Integration Of Dental Implants Research Articles

Integration of Dental Implants in Conjunction with EDTA-Conditioned Dentin Grafts: An Experimental Study.

This study was undertaken to investigate the integration of titanium micro-implants installed in conjunction with previously dentin-grafted areas and to study the morphological appearance, mineral content, and healing pattern of xenogenic EDTA-conditioned dentin blocks and granules grafted to cavities in the tibial bone of rabbits. Demineralized and non-demineralized dentin blocks and granules from human premolars were implanted into cavities prepared on the lateral aspects of the tibias of rabbits. After a healing period of six months, micro-implants were installed at each surgical site. Histological examinations were carried out after 24 weeks. Characterization of the EDTA-conditioned dentin blocks was performed by means of light microscopy, dental X-rays, scanning electron microscopy, and energy dispersive X-ray analysis (EDX). No implants were found to be integrated in direct contact with the dentin particles or blocks. On the EDTA-conditioned dentin surface, the organic marker elements C and N dominated, as revealed by EDX. The hydroxyapatite constituents Ca and P were almost absent on the dentin surface. No statistically significant difference was observed between the EDTA-conditioned and non-demineralized dentin, as revealed by BIC and BA. The bone-inductive capacity of the dentin material seemed limited, although demineralization by means of EDTA indicated higher BIC and BA values in conjunction with the installed implants in the area. A 12 h EDTA treatment did not fully decalcify the grafts, as revealed by X-ray analysis.

Does the adjunctive use of platelet-rich plasma to bone graft during sinus augmentation reduce implant failure and complication? Systematic review and meta-analysis.

Prosthetic treatment of the posterior edentulous maxilla may require bone augmentation to enable the placement and integration of dental implants. This constitutes a complex healing situation, and resorption of the grafted bone and failure of the implants often occurs. The application of platelet-rich plasma (PRP) has been suggested to improve incorporation and preservation of bone grafts. The objective was to assess the effectiveness of PRP on the implant failure and complication rate, when used as an adjunctive material with bone graft in sinus floor augmentation. An electronic search of two databases (PubMed and Cochrane) was performed to identify randomized controlled trials (RCTs) in patients requiring sinus augmentation and implant placement in the posterior edentulous maxilla with or without using PRP as an adjunctive material to the bone graft. Data were extracted independently by two reviewers. The Cochrane tool was used for assessing the quality of included studies. Meta-analysis was performed for the included RCTs. Nine RCTs were identified, four of which were included in the study. Three of these trials were judged to be at unclear risk of bias and one was at low risk of bias. The meta-analysis revealed no difference between the PRP versus non-PRP groups regarding implant failure and complication rate. The meta-analysis revealed no statistically significant difference regarding implant failure and complication rate of implants placed in the atrophic posterior maxilla with sinus floor augmentation with or without PRP as an adjunctive material to the bone graft. This finding should be interpreted with great caution given the serious numerical limitations of the included studies.

Influence of implantation side on the integration of dental implants. A study on miniature pigs.

'...significant differences in the bone-to-implant contact depending on the side of implantation.'

Porous Titanium for Dental Implant Applications

Recently, an increasing amount of research has focused on the biological and mechanical behavior of highly porous structures of metallic biomaterials, as implant materials for dental implants. Particularly, pure titanium and its alloys are typically used due to their outstanding mechanical and biological properties. However, these materials have high stiffness (Young’s modulus) in comparison to that of the host bone, which necessitates careful implant design to ensure appropriate distribution of stresses to the adjoining bone, to avoid stress-shielding or overloading, both of which lead to bone resorption. Additionally, many coating and roughening techniques are used to improve cell and bone-bonding to the implant surface. To date, several studies have revealed that porous geometry may be a promising alternative to bulk structures for dental implant applications. This review aims to summarize the evidence in the literature for the importance of porosity in the integration of dental implants with bone tissue and the different fabrication methods currently being investigated. In particular, additive manufacturing shows promise as a technique to control pore size and shape for optimum biological properties.

Assessment of a chair-side argon-based non-thermal plasma treatment on the surface characteristics and integration of dental implants with textured surfaces

The biomechanical effects of a non-thermal plasma (NTP) treatment, suitable for use in a dental office, on the surface character and integration of a textured dental implant surface in a beagle dog model were evaluated. The experiment compared a control treatment, which presented an alumina-blasted/acid-etched (AB/AE) surface, to two experimental treatments, in which the same AB/AE surface also received NTP treatment for a period of 20 or 60 s per implant quadrant (PLASMA 20′ and PLASMA 60′ groups, respectively). The surface of each specimen was characterized by electron microscopy and optical interferometry, and surface energy and surface chemistry were determined prior to and after plasma treatment. Two implants of each type were then placed at six bilateral locations in 6 dogs, and allowed to heal for 2 or 4 weeks. Following sacrifice, removal torque was evaluated as a function of animal, implant surface and time in vivo in a mixed model ANOVA. Compared to the CONTROL group, PLASMA 20′ and 60′ groups presented substantially higher surface energy levels, lower amounts of adsorbed C species and significantly higher torque levels (p=.001). Result indicated that the NTP treatment increased the surface energy and the biomechanical fixation of textured-surface dental implants at early times in vivo.

Implantable Devices: A Review of Current Treatment Modalities

The use of implantable devices as direct adjuncts to orthodontic treatment as compared to the use of conventional dental implants is relatively less in number. Currently, a limited number of such devices are used to aid in orthodontic treatment. The options include conventional titanium endosseous dental implants, palatal implants, titanium miniscrews (also known as micro- or mini-implants), and mini-bone plates. Integration of dental implants or implantable devices into contemporary orthodontic practice has the following possible advantages: Serving as a means of increasing orthodontic anchorage, virtually eliminating patient compliance issues with regard to wearing of appliances, decreasing overall treatment time, and occasionally permitting orthodontic treatments previously thought to be impossible without surgery. This article is a review of the currently available options for use of implantable devices as sources of temporary skeletal anchorage in orthodontics.

A Novel Closed-Loop Electromechanical Stimulator to Enhance Osseointegration with Immediate Loading of Dental Implant Restorations

The degree of osseomechanical integration of dental implants is acutely sensitive to their mechanical environment. Bone, both as a tissue and structure, adapts its mass and architecture in response to loading conditions. Therefore, application of predefined controlled loads may be considered as a treatment option to promote early maturation of bone/implant interface prior to or in conjunction with crown/prosthesis attachment. Although many studies have established that the magnitude, rate of the applied strain, and frequency have significant effects on the osteogenic response, the actual specific relationships between strain parameters and frequency have not yet been fully defined. The purpose of this study was to develop a stimulator to apply defined mechanical stimuli to individual dental implants in vivo immediately after implantation, exploring the hypothesis that immediate controlled loading could enhance implant integration. An electromechanical device was developed, based on load values obtained using a two-dimensional finite element analysis of the bone/implant interface generating 1000 to 4000 pe and operated at 30 and 3 Hz respectively. The device was then tested in a cadaveric pig mandible, and periosteal bone surface strains were recorded for potential future comparison with a three-dimensional finite element model to determine loading regimens to optimize interface strains and iterate the device for clinical use.

Implantable Devices as Orthodontic Anchorage: A Review of Current Treatment Modalities

Recently, there has been a dramatic increase in the use of implantable devices as direct adjuncts to orthodontic treatment. Whereas the use of conventional dental implants has been researched extensively, the body of literature associated with the more recent uses of implantable devices in orthodontics is relatively small. Currently, a limited number of such devices are used to aid in orthodontic treatment. The options include conventional titanium endosseous dental implants, palatal implants, titanium miniscrews (also known as micro- or mini-implants), and mini-bone plates. Integration of dental implants or implantable devices into contemporary orthodontic practice has the following possible advantages: serving as a means of increasing orthodontic anchorage, virtually eliminating patient compliance issues with regard to wearing of appliances, decreasing overall treatment time, and occasionally permitting orthodontic treatments previously thought to be impossible without surgery. This article is a review of the currently available options for use of implantable devices as sources of temporary skeletal anchorage in orthodontics.

Reconstruction of the Severely Resorbed Maxilla with Autogenous Bone, Platelet-Rich Plasma, and Implants: 1 -Year Results of a Controlled Prospective 5-Year Study

Prosthetic treatment of the edentulous maxilla may require bone augmentation to enable placement and integration of dental implants. This constitutes a complex healing situation, and resorption of the grafted bone and failure of the implants often occur. The application of autogenous platelet-rich plasma (PRP) has been suggested to improve incorporation and preservation of bone grafts. The aim of this controlled clinical study was to evaluate whether PRP in conjunction with grafting of particulated autogenous bone to the maxilla could improve the integration and clinical function of dental implants. An additional aim was to compare block bone grafts without PRP with PRP-treated particulated bone. Nineteen consecutive patients were included in the study and treated with iliac bone grafts and dental implants in the maxilla according to a split-mouth design. In the anterior maxilla, particulated bone mixed with PRP (test) was compared with onlay block grafts without additional PRP (control). In the posterior maxilla, particulated bone grafts with (test) or without (control) PRP were placed as sinus inlay grafts. After 6 months of healing, 152 implants (8 implants/patient) (TiOblast, Astra Tech AB, Mölndal, Sweden) were placed. Test (PRP; 76 implants) and non-PRP (76 implants) sides were evaluated and compared by implant survival rate, marginal bone level, and implant stability using resonance frequency analysis (RFA) during 1 year in function. Two control implants in control sites in two patients were lost at abutment connection. After 1 year in function, no further implants were lost, giving an overall survival rate of 98.7%. The marginal bone level measurements showed no significant differences, although there was a tendency toward less resorption on PRP sides. RFA measurements showed statistically significantly higher implant stability quotient values for PRP sites at abutment connection in the anterior but not in the posterior regions. The present clinical study showed that a high implant survival rate and stable marginal bone conditions can be achieved after 1 year of loading in the maxilla following autogenous bone grafting whether or not PRP is used. RFA measurements revealed differences at abutment connection, which could be explained by the type of graft rather than as an effect of PRP. Although no obvious positive effects of PRP on bone graft healing could be demonstrated, the handling of the particulated bone grafts was improved.

Biomimetic coatings functionalized with adhesion peptides for dental implants.

A complete biological integration into the surrounding tissues (bone, gingiva) is a critical step for clinical success of a dental implant. In this work biomimetic coatings consisting either of collagen type I (for the gingiva region) and hydroxyapatite (HAP) or mineralized collagen (for the bone interface) have been developed as suitable surfaces regarding the interfaces. Additionally, using these biomimetic coatings as a matrix, adhesion peptides were bound to further increase the specificity of titanium implant surfaces. To enhance cell attachment in the gingiva region, a linear adhesion peptide developed from a laminin sequence (TWYKIAFQRNRK) was bound to collagen, whereas for the bone interface, a cyclic RGD peptide was bound to HAP and mineralized collagen using adequate anchor systems. The biological potential of these coatings deduced from cell attachment experiments with HaCaT human keratinocytes and MC3T3-E1 mouse osteoblasts showed the best results for collagen and laminin sequence coating for the gingiva region and mineralized collagen and RGD peptide coatings for regions with bone contact. Our concept opens promising approaches to improve the biological integration of dental implants.