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Fig. 4. Comparative illustration of mean ISQ value...

Fig. 4. Comparative illustration of mean ISQ values Fig. 4. Comparative illustration of mean ISQ values

Fig. 3. Implants were placed after application of ...

Fig. 3. Implants were placed after application of CGF membrane Fig. 3. Implants were placed after application of CGF membrane

Fig. 2. CGF membrane was applied in study group im...

Fig. 2. CGF membrane was applied in study group implant sockets Fig. 2. CGF membrane was applied in study group implant sockets

Fig. 1. CGF was obtained after centrifugation : Ev...

Fig. 1. CGF was obtained after centrifugation Fig. 1. CGF was obtained after centrifugation

Table 3 Mean ISQ value changes between study and c...

  Control group Study group Immediate–1st week −2.25 ± 1.713 1.40 ± 1.847 Immediate–4th week −2.30 ± 2.774 0.60 ± 2.798 1st Week–4th week −0.05 ± 1.572 −0.80 ± 2.215   Table 3 Mean ISQ value changes between study and control groups

Table 2 Mean ISQ values in the study and control g...

  Control group Study group Immediate 75.75 ± 5.552 78.00 ± 2.828 1st week 73.50 ± 5.226 79.40 ± 2.604 4th week 73.45 ± 5.680 78.60 ± 3.136   Table 2 Mean ISQ values in the study and control groups

Table 1 Demographic data of patients : Evaluation ...

Case no. Age Sex Group Implant number 1 20 F Study 1 2 28 M Control 3 3 35 F Study 4 4 32 F Study 4 5 60 M Control 5 6 64 F Study 5 7 52 F Study 5 8 34 M Study 1 9 45 F Control 3 10 48 F Control 2 11 42 M Control 3 12 68 F Control 4   Table 1 Demographic data of patien...

About this article : Evaluation of effectiveness o...

Pirpir, C., Yilmaz, O., Candirli, C. et al. Evaluation of effectiveness of concentrated growth factor on osseointegration. Int J Implant Dent 3, 7 (2017). https://doi.org/10.1186/s40729-017-0069-3 Download citation Received: 16 December 2016 Accepted: 16 February 2017 Published: 03 March 2017 DOI: https://doi.org/10.1186/s40729-017-0069-3

Rights and permissions : Evaluation of effectivene...

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 information : Evaluation of effectiveness o...

Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Karadeniz Technical University, Trabzon, Turkey Cagasan Pirpir, Onur Yilmaz, Celal Candirli & Emre Balaban You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this a...

References : Evaluation of effectiveness of concen...

Prakash S, Thakur A. Platelet concentrates: past, present and future. J Maxillofac Oral Surg. 2011;10(1):45–9. Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scari G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772–7. Ademokun JA, Chapman C, Dunn J, Lander D, Mair K, Proctor SJ, et al...

References : Evaluation of effectiveness of concen...

Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res. 2007;18(3):275–80. Kroese-Deutman HC, Vehof JW, Spauwen PH, Stoelinga PJ, Jansen JA. Orthotopic bone formation in titanium fiber mesh loaded with platelet-rich plasma and placed in segmental defe...

References : Evaluation of effectiveness of concen...

Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E. Platelets and wound healing. Front Biosci. 2008;13:3532–48. Anitua E, Sanchez M, Zalduendo MM, de la Fuente M, Prado R, Orive G, et al. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif. 2009;42(2):162–70. He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and ...

References : Evaluation of effectiveness of concen...

Raghavendra S, Wood MC, Taylor TD. Early wound healing around endosseous implants: a review of the literature. Int J Oral Maxillofac Implants. 2005;20(3):425–31. Oncu E, Bayram B, Kantarci A, Gulsever S, Alaaddinoglu EE. Positive effect of platelet rich fibrin on osseointegration. Med Oral Patol Oral Cir Bucal. 2016;21(5):e601–7. Anitua E. Plasma rich in growth factors: preliminary results o...

Abbreviations : Evaluation of effectiveness of con...

Bone morphogenetic protein Concentrated growth factor Computed tomography Insulin-like growth factor Platelet-derived growth factor Platelet-rich fibrin Platelet-rich plasma Resonance frequency analysis Transforming growth factor-β1 Transforming growth factor-β2 Vascular endothelial growth factor

Conclusions : Evaluation of effectiveness of conce...

Considering this data, it appears that application of CGF enhanced stability of implants and accelerated osseointegration in the early period. CGF has positive effects on the ISQ value at the first week and fourth week. Further laboratory studies are needed to demonstrate the positive effects of blood products on the osseointegration process at the histopathological level.

Discussion : Evaluation of effectiveness of concen...

In a study by Monov et al. using PRP around the implant, a higher stability value was obtained in the study group during the early recovery period (6 weeks) although difference between the groups was not statistically significant [23]. Kim et al. reported in a study that there was a statistically significant increase in bone-implant contact with PRP administration in the vicinity of the implant [...

Discussion : Evaluation of effectiveness of concen...

Introduced in 1998 by Marx, PRP is used in oral and maxillofacial surgeries to speed up the recovery of grafts in bone-grafted areas [14, 26–30]. Although many studies have shown that platelet-rich plasma affects bone healing positively, the results of some other studies suggest otherwise [31, 32]. In recent years, the platelet-rich fibrin (PRF) was described by Choukroun as a second-generation...

Discussion : Evaluation of effectiveness of concen...

Implant stability is one of the important parameters that assess the loading time and dental implant success. Investigators have recommended that implants with ISQ 

Results : Evaluation of effectiveness of concentra...

The study includes 12 patients (5 males, 7 females). Patients participating in the study are between 20–68 years of age and the mean age is 44 years. A total of 40 implants were placed, 20 of these were included in the study group (50%), and the other 20 were included in the control group (50%). Twenty-one implants were placed in type 2 bone, 19 implants in type 3 bone (Table 1). The distribu...

Methods : Evaluation of effectiveness of concentra...

Independent sample t test was applied between the two groups by taking the differences between the data obtained in these periods. Two-way ANOVA and Fisher’s LSD test was used for evaluating the associations among group and insertion torque. A value of p 

Methods : Evaluation of effectiveness of concentra...

All surgical procedures were performed under local anesthesia by the same surgeon. A full-thickness mucoperiosteal flap was removed by incision on the alveolar crest. Implant cavities were prepared according to the surgical protocol of the Bego Semados implant system (BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). The final osteotomy diameters were the same as the placed implants. In the st...

Methods : Evaluation of effectiveness of concentra...

This study was conducted in compliance with the principles of the Declaration of Helsinki, and approval of the ethics committee required for the study was obtained from the Ethics Committee of the Karadeniz Technical University (2015/21). The procedures to be performed were explained in detail and patients signed the consent forms. The study was carried out on individuals who applied to Karadeniz ...

Background : Evaluation of effectiveness of concen...

That the implant has sufficient stability after placement is important for providing the necessary bone formation around the implant and for the optimal distribution of functional forces at the implant-bone interface during healing [15–17]. It can be said that resonance frequency analysis (RFA) is a very important tool for tracking the osseointegration process [18, 19]. RFA is a technique that ...

Background : Evaluation of effectiveness of concen...

Osseointegration of dental implants is important for long-term success and stability. There is no standardization in terms of the time of osseointegration and the timing of prosthetic loading. This process varies between 0–6 months [1]. Various strategies are being explored to shorten this period. Changes in implant surface properties and design have increased primer stability and helped the pe...

Abstract : Evaluation of effectiveness of concentr...

Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration. Twelve patients with maxillary anterior toothless were included in the study. Implant ca...

Fig. 5. Osteoblasts with an orientation tendency a...

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 in...

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...

Fig. 3. Diagram for visualisation of the calculati...

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...

Fig. 2. Side view of a computerized simulation, sh...

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...

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...

Table 2 Listing of the culture media and additives...

Culture medium/additives Manufacturer Order no. Concentration Dulbecco’s modified Eagle medium (DMEM) with l-glutamine, plus 4.5 g glucose,...

Table 1 Listing of the single components of the fl...

Component Manufacturer Order no. Large petri dish Becton Dickinson, Franklin Lakes, NJ, USA ...

About this article : Cellular fluid shear stress o...

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

Rights and permissions : Cellular fluid shear stre...

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...

Author information : Cellular fluid shear stress o...

Correspondence to D. G. E. Thiem.

Author information : Cellular fluid shear stress o...

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...

Acknowledgements : Cellular fluid shear stress on ...

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...

References : Cellular fluid shear stress on implan...

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...

References : Cellular fluid shear stress on implan...

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...

References : Cellular fluid shear stress on implan...

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...

References : Cellular fluid shear stress on implan...

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...

Abbreviations : Cellular fluid shear stress on imp...

Fluid shear stress

Conclusions : Cellular fluid shear stress on impla...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Results : Cellular fluid shear stress on implant s...

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...

Results : Cellular fluid shear stress on implant s...

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...

Methods : Cellular fluid shear stress on implant s...

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...

Methods : Cellular fluid shear stress on implant s...

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 =...

Background : Cellular fluid shear stress on implan...

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.

Background : Cellular fluid shear stress on implan...

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...

Abstract : Cellular fluid shear stress on implant ...

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 a...

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 in...

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...

Fig. 3. Diagram for visualisation of the calculati...

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...

Fig. 2. Side view of a computerized simulation, sh...

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...

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...

Table 2 Listing of the culture media and additives...

Culture medium/additives Manufacturer Order no. Concentration Dulbecco’s modified Eagle medium (DMEM) with l-glutamine, plus 4.5 g glucose,...

Table 1 Listing of the single components of the fl...

Component Manufacturer Order no. Large petri dish Becton Dickinson, Franklin Lakes, NJ, USA ...

About this article : Cellular fluid shear stress o...

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

Rights and permissions : Cellular fluid shear stre...

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...

Author information : Cellular fluid shear stress o...

Correspondence to D. G. E. Thiem.

Author information : Cellular fluid shear stress o...

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...

Acknowledgements : Cellular fluid shear stress on ...

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...

References : Cellular fluid shear stress on implan...

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...

References : Cellular fluid shear stress on implan...

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...

References : Cellular fluid shear stress on implan...

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...

References : Cellular fluid shear stress on implan...

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...

Abbreviations : Cellular fluid shear stress on imp...

Fluid shear stress

Conclusions : Cellular fluid shear stress on impla...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Results : Cellular fluid shear stress on implant s...

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...

Results : Cellular fluid shear stress on implant s...

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...

Methods : Cellular fluid shear stress on implant s...

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...

Methods : Cellular fluid shear stress on implant s...

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 =...

Background : Cellular fluid shear stress on implan...

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.

Background : Cellular fluid shear stress on implan...

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...

Abstract : Cellular fluid shear stress on implant ...

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. 4. Comparative illustration of mean ISQ value...

Fig. 4. Comparative illustration of mean ISQ values Fig. 4. Comparative illustration of mean ISQ values

Fig. 3. Implants were placed after application of ...

Fig. 3. Implants were placed after application of CGF membrane Fig. 3. Implants were placed after application of CGF membrane

Fig. 2. CGF membrane was applied in study group im...

Fig. 2. CGF membrane was applied in study group implant sockets Fig. 2. CGF membrane was applied in study group implant sockets

Fig. 1. CGF was obtained after centrifugation : Ev...

Fig. 1. CGF was obtained after centrifugation Fig. 1. CGF was obtained after centrifugation

Table 3 Mean ISQ value changes between study and c...

  Control group Study group Immediate–1st week −2.25 ± 1.713 1.40 ± 1.847 Immediate–4th wee...

Table 2 Mean ISQ values in the study and control g...

  Control group Study group Immediate 75.75 ± 5.552 78.00 ± 2.828 1st week ...

Table 1 Demographic data of patients : Evaluation ...

Case no. Age Sex Group Implant number 1 20 ...

About this article : Evaluation of effectiveness o...

Pirpir, C., Yilmaz, O., Candirli, C. et al. Evaluation of effectiveness of concentrated growth factor on osseointegration. Int J Implant Dent 3, 7 (2017). https://doi.org/10.1186/s40729-017-0069-3 Download citation Received: 16 December 2016 Accepted: 16 February 2017 Published: 03 March 2017 DOI: https://doi.org/10.1186/s40729-017-0069-3

Rights and permissions : Evaluation of effectivene...

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...

Author information : Evaluation of effectiveness o...

Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Karadeniz Technical University, Trabzon, Turkey Cagasan Pirpir, Onur Yilmaz, Celal Candirli & Emre Balaban You can also search for this author in PubMed Google Scholar You can also search for this author in PubMed Google Scholar You can also search for this author in ...

References : Evaluation of effectiveness of concen...

Prakash S, Thakur A. Platelet concentrates: past, present and future. J Maxillofac Oral Surg. 2011;10(1):45–9. Rodella LF, Favero G, Boninsegna R, Buffoli B, Labanca M, Scari G, et al. Growth factors, CD34 positive cells, and fibrin network analysis in concentrated growth factors fraction. Microsc Res Tech. 2011;74(8):772–7. Ademokun JA, Chapman C, Dunn J, Lander D, Mair K, Proctor SJ, et al...

References : Evaluation of effectiveness of concen...

Huwiler MA, Pjetursson BE, Bosshardt DD, Salvi GE, Lang NP. Resonance frequency analysis in relation to jawbone characteristics and during early healing of implant installation. Clin Oral Implants Res. 2007;18(3):275–80. Kroese-Deutman HC, Vehof JW, Spauwen PH, Stoelinga PJ, Jansen JA. Orthotopic bone formation in titanium fiber mesh loaded with platelet-rich plasma and placed in segmental defe...

References : Evaluation of effectiveness of concen...

Nurden AT, Nurden P, Sanchez M, Andia I, Anitua E. Platelets and wound healing. Front Biosci. 2008;13:3532–48. Anitua E, Sanchez M, Zalduendo MM, de la Fuente M, Prado R, Orive G, et al. Fibroblastic response to treatment with different preparations rich in growth factors. Cell Prolif. 2009;42(2):162–70. He L, Lin Y, Hu X, Zhang Y, Wu H. A comparative study of platelet-rich fibrin (PRF) and ...

References : Evaluation of effectiveness of concen...

Raghavendra S, Wood MC, Taylor TD. Early wound healing around endosseous implants: a review of the literature. Int J Oral Maxillofac Implants. 2005;20(3):425–31. Oncu E, Bayram B, Kantarci A, Gulsever S, Alaaddinoglu EE. Positive effect of platelet rich fibrin on osseointegration. Med Oral Patol Oral Cir Bucal. 2016;21(5):e601–7. Anitua E. Plasma rich in growth factors: preliminary results o...

Abbreviations : Evaluation of effectiveness of con...

Bone morphogenetic protein Concentrated growth factor Computed tomography Insulin-like growth factor Platelet-derived growth factor Platelet-rich fibrin Platelet-rich plasma Resonance frequency analysis Transforming growth factor-β1 Transforming growth factor-β2 Vascular endothelial growth factor

Conclusions : Evaluation of effectiveness of conce...

Considering this data, it appears that application of CGF enhanced stability of implants and accelerated osseointegration in the early period. CGF has positive effects on the ISQ value at the first week and fourth week. Further laboratory studies are needed to demonstrate the positive effects of blood products on the osseointegration process at the histopathological level.

Discussion : Evaluation of effectiveness of concen...

In a study by Monov et al. using PRP around the implant, a higher stability value was obtained in the study group during the early recovery period (6 weeks) although difference between the groups was not statistically significant [23]. Kim et al. reported in a study that there was a statistically significant increase in bone-implant contact with PRP administration in the vicinity of the implant [...

Discussion : Evaluation of effectiveness of concen...

Introduced in 1998 by Marx, PRP is used in oral and maxillofacial surgeries to speed up the recovery of grafts in bone-grafted areas [14, 26–30]. Although many studies have shown that platelet-rich plasma affects bone healing positively, the results of some other studies suggest otherwise [31, 32]. In recent years, the platelet-rich fibrin (PRF) was described by Choukroun as a second-generation...

Discussion : Evaluation of effectiveness of concen...

Implant stability is one of the important parameters that assess the loading time and dental implant success. Investigators have recommended that implants with ISQ 

Results : Evaluation of effectiveness of concentra...

The study includes 12 patients (5 males, 7 females). Patients participating in the study are between 20–68 years of age and the mean age is 44 years. A total of 40 implants were placed, 20 of these were included in the study group (50%), and the other 20 were included in the control group (50%). Twenty-one implants were placed in type 2 bone, 19 implants in type 3 bone (Table 1). The distribu...

Methods : Evaluation of effectiveness of concentra...

Independent sample t test was applied between the two groups by taking the differences between the data obtained in these periods. Two-way ANOVA and Fisher’s LSD test was used for evaluating the associations among group and insertion torque. A value of p 

Methods : Evaluation of effectiveness of concentra...

All surgical procedures were performed under local anesthesia by the same surgeon. A full-thickness mucoperiosteal flap was removed by incision on the alveolar crest. Implant cavities were prepared according to the surgical protocol of the Bego Semados implant system (BEGO Implant Systems GmbH & Co. KG, Bremen, Germany). The final osteotomy diameters were the same as the placed implants. In the st...

Methods : Evaluation of effectiveness of concentra...

This study was conducted in compliance with the principles of the Declaration of Helsinki, and approval of the ethics committee required for the study was obtained from the Ethics Committee of the Karadeniz Technical University (2015/21). The procedures to be performed were explained in detail and patients signed the consent forms. The study was carried out on individuals who applied to Karadeniz ...

Background : Evaluation of effectiveness of concen...

That the implant has sufficient stability after placement is important for providing the necessary bone formation around the implant and for the optimal distribution of functional forces at the implant-bone interface during healing [15–17]. It can be said that resonance frequency analysis (RFA) is a very important tool for tracking the osseointegration process [18, 19]. RFA is a technique that ...

Background : Evaluation of effectiveness of concen...

Osseointegration of dental implants is important for long-term success and stability. There is no standardization in terms of the time of osseointegration and the timing of prosthetic loading. This process varies between 0–6 months [1]. Various strategies are being explored to shorten this period. Changes in implant surface properties and design have increased primer stability and helped the pe...

Abstract : Evaluation of effectiveness of concentr...

Growth factor-containing products have been reported to increase implant stability and accelerate osseointegration. Concentrated growth factor (CGF) can be used for this purpose with the growth factors it contains. The aim of this study is to assess the effect of CGF on implant stability and osseointegration. Twelve patients with maxillary anterior toothless were included in the study. Implant ca...

Figure 5. Osteoblasts with an orientation tendency...

  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 ...

  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 calcula...

  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

  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 and photo...

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 : Cellular fluid shear stress on implan...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Discussion : Cellular fluid shear stress on implan...

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...

Discussion : Cellular fluid shear stress on implan...

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 : Cellular fluid shear stress on implan...

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...

Results : Cellular fluid shear stress on implant s...

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 : Cellular fluid shear stress on implant s...

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...

Methods : Cellular fluid shear stress on implant s...

  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...

Methods : Cellular fluid shear stress on implant s...

  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 : Cellular fluid shear stress on implant s...

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...

Cellular fluid shear stress on implant surfaces

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...

Figure 3. Representative SEM images of healing abu...

Figure 3. Representative SEM images of healing abutments after electrolysis of different charges and currents for 10 V and 5 min (all images × 1000 magnification)   Figure 3. Representative SEM images of healing abutments after electrolysis of different charges and currents for 10 V and 5 min (all images × 1000 magnification)

Figure 2. Microscopical images of the healing abut...

Figure 2. Microscopical images of the healing abutments after the electrochemical treatments under different currents at constant 10 V with different electrodes. The healing abutments were stained with phloxine B after electrolysis. Images from side (a, c, e, g, i, k) and from top (b, d, f, h, j, l). a, b 1 A group I. c, d 1.5 A group I. e, f 1 A group II. g, h 1.5 A group II. i, j 1 A...

Figure 1. The amount of residual contamination

Figure 1. The amount of residual contamination after electrochemical treatments under different charges and currents at constant 10 V. Mean ± SD (n = 5). *P < 0.05, **P < 0.01, ***P < 0.005 Figure 1. The amount of residual contamination after electrochemical treatments under different charges and currents at constant 10 V. Mean ± SD (n = 5). *P < 0.05, **P < 0.01, ***P < 0.005

Table 3 Composition (%wt) of the surface of the he...

Table 3. Composition (%wt) of the surface of the healing abutment analyzed with EDS. Mean of 5 samples was presented Groups Charges and currents Titanium Carbon Others I + 0.5 A 24.77 75.23 - − 0.5 A 35.13 64.87 - + 1 A 62.82 37.18 - − 1 A 84.10 15.90 - + 1.5 A 63.86 36.14 - − 1.5 A 81.71 18.29 - II ...

Table 2 Qualitative analysis of surfaces after ele...

  Mean roughness score of 4 SEM images per electrolysis of different charges and currents Mean all examiners P value compared to Control Ex 1 Ex 2 Ex 3 Control 2.00 ± 0.00 2.00 ± 0.00 2.00 ± 0.00 2.00 ± 0.00 - − 1 A, group I 4.00 ± 0.00 3.00 ± 0.00 3.25 ± 0.50 3.42 ± 0.17 * − 1.5 A, group I 4.00 ± 0.00 3.75 ± 0.50 4.00 ± 0.00 ...

Table 1 pH after electrolysis.

Table 1 pH after electrolysis. pH was measured after electrolysis for 5 min under different charges and current at constant 10 V. pH of original electrolyte, 7.5% NaHCO3, before electrolysis was 7.8 Charges and currents Group I Group II Group III −, 0.5 A 7.91 7.92 7.94 +, 0.5 A 7.02 7.03 7.02 −, 1 A 7.94 8.02 8.01 +, 1 A 6.6 6.2 7.72 ...

Discussion : cleaning methods on contaminated heal...

Although EDS analysis was performed in three areas on each sample, the atomic percentage of carbon on the contaminated area was higher than that on the clean area and the atomic percentage of titanium was lower on the contaminated areas than on the clean area except cathodic potential 1 A and 1.5 A in group III. The possible sources of carbon conta...

Discussion : cleaning methods on contaminated heal...

According to the previous studies, complete killing of bacteria was seen at anode with low current. However, in this study, complete removal of contaminant was seen in electrolysis after cathodic potential 1 A and 1.5 A in group III. This complete removing action can be attributed to the alkaline environment generated at cathodic potential. Moreover, decrease in electro...

Discussion : cleaning methods on contaminated heal...

However, copper deposition was formed on the sample after electrolysis of anodic potential in group II. It is believed that anodic current was preferentially supplied by the electrolysis of water, which occurred on the surface of the sample because deposition attained electroconductivity. Thus, it was confirmed that copper could be incorporated into the titanium surface sample, t...

Discussion : cleaning methods on contaminated heal...

Previous studies also pointed out that low direct current can kill oral bacteria forming in biofilm. Although charging the implant surface with current can kill the bacteria, organic residues still remain adhering on the surface. Infected implants present carbon-based contaminants and considerable changes in titanium surfaces composition even after sterilization. This could be the reas...

CLONE-Discussion : cleaning methods on contaminate...

Therefore, in this study, phloxine B staining was used to detect residual contamination on the surface of the healing abutments. Previous studies also pointed out that low direct current can kill oral bacteria forming in biofilm. Although charging the implant surface with current can kill the bacteria, organic residues still remain adhering on the surface. Infected implants present carbon-based c...

Discussion : cleaning methods on contaminated heal...

Discussion The current study showed that electrolysis could be an effective means to decontaminate the healing abutment surfaces with complete removal of contaminants without any surface changes at 10 V, 1 A into 5 min, cathodic potential in group III. A minimally invasive approach to remove and disinfect dental implants utilizes the fact that titanium is an electrically conducting me...

Results : cleaning methods on contaminated healing...

Analysis of healing abutment surface roughness after electrolysis Representative SEM images after electrolysis of two different charges (cathodic and anodic) and two different currents (1 A and 1.5 A) are presented in Fig. 3. The SEM images showed surface modification ranging from smoothening to roughening. The surfaces were between the electrolytic healing abutments and control unused healin...

Results : cleaning methods on contaminated healing...

Results Analysis of the electrolytes’ pH before and after electrolysis As shown in Table 1, pH of electrolyte (catholyte) was not changed after electrolysis of different currents. However, the pH decreased after electrolysis of anodic potential of 1 A and 1.5 A in group I and II. Evaluation of the amount of stained area (contamination) of the healing abutments The perce...

Materials and methods : cleaning methods on contam...

Ninety healing abutments removed from patients at the Dental Implant Clinic, Dental Hospital, Tokyo Medical and Dental University, were used. As this clinical study is an in vitro experimental study, the university ethical committee decided that ethical approval was not necessary. These healing abutments were at least for 4 weeks up to 6 weeks in patients’ oral cavities. All the healing abu...

Background : cleaning methods on contaminated heal...

Background A healing abutment is a small metal cap placed on the dental implant. In dental implant treatment, a healing abutment is first placed on the implant. The top of the healing abutment is exposed in the oral cavity, while its body penetrates the soft mucosal tissue. During the implant treatment, the healing abutment is temporarily removed and replaced into several times until the prosth...

Investigation of different electrochemical cleanin...

Abstract Background To evaluate the effects of electrolysis on cleaning the contaminated healing abutment surface and to detect the optimal condition for cleaning the contaminated healing abutment. Methods Ninety healing abutments removed from patients were placed in 1% sodium dodecyl sulfate solution and randomly divided for electrolysis with 7.5% sodium bicarbonate in the following three d...

Day 60 - 180 of soft tissue healing: keratinized e...

Figure 36. Day 60 - 180 : Initial periosteum formation After 60 to 90 days, newly formed woven bone forms a bridge across the entrance of the socket. The epithelium covering the bone is keratinized. Soft tissue healing at this stage has been completed. At 90 to 180 days after tooth extraction, the woven bone is gradually remodeled into cortical bone. A periosteum is established with collagen ...

Day 21 - 30 of soft tissue healing: keratinized ep...

Figure 35. Day 21 - 30 : keratinized epithelium After 21 to 30 days, the marginal soft tissue compartment of the socket is characterized by a well-organized fibrous connective tissue lined with a keratinized epithelium.

Day 4 - 14 of soft tissue healing: epithelial prol...

Figure 34. Day 4 - 14 : Epithelial proliferation & connective tissue After 4 to 5 days, the epithelium from the margins of the soft tissue starts to proliferate to cover the granulation tissue in the socket. At 14 days, the connective tissue at the marginal portion of the extraction socket is partially lined by epithelial cells.

Day 3 of soft tissue healing: granulation tissue &...

Figure 33. Day 3: granulation tissue & inflammatory cells After 3 days, small segments of the coagulum at the margins of the socket are replaced by a highly vascularized granulation tissue with an inflammatory cell infiltrate.

Day 1 of soft tissue healing: coagulum & inflammat...

Figure 32. Day 1: Coagulum & inflammatory cells   Figure 33. Day 3: granulation tissue & inflammatory cells The soft tissue healing at the entrance of the socket also follows a specific pattern: At day 1 after extraction, the marginal portion of the coagulum is covered with a layer of inflammatory cells, mainly neutrophils. After 3 days, small segments of the coagulum a...

Quantitative tissue analysis

Figure 30. Quantitative tissue analysis Trombelli and coworkers monitored the healing of human extraction sockets for a 6-month period and presented a semi-quantitative analysis of tissues and cell populations involved in various stages of socket healing. They showed that granulation tissue was present in comparatively large amounts in the early phases of socket healing. At 6 to 8 weeks, th...

Day 3 : At the end of this initial healing period

  Figure 24. Day 3: blood coagulation, inflammatory cells, granulation tissue At the end of this initial healing period, small segments of the coagulum are replaced by a highly vascularized granulation tissue and an inflammatory cell infiltrate that is stained dark red/blue.

Day 3 : tissue composition in extraction socket

  Figure 23. summary of biological events on third day after extraction On day 3, the socket is filled with a blood coagulum comprised of red blood cells and platelets trapped in a fibrin network together with isolated inflammatory cells such as neutrophils. Close to the bundle bone, mesenchymal cells, severed periodontal fibers, and dilated vascular units can be observed. 

Healing extraction socket

Figure 1. Tooh extraction Figure 2. Post-extraction socket Following tooth extraction, a well-described process of wound healing takes place in the extraction socket. A series of physiological events occur, resulting in wound healing and bone regeneration within the socket. Bone resorption results in external changes to the alveolar ridge. ...