Resonance frequency analysis
Implant stability quotient
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
The null hypothesis that finger tightening of transducer devices for RFA analysis may have a negative impact on the accuracy of ISQ measurements was rejected. Different forces applied during transducer tightening by different clinicians had no significant effect on the resulting ISQ values. Manual tightening of smartpeg magnetic devices allows for an objective and reliable determination of ISQ val...
A great number of studies have summarized that the measurement of implant stability with RFA is reliable, is noninvasive, and can be used at any time after implant insertion and during follow-up [19, 20]. Various parameters have been demonstrated to influence the degree of primary implant stability [21, 22]. These include bone density [23, 24], surgical technique [25], implant insertion torque [26...
In the test group, mesial and buccal ISQ values of 30 implants were recorded by four examiners (S1–S4) after hand tightening the smartpegs. The control group considered mesial and buccal ISQ values of 30 implants with mechanically inserted smartpegs. Only 147 values could be recorded because one transducer broke and thereafter no further values could be obtained for this implant. At torque value...
Statistical analysis was performed to evaluate the difference between the test and control group. Variance analysis and continuous variables were determined. Pearson r correlation coefficient was tested to verify the relationship between the two variables (e.g., relationship between torque and ISQ). Statistical significance was set at p > 0.05.
Three fresh bovine ribs from the same animal were selected for the current in vitro testing; the bovine ribs were of a similar size to those used by Gecikli et al. [16], thus attempting to imitate human edentulous bone with a similar composition of cortical and cancellous bone. The animal was farmed and sacrificed for food production. The bone was stored airtight, humid, and cool from the time the...
While dental implants have become increasingly important in the functional and esthetic rehabilitation of patients, implant failure still does occur. Primary stability at the time of implant placement and the development of osseointegration in the following healing process (secondary stability) are essential parameters for implant success [1]. Primary stability can be considered as the biomechanic...
There is disagreement about the optimal torque for tightening smartpegs for resonance frequency analysis (RFA). Subjective finger pressure during hand tightening could affect the reliability of the resulting values. The aim of the current study was therefore to assess whether or not the insertion torque of a smartpeg magnetic device influences the implant stability quotient (ISQ) value during RFA....
Fig. 8. Maximum von Mises stress value in implant bodies (MPa)
Fig. 8. Maximum von Mises stress value in implant bodies (MPa)
Fig. 7. Von Mises stress distribution in implant bodies. (right: buccal side, left: lingual side)
Fig. 7. Von Mises stress distribution in implant bodies. (right: buccal side, left: lingual side)
Fig. 6. Largest maximum principle stress value in cortical bone (MPa)
Fig. 6. Largest maximum principle stress value in cortical bone (MPa)
Fig. 5. Distribution of the maximum principle stress in the surrounding bone (occlusal view)
Fig. 5. Distribution of the maximum principle stress in the surrounding bone (occlusal view)
Fig. 4. Distribution of the maximum principle stress in the surrounding bone (right: buccal side, left: lingual side)
Fig. 4. Distribution of the maximum principle stress in the surrounding bone (right: buccal side, left: lingual side)
Fig. 3. Assembly of implant and bone models. A static load of 100 N was applied obliquely from the buccal side to the occlusal plane of the superstructure at 30 to the long axis of the implant
Fig. 3. Assembly of implant and bone models. A static load of 100 N was applied obliquely from the buccal side to the occlusal plane of the superstructure at 30 to the long axis of the implant
Fig. 2. Models of different implant body lengths
Fig. 2. Models of different implant body lengths
Fig. 1. Three-dimensional CAD model. (upper: a abutment screw, b superstructure, c implant body; Lower: bone model)
Fig. 1. Three-dimensional CAD model. (upper: a abutment screw, b superstructure, c implant body; Lower: bone model)
Young’s modulus (GPa)Poisson’s ratioReferenceAbutment screw (Ti-6Al-4V)1100.33[19]Superstructure (gold alloy)96.60.35[20]Cortical bone130.3[21]Cancellous bone1.370.3[21]Implant body (cpTi)1100.34 Implant body (TiZr)97.30.36 Table 1 Mechanical properties of each model component
Araki, H., Nakano, T., Ono, S. et al. Three-dimensional finite element analysis of extra short implants focusing on implant designs and materials. Int J Implant Dent 6, 5 (2020). https://doi.org/10.1186/s40729-019-0202-6
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Received: 20 August 2019
Accepted: 11 December 2019
Published: 29 January 2020
DOI: https://doi.org/10.1186/s40729-019-0202-6
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Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, 565-0871, Japan
Haruka Araki, Tamaki Nakano, Shinji Ono & Hirofumi Yatani
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This research was supported by Grants-in-Aid for Scientific Research T15K204780 and T15K111560 from the Japan Society for the Promotion of Science.
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Within the limitations of this study, the following conclusions were drawn.
The stress distribution in the cortical bone and implant body was smaller in the TL implant than in the BL implant.
The TiZr alloy had a lower elastic modulus than cpTi, and the stress distribution generated in the cortical bone and implant body was also lower.
The stress distribution generated in the cortical bone an...
Clinically, it is generally considered that the crown length increases proportionally when the length of the implant body decreases because of alveolar bone resorption. However, most previous studies performing FEA of short implants have analyzed them with a standard crown length [38]. In this study, the distance from the tip of the implant body to the occlusal plane was standardized to make the a...
The difference in the implant body structure between the submerged and non-submerged implants greatly affected the stress distribution. Since the TL implant body lies above the bone level rather than level with the crestal bone, it was found that the stress concentrates above the apex of the alveolar bone, regardless of the material type. As a result, the maximum stress value in the cortical bone ...
Overloading, which is one of the factors contributing to bone resorption around an implant body, can lead to complications because force is applied beyond the prosthodontic or biological tolerance [23]. It is believed that when stress of a certain magnitude is applied to the bone, microscopic bone destruction occurs resulting in bone resorption [24, 25]. Because implants do not have buffering mech...
The distribution of the maximum principal stress in the cortical bone concentrated on the neck of the implant body. In the TL implants, tensile stress was concentrated on the buccal side and compressive stress on the lingual side. In the BL implants, tensile stress concentration was observed on the lingual side. The distributions were similar between the cpTi and TiZr implants (Figs. 4 and 5). Th...
To validate the accuracy of the FEA model, microstrain of the surrounding bone were compared with the results of in vitro experiment measured with strain gauge [22]. In the literature, it was reported that microstrain of 59.3876 ± 24.7185 μe at the neck of implant and 17.3456 ± 12.9147 μe at the apical occurred in a bovine bone under an oblique load of 120 N. Under the same conditi...
TL and BL three-dimensional computer-aided design (CAD) implant models were created using the CAD function in computer-aided engineering software (SolidWorks 2014, Dassault Systèmes SolidWorks Corporation, MA, USA), and they were created with reference to conical connection implant used clinically. The connection part of superstructure has a tapered 15° conical shape without any special locking ...
Dental implants are widely used as a treatment option to replace a defective prosthesis. In recent years, treatment using short implants, which are ≤ 8 mm in length, has been increasing in cases with vertical bone resorption [1]. It is thought that this will become more popular as the number of patients who require minimally invasive treatment, such as older patients and those with chronic d...
When using short implants, fracture of the implant body and bone resorption are a concern because stress concentrates on and around a short implant. The purpose of this research is to investigate the differences in stress distribution between tissue level (TL) and bone level (BL) implant body designs, and between commercially pure titanium (cpTi) and the newer titanium–zirconium (TiZr) alloy in ...
Within the limitations of this study, the following conclusions were drawn.
The stress distribution in the cortical bone and implant body was smaller in the TL implant than in the BL implant.
The TiZr alloy had a lower elastic modulus than cpTi, and the stress distribution generated in the cortical bone and implant body was also lower.
The stress distribution generated in the cortical bone and ...
Clinically, it is generally considered that the crown length increases proportionally when the length of the implant body decreases because of alveolar bone resorption. However, most previous studies performing FEA of short implants have analyzed them with a standard crown length [38]. In this study, the distance from the tip of the implant body to the occlusal plane was standardized to make the a...
The difference in the implant body structure between the submerged and non-submerged implants greatly affected the stress distribution. Since the TL implant body lies above the bone level rather than level with the crestal bone, it was found that the stress concentrates above the apex of the alveolar bone, regardless of the material type. As a result, the maximum stress value in the cortical bone ...
Overloading, which is one of the factors contributing to bone resorption around an implant body, can lead to complications because force is applied beyond the prosthodontic or biological tolerance [23]. It is believed that when stress of a certain magnitude is applied to the bone, microscopic bone destruction occurs resulting in bone resorption [24, 25]. Because implants do not have buffering mech...
The distribution of the maximum principal stress in the cortical bone concentrated on the neck of the implant body. In the TL implants, tensile stress was concentrated on the buccal side and compressive stress on the lingual side. In the BL implants, tensile stress concentration was observed on the lingual side. The distributions were similar between the cpTi and TiZr implants (Figs. 4 and 5). Th...
To validate the accuracy of the FEA model, microstrain of the surrounding bone were compared with the results of in vitro experiment measured with strain gauge [22]. In the literature, it was reported that microstrain of 59.3876 ± 24.7185 μe at the neck of implant and 17.3456 ± 12.9147 μe at the apical occurred in a bovine bone under an oblique load of 120 N. Under the same conditi...
TL and BL three-dimensional computer-aided design (CAD) implant models were created using the CAD function in computer-aided engineering software (SolidWorks 2014, Dassault Systèmes SolidWorks Corporation, MA, USA), and they were created with reference to conical connection implant used clinically. The connection part of superstructure has a tapered 15° conical shape without any special locking ...
Dental implants are widely used as a treatment option to replace a defective prosthesis. In recent years, treatment using short implants, which are ≤ 8 mm in length, has been increasing in cases with vertical bone resorption [1]. It is thought that this will become more popular as the number of patients who require minimally invasive treatment, such as older patients and those with chronic d...
When using short implants, fracture of the implant body and bone resorption are a concern because stress concentrates on and around a short implant. The purpose of this research is to investigate the differences in stress distribution between tissue level (TL) and bone level (BL) implant body designs, and between commercially pure titanium (cpTi) and the newer titanium–zirconium (TiZr) alloy in ...
Figure 12. Equivalent stresses at (a) the neck and (b) the tip of the implant.
Figure 12. Equivalent stresses at (a) the neck and (b) the tip of the implant.
Figure 11. The distribution of equivalent stress (MPa) around the first molar.
Figure 11. The distribution of equivalent stress (MPa) around the first molar.
Figure 10. Displacement in the inferior-superior direction (z-axis). (a) The contact model and (b) the fixation model.
Figure 10. Displacement in the inferior-superior direction (z-axis). (a) The contact model and (b) the fixation model.
Figure 9. Displacement in the mesiodistal direction (y-axis). (a) The contact model and (b) the fixation model.
Figure 9. Displacement in the mesiodistal direction (y-axis). (a) The contact model and (b) the fixation model.
Figure 8. Displacement in the buccolingual direction (x-axis). (a) The contact model and (b) the fixation model.
Figure 8. Displacement in the buccolingual direction (x-axis). (a) The contact model and (b) the fixation model.
Figure 7. The displacement of the three implants. (M) Mesial side, (D) Distal side, (B) Buccal side, and (L) Lingual side are shown.
Figure 7. The displacement of the three implants. (M) Mesial side, (D) Distal side, (B) Buccal side, and (L) Lingual side are shown.
Figure 6. Implant displacement under loading conditions.
Figure 6. Implant displacement under loading conditions.
Figure 5. An FEA model. (a) Buccal loading, (b) central loading, and (c) lingual loading are shown.
Figure 5. An FEA model. (a) Buccal loading, (b) central loading, and (c) lingual loading are shown.
Figure 4. An experimental model loading test.
Figure 4. An experimental model loading test.
Figure 3. An experimental model. (a) Buccal loading, (b) central loading, and (c) lingual loading are shown.
Figure 3. An experimental model. (a) Buccal loading, (b) central loading, and (c) lingual loading are shown.
Figure 2. Three implants were embedded in an artificial mandible.
Figure 2. Three implants were embedded in an artificial mandible.
Figure 1. An artificial mandible.
Figure 1. An artificial mandible.
Model
Loading points
Buccal loading
Central loading
Lingual loading
Average
The neck of the implant
Contact model
No. 34
9.62
...
Source
Sum of squares
df
Mean squared
F
value
p
value
The neck of the implant
A: Boundary conditions
64.725
1
...
Source
Sum of squares
df
Mean squared
F
value
p
value
Contact model
A: Observed area
22.324
1
22.324
...
Source
Sum of squares
df
Mean squared
F
value
p
value
Contact model
A: Observed area
116.630
1
116.63...
Source
Sum of squares
df
Mean squared
F
value
p
value
Contact model
A: Observed area
16.346
1
16.346
...
Model
Loading
Average
Buccal loading
Central loading
Lingual loading
Experimental model
2.49
4.76
4.90
4.05
...
Material
Young’s modulus (MPa)
Poisson ratio
Artificial cancellous bone
628
0.3
Artificial cortical bone
1,373
...
Omori, M., Sato, Y., Kitagawa, N. et al. A biomechanical investigation of mandibular molar implants: reproducibility and validity of a finite element analysis model.
Int J Implant Dent 1, 10 (2015). https://doi.org/10.1186/s40729-015-0011-5
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Received: 07 January 2015
Accepted: 24 March 2015
Published: 28 April 2015
DOI: https://doi.org/10.1186/s40729-015-...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and in...
Miyuki Omori, Yuji Sato, Noboru Kitagawa, Yuta Shimura and Manabu Ito declare that they have no competing interests.
MO drafted the manuscript. YS contributed advice regarding the manuscript. All authors have read and approved the final manuscript.
Department of Geriatric Dentistry, Showa University, School of Dentistry, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
Miyuki Omori, Yuji Sato, Noboru Kitagawa, Yuta Shimura & Manabu Ito
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The authors would like to express their deep appreciation to the teaching staff of the Geriatric Dentistry course at Showa University Dental Hospital for their help and cooperation. This study was supported by a Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology (Showa University Grant-in-Aid for Scientific Research (C)) (Grant Number 2546...
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Sevimay M, Turhan F, Kilicarslan MA, Eskitascioglu G. Three-dimensional finite element analysis of the effect of different bone quality on stress distr...
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Duyck J, Rønold HJ, Van Oosterwyck H, Naert I, Vander Sloten J, Ellingsen JE. The influence of static and dynamic loading on marginal bone reactions around osseointegrated implants: an animal experimental study. Clin Oral Implants Res. 2001;12:207–18.
Qu...
finite element analysis
computed tomography
coefficient of variation
computer-aided design/computer-aided manufacturing
analysis of variance
With the objective of verifying the reproducibility and validity of three-dimensional finite element models, we fabricated finite element models and multiple models in which implants were embedded in artificial mandibles and compared implant displacements under various loading conditions; the results obtained produced the following conclusions:
The CVs as calculated from the amount of displacemen...
The equivalent stress values of the contact model were higher at the implant neck than the tip, and the stress generation range was also broader. However, in the fixation model, the implant neck and tip had substantially equivalent values and the stress generation range was also narrower than that of the contact model. This shows that under immediate loading conditions, there is a high likelihood ...
It has been reported that when micromovement of an implant occurs, an ingrowth of soft tissue occurs after the implant is embedded; therefore, it is difficult to achieve osseointegration [32-34]. Brunski et al. [35] reported that when immediate loading or early loading is carried out, micromovements of the implant should be controlled to 100 μm or less and excessive movement of the implant not o...
In the experimental and contact models, the absolute values of displacement under loading were different, but aspects of the displacement under loading conditions caused by differences in the loading points were similar and showed similar tendencies. The correlation coefficient of the two was 0.925, representing a significant and strong correlation (p
In the experimental model, an implant cavity 3.0 mm in diameter was formed prior to embedding an implant 3.75 mm in diameter. In theory, the threads were completely mechanically fitted to the artificial mandibular bone. It does not osseointegrate, but does represent the circumstances of immediate loading in a state of full contact with the bone. The contact model reproduced the state of contact ...
When a three-dimensional FEA is used to analyze the mechanics of peri-implant bone, it is ideal to construct an FEA model that approximates the material properties and structures of an actual mandible. Moreover, the results should be compared with the behavior of an implant in an actual mandible. However, in an actual oral cavity, individual differences exist resulting from bone morphology and phy...
Central loading resulted in the lowest equivalent stress value, while buccal and lingual loading showed substantially similar values (Figure 12b). In the bone surrounding the implant tip, the loading point was a significant factor for the equivalent stress value (p
At all three loading sites, no. 36 had the greatest displacement; the more mesial the implant, the less the displacement, and the distal portions showed a sinking displacement (Figure 10). Central loading resulted in the least displacement; buccal and lingual loading showed substantially similar displacements. Compared with the contact model, the fixation model demonstrated less displacement, but...
Figure 6 and Table 2 show the results for implant displacement under 100 N of vertical loading at each loading point and in each model.
The implant displacement under loading conditions in the experimental model and the two FEA models showed a tendency to exhibit the smallest values under central loading; substantially similar values were exhibited in buccal and lingual loading. Buccal loading...
Regarding displacement under loading, a one-way analysis of variance (ANOVA) was used to investigate statistically significant differences between the loading sites. A three-way ANOVA was used to investigate statistically significant differences in three-dimensional implant displacements under loading conditions. The assessment site, dental formula, and loading point were used as intra-subject par...
Implant displacement measurements under loading conditions were measured using an Instron-type universal testing machine (Instron‐5500R®, Instron Japan, Kanagawa, Japan) for the experimental model. The experimental models were placed on the worktable of an Instron-type universal testing machine, and compression tests were performed using a conical jig. A vertical load was applied at a rate of 0...
The experimental models were fixed in a micro-CT scanner (inspeXio SMX-90CT, SHIMADZU, Kyoto, Japan) and scanned under the following imaging conditions: tube voltage, 90 kV; tube current, 109 nA; and slice thickness, 100 μm. FEA software (Mechanical Finder®, Research Center of Computational Mechanics, Tokyo, Japan) was used to construct three-dimensional FEA models from the resulting computed...
An artificial mandibular bone (P9-X.1135, Nissin Dental Products, Kyoto, Japan) with free-end edentulism of the left mandibular first premolar (no. 34), second premolar (no. 35), and first molar (no. 36) was used (Figure 1). The model is composed of a two-layer structure of artificial cortical bone (urethane resin) and artificial cancellous bone (urethane resin foam).
Using the anatomical crown ...
With the purpose of verifying the reproducibility and validity of a three-dimensional finite element model, the displacements of implants embedded in an experimental model and in three-dimensional FEA models constructed from the experimental model were compared under various loading conditions.
Bone remodeling to maintain osseointegration between bone and implant is absolutely essential to ensure favorable results and long-term stability in implant treatment [1,2]. Bone remodeling requires that various stresses generated around the bone caused by the occlusal load applied to the implant be within an appropriate range. Concentrations of stress at the bone-implant interface, which are caus...
Three-dimensional finite element analysis (FEA) is effective in analyzing stress distributions around dental implants. However, FEA of living tissue involves many conditions, and the structures and behaviors are complex; thus, it is difficult to ensure the validity of the results. To verify reproducibility and validity, we embedded implants in experimental models and constructed FEA models; implan...
Fig. 6. Radiographic examination: The relationship between changes in the maxillary sinus floor associated with a reduction in the grafted bone and the implant tip (a immediately after surgery, b 5 years after surgery)
Fig. 6. Radiographic examination: The relationship between changes in the maxillary sinus floor associated with a reduction in the grafted bone and the implant tip (a immediat...
Fig. 5. Radiographic examination (long-term changes in bone height surrounding the implant) n = 20 Number of implants. A total of 5 CBCT scans were taken prior to surgery, immediately after surgery, 6 months after surgery, 1–2 years after surgery, and 3–5 years after surgery
Fig. 5. Radiographic examination (long-term changes in bone height surrounding the implant) n = 20 Numbe...
Fig. 4. Clinical findings of the second surgery on biopsy at 6 months. The degree of residual grafting materials varied depending on the patient. a most of the β-TCP remained. b Replacement of the β-TCP by new bone had progressed
Fig. 4. Clinical findings of the second surgery on biopsy at 6 months. The degree of residual grafting materials varied depending on the patient. a most of the ...
Fig. 3. Radiographic examination of the height of the bone surrounding the implant (BH): Measurement of changes in the height of the implant tip to the bone fixation part over time in the frontal plane: the distance measured from the intersecting point of the long axis of the implant and the maxillary sinus floor to the implant tip: +maxillary side, −alveolar crest side. The liner valuables: r...
Fig. 2. Radiographic examination of the volume of the bone graft (BV): Calculation of area on the frontal plane prior to and immediately after surgery using polygon tool. The polygon tool is included in the CT device, which was dragged around the perimeter of the target site to measure area. Graft volume calculation method (sum of the area and calculation of volume). Volume cm3 = area cm2 ...
Fig. 1. Treatment protocol for the present study. Postoperative CBCT was performed a minimum of three times, i.e., immediately, 6 months, and 2.5 years after implant placement
Fig. 1. Treatment protocol for the present study. Postoperative CBCT was performed a minimum of three times, i.e., immediately, 6 months, and 2.5 years after implant placement
Coefficient
Standard error
95 % CI
P value
Time (months)
−0.087
...
Parameter
Mean (mm)
SD (mm)
RBH
4.48
1.51
...
NoneTable 6 Radiographic examination of BH (changes in bone height surrounding the implant)
BV
Mean
Reduction rate
Immediately after surgery (n = 30)
1206 ...
CBCT examination (year)
Number of patients
0–1
0
1–2
14
...
Implant site
Number of implants
4
6
5
16
6
24
7
12
Total: 58 implants
Table 3 The number of implants according to site
Observation period (months)
Number of patients
12–18
11
19–24
4
...
Age group (years)
Number of patients
40–49
7
50–59
10
...
Okada, T., Kanai, T., Tachikawa, N. et al. Long-term radiographic assessment of maxillary sinus floor augmentation using beta-tricalcium phosphate: analysis by cone-beam computed tomography.
Int J Implant Dent 2, 8 (2016). https://doi.org/10.1186/s40729-016-0042-6
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Received: 25 November 2015
Accepted: 23 March 2016
Published: 01 April 2016
DOI: https://do...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Tsuneji Okada, Toru Kanai, Noriko Tachikawa, Motohiro Munakata, and Shohei Kasugai declare that they have no competing interests.
TO performed the data acquisition, both of surgical and prosthodontic treatments, the data analysis, statistical analysis, and wrote the manuscript. TK performed the treatment plan, making of pictures, and collecting of references. NT and MM performed the data acquisit...
Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
Tsuneji Okada, Toru Kanai & Noriko Tachikawa
Oral Implantology Department of Prosthodontic Dentistry for Function of TMJ and Occlusion, Kanagawa Dental University, 82, Inaokachou, Yokosuka-shi, 238-8580, Kanagawa, Japan
Motohiro Munakata
Oral Implantology and...
The bone grafting agent, β-TCP (OSferion), was kindly supplied by Olympus Terumo Biomaterials Corp.
Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone. J Oral Maxillofac Surg. 1980;38:613–6.
Jensen OT, Shulman LB, Block MS, et al. Report of the sinus consensus conference of 1996. Int J Oral Maxillofac Implants. 1998;13:11–45.
Artzi Z, Weinreb M, Givol N, et al. Biomaterial resorption rate and healing site morphology of inorganic bovine bone and β-tri...
Chanavaz M. Maxillary sinus: anatomy, physiology, surgery, and bone grafting related to implantology: eleven years of surgical experience (1979–1990). J Oral Implantol. 1990;16:199–209.
Misch CE. Maxillary sinus lift and elevation with subantral augmentation. In: Misch CE, editor. Contemporary implant dentistry. St. Louis, MO: Mosby; 1993. p. 545–74.
Sharan A, Madjar D. Maxillary sinus pne...
Maxillary sinus graft augmentation using β-TCP is clinically effective.
Analysis by CBCT provides superior spatial resolution and allows for extremely accurate postoperative evaluation of maxillary sinus floor augmentation and bone volume measurements.
On the basis of CBCT examinations, although maxillary sinus pneumatization continues to progress ≥1 year after surgery, it stabilizes 3 year...
During the observation period, there was no clinical implant failure and the suvival rate for implantation and maxillary sinus floor augmentation was 100 %. Histological examination in a previous report on maxillary sinus augmentation using β-TCP (Cerasorb®), Szabo et al. compared bilateral maxillary sinus augmentation in the same patients using β-TCP and iliac bone at 6 months after surgery ...
As grafting materials for maxillary sinus floor augmentation, autogenous bone, which is considered as the gold standard and reported first by Boyne et al. using iliac bone graft, has been used as the first-choice material. In terms of osteogenic, osteoinductive, and osteoconductive properties, autogenous bone is considered ideal; however, the use of autogenous bone places great physical stress on ...
Change in height of bone surrounding the implant (height from the maxillary sinus floor to the implant tip): Immediately after surgery, all patients had grafted bone between the implant tip and the maxillary sinus floor, with a mean of 2.00 ± 1.51 mm. This height decreased to 0.73 ± 1.33 mm at 6 months after surgery and −0.72 ± 1.11 mm at 2.5 years after surgery (Fig. 5). 41...
The mean age of the 30 patients was 57.4 (40–75) years, and the male/female ratio was 4:26. The mean postoperative observation period was 3 years and 8 months (the maximum period was 5 years and 0 months; the minimum period was 2 years and 2 months). Total of 58 implants were placed at premolar and molar region. There were no dropouts, such as participants not visiting the clinic, during t...
Residual bone height (RBH): existing bone height to the maxillary sinus at the implant site
Implant length (IL): the length of the part of the implant that projects into the maxillary sinus
Width of sinus (SW): the width of the maxillary sinus from lateral wall to medial wall at the height of the center of the IL
In the present study, the radiographic examinations were statistically analyzed fo...
In the present study, we used the superior spatial resolution of CBCT to measure changes over time in (a) the volume of the bone graft (BV) and (b) the height of the bone surrounding the implant (BH).
The method of calculating the volume of the implant site is shown below (Fig. 2).
The slice thickness (voxel value) was resized (0.146 mm → 1 mm) to derive the volume of the grafting agent...
This study is a prospective observational study. The subjects included patients who had undergone maxillary sinus floor augmentation using β-TCP and implant placement at the Clinic for Implant Dentistry, Dental Hospital, Tokyo Medical and Dental University during the 3-year period from January 2009 to December 2011. All patients underwent maxillary sinus floor augmentation at the same time as imp...
Radiographic examinations to determine changes in bone mass in maxillary sinus floor augmentation have been conducted primarily using panoramic radiography [8–12], which allows for the assessment of the height of the maxillary sinus in only two dimensions. In addition, it does not allow for detailed examination or measurement of the interior of the maxillary sinus without factoring in magnificat...
The maxillary sinus gradually expands after birth and becomes fully pneumatized with the eruption of all permanent teeth. Although the physiological cause and maxillary sinus pneumatization are largely unknown, it is believed that genetics, atmospheric pressure, and hormones are involved in it. This sinus is closely related to the root apex of the premolar and molar teeth, and it is either separat...
The long-term stability of maxillary sinus floor augmentation with β-TCP remains largely unknown. We report the long-term assessment of volumetric changes in maxillary sinus floor augmentation with β-TCP by cone-beam computed tomography (CBCT).
The subjects included 30 patients who underwent maxillary sinus floor augmentation using β-TCP and 58 implant placement for unilateral maxillary defect...
Fig. 15. Load supporting area in the superstructures
Fig. 15. Load supporting area in the superstructures
Fig. 14. The distribution of equivalent stress around the no. 36 implant in the finite element analysis (FEA) models
Fig. 14. The distribution of equivalent stress around the no. 36 implant in the finite element analysis (FEA) models
Fig. 13. The distribution of equivalent stress around the peri-implant bone in the finite element analysis (FEA) models
Fig. 13. The distribution of equivalent stress around the peri-implant bone in the finite element analysis (FEA) models
Fig. 12. The strain around the no. 36 implant in the finite element analysis (FEA) models
Fig. 12. The strain around the no. 36 implant in the finite element analysis (FEA) models
Fig. 11. The strain around the no. 36 implant in the experimental models
Fig. 11. The strain around the no. 36 implant in the experimental models
Fig. 10. The displacement of the three implants
Fig. 10. The displacement of the three implants
Fig. 9. The displacement of the implants under loading in finite element analysis (FEA) models
Fig. 9. The displacement of the implants under loading in finite element analysis (FEA) models
Fig. 8. The displacement of the implants under loading in experimental models
Fig. 8. The displacement of the implants under loading in experimental models
Fig. 7. A finite element analysis (FEA) model. (a) Buccal load, (b) central load, and (c) lingual load
Fig. 7. A finite element analysis (FEA) model. (a) Buccal load, (b) central load, and (c) lingual load
Fig. 6. Loading test in the experimental model
Fig. 6. Loading test in the experimental model
Fig. 5. Application of strain gauges
Fig. 5. Application of strain gauges
Fig. 4. Experimental model. (a) Buccal load, (b) central load, and (c) lingual load
Fig. 4. Experimental model. (a) Buccal load, (b) central load, and (c) lingual load
Fig. 3. Three different models with different placements
Fig. 3. Three different models with different placements
Models
Mean difference
P value
Straight
B-offset
−58.94
...
Models
Mean difference
P value
Straight
B-offset
−402.94
...
Models
Loading
Strain (με)
Strain M
Strain B
Strain D
...
Models
Mean difference
P value
Straight
B-offset
−25.14
...
Models
Mean difference
P value
Straight
B-offset
1524.82
...
Models
Loading
Strain (με)
Strain M
Strain B
Strain D
...
Models
Displacement (μm)
Buccal loading
Central loading
Lingual loading
Buccal offse...
Models
Displacement (μm)
Buccal loading
Central loading
Lingual loading
Buccal offse...
Material
Young’s modulus (MPa)
Poisson’s ratio
Artificial cancellous bone
6.29
0.3
Artificial cortical bone
13.73
0.3
Implant and superstructure
108,000
0.3
Table 1 Mechanical properties of materials used in the FEA models
Shimura, Y., Sato, Y., Kitagawa, N. et al. Biomechanical effects of offset placement of dental implants in the edentulous posterior mandible. Int J Implant Dent 2, 17 (2016). https://doi.org/10.1186/s40729-016-0050-6
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Received: 18 January 2016
Accepted: 13 June 2016
Published: 17 June 2016
DOI: https://doi.org/10.1186/s40729-016-0050-6
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Yuta Shimura, Yuji Sato, Noboru Kitagawa, and Miyuki Omori declare that they have no competing interests.
YS drafted the manuscript. YS, NK, and MO contributed advice for the manuscript. All authors read and approved the final manuscript.
Department of Geriatric Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo, 145-8515, Japan
Yuta Shimura, Yuji Sato, Noboru Kitagawa & Miyuki Omori
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We are sincerely grateful for the assistance we received from the teaching staff of the Geriatric Dentistry course at Showa University Dental Hospital; Professor Takashi Miyazaki and the late Akihiro Fujishima of the Department of Conservative Dentistry, Division of Oral Biomaterials and Engineering; Professor Masanori Nakamura of the Department of Oral Anatomy and Developmental Biology; and Profe...
Yoshino A. Effects of ratio of superstructure length to fixture length on the strain of the bone surfaces surrounding the implant. J Jpn Soc Oral Implantol. 2001;14:398–413. in Japanese.
Rangert B, Jemt T, Jörneus L. Forces and moments on Branemark implants. Int J Oral Maxillofac Implants. 1989;4:241–7.
Sato Y. Discussion of offset arrangement in implants. Quintessence Dent Implantol. 2000;...
Nishioka RS, de Vasconcellos LG, de Melo Nishioka LN. External hexagon and internal hexagon in straight and offset implant placement: strain gauge analysis. Implant Dent. 2009;18:512–20.
Nishioka RS, de Vasconcellos LG, de Melo Nishioka GN. Comparative strain gauge analysis of external and internal hexagon, Morse taper, and influence of straight and offset implant configuration. Implant Dent. 2...
Frost HM. Wolff’s Law and bone’s structural adaptations to mechanical usage: an overview for clinicians. Angle Orthod. 1994;64:175–88.
Duyck J, Rønold HJ, Van Oosterwyck H, Naert I, Vander Sloten J, Ellingsen JE. The influence of static and dynamic loading on marginal bone reactions around osseointegrated implants: an animal experimental study. Clin Oral Implants Res. 2001;12:207–18.
Qu...
In the present study, which aimed to verify the biomechanical effects of offset placement on peri-implant bone, we created multiple finite element models and models where implants were actually placed. We compared the compressed displacement as well as the strain and stress distribution in the peri-implant bone between both kinds of models, and the results can be summarized as follows:
Central lo...
Concentration of stress in the loading-side peri-implant bone was observed in all placements and for both the experimental and the FEA models. Considerable stress was also found to be concentrated in the no. 36 peri-implant bone in buccal loading with buccal offset and lingual loading with lingual offset. Similar to the strain results, stress was observed in a large range under conditions where th...
Similar trends were observed in the direction and magnitude of displacement between placements. Buccal loading exhibited considerable motion towards the buccal rotation/tilting of the implant bodies, and lingual loading exhibited little motion towards lingual displacement. This corresponds to the fact that there was more compressed displacement during buccal loading than during lingual loading.
I...
Moreover, considering the possibility of error while using an implant placement guide, we created many FEA models for each placement to compare the accuracy between the same placement models used with different FEA models.
Most studies verifying the usefulness of offset placement used a single technique for analysis [8–19]. Therefore, the results regarding the usefulness of offset placement var...
Reported studies verifying the effects of offset placement include ones where implant bodies were embedded in rectangular experimental models [11–14], ones where rectangular bone models were constructed with FEA models [15, 16], and ones where FEA models were constructed from CT data on human mandibles [17, 18]. The artificial mandible models used in the present study were type II in the Lekholm...
Figure 11 and Table 4 show the strain, by loading site, in the implant part corresponding to the first molar in the experimental models during the application of a 100-N vertical load.
Considerable compressive strain was observed with the load-side strain gauges in all placements, and similar trends were observed between placements. As much as about 4500 με of compressive strain was observed...
Figures 8 and 9 and Tables 2 and 3 show the results for the compressed displacement of the implants, by loading site, during the application of a 100-N vertical load in each of the models.
In all placements, the compressed displacement in the experimental models and FEA models was greatest with buccal loading and smallest with central loading at the three loading points. For both the experiment...
The places on the experimental models where the strain gauges were applied were represented as coordinate points on the FEA models, and the strain in the FEA models was calculated by dividing the change in length between before and after loading by the length of the strain gauges.
An equivalent stress occurring in the peri-implant bone during loading was observed and assessed in a buccolingual cr...
Implant displacement under loading conditions was measured using an Instron-type universal testing machine (Instron-5500R®, Instron Japan, Kanagawa, Japan) for the experimental model. The experimental models were placed on the worktable of an Instron-type universal testing machine, and compression tests were performed using a conical jig. A vertical load was applied at a rate of 0.5 mm/s on the ...
Four two-wire strain gauges (KFR-02N-120-C1-11, Kyowa Electronic Instruments, Tokyo, Japan) were applied to the no. 36 peri-implant bone surface [21]. The surface of the measurement site was polished with no. 320 sandpaper and then wiped clean with acetone, following which they were adhered with a special adhesive (CC-33A, Kyowa Electronic Instruments, Tokyo, Japan). The strain gauges were applied...
An artificial mandibular bone (P9-X.1135, Nissin Dental Products, Kyoto, Japan) with free-end edentulism of the left mandibular first premolar (no. 34), second premolar (no. 35), and first molar (no. 36) was used (Fig. 1). The model was composed of a two-layer structure of artificial cortical bone (urethane resin) and artificial cancellous bone (urethane resin foam).
Using the anatomical crown w...
Bone remodeling to maintain osseointegration between the bone and implant is absolutely essential to ensure favorable results and long-term stability in implant treatment [1, 2]. Bone remodeling requires that various stresses generated around the bone caused by the occlusal load applied to the implant be within an appropriate range. The concentration of stress at the bone-implant interface, caused...
Offset placement may not necessarily be more biomechanically effective than straight placement in edentulous posterior mandibles.
Proper implant placement is very important for long-term implant stability. Recently, numerous biomechanical studies have been conducted to clarify the relationship between implant placement and peri-implant stress. The placement of multiple implants in the edentulous posterior mandible has been studied by geometric analysis, three-dimensional finite element analysis (FEA), model experimentation, ...
Fig. 8. There were moderately significant and positive correlations between the ALP levels and OC levels at all measurements from week 1 to week 12. The OC levels in pg/μg protein were associated with the ALP levels in nM/μg protein at the implant site (a), control site (b), and pooled samples of the control and implant sites (c)
Fig. 8. There were moderately significant and positive correl...
Fig. 7. Comparison between the trend of the biomarker levels and the trend of the ISQ values over time
Fig. 7. Comparison between the trend of the biomarker levels and the trend of the ISQ values over time
Fig. 6. There were weakly significant and positive correlations between the ALP or OC levels and ISQ values at all measurements from week 1 to week 12. At the implant site, the ALP levels in nM/μg protein (a) or the OC levels in pg/μg protein (b) were associated with ISQ values
Fig. 6. There were weakly significant and positive correlations between the ALP or OC levels and ISQ values at all...
Fig. 5. Change in the median values of the OC level over time. In the test group, the OC level continuously increased with time. There was a statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P
Fig. 4. Change in the median values of the ALP level over time. In the test group, the ALP level decreased at 1–4 weeks and then increased at 6, 8, 10, and 12 weeks. There was no statistically significant difference in the ALP level in either the control or the test groups at any measurement
Fig. 4. Change in the median values of the ALP level over time. In the test group, the ALP level d...
Fig. 3. Change in the median values of the GCF (control group) and PICF (test group) volume over time. In the test group, the PICF volume continuously decreased with time (a). There were no significant differences in the median values of the crevicular fluid volume in either the control group or the test groups at any measurement (b)
Fig. 3. Change in the median values of the GCF (control gro...
Fig. 2. Change in the mean ISQ values over time. There was a statistically significant decrease in the mean ISQ values between 1 and 3 weeks (P
Fig. 1. Timeline of the clinical study. I—implant site, T—contralateral posterior mandibular nonsurgical tooth
Fig. 1. Timeline of the clinical study. I—implant site, T—contralateral posterior mandibular nonsurgical tooth
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks
8 weeks
10 weeks
12 weeks
Median (interquartile range)
ALP level
(nM/μg protein)
Tooth (control)
175 (215)
203 (308)
148 (269)
143 (112)
266 (427)
145 (96)
181 (148)
191 (263)
107 (128)
Implant (test)
230 (238)
139 (139)
157 (293)
108 (134)
166 (434)
179 (251)
147 (...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks
8 weeks
10 weeks
12 weeks
Median (interquartile range)
CF volume (μl)
Tooth (control)
0.20 (0.23)
0.26 (0.25)
0.19 (0.20)
0.19 (0.50)
0.17 (0.33)
0.18 (0.08)
0.13 (0.24)
0.23 (0.42)
0.20 (0.17)
Implant (test)
0.26 (0.30)
0.25 (0.41)
0.16 (0.21)
0.17 (0.19)
0.18 (0.33)
0.13 (0.14)
...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks...
Patient no.
Age
Sex
Positiona
Bone qualityb
1
34
...
Inclusion criteria
Exclusion criteria
Patients aged 25–65 years
Presence of periodontal disease or periapical lesions
Ability to participat...
Tirachaimongkol, C., Pothacharoen, P., Reichart, P.A. et al. Relation between the stability of dental implants and two biological markers during the healing period: a prospective clinical study.
Int J Implant Dent 2, 27 (2016). https://doi.org/10.1186/s40729-016-0058-y
Download citation
Received: 14 September 2016
Accepted: 18 November 2016
Published: 08 December 2016
DOI...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Suthep sub-district, A. Muang, Chiang Mai, 50200, Thailand
Choknapa Tirachaimongkol & Pathawee Khongkhunthian
Department of Biochemistry, Faculty of Medicine, Thailand Excellence Center for Tissue Engineering and Stem Cells, Chiang Mai, Thailand
Peraphan Pothacharoen
Department of Oral Medicine, Dental...
The authors acknowledge Mrs. Yupaporn Kiatsakulcharoen and Miss Kamolwan Mangkalad, the Center of Excellent for Dental Implantology, Chiang Mai University for clinical assistance, Mr. Aitthiphon Chongchai, the Department of Biochemistry, Faculty of Medicine Chiang Mai University for laboratory assistance, Dr.Thanapat Sastraruji, Faculty of Dentistry, Chiang Mai University for statistical consultat...
Lekholm U, Zarb G, Albrektsson T. Tissue integrated prostheses. Patient selection and preparation. Chicago: Quintessence Publishing Co Inc; 1985. p. 199–209.
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Berglundh T, Abrahamsson I, Lang NP, Lindhe J. De novo alveolar bone formation adjacent to endosseous implants. Clin Oral Implants Res. 2003;3:251–62.
Emecen-Huja P, Eubank TD, Shapiro V, Yildiz V, Tatakis DN, Leblebicioglu B. Peri-implant versus periodontal wound healing. J Clin Periodontol. 2013;40:816–24.
Chapple LLC, Socransky SS, Dibart S, Glenwright DH, Matthews JB. Chemiluminescent as...
Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Implants Res. 2004;5:529–39.
Sim CPC, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration: I. Instrument positioning, bone structure, implant length. Clin Oral Implants ...
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52:155–70.
Khongkhunthian P. Implant features. In: Khongkhunthian P, editor. PW Plus Thai Dental Implant. Bangkok: STZ Mospace design; 2015. p. 12.
Lacey DL, Timms E, Tan HL, Kelley MJ, Dunstan CR, ...
Within the limitations of this study and cautious interpretation due to small number of implants/patients, the ISQ values were weakly correlated with both ALP and OC molecules in PICF during the healing period. The results also show that osteocalcin may be used as a biological marker for monitoring implant healing at 6, 8, 10, and 12 weeks after implant placement. The ISQ values showed high stabi...
Vogel and Marcotte [33] suggested that the correlation between mRNA and protein quantities is approximately 40%. As there are many mechanisms between transcription and translation, especially in human cell and protein stability, at the gene expression level, the transcription data is beneficial in making decisions about molecular candidates for future studies at the protein level. The colorimetric...
The main sources of ALP in GCF are neutrophils, bacteria within dental plaque, fibroblasts, and osteoblasts [28]. Plagnat et al. [29] suggested that longitudinal monitoring of ALP in PICF might confirm its possible use as a marker of implant failure. Considering the change in the median values of the ALP level over time, in the test group, the ALP level decreased at 1–4 weeks and then increased...
At the implant site, the OC level continuously increased with time. According to the Friedman followed by Wilcoxon signed-rank tests, there was statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P
Ten patients, seven females, and three males, aged 42.4 ± 11.99 years (range, 28 to 64 years), with either a first mandibular or second mandibular molar edentulous area, who required a single nonsubmerged implant participated in this study, as shown in Table 2. The implants used for all patients were 10 mm long and 5 mm in diameter. All patients completed the follow-up. None of the impla...
Data were analyzed by using SPSS 17.0 software (SPSS Inc., Chicago, IL, USA). Repeated measures analysis of variance was performed to evaluate the change in the ISQ values at each measurement. The independent samples t test was used to investigate the differences in implant stability in the patients’ gender and bone quality. The Friedman test, followed by the Wilcoxon signed-rank test, was used ...
The level of OC was measured by using commercially available ELISA kits (Human Osteocalcin Quantikine ELISA Kit, R&D Systems, Inc., Minneapolis, MN, USA) according to the manufacturer’s instructions. A 100 μl volume of Assay Diluent RD1-117 (R&D Systems) was added into each well of the microplate and then 50 μl of standard (0–64 ng/ml) or sample was added to each well. The microplate was ...
To observe the level of two bone formation biomarkers (alkaline phosphatase and osteocalcin) during the osseointegration period compared with control group using GCF from the first molar of the contralateral side of implant position, the sample collection of GCF was performed before the surgical procedure, immediately after the surgical operation and after 1, 2, 3, 4, 6, 8, 10, and 12 weeks. The ...
The study is a prospective clinical study during the 3-month healing period of implant. The study was approved by the Human Experimentation Committee, Faculty of Dentistry, Chiang Mai University. The study outline is shown in Fig. 1.
Ten patients, who were partially edentulous in the mandibular posterior region for whom a single nonsubmerged implant was planned, participated in this study. All o...
Osteocalcin (OC) is the most plentiful noncollagenous protein of the bone matrix. It is secreted from odontoblasts, osteocytes, and osteoblasts, in order to bind hydroxyapatite and calcium during matrix mineralization [7]. It is one of the serological markers in the bone formation process. Numerous studies have shown increased OC levels in bone formation. However, increased OC level relates more t...
Dental implants have shown a high success rate for rehabilitation of edentulous patients if certain conditions are met during treatment. Nevertheless, the risk of failure remains difficult to predict. The achievement of osseointegration depends on many factors, such as a suitable host, biocompatible materials, careful surgery, and an appropriate healing time [1].
The primary stability comes from ...
The purposes of this study were to examine the correlation between the stability of dental implants and bone formation markers during the healing period and to monitor the stability of dental implants using the resonance frequency analysis (RFA) method. The null hypothesis of the study is no correlation between the stability of dental implant and bone formation markers.
The study is a prospective...
Fig. 8. There were moderately significant and positive correlations between the ALP levels and OC levels at all measurements from week 1 to week 12. The OC levels in pg/μg protein were associated with the ALP levels in nM/μg protein at the implant site (a), control site (b), and pooled samples of the control and implant sites (c)
Fig. 8. There were moderately significant and positive correl...
Fig. 7. Comparison between the trend of the biomarker levels and the trend of the ISQ values over time
Fig. 7. Comparison between the trend of the biomarker levels and the trend of the ISQ values over time
Fig. 6. There were weakly significant and positive correlations between the ALP or OC levels and ISQ values at all measurements from week 1 to week 12. At the implant site, the ALP levels in nM/μg protein (a) or the OC levels in pg/μg protein (b) were associated with ISQ values
Fig. 6. There were weakly significant and positive correlations between the ALP or OC levels and ISQ values at all...
Fig. 5. Change in the median values of the OC level over time. In the test group, the OC level continuously increased with time. There was a statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P
Fig. 4. Change in the median values of the ALP level over time. In the test group, the ALP level decreased at 1–4 weeks and then increased at 6, 8, 10, and 12 weeks. There was no statistically significant difference in the ALP level in either the control or the test groups at any measurement
Fig. 4. Change in the median values of the ALP level over time. In the test group, the ALP level d...
Fig. 3. Change in the median values of the GCF (control group) and PICF (test group) volume over time. In the test group, the PICF volume continuously decreased with time (a). There were no significant differences in the median values of the crevicular fluid volume in either the control group or the test groups at any measurement (b)
Fig. 3. Change in the median values of the GCF (control gro...
Fig. 2. Change in the mean ISQ values over time. There was a statistically significant decrease in the mean ISQ values between 1 and 3 weeks (P
Fig. 1. Timeline of the clinical study. I—implant site, T—contralateral posterior mandibular nonsurgical tooth
Fig. 1. Timeline of the clinical study. I—implant site, T—contralateral posterior mandibular nonsurgical tooth
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks
8 weeks
10 weeks
12 weeks
Median (interquartile range)
ALP level
(nM/μg protein)
Tooth (control)
175 (215)
203 (308)
148 (269)
143 (112)
266 (427)
145 (96)
181 (148)
191 (263)
107 (128)
Implant (test)
230 (238)
139 (139)
157 (293)
108 (134)
166 (434)
179 (251)
147 (...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks
8 weeks
10 weeks
12 weeks
Median (interquartile range)
CF volume (μl)
Tooth (control)
0.20 (0.23)
0.26 (0.25)
0.19 (0.20)
0.19 (0.50)
0.17 (0.33)
0.18 (0.08)
0.13 (0.24)
0.23 (0.42)
0.20 (0.17)
Implant (test)
0.26 (0.30)
0.25 (0.41)
0.16 (0.21)
0.17 (0.19)
0.18 (0.33)
0.13 (0.14)
...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks...
Patient no.
Age
Sex
Positiona
Bone qualityb
1
34
Female
46
3
2
38
Female
36
3
3
43
Female
37
3
4
64
Male
46
2
5
30
Female
47
3
6
48
Female
36
2
7
57
Male
36
3
8
28
Female
46
3
9
33
Male
46
2
10
49
Female
46
3
Table 2 Profile of patients
Inclusion criteria
Exclusion criteria
Patients aged 25–65 years
Presence of periodontal disease or periapical lesions
Ability to participat...
Tirachaimongkol, C., Pothacharoen, P., Reichart, P.A. et al. Relation between the stability of dental implants and two biological markers during the healing period: a prospective clinical study. Int J Implant Dent 2, 27 (2016). https://doi.org/10.1186/s40729-016-0058-y
Download citation
Received: 14 September 2016
Accepted: 18 November 2016
Published: 08 December 2016
DOI: https://doi.org/10....
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Suthep sub-district, A. Muang, Chiang Mai, 50200, Thailand
Choknapa Tirachaimongkol & Pathawee Khongkhunthian
Department of Biochemistry, Faculty of Medicine, Thailand Excellence Center for Tissue Engineering and Stem Cells, Chiang Mai, Thailand
Peraphan Pothacharoen
Department of Oral Medicine, Dental...
The authors acknowledge Mrs. Yupaporn Kiatsakulcharoen and Miss Kamolwan Mangkalad, the Center of Excellent for Dental Implantology, Chiang Mai University for clinical assistance, Mr. Aitthiphon Chongchai, the Department of Biochemistry, Faculty of Medicine Chiang Mai University for laboratory assistance, Dr.Thanapat Sastraruji, Faculty of Dentistry, Chiang Mai University for statistical consultat...
Lekholm U, Zarb G, Albrektsson T. Tissue integrated prostheses. Patient selection and preparation. Chicago: Quintessence Publishing Co Inc; 1985. p. 199–209.
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Berglundh T, Abrahamsson I, Lang NP, Lindhe J. De novo alveolar bone formation adjacent to endosseous implants. Clin Oral Implants Res. 2003;3:251–62.
Emecen-Huja P, Eubank TD, Shapiro V, Yildiz V, Tatakis DN, Leblebicioglu B. Peri-implant versus periodontal wound healing. J Clin Periodontol. 2013;40:816–24.
Chapple LLC, Socransky SS, Dibart S, Glenwright DH, Matthews JB. Chemiluminescent as...
Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Implants Res. 2004;5:529–39.
Sim CPC, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration: I. Instrument positioning, bone structure, implant length. Clin Oral Implants ...
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52:155–70.
Khongkhunthian P. Implant features. In: Khongkhunthian P, editor. PW Plus Thai Dental Implant. Bangkok: STZ Mospace design; 2015. p. 12.
Lacey DL, Timms E, Tan HL, Kelley MJ, Dunstan CR, ...
Within the limitations of this study and cautious interpretation due to small number of implants/patients, the ISQ values were weakly correlated with both ALP and OC molecules in PICF during the healing period. The results also show that osteocalcin may be used as a biological marker for monitoring implant healing at 6, 8, 10, and 12 weeks after implant placement. The ISQ values showed high stabi...
Vogel and Marcotte [33] suggested that the correlation between mRNA and protein quantities is approximately 40%. As there are many mechanisms between transcription and translation, especially in human cell and protein stability, at the gene expression level, the transcription data is beneficial in making decisions about molecular candidates for future studies at the protein level. The colorimetric...
The main sources of ALP in GCF are neutrophils, bacteria within dental plaque, fibroblasts, and osteoblasts [28]. Plagnat et al. [29] suggested that longitudinal monitoring of ALP in PICF might confirm its possible use as a marker of implant failure. Considering the change in the median values of the ALP level over time, in the test group, the ALP level decreased at 1–4 weeks and then increased...
The results of this study show that, at the time of implantation, the ISQ values ranged between 67.5 and 83. The mean initial ISQ value was 77.0 ± 1.32. These findings are in harmony with those of previous studies [16, 18]. Tallarico et al. (2011) reported that the macro-design of dental implant affects the primary anchorage [16]. They suggested that the high initial ISQ value is a factor in ...
At the implant site, the OC level continuously increased with time. According to the Friedman followed by Wilcoxon signed-rank tests, there was statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P
Ten patients, seven females, and three males, aged 42.4 ± 11.99 years (range, 28 to 64 years), with either a first mandibular or second mandibular molar edentulous area, who required a single nonsubmerged implant participated in this study, as shown in Table 2. The implants used for all patients were 10 mm long and 5 mm in diameter. All patients completed the follow-up. None of the impla...
Data were analyzed by using SPSS 17.0 software (SPSS Inc., Chicago, IL, USA). Repeated measures analysis of variance was performed to evaluate the change in the ISQ values at each measurement. The independent samples t test was used to investigate the differences in implant stability in the patients’ gender and bone quality. The Friedman test, followed by the Wilcoxon signed-rank test, was used ...
The level of OC was measured by using commercially available ELISA kits (Human Osteocalcin Quantikine ELISA Kit, R&D Systems, Inc., Minneapolis, MN, USA) according to the manufacturer’s instructions. A 100 μl volume of Assay Diluent RD1-117 (R&D Systems) was added into each well of the microplate and then 50 μl of standard (0–64 ng/ml) or sample was added to each well. The microplate was ...
To observe the level of two bone formation biomarkers (alkaline phosphatase and osteocalcin) during the osseointegration period compared with control group using GCF from the first molar of the contralateral side of implant position, the sample collection of GCF was performed before the surgical procedure, immediately after the surgical operation and after 1, 2, 3, 4, 6, 8, 10, and 12 weeks. The ...
The study is a prospective clinical study during the 3-month healing period of implant. The study was approved by the Human Experimentation Committee, Faculty of Dentistry, Chiang Mai University. The study outline is shown in Fig. 1.
Ten patients, who were partially edentulous in the mandibular posterior region for whom a single nonsubmerged implant was planned, participated in this study. All o...
Osteocalcin (OC) is the most plentiful noncollagenous protein of the bone matrix. It is secreted from odontoblasts, osteocytes, and osteoblasts, in order to bind hydroxyapatite and calcium during matrix mineralization [7]. It is one of the serological markers in the bone formation process. Numerous studies have shown increased OC levels in bone formation. However, increased OC level relates more t...
Dental implants have shown a high success rate for rehabilitation of edentulous patients if certain conditions are met during treatment. Nevertheless, the risk of failure remains difficult to predict. The achievement of osseointegration depends on many factors, such as a suitable host, biocompatible materials, careful surgery, and an appropriate healing time [1].
The primary stability comes from ...
The purposes of this study were to examine the correlation between the stability of dental implants and bone formation markers during the healing period and to monitor the stability of dental implants using the resonance frequency analysis (RFA) method. The null hypothesis of the study is no correlation between the stability of dental implant and bone formation markers.
The study is a prospective...
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was 0.2981 and at 1 year 0.6613
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was ...
Fig. 2. ISQ values at placement, 6 weeks, 6 months, and 1 year. Mean and standard deviation of ISQ values taken at placement, 6 weeks, 6 months, and 1 year is presented. No statistical significant difference was determined between ISQ values at all time points. (p
Fig. 1. Implant design. The OSPTX and OSP implants are manufactured from high-grade commercially pure titanium with surface roughness produced via a fluoride treatment process. The OSP implant is a screw-shaped self-tapping implant. The diameter used in this study was 4.0 mm. The implant length used in this study was 8 mm. The OSPTX implant has the same features as the OSP except the apex of t...
Implant success
Clinically immobile when tested manually and/or with RFA (minimum ISQ = 65)
Absence of peri-implant radiolucency present on an undistorted radiograph
Absence of unresolved pain, discomfort, inf...
Inclusion
Male or female
At least 18 years old
Healthy enough to undergo routine implant surgery and subsequent dental treatment
Partially edentulous requiring...
Simmons, D.E., Maney, P., Teitelbaum, A.G. et al. Comparative evaluation of the stability of two different dental implant designs and surgical protocols—a pilot study.
Int J Implant Dent 3, 16 (2017). https://doi.org/10.1186/s40729-017-0078-2
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Received: 18 January 2017
Accepted: 22 April 2017
Published: 02 May 2017
DOI: https://doi.org/10.1186/s40729-01...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
David E. Simmons, Pooja Maney, Austin G. Teitelbaum, Susan Billiot & A. Archontia Palaiologou
Tulane University SPHTM, 1440 Canal St, Suite 2001, New Orleans, LA, 70130, USA
Lomesh J. Popat
You can also search for this author in PubMed Google...
De Bruyn H, Raes F, Cooper LF, Reside G, Garriga JS, Tarrida LG, et al. Three-years clinical outcome of immediate provisionalization of single Osseospeed() implants in extraction sockets and healed ridges. Clin Oral Implants Res. 2013;24(2):217–23.
Ebler S, Ioannidis A, Jung RE, Hammerle CH, Thoma DS. Prospective randomized controlled clinical study comparing two types of two-piece dental impla...
O'Sullivan D, Sennerby L, Meredith N. Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants. Clin Oral Implants Res. 2004;15(4):474–80.
Schwartz-Arad D, Herzberg R, Levin L. Evaluation of long-term implant success. J Periodontol. 2005;76(10):1623–8.
Alves CC, Neves M. Tapered implants: from indications to advantages. Int J Periodontics Restora...
Anitua E, Orive G. Short implants in maxillae and mandibles: a retrospective study with 1 to 8 years of follow-up. J Periodontol. 2010;81(6):819–26.
Feldman S, Boitel N, Weng D, Kohles SS, Stach RM. Five-year survival distributions of short-length (10 mm or less) machined-surfaced and Osseotite implants. Clin Implant Dent Relat Res. 2004;6(1):16–23.
Felice P, Cannizzaro G, Checchi V, March...
DENTSPLY International, Susquehanna Commerce Center, 221 West Philadelphia Street, York, PA 17401
I-CAT 17 19; Imaging Services International LLC, 1910 North Penn Rd., Hatfield, PA 19440
Intra-Lock International, 6560 S. West Rogers Circle, Suite 24, Boca Raton, FL 33487
Osstell USA, 6700 Alexander Bell Drive, Suite 200, Columbia, MD 21046
ImageJ 1.50i Wayne Rasband National Institutes of Heal...
Survival rates and stability of OSP and OSPTX implants was comparable.
Osteotomy preparation either by the standard or by the soft bone surgical protocol had no significant effect on implant survival, success, and stability.
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year.
Insertion torque presented a weak correlation to ISQ values...
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year but not at time of implant insertion. This finding is in agreement with Acil et al. who reported no statistically significant correlation between insertion torque and ISQ at time of implant placement [22].
Although a strong correlation was found between insertion torque and bone loss at...
Augmentation of the maxillary sinus prior to dental implant placement is routinely performed in order to help patients restore their maxillary posterior dentition. Unfortunately, not all patients are candidates for this procedure due to either health, personal, or financial concerns. An alternative treatment without the need for a sinus elevation procedure is the use of a shorter implant. Research...
Overall implant survival rate was 93.3%. Two implants failed, one implant in group A (OSPTXSoft) and one in group B (OSPTXStd). Both implant failures occurred at the time of uncovery (at 6 weeks) and prior to loading of the implants and were attributed to lack of integration. With the exception of these two failed implants, there was 100% success for all remaining implants using the parameters de...
ANOVA was used to compare the mean implant stabilities between the three groups. Post hoc testing was done via Tukey’s honestly significant differences test to calculate the differences between ISQ measurements at the time of implant placement, 6 weeks and 6 and 12 months (Fig. 2) as well as bone levels at 6 and 12 months (Fig. 3). The correlations of multiple parameters such as insertion t...
Following proper approval by the LSUHSC Institution Review Board (LSUNO IRB#7438), 27 (30 implant sites) systemically healthy patients at least 18 years old were enrolled in the study and randomly divided into three groups as follows (inclusion and exclusion criteria are described in detail in Table 1):
Group A received 10 OSPTX implants using the soft bone surgical protocol (OSPTXSoft).
Group...
A recent systematic review by Stocchero et al. concluded that an undersized drilling protocol in soft bone is an effective way to enhance insertion torque but recommended that further clinical studies are needed to confirm these data [18]. Our study was designed to address this question, as it compared the standard drilling protocol to a soft bone protocol.
Our study hypothesis is that the stabil...
Dental implants are now a widely accepted treatment option for the replacement of missing teeth. The therapeutic goal of dental implants is to support restorations that replace single or multiple missing teeth so as to provide patient comfort, function, and esthetics as well as assist in the ongoing maintenance of remaining intraoral and perioral structures. However, anatomic limitations such as t...
Survival and stability of OSPTX and OSP implants is comparable. Osteotomy preparation by either standard or soft bone surgical protocol presented no significant effect on implant survival and stability for the specific implant designs.
The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols.
Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long.
Group A received 10 tapered implants (OSPTX) (Astra Tech OsseoSpeed TX™) using the soft b...
Fig. 5. Osteoblasts with an orientation tendency after 24 h of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The yellow arrows show the orientation of the cells. The red arched arrow within the coloured circle shows the direction of rotation. The dashed white line oriented to the right stands for the resulting centrifug...
Fig. 4. Randomly orientated osteoblasts without influence of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The white X on the coloured circle marks the location upon the plate where the osteoblasts were located. The red X marks the centre of the plate
Fig. 4. Randomly orientated osteoblasts without influence of rotati...
centrifugal force and the glass plates’ dimensions. For example, at a distance of 25 mm from the centre of the upper plate, the shear forces’ value is 8.33 dyn/cm2, together with an additional centrifugal force that has a value of 0.55 dyn/cm2
Fig. 3. Diagram for visualisation of the calculation of shear stress rates taking into account the centrifugal force and the glass plates’ dim...
earing gap and bottom plate are shown on the left side; rotation speed = 200 rpm; colour code bar (left edge) showing shear force values [Pa] [1 Pa = 10 dyn/cm2]; flow direction presented by arrows
Fig. 2. Side view of a computerized simulation, showing the flow chambers’ lower compartment and the flow profile in between the two plates; shearing gap and bottom plate are shown on ...
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup with the components marked numerical. a as the lower plate); 2 Rotating glass panel [60 mm diameter (cell bearing)]; 3 Titanium axis. b4 Liquid medium (red). cGearwheel with set screw. eng ring with additional set screw
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experim...
Culture medium/additives
Manufacturer
Order no.
Concentration
Dulbecco’s modified Eagle medium (DMEM) with l-glutamine, plus 4.5 g glucose,...
Component
Manufacturer
Order no.
Large petri dish
Becton Dickinson, Franklin Lakes, NJ, USA
...
Kämmerer, P.W., Thiem, D.G.E., Alshihri, A. et al. Cellular fluid shear stress on implant surfaces—establishment of a novel experimental set up.
Int J Implant Dent 3, 22 (2017). https://doi.org/10.1186/s40729-017-0085-3
Download citation
Received: 27 February 2017
Accepted: 22 May 2017
Published: 31 May 2017
DOI: https://doi.org/10.1186/s40729-017-0085-3
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Correspondence to
D. G. E. Thiem.
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
P. W. Kämmerer & D. G. E. Thiem
Department of Prosthetic and Biomaterial Sciences, King Saud University, Riyadh, Saudi Arabia
A. Alshihri
Harvard School of Dental Medicine, Boston, MA, USA
A. Alshihri
Department of Oral and Maxillofacial Surge...
The authors thank the Department of Hydraulic Machines, Faculty of Mechanical Engineering, Technical University of Munich, Germany, for helping with the computerised simulations.
Nothing to declare
The datasets supporting the conclusions of this article are available at the repository of the University Medical Centre Mainz, Germany, and can be provided on request.
PK had substantial contributio...
Papadaki M, Eskin SG. Effects of fluid shear stress on gene regulation of vascular cells. Biotechnol Prog. 1997;13(3):209–21.
James NL, Harrison DG, Nerem RM. Effects of shear on endothelial cell calcium in the presence and absence of ATP. FASEB J. 1995;9(10):968–73.
Kämmerer PW, Lehnert M, Al-Nawas B, Kumar VV, Hagmann S, Alshihri A, et al. Osseoconductivity of a specific streptavidin-biot...
Hughes-Fulford M. Signal transduction and mechanical stress. Sci STKE. 2004;2004(249):RE12.
Ruel J, Lemay J, Dumas G, Doillon C, Charara J. Development of a parallel plate flow chamber for studying cell behavior under pulsatile flow. ASAIO J. 1995;41(4):876–83.
Kazakidi A, Sherwin SJ, Weinberg PD. Effect of Reynolds number and flow division on patterns of haemodynamic wall shear stress near br...
Becker J, Kirsch A, Schwarz F, Chatzinikolaidou M, Rothamel D, Lekovic V, et al. Bone apposition to titanium implants biocoated with recombinant human bone morphogenetic protein-2 (rhBMP-2). A pilot study in dogs. Clin Oral Investig. 2006;10(3):217–24.
Hung CT, Allen FD, Pollack SR, Brighton CT. What is the role of the convective current density in the real-time calcium response of cultured bon...
Ehrlich PJ, Lanyon LE. Mechanical strain and bone cell function: a review. Osteoporos Int. 2002;13(9):688–700.
Vaughan TJ, Haugh MG, Mcnamara LM. A fluid-structure interaction model to characterize bone cell stimulation in parallel-plate flow chamber systems. J R Soc Interface. 2013;10(81):20120900.
Weinbaum S, Cowin SC, Zeng Y. A model for the excitation of osteocytes by mechanical loading-in...
To create fluid shear stress under in vitro conditions, several flow chambers have been developed in the past. The experimental setup of the flow chamber in the centre of this study offers advantages such as simplicity to assemble and ease of use as well as the creation of reproducible fluid shear forces on cells. Due to the new design, different cell types could be simultaneously analysed under r...
Besides, in the model reported in this study, microscopic examinations are possible after completing the experiment only. Nevertheless, an advantage of the new flow chamber is the possibility of testing different cell colonies simultaneously in one single experiment by placing cells in different radial locations on the spinning disc. Due to the current flow gradient from the centre to the peripher...
Due to the fact that constant flows were generated within the parallel flow chamber only, the situations of in vitro experiments differ from in vivo setting where dynamic flow profiles are particular [33]. As the constant laminar flow profile is not physiological in bones [34], vessels and other tissues [35], the informative value of the experimental setting is limited but it could be used for var...
The aim of this study was to establish a new FSS model that is easy to use as well as simple to assemble in order to create reproducible fluid shear forces on cells close to implant material surfaces. Todays’ commonly used commercial flow devices differ in geometry and function, which makes comparisons between experiments difficult [4, 10, 26, 27]. The benefits of this novel testing device are r...
in which ρ = density, h = height, ω = angular velocity and r = radius.
Figure 3 shows the respective physical force and its dependence on a bigger radius and higher rotational speed. The results of this study indicate that the centrifugal force represents only a little proportion of effective forces. Hence, the centrifugal forces’ impacts on the tested cells are considered to be insignifican...
Our analysis was focused on two main aspects:
Simulation of the fluid flow characteristics as well as quantification of the arising shear forces at the plate/plate flow chamber with reliable reproducibility
Assessment of the impact of fluid shear stress on osteoblast cells in terms of altered cell morphology and intracellular structural changes
The computational fluid dynamic analysis and the q...
For constant and fully developed laminar flow between the two parallel plates, the magnitude of the wall shear stress (τ) in between was calculated by formula 1:
in which η is the dynamic fluid viscosity (dyn/cm2), r is the radius of the plate (cm), ω stands for angular velocity and H for height (vertical distance in between the two plates).
To get information whether the flow is laminar or t...
A three-dimensional illustration and photography of the plate/plate flow chamber model is shown in Fig. 1. A detailed list of used parts can be found in Appendix 1.
The circulation within the flow chamber was generated by an externally attached electric motor, which rotates up to 500 rounds per minute (rpm). A commercial grade 4 pure medical titanium gear shaft (length = 40 mm, diameter =...
Therefore, the aim of the present study was to establish a new cell chamber model for FSS simulation and stimulation. In addition to its ease of use, the reported model in this study should meet the requirements of a simple design, generating reproducible flow characteristics next to laminar flows and clearly defined flow gradients on implant surfaces.
Cells can be influenced by different mechanostimuli, which lead to an activation of cellular and inter-cellular responses. These reactions may be caused by either a direct stimulation of the cell body (mechanoreception) or indirect cellular stimulation (response) [1,2,3]. Extracellular fluid movement induces fluid shear stress (FSS) that can result in different cellular processes including prolife...
Mechanostimuli of different cells can affect a wide array of cellular and inter-cellular biological processes responsible for dental implant healing. The purpose of this in vitro study was to establish a new test model to create a reproducible flow-induced fluid shear stress (FSS) of osteoblast cells on implant surfaces.
As FSS effects on osteoblasts are detectable at 10 dyn/cm2, a custom-made f...
Fig. 5. Osteoblasts with an orientation tendency after 24 h of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The yellow arrows show the orientation of the cells. The red arched arrow within the coloured circle shows the direction of rotation. The dashed white line oriented to the right stands for the resulting centrifug...
Fig. 4. Randomly orientated osteoblasts without influence of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The white X on the coloured circle marks the location upon the plate where the osteoblasts were located. The red X marks the centre of the plate
Fig. 4. Randomly orientated osteoblasts without influence of rotati...
to account the centrifugal force and the glass plates’ dimensions. For example, at a distance of 25 mm from the centre of the upper plate, the shear forces’ value is 8.33 dyn/cm2, together with an additional centrifugal force that has a value of 0.55 dyn/cm2
Fig. 3. Diagram for visualisation of the calculation of shear stress rates taking into account the centrifugal force and the glas...
e in between the two plates; shearing gap and bottom plate are shown on the left side; rotation speed = 200 rpm; colour code bar (left edge) showing shear force values [Pa] [1 Pa = 10 dyn/cm2]; flow direction presented by arrows
Fig. 2. Side view of a computerized simulation, showing the flow chambers’ lower compartment and the flow profile in between the two plates; shearing gap...
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup with the components marked numerical. a lower plate); 2 Rotating glass panel [60 mm diameter (cell bearing)]; 3 Titanium axis. b4 Liquid medium (red). cwheel with set screw. e ring with additional set screw
Fig. 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup w...
Culture medium/additives
Manufacturer
Order no.
Concentration
Dulbecco’s modified Eagle medium (DMEM) with l-glutamine, plus 4.5 g glucose,...
Component
Manufacturer
Order no.
Large petri dish
Becton Dickinson, Franklin Lakes, NJ, USA
...
Kämmerer, P.W., Thiem, D.G.E., Alshihri, A. et al. Cellular fluid shear stress on implant surfaces—establishment of a novel experimental set up.
Int J Implant Dent 3, 22 (2017). https://doi.org/10.1186/s40729-017-0085-3
Download citation
Received: 27 February 2017
Accepted: 22 May 2017
Published: 31 May 2017
DOI: https://doi.org/10.1186/s40729-017-0085-3
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Correspondence to
D. G. E. Thiem.
Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Rostock, Schillingallee 35, 18057, Rostock, Germany
P. W. Kämmerer & D. G. E. Thiem
Department of Prosthetic and Biomaterial Sciences, King Saud University, Riyadh, Saudi Arabia
A. Alshihri
Harvard School of Dental Medicine, Boston, MA, USA
A. Alshihri
Department of Oral and Maxillofacial Surge...
The authors thank the Department of Hydraulic Machines, Faculty of Mechanical Engineering, Technical University of Munich, Germany, for helping with the computerised simulations.
Nothing to declare
The datasets supporting the conclusions of this article are available at the repository of the University Medical Centre Mainz, Germany, and can be provided on request.
PK had substantial contributio...
Papadaki M, Eskin SG. Effects of fluid shear stress on gene regulation of vascular cells. Biotechnol Prog. 1997;13(3):209–21.
James NL, Harrison DG, Nerem RM. Effects of shear on endothelial cell calcium in the presence and absence of ATP. FASEB J. 1995;9(10):968–73.
Kämmerer PW, Lehnert M, Al-Nawas B, Kumar VV, Hagmann S, Alshihri A, et al. Osseoconductivity of a specific streptavidin-biot...
Hughes-Fulford M. Signal transduction and mechanical stress. Sci STKE. 2004;2004(249):RE12.
Ruel J, Lemay J, Dumas G, Doillon C, Charara J. Development of a parallel plate flow chamber for studying cell behavior under pulsatile flow. ASAIO J. 1995;41(4):876–83.
Kazakidi A, Sherwin SJ, Weinberg PD. Effect of Reynolds number and flow division on patterns of haemodynamic wall shear stress near br...
Becker J, Kirsch A, Schwarz F, Chatzinikolaidou M, Rothamel D, Lekovic V, et al. Bone apposition to titanium implants biocoated with recombinant human bone morphogenetic protein-2 (rhBMP-2). A pilot study in dogs. Clin Oral Investig. 2006;10(3):217–24.
Hung CT, Allen FD, Pollack SR, Brighton CT. What is the role of the convective current density in the real-time calcium response of cultured bon...
Ehrlich PJ, Lanyon LE. Mechanical strain and bone cell function: a review. Osteoporos Int. 2002;13(9):688–700.
Vaughan TJ, Haugh MG, Mcnamara LM. A fluid-structure interaction model to characterize bone cell stimulation in parallel-plate flow chamber systems. J R Soc Interface. 2013;10(81):20120900.
Weinbaum S, Cowin SC, Zeng Y. A model for the excitation of osteocytes by mechanical loading-in...
To create fluid shear stress under in vitro conditions, several flow chambers have been developed in the past. The experimental setup of the flow chamber in the centre of this study offers advantages such as simplicity to assemble and ease of use as well as the creation of reproducible fluid shear forces on cells. Due to the new design, different cell types could be simultaneously analysed under r...
Besides, in the model reported in this study, microscopic examinations are possible after completing the experiment only. Nevertheless, an advantage of the new flow chamber is the possibility of testing different cell colonies simultaneously in one single experiment by placing cells in different radial locations on the spinning disc. Due to the current flow gradient from the centre to the peripher...
Due to the fact that constant flows were generated within the parallel flow chamber only, the situations of in vitro experiments differ from in vivo setting where dynamic flow profiles are particular [33]. As the constant laminar flow profile is not physiological in bones [34], vessels and other tissues [35], the informative value of the experimental setting is limited but it could be used for var...
The aim of this study was to establish a new FSS model that is easy to use as well as simple to assemble in order to create reproducible fluid shear forces on cells close to implant material surfaces. Todays’ commonly used commercial flow devices differ in geometry and function, which makes comparisons between experiments difficult [4, 10, 26, 27]. The benefits of this novel testing device are r...
in which ρ = density, h = height, ω = angular velocity and r = radius.
Figure 3 shows the respective physical force and its dependence on a bigger radius and higher rotational speed. The results of this study indicate that the centrifugal force represents only a little proportion of effective forces. Hence, the centrifugal forces’ impacts on the tested cells are considered to be insignifican...
Our analysis was focused on two main aspects:
Simulation of the fluid flow characteristics as well as quantification of the arising shear forces at the plate/plate flow chamber with reliable reproducibility
Assessment of the impact of fluid shear stress on osteoblast cells in terms of altered cell morphology and intracellular structural changes
The computational fluid dynamic analysis and the q...
For constant and fully developed laminar flow between the two parallel plates, the magnitude of the wall shear stress (τ) in between was calculated by formula 1:
in which η is the dynamic fluid viscosity (dyn/cm2), r is the radius of the plate (cm), ω stands for angular velocity and H for height (vertical distance in between the two plates).
To get information whether the flow is laminar or t...
A three-dimensional illustration and photography of the plate/plate flow chamber model is shown in Fig. 1. A detailed list of used parts can be found in Appendix 1.
The circulation within the flow chamber was generated by an externally attached electric motor, which rotates up to 500 rounds per minute (rpm). A commercial grade 4 pure medical titanium gear shaft (length = 40 mm, diameter =...
Therefore, the aim of the present study was to establish a new cell chamber model for FSS simulation and stimulation. In addition to its ease of use, the reported model in this study should meet the requirements of a simple design, generating reproducible flow characteristics next to laminar flows and clearly defined flow gradients on implant surfaces.
Cells can be influenced by different mechanostimuli, which lead to an activation of cellular and inter-cellular responses. These reactions may be caused by either a direct stimulation of the cell body (mechanoreception) or indirect cellular stimulation (response) [1,2,3]. Extracellular fluid movement induces fluid shear stress (FSS) that can result in different cellular processes including prolife...
Mechanostimuli of different cells can affect a wide array of cellular and inter-cellular biological processes responsible for dental implant healing. The purpose of this in vitro study was to establish a new test model to create a reproducible flow-induced fluid shear stress (FSS) of osteoblast cells on implant surfaces.
As FSS effects on osteoblasts are detectable at 10 dyn/cm2, a custom-made f...
Fig. 6. Loading of implant off-axially
Fig. 6. Loading of implant off-axially
Fig. 5. Loading of implant axially
Fig. 5. Loading of implant axially
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 2. Metal crown supported on two mini implants
Fig. 2. Metal crown supported on two mini implants
Fig. 1.
Fig. 1. a Standard, b short-wide, and c single-piece mini implants
Crown
Implant type
Axial
Off-axial
P-value
Mean
SD
...
Axial
Off-axial
P value
Mean
SD
Mean
SD
...
Lava Ultimate
crowns
Metal
crowns
P value
Mean
SD
Mean
...
Load
Crown type
Standard
Short-wide
Double mini
P value
...
Standard
Short-wide
Double mini
P value
Mean
SD
Mean
...
Elfadaly, L.S., Khairallah, L.S. & Al Agroudy, M.A. Peri-implant biomechanical responses to standard, short-wide, and double mini implants replacing missing molar supporting hybrid ceramic or full-metal crowns under axial and off-axial loading: an in vitro study.
Int J Implant Dent 3, 31 (2017). https://doi.org/10.1186/s40729-017-0094-2
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Received: 14 Februar...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
The authors L.S.Elfadaly, L.S.Kheirallah, and M.A.Alagroudy state that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Fixed Prosthodontics, Cairo University, Giza, Egypt
Lamiaa Said Elfadaly, Lamiaa Sayed Khairallah & Mona Atteya Al Agroudy
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Gracis S, Nicholls J, Chalupnik J, Yuodelis R. Shock-absorbing behavior of five restorative materials used on implants. Int J Prosthodont. 1990;4:282–91.
Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent. 1983;49:843–8.
Misch C. Clinical biomechanics in implant dentistry, Contemporary Implant Dentistry. 3rd ed. 2008. p. 543–56. mosby,inc.
Lundgren D, La...
Himmlova L, Dostalova T, Kacovsky A, Konvickova S. Influence of implant length and diameter on stress distribution: a finite element analysis. J Prosthet Dent. 2004;91(1):20–5.
Shetty S, Puthukkat N, Bhat S, Shenoy K. Short implants: a new dimension in rehabilitation of atrophic maxilla and mandible. Journal of Interdisciplinary Dentistry. 2014;4(2):66.
Misch C, Bidez M. Contemporary implant d...
Barbier L, Vander SJ, Krzesinski G, Schepers E, Van der Perre G. Finite element analysis of non-axial versus axial loading of oral implants in the mandible of the dog. J Oral Rehabil. 1998;25(11):847–58.
Saime S, Murat C, Emine Y. The influence of functional forces on the biomechanics of implant-supported prostheses—a review. J Dent. 2002;30:271–82.
Balshi T, Hernandez R, Pryszlak M, Range...
Mazor Z, Lorean A, Mijiritsky E, Levin L. Replacement of a molar with 2 narrow diameter dental implants. Implant Dent. 2012;21(1):36–8.
Atwood D. Postextraction changes in the adult mandible as illustrated by micrographs of midsagittal sections and serial cephalometric roentgenograms. J Prosthet Dent. 1963;13:810–24.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augment...
Within the limitations of this in vitro study, the following conclusions could be drawn:
Implant design, superstructure material, and load direction significantly affect peri-implant microstrains.
The recorded compressive and tensile microstrains for the tested designs were within the physiologic loading range, as they did not exceed the compressive or tensile strength of the bone-implant interf...
Regarding the effect of superstructure material on induced microstrains, generally, different implant designs supporting Lava Ultimate crowns showed higher mean microstrain values(1927.3 ± 1536.6 μɛ), in comparison with those supporting metal crowns (1313.7 ± 973.1 μɛ).Theoretical considerations [44, 45] and in vitro experiments [46,47,48,49] suggest that an occlusal material with ...
Regarding the effect of direction of loading on induced microstrains, it was shown that changing the position of occlusal loading had a considerable effect on the amount of distribution of stresses where axial loading generated even distribution of load around the implant in comparison to off-axial loading where stresses were more pronounced in the area of load application. This might be due to th...
Previous studies have shown that direct correlations exist between microstrain magnitudes and bone stability/instability conditions. This has been summarized by Frost, when bone is loaded below about 2000 microstrains, bone can easily repair what little microdamage occurs. Yet, when pathologic overloading occurs (over 4000 microstrains), stress and strain gradients exceed the physiologic tolerance...
To replace a missing lower molar in compromised ridge, different treatment options were suggested, using either a standard size implant with surgical procedures, short-wide implant, or two mini implants. Concerning the use of mini implant, splinted multiple implants increase the surface area that interfaces with the bone to lessen the per square millimeters of force borne by the bone [11]. The imp...
Results revealed that standard implant showed the statistically significantly highest mean microstrain values (3362.4 ± 757.4 μɛ). Double mini implant showed statistically significantly lower mean microstrain values (801.6 ± 251.4 μɛ), while short-wide implant showed the statistically significantly lowest mean microstrain values (697.6 ± 79.7 μɛ), with a P value
Data were presented as mean and standard deviation (SD) values. Data were explored for normality by checking data distribution and histograms, calculating mean and median values, and finally using Kolmogorov-Smirnov and Shapiro-Wilk tests of normality. Stress data showed non-parametric distribution, so the Kruskal-Wallis test was used to compare between the types of implants. The Mann-Whitney U te...
Each crown was cemented to its corresponding implant-abutment assembly using temporary cement (Cavex Temporary Cement, Cavex, Holland).
Each implant received 4 strain gauges (Kowa strain gages, Japan) placed on the mesial, distal, buccal, and lingual surfaces of the epoxy resin adjacent to the implants. At these selected sites, the thickness of the epoxy resin surrounding each implant was reduced...
In the present study, the following materials were used: titanium root form endosseous implants of standard diameter and length (4-mm platform, 3.8-mm diameter,12-mm length, fixture bevel 0.2 mm, Super Line System, Dentium, USA), short-wide implant (7-mm platform, 5.8-mm diameter, 7-mm length, Super Line System, Dentium, Seoul, Korea) with 1.5-mm machined surface and 5.5-mm threaded surface that ...
There are several factors that affect force magnitudes in peri-implant bone. The application of functional forces induces stresses and strains within the implant prosthesis complex and affect the bone remodeling process around implants [8, 9].
While there are several methods of measuring strain, the most common is with a strain gauge, a device whose electrical resistance varies in proportion to t...
The molars are one of the first teeth to be lost over lifetime; thus, their replacement is frequently needed. Implantation is generally the preferred choice to replace a missing single tooth avoiding vital teeth preparation and bridge fabrication [1].
The mandibular bone loss occurs as knife-edge residual ridge where there is marked narrowing of the labiolingual diameter of the crest of the ridge...
The aim of this study was to evaluate the biomechanical response of the peri-implant bone to standard, short-wide, and double mini implants replacing missing molar supporting either hybrid ceramic crowns (Lava Ultimate restorative) or full-metal crowns under two different loading conditions (axial and off-axial loading) using strain gauge analysis.
Three single-molar implant designs, (1) single, ...
Fig. 8. There were moderately significant and positive correlations between the ALP levels and OC levels at all measurements from week 1 to week 12. The OC levels in pg/μg protein were associated with the ALP levels in nM/μg protein at the implant site (a), control site (b), and pooled samples of the control and implant sites (c)
Fig. 8. There were moderately significant and positive correl...
Fig. 7. Comparison between the trend of the biomarker levels and the trend of the ISQ values over time
Fig. 7. Comparison between the trend of the biomarker levels and the trend of the ISQ values over time
Fig. 6. There were weakly significant and positive correlations between the ALP or OC levels and ISQ values at all measurements from week 1 to week 12. At the implant site, the ALP levels in nM/μg protein (a) or the OC levels in pg/μg protein (b) were associated with ISQ values
Fig. 6. There were weakly significant and positive correlations between the ALP or OC levels and ISQ values at all...
Fig. 5. Change in the median values of the OC level over time. In the test group, the OC level continuously increased with time. There was a statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P
Fig. 4. Change in the median values of the ALP level over time. In the test group, the ALP level decreased at 1–4 weeks and then increased at 6, 8, 10, and 12 weeks. There was no statistically significant difference in the ALP level in either the control or the test groups at any measurement
Fig. 4. Change in the median values of the ALP level over time. In the test group, the ALP level d...
Fig. 3. Change in the median values of the GCF (control group) and PICF (test group) volume over time. In the test group, the PICF volume continuously decreased with time (a). There were no significant differences in the median values of the crevicular fluid volume in either the control group or the test groups at any measurement (b)
Fig. 3. Change in the median values of the GCF (control gro...
Fig. 2. Change in the mean ISQ values over time. There was a statistically significant decrease in the mean ISQ values between 1 and 3 weeks (P
Fig. 1. Timeline of the clinical study. I—implant site, T—contralateral posterior mandibular nonsurgical tooth
Fig. 1. Timeline of the clinical study. I—implant site, T—contralateral posterior mandibular nonsurgical tooth
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks...
Patient no.
Age
Sex
Positiona
Bone qualityb
1
34
...
Inclusion criteria
Exclusion criteria
Patients aged 25–65 years
Presence of periodontal disease or periapical lesions
Ability to participat...
Tirachaimongkol, C., Pothacharoen, P., Reichart, P.A. et al. Relation between the stability of dental implants and two biological markers during the healing period: a prospective clinical study.
Int J Implant Dent 2, 27 (2016). https://doi.org/10.1186/s40729-016-0058-y
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Received: 14 September 2016
Accepted: 18 November 2016
Published: 08 December 2016
DOI...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Center of Excellence for Dental Implantology, Faculty of Dentistry, Chiang Mai University, Suthep sub-district, A. Muang, Chiang Mai, 50200, Thailand
Choknapa Tirachaimongkol & Pathawee Khongkhunthian
Department of Biochemistry, Faculty of Medicine, Thailand Excellence Center for Tissue Engineering and Stem Cells, Chiang Mai, Thailand
Peraphan Pothacharoen
Department of Oral Medicine, Dental...
The authors acknowledge Mrs. Yupaporn Kiatsakulcharoen and Miss Kamolwan Mangkalad, the Center of Excellent for Dental Implantology, Chiang Mai University for clinical assistance, Mr. Aitthiphon Chongchai, the Department of Biochemistry, Faculty of Medicine Chiang Mai University for laboratory assistance, Dr.Thanapat Sastraruji, Faculty of Dentistry, Chiang Mai University for statistical consultat...
Lekholm U, Zarb G, Albrektsson T. Tissue integrated prostheses. Patient selection and preparation. Chicago: Quintessence Publishing Co Inc; 1985. p. 199–209.
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Berglundh T, Abrahamsson I, Lang NP, Lindhe J. De novo alveolar bone formation adjacent to endosseous implants. Clin Oral Implants Res. 2003;3:251–62.
Emecen-Huja P, Eubank TD, Shapiro V, Yildiz V, Tatakis DN, Leblebicioglu B. Peri-implant versus periodontal wound healing. J Clin Periodontol. 2013;40:816–24.
Chapple LLC, Socransky SS, Dibart S, Glenwright DH, Matthews JB. Chemiluminescent as...
Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Implants Res. 2004;5:529–39.
Sim CPC, Lang NP. Factors influencing resonance frequency analysis assessed by Osstell mentor during implant tissue integration: I. Instrument positioning, bone structure, implant length. Clin Oral Implants ...
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52:155–70.
Khongkhunthian P. Implant features. In: Khongkhunthian P, editor. PW Plus Thai Dental Implant. Bangkok: STZ Mospace design; 2015. p. 12.
Lacey DL, Timms E, Tan HL, Kelley MJ, Dunstan CR, ...
Within the limitations of this study and cautious interpretation due to small number of implants/patients, the ISQ values were weakly correlated with both ALP and OC molecules in PICF during the healing period. The results also show that osteocalcin may be used as a biological marker for monitoring implant healing at 6, 8, 10, and 12 weeks after implant placement. The ISQ values showed high stabi...
Vogel and Marcotte [33] suggested that the correlation between mRNA and protein quantities is approximately 40%. As there are many mechanisms between transcription and translation, especially in human cell and protein stability, at the gene expression level, the transcription data is beneficial in making decisions about molecular candidates for future studies at the protein level. The colorimetric...
The main sources of ALP in GCF are neutrophils, bacteria within dental plaque, fibroblasts, and osteoblasts [28]. Plagnat et al. [29] suggested that longitudinal monitoring of ALP in PICF might confirm its possible use as a marker of implant failure. Considering the change in the median values of the ALP level over time, in the test group, the ALP level decreased at 1–4 weeks and then increased...
The results of this study show that, at the time of implantation, the ISQ values ranged between 67.5 and 83. The mean initial ISQ value was 77.0 ± 1.32. These findings are in harmony with those of previous studies [16, 18]. Tallarico et al. (2011) reported that the macro-design of dental implant affects the primary anchorage [16]. They suggested that the high initial ISQ value is a factor in ...
At the implant site, the OC level continuously increased with time. According to the Friedman followed by Wilcoxon signed-rank tests, there was statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P
Ten patients, seven females, and three males, aged 42.4 ± 11.99 years (range, 28 to 64 years), with either a first mandibular or second mandibular molar edentulous area, who required a single nonsubmerged implant participated in this study, as shown in Table 2. The implants used for all patients were 10 mm long and 5 mm in diameter. All patients completed the follow-up. None of the impla...
Data were analyzed by using SPSS 17.0 software (SPSS Inc., Chicago, IL, USA). Repeated measures analysis of variance was performed to evaluate the change in the ISQ values at each measurement. The independent samples t test was used to investigate the differences in implant stability in the patients’ gender and bone quality. The Friedman test, followed by the Wilcoxon signed-rank test, was used ...
The level of OC was measured by using commercially available ELISA kits (Human Osteocalcin Quantikine ELISA Kit, R&D Systems, Inc., Minneapolis, MN, USA) according to the manufacturer’s instructions. A 100 μl volume of Assay Diluent RD1-117 (R&D Systems) was added into each well of the microplate and then 50 μl of standard (0–64 ng/ml) or sample was added to each well. The microplate was ...
To observe the level of two bone formation biomarkers (alkaline phosphatase and osteocalcin) during the osseointegration period compared with control group using GCF from the first molar of the contralateral side of implant position, the sample collection of GCF was performed before the surgical procedure, immediately after the surgical operation and after 1, 2, 3, 4, 6, 8, 10, and 12 weeks. The ...
The study is a prospective clinical study during the 3-month healing period of implant. The study was approved by the Human Experimentation Committee, Faculty of Dentistry, Chiang Mai University. The study outline is shown in Fig. 1.
Ten patients, who were partially edentulous in the mandibular posterior region for whom a single nonsubmerged implant was planned, participated in this study. All o...
Osteocalcin (OC) is the most plentiful noncollagenous protein of the bone matrix. It is secreted from odontoblasts, osteocytes, and osteoblasts, in order to bind hydroxyapatite and calcium during matrix mineralization [7]. It is one of the serological markers in the bone formation process. Numerous studies have shown increased OC levels in bone formation. However, increased OC level relates more t...
Dental implants have shown a high success rate for rehabilitation of edentulous patients if certain conditions are met during treatment. Nevertheless, the risk of failure remains difficult to predict. The achievement of osseointegration depends on many factors, such as a suitable host, biocompatible materials, careful surgery, and an appropriate healing time [1].The primary stability comes from th...
Dental implants have shown a high success rate for rehabilitation of edentulous patients if certain conditions are met during treatment. Nevertheless, the risk of failure remains difficult to predict. The achievement of osseointegration depends on many factors, such as a suitable host, biocompatible materials, careful surgery, and an appropriate healing time [1].
The primary stability comes from ...
The purposes of this study were to examine the correlation between the stability of dental implants and bone formation markers during the healing period and to monitor the stability of dental implants using the resonance frequency analysis (RFA) method. The null hypothesis of the study is no correlation between the stability of dental implant and bone formation markers.
The study is a prospective...
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was 0.2981 and at 1 year 0.6613
Fig. 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was ...
Fig. 2. ISQ values at placement, 6 weeks, 6 months, and 1 year. Mean and standard deviation of ISQ values taken at placement, 6 weeks, 6 months, and 1 year is presented. No statistical significant difference was determined between ISQ values at all time points. (p
Fig. 1. Implant design. The OSPTX and OSP implants are manufactured from high-grade commercially pure titanium with surface roughness produced via a fluoride treatment process. The OSP implant is a screw-shaped self-tapping implant. The diameter used in this study was 4.0 mm. The implant length used in this study was 8 mm. The OSPTX implant has the same features as the OSP except the apex of t...
Implant success
Clinically immobile when tested manually and/or with RFA (minimum ISQ = 65)
Absence of peri-implant radiolucency present on an undistorted radiograph
Absence of unresolved pain, discomfort, inf...
Inclusion
Male or female
At least 18 years old
Healthy enough to undergo routine implant surgery and subsequent dental treatment
Partially edentulous requiring...
Simmons, D.E., Maney, P., Teitelbaum, A.G. et al. Comparative evaluation of the stability of two different dental implant designs and surgical protocols—a pilot study.
Int J Implant Dent 3, 16 (2017). https://doi.org/10.1186/s40729-017-0078-2
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Received: 18 January 2017
Accepted: 22 April 2017
Published: 02 May 2017
DOI: https://doi.org/10.1186/s40729-01...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, New Orleans, LA, 70119, USA
David E. Simmons, Pooja Maney, Austin G. Teitelbaum, Susan Billiot & A. Archontia Palaiologou
Tulane University SPHTM, 1440 Canal St, Suite 2001, New Orleans, LA, 70130, USA
Lomesh J. Popat
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De Bruyn H, Raes F, Cooper LF, Reside G, Garriga JS, Tarrida LG, et al. Three-years clinical outcome of immediate provisionalization of single Osseospeed() implants in extraction sockets and healed ridges. Clin Oral Implants Res. 2013;24(2):217–23.
Ebler S, Ioannidis A, Jung RE, Hammerle CH, Thoma DS. Prospective randomized controlled clinical study comparing two types of two-piece dental impla...
O'Sullivan D, Sennerby L, Meredith N. Influence of implant taper on the primary and secondary stability of osseointegrated titanium implants. Clin Oral Implants Res. 2004;15(4):474–80.
Schwartz-Arad D, Herzberg R, Levin L. Evaluation of long-term implant success. J Periodontol. 2005;76(10):1623–8.
Alves CC, Neves M. Tapered implants: from indications to advantages. Int J Periodontics Restora...
Anitua E, Orive G. Short implants in maxillae and mandibles: a retrospective study with 1 to 8 years of follow-up. J Periodontol. 2010;81(6):819–26.
Feldman S, Boitel N, Weng D, Kohles SS, Stach RM. Five-year survival distributions of short-length (10 mm or less) machined-surfaced and Osseotite implants. Clin Implant Dent Relat Res. 2004;6(1):16–23.
Felice P, Cannizzaro G, Checchi V, March...
DENTSPLY International, Susquehanna Commerce Center, 221 West Philadelphia Street, York, PA 17401
I-CAT 17 19; Imaging Services International LLC, 1910 North Penn Rd., Hatfield, PA 19440
Intra-Lock International, 6560 S. West Rogers Circle, Suite 24, Boca Raton, FL 33487
Osstell USA, 6700 Alexander Bell Drive, Suite 200, Columbia, MD 21046
ImageJ 1.50i Wayne Rasband National Institutes of Heal...
Survival rates and stability of OSP and OSPTX implants was comparable.
Osteotomy preparation either by the standard or by the soft bone surgical protocol had no significant effect on implant survival, success, and stability.
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year.
Insertion torque presented a weak correlation to ISQ values...
Insertion torque presented a moderate to strong correlation with ISQ values at 6 weeks, 6 months, and 1 year but not at time of implant insertion. This finding is in agreement with Acil et al. who reported no statistically significant correlation between insertion torque and ISQ at time of implant placement [22].
Although a strong correlation was found between insertion torque and bone loss at...
Augmentation of the maxillary sinus prior to dental implant placement is routinely performed in order to help patients restore their maxillary posterior dentition. Unfortunately, not all patients are candidates for this procedure due to either health, personal, or financial concerns. An alternative treatment without the need for a sinus elevation procedure is the use of a shorter implant. Research...
Overall implant survival rate was 93.3%. Two implants failed, one implant in group A (OSPTXSoft) and one in group B (OSPTXStd). Both implant failures occurred at the time of uncovery (at 6 weeks) and prior to loading of the implants and were attributed to lack of integration. With the exception of these two failed implants, there was 100% success for all remaining implants using the parameters de...
ANOVA was used to compare the mean implant stabilities between the three groups. Post hoc testing was done via Tukey’s honestly significant differences test to calculate the differences between ISQ measurements at the time of implant placement, 6 weeks and 6 and 12 months (Fig. 2) as well as bone levels at 6 and 12 months (Fig. 3). The correlations of multiple parameters such as insertion t...
Following proper approval by the LSUHSC Institution Review Board (LSUNO IRB#7438), 27 (30 implant sites) systemically healthy patients at least 18 years old were enrolled in the study and randomly divided into three groups as follows (inclusion and exclusion criteria are described in detail in Table 1):
Group A received 10 OSPTX implants using the soft bone surgical protocol (OSPTXSoft).
G...
A recent systematic review by Stocchero et al. concluded that an undersized drilling protocol in soft bone is an effective way to enhance insertion torque but recommended that further clinical studies are needed to confirm these data [18]. Our study was designed to address this question, as it compared the standard drilling protocol to a soft bone protocol.
Our study hypothesis is that the stabil...
Dental implants are now a widely accepted treatment option for the replacement of missing teeth. The therapeutic goal of dental implants is to support restorations that replace single or multiple missing teeth so as to provide patient comfort, function, and esthetics as well as assist in the ongoing maintenance of remaining intraoral and perioral structures. However, anatomic limitations such as t...
Survival and stability of OSPTX and OSP implants is comparable. Osteotomy preparation by either standard or soft bone surgical protocol presented no significant effect on implant survival and stability for the specific implant designs.
The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols.
Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long.
Group A received 10 tapered implants (OSPTX) (Astra Tech OsseoSpeed TX™) using the soft b...
Fig. 6. Loading of implant off-axially
Fig. 6. Loading of implant off-axially
Fig. 5. Loading of implant axially
Fig. 5. Loading of implant axially
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 4. Installation of strain gauges on surfaces of epoxy resin adjacent to mini implants
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 3. Lava Ultimate Restorative crown on the two mini implants.
Fig. 2. Metal crown supported on two mini implants
Fig. 2. Metal crown supported on two mini implants
Fig. 1. a Standard, b short-wide, and c single-piece mini implants
Crown
Implant type
Axial
Off-axial
P-value
Mean
SD
...
Axial
Off-axial
P value
Mean
SD
Mean
SD
...
Lava Ultimate
crowns
Metal
crowns
P value
Mean
SD
Mean
...
Load
Crown type
Standard
Short-wide
Double mini
P value
...
Standard
Short-wide
Double mini
P value
Mean
SD
Mean
...
Elfadaly, L.S., Khairallah, L.S. & Al Agroudy, M.A. Peri-implant biomechanical responses to standard, short-wide, and double mini implants replacing missing molar supporting hybrid ceramic or full-metal crowns under axial and off-axial loading: an in vitro study.
Int J Implant Dent 3, 31 (2017). https://doi.org/10.1186/s40729-017-0094-2
Download citation
Received: 14 Februar...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
The authors L.S.Elfadaly, L.S.Kheirallah, and M.A.Alagroudy state that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Fixed Prosthodontics, Cairo University, Giza, Egypt
Lamiaa Said Elfadaly, Lamiaa Sayed Khairallah & Mona Atteya Al Agroudy
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LSE have...
Gracis S, Nicholls J, Chalupnik J, Yuodelis R. Shock-absorbing behavior of five restorative materials used on implants. Int J Prosthodont. 1990;4:282–91.
Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent. 1983;49:843–8.
Misch C. Clinical biomechanics in implant dentistry, Contemporary Implant Dentistry. 3rd ed. 2008. p. 543–56. mosby,inc.
Lundgren D, La...
Himmlova L, Dostalova T, Kacovsky A, Konvickova S. Influence of implant length and diameter on stress distribution: a finite element analysis. J Prosthet Dent. 2004;91(1):20–5.
Shetty S, Puthukkat N, Bhat S, Shenoy K. Short implants: a new dimension in rehabilitation of atrophic maxilla and mandible. Journal of Interdisciplinary Dentistry. 2014;4(2):66.
Misch C, Bidez M. Contemporary implant d...
Barbier L, Vander SJ, Krzesinski G, Schepers E, Van der Perre G. Finite element analysis of non-axial versus axial loading of oral implants in the mandible of the dog. J Oral Rehabil. 1998;25(11):847–58.
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Within the limitations of this in vitro study, the following conclusions could be drawn:
Implant design, superstructure material, and load direction significantly affect peri-implant microstrains.
The recorded compressive and tensile microstrains for the tested designs were within the physiologic loading range, as they did not exceed the compressive or tensile strength of the bone-implant interf...
Regarding the effect of superstructure material on induced microstrains, generally, different implant designs supporting Lava Ultimate crowns showed higher mean microstrain values(1927.3 ± 1536.6 μɛ), in comparison with those supporting metal crowns (1313.7 ± 973.1 μɛ).Theoretical considerations [44, 45] and in vitro experiments [46,47,48,49] suggest that an occlusal material with ...
Regarding the effect of direction of loading on induced microstrains, it was shown that changing the position of occlusal loading had a considerable effect on the amount of distribution of stresses where axial loading generated even distribution of load around the implant in comparison to off-axial loading where stresses were more pronounced in the area of load application. This might be due to th...
Previous studies have shown that direct correlations exist between microstrain magnitudes and bone stability/instability conditions. This has been summarized by Frost, when bone is loaded below about 2000 microstrains, bone can easily repair what little microdamage occurs. Yet, when pathologic overloading occurs (over 4000 microstrains), stress and strain gradients exceed the physiologic tolerance...
To replace a missing lower molar in compromised ridge, different treatment options were suggested, using either a standard size implant with surgical procedures, short-wide implant, or two mini implants. Concerning the use of mini implant, splinted multiple implants increase the surface area that interfaces with the bone to lessen the per square millimeters of force borne by the bone [11]. The imp...
Results revealed that standard implant showed the statistically significantly highest mean microstrain values (3362.4 ± 757.4 μɛ). Double mini implant showed statistically significantly lower mean microstrain values (801.6 ± 251.4 μɛ), while short-wide implant showed the statistically significantly lowest mean microstrain values (697.6 ± 79.7 μɛ), with a P value
Data were presented as mean and standard deviation (SD) values. Data were explored for normality by checking data distribution and histograms, calculating mean and median values, and finally using Kolmogorov-Smirnov and Shapiro-Wilk tests of normality. Stress data showed non-parametric distribution, so the Kruskal-Wallis test was used to compare between the types of implants. The Mann-Whitney U te...
Each crown was cemented to its corresponding implant-abutment assembly using temporary cement (Cavex Temporary Cement, Cavex, Holland).
Each implant received 4 strain gauges (Kowa strain gages, Japan) placed on the mesial, distal, buccal, and lingual surfaces of the epoxy resin adjacent to the implants. At these selected sites, the thickness of the epoxy resin surrounding each implant was reduced...
In the present study, the following materials were used: titanium root form endosseous implants of standard diameter and length (4-mm platform, 3.8-mm diameter,12-mm length, fixture bevel 0.2 mm, Super Line System, Dentium, USA), short-wide implant (7-mm platform, 5.8-mm diameter, 7-mm length, Super Line System, Dentium, Seoul, Korea) with 1.5-mm machined surface and 5.5-mm threaded surface that ...
There are several factors that affect force magnitudes in peri-implant bone. The application of functional forces induces stresses and strains within the implant prosthesis complex and affect the bone remodeling process around implants [8, 9].
While there are several methods of measuring strain, the most common is with a strain gauge, a device whose electrical resistance varies in proportion to t...
The molars are one of the first teeth to be lost over lifetime; thus, their replacement is frequently needed. Implantation is generally the preferred choice to replace a missing single tooth avoiding vital teeth preparation and bridge fabrication [1].
The mandibular bone loss occurs as knife-edge residual ridge where there is marked narrowing of the labiolingual diameter of the crest of the ridge...
The aim of this study was to evaluate the biomechanical response of the peri-implant bone to standard, short-wide, and double mini implants replacing missing molar supporting either hybrid ceramic crowns (Lava Ultimate restorative) or full-metal crowns under two different loading conditions (axial and off-axial loading) using strain gauge analysis.
Three single-molar implant designs, (1) single, ...
Fig. 8. The association between mean osseus sinus volume of the maxillary sinus and gender. Men have a statistically significant higher mean osseus volume than women (p = 0.007)
Fig. 8. The association between mean osseus sinus volume of the maxillary sinus and gender. Men have a statistically significant higher mean osseus volume than women (p = 0.007)
Fig. 7. The association between the mean osseus sinus volume and age. No significant association between these parameters was found (p = 0.2)
Fig. 7. The association between the mean osseus sinus volume and age. No significant association between these parameters was found (p = 0.2)
Fig. 6. No statistical significant association between a patient’s age and the presence of obliteration of at least one maxillary sinus was found (p = 0.92). For better visibility, the diagram has been jittered along the y-axis
Fig. 6. No statistical significant association between a patient’s age and the presence of obliteration of at least one maxillary sinus was found (p = 0.92...
Fig. 5. The association between the obliterated volume and sinus pathology. The presence of a pathology significantly increased the obliterated volume of a maxillary sinus (p
Fig. 4. The association between the osseus volume and the dentition. Edentulous, partly edentulous, and dentate patients showed no relevant difference in the size of the osseus sinus volume (p = 0.52)
Fig. 4. The association between the osseus volume and the dentition. Edentulous, partly edentulous, and dentate patients showed no relevant difference in the size of the osseus sinus volume ...
Fig. 3. 3D view of osseus sinus volumes. Surface area (cm2) and volume (cm3) were calculated by the software
Fig. 3. 3D view of osseus sinus volumes. Surface area (cm2) and volume (cm3) were calculated by the software
Fig. 2. View from the coronal plane. The marked curves define the osseus and mucous boundaries of the maxillary sinuses. The hatched surface illustrates the measured remaining pneumatized cavity of an obliterated sinus and the filled (yellow) surface highlights the calculated obliterated volume
Fig. 2. View from the coronal plane. The marked curves define the osseus and mucous boundaries of t...
Fig. 1. Calculation of the sinus body by interpolating 15–25 curves at a distance of 2 mm, depending upon the size of the maxillary cavity
Fig. 1. Calculation of the sinus body by interpolating 15–25 curves at a distance of 2 mm, depending upon the size of the maxillary cavity
Frequency of pathologies
n
(%)
Absence of alteration
73
(57.0)
Mucosal thickening
...
Mean
Median
Minimum
Maximum
SD
Osseus sinus surface area (cm2)
...
Luz, J., Greutmann, D., Wiedemeier, D. et al. 3D-evaluation of the maxillary sinus in cone-beam computed tomography.
Int J Implant Dent 4, 17 (2018). https://doi.org/10.1186/s40729-018-0128-4
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Received: 30 January 2018
Accepted: 20 March 2018
Published: 05 June 2018
DOI: https://doi.org/10.1186/s40729-018-0128-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
JL and CR are residents at the Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Switzerland.
DG is a master student at the Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
MR is the Chairman of the Clinic for Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Zurich, Switzerland.
DW is t...
Correspondence to
Julia Luz.
Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, University Hospital Zurich, Zurich, Switzerland
Julia Luz, Dominique Greutmann, Claudio Rostetter, Martin Rücker & Bernd Stadlinger
Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
Daniel Wiedemeier
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Nunes CA, Guedes OA, Alencar AH, Peters OA, Estrela CR, Estrela C. Evaluation of periapical lesions and their association with maxillary sinus abnormalities on cone-beam computed tomographic ...
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The present study showed the volume software to be a suitable tool for the measurement of the dimensions of the maxillary sinus. The results show that the osseus volume of the maxillary sinus varies on the base of gender and that the obliterated volume varies on the base of a present pathology. No statistically significant association between the patient’s age and the sinus volume or a present s...
Velasco-Torres et al. [19] showed a larger sinus volume for dentate patients compared to edentulous and partially edentulous patients. This may be explained through the loss of posterior teeth in the maxilla, leading to the reduction of mechanical stimulation of the maxillary sinus. As a consequence, the sinus could expand (pneumatization) due to increased pressure and ostoclastic activity of the ...
The aim of this study was to analyze volume parameters of the maxillary sinus based on CBCT data. Further, neighboring anatomical structures and related pathologies were recorded. Overall, the applied volume software used in this study allowed the calculation of the surface area and volume of maxillary sinuses.
In clinics, the radiographic evaluation of the maxillary sinus is obligatory prior to ...
No relationship was observed between a patient’s age and the presence of partial or complete obliteration of at least one maxillary sinus (Fig. 6, p = 0.92). Patient’s age and the mean osseus sinus volume were also not associated significantly (Fig. 7, p = 0.20). Both maxillary sinuses (osseus borders) of each patient were quite similar in size (mean difference between left and right...
In total, 128 maxillary sinuses were analyzed. The mean surface area was found to be 39.7 cm2 and the mean volume 17.1 cm3. The mean surface area of the remaining pneumatized cavities of obliterated sinuses was found to be 36.4 cm2 and the mean volume 15 cm3 (Table 1). 42.2% of all sinuses showed an obliteration, and the mean volume of the obliterated sinuses was 5.1 cm3. If there was an obl...
Patient-specific variables like gender, date of birth, and date of CBCT were recorded. The date of the CBCT image was further divided into either being in autumn/winter (1 January 2013–19 March 2013; 22 September 2013–31 December 2013) or spring/summer (20 March 2013–21 September 2013). The maxillary sinus was classified into obliterated or nonobliterated. It was also documented if there was...
In the present study, 64 CBCT images (128 maxillary sinuses), taken between 1 January 2013 and 31 December 2013 at the Department of Cranio-Maxillofacial and Oral Surgery at the University of Zurich, were included. The inclusion criterion of each CBCT scan was the presence of two complete maxillary sinuses; the osseus borders of both sinuses had to be entirely visible.
The scans were performed us...
The precise assessment of the maxillary sinus is important in oral and maxillofacial surgery in cases of traumatology, sinusitis, and dental implantology. After the introduction of cone-beam computed tomography (CBCT) in dental medicine in 1998 [1], the number of clinicians using CBCTs increased constantly. Whereas in 2004, there were only three CBCTs registered in Switzerland, the current number ...
There are few studies measuring the dimensions of the maxillary sinus, being mostly based on computed tomography imaging and rarely being based on cone-beam computed tomography (CBCT). The aim of this study was to measure the 3D osseous and soft tissue defined volume and surface area of the maxillary sinus. Further, possible associations with patient-specific and sinus-related variables were evalu...
Fig. 8. Distribution of occlusal force in models. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7. R right TMJ, L left TMJ, 4 first premolar, 5 second premolar, 6 first molar, and 7 second molar. Numbers within circles indicate implant superstructure
Fig. 8. Distribution of occlusal force in models. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7. R right TMJ, L left TMJ, 4 first prem...
Fig. 7. Initializing models altering the load displacement curves of springs
Fig. 7. Initializing models altering the load displacement curves of springs
Fig. 6. Springs for opposing teeth and TMJs and load directions. Arrows indicate loads, arrowheads indicate restricted nods, and spiral lines indicate springs
Fig. 6. Springs for opposing teeth and TMJs and load directions. Arrows indicate loads, arrowheads indicate restricted nods, and spiral lines indicate springs
Fig. 5. Distribution of occlusal force in the natural teeth model displayed in Fig.4
Fig. 5. Distribution of occlusal force in the natural teeth model displayed in Fig.4
Fig. 4. Three-dimensional finite element model with natural teeth and no defect
Fig. 4. Three-dimensional finite element model with natural teeth and no defect
Fig. 3. Load displacement curves of natural teeth in FE model
Fig. 3. Load displacement curves of natural teeth in FE model
Fig. 2. Load displacement curves of springs
Fig. 2. Load displacement curves of springs
Fig. 1. Three-dimensional finite element model. The tooth roots and implant bodies are displayed with permeability. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7
Fig. 1. Three-dimensional finite element model. The tooth roots and implant bodies are displayed with permeability. a Im67, b Im6, c Im4567, d Im456, e MT67, and f MT7
Material
Modulus of elasticity (MPa)
Poisson ratio
References
Cortical bone
140,000
...
Yoshitani, M., Takayama, Y. & Yokoyama, A. Significance of mandibular molar replacement with a dental implant: a theoretical study with nonlinear finite element analysis.
Int J Implant Dent 4, 4 (2018). https://doi.org/10.1186/s40729-018-0117-7
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Received: 13 March 2017
Accepted: 08 January 2018
Published: 27 February 2018
DOI: https://doi.org/10.1186/s407...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Author Masazumi Yoshitani, Yoshiyuki Takayama, and Atsuro Yokoyama state that there are no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Division of Oral Functional Science, Department of Oral Functional Prosthodontics, Graduate School of Dental Medicine, Hokkaido University, Kita-13, Nishi-7, Kita-ku, Sapporo, 060-8648, Japan
Masazumi Yoshitani & Atsuro Yokoyama
Removable Prosthodontics, Hokkaido University Hospital, Hokkaido University, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan
Yoshiyuki Takayama
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Baba K, Igarashi Y, Nishiyama A, John MT, Akagawa Y, Ikebe K, Ishigami T, Kobayashi H, Yamashita S. Patterns of missing occlusal units and oral health-related quality of life in SDA patients. J Oral Rehabil. 2008;35:621–8.
Kasai K, Takayama Y, Yokoyama A. Distribution of occlusal forces during occlusal adjustment of dental implant prostheses: a nonlinear finite element analysis considering the ...
Chappuis V, Buser R, Bragger U, Bornstein MM, Salvi GE, Buser D. Long-term outcomes of dental implants with a titanium plasma-sprayed surface: a 20-year prospective case series study in partially edentulous patients. Clin Implant Dent Relat Res. 2013;15:780–90.
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Within the limitations of this theoretical study, we demonstrated that restoration with the same number of implants as missing teeth shows almost symmetric occlusal force distribution, and it produced less biomechanically stress for a unilateral defect of the mandible. However, if restoration of a missing second molar with an implant is impossible or difficult, then an SDA with implants may also b...
It should be noted that our results were obtained under conditions of vertical loading by bilaterally balanced muscle activity with tight intercuspation in the correct mandibular position because the horizontal displacement of the premolars and molars was restrained. The actual distribution of occlusal forces may differ due to individual differences in the material properties of the soft tissue. A...
Occlusal adjustment is usually performed to obtain symmetrical occlusal force distribution in natural dentition. However, occlusal force distribution among natural teeth and implants depends on occlusal force because of the difference of displaceability between a natural tooth and an implant [14, 15]. Therefore, we evaluated the result of the analysis from viewpoints of symmetry of occlusal force ...
FEA is useful for mechanical simulations of a living body and has been used in implant dentistry research under careful consideration of the analysis conditions [32, 33]. Although some reports have demonstrated that bone density varies according to bone type and location, the material properties of the mandible were homogenous and isotropic in this study. However, the effect of this difference was...
In model Im456 (Fig. 8d), under loads 100 and 200 N, the occlusal force at the premolars on the defect side was larger than that in model Im4567 (shown in Fig. 8c). The occlusal force was also larger than that in model MT7 (shown in Fig. 6f). However, the occlusal force at the second premolar under load 200 N was 34.5 N, which was slightly smaller than the occlusal force at the second molar ...
In model Im6 (Fig. 8b), the occlusal force at the second premolar under loads 100, 200, 400, and 800 N were 18.3, 37.0, 38.8, and 70.2 N, respectively. The occlusal force was larger than that in model Im67 (shown in Fig. 8a), while it was approximately equivalent to that in model MT7 (shown in Fig. 8f). Under loads 100 and 200 N, the occlusal force at the second premolar on the defect side w...
The distributions of occlusal force are shown in Fig. 8. In model MT67 (Fig. 8e), the occlusal force at the first premolar on the defect side was 10.0–86.5 N, which was 1.2–15.0-fold larger than that on the natural dentition side. The occlusal force at the second premolar on the defect side was 24.6–190.1 N, which was 2.6–8.3-fold larger than on the natural dentition side. The occlusal...
Analysis was performed according to the report by Kayumi et al. [15]. In linear finite element analysis (FEA), all teeth maintain perfect contact with antagonists with no stress on occlusal surfaces before loading. However, there must be some occlusal force on the occlusal surface when a mandible is in the intercuspal position. Since the displaceabilities of osseointegrated implants, natural teeth...
Nonlinear characteristics according to the load displacement curve of teeth [21,22,23,24] and cartilage [30] were given to the springs for the opposing teeth and TMJs, respectively (Fig. 2). The nonlinear elasticity of the springs on the teeth and implants simulated displaceability of opposing natural teeth at compression and separation of the occlusal surface from opposing teeth at tension.
The...
The 3D FEMs were constructed based on those reported by Kasai et al. [14], Kayumi et al. [15] and consisted of a mandible, natural teeth with the periodontal ligament (PDL), and titanium implant(s) with superstructures in the left premolar and molar regions.
The surface of the mandible was generated using measurements of a commercially available model (QS7, SOMSO) of the dentate mandible with a 3...
From the viewpoint of occlusal force distribution, when a second molar defect remains without prosthesis, the force might concentrate in the implant, residual teeth, or temporomandibular joints (TMJs). Therefore, the aim of this study was to investigate occlusal force distribution in SDA in the mandible with/without an implant using a three-dimensional (3D) finite element model (FEM).
Dental implant treatment has been frequently applied in dental practice as the most important prosthodontic procedure with long-term predictability to restore oral function, maintain occlusion, and improve the quality of life (QoL) of a patient [1]. Clinically, dental implants are mainly applied to correct mandibular distally extended edentulism [2]. However, implant placement in the molar region ...
Dental implants are frequently applied to unilateral defects in the mandible. However, implant placement in the molar region of the mandible can be difficult due to anatomical structure. The aim of this study was to evaluate the distribution of occlusal force in a mandibular shortened dental arch (SDA) with implants.
Three-dimensional finite element (FE) models of the mandible with varying number...
Fig. 3. Proportion of dental implant FEA articles with a validation. (Left) Among totally 522 FEA articles of dental implants which we were able to access English full text up to January 2017, there are only 47 articles with a validation. (Right) The articles with a validation were categorized according to their validation method as follows levels: A, in vivo (human bodies); B, performed in vivo...
Fig. 2. Hierarchy of validations based on their similarity to real biomechanical behaviors. The articles (n = 47) were categorized according to their validation method as follows: in vivo experiments in humans (n = 1) and other animals (n = 3), model experiments (n = 32), others’ clinical data and past literature (n = 9), and other software (n = 2)
Fig. 2. Hierarchy ...
Fig. 1. Flowchart of literature review. An electronic literature search of PubMed was conducted up to January 2017 using the Medical Subject Headings “dental implants” and “finite element analysis.” After accessing the full texts, the context of each article was searched using the words “valid” and “validation” and articles in which these words appeared were read to determine whe...
Ranking
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FEM geometry reference
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Chang, Y., Tambe, A.A., Maeda, Y. et al. Finite element analysis of dental implants with validation: to what extent can we expect the model to predict biological phenomena? A literature review and proposal for classification of a validation process.
Int J Implant Dent 4, 7 (2018). https://doi.org/10.1186/s40729-018-0119-5
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Received: 05 November 2017
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Yuanhan Chang, Abhijit Anil Tambe, Yoshinobu Maeda, Masahiro Wada, and Tomoya Gonda declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Yuanhan Chang, Yoshinobu Maeda, Masahiro Wada & Tomoya Gonda
Mahatma Gandhi Vidyamandir’s Karmaveer Bhausaheb Hiray Dental College & Hospital, Mumbai Agra Road, Panchwati, Nashik, Maharashtra, India
Abhijit Anil Tambe
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Gass SI. Decision-adding m...
High-level validation of FEA using in vivo experiments is still rare in the dental implant field.
It is necessary to clearly indicate the validation process of the model when a study using FEA is presented.
The hierarchy proposed in this study based on the evidence level of the validations can be applied to evaluate the clinical significance of studies using FEA.
To explain or analyze the mechanical properties involved in biological phenomena such as motor tasks (mastication, walking, or heart contraction), a time-dependent finite element model may provide a more realistic view. However, if time-dependent performance criteria are considered (the most common is to clarify the influence of musculoskeletal structure on function or the performance of a motor t...
Because of the limitations of computer technology, most FEA models [75,76,77,78,79] simplify the skeletal muscle architecture in terms of a uniform fiber length, pennation angle, and line of action and represent the architecture using a Hill-based muscle model. However, how well the modeling of skeletal muscles as one-dimensional strings represents the behavior of the full three-dimensional muscle...
Table 1 shows all studies in the literature that considered the need for validation of FEAs. According to these studies, we established a hierarchy based on the evidence level of the validations (A to G, i.e., high to low) (Fig. 2).
Level A: validation using living humans
Level B: validation using living heterogeneous animals
Levels C and D: validation using homogenous and heterogeneous bone
...
Level E: model experiment performed using artificial materials (n = 23) [14, 25, 26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46]
Artificial materials such as acrylic resin, polyurethane, or plastic bone models were commonly used as embedded “bone” implants in validation experiments. Level E includes the use of special materials and specific methods to measure the force di...
We classified all validation processes based on their similarity to real biomechanical behaviors into the following hierarchy (levels A to G) (Fig. 2):
Level A: performed in vivo (human bodies) (n = 1) [10]
The top level of the hierarchy, level A, includes in vivo methods of FEA validation conducted in humans. In 2006, Heckmann et al. [10] quantified the degree of stress that occurs in the...
In total, 601 articles were obtained from the PubMed electronic search using the Medical Subject Headings “dental implants” and “finite element analysis.” After excluding articles for which the full text could not be accessed (n = 69) and that were not written in English (n = 10), 522 articles remained. These articles were searched using the terms “validation,” “validity,” ...
FEA studies with validation have recently become more common in the biomechanical field. FEA validations can be divided into two types: (1) direct validation, which involves experiments on the quantities of interest (from basic material characterizations to hierarchical system analysis such as model experiments and in vitro experiments), and (2) indirect validation, which involves the use of liter...
Finite element analysis (FEA) has been applied to investigate dental implant designs, the structure and material of the superstructure, and the stability of the surrounding bone [1, 2]. According to PubMed, only 10 FEA studies of dental implants were published in 1990, while 102 papers were published in 2014.
FEA has become an increasingly useful tool in the past few decades. In the medical field...
A literature review of finite element analysis (FEA) studies of dental implants with their model validation process was performed to establish the criteria for evaluating validation methods with respect to their similarity to biological behavior. An electronic literature search of PubMed was conducted up to January 2017 using the Medical Subject Headings “dental implants” and “finite element...
Fig. 9. The comparison of two groups at average voxel values for each part. The comparison of voxel values by insertion torque. All specimens were classified into two groups by insertion torque
Fig. 8. The relationship between average voxel value and insertion torque (averaged over the entire treatment area). The comparison of average voxel value among IT groups. Average voxel value was 384.0 ± 154.6 in the low IT group, 387.7 ± 147.7 in the medium IT group, and 619.2 ± 200.4 in the high IT group
Fig. 8. The relationship between average voxel value and insertion torqu...
Fig. 7. The average voxel value between the maxilla and mandible. There was no difference between the maxilla (430.9 ± 211.6) and the mandible (475.6 ± 211.5) in the average voxel value. Also, no difference was found in each part
Fig. 7. The average voxel value between the maxilla and mandible. There was no difference between the maxilla (430.9 ± 211.6) and the mandible (475.6...
Fig. 6. The relationship between ISQ and insertion torque. Percentage of specimens showing ISQ ≥ 73 compared with groups by week. In all groups, a period of rapidly increasing percentages was observed (8–12 weeks in the low IT group, 4–6 weeks in the medium and high IT groups). In the medium and high IT Group, a statistically significant difference was observed between ISQ ≥ 73 a...
Fig. 5. The comparison of ISQ values by the insertion torque. Time-lapse migration of ISQ values was compared with IT groups. Each IT group displayed similar migration. A significant difference in The ISQ was found in the low IT group after 8 weeks
Fig. 5. The comparison of ISQ values by the insertion torque. Time-lapse migration of ISQ values was compared with IT groups. Each IT group displ...
Fig. 4. The classification of the insertion torque. All specimens classified into three groups according to insertion torque. Criteria for the classification are shown in the figure and in the “Methods” section
Fig. 4. The classification of the insertion torque. All specimens classified into three groups according to insertion torque. Criteria for the classification are shown in the figur...
Fig. 3. The evaluation of the average ISQ. Time-lapse migration of average ISQ. Average ISQ of all specimens increased in a time-dependent manner (results indicated by a line). A significant difference was observed by 6 weeks after surgery
Fig. 3. The evaluation of the average ISQ. Time-lapse migration of average ISQ. Average ISQ of all specimens increased in a time-dependent manner (results...
Fig. 2. The measurement of the voxel values. A case of bone quality diagnosis before treatment. Width and height of the bone were measured to select the proper size of the implant body. The selected implant body was simulated on the bone images as a symbol, and then the voxel value was calculated as described in the “Methods” section
Fig. 2. The measurement of the voxel values. A case of ...
Fig. 1. Genesio® Plus implant with Aanchor surface. Scheme of the dental implant body for the Genesio® Plus implants with Aanchor surface used. a Overview picture of Genesio® Plus implants with Aanchor surface. b Image from scanning electron microscopy. Both pictures were provided by GC Corporation. To obtain osseointegration from an early stage, the dental implant body was treated with sandb...
Number of implants
Insertion torque value (N cm)
Implant stability quotient value
0 week
2 weeks
...
Number of implants
Treatment area (FDI)
Size of implant (mm)
Length
Diameter
1
...
Homma, S., Makabe, Y., Sakai, T. et al. Prospective multicenter non-randomized controlled study on intraosseous stability and healing period for dental implants in the posterior region.
Int J Implant Dent 4, 10 (2018). https://doi.org/10.1186/s40729-018-0122-x
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Received: 05 September 2017
Accepted: 25 January 2018
Published: 29 March 2018
DOI: https://doi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
This research was conducted in accordance with the Helsinki Declaration of 1964 and subsequent ethical standards, with the approval of Tokyo Dental University and Fukuoka Dental College Ethics Committee (World Medical 2013). The surgeon explained the contents of the research to each patient, who then consented to participate in the present study.
All participants consented to publish their inform...
Correspondence to
Shinya Homma.
Department of Oral and Maxillofacial Implantology, Tokyo Dental College, 2-9-18 Misaki-cho, Chiyoda-ku, Tokyo, 101-0061, Japan
Shinya Homma, Yasushi Makabe & Yasutomo Yajima
Section of Oral Implantology, Department of Oral Rehabilitation, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka-City, Fukuoka, 814-0175, Japan
Takuya Sakai, Kenzou Morinaga & Hirofumi Kido
Center for Oral ...
Nedir R, Bischof M, Szmukler-Moncler S, Bernard JP, Samson J. Predicting osseointegration by means of implant primary stability. Clin Oral Implants Res. 2004;15(5):520–8.
Ito Y, Sato D, Yoneda S, Ito D, Kondo H, Kasugai S. Relevance of resonance frequency analysis to evaluate dental implant stability: simulation and histomorphometrical animal experiments. Clin Oral Implants Res. 2008;19(1):9–...
Boronat López A, Balaguer Martínez J, Lamas Pelayo J, Carrillo García C, Peñarrocha DM. Resonance frequency analysis of dental implant stability during the healing period. Med Oral Patol Oral Cir Bucal. 2008;13(4):E244–7.
Gapski R, Wang HL, Mascarenhas P, Lang NP. Critical review of immediate implant loading. Clin Oral Implants Res. 2003;14(5):515–27.
Esposito M, Hirsch JM, Lekholm U, Th...
Schulte W, Lukas D. The Periotest method. Int Dent J. 1992;42(6):433–40.
Meredith N, Book K, Friberg B, Jemt T, Sennerby L. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Clin Oral Implants Res. 1997;8(3):226–33.
Meredith N. Assessment of i...
Aparicio C, Rangert B, Sennerby L. Immediate/early loading of dental implants. A report from the Sociedad Española de Implantes World Congress consensus meeting in Barcelona, Spain 2002. Implant Dent Relat Res. 2003;5:57–60.
Cochran DL, Moeton D, Weber HP. Consensus statements and recommended clinical procedures regarding loading protocols for endosseous dental implants. Int J Oral Maxillofac ...
Cone beam CT
Computed tomography
Digital Imaging and Communications in Medicine
Implant stability quotient
Insertion torque
Multi-slice CT
The purpose of this study was to evaluate the relationship between the insertion torque value and the ISQ value at the implant treatment using the current rough-surfaced implant. As a result, no significant relationship was found between the insertion torque value and the ISQ value. Also, it was suggested that the ISQ value was considered to be an important indicator for observing the treatment st...
As accurate CT attenuation was not measured due to the lower spatial resolution of CBCT compared with MSCT, a CBCT was recognized as unsuitable for evaluating bone quality. However, several groups have recently reported the potential use of CBCT systems as an apparatus for estimating bone quality. Isoda et al. described a high correlation between voxel values obtained by CBCT and IT of the implant...
In this study, we could not find a significant relationship between insertion torque value and ISQ value. However, insertion torque value is an important indicator for predicting the progress of implant treatment, and ISQ value is considered to be an important indicator for observing the treatment state of the implant. Currently, the insertion torque value is used as the major decision index for t...
Increases or decreases of ISQ values are explained as follows: The inserted dental implant body is supported by mechanical interdigitating force after surgery, but this interdigitating force will be reduced time-dependently by the effects of osteoclasts activation at the initial stage of the bone remodeling process, then osseointegration will be completed by an increasing contact area between the ...
The insertion torque value in this study showed broader (10 to 50 N cm) than the previous publication (Table 2) [22, 32], and the cause of reasons for the difference are as follows: Primary stability may be affected by the bone quantity and bone quality in the treatment area, the micro- and macro-level design of the implant body, and the accuracy of the surgical technique [18, 25]. In this stud...
According to the previous literature, the obtaining osseointegration is integral to the intraosseous stability of the implant body during the healing period [24]; moreover, the importance of postoperative assessment of the intraosseous stability of the implant has also been reported [10]. Intraosseous stability of the implant body is evaluated immediately after the implant insertion and during the...
Average ISQ tended to increase during the healing period in all IT groups (Fig. 5). Average ISQ of the low IT group was 59.81 at 0 week, increasing significantly after ≥ 8 weeks (P
A total of 33 implant bodies (8 in the maxilla, 25 in the mandible) were inserted into the 27 participants (11 men, 16 women), with the average age of 54.6 ± 12.2 years (range, 32–78 years). The average IT value was 32.7 ± 9.2 N cm (32.5 ± 11.6 N cm in the maxilla, 32.8 ± 8.5 N cm in the mandible). The diameter of the implant body was 4.4 mm in 20 (60.6%) and 3.8 mm...
The CBCT was performed using a 3DX Multi-Image Micro CT FPD 8 system (J. MORITA MFG., Kyoto, Japan) (tube voltage, 80 kV; imaging area, 80 × 80 mm), and voxel values were measured with coDiagnostix™ 9.7 (dental wings, Montreal, Canada). The voxel values were calculated based on CT images for bone quality diagnosis. Voxel values were measured three times at 12 locations covering the mesial...
Implant treatment was performed in accordance with the procedure recommended by the manufacturer, without bone augmentation. A healing abutment was connected to the implant bodies after insertion (implant insertion in one stage method). A total of 17 dentists (treatment experience, 5–35 years; average, 11.5 years) performed all implant treatments in this study. All dentists who performed the i...
This prospective study was conducted jointly by Tokyo Dental College (Tokyo, Japan) and Fukuoka Dental College (Fukuoka, Japan) from January to December 2015. All study protocols were conducted in accordance with the Declaration of Helsinki [21] and were approved by the ethics committees of Tokyo Dental College (approval #416) and Fukuoka Dental College (approval #213).
Participants comprised pat...
The purpose of this study is to evaluate the relationship between IT and ISQ at implant treatment using the current rough surfaced implant. We evaluated the implant treatment sites with implant stability quotient (ISQ) values, IT values, and voxel values. We assumed that there is relevance between the insertion torque value and the ISQ value.
Dental implant treatments have improved in both convenience and predictability with refinements in implant bodies and treatment procedures as compared to about 50 years ago when clinical applications were started. Currently, an implant body surface is treated with “rough processing” by sandblasting and acid etching for the purposes of obtaining more reliable osseointegration and shortening tr...
A current implant body surface was treated with “rough processing” by sandblasting and acid etching for the purposes of obtaining more reliable osseointegration and shortening the treatment period. Various reports have examined the healing period with the use of these implant bodies, but a consensus opinion has not yet been obtained. The purpose of this study is to evaluate the relationship be...
A current implant body surface was treated with “rough processing” by sandblasting and acid etching for the purposes of obtaining more reliable osseointegration and shortening the treatment period. Various reports have examined the healing period with the use of these implant bodies, but a consensus opinion has not yet been obtained. The purpose of this study is to evaluate the relationship be...
Fig. 6. Funnel plot for anchorage loss in the vertical dimension (MD mean difference, SE standard error)
Fig. 6. Funnel plot for anchorage loss in the vertical dimension (MD mean difference, SE standard error)
Fig. 5. Funnel plot for anchorage loss in the horizontal dimension (MD mean difference, SE standard error)
Fig. 5. Funnel plot for anchorage loss in the horizontal dimension (MD mean difference, SE standard error)
Fig. 4. Forest plot for anchorage loss in the vertical dimension
Fig. 4. Forest plot for anchorage loss in the vertical dimension
Fig. 3. Forest plot for anchorage loss in the horizontal dimension
Fig. 3. Forest plot for anchorage loss in the horizontal dimension
Fig. 2. Graphic visualization of the risk of bias judgements
Fig. 2. Graphic visualization of the risk of bias judgements
Fig. 1. PRISMA study flow diagram
Fig. 1. PRISMA study flow diagram
NoneTable 3 Risk of bias judgment according to the Cochrane Collaboration
Reference
Number of patients
Type of study (RCT/CCT/other)
Control intervention
Type of implant (length, material)
...
Reference
Reason for exclusion
Barros et al. (2017) [3]
Anchorage loss at first molar not specified
Borsos et al. (2012) [7]...
Becker, K., Pliska, A., Busch, C. et al. Efficacy of orthodontic mini implants for en masse retraction in the maxilla: a systematic review and meta-analysis.
Int J Implant Dent 4, 35 (2018). https://doi.org/10.1186/s40729-018-0144-4
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Received: 04 May 2018
Accepted: 27 August 2018
Published: 25 October 2018
DOI: https://doi.org/10.1186/s40729-018-0144-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Data extraction template. (CSV 2 kb)
Not applicable
Not applicable
Kathrin Becker, Annika Pliska, Caroline Busch, Benedict Wilmes, Michael Wolf, and Dieter Drescher declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Kathrin Becker.
Michael Wolf and Dieter Drescher contributed equally to this work.
Department of Orthodontics, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
Kathrin Becker, Annika Pliska, Caroline Busch, Benedict Wilmes & Dieter Drescher
Department of Orthodontics, Universitätsklinikum RWTH Aachen, Aachen, Germany
Michael Wolf
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We acknowledge the work of S. Moscarino, E. Burceck, and J. Bartz who assisted in the abstract screening and hand searching.
The study was self-funded by the authors.
The data extracted for the meta-analysis are available in the Additional file 1.
Xun CL, Zeng XL, Wang X. Clinical application of miniscrew implant for maximum anchorage cases. Zhonghua Kou Qiang Yi Xue Za Zhi. 2004;39(6):505–8.
Yao CC, Lai EH, Chang JZ, Chen I, Chen YJ. Comparison of treatment outcomes between skeletal anchorage and extraoral anchorage in adults with maxillary dentoalveolar protrusion. Am J Orthod Dento Orthoped. 2008;134(5):615–24.
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Upadhyay M, Yadav S, Patil S. Mini-implant anchorage for en-masse retraction of maxillary anterior teeth: a clinical cephalometric study. Am J Orthod Dentofac Orthop. 2008b;134(6):803–10.
Upadhyay M, Yadav S, Nagaraj K, Uribe F, Nanda R. Mini-implants vs fixed functional appliances for treatment of young adult Class II female patients: a prospective clinical trial. Angle Orthod. 2012;82(2):294...
Nienkemper M, Wilmes B, Pauls A, Drescher D. Impact of mini-implant length on stability at the initial healing period: a controlled clinical study. Head Face Med. 2013;9:30.
Papageorgiou SN, Zogakis IP, Papadopoulos MA. Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis. Am J Orthod Dentofac Orthop. 2012;142(5):577–595.e577.
Park HS, Kwon TG, Sung JH. ...
Kawa D, Kunkel M, Heuser L, Jung BA. What is the best position for palatal implants? A CBCT study on bone volume in the growing maxilla. Clin Oral Investig. 2017;21(2):541–9.
Kuhlberg AJ, Burstone CJ. T-loop position and anchorage control. Am J Orthod Dentofac Orthop. 1997;112(1):12–8.
Kuhlberg AJ, Priebe DN. Space closure and anchorage control. Semin Orthod. 2001;7(1):42–9.
Kuroda S, Yam...
de Almeida MR, Herrero F, Fattal A, Davoody AR, Nanda R, Uribe F. A comparative anchorage control study between conventional and self-ligating bracket systems using differential moments. Angle Orthod. 2013;83(6):937–42.
Durrani OK, Shaheed S, Khan A, Bashir U. Comparison of in-vivo failure of single-thread and dualthread temporary anchorage devices over 18 months: A split-mouth randomized contr...
Al-Sibaie S, Hajeer MY. Assessment of changes following en-masse retraction with mini-implants anchorage compared to two-step retraction with conventional anchorage in patients with class II division 1 malocclusion: a randomized controlled trial. Eur J Orthod. 2014;36(3):275–83.
Alharbi F, Almuzian M, Bearn D. Miniscrews failure rate in orthodontics: systematic review and meta-analysis. Eur J O...
The present systematic review and meta-analysis revealed that orthodontic mini implants are associated with a significantly lower anchorage loss at the first upper molars compared to conventional anchorage devices for en-masse retraction in the maxilla. However, the ideal implant location (anterior palate versus alveolar ridge) and the most beneficial concept (direct or indirect anchorage) need t...
Indirect anchorage through implants in the alveolar ridge was associated with mesial molar migration in all studies included in the present review [5, 9, 54, 57]. Nonetheless, anchorage loss with indirect anchorage was significantly lower compared to the conventional devices [5, 9, 57]. It has been suggested that the anchorage loss at indirectly anchored mid-palatal implants may be caused by a sli...
The present systematic review was conducted to address the following focused question: “In patients with a need for en masse retraction of the upper front teeth, what is the efficacy of orthodontic mini implants for anchorage control compared with conventional anchorage devices?”
The literature search revealed that efficacy of anchorage control of orthodontic mini implants in comparison to co...
Meta-analysis was performed on RCTs reporting on anchorage loss at the first molar.
Based on seven studies [1, 4, 11, 28, 49, 50, 52], the weighted mean differences (WMD) [95% CI, p] in horizontal anchorage loss between test and control groups amounted up to − 2.79 mm [− 3.56 to − 2.03 mm, p
The overall success rates of the orthodontic mini implants varied among the studies. A success rate of 95.7% with a loss of 2 from 46 implants was reported by Upadhyay et al. [48], and the implants could be replaced immediately. Two patients developed a peri-implant inflammation which was resolved through improved oral hygiene. A loss of 5 of 72 implants was reported by Upadhyay et al. [49], and i...
In detail, anchorage loss associated with indirect anchorage and a mid-palatal implant amounted to 1.5 ± 2.6 mm versus 3 ± 3.4 mm [5], 0.7 ± 0.4 (right molar) and 1.1 ± 0.3 mm (left molar) [54], 1.73 ± 0.39 mm (horseshoe), and 0.36 ± 0.11 mm (posterior reinforcement) versus 4.21 ± 1.17 mm [57]. An anchorage loss of 0.2 ± 0.35 mm versus 2.0 mm ± ...
The study samples considered for the qualitative synthesis consisted of females exhibiting Angle Class II,1 malocclusion with upper dental protrusion and an overjet of at least 7 mm [48], patients with a dental Class II, a need for extraction of the first upper premolars and front retraction [54], or Class III patients with a need for pre-surgical decompensation through premolar extraction and fr...
The search for the review was undertaken at December 31, 2017. A total of 2046 potentially relevant titles and abstracts were found during the electronic and manual search (676 after duplicate removal) of which 99 titles were considered relevant for abstract screening. During the first stage of study selection, 58 publications were excluded based on the abstract. For the second phase, the complete...
When data were not available in the printed report, we calculated the missing information whenever possible (e.g., by subtracting pre- and post en masse retraction values). In cases where a zero variance (0.00 mm) was presented in the summary tables, these values were changed to 0.01 mm to enable meta-analysis. The corresponding authors of the published studies were contacted when needed.
Heter...
Inclusion of less than five patients
Lack of clinical data on anchorage loss
Measurement of anchorage loss not by superimposition of lateral cephalograms or superimposition of study casts
Previous orthodontic treatment
Treatment in control group not specified
Inclusion of diseased patients, e.g., patients with systemic diseases, periodontal disease, and syndromes
Other treatment than en mass...
AND (“anchorage loss” OR “anchorage quality” OR “quality of life” OR “benefit” or “harm” OR “efficacy” OR “side effects” OR “effect” OR “orthodontic anchorage procedures”[mh] OR “treatment outcome”[mh])
Search terms EMBASE (including EMTREE terms)
(“en-masse retraction” OR “incisor retraction” OR “front retraction” OR “orthodontic gap clo...
This systematic review was structured and conducted according to the preferred reporting items of the PRISMA statement [34].
The focused question serving for literature search was structured according to the PICO (Patients, Intervention, Control, Outcome) format: “In patients with a need for en masse retraction of the upper front teeth, what is the efficacy of orthodontic mini implants for anch...
Extraction of the permanent teeth for retraction of the protruded front teeth is a routine approach in orthodontics. Various techniques such as headgear, Nance button, and transpalatal arches (TPA) have been proposed to achieve sufficient anchorage [5, 8, 9, 12, 28, 31, 45]. Nevertheless, anchorage control turned out to be highly demanding as the conventional approaches were commonly associated wi...
Retraction of the upper incisors/canines requires maximum anchorage. The aim of the present study was to analyze the efficacy of mini implants in comparison to conventional devices in patients with need for en masse retraction of the front teeth in the upper jaw.
An electronic search of PubMed, Web of Science, and EMBASE and hand searching were performed. Relevant articles were assessed, and data...
Figure 5. Osteoblasts with an orientation tendency after 24 h of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The yellow arrows show the orientation of the cells. The red arched arrow within the coloured circle shows the direction of rotation. The dashed white line oriented to the right stands for the r...
Figure 4. Randomly orientated osteoblasts without influence of rotation (phallacidin fluorescence staining). On the left side with 200× and on the right side with 400× magnification. The white X on the coloured circle marks the location upon the plate where the osteoblasts were located. The red X marks the centre of the plate
Figure 3. Diagram for visualisation of the calculation of shear stress rates taking into account the centrifugal force and the glass plates’ dimensions. For example, at a distance of 25 mm from the centre of the upper plate, the shear forces’ value is 8.33 dyn/cm2, together with an additional centrifugal force that has a value of 0.55 dyn/cm2
Figure 2. Side view of a computerized simulation, showing the flow chambers’ lower compartment and the flow profile in between the two plates; shearing gap and bottom plate are shown on the left side; rotation speed = 200 rpm; colour code bar (left edge) showing shear force values [Pa] [1 Pa = 10 dyn/cm2]; flow direction presented by arrows
Figure 1. Three-dimensional illustration (a–e) and photography (f) of the experimental setup with the components marked numerical. a 1 Lower petri dish (s’ bottom serving as the lower plate); 2 Rotating glass panel [60 mm diameter (cell bearing)]; 3 Titanium axis. b 4 Liquid medium (red). c 5 Reversed upper petri dish. d 6 Gearwheel with set screw. e 7 Closing; 8 Electronic motor device and ...
References
Ehrlich PJ, Lanyon LE. Mechanical strain and bone cell function: a review. Osteoporos Int. 2002;13(9):688–700.
Vaughan TJ, Haugh MG, Mcnamara LM. A fluid-structure interaction model to characterize bone cell stimulation in parallel-plate flow chamber systems. J R Soc Interface. 2013;10(81):20120900.
Weinbaum S, Cowin SC, Zeng Y. A model for the excitation of osteocytes by mec...
Besides, in the model reported in this study, microscopic examinations are possible after completing the experiment only. Nevertheless, an advantage of the new flow chamber is the possibility of testing different cell colonies simultaneously in one single experiment by placing cells in different radial locations on the spinning disc. Due to the current flow gradient from the centre to the pe...
Due to the fact that constant flows were generated within the parallel flow chamber only, the situations of in vitro experiments differ from in vivo setting where dynamic flow profiles are particular. As the constant laminar flow profile is not physiological in bones, vessels and other tissues, the informative value of the experimental setting is limited but it could be used for various cell...
Further on, the simulations indicated that the flow profile in between the two plates was not influenced by peripheral turbulences alongside the peripheral regions. To verify a cellular realignment towards the shear direction, cells were microscopically examined prior and after exposure to shear forces for 24 h upon a spinning disc at a speed level of 200 rpm. Even if not sufficiently ...
Discussion
The aim of this study was to establish a new FSS model that is easy to use as well as simple to assemble in order to create reproducible fluid shear forces on cells close to implant material surfaces. Todays’ commonly used commercial flow devices differ in geometry and function, which makes comparisons between experiments difficult. The benefits of this novel testing device are...
Regarding the upper compartment, peripheral turbulent flow along the outer edges was similar to the fluid movements within the area in between the plates. At the top, the turbulent flow directed from the centre to the periphery whereas the turbulences at the bottom were orientated in reverse to that. Moreover, the effect of the shear forces on the osteoblast cells was also influenced by the centri...
Results
Our analysis was focused on two main aspects:
Simulation of the fluid flow characteristics as well as quantification of the arising shear forces at the plate/plate flow chamber with reliable reproducibility
Assessment of the impact of fluid shear stress on osteoblast cells in terms of altered cell morphology and intracellular structural changes
Evaluation of the f...
Test procedure
The experimental process involved three steps. First, a count of n = 50.000 commercially available osteoblasts (PromoCell, Heidelberg, Germany) per millilitre of culture medium were cultured on the bottom of the cell-bearing surface (glass panel). Therefore, cells were seeded in a culture medium (cf. Appendix 2 for a detailed composition) at 37 °C. Prior to the test proce...
Analytical formula for evaluating the flow characteristics
Frequently used flow chambers are characterised by an internal fluid flow along a stationary cell-bearing surface, whereas the osteoblast test cells of this newly developed model are circulating within a resting culture medium.
For constant and fully developed laminar flow between the two parallel plates, the magnitude of the wall sh...
Methods
Experimental setup
A three-dimensional illustration and photography of the plate/plate flow chamber model is shown in Fig. 1. A detailed list of used parts can be found in Appendix 1.
The circulation within the flow chamber was generated by an externally attached electric motor, which rotates up to 500 rounds per minute (rpm). A commercial grade 4 pure medical titanium gear shaft (len...
Abstract
Background
Mechanostimuli of different cells can affect a wide array of cellular and inter-cellular biological processes responsible for dental implant healing. The purpose of this in vitro study was to establish a new test model to create a reproducible flow-induced fluid shear stress (FSS) of osteoblast cells on implant surfaces.
Methods
As FSS effects on osteoblasts are detectabl...
Models
Mean difference
P value
Straight
B-offset
−58.94
0.855
Straight
L-offset
270.67
0.061
B-offset
L-offset
329.61
0.020
Models
Mean difference
P value
Straight
B-offset
−402.94
0.007
Straight
L-offset
−323.79
0.029
B-offset
L-offset
79.16
0.772
Table 7 Means and standard deviations (SD) of strain around the no. 36 implant (με) in the finite element analysis (FEA) models
Models
Loading
Strain (με)
Strain M
Strain B
Strain D
Strain L
Buccal offset
Buccal loading
−222.34 ± 158.56
−934.84 ± 76.82
252.11 ± 103.72
−98.32 95.94
Central loading
−336.26 ± 94.27
−477.17 ±...
Table 6 Tukey’s test for strain L in the experimental models
Models
Mean difference
P value
Straight
B-offset
−25.14
0.999
Straight
L-offset
168.04
0.948
B-offset
L-offset
193.18
0.932
Table 5 Tukey’s test for strain B in the experimental models
Models
Mean difference
P value
Straight
B-offset
1524.82
0.044
Straight
L-offset
−503.40
0.670
B-offset
L-offset
−2028.22
0.007
Table 4 Means and standard deviations (SD) of strain around the no. 36 implant (με) in the experimental models
Models
Loading
Strain (με)
Strain M
Strain B
Strain D
Strain L
Buccal offset
Buccal loading
−599.33 ± 595.46
−4507.35 ± 1192.62
1164.77 ± 169.94
−148.09 ± 174.19
Central loading
−697.29 ± 651.92
−2526.69 ± 5...
Models
Displacement (μm)
Buccal loading
Central loading
Lingual loading
Buccal offset
72.24 ± 1.43
28.24 ± 1.86
28.02 ± 1.41
Straight
68.49 ± 5.24
31.43 ± 1.23
40.18 ± 1.29
Lingual offset
49.63 ± 2.03
26.39 ± 0.37
38.44 ± 1.46
Table 2 Means and standard deviations (SD) of displacement of the implants (μm) under loading in experimental models
Models
Displacement (μm)
Buccal loading
Central loading
Lingual loading
Buccal offset
54.60 ± 8.53
37.39 ± 5.53
40.22 ± 4.24
Straight
80.66 ± 7.47
52.92 ± 1.07
63.03 ± 3.69
Lingual offset
53.11 ± 4.35
40....
Table 1 Mechanical properties of materials used in the FEA models
Material
Young’s modulus (MPa)
Poisson’s ratio
Artificial cancellous bone
6.29
0.3
Artificial cortical bone
13.73
0.3
Implant and superstructure
108,000
0.3
Figure 15. Load supporting area in the superstructures
Figure 14. The distribution of equivalent stress around the no. 36 implant in the finite element analysis (FEA) models
Figure 13. The distribution of equivalent stress around the peri-implant bone in the finite element analysis (FEA) models
Figure 12. The strain around the no. 36 implant in the finite element analysis (FEA) models
Figure 11. The strain around the no. 36 implant in the experimental models
Figure 9. The displacement of the implants under loading in finite element analysis (FEA) models
Figure 8. The displacement of the implants under loading in experimental models
Figure 7. A finite element analysis (FEA) model. (a) Buccal load, (b) central load, and (c) lingual load
Figure 7. A finite element analysis (FEA) model. (a) Buccal load, (b) central load, and (c) lingual load
Figure 6. Loading test in the experimental model
Figure 5. Application of strain gauges
Figure 4. Experimental model. (a) Buccal load, (b) central load, and (c) lingual load
Figure 3. Three different models with different placements
Figure 2. Three implants were embedded in an artificial mandible
Figure 1. An artificial mandible
References
Frost HM. Wolff’s Law and bone’s structural adaptations to mechanical usage: an overview for clinicians. Angle Orthod. 1994;64:175–88.
Duyck J, Rønold HJ, Van Oosterwyck H, Naert I, Vander Sloten J, Ellingsen JE. The influence of static and dynamic loading on marginal bone reactions around osseointegrated implants: an animal experimental study. Clin Oral Implants Res. 200...
In addition, there was not a significantly less strain site by offset placement. Anitua et al. have reported that offset placement did not affect marginal bone loss around the implant in the oral cavity of the living body. Overloading of the peri-implant bone has been reported to result in bone resorption, and the concentration of considerable stress in the load-side peri-implant bone observ...
Thus, compressed displacement exhibited the same trend in the experimental models and FEA models. The results of both models may be reliable. When the effects of offset placement are considered, there is the concept of the load-supporting area (Fig. 15) put forth by Sato. The load-supporting area is the area surrounded by the lines connecting the implant peripheries, and if a loading point falls w...
In previous studies verifying the usefulness of offset placement, one set of FEA models was created and analyzed by changing the conditions or settings. Few studies used different FEA models with the same placement models. In the present study, we carried out the same experiments with both the models to verify the validity of each analysis.
Moreover, considering the possibility of error while usi...
Strain in the FEA models also exhibited considerable compressive strain on the loading side, similar to the experimental models. In terms of quantitative data for comparison with the experimental models, the length of the places where the strain gauges were applied was measured on the FEA models and the strain was calculated from the length before and after loading and compared with the expe...
Discussion
Experimental models
Reported studies verifying the effects of offset placement include ones where implant bodies were embedded in rectangular experimental models, ones where rectangular bone models were constructed with FEA models, and ones where FEA models were constructed from CT data on human mandibles. The artificial mandible models used in the present study were type II in the ...
Strain on the peri-implant bone
Strain in the experimental models
Figure 11 and Table 4 show the strain, by loading site, in the implant part corresponding to the first molar in the experimental models during the application of a 100-N vertical load.
Considerable compressive strain was observed with the load-side strain gauges in all placements, and similar trends were observed between pl...
A strain gauge (2630-100, Instron Japan, Kanagawa, Japan) was attached between the worktable and jig, and the change in the distance between the worktable and jig was measured under the assumption that it would be the same as the implant displacements under loading conditions (Fig. 6). Measurements were taken five times at each loading site, and the mean of the five measurements was considered the...
FEA software (Mechanical Finder®, Research Center of Computational Mechanics, Tokyo, Japan) was used to construct three-dimensional FEA models from the resulting CT data. The mesh was constructed of tetrahedral elements, and the total numbers of nodes and elements were approximately 260,000 and 1,400,000, respectively. FEA models were prepared with appropriate physical properties (Table 1) determ...
Preparation of the superstructure
Using the anatomical crown width as a reference, it was determined that the occlusal surface view of the superstructure would be trapezoidal with a 7-mm buccolingual width in the mesial first premolar section, a 10-mm buccolingual width in the distal first molar section, and a 26-mm mesiodistal width (Fig. 4). The vertical dimension was 8 mm; the upper 4 mm was t...
Compressed displacement
Figures 8 and 9 and Tables 2 and 3 show the results for the compressed displacement of the implants, by loading site, during the application of a 100-N vertical load in each of the models.
In all placements, the compressed displacement in the experimental models and FEA models was greatest with buccal loading and smallest with central loading at the three loading points....
Methods
Fabrication of the experimental model
Artificial mandibular bone
An artificial mandibular bone (P9-X.1135, Nissin Dental Products, Kyoto, Japan) with free-end edentulism of the left mandibular first premolar (no. 34), second premolar (no. 35), and first molar (no. 36) was used (Fig. 1). The model was composed of a two-layer structure of artificial cortical bone (urethane resin) and ar...
Background
Bone remodeling to maintain osseointegration between the bone and implant is absolutely essential to ensure favorable results and long-term stability in implant treatment. Bone remodeling requires that various stresses generated around the bone caused by the occlusal load applied to the implant be within an appropriate range. The concentration of stress at the bone-implant interface,...
Biomechanical effects of offset placement of dental implants in the edentulous posterior mandible
Abstract
Background
Proper implant placement is very important for long-term implant stability. Recently, numerous biomechanical studies have been conducted to clarify the relationship between implant placement and peri-implant stress. The placement of multiple implants in the edentulous posterio...
Figure 8. There were moderately significant and positive correlations between the ALP levels and OC levels at all measurements from week 1 to week 12. The OC levels in pg/μg protein were associated with the ALP levels in nM/μg protein at the implant site (a), control site (b), and pooled samples of the control and implant sites (c)
Figure 7. Comparison between the trend of the biomarker levels and the trend of the ISQ values over time
Figure 6. There were weakly significant and positive correlations between the ALP or OC levels and ISQ values at all measurements from week 1 to week 12. At the implant site, the ALP levels in nM/μg protein (a) or the OC levels in pg/μg protein (b) were associated with ISQ values
Figure 5. Change in the median values of the OC level over time. In the test group, the OC level continuously increased with time. There was a statistically significant increase in the OC level at 6, 8, 10, and 12 weeks when compared with 1 week (P
Figure 4. Change in the median values of the ALP level over time. In the test group, the ALP level decreased at 1–4 weeks and then increased at 6, 8, 10, and 12 weeks. There was no statistically significant difference in the ALP level in either the control or the test groups at any measurement
Figure 3. Change in the median values of the GCF (control group) and PICF (test group) volume over time. In the test group, the PICF volume continuously decreased with time (a). There were no significant differences in the median values of the crevicular fluid volume in either the control group or the test groups at any measurement (b)
Figure 2. Change in the mean ISQ values over time. There was a statistically significant decrease in the mean ISQ values between 1 and 3 weeks (P
Figure 1. Timeline of the clinical study. I—implant site, T—contralateral posterior mandibular nonsurgical tooth
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks
8 weeks
10 weeks
12 weeks
Median (interquartile range)
ALP level
(nM/μg protein)
Tooth (control)
175 (215)
203 (308)
148 (269)
143 (112)
266 (427)
145 (96)
181 (148)
191 (263)
107 (128)
Implant (test)
230 (238)
139 (139)
157 (293)
108 (134)
166 (434)
179 (251)
147 (...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks
8 weeks
10 weeks
12 weeks
Median (interquartile range)
CF volume (μl)
Tooth (control)
0.20 (0.23)
0.26 (0.25)
0.19 (0.20)
0.19 (0.50)
0.17 (0.33)
0.18 (0.08)
0.13 (0.24)
0.23 (0.42)
0.20 (0.17)
Implant (test)
0.26 (0.30)
0.25 (0.41)
0.16 (0.21)
0.17 (0.19)
0.18 (0.33)
0.13 (0.14)
...
Time
Day 0
1 week
2 weeks
3 weeks
4 weeks
6 weeks
8 weeks
10 weeks
12 weeks
Mean ISQ values
77.0 ± 1.32
65.6 ± 2.70a
70.5 ± 2.03a
72.1 ± 1.64a
74.2 ± 1.65
76.1 ± 1.33
78.1 ± 1.38
78.2 ± 1.32
79.6 ± 1.06
Gender
Male (n = 3)
77.0 ± 0.58
59.7 ± 4.62
71.7 ± 3.24
75.0 ± 1.89
7...
Patient no.
Age
Sex
Positiona
Bone qualityb
1
34
Female
46
3
2
38
Female
36
3
3
43
Female
37
3
4
64
Male
46
2
5
30
Female
47
3
6
48
Female
36
2
7
57
Male
36
3
8
28
Female
46
3
9
33
Male
46
2
10
49
Female
46
3
Inclusion criteria
Exclusion criteria
Patients aged 25–65 years
Presence of periodontal disease or periapical lesions
Ability to participate in this study
History of bone augmentation at the implant site in the past 6 months
No systemic diseases (e.g., diabetes, osteoporosis, hypertension, etc.)
History of tooth extraction at the implant site in the past 6 months
...
References
Albrektsson T, Brånemark PI, Hansson HA, Lindström J. Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man. Acta Orthop Scand. 1981;52:155–70.
Khongkhunthian P. Implant features. In: Khongkhunthian P, editor. PW Plus Thai Dental Implant. Bangkok: STZ Mospace design; 2015. p. 12.
Lacey DL, Timms E, Tan HL, Kelle...
Regarding the relationship between the ISQ values and ALP or OC levels, although the ISQ values were weakly correlated with the bone markers (r = 0.226 for ALP level and r = 0.245 for OC level, P = 0.05), there were significant and positive correlations between the ISQ values and ALP or OC levels at all measurements from week 1 to week 12. These results are in harmony with the ...
That study showed that PICF volume decreased significantly from week 1 to week 3. Alteration of the gingival fluid volume and contents occur according to the condition of the tissues surrounding the teeth. The presence of inflammation increases the gingival fluid volume. Also, changes in peri-implant crevicular fluid contents and volume result from the condition of the peri-implant tis...
Discussion
The results of this study show that, at the time of implantation, the ISQ values ranged between 67.5 and 83. The mean initial ISQ value was 77.0 ± 1.32. These findings are in harmony with those of previous studies. Tallarico et al. (2011) reported that the macro-design of dental implant affects the primary anchorage. They suggested that the high initial ISQ value is a factor...
Results
Ten patients, seven females, and three males, aged 42.4 ± 11.99 years (range, 28 to 64 years), with either a first mandibular or second mandibular molar edentulous area, who required a single nonsubmerged implant participated in this study, as shown in Table 2. The implants used for all patients were 10 mm long and 5 mm in diameter. All patients completed the follow-up. None of t...
The color in the wells changed from blue to yellow. After that, the color solution in each well was measured at 450/540 nm within 30 min. The OC level in each sample was calculated from a standard curve and normalized by total protein.
The level of the ALP activity was measured by colorimetric analysis. Briefly, 80 μl of sample solution were added into each well of a 96-well microplate, and t...
Sample preparation and analysis
GCF/PICF in the Periopaper strip was eluted by adding 320 μl quantity of phosphate-buffered saline (PBS) into the sample tube and incubated at 4 °C, overnight. The eluted protein solution from each gingival fluid sample was used for the biochemical analysis.
Total protein in the gingival fluid sample was measured by the Bradford analysis. Briefly, a 10 μl...
RFA assessments
At implant placement and after 1, 2, 3, 4, 6, 8, 10, and 12 weeks, RFA assessments were performed using the Osstell® ISQ (Integration Diagnostics AB, Goteborg, Sweden) according to the manufacturer’s instructions. A Smartpeg™ (type 47) (Integration Diagnostics AB) was screwed to the implant using a Smartpeg mount. After Smartpeg mount removal, the RFA assessment was perf...
Methods
The study is a prospective clinical study during the 3-month healing period of implant. The study was approved by the Human Experimentation Committee, Faculty of Dentistry, Chiang Mai University. The study outline is shown in Fig. 1.
Patients
Ten patients, who were partially edentulous in the mandibular posterior region for whom a single nonsubmerged implant was planned, participated ...
The second phenomenon is contact osteogenesis, in which bone formation takes place from the implant surface toward the local bone. This osteogenesis consists of the early phase of osteogenic cell migration, osteoconduction, and de novo bone formation. The de novo bone formation at a solid surface has four stages. The first stage is secretion of the two noncollagenous proteins, osteopontin, and bon...
Background
Dental implants have shown a high success rate for rehabilitation of edentulous patients if certain conditions are met during treatment. Nevertheless, the risk of failure remains difficult to predict. The achievement of osseointegration depends on many factors, such as a suitable host, biocompatible materials, careful surgery, and an appropriate healing time.
The primary stability c...
Relation between the stability of dental implants and two biological markers during the healing period: a prospective clinical study
Abstract
Objectives
The purposes of this study were to examine the correlation between the stability of dental implants and bone formation markers during the healing period and to monitor the stability of dental implants using the resonance frequency analysis (R...
Implant success
Clinically immobile when tested manually and/or with RFA (minimum ISQ = 65)
Absence of peri-implant radiolucency present on an undistorted radiograph
Absence of unresolved pain, discomfort, infection or neuropathy, or peri-implant soft tissue complications attributable to the implant
Implant placement that does not preclude delivery of a prosthetic crown w...
Figure 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 months was 0.2981 and at 1 year 0.6613
Figure 3. Mean bone loss at 6 months and 1 year. Mean bone loss distribution charts at 6 months and 1 year present no statistically significant difference. p value at 6 month...
Figure 2. ISQ values at placement, 6 weeks, 6 months, and 1 year. Mean and standard deviation of ISQ values taken at placement, 6 weeks, 6 months, and 1 year is presented. No statistical significant difference was determined between ISQ values at all time points. (p
Inclusion
Male or female
At least 18 years old
Healthy enough to undergo routine implant surgery and subsequent dental treatment
Partially edentulous requiring single dental implants in the maxilla
Adequate volume of native or grafted bone to accommodate dental implants at least 8 mm long
No active infections
Physically, emotionally, and financially able to u...
Figure 1. Implant design. The OSPTX and OSP implants are manufactured from high-grade commercially pure titanium with surface roughness produced via a fluoride treatment process. The OSP implant is a screw-shaped self-tapping implant. The diameter used in this study was 4.0 mm. The implant length used in this study was 8 mm. The OSPTX implant has the same features as the OSP except the apex ...
Discussion
Augmentation of the maxillary sinus prior to dental implant placement is routinely performed in order to help patients restore their maxillary posterior dentition. Unfortunately, not all patients are candidates for this procedure due to either health, personal, or financial concerns. An alternative treatment without the need for a sinus elevation procedure is the use of a shorter...
Results
Overall implant survival rate was 93.3%. Two implants failed, one implant in group A (OSPTXSoft) and one in group B (OSPTXStd). Both implant failures occurred at the time of uncovery (at 6 weeks) and prior to loading of the implants and were attributed to lack of integration. With the exception of these two failed implants, there was 100% success for all remaining implants using the par...
Methods
Following proper approval by the LSUHSC Institution Review Board (LSUNO IRB#7438), 27 (30 implant sites) systemically healthy patients at least 18 years old were enrolled in the study and randomly divided into three groups as follows (inclusion and exclusion criteria are described in detail in Table 1):
Group A received 10 OSPTX implants using the soft bone surgical protocol (OSPT...
To avoid invasive sinus augmentation procedures, implants have been designed in shorter lengths such as 8 mm. To further enhance short implant primary stability, a tapered design has been developed which has been proven to provide greater initial stability. Implant stability can be evaluated by different measures such as torque at the time of implant placement, resistance to reverse torque, and re...
Background
Dental implants are now a widely accepted treatment option for the replacement of missing teeth. The therapeutic goal of dental implants is to support restorations that replace single or multiple missing teeth so as to provide patient comfort, function, and esthetics as well as assist in the ongoing maintenance of remaining intraoral and perioral structures. However, anatomic limitat...
Abstract
Background
The purpose of this study was to compare a parallel wall design implant to a tapered apex design implant when placed in the posterior maxilla using two different surgical protocols.
Methods
Twenty-seven patients (30 implants) were divided into three groups. All implants were 4 mm wide in diameter and 8 mm long.
Group A received 10 tapered implants (OSPTX) (Astra Tech O...
Figure 8. Distribution of the occlusal forces. Left column: model-T, right column: model-I, “Natural dentition” indicates the results in model-N under the load during occlusal adjustment
Figure 7. Load-displacement curve of the left canine
Figure 6. FE model with natural dentition (model-N). Tooth root is displayed with permeability
Figure 5. Schematic diagram for each phase of the load-displacement curve after occlusal adjustment of implants. a: Before loading, only anterior natural teeth were in contact with opposing teeth. Occlusal forces were not yet exerted anywhere. b: When a slight load caused the displacement of the mandible upward by the distance corresponding to the gap, i.e., the quantity of occlusal adjust...
Figure 4. Occlusal adjustment was simulated by altering the load-displacement curves of the springs
Figure 3. Load-displacement curves of the springs
Figure 2. Boundary conditions to verify the displaceability of teeth (a) and analyze the distribution of occlusal forces (b). Arrows: loads, triangles: restricted nodes, zigzags: springs
Figure 1. Finite element models (model-I and model-T). The tooth roots and the implant bodies are displayed with permeability
Occlusal adjustment (model)
___
___
___
___
4
5
6
7
Adj40N (model-T)
25.0
26.0
13.0
12.0
Adj200N (model-T)
30.0
37.0
23.5
24.0
Adj40N (model-I)
39.4
41.0
42.8
43.5
Adj200N (model-I)
70.9
75.4
79.9
81.6
Materials
Modulus of elasticity (MPa)
Poisson ratio
Enamel
80,000
0.3
Dentin
17,600
0.25
Inplant (titanium)
117,000
0.32
Superstructure (gold alloy)
94,000
0.3
Cortical bone
14,000
0.3
Cancellous bone
7,900
0.3
Since it was far larger than that of the teeth and implants (Fig. 3), the TMJs and ramus of the mandible were displaced upward and the most posterior implants became fulcrums of the rotation of the mandible. On the other hand, posterior implants were considered to be separated from opposing teeth and implants when the load was less than that exerted during occlusal adjustment. However, becau...
Thus, the “occlusal adjustment” performed on the FE models in this study was not a clinical procedure itself but a procedure to set the models in the state of the ICP under various occlusal loads.
This problem can be clarified by the definition of the ICP itself. Although load and deformation of the bone, joints, periodontal ligaments, and teeth in the ICP depend on the amount of the oc...
Discussion
FE models
The FE models in this study were based on those reported by Kasai et al. The material properties of the soft tissues such as the PDL and the TMJ, which were mainly deformed in the analysis, were considered to be crucial, because the aim of this study was to investigate the distribution of occlusal forces on the teeth, implants, and TMJs. In Figs. 3 and ...
Under Load200N, 20.3 % of the occlusal force was distributed at the molar site implants and 14.0 % of the occlusal force was distributed at the premolar site implants. The POF in the TMJ was larger than that in model-N. Under Load800N, the POF at the molar site implants was 36.3 %. However, almost no occlusal force occurred at the premolar site implants and anterior teeth. The POF in the TMJ wa...
Results
Displaceability of teeth
The load-displacement curve of the left canine under vertical load indicated two-phase displacement as shown in Fig. 7.
Model-T
The results of model-T are shown in Fig. 8. Adj40N resulted in the concentration of approximately 25 % of the occlusal force at the most posteriorly located implant on each side. In other words, about half of the total occlusal force...
Loading conditions
The loading conditions assumed intercuspal clenching. On the assumption that occlusal force was generated by the contractile force of four bilateral masticatory muscles, the masseter, temporalis, mesial, and lateral pterygoid muscles, the loading points and the directions of the loads were determined based on the report by Korioth and Hannam and anatomical findi...
Boundary conditions of the model and simulation of occlusal adjustment
The boundary conditions used to verify the displaceability of teeth and analyze the distribution of occlusal forces are shown in Fig. 2a, b, respectively. In the former model, a vertical load was applied to the left canine with the restriction of nodes on the bottom of the mandible (Fig. 2a). FE analysis was pe...
Methods
Finite element model
Three-dimensional finite element (FE) models were based on those reported by Kasai et al. and consisted of a mandible, natural teeth with periodontal ligaments, and titanium implants with superstructures. All elements were homogenous and isotropic. In the models, eight implants replaced all of the premolars and molars (Fig. 1).
The mass/volume and ...
Background
Dental implants have been widely used to restore or maintain occlusion, function, and esthetics and are particularly effective for partially edentulous jaws. However, the difference of the displaceability of the implants and natural teeth with periodontal ligaments (PDLs) may cause a problem in an arch that includes both implants and teeth. There is controversy about ...
Effect of bite force in occlusal adjustment of dental implants on the distribution of occlusal pressure: comparison among three bite forces in occlusal adjustment
Abstract
Background
The purpose of this study was to investigate the influence of occlusal forces (the contractile force of masticatory muscles) exerted during occlusal adjustment on the distribution of the forces among teeth, i...
Number of implants
Insertion torque value (N cm)
Implant stability quotient value
0 week
2 weeks
4 weeks
6 weeks
8 weeks
12 weeks
1
25
33.0
75.0
77.0
78.3
79.7
77.0
2
40
68.0
70.3
70.0
72.0
75.7
75.3
3
40
78.3
77.0
78.0
78.7
80.0
80.0
4
35
74.0
43.0
61.0
73.0
75.7
80.0
5
45
85.3
85.7
84.0
83.3
84.0
83.0
6...
Number of implants
Treatment area (FDI)
Size of implant (mm)
Length
Diameter
1
14
10
3.8
2
14
10
3.8
3
14
10
3.8
4
16
8
3.8
5
16
10
4.4
6
16
8
4.4
7
16
8
4.4
8
17
10
4.4
9
36
10
3.8
10
36
10
4.4
11
36
8
3.8
12
36
10
3.8
13
36
12
4.4
14
36
10
4.4
15
36
10
4.4
...
Figure 9. The comparison of two groups at average voxel values for each part. The comparison of voxel values by insertion torque. All specimens were classified into two groups by insertion torque
Figure 8. The relationship between average voxel value and insertion torque (averaged over the entire treatment area). The comparison of average voxel value among IT groups. Average voxel value was 384.0 ± 154.6 in the low IT group, 387.7 ± 147.7 in the medium IT group, and 619.2 ± 200.4 in the high IT group
Figure 7. The average voxel value between the maxilla and mandible. There was no difference between the maxilla (430.9 ± 211.6) and the mandible (475.6 ± 211.5) in the average voxel value. Also, no difference was found in each part
Figure 6. The relationship between ISQ and insertion torque. Percentage of specimens showing ISQ ≥ 73 compared with groups by week. In all groups, a period of rapidly increasing percentages was observed (8–12 weeks in the low IT group, 4–6 weeks in the medium and high IT groups). In the medium and high IT Group, a statistically significant difference was observed between ISQ ...
Figure 5. The comparison of ISQ values by the insertion torque. Time-lapse migration of ISQ values was compared with IT groups. Each IT group displayed similar migration. A significant difference in The ISQ was found in the low IT group after 8 weeks
Figure 4. The classification of the insertion torque. All specimens classified into three groups according to insertion torque. Criteria for the classification are shown in the figure and in the “Methods” section
Figure 3. The evaluation of the average ISQ. Time-lapse migration of average ISQ. Average ISQ of all specimens increased in a time-dependent manner (results indicated by a line). A significant difference was observed by 6 weeks after surgery
Figure 2. The measurement of the voxel values. A case of bone quality diagnosis before treatment. Width and height of the bone were measured to select the proper size of the implant body. The selected implant body was simulated on the bone images as a symbol, and then the voxel value was calculated as described in the "Method" section
Figure 1. Genesio® Plus implant with Aanchor surface. Scheme of the dental implant body for the Genesio® Plus implants with Aanchor surface used. a Overview picture of Genesio® Plus implants with Aanchor surface. b Image from scanning electron microscopy. Both pictures were provided by GC Corporation. To obtain osseointegration from an early stage, the dental implant body was treated...
According to the measurement of the average voxel values in this study, a significant difference was seen between the high IT group and the low/medium IT group, but no significant difference was found between the low and medium IT groups (Fig. 7). Specimens showing IT ≥ 40 N cm were thought to have a good bone quality, and voxel values at each part of the implant (neck, middle apex) were...
A bone quality of the treated area may affect primary stability as described above, preoperative analysis of bone quality is important for clarifying the primary stability of dental implants. This study analyzed bone quality using voxel values obtained using Digital Imaging and Communications in Medicine (DICOM) data from CBCT. According to the result of that analysis, it was...
A significant difference was observed between 0 and ≥ 8 weeks (Fig. 5). The ISQ did not change significantly during the experimental period in the medium or high IT groups, but the percentage of high ISQ (≥ 73) specimens was significantly higher at 4 to 6 weeks compared to other time periods in both groups (Figs. 5 and 6). The results in this study suggest that if the...
Other studies have suggested that ISQ immediately after implant insertion should be about 60, with ISQ subsequently decreasing over weeks 0–4 and increasing over weeks 4–8 after surgery. ISQ values 57–70 may indicate that intraosseous stability of the implant body is constant.
Increases or decreases of ISQ values are explained as follows: The inserted dental implant bo...
The insertion torque value in this study showed broader (10 to 50 N cm) than the previous publication (Table 2), and the cause of reasons for the difference are as follows: Primary stability may be affected by the bone quantity and bone quality in the treatment area, the micro- and macro-level design of the implant body, and the accuracy of the surgical technique. In this ...
Discussion
According to the previous literature, the obtaining osseointegration is integral to the intraosseous stability of the implant body during the healing period; moreover, the importance of postoperative assessment of the intraosseous stability of the implant has also been reported. Intraosseous stability of the implant body is evaluated immediately after the implant ...
Average ISQ tended to increase during the healing period in all IT groups (Fig. 5). Average ISQ of the low IT group was 59.81 at 0 week, increasing significantly after ≥ 8 weeks (P
Methods
Research design and study participants
This prospective study was conducted jointly by Tokyo Dental College (Tokyo, Japan) and Fukuoka Dental College (Fukuoka, Japan) from January to December 2015. All study protocols were conducted in accordance with the Declaration of Helsinki and were approved by the ethics committees of Tokyo Dental College (approval #416) and Fukuoka Dental Colle...
Results
Study overview
A total of 33 implant bodies (8 in the maxilla, 25 in the mandible) were inserted into the 27 participants (11 men, 16 women), with the average age of 54.6 ± 12.2 years (range, 32–78 years). The average IT value was 32.7 ± 9.2 N cm (32.5 ± 11.6 N cm in the maxilla, 32.8 ± 8.5 N cm in the mandible). The diameter of the implant body wa...
Methods
Research design and study participants
This prospective study was conducted jointly by Tokyo Dental College (Tokyo, Japan) and Fukuoka Dental College (Fukuoka, Japan) from January to December 2015. All study protocols were conducted in accordance with the Declaration of Helsinki and were approved by the ethics committees of Tokyo Dental College (approval #416) and Fuku...
Background
Dental implant treatments have improved in both convenience and predictability with refinements in implant bodies and treatment procedures as compared to about 50 years ago when clinical applications were started. Currently, an implant body surface is treated with “rough processing” by sandblasting and acid etching for the purposes of obtaining more reliable osseo...
Abstract
Background
A current implant body surface was treated with “rough processing” by sandblasting and acid etching for the purposes of obtaining more reliable osseointegration and shortening the treatment period. Various reports have examined the healing period with the use of these implant bodies, but a consensus opinion has not yet been obtained. The purpose of this study is to eval...
Figure 3. Comparison of standard and over-dimensioned protocol. The figure displayed shows the comparison between standard and over-dimensioned protocol. a Displays the measurements obtained by RFA. The unit is ISQ with a range of 0 to 100 (minimum to maximum stability). b Displays the results obtained by the torque in and c by the torque out test. Although, there was no statistically s...
Figure 2. Over-dimensioned protocol. The over-dimensioned protocol was conducted by a final drill of 1 mm narrower than the implant diameter. The final drill for implants of 3.3. mm was 3.2 mm and of implants measuring 3.75 mm, it was 3.65 mm. Within this study, an over-dimensioned protocol was defined as a final drill larger than recommended by the company, which is in this case 4 o...
Figure 1. Standard protocol. This figure shows the implant types and drilling protocol used within this study. Standard protocol was conducted by a final drill of 2.80 mm for 3.3 mm implants, 3.20 mm for 3.75 mm implants, and 3.65 mm for 4.2 mm implants. Permissions for reproducing the figures were received from HI-TEC IMPLANTS LTD. Source: Product Catalogue 12th Edition [40]
3.3 mm
3.75 mm
4.2 mm
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
ISQ
66.33 (4.59)
63.79–68.88
69.00 (5.98)
64.72–73.28
69.87 (8.88)
64.94–74.78
IT (Ncm)
102.65 (28.42)
86.91–118.39
90.97 (27.54)
71.27–110.67
78.19 (33.28)
59.76–96.62
TO (Ncm)
94.54 (29.09)
78.43–110.65
81.28 (28.89)
60.67–101.88
100.86 (36....
8.0 mm
10.0 mm
11.5 mm
13.0 mm
16.0 mm
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
Mean (SD)
CI
ISQ
65.5 (8.40)
58.48–72.52
73.17 (3.60)
69.39–76.95
67.11 (6.09)
62.43–71.79
66.15 (8.15)
59.43–73.07
70.67 (4.97)
66.84–74.49
IT (Ncm)
98.23 (18.56)
82.71–113.74
99.49 (43.73)
53.60–145.48
101.02 (36.80)
72.74–...
Insertion mode — manual insertion
Insertion mode — machine-driven insertion
n
Mean (SD)
CI
n
Mean (SD)
CI
ISQ
45
68.33 (6.83)
66.14–70.51
45
70.25 (5.52)
68.38–72.12
IT (Ncm)
45
90.56 (31.27)
80.56–100.56
45
83.94 (31.81)
73.17–94.7
TO (Ncm)
45
93.59 (32.3)
83.27–103.92
45
89.80 (37.32)
77.18–102.43
ISQ impla...
Drilling sequence — standard protocol
Drilling sequence — over-dimensioned protocol
n
Mean (SD)
CI
n
Mean (SD)
CI
ISQ
45
68.33 (6.83)
66.14–70.51
30
68.5 (8.82)
65.08–71.92
IT (Ncm)
45
90.56 (31.27)
80.56–100.56
30
63.74 (48.61)
44.89–82.59
TO (Ncm)
45
93.59 (32.3)
83.27–103.92
30
58.35 (40.43)
42.67–74.02
ISQ im...
Contrary to the research hypothesis, there was no difference in primary stability between manually and machine-driven inserted implants. To date, little is known about the influence of the insertion mode on the dental implant primary stability. Novsak et al. assumed a better primary stability in implants inserted manually and suspected that this behavior was related to a higher tac...
However, caution is recommended when using under-dimensioned drilling protocols: although high insertion torques ensure a greater initial implant stability and prevent adverse micromotions under loading, the induced over-compression could jeopardize the healing process. In addition, high stress is known to alter angiogenesis and impair new vessel formations, to induce local hypoxia and n...
Discussion
This study was performed in order to investigate changes in primary stability within an experimental setup of different insertion protocols and insertion modes. In order to obtain a high level of diagnostic certainty, three different methods for measurement of primary stability were recorded. As a secondary outcome parameter, potential differences between implants of different le...
Results
Drilling protocol: standard versus over-dimensioned
No statistically significant difference in RFA could be measured (Cohen’s d = − 0.022, effect size r = 0.011, p = 0.260), whereas IT values were significantly higher in implants inserted via SP (90.56 ± 31.27 Ncm) in comparison with the ODP (63.74 ± 48.61 Ncm, p = 0.002; Cohen’s d = 0.656, effect size r = 0.312). T...
Preparation protocol for oversized osteotomies (ODP)
This protocol repeated the steps of the standard protocol but then added a larger final drill. For the 3.3-mm implants, the final drill size was 3.2 mm; for the 3.75-mm implants, the final drill size was 3.65 mm (Fig. 2).
RFA
To analyze the data, an Osstell® SmartPeg threaded transducer (implant diameter 3.3 and 3.75 mm: SmartPeg Type ...
Methods
Bone specimens
Twenty mandibles from fresh porcine cadavers were obtained from a local slaughterhouse. The animals did not show any macroscopic signs of any pathologic bone conditions. After removal of the surrounding soft tissue, the surfaces of the bone samples were thoroughly cleaned. Each sample was checked macroscopically for irregularities and a minimum thickness of 20 mm at th...
Analyzing those, a decrease in primary and an increase in secondary stability with a shorter healing period for implants became apparent. Kim et al. compared the effect of oversized drilling sockets regarding bone-to-implant contact and bone density after 4 and 8 weeks in an in vivo dog model. They used a final drill of 4.00 mm for implants with a diameter of 4 mm in the oversized group and a ...
With increasing stiffness of the bone-implant interface, the vibration frequency of the sensor increases. While RFA is expressed in hertz, implant stability quotient (ISQ) is the scale used to quantify RFA values (range 1–100).
Even though RFA has been reported to be a reliable, reproducible, and objective method to measure the stiffness of bone-implant-complex, it has also been reported that R...
Background
A reliable option for replacing teeth is the insertion of osseointegrated implants. Dental implant primary stability (DIS) has also been reported to be a fundamental prerequisite for long-term success of dental implants, even though osseointegration has also been achieved without a certain amount of primary stability. Primary stability has been defined as the ability to withstand axi...
Abstract
Background
Dental implant primary stability is thought to be a fundamental prerequisite for the long-term survival and success. The aim of this study was to analyze the influence of protocol and insertion mode on dental implant stability ex vivo. One hundred and twenty implants were inserted either manually or machine-driven into porcine mandibles by a standard or over-dimensioned pro...
Figure 6. Figure 6. a–d Von Mises stress distribution on bone. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. The stress concentration occurred in the cortical bone around the neck of the implant. Groups L-M and ZL-M were quite similar and reduced stress
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated at the coronal part of the abutment in all groups
Figure 5. a–d Von Mises stress distribution on abutment. From a to d: L-M, ZL-M, L-V, and ZL-V respectively. Von Mises stresses were relatively similar and concentrated ...
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 4. a–d Von Mises stress distribution on implant. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 3. a–d Maximum principal stress distribution on crown restoration. From a to d: L-M, ZL-M, L-V, and ZL-V respectively
Figure 2. The graph of the interaction of the materials and restoration design
Group
N
Mean (N)
Standard deviation
Minimum
Maximum
L-M
12
2891.88a
410.12
2079.74
3486.96
L-V
12
2077.37bc
356.59
1220.96
2493.39
ZL-M
12
1750.28c
314.96
1084.36
2163.95
ZL-V
12
2202.55b
503.14
1292.20
2912.81
Material
Young’s modulus (GPa)
Poisson ratio
Reference
E.max CAD
95
0.20
[1]
Vita Suprinity
65
0.23
[2]
Vita VM 11
65
0.23
*
E.max Ceram
64
0.23
[4]
Implant and abutment
114
0.34
[5]
Cortical bone
13.7
0.3
[5]
Spongious bone
1
0.3
[5]
Figure 1. Crown restoration design
Groups
N
Materials
L-M
12
IPS e-max CADIPS e.max CAD glaze
L-V
12
IPS e-max CADe.max Ceram DentinIPS e.max Ceram Glaze
ZL-M
12
Vita SuprinityVita Akzent Plus
ZL-V
12
Vita SuprinityVM-11Vita Akzent Plus
Material
Chemical composition (%)
Coefficient of thermal expansion (10−6 K−1)
Flexural strength (MPa)
Manufacturer
IPS e.max CAD; lithium disilicate glass ceramic (LDS)
SiO2 (57–80), Li2O (11–19), K2O (0–13), P2O5 (0–11), ZrO2 (0–8), ZnO (0–8), Al2O3 (0–5), MgO (0–5), coloring oxides (0–8)
10.2
360
Ivoclar Vivadent
IPS e.max Ceram; low-fusing nan...
Conclusions
Within the limitation of the present study, it can be concluded that the restoration design affected the failure load of ceramics. Monolithic design had a statistically significant effect on the failure load of two different ceramics (LDS > ZLS). Veneer application had opposite effects on two different ceramics which increased the failure load of ZLS and reduced it for LDS witho...
Zheng et al. compared the stress distribution of the same veneering ceramic on different cores and concluded that the zirconia core was clearly different from other materials with higher tensile stresses at the veneer core interface because the increasing differences between the elasticity modulus of the core and the veneer transmitted higher stress concentrations to the cores. Con...
Veneer application provided additional strength to the ZLS crowns in contrast to the LDS crowns. The higher failure load of the veneered ZLS crowns (2202.55 N; group L-V 2077.37 N) may be associated with the higher flexural strength of the veneering porcelain VM-11 (100 MPa; emax Ceram 90 MPa). These veneered groups had a statistically significant difference from the monoli...
Similar results were presented in a study of Traini et al. as it was concluded that ZLS was comparable to that of existing zirconia-based ceramics and was suitable for oral function even in the posterior regions. In the literature, there have been few studies on this ceramic and a limited number of them include the failure load of the material. In one of these studi...
In literature, it has been stated that the failure load of LDS crowns was higher than veneered zirconia and could be comparable with metal ceramic systems. Doğan et al. evaluated the fracture strength of different CAD/CAM-manufactured crowns and concluded that the monolithic LDS crowns had the highest fracture resistance. Present study confirmed as monolithic LDS crowns demonstrated so satisfying...
Discussion
Implant-supported restorations have been accepted as an alternative treatment for the rehabilitation of edentulous spaces. Despite the high success rates, implant failures are inevitable and classified as early or late implant failures. Late implant failures are observed after prosthetic restoration which is primarily related to biomechanical complications. Since occlusal loads are t...
Results
Descriptive analysis (mean, standard deviation (SD), minimum, maximum) of the groups is presented in Table 4.
Group L-M exhibited the highest failure load values (2891.88 N ± 410.12 N), and the lowest values were observed in group ZL-M (1750.28 N ± 314.96 N). Two-way ANOVA indicated a statistically significant difference between materials and veneering technique (p = 0.00 < ...
Statistical analysis
The statistical analysis was performed with SPSS 24.0 (SPSS Inc, Chicago, USA). The Kolmogorov–Smirnov normality test was used to evaluate whether the data distribution of the groups was normal. The homogeneity of the variances was analyzed by Levene’s test. Since test results indicated that data distribution of the groups was normal and the variances were homogenous,...
All crowns were subjected to a combination firing that included crystallization and glaze firing according to each manufacturer’s guidelines in the ceramic furnace (Vita Vacumat 6000 M, Vita Zahnfabrik, Bad Sackingen, Germany).
For veneered restorations, the design mode was changed to “split,” and the core was constructed in 0.6-mm thickness. In group L-V (n = 12), e.max ...
Methods
Preparation of test groups
This study tested the current glass ceramic ZLS by comparing LDS with monolithic and conventional veneering techniques in implant-supported crowns: group L-M: lithium disilicate ceramic (monolithic), group L-V: lithium disilicate ceramic (conventional veneering), group ZL-M: zirconia-reinforced lithium silicate ceramic (monolithic), group ZL-V: zirconia-reinf...
Background
Implants have been successfully used to replace missing teeth for many years. Notwithstanding the high success rates, complications such as screw loosening and/or fracture, prosthesis fracture, and even implant fracture are inevitable. The reasons of the complication may be related to decreased proprioception and low tactile sensitivity which makes implant-supported crowns more susc...
Abstract
Background
Present study compared the failure load of CAD/CAM-manufactured implant-supported crowns and the stress distribution on the prosthesis-implant-bone complex with different restoration techniques.
Methods
The materials were divided into four groups: group L-M: lithium disilicate ceramic (LDS, monolithic), group L-V: LDS ceramic (veneering), group ZL-M: zirconia-reinforced l...
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Properti tegangan-regangan yang dipunyai bahan-bah...