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Resonance Frequency Analysis (resonance + frequency_analysis)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Implant Dentistry	80%
Periodontology	11%

Selected Abstracts

In-patient comparison of immediate and conventional loaded implants in mandibular molar sites within 12 months

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2008
Güncü, M. Bar
Abstract Objectives: The aim of this prospective clinical study was to evaluate the clinical outcomes of dental implants placed in the mandibular molar sites and immediately functionally restored compared with conventionally loaded controls in an in-patient study. Material and methods: Twenty-four dental implants were placed in 12 patients who had first molar loss bilaterally in the mandibular area. One site of the patient was determined as immediately loaded (IL) and the other side was conventionally loaded (CL). Resonance frequency analyses for implant stability measurements, radiographic examinations for marginal bone levels and peri-implant evaluations were performed during the clinical follow-up appointments within 12 months. Results: During the 12-month follow-up period, only one implant was lost in the IL group. The mean implant stability quotient values were 74.18±5.72 and 75.18±3.51 for Groups IL and CL at surgery, respectively, and the corresponding values were 75.36±5.88 and 75.64±4.84 at 1-year recall, respectively. The difference was not statistically significant between the two groups during the 12-month study period (P>0.05). When peri-implant parameters were evaluated, excellent peri-implant health was demonstrated during the 1-year observation period and all implants showed less than 1 mm of marginal bone resorption during the first year. Conclusions: In the present study, immediate functionally loading did not negatively affect implant stability, marginal bone levels and peri-implant health when compared with conventional loading of single-tooth implants. [source]

Analysis of the possibility of the relationship between various implant-related measures: an 18-month follow-up study

JOURNAL OF ORAL REHABILITATION, Issue 2 2008
T. F. TÖZÜM
Summary, Better clarification of the long-term relationship among the various implant-related measures could improve the evaluation process for dental implants. Thus, the aim of the present study was to determine the potential correlations among the volumetric features and nitric oxide content of peri-implant sulcus fluid (PISF) and measures of implant stability, and the marginal bone loss. Completely edentulous patients (n = 15) treated with dental implants and ball attachment mandibular over dentures were included. Resonance frequency analysis (RFA), marginal bone level measurements, PISF volume and spectrophotometrically determined nitrite levels were recorded for all dental implant sites. Measures for early (n = 16) and delayed (n = 14) loaded dental implants were comparatively analysed for a period of 18 months. Some random correlations between PISF volume and marginal bone level, PISF nitrite level and marginal bone level and PISF volume and PISF nitrite content, and RFA and PISF volume were observed. However, the only constant correlation was noticed between implant stability (RFA scores) and marginal bone level. This correlation was negative and significant for all dental implants and for delayed loaded implants (P < 0·05). The pattern of loading seemed to affect the extent, but not the pattern of this relationship. While some of the implant-related measures may be strongly associated (e.g. dental implant stability and marginal bone level), not all measures from a single implant site are likely to be related. Such associations may be under the influence of a variety of factors including the loading protocol of dental implants. [source]

Turned, Machined Versus Double-Etched Dental Implants In Vivo

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2007
B. Al-Nawas Priv.-Doz., DrMed, DrMedDent
ABSTRACT Background:, Positive effects on the clinical outcome of moderately rough implant surfaces are described. Intercomparison of clinical data, however, is rarely found. Purpose:, The aim of this study was to compare the clinical results of two macroscopically identical implants, the one with a turned, machined and the other with an etched surface. Materials and Methods:, In a retrospective cohort study, the included implants followed the criteria: standard surgical protocol, >12 months in situ; minimally rough self-threading implants with a turned, machined surface (Mk IITM Nobel Biocare AB, Göteborg, Sweden], n=210); etched implants of the same macrodesign (3iTM Implant Innovations Inc., Palm Beach Gardens, FL, USA], n=151), length , 10 mm. Clinical data and implant success were rated. Resonance frequency analysis (RFA) and Periotest® (Siemens AG, Bensheim, Germany) were measured and related to the corresponding implant survival rate in the respective group. Results:, The total number of implants was 361, of which 264 (73%) were subject to clinical reexamination. RFA and Periotest could be recorded in 25% of the implants. Neither clinically relevant nor statistically significant differences between the surface designs were found in the RFA (64 ± 8.6 vs 63 ± 9.7), in Periotest (,2 ± 3.3 vs ,1 ± 5.1), and in mean survival periods (49 months, 95% confidence interval CI]: 46,51 months, for the turned vs 46 months, 95% CI: 43,49 months, for the double-etched implant). After osteoplastic procedures, a significantly higher rate of implant losses in the turned, machined implant group was observed (17 vs 1) with a mean survival period of 43 (40,46) months for the turned and 46 (45,48) months for the double-etched implants. Conclusion:, No difference between implants with two different minimally rough surfaces was found. A positive effect of surface roughness is observed in poor quality bone, but the pivotal proof of this effect is still lacking. [source]

Early Functional Loading of Unsplinted Roughened Surface Implants with Mandibular Overdentures 2 Weeks after Surgery

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2003
Alan G.T. Payne BDS, FCD (SA), MDent
ABSTRACT Background: Before early functional loading of unsplinted implants with mandibular overdentures can become widespread, more clinical studies are needed to investigate the success of the approach. Purpose: To evaluate the success rates of two types of roughened titanium surface implants with early 2-week functional loading of paired mandibular interforaminal implants with overdentures. Materials and Methods: Random allocation divided 24 strictly selected edentulous participants into two groups, with each group to receive a different implant system (ITI Dental Implant System, Straumann AG, Waldenburg, Switzerland; or Southern Implant System, Southern Implants, Irene, South Africa). Two implants were placed in the anterior mandible of all participants using one-stage standardized surgical procedures. Previously constructed conventional mandibular dentures (opposing maxillary complete dentures) were temporarily relined and worn by the participants for the first 2 weeks; participants used a soft diet. Two weeks after implant surgery and following some mucosal healing, the mandibular dentures had the tissue conditioner removed and the appropriate matrices included for an unsplinted prosthodontic design. Results: No implant from either group was lost. Resonance frequency analysis (RFA) indicated higher primary stability at surgery for the Southern group than for the ITI group, with a statistically significant difference between the groups throughout the study period. The drop in RF values between surgery and 6 weeks was significant and was greater for the Southern group. RFA also indicated stabilized osseointegration between 6 to 12 and 12 to 52 weeks, with no participant showing any decrease in those values over time. Participants with type 3 bone showed a significant improvement in RF values between 12 and 52 weeks, eventually matching those of participants with type 2 bone. There were no significant differences in marginal bone loss, periimplant parameters, or prosthodontic maintenance between the groups over the study period. Conclusions: Using only strict patient selection criteria, 1-year follow-up data indicate that early functional loading of ITI and Southern implants with mandibular two-implant overdentures is possible as early as 2 weeks after implant surgery. [source]

Effects of Implant Design and Surface on Bone Regeneration and Implant Stability: An Experimental Study in the Dog Mandible

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2001
Lars Rasmusson DMD
ABSTRACT Background: Previous experimental studies have shown a higher degree of bone-implant contact for surface-enlarged implants compared with machined implants. Yet, there is insufficient evidence that such implants show higher stability and an increased survival rate. Purpose: The purpose of this investigation was to study the integration and stability of grit-blasted implants with retention elements on the implant neck, with and without marginal bone defects, compared with machined implants without retention elements. Materials and Methods: After tooth extraction of the mandibular premolars in six dogs, two grit-blasted, partly microthreaded Astra Tech implants and one standard Branemark implant were bilaterally placed in each dog. On one side, 3 ± 3 mm large buccal defects were created, to expose three to four implant threads. The contralateral side served as control, and no defects were made. The animals were sacrificed after 4 months of healing. Implant stability was measured using resonance frequency analysis at implant installation and after 4 months of healing. Histologic and histomorpho-metric evaluation was made after 4 months of healing. Results: Resonance frequency analysis indicated that all implants in the test and control groups were osseointegrated after 4 months, with a tendency toward higher implant stability for the Astra Tech implants. There was a statistically significant higher increase in resonance frequency for the Astra test implants compared with their corresponding controls. Histology and histomorphometry showed well-integrated implants with varying degrees of bone repair at the defect sites. The greater bone-implant contact for the Astra implants was statistically significant. No significant difference between the implants in amount of bone filling the threads was recorded. Conclusions: The Astra Tech implants tested showed a higher degree of bone,implant contact and higher level of bone regenerated at defect sites compared with the Brånemark implants. Resonance frequency analysis demonstrated a significantly higher increase in the Astra test implants compared with their control groups than did the Brånemark test implants versus their controls. [source]

Relevance of resonance frequency analysis to evaluate dental implant stability: simulation and histomorphometrical animal experiments

CLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2008
Yoshihiro Ito
Abstract Background: Resonance frequency analysis (RFA) is applied to evaluate implant stability, and the clinical relevance of this application is accepted. However, a discrepancy between resonance frequency (RF) and other parameters of implant stability such as implant insertion torque and bone mineral density at the insertion site has been reported. In addition, the relation between RF and histological implant,bone contact has not been well documented. Purpose: To explain this discrepancy and to clarify the relation between RF and histological implant,bone contact, we conducted the present study. Materials and methods: A hydroxyapatite-coated implant, 4 mm diameter and 10 mm length, was used. We placed the implant in a small plastic box vertically and fixed the implant in the box with small screws at different height positions. An ,Osstell' transducer was mounted on the implant and RF was measured with or without loosening the screws. Twenty-four implants were placed in the tibiae of four mini-pigs. The animals were sacrificed 1, 2 and 4 weeks after the placement, and the RF of each implant was measured. Ground sections were prepared and implant,bone contact was histomophometrically measured. Results: Loosening the screw at the neck region of the implant remarkably decreased RF compared with the screws of the other regions. Correlation between RF and implant,bone contact, which was measured all around the implant, was not significant (r=0.221, P=0.299). However, the correlation coefficient increased to ,0.361' when implant,bone contact was measured at the neck of the implant (P=0.0835), although these two parameters were not statistically correlated. Conclusions: Although RF did not correlate with histological implant,bone contact, the present results demonstrated that a connection between the implant and bone at the neck region of the implant affects RF the most effectively, further suggesting the superiority of RFA in the process of implant treatment and the follow-up. The present results could explain the discrepancy between RFA and other parameters of implant stability. [source]

Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation

CLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2007
M. A. Huwiler
Objectives: To monitor resonance frequency analysis (RFA) in relation to the jawbone characteristics and during the early phases of healing and incorporation of Straumann® dental implants with an SLA surface. Material and methods: 17 Straumann 4.1 mm implants (10 mm) and 7 Straumann 4.8 mm implants (10 mm) were installed and ISQ determined at baseline and after 1, 2, 3, 4, 5, 6, 8 and 12 weeks. Central bone cores were analyzed from the 4.1 mm implants using micro CT for bone volume density (BVD) and bone trabecular connectivity (BTC). Results: Pocket probing depths ranged from 2,4 mm and bleeding on probing from 5,20%. At baseline, BVD varied between 24% and 65% and BTC between 4.9 and 25.4 for the 4.1 mm implants. Baseline ISQ varied between 55 and 74 with a mean of 61.4. No significant correlations were found between BVD or BTC and ISQ Values. For the 4.8 mm diameter implants baseline ISQ values ranged from 57,70 with a mean of 63.3. Over the healing period ISQ values increased at 1 week and decreased after 2,3 weeks. After 4 weeks ISQ values, again increased slightly, no significant differences were noted over time. One implant (4.1 mm) lost stability at 3 weeks. Its ISQ value had dropped from 68 to 45. However the latter value was determined after the clinical diagnosis of instability. Conclusion: ISQ values of 57,70 represented homeostasis and implant stability. However no predictive value for loosing implant stability can be attributed to RFA since the decrease occurred after the fact. [source]

Validity and clinical significance of biomechanical testing of implant/bone interface

CLINICAL ORAL IMPLANTS RESEARCH, Issue S2 2006
Carlos Aparicio
Abstract Purpose: The aim of this paper was to review the clinical literature on the Resonance frequency analysis (RFA) and Periotest techniques in order to assess the validity and prognostic value of each technique to detect implants at risk for failure. Material and methods: A search was made using the PubMed database to find clinical studies using the RFA and/or Periotest techniques. Results: A limited number of clinical reports were found. No randomized-controlled clinical trials or prospective cohort studies could be found for validity testing of the techniques. Consequently, only a narrative review was prepared to cover general aspects of the techniques, factors influencing measurements and the clinical relevance of the techniques. Conclusions: Factors such as bone density, upper or lower jaw, abutment length and supracrestal implant length seem to influence both RFA and Periotest measurements. Data suggest that high RFA and low Periotest values indicate successfully integrated implants and that low/decreasing RFA and high/increasing Periotest values may be signs of ongoing disintegration and/or marginal bone loss. However, single readings using any of the techniques are of limited clinical value. The prognostic value of the RFA and Periotest techniques in predicting loss of implant stability has yet to be established in prospective clinical studies. [source]

Human ex vivo bone tissue strains around immediately loaded implants supporting maxillary overdentures

CLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2005
vanç Akça
Abstract Purpose: To evaluate ex vivo bone tissue strains around maxillary implants supporting immediately loaded bar-retained overdentures. Material and methods: Ninety degree two-element rosette strain gauges were bonded on the labial bone of four ITI® dental implants placed in the maxillary anterior region of four completely edentulous maxilla of fresh human cadavers. The installation torque value (ITV) of each implant was measured by a custom-made torque wrench and resonance frequency analyses (RFAs) were undertaken. A bar-retained overdenture was fabricated for each cadaver, and two miniature load cells were integrated in the first molar region of the overdentures for controlled loading experiments. Strain measurements were performed at a sample rate of 10 kHz and under a maximum load of 100 N, simultaneously monitored from a computer connected to a data acquisition system. Finally, removal torque values (RTVs) of the implants were measured. Results: RFA values did not mirror ITVs, while RTVs of implants were slightly lower than the ITVs. Any correlation could not be obtained between RFA values and ITVs or RTVs. Maximum strains around loaded implants ranged between ,100 and ,550 ,, under 25,100 N. The axial and lateral strain values of posterior implants of both sides were higher than those of anterior implants under all loads (P<0.05). Conclusion: Because occlusal forces in humans tend to decrease because of age-related factors, maximum strains around immediately loaded implants supporting maxillary overdentures fall within physiologic levels. Résumé Le but de cette étude a été d'évaluer les tensions du tissu osseux ex vivo autour d'implants maxillaires portant des prothèses amovibles retenues sur une barre placée immédiatement après l'insertion des implants. Deux jauges de force en rosette à 90° ont été attachées au côté lingual de l'os de quatre implants dentaires ITI® placés dans la région antérieure du maxillaire de quatre cadavres humains frais aux maxillaires édentées. La valeur du couple de torsion lors de l'installation (ITV) de chaque implant a été mesurée par un couple fabriqué et des analyses de fréquence de résonnance (RFA) ont été faites. Une prothèse retenue par une barre a été fabriquée pour chaque cadavre et deux cellules de charge miniatures ont été intégrées dans la région de la première molaire de ces prothèses pour les expériences de charge contrôlées. Les mesures de force ont été effectuées à un taux d'échantillonnage de 10 kHz et sous une charge maximale de 100 N, suivies simultanément par un ordinateur connectéà un système d'acquisition de données. Finalement les valeurs des couples de torsion à l'enlèvement (RTV) des implants ont été mesurées. Les valeurs RFA n'étaient pas en ligne avec les ITV tandis que les RTV des implants étaient légèrement inférieurs aux ITV. Aucune corrélation n'a pûêtre établie entre les valeurs RFA et ITV ou RTV. Les forces maximales autour des implants chargés s'étalaient de ,100 ,e à,550 ,e sous 25 N à 100 N. Les valeurs des forces axiales et latérales des implants postérieurs des deux côtés étaient supérieures à celles des implants antérieurs sous toutes les charges (P<0.05). Zusammenfassung Ziel: Es war das Ziel dieser Arbeit, an bis vor kurzem vitalen Knochengewebe Spannungen um Oberkieferimplantate zu untersuchen, welche sofortbelastete und stegverankerte Hybridprothesen tragen. Material und Methoden: Auf den labialen Knochen von vier ITI-Implantaten in der vorderen Region des zahnlosen Oberkiefers von vier frisch verstorbenen Menschen klebte man Dehnmessinstrumente an. Man mass den Wert der Eindrehkraft (ITV) jedes einzelnen Implantates mit einem handelsblichen Drehmomentschlssel und fhrte eine Resonanzfrequenzanalyse (RFA) durch. Man stellte fr jede Leiche eine stegverankerte Hybridprothese her und man baute in der Region der ersten Molaren zwei kleine Messgerte ein, die kontrollierte Belastungsexperimente erlaubten. Dehnmessungen fhrte man mit einer Frequenz von 10 kHz und einer maximalen Belastung von 100 N durch, simultan aufgezeichnet von einem mit dem Messsystem verbundenen Komputer. Schliesslich mass man auch die Krfte, die es brauchte um die Implantate wieder auszudrehen (RTV). Resultate: Die RFA wiederspiegelte die ITV-Werte nicht, whrenddem die RTV-Werte der Implantate geringfgig tiefer waren als die ITV-Werte. Man konnte weder zwischen der RFA, den ITV-Werten oder den RTV-Werten eine Korrelation herstellen. Die maximalen Dehnungen um die Implantate erreichte Werte zwischen ,100 E und ,550 E bei einer Belastung zwischen 25 N und 100 N. Die axialen und lateralen Dehnkrfte bei posterioren Implantaten waren unter smtlichen getesteten Belastungen beidseits grsser als diejenigen der anterioren Implantate (P<0.05). Resumen Propósito: Evaluar las tensiones del tejido óseo ex vivo alrededor de implantes maxilares soportando sobredentaduras retenidas por barras con carga inmediata. Material y Métodos: Se pegaron dos indicadores de tensión de roseta de dos elementos de 90° en el hueso labial de cuatro implantes dentales ITI® colocados en la región maxilar anterior de cuatro maxilares completamente edéntulos de cadáveres humanos frescos. Se midió el valor del torque de instalación (ITV) de cada implante por medio de una chicharra de torque hecha a medida y se llevó a cabo análisis de frecuencia de resonancia (RFA). Se fabricó una sobredentadura retenida por barras para cada cadáver y se integraron dos células miniatura de carga en la región del primer molar de las sobredentaduras para los experimentos de carga controlada. Se llevaron a cabo mediciones de la tensión a un índice de muestra de 10 kHz y bajo una carga máxima de 100 N, simultáneamente monitorizada desde un ordenador conectado a sistema de adquisición de datos. Finalmente, se midieron los valores del torque de remoción (RTV) de los implantes. Resultados: Los valores de RFA no se reflejaron en los ITVs, mientras que los RTVs de los implantes fueron ligeramente más bajos que los ITVs. No se pudieron obtener correlaciones entre los valores de RFA y los ITVs o RTVE. Las tensiones máximas alrededor de los implantes cargados variaron entre ,100 ,, y ,550 ,, bajo 25 N a 100 N. Los valores de las tensiones axiales y laterales de los implantes posteriores de ambos lados fueron mayores que aquellos implantes anteriores bajo todas las cargas (P<0.05). [source]

Increased bone formation around coated implants

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 8 2009
Bernd Stadlinger
Abstract Aim: We hypothesized that coating threaded, sandblasted acid-etched titanium implants with collagen and chondroitin sulphate (CS) increases bone formation and implant stability, compared with uncoated controls. Materials and Methods: Three different implant surface conditions were applied: (1) sandblasted acid-etched (control), (2) collagen/chondroitin sulphate (low-dose , CS1), (3) collagen/chondroitin sulphate (high-dose , CS2). Sixty 9.5 mm experimental implants were placed in the mandible of 20 minipigs. Bone,implant contact (BIC) and relative peri-implant bone-volume density (rBVD , relation to bone-volume density of the host bone) were assessed after 1 and 2 months of submerged healing. Implant stability was measured by resonance frequency analysis (RFA). Results: After 1 month, coated implants had significantly more BIC compared with controls (CS1: 68%, p<0.0001, CS2: 63%, p=0.009, control: 52%). The rBVD was lower for all surface conditions, compared with the hostbone. After 2 months, BIC increased for all surfaces. No significant differences were measured (CS1: 71%, p=0.016, CS2: 68%, p=0.67, control: 63%). The rBVD was increased for coated implants. RFA values were 71,77 at implantation, 67,73 after 1 month and 74,75 after 2 months. Differences in rBVD and RFA were not statistically significant. Conclusions: Data analysis suggests that collagen/CS has a positive influence on bone formation after 1 month of endosseous healing. [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]

Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placement

JOURNAL OF ORAL REHABILITATION, Issue 12 2006
I. TURKYILMAZ
summary, The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty-five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751·4 ± 256 HU and 39·7 ± 7 Ncm for 158 implants. The average primary implant stability was 73·2 ± 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0·001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre-surgical CT diagnosis. [source]

Implant stability measurements using resonance frequency analysis: biological and biomechanical aspects and clinical implications

PERIODONTOLOGY 2000, Issue 1 2008
Lars Sennerby
First page of article [source]

RFA Values of Implants Placed in Sinus Grafted and Nongrafted Sites after 6 and 12 Months

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2009
Marco Degidi MD
ABSTRACT Background: Maxillary sinus floor elevation surgery is widely used as a preimplantology method to permit implant insertion. Nevertheless, very few data are available about long-term stability of dental implants inserted in grafted sites. Purpose: The aims of the present study were to evaluate the evolution of resonance frequency analysis (RFA) values at 6 and 12 months from the implant insertion in sinus grafted sites and nongrafted sites. Materials and Methods: In 14 patients, 80 Xive implants (Dentsply Friadent GmbH, Mannheim, Germany) were inserted. Sixty-three implants were inserted in a site previously treated with a sinus lift; 17 implants were inserted in healed or postextraction sites. For each implant diameter, length, bone density, insertion torque, and percentage of implant fixed to a nongrafted bone were recorded. RFA values at implant insertion after 6 and 12 months were recorded. Results: After 6 and 12 months, grafted sites showed higher RFA values than the control sites; after 12 months, the difference was statistically significant (.007). A statistically significant positive correlation was found between resonance frequency values and bone quality after 12 months (.05). No statistically significant correlation between RFA values and all the other variables considered was found. Conclusions: Sites treated with sinus lift can offer good long-term stability. After 6 and 12 months, the geometric characteristics of the implant are no longer important to obtain high RFA values, and the bone,implant interface seems to be determinant. [source]

Bone Reformation and Implant Integration following Maxillary Sinus Membrane Elevation: An Experimental Study in Primates

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006
Vinicius C Palma DDS
ABSTRACT Background:, Recent clinical studies have described maxillary sinus floor augmentation by simply elevating the maxillary sinus membrane without the use of adjunctive grafting materials. Purpose:, This experimental study aimed at comparing the histologic outcomes of sinus membrane elevation and simultaneous placement of implants with and without adjunctive autogenous bone grafts. The purpose was also to investigate the role played by the implant surface in osseointegration under such circumstances. Materials and Methods:, Four tufted capuchin primates had all upper premolars and the first molar extracted bilaterally. Four months later, the animals underwent maxillary sinus membrane elevation surgery using a replaceable bone window technique. The schneiderian membrane was kept elevated by insertion of two implants (turned and oxidized, Brånemark System®, Nobel Biocare AB, Göteborg, Sweden) in both sinuses. The right sinus was left with no additional treatment, whereas the left sinus was filled with autogenous bone graft. Implant stability was assessed through resonance frequency analysis (OsstellTM, Integration Diagnostics AB, Göteborg, Sweden) at installation and at sacrifice. The pattern of bone formation in the experimental sites and related to the different implant surfaces was investigated using fluorochromes. The animals were sacrificed 6 months after the maxillary sinus floor augmentation procedure for histology and histomorphometry (bone-implant contact, bone area in threads, and bone area in rectangle). Results:, The results showed no differences between membrane-elevated and grafted sites regarding implant stability, bone-implant contacts, and bone area within and outside implant threads. The oxidized implants exhibited improved integration compared with turned ones as higher values of bone-implant contact and bone area within threads were observed. Conclusions:, The amount of augmented bone tissue in the maxillary sinus after sinus membrane elevation with or without adjunctive autogenous bone grafts does not differ after 6 months of healing. New bone is frequently deposited in contact with the schneiderian membrane in coagulum-alone sites, indicating the osteoinductive potential of the membrane. Oxidized implants show a stronger bone tissue response than turned implants in sinus floor augmentation procedures. [source]

Report of a Case Receiving Full-Arch Rehabilitation in Both Jaws Using Immediate Implant Loading Protocols: A 1-Year Resonance Frequency Analysis Follow-Up

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2006
Michael Portmann DDS
ABSTRACT Background:, Immediate occlusal implant loading has been documented as a viable treatment option for various indications. However, documentations related to full-arch rehabilitation are usually limited to treatment of one jaw at a time, thereby leaving the opposing dentition unchanged. Furthermore, clinical documentation using traditional, well-accepted measuring techniques may not be adequate when it comes to short-term evaluation of the success or failure of implants subjected to immediate occlusal loading. Purpose:, The purpose of this case report is to (1) present an implant stability follow-up of a patient receiving an immediate, implant-supported full-arch rehabilitation in both jaws and (2) evaluate the patient's acceptance of this rehabilitation. Materials and Methods:, A 68-year-old patient scheduled for implant treatment was selected for an immediate implant loading protocol in both jaws. During two surgical events 3 weeks apart, eight maxillary and four mandibular Brånemark System® Mk IV TiUniteTM fixtures (Nobel Biocare AB, Göteborg, Sweden) were inserted and subsequently used to immediately support a cross-arch fixed prosthesis in the maxilla and a bar-retained overdenture in the mandible. Implant stability was recorded from the day of surgery periodically during a 1-year follow-up using resonance frequency analysis (RFA). Results:, At the 1-year follow-up, based on clinical, RFA, and radiographic evaluations, all implants and the reconstructions were classified as successful. All maxillary implants showed a decrease in the implant stability quotient (ISQ) value from the measurement at the time of surgery to the first follow-up, whereas two of four mandibular implants revealed an initial drop in stability. Irrespective of a specific ISQ level measured at implant surgery (ISQ range 53,74) and despite an initial decrease in stability, measurements recorded at the 12-month follow-up indicated similar stability levels for all maxillary implants (ISQ range 64,68) or the group of mandibular implants (ISQ range 72,75) but with a higher ISQ level for mandibular implants. Furthermore, the patient's acceptance of the immediate full-arch rehabilitation in both jaws was high. Conclusions:, The present case report demonstrates that a slightly staged approach for full-arch rehabilitation in both jaws using immediate implant loading protocols is a realistic treatment option. Furthermore, RFA follow-up indicates that immediately occlusally loaded implants placed in reduced bone quality and quantity are more prone to loose stability in the early healing period compared with implants placed in dense bone quality. [source]

Implant Stability during Initiation and Resolution of Experimental Periimplantitis: An Experimental Study in the Dog

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2005
Lars Sennerby DDS
ABSTRACT Background: Histologic studies have demonstrated the possibility to reestablish direct bone-implant contacts after ligature-induced periimplantitis. The influence of the reosseointegration on the stability of implants is not known. Purpose: The aim of the present investigation was to study bone tissue and associated implant stability alterations that occurred during induction and resolution of periimplantitis using resonance frequency analysis (RFA), radiography, and histology. Materials and Methods: Three implants with smooth (turned) or roughened (SLA®) surfaces were placed in each side of the edentulous mandible of four dogs. Experimental periimplantitis was induced for 3 months. Five weeks later, the animals were treated with antibiotics and surgical therapy and were followed for another 6 months. Periapical radiographs and RFA were used to evaluate marginal bone levels and implant stability throughout the study period. After termination, the tissue-implant interface was evaluated by light microscopy in ground sections. Results: There was a linear relationship between radiographic and RFA findings because continuous loss of marginal bone and a decrease in implant stability were observed for both implant surfaces during the periimplantitis period. Antibiotic treatment and surgical therapy resulted in some reosseointegration, which was more marked for the SLA surface. The resonance frequency values corresponded well to the histometric measurements because reosseointegration resulted in an increase in implant stability. Conclusions: The findings from the present study indicate a linear relationship between marginal bone level and resonance frequency value. It is suggested that the RFA technique is sensitive and may be used to detect even a minor change in the level of bone-implant contact. [source]

Stability Measurements of Osseointegrated Implants Using Osstell in Partially Edentulous Jaws after 1 Year of Loading: A Pilot Study

CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 3 2002
Piero Balleri MD
ABSTRACT Background: The introduction of resonance frequency analysis (RFA) as a commercially available technique has made it possible to measure implant stability in implant stability quotient (ISQ) units at any time during the course of implant treatment and loading. However, no information on normal ISQ levels can be found in the literature. Purpose: The aim of this pilot study was to measure the stability of clinically successful implants in partially edentulous patients after 1 year of loading and to study the influence of jaw, anterior/posterior position, implant length, and marginal bone level on implant stability. Materials and Methods: Fourteen partially edentulous patients previously treated with 45 implants were subjected to clinical and radiographie evaluations and RFA measurements using Osstell (Integration Diagnostics, Sävedalen, Sweden) after 1 year of loading. Results: All 45 implants were stable, and implant stability levels were in the range of 57 to 82 ISQ units with a mean of 69 ± 6.5 ISQ after 1 year of loading. Mandibular implants were more stable than were maxillary ones. There were no differences between anterior and posterior implants. No correlation could be found between implant length and stability. Only minor marginal bone resorption was observed. Conclusions: The results from this limited material showed that successfully integrated implants have ISQ levels from 57 to 82 ISQ with a mean of 69 ISQ after 1 year of loading. Mandibular implants are more stable than are maxillary ones. High implant stability can be achieved with short implants and placement in posterior regions. [source]

Effects of Implant Design and Surface on Bone Regeneration and Implant Stability: An Experimental Study in the Dog Mandible

Resonance frequency measurements in vivo and related surface properties of magnesium-incorporated, micropatterned and magnesium-incorporated TiUnite®, Osseotite®, SLA® and TiOblast® implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 10 2009
Young-Taeg Sul
Abstract Objective: To investigate implant stability using resonance frequency measurements of topographically changed and/or surface chemistry-modified implants in rabbit bone. Material and methods: Six groups of microstructured, screw-shaped titanium implants: two oxidized, cation-incorporated experimental implants [Mg implants and MgMp implants with micropatterned thread flanges (80,150 ,m wide and 60,70 ,m deep)] and four commercially available clinical implants (TiUnite®, Osseotite®, SLA®, and TiOblast®) were installed in 10 rabbit tibia for 6 weeks. The surface properties of the implants were characterized in detail using several analytical techniques. Implant stability was measured using a resonance frequency analyzer (OsstellÔ). Results: Surface characterization of the implants revealed microstructured, moderately rough implant surfaces varying 0.7,1.4 ,m in Sa (mean height deviation), but with clear differences in surface chemistry. After 6 weeks, all implants showed statistically significantly higher increases in implant stability. When compared with one another, MgMp implants showed the most significant mean implant stability quotient (ISQ) value relative to the others (P,0.016). In terms of increment (,ISQ) in implant stability, MgMp implants showed a significantly greater value as compared with Osseotite® (P,0.005), TiOblast® (P,0.005), TiUnite® (P,0.005), SLA® (P,0.007), and Mg implants (P,0.012). In addition, transducer direction dependence of resonance frequency analysis (RFA) measurements was observed such that the differences in the mean ISQ values between longitudinal and perpendicular measurements were significant at implant placement (P,0.004) and after 6 weeks (P,0). Conclusion: The present study found that implant surface properties influence RFA measurements of implant stability. Surface chemistry-modified titanium implants showed higher mean ISQ values than did topographically changed implants. In particular, cation (magnesium)-incorporated micropatterns in MgMp implants may play a primary role in ,ISQ. [source]

Fresh-frozen vs. embalmed bone: is it possible to use formalin-fixed human bone for biomechanical experiments on implants?

CLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2009
Ayhan Cömert
Abstract Purpose: As formalin is an extremely reactive electrophilic chemical that reacts with tissues, the purpose of this study was to explore whether formalin fixation could potentially alter the mechanical properties of bone tissue and have an effect on the primary stability measurements of implants. Material and methods: ,3.3 × 8 mm, ,4.1 × 8 mm, and ,4.8 × 8 mm implants were placed on sockets prepared into the anterior surface of the radius of two fresh-frozen human cadavers. The insertion torque of each implant was quantified using a strain-gauged torque-wrench connected to a data acquisition system at a sample rate of 10 KHz, and resonance frequency analysis measurements were also undertaken for each implant. The cadavers were then subjected to embalment with 10% formalin for 3 months, and the same experiments were undertaken on the contra lateral radius of the cadavers. Results: The insertion torques before and after chemical fixation were similar for ,3.3 mm (P>0.05), and higher values were obtained for ,4.1 mm and ,4.8 mm implants after chemical fixation (P<0.05). The resonance frequency analysis values before and after chemical fixation were similar for all implants (P>0.05). Conclusions: Implants have higher insertion torque values in formalin-fixed bone than fresh-frozen human bone, but similar implant stability quotients in both cases. The insertion torque technique can detect the difference between formalin-fixed and fresh-frozen human bone, but resonance frequency analysis cannot. [source]

Implant stability during osseointegration in irradiated and non-irradiated minipig alveolar bone: an experimental study

CLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2008
Henk W. D. Verdonck
Abstract: Objectives: Primary implant stability is related to local bone density. After insertion of an implant, implant stability is subject to changes due to bone remodeling. In patients who have undergone radiotherapy in the head and neck region, implant stability is impaired because irradiation reduces bone vitality. The current study was designed to monitor and test implant stability immediately after implant placement and during osseointegration in irradiated and non-irradiated minipig alveolar bone. Materials and methods: All maxillary and mandibular premolars and molars of six adult Göttingen minipigs were extracted. The maxilla and mandible of three minipigs received three irradiation exposures at a total dose of 24 Gy. After irradiation, five initial implant holes were drilled in the residual alveolar ridge of each edentulous site. In order to assess bone vascularity, laser Doppler flowmetry recordings were carried out in the initial holes. A total of 120 implants were placed in the six minipigs. Subsequently, and at 8, 16, and 24 weeks after implant placement, implant stability was recorded by resonance frequency analysis (RFA). RFA values were expressed as an implant stability quotient (ISQ). Results: ISQ values recorded immediately after implant placement showed no differences between irradiated and non-irradiated minipigs. Repeated measurements at the four recording moments showed a decrease of ISQ values in all minipigs, being more pronounced in irradiated bone, when compared with non-irradiated bone. The results at the third and fourth recording moments showed a stabilization or even a slight increase of ISQ values. Conclusions: The results document the negative effect of irradiation on bone vascularity and hence on implant stability. [source]

Relevance of resonance frequency analysis to evaluate dental implant stability: simulation and histomorphometrical animal experiments

Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation

Positive effect of early loading on implant stability in the bi-cortical guinea-pig model

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2005
Els De Smet
Abstract: Loading, early after implant placement, has gained rapid interest in dentistry. Primary implant stability, as e.g. defined by resonance frequency instrumentation, has been isolated as a predicator when immediate and early implant loading is applied. The aim of this study was to investigate the effect of early (after 7 days) mechanical loading on the establishment of osseointegration by means of resonance frequency analysis (RFA). Percutaneous titanium implants were installed in both tibiae of 10 guinea-pigs. One week after implant installation, one implant (test) was loaded daily for 6 weeks, while the contra-lateral served as the unloaded one (control). A sinusoidally varying bending moment was applied at a frequency of 3 Hz and a force amplitude of 5 N, for 1800 cycli. Resonance frequency was measured at implant installation and from then on weekly using the RFA-device (Osstell®). Contrary to control implants, that showed a decrease in stability 1 week after installation, reaching a minimum at 3 weeks (,200 Hz), test implants showed a progressive increase in stability over time. After 6 weeks, the mean resonance frequency of test and control implants reached the same values. As confirmed by recent literature, early loading does not have to endanger the establishment of osseointegration of titanium implants. On the contrary, controlled loading is beneficial to maintain the implant stability during the early critical healing period as determined by RFA-measurements. Résumé La mise en charge précoce après l'insertion de l'implant acquière beaucoup d'intérêt en médecine dentaire. La stabilité primaire de l'implant, qui est par exemple définie par l'instrumentation de fréquence de résonnance RFA, a été isolée comme un annonciateur lorsque la mise en charge de l'implant était précoce ou immédiate. Le but de cette étude a été d'étudier l'effet d'une mise en charge précoce (sept jours) sur l'établissement de l'ostéïntégration à l'aide de RFA (Osstell®). Des implants titane percutanés ont été insérés dans les deux tibias de dix cobayes. Une semaine après le placement des implants, un implant test a été mis en charge tous les jours pendant six semaines tandis que le contralatéral servait de contrôle et n'était pas mis en charge. Un moment sinusoïdal a été appliquéà une fréquence de trois hertz et une amplitute d'une force de 5 N pour 1 800 cycles. La fréquence de résonnance a été mesurée lors de l'insertion de l'implant et ensuite hebdomadairement en utilisant le RFA. Contrairement aux implants contrôles, qui accusaient une diminution de la stabilité une semaine après leur insertion atteignant un minimum après trois semaines (,200 Hz), les implants tests ont montré une augmentation progressive de la stabilité avec le temps. Après six semaines, la fréquence de résonnance moyenne des implants tests et contrôles atteignaient les mêmes valeurs. Comme décrit dans la littérature récente, la mise en charge précoce ne met pas en danger l'établissement de l'ostéoïntégration des implants en titane. Au contraire, une mise en charge contrôlée est bénéfique au maintien de la stabilité implantaire durant la période de guérison critique précoce comme déterminée par les mesures RFA. Zusammenfassung Die Belastung kurz nach der Implantatplatzierung hat in der Zahnmedizin schnell an Interesse gewonnen. Die Primärstabilität der Implantate, bestimmt z.B. durch Messung der Resonanzfrequenz, hat sich als Voraussagewert herauskristallisiert, wenn eine Sofort-oder Frühbelastung der Implantate durchgeführt wird. Das Ziel dieser Studie war, den Einfluss der frühen (nach 7 Tagen) mechanischen Belastung auf die Ausbildung der Osseointegration mittels Resonanzfrequenzanalyse (RFA) zu untersuchen. In die beiden Tibias von 10 Meerschweinchen wurden perkutane Titanimplantate eingesetzt. Eine Woche nach der Implantation wurde ein Implantat (Test) während 6 Wochen täglich belastet, während das kontralaterale Implantat unbelastet blieb (Kontrolle). Es wurde ein Biegemoment mit sinusoidalen Schwankungen mit einer Frequenz von 3 Hz und einer Kraftamplitude von 5 N in 1800 Zyklen appliziert. Die Resonanzfrequenz wurde nach der Implantation und dann wöchentlich mit einem RFA-Gerät (Osstell®) gemessen. Im Gegensatz zu den Kontrollimplantaten, welche eine Woche nach dem Setzen eine Stabilitätsabnahme zeigten und das Minimum nach drei Wochen (,200 Hz) erreichten, konnte bei den Testimplantaten eine progressive Zunahme der Stabilität über die Zeit beobachtet werden. Nach sechs Wochen erreichten die mittleren Resonanzfrequenzen der Test-und Kontrollimplantate dieselben Werte. Die frühe Belastung gefährdet die Ausbildung einer Osseointegration bei Titanimplantaten nicht, was auch durch die neuere Literatur bestätig wird. Im Gegenteil, eine kontrollierte Belastung ist von Vorteil für den Erhalt der Implantatstabilität während der kritischen frühen Einheilphase. Dies konnte mittels RFA Messungen ermittelt werden. Resumen La carga temprana tras la colocación del implante ha ganado rápidamente interesen odontología. Se ha aislado como predictor, la estabilidad primaria del implante, definida por instrumentación de frecuencia de resonancia, cuando se aplica la carga temprana al implante. La intención del estudio fue investigar el efecto de carga mecánica temprana (tras 7 días) en el establecimiento de la osteointegración por medio del análisis de la frecuencia de resonancia (RFA). Se instalaron implantes de titanio percutaneos en ambas tibias de 10 conejos de indias. Una semana tras la instalación, un implante (prueba) se cargó diariamente durante 6 semanas, mientras que el contralateral sirvió como el implante sin carga (control). Se aplicó un momento de flexión variante sinusoidalmente a una frecuencia de 3 Hz y una amplitud de la fuerza de 5 N, durante 1899 ciclos. Se midió la frecuencia de resonancia al instalar el implante y a partir de ahí semanalmente usando el dispositivo RFA (Ostell®). Contrariamente a los implantes de control, que mostraron una disminución de la estabilidad una semana después de la instalación, alcanzando un mínimo a las tres semanas (,200 Hz), los implantes de prueba mostraron un incremento progresivo de la estabilidad a lo largo del tiempo. Tras seis semanas, la frecuencia de resonancia de los implantes de prueba y de control alcanzaron los mismos valores. Tal como se confirma por la literatura reciente, la carga temprana no debe hacer peligrar el establecimiento de la osteointegración de los implantes de titanio. Por lo contrario, la carga controlada es beneficiosa para mantener la estabilidad de los implantes durante el periodo crítico de la cicatrización determinado por las mediciones de RFA. [source]

Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants

CLINICAL ORAL IMPLANTS RESEARCH, Issue 4 2004
Dominic O'Sullivan
Abstract Objectives: The study presented was designed to analyse the mechanical performance and the primary and secondary stability characteristics of endosseous titanium implants with 1° (EXP1) and 2° (EXP2) of taper when compared with the standard Brånemark design (Nobel Biocare AB, Gothenburg, Sweden). Materials and methods: One pair of 10 mm EXP1 and control implants were placed in the femoral condyles of six rabbits. Paired 6 mm EXP1 and control implants and 6 mm EXP2 and control implants were placed in the tibial metaphysis. The control implants used were 4 mm diameter standard Brånemark implants, the same length as the test implants. At placement, insertion torque (IT) and resonance frequency analysis (RFA) measurements were performed. Six weeks postoperatively when the animals were killed, RFA and removal torque (RT) measurements were made. Results: At placement, significantly higher IT was needed to insert the EXP implants compared with the controls. RFA values were significantly higher for EXP1 implants placed in the tibia but not in the femur. In pooling data from the femur and tibia there was a significant difference. The EXP2 implants failed to insert fully and demonstrated a lower RFA value than may have been expected due to the exposed threads, although this difference was not statistically significant. Conclusions: The results from the present study showed that 1° of taper results in a better primary stability compared with the standard Brånemark design. There was no evidence that the tapered design caused negative bone tissue reactions. All the implants gained in stability during the healing period. Résumé L'étude présente a été effectuée pour analyser la performance mécanique et les caractéristiques de stabilité primaire et secondaire d'implants endoosseux en titane avec un taper (fuselé) 1° (EXP1) et 2 (EXP 2) comparés au modèle ad modum Branemark® standard. Une paire d'implants contrôles et un EXP1 de 10 mm ont été placés dans les condyles fémoraux de six lapins. Des paires d'implants contrôles et EXP1 de 6 mm et des implants contrôles et EXP2 de 6 mm ont été placés dans les métaphyses tibiales. Les implants contrôles utilisés avaient un diamètre standard de 4 mm, la même longueur que les implants tests. Lors du placement, des mesures de force d'insertion (IT) et d'analyse de fréquence de résonnance (RFA) ont été effectuées. Six semaines après l'opération lorsque les animaux ont été euthanasiés, les mesures RFA et les forces d'enlèvement (RT) ont été relevées. Lors du placement un IT significativement plus important a été nécessaire pour insérer les implants EXP1 comparé au contrôle. Les valeurs RFA étaient significativement plus importantes pour les implants EXP1 placés dans le tibia mais pas dans le fémur. En rassemblant les données du fémur et du tibia il y avait une différence significative. Les implants EXP2 ne parvenaient pas àêtre insérés à fond et ont montré une valeur RFA inférieure qui n'était pas inattendue vu les filetages exposés bien que ces différences n'étaient pas statistiquement significatives. Les résultats de l'étude présente ont montré que le taper 1 résultait en une stabilité primaire supérieure comparé au modèle ad modum Branemark® standard. Il n'y avait aucun signe que ce nouveau modèle causait des réactions tissulaires osseuses négatives. Tous les implants ont gagné en stabilité durant leur période de guérison. Zusammenfassung Ziele: Die hier vorgestellte Studie hatte zum Ziel, das mechanische Verhalten und die Charakteristika von Primär- und Sekundärstabilität bei enossalen Implantaten mit einer Gewindeneigung von 1° (EXP1) und von 2° (EXP2) zu untersuchen. Man verglich die Daten mit dem Standarddesign von Brånemark (Nobel Biocare AB, Gothenburg, Schweden). Material und Methode: Man implantierte ein Päärchen von 10mm-Implantaten (EXP1 und Kontrollimplantat) in die Femurkondylen von 6 Kaninchen. Zwei weitere Päärchen von 6mm-Implantaten (EXP1 und Kontrollimplantat, sowie EXP2 und Kontrollimplantat) implantierte man in die Metaphyse der Tibia. Bei den Kontrollimplantaten handelte es sich um Standardtypen von Brånemark mit einem Durchmesser von 4 Millimetern und derselben Länge wie die Testimplantate. Bei der Implantation mass man die Kraft, die es zu Eindrehen der Implantate brauchte (IT) und führte Messungen mit der Resonanzfrequenzanalyse (RFA) durch. Sechs Wochen nach der Operation wurden die Tiere geopfert, die RFA erneut durchgeführt und anschliessend der Ausdrehwiderstand (RT) bestimmt. Resultate: Bei der Implantation brauchte es signifikant grössere IT um die EXP-Implantate einzusetzen, als bei den Kontrollimplantaten. Die RFA-Werte waren bei den EXP1-Implantaten, die in die Tibia geschraubt worden waren, signifikant höher. Dies gilt aber nicht für die in den Femur geschraubten Implantate. Wurden die Daten vom Femur mit denen der Tibia verglichen, so erkannte man signifikante Unterschiede. Die EXP2-Implantate konnten nicht vollständig inseriert werden und zeigten auch tiefere RFA-Werte, als man den freiliegenden Schraubenwindungen entsprechend erwarten könnte. Diese Unterschiede waren aber nicht statistisch signifikant. Zusammenfassung: Die Resultate dieser Studie zeigten, das Schraubenwindungen mit 1° Steigung verglichen mit dem Standarddesign von Brånemark eine bessere Primärstabilität erzielten. Man fand andererseits keine Beweise, dass sich dieses neue Design der Schraubenwindungen negativ auf die Reaktion des Knochengewebes auswirkt. Alle Implantate gewannen während in der Heilphase an Stabilität dazu. Resumen Objetivos: El estudio presentado se diseñó para analizar el rendimiento mecánico y las características de estabilidad primaria y secundaria de implantes endoóseos de titanio con 1o (EXP1) y 2o (EXP 2) de autoroscado al compararlos con el diseño estándar de Brånemark (Nobel Biocare AB, Gothenburg, Suecia). Material y Métodos: Se colocó una pareja de implantes de 10 mm EXP1 y de control en los cóndilos femorales de 6 conejos. Se colocaron pareja de implantes de 6 mm EXP1 y de control y de 6 mm EXP2 y de control en la metáfisis tibial. Los implantes de control utilizados fueron Brånemark estándar de 4 mm de diámetro. A la colocación, se llevaron a cabo mediciones del torque de inserción (IT) y del análisis de la frecuencia de resonancia (RFA). Los animales se sacrificaron a las seis semanas de la operación, y se tomaron medidas del torque de remoción (RT). Resultados: Al colocarse, se necesitó un IT significativamente mas alto para insertar los implantes EXP en comparación con los de control. Los valores RFA fueron significativamente mas altos para implantes EXP1 colocados en la tibia pero no en el fémur. Confrontando los datos del fémur y de la tibia apareció una diferencia significativa. Los implantes EXP2 fracasaron en insertarse completamente y demostraron un menor valor de RFA del que se podía esperar debido a la exposición de las roscas, aunque esta diferencia no fue estadísticamente significativa. Conclusiones: Los resultados del presente estudio mostraron que 1o de autoroscado resultan en una mejor estabilidad primaria comparada con el diseño estándar de Brånemark. No hubo evidencia de que el diseño de autoroscado causara reacciones negativas en el tejido óseo. Todos los implantes ganaron estabilidad durante el periodo de cicatrización. [source]