Percentage Of Bone-to-implant Contact Research Articles

Three-dimensional radiographic assessment of immediate implant placement in the posterior mandible: A novel parameter-based classification

ObjectivesTo assess the implant position (IP), the interradicular septum width (ISW) and radiographic bone to implant contact (BIC), when simulating an immediate implant placement in first and second mandibular molars. Study Design75 patients (150 sites) were studied using cone beam computed tomography scans (CBCT) and computer aided design software. Implants were placed in a prosthetically driven position; subsequently, IP and BIC were digitally calculated. Linear ISW was also analyzed at 2, 4 and 6mm apically to the highest septal bony peak.Multiple linear regressions were performed to assess relationships between BIC and the different predictive variables. Additionally, the receiver operating characteristics (ROC) curve was used to create a model for BIC based on the ISW at 2mm. ResultsBIC in implants replacing first molars was the highest at the septal (S) position when compared to those in septal-mesial (S–M) position (p-value 0.001). As for the second molar, the highest percentage of BIC was recorded at the septal (S) position, followed by those in S–M and mesial (M) positions (p<0.001). ConclusionAccording to the proposed classification, clinician must consider the ISW and IP when placing immediate implant in the first and second mandibular molar sites. When tackling first molars, S position is predominant, while S–M position is the most common in the second molars. ISW at 2mm should be at least respectively 2mm and 2.5mm at the first and second molar sites to achieve 50% of BIC.

Osseointegration of Tantalum Trabecular Metal in Titanium Dental Implants: Histological and Micro-CT Study.

This study aimed to investigate the impact of the Tantalum Trabecular Metal dental implant design on implant stability and the process of osseointegration following its placement in the rabbit femoral condyle. The subjects for the experiment consisted of 10 New Zealand white rabbits. Twenty implants, comprising 10 Trabecular Metal (TM) and 10 Traditional Screw Vent (TSV) implants, were placed into the femoral condyles of these rabbits. The implant type was alternated based on a random sequence. Following a healing period of 8 weeks, the implants were retrieved for further analysis using micro-computed tomography (micro-CT), histological studies, and histomorphometry evaluations. The Bone-to-Implant Contact (BIC) ratio and the Bone Volume (BV) percentage in the region of interest were subsequently assessed. The BIC and BV values between TM and TSV implants were compared using the Student t-test. The TM implants exhibited significantly greater BIC and BV scores. In particular, the BIC percentage was recorded as 57.9 ± 6.5 for the TM implants, as opposed to 47.6 ± 8 for the TSV implants. Correspondingly, the BV percentage was 57 ± 7.3 for the TM implants and 46.4 ± 7.4 for the TSV implants. The bone volume percentage measured using micro-CT evaluation was 89.1 ± 8.7 for the TM implants and 79.1 ± 8.6 for the TSV implants. Given the observed results, it is plausible to suggest that the bone growth surrounding the tantalum mesh could have improved the integration of the bone and facilitated its ingrowth into the TM implant.

Effects of Implant Diameter on Implant Stability and Osseointegration in the Early Stage in a Dog Model.

Purpose: To determine the optimal implant diameter under limited bone width by comparing the effects of implants with different diameters on implant stability, peri-implant bone stability, and osseointegration. In addition, to evaluate the reliability of resonance frequency analysis (RFA) in detecting osseointegration and marginal bone level (MBL). Materials and Methods: Mandibular premolars and first molars of seven beagle dogs were extracted. After 8 weeks, their mandibular models and radiographic information were collected to fabricate implant templates. Implant sites were randomly divided into three groups according to diameter: Ø3.3, Ø4.1, and Ø4.8 mm. Implant stability quotient (ISQ) measurement and radiographic evaluation were performed after surgery (baseline) and at 4, 8, and 12 weeks. Three dogs were euthanized at 4 weeks to observe osteogenesis and implant-tissue interface biology. Four dogs were euthanized at 12 weeks to observe osseointegration. Hard tissue sections were prepared to analyze osteogenesis (fluorescence double labeling) and osseointegration (methylene blue-acid fuchsin staining). Results: At baseline and at 4, 8, and 12 weeks, the ISQ values of Ø4.1- and Ø4.8-mm implants did not differ (P > .05), but both had higher values than the Ø3.3-mm implants (P < .05). The mean marginal bone resorption (MBR) associated with Ø3.3-, Ø4.1-, and Ø4.8-mm implants was 0.65 ± 0.58 mm, 0.37 ± 0.28 mm, and 0.73 ± 0.37 mm, respectively. The buccal MBR of Ø4.8-mm implants was significantly higher than that of Ø4.1-mm implants (P < .05). The bone-to-implant contact (BIC) percentage at 12 weeks did not differ for any group (P > .05). The correlation coefficients between the ISQ and MBL of the Ø3.3-, Ø4.1-, and Ø4.8-mm implants were -0.84 (P < .01), -0.90 (P < .001), and -0.93 (P < .001), respectively, while that between the ISQ and BIC was 0.15 (P > .05). Conclusions: During the early healing stage, the performance of Ø4.1- and Ø4.8-mm implants in terms of implant stability was better than that of Ø3.3-mm implants. Implant diameter may not influence BIC percentage. RFA can be used to evaluate implant stability and MBL but is not suitable to assess the degree of osseointegration.

Sequential osseointegration of a novel implant system based on 3D printing in comparison with conventional titanium implants

To evaluate the sequential osseointegration of a novel titanium implant system based on a 3D printing technology in comparison with conventional titanium implants. Two novel titanium implants based on 3D printing were tested in the mandible of eight Beagle dogs. As a control, two different commercially available titanium implants were used. The implants were staged to accommodate healing periods of 2 and 6 weeks. The primary outcome variable was bone-to-implant contact (BIC) in non-decalcified tissue sections and micro-CT analysis. Histomorphometrically, the proportions of tissues adjacent to the implant surfaces were similar for all implants, whereas the BIC percentage of new mineralized bone was greater for the control implants after both 2 and 6 weeks (p < .05). Micro-CT analysis revealed increasing osseous volume and BIC from 2 to 6 weeks. In contrast to the histomorphometry, the BIC evaluation with the micro-CT data revealed a significantly higher BIC for the two test implants compared with controls (p < .001). The analysis of the total implant surface area disclosed a value that was approximately double as high for the test compared to the control implants. The novel titanium implant system based on 3D printing yielded values for osseointegration that were adequate and satisfactory. The higher percentage of new mineralized bone in the control implants is explained by the fact of a completely different three-dimensional surface area.

Innovative implant design for continuous implant stability: A mechanical and histological experimental study in the iliac crest of goats

Objectivesthis in vivo study reports on mechanical torque data as well as the biological evaluation up to 6 weeks after placement of implants with a unique wide knife thread design in a goat iliac crest model. We hypothesized that implants with this thread design would show substantial primary stability at a continuous level toward secondary stability. Methods64 MegaGen Anyridge® implants were used with diameters 3.5 mm, 4.0 mm, 5.0 mm and 6.0 mm (n = 8). Implants were placed monocortically in the iliac crest of 16 healthy female Saanen goats, both on the right (for torque measurements) and left side (for histology/-morphometry). Torque-in at implant installation and torque-out at 2 and 6 weeks of implantation was measured, as well as bone-to-implant contact (BIC) and bone-area between the screw threads (BA). ResultsHistology showed intimate bone-to-implant contact with a maturating trabecular structure between 2 and 6 weeks. Torque values showed a dependency on implant diameter. For all implant diameters, torque-in values were similar to torque-out values at 2 weeks. At 6 weeks however, all torque-out values were significantly increased. BIC and BA percentages showed similar values for all diameters at both 2 and 6 weeks. ConclusionsThese results prove the absence of a lag-phase in implant stability for MegaGen Anyridge® implants in the goat iliac crest model. The increased torque-out values at 6 weeks without increasing BIC and BA percentages correlate with the observed maturation of bone-to-implant contact quality over time. Clinical significanceIt is a challenge to optimize implants with continuous primary stability and rapid transition into secondary stability to minimize the duration of the lag-phase. The results of this study prove the absence of a lag-phase in implant stability for MegaGen Anyridge® implants. Consequently, the data from this work are important for the treatment of individual patients ‘translating’ these findings into clinical implant procedures.

Hard tissue volumetric and soft tissue contour linear changes at implants with different surface characteristics after experimentally induced peri-implantitis: an experimental in vivo investigation.

To evaluate the hard tissue volumetric and soft tissue contour linear changes in implants with two different implant surface characteristics after a ligature-induced peri-implantitis. In eight beagle dogs, implants with the same size and diameter but distinct surface characteristics were placed in the healed mandibular sites. Test implants had an external monolayer of multi-phosphonate molecules (B+), while control implants were identical but without the phosphonate-rich surface. Once the implants were osseointegrated, oral hygiene was interrupted and peri-implantitis was induced by placing subgingival ligatures. After 16weeks, the ligatures were removed and peri-implantitis progressed spontaneously. Bone to implant contact (BIC) and bone loss (BL) were assessed three-dimensionally with Micro-Ct (μCT). Dental casts were optically scanned and the obtained digitalized standard tessellation language (STL) images were used to assess the soft tissue vertical and horizontal contour linear changes. Reduction of the three-dimensional BIC percentage during the induction and progression phases of the experimental peri-implantitis was similar for both the experimental and control implants, without statistically significant differences between them. Soft tissue analysis revealed for both implant groups an increase in horizontal dimension after the induction of peri-implantitis, followed by a decrease after the spontaneous progression period. In the vertical dimension, a soft tissue dehiscence was observed in both groups, being more pronounced at the buccal aspect. The added phosphonate-rich surface did not provide a more resistant environment against experimental peri-implantitis, when assessed by the changes in bone volume and soft tissue contours. Ligature-induced peri-implantitis is a validated model to study the tissue changes occurring during peri-implantitis. It was hypothesized that a stronger osseointegration mediated by the chemical bond of a phosphonate-rich implant surface would develop an environment more resistant to the inflammatory changes occurring after experimental peri-implantitis. These results, however, indicate that the hard and soft tissue destructive changes occurring at both the induction and progression phases of experimental peri-implantitis were not influenced by the quality of osseointegration.

Effects of ibuprofen-loaded TiO₂ nanotube dental implants in alloxan-induced diabetic rabbits.

PurposeSome systemic conditions, especially diabetes mellitus (DM), adversely affect dental implant success. This study aimed to investigate the effects of ibuprofen-loaded TiO2 nanotube (ILTN) dental implants in alloxan-induced diabetic rabbits.MethodsTwenty-six New Zealand white rabbits were treated with alloxan monohydrate to induce DM. At 2 weeks following DM induction, 3 types of implants (sandblasted, large-grit, and acid-etched [SLA], ILTN, and machined) were placed into the proximal tibia in the 10 rabbits that survived following DM induction. Each type of implant was fitted randomly in 1 of the holes (round-robin method). The animals were administered alizarin (at 3 weeks) and calcein (at 6 weeks) as fluorescent bone markers, and were sacrificed at 8 weeks for radiographic and histomorphometric analyses.ResultsTiO2 nanotube arrays of ~70 nm in diameter and ~17 μm in thickness were obtained, and ibuprofen was loaded into the TiO2 nanotube arrays. A total of 26 rabbits were treated with alloxan monohydrate and only 10 rabbits survived. The 10 surviving rabbits showed a blood glucose level of 300 mg/dL or higher, and the implants were placed in these diabetic rabbits. The implant stability quotient (ISQ) and bone-to-implant contact (BIC) values were significantly higher in the ILTN group (ISQ: 61.8, BIC: 41.3%) and SLA group (ISQ: 62.6, BIC: 46.3%) than in the machined group (ISQ: 53.4, BIC: 20.2%), but the difference in the BIC percentage between the SLA and ILTN groups was not statistically significant (P=0.628). However, the bone area percentage was significantly higher in the ILTN group (78.0%) than in the SLA group (52.1%; P=0.000).ConclusionsThe ILTN dental implants showed better stability (ISQ) and BIC than the machined implants; however, these values were similar to the commercially used SLA implants in the 2-week diabetic rabbit model.

Effects of the local administration of antibiotics on bone formation on implant surface in animal models: A systematic review and meta-analysis.

SummaryPurposeThis review aimed to evaluate the effects of the local delivery of antibiotics incorporated in implant surfaces on some quantitative parameters of bone formation.Materials and methodsAn electronic search was undertaken in three databases (PubMed, Scopus, Embase) in addition to hand searching. The search was limited to animal experiments using endosseous implants combined with localized antibiotics release. Meta-analyses were performed for the percentages of bone volume (BV) and bone-to-implant contact (BIC).ResultsNine studies met the inclusion criteria. Several methods were identified for local delivery of antibiotics at the bone-implant interface, but the most commonly used method was by coating (incorporating the implant surface with the antibiotic agents). Different antibiotic agents were used, namely bacitracin, doxycycline, enoxacin, gentamicin, minocycline, tobramycin, and vancomycin. There was no statistically significant difference in the percentage of BIC between implants with or without localized antibiotic release (P = 0.59). The meta-analysis revealed higher BV around implants coated with antibiotics compared to control groups (without antibiotics) (P < 0.01).ConclusionIt is suggested that the local administration of antibiotics around implants did not adversely affect the percentage of direct bone contact around implants, with a tendency for a slightly better bone formation around implants when combined with local administration of antibiotics. It is a matter of debate whether these in vivo results will have the same effect in the clinical setting. However, the risk of bias of these studies may, to some extent, question the validity of these results.

Comparison of bone-to-implant contact and bone volume around implants placed with or without site preparation: a histomorphometric study in rabbits

The objective of this in vivo study was to compare bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) values of a new implant, designed to be inserted without bone preparation, using two different preparation protocols: no site preparation and prior limited cortical perforation, versus the values of a control implant using a conventional drilling protocol. Forty-one implants were inserted in 13 rabbits. Thirteen test implants with a new thread design were inserted using no bone preparation (NP), 14 test implants were inserted with limited cortical perforation (CP), and 14 conventional implants served as control. Five animals were sacrificed after 21 days and eight animals after 42 days. Histomorphometric analysis was performed and percentage of BIC and BAFO values were measured. ANOVA with Tukey post hoc and Mann–Whitney nonparametric tests were calculated to compare between the groups. Statistical analysis showed no significant difference in the measured values between any of the groups, neither compered by implant nor by compered day. The results demonstrated that biological osseointegration parameters of implant that was inserted without any bone preparation was non-inferior compared to conventional preparation. The clinical relevance is that novel implant designs may not require bone preparation prior to placement.

Development of a Novel Nanotextured Titanium Implant. An Experimental Study in Rats.

This animal study evaluated the osseointegration level of a new nanotextured titanium surface produced by anodization. Ti-cp micro-implants (1.5 mm diameter by 2.5 mm in length) divided into two groups: titanium nanotextured surface treatment (Test Group) and acid etched surface treatment (Control Group). Surface characterization included morphology analysis using scanning electron microscopy and wettability by measuring contact angle. Sixteen Wistar rats were submitted to two micro implants surgical placement procedures. In each rat, one type of micro implant placed in each tibia. The animals sacrificed after two (T1) and six weeks (T2) post-implantation. After the euthanasia, tibias processed for histomorphometric analysis, which allowed the evaluation of bone to implant contact (BIC) and the bone area fraction occupancy between the threads (BAFO). Our surface analysis data showed that the Control Group exhibited an irregular and non-homogenous topography while the Test Group showed a nanotextured surface. The Test Group showed higher wettability (contact angle = 5.1 ± 0.7°) than the Control Group (contact angle = 75.5 ± 4.6°). Concerning the histomorphometric analysis results for T1, Control and Test groups showed BIC percentages of 41.3 ± 15.2% and 63.1 ± 8.7% (p < 0.05), respectively, and for BAFO, 28.7 ± 13.7% and 54.8 ± 7.5%, respectively (p < 0.05). For T2, the histomorphometric analysis for Control and Test groups showed BIC percentages of 51.2 ± 11.4% and 64.8 ± 7.4% (p < 0.05), respectively and for BAFO, 36.4 ± 10.3% and 57.9 ± 9.3% (p < 0.05), respectively. The findings of the current study confirmed that the novel nanotextured surface exhibited superior wettability, improved peri-implant bone formation, and expedited osseointegration.

Influence of Implant Length and Associated Parameters Upon Biomechanical Forces in Finite Element Analyses: A Systematic Review.

The aim of this systematic review is to provide an overview of finite element analyses comparing standard and short dental implants concerning biomechanical properties and to detect the most relevant parameters affecting periimplant stress concentrations. After screening the literature and assessment of studies, 36 studies were included in this review. Eighty-three percent of the studies state that short dental implants have to bear higher stress concentrations compared with standard length implants. At the same time, 44% of articles note that implant diameter can be considered a more effective design parameter than implant length to reduce stress concentrations and to avoid an overload of periimplant bone. Regardless of implant dimension, in all studies, the highest stress concentrations are found in the cortical section around the upper part of the implant. Unaffected of bone quality, implant diameter is found to play a key role to minimize periimplant stress concentrations. Concerning stress reduction implant length gains increasing relevance with decreasing bone density. Furthermore, splinting of short implants constitute an appropriate tool to avoid crestal overloading.

Effects of implant length and 3D bone-to-implant contact on initial stabilities of dental implant: a microcomputed tomography study

BackgroundThe influences of potential bone-to-implant contact (BIC) area (pBICA), BIC area (BICA), and three dimensional (3D) BIC percentage (3D BIC%; defined as BICA divided by pBICA) in relation to the implant length on initial implant stability were studied. Correlations between these parameters were also evaluated.MethodsImplants with lengths of 8.5, 10, 11.5, and 13 mm were placed in artificial bone specimens to measure three indexes of the initial implant stability: insertion torque value (ITV), Periotest value (PTV), and implant stability quotient (ISQ). The implants and bone specimens were also scanned by microcomputed tomography, and the obtained images were imported into Mimics software to reconstruct the 3D models and calculate the parameters of 3D bone-to-implant contact including pBICA, BICA, and 3D BIC%. The Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni adjustment, and Spearman correlations were applied for statistical and correlation analyses.ResultsThe implant length affected ITV more than PTV and ISQ, and significantly affected pBICA, BICA, and 3D BIC%. A longer implant increased pBICA and BICA but decreased 3D BIC%. The Spearman coefficients were high (>0.78) for the correlations between the three 3D BIC parameters and the three indexes of the initial implant stability.ConclusionspBICA, BICA, and 3D BIC% are useful when deciding on treatment plans related to various implant lengths, since these 3D BIC parameters are predictive of the initial implant stability.

A New Biphasic Dicalcium Silicate Bone Cement Implant.

This study aimed to investigate the processing parameters and biocompatibility of a novel biphasic dicalcium silicate (C2S) cement. Biphasic α´L + β-C2Sss was synthesized by solid-state processing, and was used as a raw material to prepare the cement. In vitro bioactivity and biocompatibility studies were assessed by soaking the cement samples in simulated body fluid (SBF) and human adipose stem cell cultures. Two critical-sized defects of 6 mm Ø were created in 15 NZ tibias. A porous cement made of the high temperature forms of C2S, with a low phosphorous substitution level, was produced. An apatite-like layer covered the cement’s surface after soaking in SBF. The cell attachment test showed that α´L + β-C2Sss supported cells sticking and spreading after 24 h of culture. The cement paste (55.86 ± 0.23) obtained higher bone-to-implant contact (BIC) percentage values (better quality, closer contact) in the histomorphometric analysis, and defect closure was significant compared to the control group (plastic). The residual material volume of the porous cement was 35.42 ± 2.08% of the initial value. The highest BIC and bone formation percentages were obtained on day 60. These results suggest that the cement paste is advantageous for initial bone regeneration.

Impacts of 3D bone-to- implant contact and implant diameter on primary stability of dental implant.

This study investigated the effects of three three-dimensional (3D) bone-to-implant contact (BIC) parameters-potential BIC area (pBICA), BIC area (BICA), and 3D BIC percentage (3D BIC%; defined as BICA divided by pBICA)-in relation to the implant diameter on primary implant stability, as well as their correlations were also evaluated. Dental implants with diameters of 3.75, 4, 5, and 6mm and artificial bone specimens were scanned by microcomputed tomography to construct 3D models for calculating pBICA, BICA, and 3D BIC%. Indexes of the primary implant stability including the insertion torque value (ITV), Periotest value (PTV), and implant stability quotient (ISQ) were measured after implants with various diameters were placed into bone specimens. The Kruskal-Wallis test, Wilcoxon rank-sum test with Bonferroni adjustment, and Spearman correlations were all performed as statistical and correlation analyses. The implant diameter significantly influenced pBICA and BICA, but not 3D BIC%. ITV and PTV were more sensitive to implant diameter than was ISQ. The coefficients of determination were high (>0.92) for the correlations between pBICA (or BICA) and indexes of the primary implant stability. This study revealed how the implant diameter and the three-dimensional (3D) BIC influence the primary stabilities of dental implant. ITV and PTV were more sensitively influenced by the implant diameter than ISQ. The pBICA and BICA seem to be more important than 3D BIC % for using wider implant in treatment plan, since those two parameters are highly predictive of variations in the primary stability of dental implant.

Effect of the long-term administration of Cyclosporine A on bone healing around osseointegrated titanium implants: A histomorphometric study in the rabbit tibia.

The aim of this study was to investigate the effect of cyclosporine A (CsA) therapy on bone healing around osseointegrated implants in the rabbit by means of descriptive histologic and histomorphometric analyses. Eighteen rabbits received one implant each in the right tibia proximal metaphysis. After the bone-healing period of 3 months, 6 randomly selected animals were sacrificed (Group CTL-12) before the immunosuppression therapy initiation to obtain a standard of implant integration. Another six randomly selected animals were submitted to a daily subcutaneous (sc) injection of 10 mg/kg CsA (Group CsA) whereas the six remaining animals received daily sc injections of saline solution (Group CTL-24). Groups CTL-24 and CsA were sacrificed after another 12 weeks. Bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) within the implant threads were measured. Bone density (BD) and descriptive histological analyses were also accomplished. Rabbits under CsA therapy presented statistically lower percentage of BIC (33.28 ± 6.19) compared to the animals of CLT-24 (55.6 ± 17.73). No differences were found between CsA and CTL-12 (38.7 ± 7.87). Significant decreased percentage of BAFO between the implant threads in the CsA (48.43 ± 9.48) group compared to the CTL-24 (72.26 ± 11.72) was observed. No differences were found between CsA and CTL-12 (61.99 ± 13.94) groups. BD analysis showed significant lower BD in the CsA (48.56 ± 9.32) group compared to the CTL-12 (68.74 ± 10.89) and CTL-24 (77.96 ± 4.96) groups. Collectively, our findings demonstrated that CsA therapy negatively affect the bone healing around osseointegrated implants due to the significant lower values for BIC, BAFO, and BD.

Bone Regeneration Using Adipose-Derived Stem Cells with Fibronectin in Dehiscence-Type Defects Associated with Dental Implants: An Experimental Study in a Dog Model.

To determine the bone regeneration potential of a ceramic biomaterial coated with fibronectin and adipose-derived stem cells covered in three-wall critical-size defects associated with dental implants. In a total of 18 dogs, four dehiscence-type and critical-size defects were created surgically in the edentulous alveolar ridge with the simultaneous placement of dental implants. Defects were randomly regenerated using biomaterials coated with particulate ß-tricalcium phosphate (β-TCP), β-TCP with fibronectin (Fn) (β-TCP-Fn), and β-TCP with a combination of Fn and autologous adipose-derived stem cells (ADSCs) (β-TCP-Fn-ADSCs), leaving one defect as the control. The animals were divided into three groups according to the time of euthanasia (1, 2, or 3 months). Statistically significant differences between the three study groups (β-TCP, β-TCP-Fn, β-TCP-Fn-ADSCs) and the control group in the total area of bone regeneration and mineralized and nonmineralized tissue at 1, 2, and 3 months of healing were not observed. At 2 months, defects treated with β-TCP-Fn-ADSCs showed a significant decrease in the percentage of bone-to-implant contact (BIC) as compared with the β-TCP-Fn (P = .041) and control (P = .012) groups. At 3 months of healing, however, significant differences in BIC between the three study groups and controls were not found (P = .388). The use of ADSCs in the bone regeneration processes of dehiscencetype defects associated with simultaneous implant insertion does not seem to improve the area of bone regeneration or the percentage of BIC compared with other biomaterials or the control alveolar defect.

A comparative study of the bone contact to zirconium and titanium implants after 8\xa0weeks of implantation in rabbit femoral condyles

Zirconium (Zr) has been found to have comparable characteristics to titanium with a favorable modulus of elasticity. In addition, the release of Zr-ions of a Zr implant is supposed to further increase the bone-to-implant response. Therefore, the objective of this study is to compare the bone contact to Zr and Ti implants in the femoral trabecular bone of rabbits. In addition, implants provided with a hydroxyapatite (HA) coating were included, as such a coating was proven before to enhance the secondary implant stability. A total of 32 implants consisting of 16 Zr (8 HA coated) and 16 Ti (8 HA coated) implants were installed in the femoral condyle of 16 rabbits. After 8 weeks of healing the femoral condyles including the implants were retrieved and studied histologically. The bone-to-implant contact (BIC) percentage was assessed and analyzed statistically. The BIC values of the uncoated Zr and Ti implants showed comparable BIC values (45.1 ± 14.8 vs. 45.5 ± 13.1). The BIC percentage was slightly higher for HA coated Zr and Ti implants (60.3 ± 17.1, 59.8 ± 16.4, respectively) compared to uncoated, but statistical testing indicated that this difference was not significant. It can be concluded that Zr and Ti implants show a comparable bone-implant contact after 8 weeks of implantation in the currently used rabbit model. In addition, the deposition of a sputtered HA coating on both Zr and Ti implants did not further improve their bone integration.

MicroCT assessment of bone microarchitecture in implant sites reconstructed with autogenous and xenogenous grafts: a pilot study.

To assess bone microarchitecture in maxillary sites grafted with autogenous or xenogenous grafts as well as to demonstrate the usefulness of microCT in dental implant research. Samples (n=12) consisting of titanium fixation screws covered by at least 0.5-1mm of human bone were obtained from 17 sites grafted with autogenous or xenogenous materials and prepared for microCT scanning and conventional histology. Bone histomorphometric parameters were evaluated in three distinct regions (graft region, transitional region, and native bone region). Three-dimensional (3D) bone-to-implant contact (BIC) calculation was performed using microCT data. Histological sections were used to calculate two-dimensional (2D) BIC percentages, which were compared with values obtained from 2D microCT images. Histomorphometric parameters varied according to the type of graft used, but sites reconstructed with autogenous bone showed higher mean values in general. In autograft samples, indices for parameters such as Tb.Th and Tb.Sp were significantly different when the native bone region was compared to the graft region. While a higher mean 3D BIC was found in the native bone region for both graft materials, significant BIC differences were absent when graft types were compared. The 2D BIC percentages obtained from histological and microCT images were similar. Autografts outperformed the xenogenous material used in this study concerning the histomorphometric parameters assessed. While graft type did not seem to influence 3D BIC, the native bone region showed the highest BIC percentages when compared to the other regions in both graft groups. In addition, 2D BIC ratios were similar regardless of graft material or image source (histological sections x microCT slices). Taken together, our findings suggest that microCT is an effective tool for 2D and 3D histomorphometric and BIC assessments in dental implant research.

A site-specific intraoperative measurement of bone-to-implant contact during implant insertion: A study on bovine ribs using a computerized implant motor

Background/purposeThe aim of the current in vitro study was to determine if there was a correlation between the integrals (I) of the function cutting resistance/depth, obtained using a computerized implant motor, and the bone-to-implant contact (BIC) percentages of dental implants inserted in bovine ribs. Materials and methodsSegments of bovine ribs were used, and a total of 21 perforations were performed. A total of 21 dental implants were inserted in the prepared bone sites. A computerized implant motor (“Torque Measuring Motor”) was used to assess, before implant insertion, the values of the bone cutting resistance. The data of bone density obtained by the implant motor were statistically correlated with the BIC percentages. ResultsA significant positive linear correlation was found between the integrals measured by the implant motor and the BIC assessed by histomorphometry (r = 0.78, n = 21, P < 0.0001). Indeed, the increase of the integral values recorded by the reader matched with the increase of BIC percentages measured by histomorphometry. Pearson correlation coefficient for linear regression (R2) between values assessed by the surgical motor and histomorphometry was 0.61 (P < 0.0001), indicating that 61% of the data points were aligned with the regression line. ConclusionThe instrument under testing seems to provide a reliable quantitative estimator, the integral, of the final BIC achieved at implant insertion, and therefore of the implant primary stability, and could represent a significant aid for a proper planning of rehabilitations with the use of dental implants.

Bone remodeling at implants with different configurations and placed immediately at different depth into extraction sockets. Experimental study in dogs.

This study evaluated the effect of implant macrodesign and position, related to the bone crest, on bone-to-implant contact (BIC) and crestal bone (CB) in immediate implants. The study comprised of six foxhound dogs in which 48 immediate implants were placed. Three types of implants from the same manufacturer with similar surface characteristics but different macrodesigns were randomly placed: Group A (external hex with no collar microthreads), Group B (internal hex and collar microrings), and Group C (internal conical connection and collar microrings). Half of the implants were placed leveled with the bone crest (control) and the remaining, 2 mm subcrestally (test). Block sections were obtained after 12 weeks and processed for mineralized ground sectioning. Statistical analysis consisted of nonparametric Friedman and Wilcoxon test. All implants were clinically stable and histologically osseointegrated. Mean BIC percentage within the control group was as follows: A: 42.52 ± 8.67, B: 35.19 ± 18.12, and C: 47.46 ± 11.50. Within the test group: A: 47.33 ± 5.23, B: 48.38 ± 11.63, and C: 54.88 ± 11.73. Differences between each subgroup in the test and the control groups were statistically significant. BIC was statistically significantly higher in the test (50.588 ± 8.663) than in the control (43.317 ± 9.851) group. Within both groups, differences between group C and the other 2 were statistically significant. Distance from the implant shoulder to the buccal CB was statistically significantly larger in the control than in the test group and between subgroups B and C in the control and test groups. Within the test groups, relative bone gain was noticed. Subcrestal immediate implant positioning may lead to a relatively reduced CB resorption and increased BIC. Implants macrodesign with crestal microrings may enhance BIC in post-extraction implants.