a una media de integración de solo el 34 por ciento, mientras que los implantes con forma de raíz mantuvieron el 62 por ciento de integración, una diferencia significativa. Estos datos muestran que en este modelo de primates, lo implantes con forma de placa y forma de raíz mantuvieron la integración en función durante 2 años. Al estresarse con ligaduras, los implantes con forma de raíz mantuvieron unas cantidades relativas de osteointegración, mientras que el porcentaje de integración de los implantes con forma de placa disminuyó. [source]

    Segmental osteotomy to reposition multiple osseointegrated dental implants in the anterior maxilla in a trauma patient

    DENTAL TRAUMATOLOGY, Issue 1 2007
    Shou-Yen Kao
    Abstract,,, A 16-year-old young man had severe loss of alveolar bone and lost four teeth in the anterior maxilla because of traumatic injury in a traffic accident. To overcome the surgically compromised condition for implant rehabilitation, the deficient ridge was augmented by autogenous bone graft from the mandibular symphysis. The augmented ridge had much improvement in width but less in vertical height. Four implants were placed to gain initial osseointegration. Segmental osteotomy was performed to occlusally reposition the implants and bone for 5-mm in the anterior maxilla. After 2 years of clinical follow-up, the rehabilitation outcome is satisfactory and stable. [source]

    Electrochemically Deposited Ca(OH)2 Coatings as a Bactericidal and Osteointegrative Modification of Ti Implants

    ADVANCED ENGINEERING MATERIALS, Issue 3 2009
    Claus Moseke
    Coating of metallic implants with CaP is a common method of improving osseointegration of the device. In this study Ca(OH)2 coatings are analyzed combining the advantage of initial bacteriocidity with,after conversion of the hydroxide to hydroxyapatite in physiological media,good osteoconductivity. [source]

    A Computational Approach on the Osseointegration of Bone Implants Based on a Bio-Active Interface Theory

    GAMM - MITTEILUNGEN, Issue 2 2009
    André Lutz
    Abstract In this presentation an integrated approach on the simulation of osseointegration in the boneimplant interface is outlined. Besides the consistent combination of computational bone remodelling simulation and established medical imaging techniques, a new model refinement in terms of a bioactive interface theory is introduced, which enables the simulation of bone ingrowth in rough coated uncemented implants. Under consideration of seven physiological loads of daily motion the bone-implant relative micromotion in a soft tissue region around the endoprosthesis is investigated. As the micromotions are an important factor for osseointegration, because excessive micromotion leads to apposition of fibrous tissue, they are considered for the simulation of osseointegration. Results for different parameter constellations, regarding thickness and stiffness of bone-implant interface layer, are compared and the ingrowth for different configurations is predicted. With these results conclusions can be made about the stability of prosthesis in the host bone, which is an important factor for the clinical success of the treatment (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

    Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2010
    Giuseppe Polimeni
    Polimeni G, Wikesjö UME, Susin C, Qahash M, Shanaman RH, Prasad HS, Rohrer MD, Hall J. Alveolar ridge augmentation using implants coated with recombinant human growth/differentiation factor-5: histologic observations. J Clin Periodontol 2010; 37: 759-768 doi: 10.1111/j.1600-051X.2010.01579.x. Abstract Objectives: In vitro and in vivo preclinical studies suggest that growth/differentiation factor-5 (GDF-5) may induce local bone formation. The objective of this study was to evaluate the potential of recombinant human GDF-5 (rhGDF-5) coated onto an oral implant with a purpose-designed titanium porous oxide surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with 30 or 60 ,g rhGDF-5, and six animals received implants coated with 120 ,g rhGDF-5 or left uncoated (control). Treatments were alternated between jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7, and 8 post-surgery when they were euthanized for histologic evaluation. Results: The clinical examination showed no noteworthy differences between implants coated with rhGDF-5. The cover screw and implant body were visible/palpable through the alveolar mucosa for both rhGDF-5-coated and control implants. There was a small increase in induced bone height for implants coated with rhGDF-5 compared with the control, induced bone height averaging (±SD) 1.6±0.6 mm for implants coated with 120 ,g rhGDF-5 versus 1.2±0.5, 1.2±0.6, and 0.6±0.2 mm for implants coated with 60 ,g rhGDF-5, 30 ,g rhGDF-5, or left uncoated, respectively (p<0.05). Bone formation was predominant at the lingual aspect of the implants. Narrow yellow and orange fluorescent markers throughout the newly formed bone indicate relatively slow new bone formation within 3,4 weeks. Implants coated with rhGDF-5 displayed limited peri-implant bone remodelling in the resident bone; the 120 ,g dose exhibiting more advanced remodelling than the 60 and 30 ,g doses. All treatment groups exhibited clinically relevant osseointegration. Conclusions: rhGDF-5-coated oral implants display a dose-dependent osteoinductive and/or osteoconductive effect, bone formation apparently benefiting from local factors. Application of rhGDF-5 appears to be safe as it is associated with limited, if any, adverse effects. [source]

    Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010
    Cristiano Susin
    Susin C, Qahash M, Polimeni G, Lu PH, Prasad HS, Rohrer MD, Hall J, Wikesjö UME. Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-7 (rhBMP-7/rhOP-1): histological observations. J Clin Periodontol 2010; 37: 574,581. doi: 10.1111/j.1600-051X.2010.01554.x. Abstract Background: Pre-clinical studies have shown that recombinant human bone morphogenetic protein-2 (rhBMP-2) coated onto purpose-designed titanium porous-oxide surface implants induces clinically relevant bone formation and osseointegration. The objective of this study was to examine the potential of rhBMP-7, also known as recombinant human osteogenic protein-1 (rhOP-1), coated onto titanium porous-oxide surface implants to support vertical alveolar ridge augmentation and implant osseointegration. Materials and Methods: Bilateral, critical-size, 5 mm, supraalveolar peri-implant defects were created in six young adult Hound Labrador mongrel dogs. The animals received implants coated with rhBMP-7 at 1.5 or 3.0 mg/ml randomized to contra-lateral jaw quadrants. The mucoperiosteal flaps were advanced, adapted, and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at 3, 4, 7, and 8 weeks post-surgery when they were euthanized for histological evaluation. Results: Without striking differences between treatments, the implant sites exhibited a swelling that gradually regressed to become hard to palpation disguising the implant contours. The histological evaluation showed robust bone formation; the newly formed bone assuming characteristics of the contiguous resident bone, bone formation (height and area) averaging 4.1±1.0 versus 3.6±1.7 mm and 3.6±1.9 versus 3.1±1.8 mm2; and bone density 56%versus 50% for implants coated with rhBMP-7 at 1.5 and 3.0 mg/ml, respectively. Both treatments exhibited clinically relevant osseointegration, the corresponding bone,implant contact values averaging 51% and 47%. Notable peri-implant resident bone remodelling was observed for implants coated with rhBMP-7 at 3.0 mg/ml. Conclusions: rhBMP-7 coated onto titanium porous-oxide surface implants induces clinically relevant local bone formation including osseointegration and vertical augmentation of the alveolar ridge, the higher concentration/dose associated with some local side effects. [source]

    Evaluation of implants coated with rhBMP-2 using two different coating strategies: a critical-size supraalveolar peri-implant defect study in dogs

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2010
    Jaebum Lee
    Lee J, Decker JF, Polimeni G, Cortella CA, Rohrer MD, Wozney JM, Hall J, Susin C, Wikesjö UME. Evaluation of implants coated with rhBMP-2 using two different coating strategies: a critical-size supraalveolar peri-implant defect study in dogs. J Clin Periodontol 2010; 37: 582,590. doi: 10.1111/j.1600-051X.2010.01557.x. Abstract Background: Implants coated with recombinant human bone morphogenetic protein-2 (rhBMP-2) induce relevant bone formation but also resident bone remodelling. Objectives: To compare the effect of implants fully or partially coated with rhBMP-2 on new bone formation and resident bone remodelling. Materials and Methods: Twelve, male, adult, Hound Labrador mongrel dogs were used. Critical-size, supraalveolar, peri-implant defects received titanium porous oxide surface implants coated in their most coronal aspect with rhBMP-2 (coronal-load/six animals) or by immersion of the entire implant in an rhBMP-2 solution (soak-load/six animals) for a total of 30 ,g rhBMP-2/implant. All implants were air-dried. The animals were euthanized at 8 weeks for histometric evaluation. Results: Clinical healing was uneventful. Supraalveolar bone formation was not significantly affected by the rhBMP-2 application protocol. New bone height and area averaged (± SE) 3.4 ± 0.2 versus 3.5 ± 0.4 mm and 2.6 ± 0.4 versus 2.5 ± 0.7 mm2 for coronal-load and soak-load implants, respectively (p>0.05). The corresponding bone density and bone,implant contact (BIC) recordings averaged 38.0 ± 3.8%versus 34.4 ± 5.6% and 25.0 ± 3.8%versus 31.2 ± 3.3% (p>0.05). In contrast, resident bone remodelling was significantly influenced by the rhBMP-2 application protocol. Bone density outside the implants threads averaged 74.7 ± 3.8% and 50.8 ± 4.1% for coronal-load and soak-load implants, respectively (p<0.05); bone density within the thread area averaged 51.8 ± 1.2% and 37.8 ± 2.9%, and BIC 70.1 ± 6.7% and 43.3 ± 3.9% (p<0.05). Conclusion: Local application of rhBMP-2 appears to be a viable technology to support local bone formation and osseointegration. Coronal-load implants obviate resident bone remodelling without compromising new bone formation. [source]

    Evaluation of nano-technology-modified zirconia oral implants: a study in rabbits

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2009
    Jaebum Lee
    Abstract Objective: The objective of this study was to screen candidate nano-technology-modified, micro-structured zirconia implant surfaces relative to local bone formation and osseointegration. Materials and Methods: Proprietary nano-technology surface-modified (calcium phosphate: CaP) micro-structured zirconia implants (A and C), control micro-structured zirconia implants (ZiUniteÔ), and titanium porous oxide implants (TiUniteÔ) were implanted into the femoral condyle in 40 adult male New Zealand White rabbits. Each animal received one implant in each hind leg; thus, 20 animals received A and C implants and 20 animals received ZiUniteÔ and TiUniteÔ implants in contralateral hind legs. Ten animals/group were euthanized at weeks 3 and 6 when biopsies of the implant sites were processed for histometric analysis using digital photomicrographs produced using backscatter scanning electron microscopy. Results: The TiUniteÔ surface demonstrated significantly greater bone,implant contact (BIC) (77.6±2.6%) compared with the A (64.6±3.6%) and C (62.2±3.1%) surfaces at 3 weeks (p<0.05). Numerical differences between ZiUniteÔ (70.5±3.1%) and A and C surfaces did not reach statistical significance (p>0.05). Similarly, there were non-significant differences between the TiUniteÔ and the ZiUniteÔ surfaces (p>0.05). At 6 weeks, there were no significant differences in BIC between the TiUniteÔ (67.1±4.2%), ZiUniteÔ (69.7±5.7%), A (68.6±1.9%), and C (64.5±4.1%) surfaces (p>0.05). Conclusion: TiUniteÔ and ZiUniteÔ implant surfaces exhibit high levels of osseointegration that, in this model, confirm their advanced osteoconductive properties. Addition of CaP nano-technology to the ZiUniteÔ surface does not enhance the already advanced osteoconductivity displayed by the TiUniteÔ and ZiUniteÔ implant surfaces. [source]

    Early healing of implants placed into fresh extraction sockets: an experimental study in the beagle dog.

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2009
    De novo bone formation
    Abstract Objectives: Describe the early phases of tissue integration in implants placed into fresh extraction sockets and test whether a new implant surface nano-topography (DCD nano-particles, NanotiteÔ) promotes early osseointegration when compared with minimally rough surface implants (DAE, Osseotite®). Material and Methods: Sixteen beagle dogs received 64 test and control implants randomly installed into the distal socket of 3P3 and 4P4. Histomorphometric analysis of bone to implant contact (BIC) and bone area was performed at 4 h, 1, 2, 4 and 8 weeks. Results: Wound healing initiated with a coagulum that was substituted by a provisional matrix at 1 week. Bone formation started concomitant to a marked bone resorption. At 2 weeks, woven bone formation was evident and gradually remodelled into lamellar bone at 4 and 8 weeks. BIC increased similarly throughout the study in both groups with a tendency to higher percentages for the test devices at 2 and 4 weeks. The influence of the DCD nano-particles was more evident at the fourth premolar site. Conclusion: Osseointegration occurred similarly at both implant groups, although the socket dimension appeared to influence bone healing. It is suggested that the enhanced nano-topography has a limited effect in the immediate implant surgical protocol. [source]

    Bone formation at recombinant human bone morphogenetic protein-2-coated titanium implants in the posterior maxilla (Type IV bone) in non-human primates

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2008
    Ulf M. E. Wikesjö
    Abstract Background: Studies using ectopic rodent and orthotopic canine models (Type II bone) have shown that titanium porous oxide (TPO) surface implants adsorbed with recombinant human bone morphogenetic protein-2 (rhBMP-2) induce local bone formation including osseointegration. The objective of this study was to evaluate local bone formation and osseointegration at such implants placed into Type IV bone. Material and Methods: rhBMP-2-coated implants were installed into the edentulated posterior maxilla in eight young adult Cynomolgus monkeys: four animals each received three TPO implants adsorbed with rhBMP-2 (2.0 mg/ml) and four animals each received three TPO implants adsorbed with rhBMP-2 (0.2 mg/ml). Contra-lateral jaw quadrants received three TPO implants without rhBMP-2 (control). Treatments were alternated between left and right jaw quadrants. Mucosal flaps were advanced and sutured to submerge the implants. The animals received fluorescent bone markers at weeks 2, 3, 4, and at week 16 when they were euthanized for histologic analysis. Results: Clinical healing was uneventful. Extensive local bone formation was observed in animals receiving implants adsorbed with rhBMP-2 (2.0 mg/ml). The newly formed bone exhibited a specific pinpoint bone,implant contact pattern regardless of rhBMP-2 concentration resulting in significant osseointegration; rhBMP-2 (2.0 mg/ml): 43% and rhBMP-2 (0.2 mg/ml): 37%. Control implants exhibited a thin layer of bone covering a relatively larger portion of the implant threads. Thus, TPO control implants bone exhibited significantly greater bone,implant contact (,75%; p<0.05). There were no statistically significant differences between rhBMP-2-coated and control implants relative to any other parameter including peri-implant and intra-thread bone density. Conclusion: rhBMP-2-coated TPO implants enhanced/accelerated local bone formation in Type IV bone in a dose-dependent fashion in non-human primates resulting in significant osseointegration. rhBMP-2-induced de novo bone formation did not reach the level of osseointegration observed in native resident bone within the 16-week interval. [source]

    Alveolar ridge augmentation using implants coated with recombinant human bone morphogenetic protein-2: histologic observations

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2008
    Ulf M. E. Wikesjö
    Abstract Background: Studies using ectopic rodent, orthotopic canine, and non-human primate models show that bone morphogenetic proteins (BMPs) coated onto titanium surfaces induce local bone formation. The objective of this study was to examine the ability of recombinant human BMP-2 (rhBMP-2) coated onto a titanium porous oxide implant surface to stimulate local bone formation including osseointegration and vertical augmentation of the alveolar ridge. Material and Methods: Bilateral, critical-size, 5 mm, supra-alveolar, peri-implant defects were created in 12 young adult Hound Labrador mongrel dogs. Six animals received implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml, and six animals received implants coated with rhBMP-2 at 3.0 mg/ml or uncoated control. Treatments were randomized between jaw quadrants. The mucoperiosteal flaps were advanced, adapted and sutured to submerge the implants for primary intention healing. The animals received fluorescent bone markers at weeks 3, 4, 7 and 8 post-surgery when they were euthanized for histologic evaluation. Results: Jaw quadrants receiving implants coated with rhBMP-2 exhibited gradually regressing swelling that became hard to palpate disguising the contours of the implants. The histologic evaluation showed robust bone formation reaching or exceeding the implant platform. The newly formed bone exhibited characteristics of the adjoining resident Type II bone including cortex formation for sites receiving implants coated with rhBMP-2 at 0.75 or 1.5 mg/ml. Sites receiving implants coated with rhBMP-2 at 3.0 mg/ml exhibited more immature trabecular bone formation, seroma formation and peri-implant bone remodelling resulting in undesirable implant displacement. Control implants exhibited minimal, if any, bone formation. Thus, implants coated with rhBMP-2 at 0.75, 1.5 and 3.0 mg/ml exhibited significant bone formation (height and area) compared with the sham-surgery control averaging (±SD) 4.4±0.4, 4.2±0.7 and 4.2±1.2 versus 0.8±0.3 mm; and 5.0±2.2, 5.6±2.2 and 7.4±3.5 versus 0.7±0.3 mm2, respectively (p<0.01). All the treatment groups exhibited clinically relevant osseointegration. Conclusions: rhBMP-2 coated onto titanium porous oxide implant surfaces induced clinically relevant local bone formation including vertical augmentation of the alveolar ridge and osseointegration. Higher concentrations/doses were associated with untoward effects. [source]

    Mesenchymal stem cells and platelet-rich plasma enhance bone formation in sinus grafting: a histomorphometric study in minipigs

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2008
    Francesco Pieri
    Abstract Objectives: Autologous, allogenic, and alloplastic materials for sinus augmentation have specific drawbacks, which has stimulated an ongoing search for new materials and tissue-engineering constructs. We investigated whether mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) seeded on a fluorohydroxyapatite (FH) scaffold can improve bone formation and bone-to-implant contact (BIC) in maxillary sinus grafting. Material and Methods: Bilateral sinus augmentation procedures were performed in eight minipigs. MSCs, PRP, and FH scaffold (test site) or FH alone (control site) were grafted in each maxillary sinus. Distal to the osteotomy, one dental implant per sinus was placed in the grafting material through the facial sinus wall. The animals were killed 3 months after grafting, and block sections of the implant sites were harvested and prepared for histomorphometric analysis. Results: After 12 weeks, a significant increase in bone formation occurred in the test sites compared with the control sites (42.51%versus 18.98%; p=0.001). In addition, BIC was significantly greater in the test sites compared with the control sites in the regenerated area (23.71%versus 6.63%; p=0.028). Conclusions: These findings show that sinus augmentation with MSCs,PRP, combined with FH may enhance bone formation and osseointegration of dental implants compared with FH alone in minipigs. [source]

    The critical-size supraalveolar peri-implant defect model: characteristics and use

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2006
    Ulf M. E. Wikesjö
    Abstract Objective: Novel implant technologies and reconstructive therapies for alveolar augmentation require pre-clinical evaluation to estimate their biologic potential, efficacy, and safety before clinical application. The objective of this report is to present characteristics and use of the critical-size, supraalveolar, peri-implant defect model. Methods: Bilateral extraction of the mandibular premolars was performed in 12 Hound Labrador mongrel dogs following horizontal surgical cut-down of the alveolar ridge approximating 6 mm. Each jaw quadrant received three custom-produced TiUniteÔ, ,4.0 × 10 mm threaded implants placed into osteotomies prepared into the extraction sites of the third and fourth premolars. The implants exhibited a reference notch 5 mm from the implant platform to facilitate surgical placement leaving 5 mm of the implant in a supraalveolar position, and to serve as a reference point in the radiographic, histologic and histometric analysis. The implants were submerged under the mucoperiosteal flaps for primary intention healing. Fluorescent bone markers were administered at weeks 3 and 4 post-surgery, and pre-euthanasia. The animals were euthanized following an 8-week healing interval when block biopsies were collected for analysis. Results: Healing was generally uneventful. The radiographic and histometric evaluations demonstrate the limited osteogenic potential of this defect model. Whereas lingual peri-implant sites exhibited a mean (±SE) bone gain of 0.4±0.1 mm, resorption of the buccal crestal plate resulted in a mean bone loss of 0.4±0.2 mm for an overall osteogenic potential following sham-surgery averaging 0.0±0.1 mm. Overall bone density and bone,implant contact in the contiguous resident bone averaged 79.1±1.1% and 76.9±2.3%, respectively. Conclusion: The results suggest that the critical-size, supraalveolar, peri-implant defect model appears a rigorous tool in the evaluation of candidate technologies for alveolar reconstruction and osseointegration of endosseous oral implants. Limited innate osteogenic potential allows critical evaluation of osteogenic, osteoconductive, or osteoinductive technologies in a challenging clinical setting. [source]

    Bone reactions to longstanding functional load at implants: an experimental study in dogs

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2005
    T. Berglundh
    Abstract Objectives: The aims of the present investigation were (i) to study marginal bone level alterations following implant installation, abutment connection and functional loading and (ii) to analyse bone tissue reactions to functional load. Material and Methods: Six beagle dogs, about 1-year old, were used. All mandibular pre-molars were extracted. Three months later four implants of the Astra Tech Implants® Dental System were installed in one side of the mandible and four standard fixtures of the Brånemark System® were placed in the contralateral side of the mandible. Abutment connection was performed 3 months later and a plaque control programme was initiated. Three months after abutment connection fixed partial dentures (FPDs) made in gold were cemented to the maxillary canines and pre-molars. FPDs were also connected to the three posterior implants in each side of the mandible, while the mesial implant in each side was used as an unloaded control. Radiographs were obtained from all implant sites following implant installation, abutment connection and FPD placement. Ten months after the FPD placement the radiographic examination was repeated. The animals were sacrificed and biopsies from all implant sites were obtained and prepared for histological analysis. Results: The radiographic analysis revealed that largest amount of bone loss occurred following implant installation and abutment connection and that this loss was more pronounced at Brånemark than at Astra implants. The bone level alterations that were observed at implants exposed to 10 months of functional load in both implant systems were small and did not differ from control sites. The histological analysis revealed that implants exposed to functional load exhibited a higher degree of bone-to-implant contact than control implants in both implant systems. Conclusion: It is suggested that functional load at implants may enhance osseointegration and does not result in marginal bone loss. [source]

    Enamel matrix derivative and titanium implants

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2003
    An experimental pilot study in the rabbit
    Aim: The aim of present study was to evaluate if an enamel matrix derivative (Emdogain®) may enhance bone formation and osseointegration of titanium implants, using a well-documented rabbit model. Material and methods: Thirty-six threaded commercially pure titanium (cp.ti.) implants were inserted in six New Zealand white rabbits. One implant was placed in each femur and two in each tibia. Prior to implant insertion approximately 0.5 mL of Emdogain (EMD) (test) or the vehicle gel (PGA: propylene glycol alginate) (control) was injected into the surgically prepared implant site. The follow-up time was 6 weeks. Biomechanical evaluations by resonance frequency analysis (RFA) and removal torque measurements (RTQ) were performed. Histomorphometrical quantifications were made on ground sections by measurements of the percentage of bone-to-metal contact, bone area inside the threads as well as outside the threads (mirror image). Bone lengths along the implant surface were also measured and used for shear strength calculations. Results: The results demonstrated no beneficial effects from the EMD treatment on bone formation around titanium implants in any of the tested parameters. Significant differences were demonstrated with removal torque test and shear force calculations for the control implants. No other parameter demonstrated a statistically significant difference. Conclusion: The results of the present study may indicate that EMD does not contribute to bone formation around titanium implants. This observation may indicate that the bone formation that occurs after EMD treatment in periodontal defects is the result of functional adaptation. However, further research is required to evaluate the effect of EMD treatment on bone formation. Zusammenfassung Schmelzmatrixprotein und Titanimplantate. Eine experimentelle Pilotstudie beim Kaninchen Zielsetzung: Untersuchung im gut dokumentierten Kaninchenmodell, ob Schmelzmatrixprotein (Emdogain®) die Knochenbildung und Osseointegration von Titanimplantaten verbessert. Material und Methoden: 36 kommerziell erhältliche Schraubenimplantate aus reinem Titan (cp.ti.) wurden bei 6 weißen Neuseeländischen Kaninchen inseriert. Ein Implantat wurde in jeden Femur und 2 in jede Tibia gesetzt. Vor Implantatinsertion wurden etwa 0,5 ml Emdogain (EMD) (Test) oder das Trägergel (PGA: Propylenglykolalginat) (Kontrolle) in die chirurgisch vorbereitete Insertionsstelle gespritzt. Die Nachuntersuchungszeit betrug 6 Wochen. Die biomechanischen Untersuchungen umfassten eine Resonanzfrequenzanalyse (RFA) und die Messung des Drehmoments, das zur Entfernung der Implantate nötig war (RTQ). Folgende histomorphometrische Messungen wurden auf Schliffpräparaten durchgeführt: Messung des prozentualen Knochen-zu-Metall-Kontaktes, Knochenbereich innerhalb und außerhalb der Schraubengewinde (Spiegelbild). Die Knochenlänge entlang der Implantate wurde ausgemessen und für Scherkraftberechnungen genutzt. Ergebnisse: Es konnten für keinen der untersuchten Parameter günstige Auswirkungen der Anwendung von EMD auf die Knochenbildung um Titanimplantate beobachtet werden. Signifikante Unterschiede konnten für RTQ und Scherkraftberechnungen für die Kontrollimplantate gezeigt werden. Für keinen anderen Parameter konnten statistisch signifikante Unterschiede gefunden werden. Schlussfolgerungen: Die Ergebnisse dieser Studie zeigen, dass der Einsatz von EMD nicht zur Knochenbildung um Titanimplantate beiträgt. Diese Beobachtung kann darauf hinweisen, dass die Knochenbildung, die nach Gabe von EMD in parodontalen Defekten stattfindet, das Ergebnis funktioneller Adaptation ist. Allerdings sind weitere Untersuchungen erforderlich, um die Auswirkung von EMD auf die Knochenbildung zu verstehen. Résumé Dérivés de la matrice amellaire et implants en titane. Une étude pilote expérimentale sur le lapin. But: Le but de cette étude était d'évaluer si un dérivé de la matrice amellaire (Emdogain®) pouvait augmenter la formation osseuse et l'ostéo-intégration d'implants en titane en utilisant un modèle éprouvé de lapin. Matériel et méthodes: 36 implants en titane commercialement purs (cp.ti.) ont été vissés chez 6 lapins blancs de Nouvelle Zélande. 1 implant fut placé dans chaque fémur et 2 dans chaque tibia. Préalablement à l'insertion, environ 0.5 mL d' Emdogain (EMD) (test) ou du gel vecteur (PGA: propylene glycol alginate) (control) fut injecté dans le site implantaire préparé chirurgicalement. Le suivi était réalisé sur 6 semaines. Des évaluations biomécaniques par analyse de la fréquence de résonance (RFA) et des mesures de torque de retrait (RTQ) furent utilisées. Les quantifications histo-morphométriques furent réalisées sur des coupes en mesurant le pourcentage de contact os-métal, les surfaces osseuses à l'intérieur ainsi qu'à l'extérieur des spires (Image miroir). Les longueurs d'os le long des surfaces implantaires furent aussi mesurées et utilisées pour calculer les forces de cisaillement. Résultats: Les résultats n'ont montré aucun effet bénéfique du traitement à l'EMD sur la formation osseuse autour des implants en titane pour aucun des paramètres test. De significatives différences furent trouvées avec le test de torque et les calculs de force de cisaillement pour les implants contrôles. Aucun autre paramètre ne montrait de différences statistiquement significatives. Conclusion: Les résultats de cette étude pourrait indiquer que l'EMD ne contribue pas à la formation osseuse autour des implants en titane. Cette observation peut indiquer que la formation osseuse qui survient après traitement à l'EMD dans les lésions parodontales serait le résultat d'une adaptation fonctionnelle. Cependant, de futures recherches sont nécessaires pour évaluer l'effet du traitement à l'EMD sur la formation osseuse. [source]

    Bone healing around implants placed in a jaw defect augmented with Bio-Oss®

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 11 2000
    An experimental study in dogs
    Abstract The present experiment was carried out to study some tissue reactions around implants that were placed in an edentulous ridge which had been augmented with deproteinized natural bovine cancellous bone mineral. In 4 male beagle dogs, the premolars in the right side of the mandible were extracted and a large buccal ridge defect was created by mechanical means. The bone plate at the lingual aspect of the defect was left intact. 5 months later, the distal 2/3 of the defect area was augmented with Bio-Oss® (Geistlich Sons Ltd, Wolhusen, Switzerland) mixed with a fibrin sealer (Tisseel®, Immuno AG, Vienna, Austria). After 3 months of healing, 3 fixtures (Astra Tech AB, Mölndal, Sweden; TiO-blast; 8×3.5 mm) were installed in the mandible; 2 were placed in the augmented portion and 1 was placed in the non-augmented portion of the defect. After a healing period of 3 months, abutment connection was performed and a plaque control period initiated. 4 months later, the dogs were sacrificed and each implant region was dissected. The tissue samples were dehydrated, embedded in plastic, sectioned in the bucco-lingual plane and examined in the light microscope. It was observed that osseointegration failed to occur to implant surfaces within an alveolar ridge portion previously augmented with Bio-Oss®. In the augmented portion of the crest, the graft particles were separated from the host tissue as well as from the implant by a well-defined connective tissue capsule. Although the lingual aspect of all fixtures (test and control) was in contact with hard tissue at the time of installation, after 4 months of function, a deep vertical bone defect frequently had formed at the lingual surface of the implants. It was concluded that in this model (i) Bio-Oss® failed to integrate with the host bone tissue and (ii) no osseointegration occurred to the implants within the augmented portion of the crest. [source]

    Growth analysis of a patient with ectodermal dysplasia treated with endosseous implants: 6-year follow-up

    JOURNAL OF ORAL REHABILITATION, Issue 3 2006
    T. ALCAN
    summary, The purpose of this article is to report the clinical course and 6-year follow-up of a child with ectodermal dysplasia who was treated with implants surgery very early. This article reports placement of mandibular endosseous implants in a 4-year-old patient with hypohidrotic ectodermal dysplasia and oligodontia. This congenital anomaly does not appear to retard healing and the osseointegration remains after 6 years and 3 months of loading. Mandibular and maxillary skeletal growth and development was normal. However, because of lack of alveolar growth, in time, patient's vertical growth pattern changed to low angle. This could be corrected by changing the vertical heights of the abutment and prosthesis. As a result, in ectodermal dysplasias cases with anadontia, early implant placement and fixed prosthesis could be a good multidisciplinary treatment option for poor cooperative child. [source]