Peri-implant Bone Density Research Articles

Radiological humeral adaptative changes five years after anatomical total shoulder arthroplasty using a standard-length cementless hydroxyapatite-coated humeral component.

The purpose of this study was to report bone adaptive changes after anatomical total shoulder arthroplasty (TSA) using a standard-length hydroxyapatite (HA)-coated humeral component, and to report on a computer-based analysis of radiographs to determine changes in peri-implant bone density objectively. A total of 44 TSAs, performed between 2011 and 2014 using a cementless standard-length humeral component proximally coated with HA, were included. There were 23 males and 21 females with a mean age of 65 years (17 to 65). All shoulders had good quality radiographs at six weeks and five years postoperatively. Three observers graded bone adaptive changes. All radiographs were uploaded into a commercially available photographic software program. The grey value density of humeral radiological areas was corrected to the grey value density of the humeral component and compared over time. Stress shielding was graded as mild in 14 shoulders and moderate in three; the greater tuberosity was the predominant site for stress shielding. The mean metaphyseal and diaphyseal fill-fit ratios were 0.56 (SD 0.1) and 0.5 (SD 0.07), respectively. For shoulders with no radiologically visible stress shielding, the mean decrease in grey value in zones 1 and 7 was 20%, compared with 38% in shoulders with radiologically visible stress shielding. The rate of moderate stress shielding was 7%, five years after implantation of a cementless standard-length HA-coated humeral component. Clinical observation of stress shielding identified on radiographs seems to represent a decrease in grey value of 25% or more. Cite this article: Bone Joint J2021;103-B(5):958-963.

Assessment of the Tissue Response to Modification of the Surface of Dental Implants with Carboxyethylphosphonic Acid and Basic Fibroblastic Growth Factor Immobilization (Fgf-2): An Experimental Study on Minipigs.

Simple SummaryThis study aimed to evaluate the efficacy of treating the surface of dental implants with carboxyethylphosphonic acid for the immobilization of FGF-2, the influence of FGF-2 on cortical bone in close contact with dental implants, new bone formation around dental implants in the presence of FGF-2 and the influence of FGF-2 on the interthread bone area of dental implants during the healing period after insertion.The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.

Effect of Different Locator heights on peri-implant bone changes in Mandibular implant retained Overdenture

Introduction: The implant supported overdentures offered better chewing and masticatory functions. Locator attachment has more advantages than other attachment types. Aim: The aim of the study was to compare radio-graphically the effect of implant locator’s height on peri-implant bone height and density in mandibular over-denture. Patients and method: Twelve completely edentulous male patients had received con­ventional complete maxillary dentures and mandibular overdenture that retained by two implants that were inserted in the canine region by the help of CAD/CAM based surgical guides. The patients were divided randomly into two groups. Group I: the patients were received locator abutment with 1mm in height. Group II: the patients were received locator abutment with 3mm in height, a series of cone beam radiographs were taken at 0, 6, 12 and 18 months starting from the first day of lower over denture installation, peri-implant bone changes regarding height and density were estimated. Results: It was found that the mean marginal bone loss measurements were relatively higher for group I than group II with non-statistical significant difference. The aver­age difference in bone density measurements around the implants for both groups showing initial increase followed by marked decrease through the follow up periods. Conclusion: locator height has an effect on peri-implant bone height, bone density.

Evaluation of cervical peri-implant optical density in longitudinal control of immediate implants in the anterior maxilla region.

This research aimed to longitudinally evaluate the optical density of peri-implant alveolar bone. The data acquired from study participants previously treated with 37 osseointegrated implants were analyzed utilizing the radiographic subtraction technique. The radiographic follow-ups were performed five times: at the implantation of the prostheses and after 15, 90, 180 and 360 days. Intraoral radiographs were obtained by the paralleling technique using individualized Hanshin-type positioners to guarantee the standardization of the images. The obtained digital images were aligned and equalized before they were submitted to the radiographic subtraction procedure. A significant difference was found between the distal region of Group I (patients treated with osseointegrated implants who required extraction of the dental element) and the 360 day follow-up and the distal region of Group II (patients with healed alveolar sockets) in all follow-up analyses (p < 0.05). We did not observe a significant difference between the groups analyzed and other follow-ups concerning the subcrestal and middle third regions for both the mesial and distal variables (p > 0.05). There was a statistically significant difference in the distal sites [χ2 = 5,745,, p = 0.03], showing a significant association between time and the presence of bone resorption. This association was not shown on the mesial surface (p = 0.16). We concluded that there was no statistically significant difference between groups I and II. Using this technique, we were able to quantitatively and qualitatively evaluate the changes in the proximal sites on the digital radiographic images for the analyzed data. Digital subtraction technology to measure peri-implant bone density is an accurate and reproducible technique for quantifying peri-implant bone reactions to different therapeutic modalities.

Changes of Radiographic Trabecular Bone Density and Peri-Implant Marginal Bone Vertical Dimensions Around Non-Submerged Dental Implants with a Laser-Microtextured Collar after 5 Years of Functional Loading.

Objectives: The progressive peri-implant bone remodeling caused by dynamic cycles of microdamage may change peri-implant bone characteristics and volume after the functional loading. This prospective study was designed to evaluate the radiographic trabecular bone density and peri-implant vertical dimensional changes around the non submerged dental implant with a laser-microtextured collar (NSLI)s after 5 years of functional loading. Methods: Digital periapical radiographs of 58 NSLIs supported fixed single crowns and fixed partial dentures in 26 patients (14 men, mean age of 52 ± 3.8 years) were used for comparative evaluation between the implant placement [Baseline (BSL)], the definitive Crowns Delivery (CD) and the 5 years post-functional loading examination (T5). Regions of interest (ROI) were taken into consideration for the measurement of mean gray levels, standard deviation, and variation coefficient. The texture parameters, such as contrast, correlation, angular second moment and entropy, were investigated by using the software ImageJ (v.1.50i), by means of the Gray-level Co-occurrence Matrix (GLCM) Texture Tool plugin. Vertical Peri-implant Marginal Bone Level (VPMBL) was assessed at the mesial and the distal sides of each implant by subtracting the measure at BSL from the measure at T5 by means of dedicate software (VixWin Platinum Imaging Software). Mixed regression models were adopted to analyze data. The possible effects of some variables, such as the use of provisional denture, location, crown/implant ratio, type of prosthetic design (single or splinted), on radiographic dimensional vertical changes, gray levels and texture analysis variables were also evaluated. Results: From BSL to T5, mesial and distal VPMBL showed a statistically significant gain of 0.9 ±0.5, and 0.10 mm ±0.6, respectively (P&lt;0.05). From CD to T5, mean gray levels increased from 94.4±26.8) to 111.8±27.1 (P&lt;0.05), while the coefficient of variation decreased from 0.08±0,03 to 0.05±0.04) (P&lt;0.05). Variables showed no statistically significant correlation with texture parameters (P &gt; 0.05). Conclusion: NSLIs showed an increase in radiographic vertical peri-implant marginal bone levels and bone density up to 5 years of loading.

THE EFFECT OF SODIUM ALENDRONATE GEL ON OSSEOINTEGRATION OF SUBMERGED DENTAL IMPLANTS

INTRODUCTION: A plenty of materials have been used to increase the success rate, decrease time needed for osseointegration, stimulate bone formation around dental implants. Bisphosphonates increase bone mineral density by inhibiting osteoclast-mediated bone resorption. Alendronate sodium hydrate is a bisphosphonate that potently inhibits bone resorption and is used to treat osteoporosis. A 1% sodium alendronate gel is manufactured and tested in order to accelerate osseointegration around dental implants.OBJECTIVES: This study aims to compare clinically and radiographically the osseointegration for 2 groups of submerged dental implants both in upper anterior and premolar region, first group with the use of local sodium alendronate gel prior to placement of dental implant and the second group without.MATERIALS AND METHODS: A clinical trial on 24 implants divided into 2 groups indicated for dental implant placement in the upper anterior and premolar region selected from the outpatient clinic of the Oral and Maxillofacial department, Faculty of Dentistry, Alexandria University. For the test group 12 implants were placed with sodium alendronate gel just prior to implant placement. For control group 12 implants were placed without sodium alendronate gel.RESULTS: On the 12 week the resonance frequency analysis (RFA) median records were (55.50, 54.0) and the Mean ± SD (55.08 ± 4.94, 54.67 ± 5.69) for the control group and test group, respectively. The bisphosphonate-coated implants showed an increase in implant stability from 0 to 12 weeks more than the control's measures. On the 12 week, the mean peri-implant bone density value was 1417.92 ± 310.54 for control group and 1550.25 ± 286.15 for test group. These increases in the bone density were higher in test group than the control group.CONCLUSIONS: Using sodium alendronate gel with delayed implant placement could enhance the osseointegration around dental implants.

Histological characteristics of advanced peri-implantitis bone defects in humans

BackgroundInflammatory osteolysis is the clinical hallmark of peri-implantitis. The morphology of the remaining peri-implant bone and the level of osseointegration, however, remain unknown. Our aim was to characterize advanced peri-implantitis bone defects in humans.MethodsFour patients (3 female and 1 male) were diagnosed with peri-implantitis. A total of 5 implants with machined surfaces and a mean loading time of 12 ± 6 years were removed due to advanced bone loss. The defect extension, the peri-implant bone density (bone area per tissue area in percentage), bone-to-implant contact (%), and the number of filled and empty osteocyte lacunae were calculated based on undecalcified histological specimens.ResultsThe defect extension was on average 4.2 mm (95% CI 0.8–3.4). Remaining peri-implant bone showed a high density of 85.5% (95% CI 79.1–91.3) and covered in total 74% (95% CI 70.5–77.5) of the implant surface. Filled and empty osteocyte lacunae density was on average 191 and 165/mm2 (95% CI 132–251; 103–225), respectively. Histology further revealed signs of ongoing bone formation and resorption.ConclusionThere are signs that suggest that once the original cortical bone is lost due to peri-implantitis, the remaining apical trabecular bone is reinforced and transformed into cortical bone that might take over the functional load.

Resveratrol treatment promotes titanium implant osseointegration in diabetes mellitus rats.

Type II diabetes mellitus (T2DM) is the most common metabolic disorder; it is characterized by hyperglycemia and causes implant failure by influencing implant osseointegration. Resveratrol promotes bone formation, but it is unclear if resveratrol improves implant osseointegration. Thirty 12-week-old Sprague-Dawley rats were divided into control (CTL), diabetes mellitus (DM), and resveratrol treatment (DM + Res) groups. In the DM and DM + Res groups (n = 10 each), T2DM was induced via streptozotocin injections; the remaining 10 rats were considered the CTL group. Eight weeks after the insertion of a rod-like Ti implant with a 12-mm length and 1-mm diameter in the left leg, the rats were euthanized. We analyzed implant osseointegration using microcomputed tomography (micro-CT), histological analyses, and biomechanical tests. The parameters showed that T2DM negatively influenced implant osseointegration in the tibia. Compared to that in the DM group, the bone loss of peri-implant bone mass in the DM + Res group was decreased significantly. However, resveratrol still did not induce the same level of implant osseointegration as that observed in the CTL group according to the histological and micro-CT analyses. These results indicated that resveratrol reduced the influence of DM in implant osseointegration, resulting in increased peri-implant bone density, improved trabecular architecture, and enhanced biomechanical fixation.

Effects of condensation and compressive strain on implant primary stability: A longitudinal, in vivo, multiscale study in mice.

AimsSurgeons and most engineers believe that bone compaction improves implant primary stability without causing undue damage to the bone itself. In this study, we developed a murine distal femoral implant model and tested this dogma.MethodsEach mouse received two femoral implants, one placed into a site prepared by drilling and the other into the contralateral site prepared by drilling followed by stepwise condensation.ResultsCondensation significantly increased peri-implant bone density but it also produced higher strains at the interface between the bone and implant, which led to significantly more bone microdamage. Despite increased peri-implant bone density, condensation did not improve implant primary stability as measured by an in vivo lateral stability test. Ultimately, the condensed bone underwent resorption, which delayed the onset of new bone formation around the implant.ConclusionCollectively, these multiscale analyses demonstrate that condensation does not positively contribute to implant stability or to new peri-implant bone formation.Cite this article: Bone Joint Res. 2020;9(2):60–70.

The effect of osseodensification on implant stability and bone density: A prospective observational study.

BackgroundThe aims of this study were to evaluate the effect of implant site preparation in low-density bone using osseodensification method in terms of implant stability changes during the osseous healing period and peri-implant bone density using CBCT. Material and MethodsThis prospective observational clinical study included 24 patients who received 46 dental implants that were installed in low-density bone using the osseodensification method. CBCT was used to measure the bone density pre- and postoperatively and implant stability was measured using Periotest® immediately after implant insertion and then after 6 weeks and 12 weeks postoperatively. The data were analyzed using paired t-test and the probability value <0.05 was considered statistically significant. ResultsOf the 46 implants, 43 were osseointegrated making the early survival of the implants 93.5%. There was a significant increase in bone density postoperatively; 337.6 ±182.9 compared to 265.3 ±173.9 Hounsfield units preoperatively. The primary implant stability was -2.7 ± 2.13 Periotest values (PTV), at the 6th week it decreased significantly (p<0.0001) to become 0.7 (± 4) PTV, and at the 12th week (secondary stability) it increased significantly (p<0.0001) to become -2.1 (± 2.8) PTV. The difference between primary and secondary stability was statistically non-significant (p=0.0814). ConclusionsOsseodensification resulted in high primary stability and increased peri-implant bone density but it did not prevent the implant stability drop during the first 6 weeks after insertion of implants. Key words:Osseodensification, implant stability, low-density bone.

Effect of Two Types of Surface Treatment of Dental Implants Retaining Mandibular Complete Overdenture on Bone Density Changes

The aim of the study: was to evaluate the influence of the surface treatment of implant retained mandibular overdenture on peri-implant bone density.Resorbable Blast Media (RBM) implant surface treatment and acidetched implant surface treatment was used.Materials and Methods: Ten completely edentulous male patients wererehabilitated by mandibular overdenture retained by two dental implantsin the interforaminal region, the one on the right side was acid etched andthe left side was with resorbable blast media (RBM). Peri-implant bonedensity was assessed with cone beam computed tomography at the timeof implant loading, six months and twelve months after denture insertion.Results: There was no significant difference between Acid etched andRBM dental implants on the peri-implant bone density during the followup period. Conclusion: Within the limitations of the number of studiedpatients it could be stated that Acid etched and RBM dental implantsfulfill the criteria of dental implant success and are recommended to beused.

THE USE OF CALCIUM ION NANOSTRUCTURE IMPLANT SYSTEM FOR MISSING MAXILLARY ANTERIOR TEETH

INTRODUCTION: The goal of modern dentistry is to restore the patient to normal contour, function, comfort, esthetics, speech and health regardless of the atrophy, disease or injury of the stomatognathic system. Dental implant is defined as a prosthetic device alloplastic material implanted into the oral tissues beneath the mucosal or periosteal layer within the bone to provide retention and support for a fixed or removable prosthesis. OBJECTIVES: The aim of this study was to evaluate clinically and radiographically the use of calcium ion surface treated nanostructure implant system for missing maxillary anterior teeth. MATERIALS AND METHODS: Eleven patients with anterior maxillary missing tooth were treated with calcium ion nanostructure implant. An implant stability and assessment of the osseointegration progress evaluation was conducted using the resonance frequency analysis technique (Osstell) immediately after implant placement and after one and half month at the loading time. Also, radiographic investigations were performed after one and half and three months to estimate the peri-implant mean bone density. RESULTS: all of the cases showed an uneventful wound healing. Mean bone density after three months showed a statistically significant (p < 0.001) increase in its values when compared to the immediately postoperative values. Implant stability showed statistical significant difference detected clinically by Osstell. CONCLUSIONS: The calcium ion nanostructure implant system showed an adequate clinical and radiographic performance in the replacement of missing maxillary anterior teeth with and early loading protocol.

Excessive occlusal load on chemically modified and moderately rough titanium implants restored with cantilever reconstructions. An experimental study in dogs.

To evaluate the outcomes of excessively loaded implants. In five dogs, all mandibular premolars were extracted. After 3months, six implants (three SLA® and three SLActive®) were placed (S). After 4weeks, implants were restored: one single crown with stable occlusal contacts (SC), one crown and a cantilever unit with excessive occlusal contacts (OL), and a non-loaded implant (NL). Bleeding-on-probing (BoP), attachment level (AL), mucosal margin (GM) were assessed. Resonance frequency analysis (RFA) was assessed weekly. Standardized X-rays were taken at S, 4 and 24weeks. Similar findings were observed for SLA® and SLActive® implants regarding PlI, GI, GM, AL, and BL. No significant differences were detected between baseline and 24-weeks or between treatment modalities for all clinical parameters (p>.05). Six months after loading, RFA values were significantly greater than at implant placement. No significant differences between treatment modalities were found. Linear radiographic measurements yielded similar results between SLA® and SLActive® implants. SLA® OL implants yielded a statistically significant gain on peri-implant bone density over all other groups (p=.012). Radiographic results were confirmed by descriptive histology. Technically, loosened occlusal screws occurred in 13.3% (SC=3.3%; OL=10%), while abutment fractures totalized 23.3% (SC=6.6%; OL=16.6%). Excessive occlusal load applied to implants (SLA® or SLActive®) restored with cantilevers did not cause loss of osseointegration or significant changes in their clinical, radiographic, or histologic outcomes. Early excessive occlusal load on SLA® implants promoted a gain in peri-implant bone density. Excessively loaded implants showed more technical complications.

Influence of time on primary stability of dental implants placed with osteotomes due to the elastic properties of peri-implant bone

Background/purposeThe use of osteotomes as a technique for densification and expansion of the residual ridge is one of the most widely used procedures to achieve adequate peri-implant bone quantity and density. The aim of this study was to evaluate the influence of time and the elastic deformation of peri-implant bone in the primary stability of implants placed using osteotomes. Materials and methodsIn each of 10 fresh fragments of cow rib, two implants were placed using osteotomes. The insertion torque and initial implant stability quotient (ISQ) values were measured. In the control implants, the immediate removal torque was measured, while in the test implants, after 15 min of placement, ISQ values were measured again, and the removal torque was measured. ResultsThere were significant differences between the ISQ values and between the insertion torque and removal torque at 15 min. The ISQ values (perpendicular/parallel) increased between the initial moment (64.4 ± 9/70.3 ± 5.9) and 15 min (66/71.4 ± 6.4). The removal torque at 15 min (12.4 ± 5.8) was lower than the insertion torque (15.9 ± 5.9). Compression of the trabeculae in contact with the implant placed using osteotomes was observed, as well as a greater number of trabecular fractures in the implants placed using conventional drilling. ConclusionThere is an increase in ISQ values of dental implants placed using osteotomes after 15 min of placement.

The Effect of Piezosurgical Ridge Splitting and Osseodensification on The Primary Stability of The Implant in Narrow Ridge: (Comparative Randomized Controlled Split Mouth Clinical Trial)

Aim: This study aims to evaluate the effect of and compare between the piezosurgical ridge splitting and osseodensification in implant primary stability. Subjects and Methods: 28 implants were divided into two groups. Group I: 14 implants in sites received piezosurgery technique. Group II: 14 implants in sites received osseodensification technique. Then, all implants were evaluated clinically for primary stability after implant insertion by Osstell mentor magnetic resonance device and radiographically for peri-implant bone density. Results: unpaired t-test between the two groups showed moderate statistical significant difference in group II when compared with group I in both primary stability and bone density Conclusion: The primary stability in both piezosurgical ridge splitting and osseodensification techniques is within normal range but in favor of osseodensification technique suggesting that osseodensification enhance the bone density thereby improve the implant primary stability.

Evaluation of The Bio-Stimulatory Effect of Platelet Rich Fibrin Augmented by Diode LASER Compared to Platelet Rich Fibrin Alone on Dental Implant Replacing Posterior Mandibular Teeth. Randomised Clinical Trial: Split Mouth Study.

BACKGROUND:Restoring masticatory function and replacing missing teeth with minimal pain and discomfort are the most important issues for the patient and clinician. Nowadays dental implants became the most popular line of treatment to replace missing teeth; offering a comfortable long lasting prosthesis. Osseo-integration reflects the long term success of a dental implant. Many bio-modulators are used aiming to improve the osseointegration and healing around dental implants such as Low-Level Laser treatment (LLLT) and Platelet Rich Fibrin (PRF). PRF has been proven to improve bone repair process around the dental implant. LLLT is considered a noninvasive, safe technique that stimulates osteogenesis and alleviates post-operative pain.AIM:Evaluation of the bio-stimulatory effect of LLLT on a dental implant with PRF compared to PRF alone clinically and radiographically.METHODS:A randomised clinical trial with the split-mouth design was conducted on nine patients with bilaterally missing lower posterior tooth. All patients received one dental implant on each side with PRF. LASER application was performed to one side twice weekly for one month starting on the day of insertion. Post-operative pain was assessed daily through the first week using numerical rating pain scale (NRS) as the primary outcome. Relative peri-implant bone density was measured using direct digital intraoral radiography immediately after insertion, one, four and nine months postoperatively. Implants stability were measured using radio frequency assessment immediately after insertion, four and nine months post-operative as secondary outcomes.RESULTS:The NRS for pain was significantly decreased by the end of the first-week postoperatively in the intervention and control group with a mean of (2.22 ± 1.56) (2.11 ± 1.83) respectively. However, there was no statistically significant difference between the test groups at P-Value (0.892). The relative bone density values were decreased by the end of the ninth month of follow-up in the intervention and control group with a mean of (134.42 ± 16.13) (128.77 ± 33.54) respectively. No statistically significant difference was observed between the two test groups at P-value (0.863). The radiofrequency values for implant stability showed no statically significant difference after nine months of follow up when compared to the initial stability values at the day of insertion in the intervention and control group. The mean radiofrequency values were (67.24 ± 1.79) and (66.9 ± 2.57) respectively, and no statistically significant difference was observed between the two test groups at P-value (0.793)CONCLUSION:There are no statistically significant differences in post-operative pain values, implant stability and bone density between the implant sites treated with PRF augmented by Diode laser compared to implant sites treated by PRF alone.

Comparative Study of Bone Formation around the Implant Surface Following Simultaneous Sinus Membrane Elevation and Implant Placement With and Without Platelet Rich Fibrin.

Brief Background Rehabilitation of edentulous posterior atrophic maxilla has always been an exigent task in the field Implantology. Studies have shown, the use of Choukron’s platelet rich fibrin as a sole grafting material in sinus floor and immediate implant placement leading to bone formation in the peri-implant region. Purpose of the Study This study was conducted as novel research where, Direct Sinus Membrane elevation and simultaneous Implant placement without any bone graft resulted in bone formation in sub-antral space. This study compares and evaluates the bone formation with the help of Cone Beam CT Scan (CBCT) in sub-antral space following direct sinus membrane elevation and simultaneous implant placement and platelet rich fibrin as the sole graft. Materials and Methods 48 patients who fulfill the inclusion criteria were divided as Group I- direct sinus membrane elevation and implant placement without any graft and Group II- direct sinus membrane elevation and implant placement along with PRF as sole graft Results and Analysis Unpaired‘t test’ was used where, we ‘p’ value was compared with the level of significance. On comparing the peri-implant bone density in Hounsefield units, in CBCT scans; the bone density was more in group II which was statistically significant (p&lt;0.05). Summary and Conclusions PRF has proved to be a valuable autologous augmenting material in direct sinus membrane elevation and simultaneous implant placement in edentulous posterior maxilla. Key Words Hounsefield Units, Sub-antral space, Peri-implant, Cone Beam CT Scan.

Clinical and Radiographic Assessment of Platelet Rich Fibrin Effect in One-Stage Dental Implant

Purpose : The present study was conducted to evaluate the clinical and radiographic effect of Platelet Rich Fibrin (PRF) in one stage dental implants in an attempt to improve outcomes of dental implants. Material and methods : This study was conducted on twelve (12) healthy patients that were randomly divided into two groups: Group A (control group) six (6) patients with one stage implant insertion without the use of platelet rich fibrin membrane ; Group B (Test group) six (6) patients with one stage implant insertion with the use of Platelet Rich Fibrin membrane. Results: Test group showed a highly significant increase in its bone density (P-value 0.009) after six months in comparison with control group after six months follow up. Conclusion: The use of platelet rich fibrin membrane in one stage implant insertion showed an improvement in peri-implant bone density which will affect implant stability and subsequent long implant survival.a

Surface conditioning with cold argon plasma and its effect on the osseointegration of dental implants in miniature pigs

PurposeSuccessful implant therapy is based on fast, safe, and predictable osseointegration. Several surface modifications have been introduced to improve the bone-to-implant interaction. This in vivo study evaluates the impact of plasma surface conditioning on early wound healing and osseointegration. Materials and methodsA total of 16 dental implants with a sand-blasted and acid-etched surface were conditioned with cold atmospheric plasma prior to insertion in the frontal bone of four miniature pigs. Sequential fluorescence labeling was administered to label bone metabolism, and after 8 weeks, bone blocks were harvested for radiological, histological, and histomorphometrical evaluation. ResultsThe plasma conditioning had no impact on the morphology of the implant surface. The bone-to-implant contact ratio was 90.4% and 86.5%, the interthread bone density 72.5% and 63.4%, and the periimplant bone density 60.5% and 61.1%, in the plasma conditioned group and control group, respectively. Concentric bands of fluorescence enrichment indicated a chronological and homogenous mineralization of newly formed bone. No unwanted periimplant side effects were detected. ConclusionThe increased parameters for osseointegration in this in vivo study merit further investigation in prospective clinical trials.

EFFECT OF HYPERBARIC OXYGEN THERAPY ON osseointegration OF DENTAL IMPLANT RETAIN MANDIBULAR OVERDENTURES WITH BISPHOSPHONATE TREATED PATIENTS

Aim of the study: This study aimed to evaluate the effect of hyperbaric oxygen therapy on success rate of implants used to retain mandibular overdentures and possibility of osteonecrosis of the jaw in Bisphosphonate treated osteoporotic patients.Materials and methods: Eight systemic free patients were selected as control group (CG) and eight osteoporotic patients treating with Bisphosphonate drugs orally more than two years were selected as study group (SG). For both groups, patients received mandibular implant retained overdentures with locator anchors following two stage surgical protocol. Patients of study group were received Hyperbaric oxygen thereby (HBO) after the first stage surgery, while those of control group were not received (HBO). Peri-implant marginal bone height and density were evaluated at six months (T6), twelve months (T12) after insertion using Cone Beam Computed Tomography (CBCT).Results: No failure of dental implants were recorded with 100% cumulative survival rates for both groups. Both groups showed increase in bone density and decrease in marginal bone height through a period of one year follow-up. However, the group that received HBO therapy showed less marginal bone loss and more increase in bone density than the control group.Conclusion: Hyperbaric oxygen therapy is valuable and effective treatment for osteoporotic treated Bisphosphonate patients receiving implant retained mandibular overdentures as it eliminate the possibility of Bisphosphonate associated osteonecrosis of the jaw (BONJ), reduces bone loss and increase bone density around dental implant resulting in normal survival rate.