Field Of Implantology Research Articles

Effect of changes in the centre of rotation after hip arthroplasty on knee joint function

Introduction: A common complication after hip arthroplasty is pain and inflammation in other large joints, especially the knee joint. Displacement of the centre of rotation of the femoral head after endoprosthetics can change the redistribution of force vectors acting on the femur, change its tilt and pressure on the surface of the knee joint. Objective: The investigation of the effect of displacement of the centre of rotation of the hip joint after arthroplasty on the knee joint.Methods: Using SolidWorks software and the SimulationXpress tool, a 3D model of the lower limb was created that reproduced the interaction between the components of the musculoskeletal system.Results: As a result, it was found that the displacement of the centre of rotation of the hip joint medially and laterally from the anatomical position leads to a significant increase in pressure on the corresponding tibial condyles. The increase in load is linear and increases from a minimum value of 1.77 N⋅m in anatomical position to 123.79 N⋅m with a medial displacement of up to 8 mm.Conclusions: This study indicates the need for proper restoration of the centre of rotation of the hip joint after implantation and the possible consequences of changes in knee joint loads. The data may be useful for specialists working in the field of implantology and the development of hip prosthesis systems

The Reuse of Healing Abutments: A Questionnaire-Based Survey.

Healing abutments (HA) are used in second-stage implant surgery to create the optimal peri-implant environment. Despite being a component intended only for short-term use, it remains in the mouth for a few weeks to several months and stays in close contact with organic debris, intraoral fluids, and bacteria.Reusing the HAs modifies their surfaces, expands the coating layer's porosity, and promotes bacterial colonization at the HA-implant interface in addition to the previous contamination. Therefore, the study's goals were to determine the frequency of HA reuse, examine the sterilizing and disinfection techniques employed, and examine the factors that contributed to the dental professionals in the Indian state of Maharashtra utilizing these components again when placing dental implants. For the study, 150 dentists who worked in the field of implantology were chosen. An online questionnaire issued via email and WhatsApp was used to collect data, which started in January 2023. The survey was designed to store the demographic information and responses of the participants, and it was made available through Google Forms. By the end of February 2023, the responses had been gathered.Tables and graphs were used to present the study outcomes that were based on the statistical analysis. The analysis employed the Chi-square test, with a p-value of 0.05 deemed statistically significant. There were 150 answers in all, with 44% women and 56% men. Merely 7.4% of participants do not reuse healed abutments, compared to 92.6% who follow this procedure. The respondents were also asked about the number of times theyreused the HAs, 69% of the implantologists reused the same component countless times, while 31% reused it only once. All the respondents reported sterilizing the HAs before reuse and the method used for sterilization was autoclave (96.4%) and UV chamber (3.6%). In response to a question concerning informing patients about the reuse of HAs, 77.6% of implantologists stated they do not interact with patients, while only 22.4 reported doing so. Implantologists in the state of Maharashtra, India reuse HAs and use heterogeneous methods for disinfection and autoclave sterilization.

Tackling Impediments: Bespoke Solutions for Optimized Implant Outcomes

The field of implantology has transformed dental restoration, yet significant challenges persist that can impede successful treatment outcomes. This review examines the technical and biological roadblocks encountered in dental implant procedures, highlighting the vital role of tailored innovations in overcoming these obstacles. Advances in materials science, digital technology, and surgical techniques are crucial for enhancing osseointegration and ensuring overall implant success. Common complications include surgical issues such as infections and nerve damage, prosthetic challenges like misalignment and aesthetic concerns, and biological threats such as peri-implantitis and bone loss. To combat these, proactive management strategies—encompassing meticulous preoperative planning, regular monitoring, and personalized solutions—are essential for improving patient care. This review underscores the importance of interdisciplinary collaboration of prosthodontists, oral surgeons, periodontists and oral radiologists in mitigating risks and presents effective management strategies to optimize outcomes. By elevating awareness of potential complications and implementing precise diagnosis and treatment planning, practitioners can significantly enhance the longevity and effectiveness of dental implants, ultimately securing a better quality of life for patients.

The Influence of Anxiety on Postoperative Quality of Life Regarding Implant Treatments: An Epidemiological Study.

Dental treatment anxiety is highly prevalent worldwide. This is particularly important in the field of implantology since, in daily clinical practice, it translates into an increase in the difficulty of treatments, extending surgical times and having repercussions in the postoperative period. The aim of this multicentre, cross-sectional, epidemiological study was to determine the influence of anxiety levels in the postoperative period of an implant treatment on patients treated at two dental departments in Extremadura (Spain). To analyse anxiety levels, the modified Corah's Dental Anxiety Scale questionnaire was administered before surgical treatment. To analyse the postoperative period, another questionnaire was provided 7 days after surgery. The study was conducted on a total of 102 patients (55 men and 47 women), with a mean age of 47.99 years. The results indicated that patients with a high and severe degree of anxiety had a poorer quality of life in general. Patients with a higher degree of anxiety perceived greater swelling at 24, 48, 72 h and one week after surgery.

The impact of tooth loss and the role of implantology in the elderly population

Tooth loss can lead to changes in the mouth and various health complications in older adults. In addition to affecting oral health, the loss of teeth can impact speech, chewing, and overall quality of life. Dental implants have been proposed as one possible solution for missing teeth. This article aims to discuss the potential negative effects of tooth loss in the elderly population and emphasize the important role of implantology in addressing these challenges. The field of implantology extends beyond just replacing a single tooth and involves ongoing research to meet the unique needs of older adults. Ultimately, the goal of implantology is to ensure both oral and overall health, as well as the long-term success of dental implants.

Nano-topographical surface engineering for enhancing bioactivity of PEEK implants (in vitro—histomorphometric study)

ObjectivesDental implants are currently becoming a routine treatment decision in dentistry. Synthetic polyetheretherketone (PEEK) polymer is a prevalent component of dental implantology field. The current study aimed to assess the influence of Nd:YAG laser nano-topographical surface engineering combined with ultraviolet light or platelet rich fibrin on the bioactivity and osseointegration of PEEK implants in laboratory and animal testing model.Materials and methodsComputer Aided Design-Computer Aided Manufacturing (CAD CAM) discs of PEEK were used to fabricate PEEK discs (8 mm × 3 mm) N = 36 and implant cylinders (3 mm × 6 mm) N = 72. Specimens were exposed to Nd:YAG laser at wavelength 1064 nm, and surface roughness topography/Ra parameter was recorded in nanometer using atomic force microscopy. Laser modified specimens were divided into three groups: Nd:YAG laser engineered surfaces (control), Nd:YAG laser/UV engineered surfaces and Nd:YAG laser/PRF engineered surfaces (N = 12 discs–N = 24 implants). In vitro bioactivity test was performed, and precipitated apatite minerals were assessed with X-ray diffraction analysis (XRD) and scanning electron microscopy (SEM). In vivo histomorphometric analysis was performed in rabbits with BIC% calculation.ResultsRa mean value of PEEK laser engineered surfaces was 125.179 nm. For the studied groups, XRD patterns revealed distinctive peaks of different apatite minerals that were demonstrated by SEM as dispersed surface aggregations. There was a significant increase in the BIC% from control group 56.43 (0.97) to laser/UV surfaces 77.30 (0.78) to laser/PRF 84.80 (1.29) (< 0.0001).ConclusionsSuccessful engineered nano-topographical biomimetic PEEK implant could be achieved by Nd:YAG laser technique associated with improving bioactivity. The combination with UV or PRF could be simple and economic methods to gain more significant improvement of PEEK implant surface bioactivity with superior osteointegration.

The Comparison between the Traditional and Injection Molding Technique in the Construction of Removable Dentures-Systemic Review

Introduction: Although the high development of the implantology field, the risks of the surgical procedures, possible complications and the high cost of the implant-prosthetic restorations have made that the removable dentures treatment are still an important option treatment for edentulous patients. The aim of our study was to evaluate the existing literature regarding the patient’s satisfaction regarding two different types of dentures: dentures constructed with the traditional compression molding technique and dentures constructed with the injection molding technique. Methodology: A search in PubMed was done first with the following words: injection And molding And denture.143 results were found. A second search was done with the following key words: Ivocap And dentures. 54 results were identified. A third search was done with the words: processing And denture And comparison, from which 322 data resulted. The fourth search was done with the key words: denture And satisfaction. 2033 results were found. Results and Conclusion: Based on the evaluation of the current literature there is no data in the patient satisfaction term related with the two different processing techniques of the removable dentures. Further studies are encouraged to determine the advantages and disadvantages of each method, especially in the patient satisfaction term.

Influence of deposition temperature on the structure and functional properties of Mg doped hydroxyapatite coatings deposited on manufactured AZ31B alloy substrates by RF magnetron sputtering

In this paper, we study the effect of deposition temperature on the structural and nanomechanical properties on the degradation and bioactivity behaviour of Mg doped hydroxyapatite (HAP) deposited on AZ31B alloy substrates extracted by parts manufactured according to the prostheses production route. The coatings were prepared by RF (Radio Frequency) magnetron sputtering technique at room temperature (RT) and 200 °C, respectively. By adding Mg into the HAP matrix, the hardness and elastic modulus values of the coatings have significantly improved as compared to the bare HAP, the highest H3/E2 ratio of 0.022 being obtained for the HAP + Mg at 200 °C. XRD analysis showed the presence of an α-Mg hexagonal structure for the uncoated AZ31B alloy, while the GIXRD patterns revealed the presence of HAP and Mg in the coated samples. The crystallinity degree of HAP is not changed by Mg addition, while the apatite structure was preserved for all investigated coatings. All investigated samples exhibited typical IR bands of phosphate, carbonate, and hydroxyl functional groups, confirming the formation of apatite phases. By increasing the deposition temperature from room temperature up to 200 °C, the electrochemical behaviour of the coatings, in simulated body fluid and Dulbecco's Modified Eagle Medium, is improved obtaining more electropositive values for corrosion potential, smaller current densities, and higher polarization resistance. The coatings deposited at 200 °C showed the best electrochemical behaviour. Also, by increasing the deposition temperature and incorporating Mg into HAP matrix, the hardness and elastic modulus are increased by more than two-fold, as compared to pure HAP. Furthermore, all coatings deposited on AZ31B alloys are suited for further coating with a mussel-derived surface-binding peptides, but the coatings deposited at 200 °C led to the most regular peptide distribution on the surface. Overall, the results indicated that the biodegradation of HAP + Mg based coatings and the AZ31B alloys can be controlled according to the current clinical needs within implantology field.

Comparative Evaluation of the Accuracy, Operator Comfort and Time Taken for Implant Placement among Different Practitioners under Dynamic Navigation

Introduction: Dynamic Navigation (DN) can be an effective alternative in cases where there are anatomical limitations. It can serve as an advanced training tool for young practitioners in implantology. The learning curve with the DN system can be steep; however, with practice and proper protocol implementation in an institutional set-up, DN can become an invaluable tool for implant placement in challenging situations. Aim: To evaluate operator comfort, accuracy, and time taken for implant placement among different practitioners using DN. Materials and Methods: This prospective cohort study was conducted at the Department of Implantology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu, India, from October 2022 to February 2023. Three groups, each consisting of five practitioners, were included: Group 1 (experienced practitioners), Group 2 (intermediate practitioners), and Group 3 (beginners in the field of implantology). The practitioners underwent orientation to the DN system through lectures and digital planning sessions. They performed hands-on in-vitro implant placement on 3D printed models and one implant placement each on live patients. Surgical time, operator comfort, and accuracy of implant placement were assessed among the three groups. Statistical analysis was performed using the Kruskal-Wallis test. Results: In comparison to the digitally planned position, beginners in implantology showed the least variation in implant placement position. The apico-coronal variation was 0.494±0.428 mm in implant placements for patients in the beginners group, while the maximum variation was 2.140±1.355 mm in the experienced practitioners group. There was a sequential increase in accuracy and lesser deviation from the originally planned implant sites when comparing the virtual simulation device, model, and patient implant placement. Beginners took significantly less time for implant placement in patients (p=0.004). Conclusion: There was a sequential improvement in the accuracy in implant angulation from virtual simulation to placement of implants in patients. The beginners group exhibited the shortest implant placement time in patients.

Use of CGF in Oral and Implant Surgery: From Laboratory Evidence to Clinical Evaluation

Edentulism is the condition of having lost natural teeth, and has serious social, psychological, and emotional consequences. The need for implant services in edentulous patients has dramatically increased during the last decades. In this study, the effects of concentrated growth factor (CGF), an autologous blood-derived biomaterial, in improving the process of osseointegration of dental implants have been evaluated. Here, permeation of dental implants with CGF has been obtained by using a Round up device. These CGF-coated dental implants retained a complex internal structure capable of releasing growth factors (VEGF, TGF-β1, and BMP-2) and matrix metalloproteinases (MMP-2 and MMP-9) over time. The CGF-permeated implants induced the osteogenic differentiation of human bone marrow stem cells (hBMSC) as confirmed by matrix mineralization and the expression of osteogenic differentiation markers. Moreover, CGF provided dental implants with a biocompatible and biologically active surface that significantly improved adhesion of endothelial cells on CGF-coated implants compared to control implants (without CGF). Finally, data obtained from surgical interventions with CGF-permeated dental implants presented better results in terms of optimal osseointegration and reduced post-surgical complications. These data, taken together, highlight new and interesting perspectives in the use of CGF in the dental implantology field to improve osseointegration and promote the healing process.

Modeling of Biological Activity of PEO-Coated Titanium Implants with Conjugates of Cyclic RGD Peptide with Amino Acid Bisphosphonates.

Titanium is considered to be the most essential metal in the field of implantology. The main factors determining metal biocompatibility, among others, include the morphology and chemical composition of the titanium surface. Therefore, the aim of this work was to develop approaches to control the biological activity of the titanium surface by creating coatings that combine both an inorganic phase with a given morphology and organic molecules containing an integrin-selective peptide that regulate cell adhesion and proliferation. As such, we synthesized new c(RGDfC) derivatives of amino acid bisphosphonates (four examples) with different bisphosphonate anchors and maleimide linkers. These molecules were deposited on a highly developed porous surface obtained via the plasma electrolytic oxidation (PEO) of coarse-grained and nanostructured titanium. In vitro studies demonstrated the increase in the viability degree of mesenchymal stem cells and fibroblasts on the surface of coarse-grained or nanostructured titanium modified with PEO and a c(RGDfC) derivative of ε-aminocaproic acid bisphophonate with an SMCC linker. As a result, the use of conjugates of amino acid bisphosphonates with a cyclic RGD peptide for the modification of PEO-coated titanium opens the ways for the effective control of the biological activity of the metal implant surface.

Biomechanical properties of animals bones and the influence of oncologic drug on pig femur

Over the years, we have seen how, thanks to experimentation on animal models, the foundations have been laid in the field of implantology. In most cases, studies related to the bone scale are carried out on the species that are most similar in their movements and behavior to humans. The femur has been selected as the reference bone for our test, selecting as animals to experiment with the goat breed, the bovine breed and the porcine breed for their similarity to the human body, obtaining specimens of the cortical part of the bone. Destructive bending tests will be carried out in the same way on each of the femur fragments of each animal. When interpreting the results, we will be guided by taking sections of the transverse and longitudinal part of the bone, performing the tests in both cases inside the femur, and once the results have been obtained, we will proceed to their subsequent evaluation. We relate the bone resistance of the samples to the effect of an oncological drug, Altan Zolendronic Acid 4 mg/ 100 ml solution for perfusion EFG, administered in cases of bone metastasis.

A Review of Flapless Implant Surgery

Dental implants, which are usually foreign matter to patients, are surgically inserted into or onto the jawbone. These alloplasts are used to support a single prosthetic tooth and serve as either abutments or cosmetic products for missing teeth. Several methods have been conducted to satisfy patients and surgeons. Flapless implant surgery, a more accepted procedure by patients and doctors nowadays, which uses the soft tissue punch device requiring a circumferential excision of keratinized tissue at the implant site may guarantee predictable and esthetic results. This review aims to analyze literature published in the field of implantology with flapless surgery, to compare traditional flap implant surgery and the latest flapless implant surgery, to illustrate the current scientific evidence and the new developments of this technique.is not strong enough and deformed. The second one is the most useful for needle knife instruments. More clinical study is recommended.

The effect of type of specialty (periodontology/oral surgery) on early implant failure: a retrospective “Big-Data” study from a nation-wide dental chain in Israel

ObjectivesTo evaluate early implant failure rate of implants placed by maxillofacial-oral surgeons and periodontists.Material and methodsA nested case-case study was performed to analyze treatment outcome of 27 oral surgeons and 30 periodontists who performed at least 100 dental implants between 2017 and 2019 in 54 clinics of “Maccabi-Dent,” a nation-wide dental chain. A total of 26,865 implants were evaluated.ResultsThe early failure rate of 1.3% achieved by the periodontists was lower than the 1.7% early failure rate achieved by oral surgeons. Differences were not statistically different. Oral surgeons in the study cohort were insignificantly older in age, with more years of experience as dentists and as specialists. However, the only parameter found to be a predictor to early implant failure in a linear regression model was related to postgraduate training. Explicitly, the mean number of implants placed during specialty program. This number was higher for the periodontists and found to be significantly contributing predictor to early implant failure. Clinicians’ age and years of experience as dentists or as specialist were not found to be predictors to early implant failure rate.ConclusionsNo statistically significant differences were found in early implant failure rate between oral surgeons and periodontists. The number of implants placed during specialty program has a statistical predictive value to early implant failure rate.Clinical relevanceCare and attention should be taken to re-evaluate clinical training in the field of implantology during specialty program. To optimize surgeons’ control on treatment outcome.

Peri-Implantitis: A New Definition Proposal Based on Unnatural Spatial Arrangement and Late Mechanical Coupling between Two Cortical Bone Layers during Osseointegration Phase: Part I

Scientists have been speculating for three decades about the reasons for the occurrence of peri-implantitis around dental implants. Many theories have been proposed since the beginning of 1990. Since then, the dental profession has been exposed to a vast number of peri-implantitis cases, whereas the “disease” had been unknown before this time. However, the situation has not improved because we focus more on how to treat the problem instead of trying to understand it completely. The aim of this paper is to present a purely bone-based explanation for the beginning of the “bone loss” process around already “osseointegrated” implants. Conclusion: There are a number of possible chain reactions of physiological bone response to dental implants which may explain the occurrence of peri-implantitis. Bacteria and “immunological reactions” may not be the main causes of this disease. In the first part, the authors present the principles of bone biology and physiology based on the theories of Donath, Jansen and Frost and transfer them to the field of implantology. They describe the stages of “osseointegration”, explaining the subsequent changes in the bone at the implant–bone interface.

A comparative evaluation of the effect of platelet rich fibrin matrix with and without peripheral blood mesenchymal stem cells on dental implant stability: A randomized controlled clinical trial

Technological advances in the field of implantology have led to the concept of surface modifications to enhance implant stability by utilization of current concepts of tissue engineering and materials such as platelet concentrates and stem cells. The purpose of the present randomized controlled clinical trial was to evaluate and compare the effect of platelet rich fibrin matrix (PRFM) with and without peripheral blood mesenchymal stem cells (PBMSCs) on implant stability; by assessing the bone to implant contact (BIC) using resonance frequency analysis (RFA), insertion torque and also to establish and correlate the same with implant stability quotient (ISQ). A total of 15 patients with 30 sites ensuring a minimum of two dental implants adjacently placed in an edentulous area; with the age group of 25-50years of both the sexes were categorized into Group 1 (dental implant with PRFM) and Group 2 (dental implant with PBMSCs embedded in PRFM). Insertion torque values at the time of dental implant placement and ISQ using RFA was recorded at 1week, 1month, and 3months post operatively. There was no significant difference (p=0.81) in Insertion torque values between both the groups (G1 and G2). Platelet rich fibrin matrix along with PBMSCs enhanced implant stability as higher and statistically significant ISQ values were noted at 1week (p=0.18), 1month (p≤0.001), and 3months (p≤0.001) intervals in the G2 group. Platelet rich fibrin matrix and PBMSCs showed promising results as a potential regenerative material for increasing and enhancing BIC and hence implant stability.

Application of face scanning in implant-supported restoration treatment of dentition defect

In recent years, the increasingly mature oral digital technology has opened a new era of implant treatment. Before implant treatment, digital information is collected from various aspects and virtual patients are constructed based on three-dimensional (3D) scanning technology, and this greatly optimizes the preoperative virtual tooth arrangement, esthetic design and implant treatment plan, and brings great clinical convenience to patients and doctors. In this review, the application and new progress of facial 3D scanning technology in the field of implantology will be described, and the opportunities and challenges brought by digitalization technology to clinicians will be deeply discussed, in order to provide a reference for implantologists to fully understand the application of digitalization in the field of implantology.

DESIGN OF SPECIALIZED SURGICAL SCREW INSERTED IN PLATE TYPE CERVICAL IMPLANT

In the field of Implantology the screws are an important part because they transfer the loads that occur in the bones. Surgical screws are similar to those in Mechanical Engineering, but the materials should have specific characteristics like biocompatibility, strength, corrosion resistance and fatigue strength. The main function of the surgical screw is to create pressure between two bones which is necessary in order to heal the injured bones. The surgical screw transforms all forces of the movements to pressure and distributes the pressure on the bone’s surfaces. Surgical screws can help in the setting of implants into an injured area. It also ensures static position of the injured bones. The research aims to analyse how the surgical screw type affects the bone of the patient with the help of the Finite Elements Method (FEM). Based on the results from the analysis of the surgical screw a new specialized surgical screw was designed with complex geometry to withstand the occurring loads and also be able to transfer them to the bone tissue. In additional, a comparison analysis between two different types of surgical screws was conducted. This paper shows how a surgical screw could be optimized in order to improve its function with the help of virtual tools. Finally, the materials used are biocompatible and often used for such screws and surgical implant analysis, the challenge was to recreate the bone tissue properties and to used them in the FEM analysis.

Digital oral rehabilitation with cast partial denture: A clinical report

Digitization has slowly become the new conventional technique today offering multiple advantages, its application in the field of implantology and fixed prosthodontics has been time tested, and its gradually being utilized in removable prosthodontics also. Digitization allows digital surveying, designing the framework with components, and obtaining a 3D printed resin framework, which can be tried intraorally and cast using conventional techniques. This technology is time-saving, highly accurate, also allows digital archiving of casts. This case report presents rehabilitation of a partially edentulous mandibular arch opposing completely edentulous maxillary arch using digital technology and casting using conventional technique.

Stress Distribution Around Two Dental Implant Materials with New Designs: Comparative Finite Element Analysis Study

Background: The introduction of modified thread designs is one of the research areas of interest in the dental implantology field. Two suggested Buttress and Reverse Buttress thread designs in TiG5 and TiG4 models are tested against a standard TiG5 Fin Thread design (IBS®). Purpose: The study aims to compare stress distribution around the suggested designs and Fin Thread design. Methods: Three dental implant models: Fin Thread design, and newly suggested Buttress and Reverse Buttress designs of both TiG5 and TiG4 models were tested using FEA for stress distribution using static (70N, 0°) and (400N, 30°) occlusal loads. Results: The main difference between the suggested Buttress design and Fin Thread design lies in the overload (400N, 30°) condition. Maximum Von Mises stress is less in Buttress design than Fin Thread design. On the other hand the level of Von Mises stress over the buccolingual slop of the cancellous bone in Fin Thread design liess within the lowest stress level. The suggested Reverse Buttress design, on the other hand showed almost uniform stress distribution in both TiG4 and TiG4 models with maximum Von Mises stress higher than the elastic modulus of cancellous bone in overload (400N, 30°) condition. Conclusion: The suggested TiG4 Buttress design might have a minor advantage of stress level in cases of stress overload. In contrast, Fin Thread design shows minimal stress over the buccolingual slop of the cancellous bone. The suggested Reverse Buttress design might be more suitable for the D1 bone quality region with the advantage of almost uniform stress distribution