Abstract
ObjectiveBone augmentation delays implant placement and increases risks due to additional surgeries. Implant systems compatible with reduced alveolar bone volume are required. To design, manufacture, and test a non‐cylindrical dental implant system using piezotomes and custom‐designed matching titanium mini‐implants to address the needs of patients with missing teeth and narrow jawbone.Materials and methodsTapered mini‐implants with a rectangular cross‐section (4.6 mm × 2.1 mm) were machined with dimensions that could accommodate narrow alveolar ridges. The performance of the implants were tested in both static and fatigue cycle 30° compression tests. Tapered, rectangular cutting tools that matched the overall trapezoidal morphology of the implant were also designed. These novel tools were engineered to be compatible with commercially available piezoelectric osteotomes. Tools were optimized using finite element analysis and were manufactured accordingly and were used by a periodontal surgery team in a pork rib bone model to monitor utility of the device and ease of use.ResultsThe rectangular design of the implant allows for a full occlusal load due to the larger implant flexural rigidity compared to a similar diameter mini‐implant with a standard cylindrical design. During 30° compression fatigue tests, the implant tested at 340 N did not fail after 5M cycles as shown in Kaplan‐Meier survival curves. Finite element analysis allowed for functional optimization of the roughing and finishing tools. In the pork rib model, these tools successfully cut trapezoidal holes that matched the dimensions of the implant.ConclusionsThe implant system here demonstrates the feasibility of a mini‐implant system that has superior flexural rigidity and potentially circumvents the need for patient bone augmentation.
Highlights
A recent systematic review of the literature estimates that the average reduction in alveolar bone width is 3.87 mm, and the average reduction of alveolar bone height is 1.67 mm 1 year after tooth extraction (Van der Weijden, Dell'Acqua, & Slot, 2009)
To address the shortcomings of currently available implants, we have developed a PiezoImplant system based on the notion that the implant should match the shape of the available bone, eliminating the need for bone augmentation
Definitions in the literature vary, at 2.1-mm wide, our PiezoImplant is categorized as extra-narrow (
Summary
Tooth loss leads to local resorption of the alveolar bone. This part of the jawbone follows the “use it or lose it” principle. An available alternative to bone grafting in patients with narrow alveolar bone is to forego implant restoration altogether and restore missing teeth with a bridge or removable denture. A piezotome is a miniature bone saw vibrating at ultrasonic frequencies and submillimeter amplitudes It is currently used in bone surgery for small and precise cuts and in areas where sparing soft tissues is critical. We envision that our PiezoImplant would shorten treatment time by 6 months; present a minimally invasive option to patients; provide significant cost savings; require less specialized skill to implant; and offer increased implant stability due to the observed increased bone density around piezotome cuts in alveolar bone of orthodontic patients. We present the design of the implant and piezo cutting tools, fatigue testing of the implant, and performance of the cutting tools
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