Fig. 3. Quantification of type I collagen via ELISA. Data representative of the experiment run in triplicate. Values are expressed as mean (± SD). The asterisk symbol indicates a significant difference between groups (p < 0.05)
Fig. 2. a Cell proliferation in gingival fibroblasts at 24 h, 48 h, and 72 h. The line chart represents the means and standard deviations from three separate experiments. b Cell viability assay in gingival fibroblast at 24 h, 48 h, and 72 h. The line chart represents the means and standard deviations from three separate experiments. The values are expressed in means (± SD). The as...
Fig. 1. Scanning electron microscopy and laser interferometry. a, d Machined surface. b, e 20-min acid treatment. c, f 60-min acid treatment. Original magnification, × 15,000
de Souza, V.Z., Manfro, R., Joly, J.C. et al. Viability and collagen secretion by fibroblasts on titanium surfaces with different acid-etching protocols.
Int J Implant Dent 5, 41 (2019). https://doi.org/10.1186/s40729-019-0192-4
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Received: 09 August 2019
Accepted: 24 October 2019
Published: 21 November 2019
DOI: https://doi.org/10.1186/s40729-019-0192-4
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...
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This study was approved by the Research Ethics Committee of the São Leopoldo Mandic Research Institute, Campinas/SP (protocol No. 59866216.6.0000.5374).
Not applicable.
Vilton Zimmermann de Souza, Rafael Manfro, Júlio César Joly, Carlos Nelson Elias, Daiane Cristina Peruzzo, Marcelo Henrique Napimoga, and Elizabeth Ferreira Martinez state that they have no conflicts of interest.
VZS and EFM interpreted and analyzed the data collected, contributed to the drafting of the paper and revised it critically, and were major contributors in writing the manuscript. RM, JCJ, and CNE contributed to the concept/design of the study and the final manuscript. DCP and MHN critically revised and contributed to the final manuscript. All authors read and approved the final version to be publ...
Division of Implantology, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil
Vilton Zimmermann de Souza, Júlio César Joly & Daiane Cristina Peruzzo
Division of Implantology, SOEBRÁS, Passo Fundo, RS, Brazil
Rafael Manfro
Materials Science Department, Instituto Militar de Engenharia, Rio de Janeiro, RJ, Brazil
Carlos Nelson Elias
Division of Immunology, Faculdade São Leopoldo Mandic,...
The funding received for this study was from the researcher himself.
The authors wish to thank Mrs. Pollyanna Tombini Montaldi for her excellent technical expertise and assistance.
Velasco-Ortega E, Alfonso-Rodríguez CA, Monsalve-Guil L, España-López A, Jiménez-Guerra A, Garzón I, Alaminos M, Gil FJ. Relevant aspects in the surface properties in titanium dental implants for the cellular viability. Mater Sci Eng C Mater Biol Appl. 2016;64:1–10.
Cao J, Wang T, Pu Y, Tang Z, Meng H. Influence on proliferation and adhesion of human gingival fibroblasts from different tit...
Martinez EF, Araújo VC. In vitro immunoexpression of extracellular matrix proteins in dental pulpal and gingival human fibroblasts. Int Endod J. 2004;37(11):749–55.
Lee HJ, Lee J, Lee JT, Hong JS, Lim BS, Park HJ, Kim YK, Kim TI. Microgrooves on titanium surface affect peri-implant cell adhesion and soft tissue sealing; an in vitro and in vivo study. J Periodontal Implant Sci. ...
Chai WL, Moharamzadeh K, Brook IM, Van Noort R. A review of histomorphometric analysis techniques for assessing implant-soft tissue interface. Biotech Histochem. 2011;86(4):242–54.
Buser D, Weber HP, Donath K, Fiorellini JP, Paquette DW, Williams RC. Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs. J Periodontol. 1992;63(3):225–35.
Schierano G, Ramieri G, Cor...
All data generated or analyzed during this study are included in this published article.
Therefore, the results of the present study indicate that the acid treatments used did not compromise cell growth nor collagen synthesis by gingival fibroblasts compared to machined titanium. The cost-benefit of manufacturing prosthetic abutments with treated surfaces should however be considered. In addition, in vitro studies using human keratinocytes and histological studies in vivo should be pe...
The connective tissue seal around the abutment is crucial for perimplant health. Several efforts have previously been made to optimize abutment surfaces, though without consensus on the ideal surface features. Blasquez et al. [11] have shown in their systematic review that different types of surface modifications for implant abutments may provide benefit to the surrounding connective tissue, which...
The results showed that, regardless of the treatment used, there was no difference in the values of cell proliferation in the different times of analysis. Similarly, cell viability values did not differ, especially after 24 h and 72 h. Corroborating the results of this study, Baltriukiene et al. [17] used grade 2 titanium disks with different surface treatments and demonstrated that the modifi...
Implant dentistry has for years focused on studying the interface between the bone and implant, searching for a suitable seal to prevent the advance of perimplant disease. Long-term prognosis of dental implants, however, depends not only on osseointegration, but also on the quality of the seal between the mucosa and the implant abutment [13].
The seal provided by the contact between mucosal tissu...
The results showed that acid treatment of the titanium surfaces for 20 or 60 min did not affect cell proliferation, either after 24 h (p = 0.484), 48 h (p = 0.698), or 72 h (p = 0.287) (Fig. 2a).
For the cell viability test, loss of viability was observed for the machined surface after 48 h of culture compared to the groups submitted to acid treatment for 20 or 60 min, which did not...
The experiments were repeated three times, under the same conditions, to ensure accuracy.
Quantification of secreted type I collagen by fibroblast cultures on to the different surfaces was evaluated by enzyme-linked immunosorbent assay (ELISA). The supernatant was collected and centrifuged at 336g for 10 min. Type I collagen quantification was carried out using the Human Type I Collagen kit (R&...
This study was approved by the Research Ethics Committee of the São Leopoldo Mandic Research Institute, Campinas/SP (protocol No. 59866216.6.0000.5374). Titanium disks were commercially pure, grade 4 (n = 108), measuring 6 mm in diameter by 2 mm in thickness, provided by the company Conexão Sistemas de Próteses (Arujá, São Paulo).
For the treatment of titanium disk surfaces, sulfuric, ni...
Consolidation of surface treatments for dental implants and knowledge on the cellular mechanisms of osseointegration has propelled research on the sealing capacity of bone to implant surfaces. Although osseointegration is extremely important for implant success, biological sealing of the perimplantar connective tissue is crucial to maintain success in the long-term because it acts as a first barri...
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
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...
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The authors declare that they have no competing interests.
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.
Gottlow J, Dard M, Kjellson F, Obrecht M, Sennerby L. Evaluation of a new titanium-zirconium dental implant: a biomechanical and histological comparative study in the mini pig. Clin Implant Dent Relat Res. 2012;14:538–45.
Jimbo R, Naito Y, Galli S, Berner S, Dard M, Wennerberg A. Biomechanical and histomorphometrical evaluation of TiZr alloy implants: an in vivo study in the rabbit. Clin Implan...
Yamanishi Y, Yamaguchi S, Imazato S, Nakano T, Yatani H. Influences of implant neck design and implant–abutment joint type on peri-implant bone stress and abutment micromovement: three-dimensional finite element analysis. Dent Mater. 2012;28:1126–33.
Harel N, Eshkol-Yogev I, Piek D, Livne S, Lavi D, Ormianer Z. Bone microstrain values of 1-piece and 2-piece implants subjected to mechanical lo...
Lee TJ, Ueno T, Nomura N, Wakabayashi N, Hanawa T. Titanium-zirconium binary alloy as dental implant material: analysis of the influence of compositional change on mechanical properties and in vitro biologic response. Int J Oral Maxillofac Implants. 2015;31:547–54.
Al-Nawas B, Brägger U, Meijer HJA, Naert I, Persson R, Perucchi A. A double-blind randomized controlled trial (RCT) of titanium-13...
Renouard F, Nisand D. Impact of implant length and diameter on survival rates. Clin Oral Implants Res. 2006;17(Suppl 2):35–51.
Lee SA, Lee CT, Fu MM, Elmisalati W, Chuang SK. Systematic review and meta-analysis of randomized controlled trials for the management of limited vertical height in the posterior region: short implants (5 to 8 mm) vs longer implants (> 8 mm) in vertically augmented site...
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 ...
Fig. 3. Peri-implant bone level at baseline, 3 months post-operative, and 6 months post-operative. a Mesial defect depth. b Mesial defect width. c Distal defect depth. d Distal defect width
Fig. 3. Peri-implant bone level at baseline, 3 months post-operative, and 6 months post-operative. a Mesial defect depth. b Mesial defect width. c Distal defect depth. d Distal defect width
Fig. 2. Test group (PRF augmentation)
Fig. 2. Test group (PRF augmentation)
Fig. 1. Control group (no PRF augmentation)
Fig. 1. Control group (no PRF augmentation)
Illustration 11. ive (a), 1 week post-operative (b), 1 month post-operative (c), and 3 months post-operative (d)
Illustration 11. a–d Post-operative healing process at 3 days post-operative (a), 1 week post-operative (b), 1 month post-operative (c), and 3 months post-operative (d)
Illustration 10. a–d Second measuring, reentry, and insertion of a screwed, full ceramic crown
Illustration 10. a–d Second measuring, reentry, and insertion of a screwed, full ceramic crown
Illustration 9. a–c Radiographic control a at time of implant placement (a), 3 months post-operative (b), and 6 months post-operative (c)
Illustration 8. Fixation of the flap with Seralene® 6.0
Illustration 8. Fixation of the flap with Seralene® 6.0
Illustration 7. Insertion of PRF membranes in a double-layered technique for tissue augmentation
Illustration 7. Insertion of PRF membranes in a double-layered technique for tissue augmentation
Illustration 6. PRF membrane made by centrifugating and pressing the patient’s blood
Illustration 6. PRF membrane made by centrifugating and pressing the patient’s blood
Illustration 5. Implant placed with a split-flap technique
Illustration 5. Implant placed with a split-flap technique
Illustration 4. NobelSpeedy Replace® (source: https://www.nobelbiocare.com/de/de/home/products-and-solutions/implant-systems/nobelspeedy.html)
Illustration 4. NobelSpeedy Replace® (source: https://www.nobelbiocare.com/de/de/home/products-and-solutions/implant-systems/nobelspeedy.html)
Illustration 3. Insertion of the implant
Illustration 3. Insertion of the implant
Illustration 2. Crestal incision and preparation of a split-flap
Illustration 2. Crestal incision and preparation of a split-flap
Illustration 1. Measurement of tissue thickness with an endodontic micro-opener
Illustration 1. Measurement of tissue thickness with an endodontic micro-opener
Hehn, J., Schwenk, T., Striegel, M. et al. The effect of PRF (platelet-rich fibrin) inserted with a split-flap technique on soft tissue thickening and initial marginal bone loss around implants: results of a randomized, controlled clinical trial.
Int J Implant Dent 2, 13 (2016). https://doi.org/10.1186/s40729-016-0044-4
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Received: 30 July 2015
Accepted: 23 ...
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...
Julia Hehn, Thomas Schwenk, Marcus Striegel, and Markus Schlee declare that they have no competing interests. This study was self-supported.
JH was responsible for the study design and recruitment of the patients, carried out the implant surgery and follow-up examinations, and drafted the manuscript. TS participated in the surgical treatment and follow-up examinations. MS performed the digital me...
Periodontology, Edel & Weiß Clinic, Ludwigsplatz 1a, 90403, Nuremberg, Germany
Julia Hehn
Esthetic Dentistry, Edel & Weiß Clinic, Nuremberg, Germany
Thomas Schwenk & Markus Striegel
Private Clinic for Periodontology, Forchheim and Department of Maxillofacial Surgery, Goethe University, Frankfurt, Germany
Markus Schlee
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The authors thank Dr. Wolfgang Reimers of MedCommTools for performing the statistics.
Abrahamsson I, Berglundh T. Effects of different implant surfaces and designs on marginal bone-level alterations: a review. Clin Oral Implants Res. 2009;20 Suppl 4:207–15.
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Dohan DM et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part II: platelet-related biologic features. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3):e45–50.
Choukroun J, et al. Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part IV: clinical effects on tissue healing. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101(3)...
Cardaropoli G et al. Tissue alterations at implant-supported single-tooth replacements: a 1-year prospective clinical study. Clin Oral Implants Res. 2006;17(2):165–71.
Fickl S et al. Dimensional changes of the alveolar ridge contour after different socket preservation techniques. J Clin Periodontol. 2008;35(10):906–13.
Vela-Nebot X et al. Benefits of an implant platform modification techniqu...
platelet-derived growth factor
platelet-rich fibrin
standard deviation
transforming growth factor-b
Soft tissue augmentation with PRF using a split-flap technique cannot be recommended to alter thin gingiva types. Future experimental and clinical studies will be necessary to evaluate whether augmentation with PRF is suitable for mucosa thickening.
With respect to marginal bone loss, it could be shown that there were no significant differences when comparing dimension of bone loss between test and control groups. The study of present research data shows, to the best knowledge of the authors, no other RCTs about tissue thickening with PRF and peri-implant bone loss. However, several studies focused on mucosa thickening with tissue grafts and ...
In this study over a period of 6 months, it could be demonstrated that mucosal tissue thickening above implants with PRF led to reduced tissue thickness when performed in a split-flap technique.
The initial post-operative dehiscence and the associated complete loss of mucosal and augmented tissue above the implant were observed in all test patients.
PRF is supposed to be a good healing aid in v...
The mean marginal bone level alterations are displayed in Fig. 3.
Six months after surgery, both groups showed a statistically significant peri-implant bone loss.
The mesial resp. distal defect depth was 0.70 mm ± 0.72 SD resp. 0.64 mm ± 0.66 SD at baseline. Six months later, the marginal bone defect increased to 1.47 mm ± 0.65 SD on the mesial side resp. 1.46 mm ± 0.54 ...
At time of surgery, the patients ranged in age from 33 to 79 years (mean age 53.8 years).
The first surgeries for implant placement in the test group were carried out as described above. Two layers of a PRF matrix were placed on top of the implant. Though surgical flaps were all sutured completely free of tension, a post-operative dehiscence above the implant could be observed in all test pati...
Comparison of bone level alterations between test and control groups.
Data were expressed as means ± standard deviation. Comparisons were made using the Wilcoxon test, the Mann–Whitney U test, and the multiple comparisons test by Schaich-Hamerle (p = 0.05).
After the implantation, standardized digital X-rays were taken with parallel technique (baseline) (illustration 9). For each patient, an individual customized digital film holder was fabricated to ensure a reproducible radiographic analysis. Patients were instructed to avoid chewing hard nutrition in the treated area and to use chlorhexidine mouthwash and a soft brush twice a day for the first 2 ...
Patients aged 18+ who required an implant in the posterior mandible were eligible for this study.
Exclusion criteria were the following:
general contraindications to implant surgery
insufficient oral hygiene and periodontitis
patients with a history of severe periodontitis
bone augmentation required
smokers
substance abuse
uncontrolled diabetes
severe cardiovascular problems
treated or u...
As a consequence, recent research focused on soft tissue augmentation of thin gingiva types prior to or simultaneous to implant insertion. Wiesner et al. published a significant gain of soft tissue by thickening the gingiva with a connective soft tissue graft harvested from the palate [12]. Soft tissues at augmented sites were 1.3 mm thicker than on control sites and had a better pink esthetic sc...
The initial bone modeling around implants within the first year after insertion presents a challenging topic in current research. Previous studies have shown that this process is characterized by a remodeling of the horizontal and vertical bone dimension with a range of 0.7 to 3 mm within the first year [1].
First attempts to reduce this loss of tissue focused on changes of implant shapes, impla...
Previous studies have shown that adequate thickness or initial augmentation of soft tissue has a positive effect on the stability of peri-implant bone. This randomized, controlled trial aimed to evaluate the influence of augmenting soft tissue with platelet-rich fibrin (PRF) on crestal bone and soft tissue around implants.
After randomization, 31 fully threaded titanium implants were inserted in ...
Fig. 4. Scatterplot depicting indirect calculated and direct measured ISQ values of the tested implants
Fig. 4. Scatterplot depicting indirect calculated and direct measured ISQ values of the tested implants
Fig. 3. Example of a typical autospectrum pointing to a 1 maximum RF based on 1000 measurements in case of a Straumann test implant
Fig. 3. Example of a typical autospectrum pointing to a 1 maximum RF based on 1000 measurements in case of a Straumann test implant
Fig. 2. Clamped Osstell probe orientated towards a Smartpeg mounted on a test implant. Note the red laser beam dot on the flat surface of the Smartpeg hexagon part
Fig. 2. Clamped Osstell probe orientated towards a Smartpeg mounted on a test implant. Note the red laser beam dot on the flat surface of the Smartpeg hexagon part
Fig. 1. Concept for study of deflection and stiffness aspects of implant-Smartpeg complex by laser Doppler vibrometry. Intentional partial imbedding of implants allows to detect both the deflection of implant and Smartpeg separately at different vertical levels by changing the position of the laser beam
Fig. 1. Concept for study of deflection and stiffness aspects of implant-Smartpeg complex ...
Batch #
Implant system
Implant length (mm)
Implant diameter (mm)
Mean measured resonance freq (kHz)
SD meas...
Author and study
Implant position (implant number)
Mean ISQ values at given time-point post-insertion
Type of Osstell device used
Barewal et al. 2003 [10]
...
Debruyne, S., Grognard, N., Verleye, G. et al. ISQ calculation evaluation of in vitro laser scanning vibrometry-captured resonance frequency.
Int J Implant Dent 3, 44 (2017). https://doi.org/10.1186/s40729-017-0105-3
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Received: 11 April 2017
Accepted: 28 September 2017
Published: 12 October 2017
DOI: https://doi.org/10.1186/s40729-017-0105-3
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...
Stijn Debruyne, Nicolas Grognard, Gino Verleye, Korneel Van Massenhove, Dimitrios Mavreas, and Bart Vande Vannet declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Nicolas Grognard.
Department of Mechanics, Research Group Propolis, School of Engeneering Sciences, Katholieke Hoge School Brugge-Oostende, Ostend, Belgium
Stijn Debruyne
Kliniek Royal, Koningstraat 41, 8400, Ostend, Belgium
Nicolas Grognard
CHIR-Unit Dentistry–ORHE, Department of Orthodontics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
Nicolas Gro...
Han J, Lulic M, Lang NP. Factors influencing resonance frequency analyis assessed by Osstell Mentor during implant issue integration: II: implant surface modifications and implant diameter. Clin Oral Implants Res. 2010;6:605–11.
Bornstein M, Hart C, Halbritter S, Morton D, Buser D. Early loading of nonsubmerged titanium implants with a chemically modified sand-blasted and acid-etched surface: 6...
Adell R, Lekholm U, Brånemark PI. Surgical procedures. In: Brånemark PI, Zarb GA, Albrektsson T, editors. Tissue integrated prothese. Osseointegration in clinical dentistry. Chigaco: Quintessence; 1985. p. 211–32.
Strid K. Radiographic procedures. In: Brånemark P-I, Zarb G, Albrektsson T, editors. Tissue integrated prothese. Osseointegration in clinical dentistry. Chigaco: Quintessence; 1985...
In conclusion, the present study demonstrated that the algorithm applied and provided by Osstell to calculate ISQ values is correct, making the laboratory procedure valuable for future research focused on stiffness aspects of the implant-Smartpeg complex and its possible influence on the overall RFA measurement. Vice versa, the present study demonstrates the correctness of the actual applied algor...
The focus of this in vitro study was to develop a laboratory method, intended for future research of aspects of implant-Smartpeg complex stiffness and its possible influence on the overall RFA-based implant stability determination. In the past, other laboratory methodologies have been engineered to investigate implant deflection and/or lateral displacement by means of transducers. A setup using a ...
Mean values (± SD) of recorded maximum RF values, calculated indirect ISQ values, and direct recorded ISQ values for Ankylos (A) and Straumann (S) test implants are shown in Table 2.
Using the Shapiro-Wilk test for indirect ISQ (p = 0.05) and direct ISQ (p = 0.02), we can conclude that both indirect and direct ISQ measures are not drawn from a normal distribution (data not shown). Bot...
In total, for each given implant type with a given diameter/length configuration, 25 measurements for indirect and 5 measurements for direct ISQ computing were performed.
The SPSS statistical software package 22.0 (IBM SPSS, Chicago, USA) was used. A Shapiro-Wilk test was used to verify distribution normality for both direct and indirect determined ISQ values. The paired sample t test and the Wil...
The Smartpeg excitation mode was exactly performed as described above. Notation of the maximum resonance frequency for indirect measurements is followed by notation of direct ISQ value on the display of Osstell IDx device. Positioning of the probe was not changed during indirect and direct recordings for a given test implant.
Each resin block contained five identical implants with attached Smartp...
Test implants originating from various manufacturers were investigated. Straumann sandblasted, large-grit, acid-etched (SLA)® tissue level standard implants (Straumann AG, Basel, Switzerland) with the following diameter: length configurations were 3.3–12 mm (RN connection), 3.3–4.1 mm (RN connection), and 4.8–8 mm (WN connection), Ankylos Cell Plus® surfaced B-implant types (Dentsply Im...
Laser Doppler vibrometry possesses a working principle based on the so-called Doppler effect and allows non-contact quantitative measurement of vibration (https://en.wikpedia.org/wiki/Laser_scanning_vibrometry, 2017). The Doppler effect itself finds its origin when a light beam is backscattered on a vibrating surface and experiences a change in wave phase (https://en.wikipedia.org/wiki/Doppler_eff...
The computed ISQ value is based on the following calculation formulae:
Hereby, f denotes the measured maximum resonance frequency (RF). Coefficients a, b, c, d, and e are property information of Osstell (Osstell AB, Gothenburg, Sweden). The coefficients were provided for internal use under the agreement of no publication. From clinical reports [10,11,12,13,14,15,16] listed in Table 1, it ...
At present, multiple implant stability assessment methodologies are used, both of invasive and non-invasive nature, including percussion test [1], X-ray evaluation [2], cutting resistance during implant insertion (e.g., electronic insertion torque determination) [3], turn-out or reverse torque test [4], Periotest® [5, 6], and resonance frequency analysis (“RFA”), e.g., the Osstell method [7, ...
Implant stability testing at various stages of implant therapy by means of resonance frequency analysis is extensively used. The overall measurement outcome is a function of the resulting stiffness of three entities: surrounding bone, bone-implant complex, and implant-Smartpeg complex. The influence of the latter on the overall measurement results is presently unknown. It can be investigated in vi...
Fig. 4. Scatterplot depicting indirect calculated and direct measured ISQ values of the tested implants
Fig. 4. Scatterplot depicting indirect calculated and direct measured ISQ values of the tested implants
Fig. 3. Example of a typical autospectrum pointing to a 1 maximum RF based on 1000 measurements in case of a Straumann test implant
Fig. 3. Example of a typical autospectrum pointing to a 1 maximum RF based on 1000 measurements in case of a Straumann test implant
Fig. 2. Clamped Osstell probe orientated towards a Smartpeg mounted on a test implant. Note the red laser beam dot on the flat surface of the Smartpeg hexagon part
Fig. 2. Clamped Osstell probe orientated towards a Smartpeg mounted on a test implant. Note the red laser beam dot on the flat surface of the Smartpeg hexagon part
Fig. 1. Concept for study of deflection and stiffness aspects of implant-Smartpeg complex by laser Doppler vibrometry. Intentional partial imbedding of implants allows to detect both the deflection of implant and Smartpeg separately at different vertical levels by changing the position of the laser beam
Fig. 1. Concept for study of deflection and stiffness aspects of implant-Smartpeg complex ...
Batch #
Implant system
Implant length (mm)
Implant diameter (mm)
Mean measured resonance freq (kHz)
SD meas...
Author and study
Implant position (implant number)
Mean ISQ values at given time-point post-insertion
Type of Osstell device used
Barewal et al. 2003 [10]
...
Debruyne, S., Grognard, N., Verleye, G. et al. ISQ calculation evaluation of in vitro laser scanning vibrometry-captured resonance frequency.
Int J Implant Dent 3, 44 (2017). https://doi.org/10.1186/s40729-017-0105-3
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Received: 11 April 2017
Accepted: 28 September 2017
Published: 12 October 2017
DOI: https://doi.org/10.1186/s40729-017-0105-3
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...
Stijn Debruyne, Nicolas Grognard, Gino Verleye, Korneel Van Massenhove, Dimitrios Mavreas, and Bart Vande Vannet declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Nicolas Grognard.
Department of Mechanics, Research Group Propolis, School of Engeneering Sciences, Katholieke Hoge School Brugge-Oostende, Ostend, Belgium
Stijn Debruyne
Kliniek Royal, Koningstraat 41, 8400, Ostend, Belgium
Nicolas Grognard
CHIR-Unit Dentistry–ORHE, Department of Orthodontics, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
Nicolas Gro...
Han J, Lulic M, Lang NP. Factors influencing resonance frequency analyis assessed by Osstell Mentor during implant issue integration: II: implant surface modifications and implant diameter. Clin Oral Implants Res. 2010;6:605–11.
Bornstein M, Hart C, Halbritter S, Morton D, Buser D. Early loading of nonsubmerged titanium implants with a chemically modified sand-blasted and acid-etched surface: 6...
Adell R, Lekholm U, Brånemark PI. Surgical procedures. In: Brånemark PI, Zarb GA, Albrektsson T, editors. Tissue integrated prothese. Osseointegration in clinical dentistry. Chigaco: Quintessence; 1985. p. 211–32.
Strid K. Radiographic procedures. In: Brånemark P-I, Zarb G, Albrektsson T, editors. Tissue integrated prothese. Osseointegration in clinical dentistry. Chigaco: Quintessence; 1985...
In conclusion, the present study demonstrated that the algorithm applied and provided by Osstell to calculate ISQ values is correct, making the laboratory procedure valuable for future research focused on stiffness aspects of the implant-Smartpeg complex and its possible influence on the overall RFA measurement. Vice versa, the present study demonstrates the correctness of the actual applied algor...
The focus of this in vitro study was to develop a laboratory method, intended for future research of aspects of implant-Smartpeg complex stiffness and its possible influence on the overall RFA-based implant stability determination. In the past, other laboratory methodologies have been engineered to investigate implant deflection and/or lateral displacement by means of transducers. A setup using a ...
Mean values (± SD) of recorded maximum RF values, calculated indirect ISQ values, and direct recorded ISQ values for Ankylos (A) and Straumann (S) test implants are shown in Table 2.
Using the Shapiro-Wilk test for indirect ISQ (p = 0.05) and direct ISQ (p = 0.02), we can conclude that both indirect and direct ISQ measures are not drawn from a normal distribution (data not shown). Bot...
In total, for each given implant type with a given diameter/length configuration, 25 measurements for indirect and 5 measurements for direct ISQ computing were performed.
The SPSS statistical software package 22.0 (IBM SPSS, Chicago, USA) was used. A Shapiro-Wilk test was used to verify distribution normality for both direct and indirect determined ISQ values. The paired sample t test and the Wil...
The Smartpeg excitation mode was exactly performed as described above. Notation of the maximum resonance frequency for indirect measurements is followed by notation of direct ISQ value on the display of Osstell IDx device. Positioning of the probe was not changed during indirect and direct recordings for a given test implant.
Each resin block contained five identical implants with attached Smartp...
Test implants originating from various manufacturers were investigated. Straumann sandblasted, large-grit, acid-etched (SLA)® tissue level standard implants (Straumann AG, Basel, Switzerland) with the following diameter: length configurations were 3.3–12 mm (RN connection), 3.3–4.1 mm (RN connection), and 4.8–8 mm (WN connection), Ankylos Cell Plus® surfaced B-implant types (Dentsply Im...
Laser Doppler vibrometry possesses a working principle based on the so-called Doppler effect and allows non-contact quantitative measurement of vibration (https://en.wikpedia.org/wiki/Laser_scanning_vibrometry, 2017). The Doppler effect itself finds its origin when a light beam is backscattered on a vibrating surface and experiences a change in wave phase (https://en.wikipedia.org/wiki/Doppler_eff...
The computed ISQ value is based on the following calculation formulae:
Hereby, f denotes the measured maximum resonance frequency (RF). Coefficients a, b, c, d, and e are property information of Osstell (Osstell AB, Gothenburg, Sweden). The coefficients were provided for internal use under the agreement of no publication. From clinical reports [10,11,12,13,14,15,16] listed in Table 1, it ...
At present, multiple implant stability assessment methodologies are used, both of invasive and non-invasive nature, including percussion test [1], X-ray evaluation [2], cutting resistance during implant insertion (e.g., electronic insertion torque determination) [3], turn-out or reverse torque test [4], Periotest® [5, 6], and resonance frequency analysis (“RFA”), e.g., the Osstell method [7, ...
Implant stability testing at various stages of implant therapy by means of resonance frequency analysis is extensively used. The overall measurement outcome is a function of the resulting stiffness of three entities: surrounding bone, bone-implant complex, and implant-Smartpeg complex. The influence of the latter on the overall measurement results is presently unknown. It can be investigated in vi...
Maiorana, C., Pivetti, L., Signorino, F. et al. The efficacy of a porcine collagen matrix in keratinized tissue augmentation: a 5-year follow-up study.
Int J Implant Dent 4, 1 (2018). https://doi.org/10.1186/s40729-017-0113-3
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Received: 06 September 2017
Accepted: 20 December 2017
Published: 10 January 2018
DOI: https://doi.org/10.1186/s40729-017-0113-3
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 m...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the IRCCS Ospedale Maggiore Policlinico di Milano, Fondazione Ca’ Granda. The procedures to be performed were explained in detail, and the patients signed the consent form.
Carlo Maiorana, Luca Pivett...
Correspondence to
F. Signorino.
Oral Surgery, Center for Edentulism and Jaw Atrophies, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda—Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
C. Maiorana
Center for Edentulism and Jaw Atrophies, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda—Ospedale Maggiore Policlinico, University of Milan, Via della Commenda 10, 20122,...
The authors declare no funds for the research.
Schmitt CM, Moest T, Lutz R, Wehrhan F, Neukam FW, Schlegel KA. Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft®) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Impl Res. 2016;27:e125–33.
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Harris RJ. Gingival augmentation with an acellular dermal matrix: human histologic evaluation of a case—placement of the graft on periosteum. Int J Periodontics Restorative Dent. 2004;24(4):378–85.
Wei PC, Laurell L, Geivelis M, Lingen MW, Maddalozzo D. Acellular dermal matrix allografts to achieve increased attached gingiva. Part 1. A clinical study. J Periodontol. 2000;71(8):1297–305.
Ha...
Vignoletti F, Nuñez J, Discepoli N, De Sanctis F, Caffesse R, Muñoz F, et al. Clinical and histological healing of a new collagen matrix in combination with the coronally advanced flap for the treatment of Miller class-I recession defects: an experimental study in the minipig. J Clin Periodontol. 2011;38(9):847–55.
Jepsen K, Jepsen S, Zucchelli G, Stefanini M, de Sanctis M, Baldini N, et al. ...
Forman G. Presenile mandibular atrophy: its aetiology, clinical evaluation and treatment by jaw augmentation. Br J Oral Surg. 1976;14(1):47–56.
Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24(Suppl):237–59.
Grusovin MG, Coulthard P, Worthington HV, Esposito M. Maintaining and recovering soft tissue health around...
With the limits of this study, it can be assessed that the CM is an effective option for the keratinized tissue augmentation. The percentage of shrinkage of the graft is comparable to data recovered from other studies and does not represent a problem also after 5 years. The CM integration is slow and constant, providing the necessary scaffold to regenerate keratinized mucosa and ensuring a perfec...
The study was carried out to evaluate the efficacy of a xenogeneic CM when used as a soft tissue substitute in the reconstruction of an adequate amount (at least 2 mm) of keratinized tissue around dental implants. The xenogeneic CMs have already been investigated in order to check their compatibility and effectiveness as scaffold [19, 20]. One of the first studies was conducted by Schoo and Coppe...
A total of 15 patients were enrolled for the study, 12 females and 3 males, aged between 43 and 72 years old. Of these patients, 11 received surgery in the mandible and 4 in the maxilla. No complications were registered during surgeries and the immediate post-operative course was uneventful for all patients. At 1 year, 2 patients dropped out of the study: the first patient experienced a peri-imp...
Since a split-mouth design was not feasible and the defects being corrected by the mucosa particularly in the vestibular portion of the study are not usually symmetrical or bilateral, the use of paired subjects was not a reliable format. All the data were analyzed with IBM’s SPSS Statistics using ANOVA Repeated Measurements statistical method. Mean values for keratinized mucosal width and probin...
The primary endpoints were to evaluate the shrinkage degree of the width of keratinized mucosa and length of the re-epithelization process. The secondary endpoints assessed clinical evaluation of the grafted area, post-operative hemostatic effect, pain level, and length of surgery. Follow-up control visits were scheduled at 3 days after surgery and then 10 days, 2 weeks, 3 weeks, 1 month, 2 ...
The study was designed as a multicentered (Milan University—School of Dentistry/Loma Linda University—School of Dentistry) prospective observational (non-controlled) clinical study according to the STROBE criteria. The participants of the study presented areas of deficient attached and unattached mucosa precluding the construction of effective functioning prosthesis. The study included a total...
A variety of factors can lead to teeth loss. From periodontal disease to trauma, the bone remodeling that always follows this event can complicate the subsequent prosthetical rehabilitation [1]. Both removable and implant-fixed restorations require both an adequate quantity of bone and sorrounding soft tissue. Even in severe atrophies of the jaw, nowadays, many bone augmentation techniques are app...
When keratinized tissue width around dental implants is poorly represented, the clinician could resort to autogenous soft tissue grafting. Autogenous soft tissue grafting procedures are usually associated with a certain degree of morbidity. Collagen matrices could be used as an alternative to reduce morbidity and intra-operatory times. The aim of this study was to assess the efficacy of a xenogene...
Fig. 4. Vestibular view of contralateral lateral incisor
Fig. 4. Vestibular view of contralateral lateral incisor
Fig. 3. Vestibular view of right lateral implant supported crown
Fig. 3. Vestibular view of right lateral implant supported crown
Fig. 2. Probing of the peri-implant sulcus
Fig. 2. Probing of the peri-implant sulcus
Fig. 1. a Pre-operative panoramic radiograph of the patient, (b) abutment in place, following the osseointegration period, (c) periapical radiograph at 1-year follow up, (d) final restoration at 1-year follow up, and (e) smile line
Fig. 1. a Pre-operative panoramic radiograph of the patient, (b) abutment in place, following the osseointegration period, (c) periapical radiograph at 1-year foll...
Smile line
VAS
Smile line
Correlation coefficient
1
− .699a
...
PES result
Smile line
Low (n = 4)
Medium (n = 10)
High (n = 5)
Poor (0–...
PES
WES
VAS
Spearman’s rho
VAS
Correlation coefficient
...
Esthetic score
0
1
2
PES
Mesial papilla
...
Number of patients
Percentage
Pink esthetic score
Poor (0–7)
2
10.5%
...
Implant site
Biotype
Smile line
Placement timing
PES
WES
...
Altay, M.A., Sindel, A., Tezerişener, H.A. et al. Esthetic evaluation of implant-supported single crowns: a comparison of objective and patient-reported outcomes.
Int J Implant Dent 5, 2 (2019). https://doi.org/10.1186/s40729-018-0153-3
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Received: 25 July 2018
Accepted: 09 December 2018
Published: 07 January 2019
DOI: https://doi.org/10.1186/s40729-018-0...
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 study was approved by the Akdeniz University Ethical Review Board.
All participants consented to publish their information details.
Dr. Altay has provided consultancy for Checkpoint Surgical LLC in 2014. All other authors declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Dumlupinar Boulevard, Campus, 07058, Antalya, Turkey
Mehmet Ali Altay, Alper Sindel, Hüseyin Alican Tezerişener & Nelli Yıldırımyan
Department of Prosthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
Mehmet Mustafa Özarslan
You can also search for this author in
...
Not applicable.
This study was conducted without external funding.
All data generated and analyzed during this study are included in this article.
Jivraj S, Chee W. Treatment planning of implants in the aesthetic zone. British Dental J. 2006;201(2):77–89.
Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants. 2004;19:43–61.
Huynh-Ba G, Meister DJ, Hoders AB, Mealey BL, Mills MP, Oates TW, Cochran DL, Prihoda TJ, McMahan C...
Hof M, Umar N, Budas N, Seemann R, Pommer B, Zechner W. Evaluation of implant esthetics using eight objective indices-comparative analysis of reliability and validity. Clin Oral Implants Res. 2018;29(7):697–706.
Li X, Wu B, Cheng X, Li Y, Xie X, Deng F. Esthetic evaluation of implant-supported single crowns: the implant restoration esthetic index and patient perception. J Prosthodont. 2017. htt...
Rokn A, Bassir S, Ghahroudi AR, Kharazifard M, Manesheof R. Long-term stability of soft tissue esthetic outcomes following conventional single implant treatment in the anterior maxilla: 10-12 year results. Open Dent. 2016;10:602.
Angkaew C, Serichetaphongse P, Krisdapong S, Dart MM, Pimkhaokham A. Oral health-related quality of life and esthetic outcome in single anterior maxillary implants. Clin...
Pink esthetic score
Standard deviation
Statistical Package for the Social Sciences
Visual analogue scale
White esthetic score
Professionally reported esthetic outcomes (PES and WES results) may not significantly correlate with patient-reported outcomes, although they are helpful in monitorization of implants in the anterior zone during follow-ups. This study reveals that smile line is a significant factor in patient satisfaction, which should be evaluated thoroughly prior to implant placement in the anterior maxilla.
Only a limited number of studies compared esthetic outcomes of implants placed using different protocols [3, 25, 26]. A majority of these studies compared the results of immediate implant placement (type 1) with other protocols. Huynh-Ba et al. found no difference in terms of esthetics between type 1 and type 2 implant placement [25]. Similarly, Boardman et al. observed higher PES results followin...
In the present study, only two implants in patients with thin gingival biotypes failed to reach the clinically acceptable PES level. All other patients with both thick and thin biotypes achieved either acceptable or almost perfect scores for both PES and WES. According to the results of Angkaew et al., the PES/WES scores of patients with thick gingival biotype were significantly higher than those ...
Ever since the introduction of dental implants in the 1960s, they have been used worldwide with high success rates and accepted predictability [13]. Initial efforts of implant treatment mainly focused on osseointegration and function, whereas today, esthetics is also regarded as an essential component, which is commonly addressed together with functional goals of rehabilitation with dental implant...
All implants were loaded 3–6 months after implant surgery (conventional loading protocol); therefore, this parameter was not analyzed in this study.
The overall effect of gingival biotype and smile line on PES, WES, or VAS was studied using a general linear regression analysis for multivariate tests. Although both PES and WES were not affected (p = 0.580, p = 303; respectively), VAS wa...
Question4. “How do you feel about the color of the gum that is around your new implant tooth?” Mean patient rating was calculated as 8.4 (range 2–10, SD ± 2.0). Median score was 9. Fifteen patients responded with a score of ≥ 8 and 17 patients responded with a score of ≥ 6.
Question5. “What is your overall satisfaction with the new implant tooth?” Mean patient rating was ca...
A total of 19 (7 female and 12 male) patients, who were rehabilitated with a single implant in the anterior maxilla, were included in this study. Patients’ ages ranged between 19 and 42 with a mean of 31.8 years. None of the implants were associated with increased probing depth, bleeding, suppuration, foreign body sensation, pain, morbidity, or infection. Clinical features related to anterior s...
All patients were assessed according to the White Esthetic Score [8] which comprised the evaluation of five variables including general tooth form, tooth contour, tooth color (hue and value), surface texture, and translucence. Each variable was given a score of 0, 1, or 2. A score of 0 indicated the worst and a score of 2 indicated the best result for each variable. The implant-supported tooth was...
This study was conducted in accordance with the Declaration of Helsinki on medical protocol and was approved by the Akdeniz University Ethical Review Board.
The patients rehabilitated with a single implant-supported fixed prosthesis in the maxillary esthetic zone at the departments of Oral and Maxillofacial Surgery and Prosthetic Dentistry of Akdeniz University between June 2015 and April 2017 we...
Patient satisfaction, which indicates the success of the implant treatment from the patient’s perspective, is another important outcome measure and is commonly performed with questionnaires or a visual analog scale (VAS) [2, 8]. A current review of the literature, however, reveals only a limited number of studies reporting on patient-centered outcomes in addition to objective evaluations of impl...
Rehabilitation of missing teeth in the anterior maxilla with an implant-supported fixed prosthesis is a widely accepted treatment modality [1]. Dental implants have high rates of predictability in terms of osseointegration, particularly due to improvements in treatment techniques and surface topography [2]. However, rehabilitation with dental implants is not yet considered a perfect treatment moda...
This study investigated objective and patient-reported esthetic outcomes and their correlation for single-tooth implant restorations in the maxillary anterior region.
Nineteen patients were included. Gingival biotypes and smile lines were evaluated. Esthetic evaluation was performed according to the pink and white esthetic scores (PES and WES). Patients rated their satisfaction regarding the impl...
Figure 4. Patient satisfaction throughout the study
Figure 3. Bone level changes from loading to 5-year follow up
Figure 2. Clinical parameters and soft tissue parameters. a Modified plaque index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. b Sulcus bleeding index. Error bars indicate standard deviation. * = p ≤ 0.05, *** = p ≤ 0.001. c Pocket probing depth. The asterisk represents statistically significant differences (* = p ≤ 0.05) observed between ...
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Figure 1. Study flow diagram: follow up status and reasons for not completing the study; six-month, 2-year and 4-year follow up was optional
Table 4 Life table analysis showing the cumulative success rate according to Albrektsson et al. and Buser et al.
Interval(months)
Implants in interval
According to Albrektsson et al.
According to Buser et al.
Implants withdrawn during interval
Failures during interval
Cumulative success rate (%)
Implants withdrawn during interval
Failures during interval
Cumulativ...
Table 3 Patient demographics with respect to implants
Overall
Subgroup*
Platform switching
Platform matching
Total Implants, n
285
203*
68*
Number of implants placed per patient, n (%)
1
125 (63.8)
97 (67.4)
20 (48.8)
2
56 (28.6)
37 (25.7)
16 (39.0)
3
12 (6.1)
7 (4.9)
5 (12.2)
4
3 (1.5)
3 (2.1)
0 (0.0)
Implant...
Table 2 Patient demographics
Overall
Subgroup*
Platform switching
Platform matching
Patients, n (%)
196 (100)
144
41
Sex, n (%)
Male
87 (44.4)
62 (43.1)
19 (46.3)
Female
109 (55.6)
82 (56.9)
22 (53.7)
Age, years
Mean (SD)
51.5 (14.2)
53.1 (14.4)
47.4 (12.9)
Range
17.9–82.1
17.9–82.1
19.3–78.5
Pr...
Investigator*
City/country
Number of patients included
Number of implants included
Dr. Helfried Hulla
Strass in Steiermark, Austria
10
15
Prof. DDr. Gerald Krennmair
Marchtrenk, Austria
10
20
Dr. S. Marcus Beschnidt (PI)
Baden-Baden, Germany
8
12
Dr. Karl-Ludwig Ackermann
Filderstadt, Germany
14
18
Dr. Thomas Barth
Leipzig, Germany
15
28
Dr...
Abbreviations
ASA:
American Society of Anesthesiologists
MPI:
Modified Plaque Index
PPD:
Pocket probing depth
RCT:
Randomized controlled clinical trial
SBI:
Sulcus Bleeding Index
SD:
Standard deviation
SLA:
Sand-blasted, large grit, acid-etched
References
Hjalmarsson L, Gheisarifar M, Jemt T. A systematic review of survival of s...
The appearance of poorer oral hygiene later in the study also appears to correspond with the drop in follow-up attendance, which again supports the importance of follow-up. All other complications could be resolved and were not persisting. Furthermore, patients selected for inclusion in this study were optimal candidates for dental implants. Though the inclusion criteria predestinate the patient s...
At 5-year follow-up, the overall SBI was 0.32 ± 0.49, reflective of no bleeding given that 0 equals no bleeding and 1 equals isolated bleeding spots visible [27]. The PPD initially decreased within the first 6 months from which point it significantly increased to 2.34 ± 1.18 mm at 5-year follow-up.
Nevertheless, the measured mean PPD still reflects the norm for conventionally placed i...
On the one hand, the variety of bone level changes in this study may be explained by different vertical soft tissue thicknesses, but cannot be validated due to these missing data. On the other hand, there are multiple confounding factors influencing the change in bone level, such as the size of the platform (mismatch), occlusal loading, and the microgap. Additional to the standard success criteria...
Over the 5-year study period, we report
At 3-year follow-up, bone loss was noted in one patient (reclassified as peri-implantitis at the 4-year follow-up) and an important bone loss (due to poor oral hygiene and bruxism; two implants) in a patient with psychosocial issues who could not be treated during the study. Such a patient would not have been included in an RCT.
Consequently, three implants were lost based on the bone loss criter...
Discussion and conclusions
This large, multicenter study provides real-life long-term data on 285 implants placed in 196 patients. The results show that the placement of CAMLOG SCREW-LINE implants with platform-matching or platform-switching abutments results in high survival and success in the long term. The overall success rate for implants was 97.1% at 5-year post-loading, and 97.4% and 96.2...
Jemt papilla score
At loading, the Jemt papilla score was 1.93 ± 1.01, significantly increasing to 2.14 ± 0.95 at 5-year follow-up (p = 0.023) (Fig. 2d). For the platform-switching subgroup, a significant difference was observed between baseline and 5-year follow-up (p
Implant survival
The cumulative survival rate was 100% at 1-year follow-up, 99.6% at 3-year follow-up, and 98.6% at 5-year follow-up. All three late failures were in the platform-switching subgroup.
Clinical parameters/soft tissue parameters
Plaque index
Mean modified plaque indices were very low at below 0.5 for all but one measurement throughout the course of the study (Fig. 2a). At loading...
Results
Patient demographics
In total, 196 patients from 17 centers met the inclusion criteria for this study and were included in the per-protocol analysis. In total, 285 implants were placed (Table 1). At the 5-year follow-up, data were available for the 137 patients who completed the study (Fig. 1). Patient demographic data is presented in Tables 2 and 3.
Implant success
Implant success...
The primary stability of the implant was assessed during surgery. Implant success and survival were evaluated in the group of implants restored with abutments [5, 29] at both placements of the provisional and definitive prostheses and at each follow-up visit thereafter. Implants were deemed successful in accordance with the criteria for implant success laid down by Albrektsson et al. [30]. Implan...
Assessments
Throughout the study, only radiographs consistent with standard implant procedures were taken. Bone level changes were assessed based on available and evaluable standardized periapical radiographs with a film-holder using parallel-technique or panoramic radiographs (depending on the standard in the study centers). Baseline was defined as the time of the first prosthetic installati...
The treatment indications were single or multiple tooth replacement in the maxilla or mandible without the use of simultaneous augmentation or membrane, of which the implants were to be restored with either fixed single crown or fixed partial denture restorations.
Treatment procedure
Patients were to be treated according to standard practice for implant procedures applicable in the countries par...
Methods
Study design
This was a prospective multicenter non- interventional study to assess implant success and survival rates in daily dental practices using the CAMLOG SCREW-LINE implants (CAMLOG Biotechnologies AG, Basel, Switzerland) used with or without platform-switching abutments. Patients were enrolled over a period of 2 years from October 2008 to September 2010 from 17 sites across f...
In the present study, CAMLOG SCREW-LINE implants with the Promote plus surface (sandblasted and acid-etched surface) were used. These implants in combination with platform-matching abutments have been shown to have high long-term success rates ranging from 97.8 to 100% at 5-year to 10-year follow-up [9,10,11,12,13]. They can be restored with either platform-matching or platform-switching abutments...
Background
Success and survival rates of endosseous implants are well-documented in a number of controlled clinical trials and systematic reviews [1,2,3]. Generally, controlled trials evaluate endosseous implants in specific clinical situations; thus, the patient population is subjected to rigorous inclusion criteria and follow-up. Accordingly, controlled clinical trials do not reflect th...
Implant success and survival rates in daily dental practice: 5-year results of a non-interventional study using CAMLOG SCREW-LINE implants with or without platform-switching abutments
Abstract
Background
The performance of dental implants in controlled clinical studies is often investigated in homogenous populations. Observational studies are necessary to evaluate the outcome of implant resto...
Pengukuran tulang (bone sounding)
Bone sounding atau transmucosal sounding (TS) adalah pengukuran yang digunakan untuk menentukan ketinggian seluruh cuff (manset) jaringan lunak pada berbagai kelompok gigi dan implant. Matra mukosa peri-implan dan gingiva pada letak gigi yang berdekatan dipelajari dengan pengukuran klinis yang dilakukan terutama pada subjek edentulous sebagian yang telah dirawa...
How do we define a case of peri‐implantitis in day‐to‐day clinical practice and teaching situations?
Diagnosis of peri‐implantitis requires:
Presence of bleeding and/or suppuration on gentle probing.
Increased probing depth compared to previous examinations.
Presence of bone loss beyond crestal bone level changes resulting from initial bone remodeling.
In the a...
The following case definitions and characteristics of peri‐implant health, peri‐implant mucositis, and peri‐implantitis should be viewed within context of several potential confounding factors.
It is known that there is no generic implant and that there are numerous implant designs with different surface characteristics, surgical and loading protocols. The degree of physiological remodeli...
What are the main factors associated with hard‐ and soft‐tissue deficiencies at potential implant sites?
The healing process following tooth loss leads to diminished dimensions of the alveolar process/ridge representing hard‐ and soft‐tissue deficiencies. Larger deficiencies may occur at sites exposed to the following factors: loss of periodontal support, endodontic in...
What is peri‐implantitis?
Peri‐implantitis is a plaque‐associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri‐implant mucosa and subsequent progressive loss of supporting bone.
What is the evidence for plaque/biofilm as a principal etiological factor for peri‐implantitis?
There is evidence ...
What are the clinical characteristics of peri‐implant mucositis?
The main clinical characteristic of peri‐implant mucositis is bleeding on gentle probing. Erythema, swelling and/or suppuration may also be present.
Does peri‐implant mucositis exist in the absence of clinical signs of inflammation?
Clinical signs of inflammation are necessary for a diagnosis of peri...
What are the clinical characteristics of a healthy peri‐implant site?
In health, the peri‐implant site is characterized by absence of erythema, bleeding on probing, swelling and suppuration.
What are the main clinical differences between healthy peri‐implant and periodontal tissues?
In health, there are no visual differences between peri‐implant and periodontal t...
The objective of Workgroup 4 was to present a classification on peri‐implant diseases and conditions. Five position papers describing the characteristics of peri‐implant health, peri‐implant mucositis, peri‐implantitis, soft and hard tissue deficiencies and case definitions and diagnostic considerations were prepared prior to the workshop.
In preparing this consensus report regarding...
Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions
Abstract
A classification for peri‐implant diseases and conditions was presented. Focused questions on the characteristics of peri‐implant health, peri‐implant mucositis, peri‐implantitis, and soft‐ and hard‐tissue deficiencies were addressed.
...
The implant device lacks tooth characteristic structures such as root cementum, periodontal ligament, and bundle bone (alveolar bone proper). The dento‐alveolar and the dento‐gingival fiber bundles connect the soft tissues with the tooth (root cementum), while no such fiber bundles are apparent in the peri‐implant tissues. At periodontally healthy sites, the margin of the gingiva follow...
Bone tissue in the edentulous ridge
In a study involving partially edentulous subjects, hard tissue biopsies were sampled from the maxilla and the mandible with the use of trephine drills. The bone tissue was found to include a blend of mainly lamellar bone (46%) and bone marrow (23%) with less amounts of fibrous (12%) and osteoid (4%) tissue. Bone marrow was the dominant tissu...
KERATINIZED MUCOSA (KM)
Keratinized mucosa is a term used to describe the masticatory mucosa that is present at many, but not all, implant sites. Keratinized mucosa extends from the margin of the peri‐implant mucosa to the movable lining (oral) mucosa. Keratinized mucosa is comprised of a lamina propria (fibrous connective tissue that contains fibroblasts and equal amounts of ty...
BONE SOUNDING
Bone sounding or transmucosal sounding (TS) is a measurement that is used to determine the height of the entire soft tissue cuff at various groups of teeth and implants. The dimensions of the peri‐implant mucosa and the gingiva at adjacent tooth sites was studied by clinical measurements performed mainly in partially edentulous subjects who had been treated with im...
PERI‐IMPLANT TISSUES IN CLINICAL HEALTH
The gingiva and the peri‐implant mucosa and their adhesion (seal) are consistently challenged by the oral environment, including the steady exposure to microorganisms in the biofilm present on the tooth and implant surfaces. In the clinically normal peri‐implant mucosa (and gingiva), the continuous host response includes both vascular ...
Animal studies
The dimension of the peri‐implant mucosa, often called the biological width or dimension, was examined in biopsies mainly obtained from studies in dogs. Such measurements disclosed that a certain width of soft tissue may be required to cover the peri‐implant bone. The studies referred to the length of the epithelium (from the peri‐implant mucosa margin to the...
The formation of the mucosal adhesion was studied in a dog model. One‐piece implant devices were placed in the edentulous mandible of dogs, and healing was monitored using light microscopic examination of biopsies sampled at different intervals during a 3‐month period. In the initial phase of the wound between the implant and cut connective tissue, a fibrin clot/coagulum formed that was inf...
PERI‐IMPLANT MUCOSA
Most information regarding the structural features of the peri‐implant mucosa is derived from animal studies using dog models. In such studies implants were placed in the edentulous ridge (alternatively, the fresh extraction socket), the outer osseous part of which was covered with masticatory mucosa. It was also shown that the healed peri‐implant mucosa on the buccal a...
Peri‐implant tissues are those that occur around osseointegrated dental implants. They are divided into soft and hard tissue compartments. The soft tissue compartment is denoted “peri‐implant mucosa” and is formed during the wound healing process that follows implant/abutment placement. The hard tissue compartment forms a contact relationship to the implant surface to secure implant stab...
Abstract
Objective
The aim is to define clinical and histologic characteristics of peri‐implant tissues in health and describe the mucosa–implant interface.
Importance
An understanding of the characteristics of healthy peri‐implant tissues facilitates the recognition of disease (i.e., departure from health).
Findings
The healthy peri‐implant mucosa is, at the microscopic ...
Figure 48. Dimensional ridge alterations: 4 weeks
At 4 weeks after tooth extraction, the socket is filled with woven bone. Osteoclasts are present on the outer surfaces at the margin of the buccal and lingual walls, signaling resorption of cortical plates. The resorption of the bundle bone is almost complete. Osteoclasts also line the trabeculae of woven bone present in the central and latera...
Figure 47. Dimensional ridge alterations: 2 weeks
At 2 weeks after tooth extraction, the apical and lateral parts of the socket are filled with woven bone, while the central and marginal portions of the socket are occupied by provisional connective tissue. On the inner and outer surfaces of the socket walls, numerous osteoclasts can be seen. In several areas of the socket wall, the bundle bon...
Figure 46. Dimensional ridge alterations in 1 week
Araujo and Lindhe described the edentulous ridge profile alterations following tooth extraction in an experimental study in a dog model. During the first week of post-extraction healing, the socket area is occupied by coagulum and granulation tissue. A large number of osteoclasts are seen on the outer as well as on the inner s...
Figure 39. Alveolar atrophy
The amount of tissue atrophy can also be influenced by factors such as pre-existing pathological processes and excessive pressure from a removable prosthesis.
Figure 38. Reduction in dimension
This reduction occurs in both the horizontal and the vertical dimension, and as a result the arch is shortened. The amount of tissue atrophy following the loss of a single tooth can be substantial and is variable between different teeth and areas of the alveolar process.
Figure 37. Alveolar atrophy
Following multiple- or single-tooth extraction and the subsequent loss of masticatory function, the alveolar ridge will present a series of adaptive alterations known as alveolar atrophy. The alveolar atrophy is characterized by a reduction in the dimensions of the alveolar ridge that is a combination of hard and soft tissue changes.
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 ...
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.
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.
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.
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...
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...
Figure 26. Day 14: woven bone & connective tissue
After 14 days of healing woven bone, which appears as a loose, unstructured network of bone, has started to fill the socket except in the central region, where significant amounts of the provisional connective tissue matrix still remain. This is because the woven bone forms first at the periphery of the socket and gradually extends from the wa...
Figure 18. Extraction socket wall
The buccal bone plate is usually thin, less than 1 mm, especially in the anterior dentition, and it consists mainly of bundle bone. On the contrary, the lingual or palatal wall of the socket is usually thicker than its buccal counterpart, and some trabecular bone may be present.
Figure 17. Extraction socket
The extraction socket is a term used to describe the tissues remaining after tooth removal. The outer walls of the extraction socket consist mainly of cortical bone.
Discussion
Complex tissue engineering concepts have to be evaluated in terms of their clinical applicability. Thus, the overall goal should be to establish a method that could ideally be completed within a short time span before or during intended regenerative surgical procedures. Over the last few years, Choukroun's PRF has proven to be a method that comes close to the ideal concept of guide...
Results
Histochemical studies (H&E, Mason-Goldner, and Giemsa)
S-PRF
In the longitudinal section of the S-PRF clot, produced according to the standard centrifugation protocol (2700 rpm, 12 minutes), a dense fibrin clot was seen with minimal interfibrous space. With the standard histochemical staining methods, cells were observed throughout the clot, albeit decreasing toward the more distal ...
Production of Choukroun's PRF
The PRF scaffolds were prepared according to a previously published protocol.11,26 Four healthy (ie, with no history of anticoagulant usage) volunteers in an age range between 18 to 60 years participated in this study. For each individual, 4 tubes of peripheral blood were collected and immediately placed in a preprogrammed centrifuge (PC-O2, PROCESS for PRF, N...
A major objective of biomaterial research and tissue engineering is to promote a material-induced tissue reaction that leads to regeneration and an effective wound-healing process in the defective area. Thus, a biomaterial should serve as a temporary barrier to cover defects and promote tissue regeneration while being tissue compatible and, most importantly, clinically applicable. In the field o...
Advanced Platelet-Rich Fibrin: A New Concept for Cell-Based Tissue Engineering by Means of Inflammatory Cells
Shahram Ghanaati, MD, DMD; Patrick Booms, PhD; Anna Orlowska, BSc, DVM; Alica Kubesch; Jonas Lorenz, DDS; Jim Rutkowski, DMD, PhD; Constantin Landes, MD, DMD, PhD; Robert Sader, MD, DDS, PhD; CJ Kirkpatrick, MD, PhD, DSc; Joseph Choukroun, MD
J Oral Impla...
Pendahuluan
Menggabungkan perancah dan sel hidup untuk membentuk konstruksi rekayasa jaringan adalah konsep yang penting untuk memajukan perbaikan dan regenerasi jaringan tulang. Sel induk mesenkim sering digunakan dalam konstruksi seperti itu karena kemampuannya untuk berkembangbiak dan berdiferensiasi menuju pembentuk sel tulang. Desain dan pembuatan perancah, isolasi dan karakterisasi sel indu...
Conclusions
The porous Col-HA composites developed in the present study are biocompatible and can be used as scaffolds for bone tissue regeneration. The Col-HA ratio is an important factor in promoting the attachment and proliferation of mouse MSCs. The Col-HA composite complexes have strong potentials in bone tissue regeneration applications. hPDSCs may be a suitable resource of cells for maxi...
Discussion
The findings of the presented study indicate that the porous sponge-like Col-HA composites have good biocompatibility and biomimetic properties and may be used as scaffolds for bone tissue regeneration. The Col-HA composites with ratios 80:20 and 50:50 supported the attachments and proliferations of mouse MSCs and hPDSCs. These findings indicate that Col-HA composite complexes have str...
Results
The sponge-like plugs of prototype Col-HA composites were successfully fabricated with different collagen and HA ratios. The macroscopic and SEM views of the prototype type I collagen without HA and 3 different ratios of collagen-HA (20%Col-80%HA; 50%Col-50%HA; 80%Col-20%HA) composites are shown in Figure 1. The SEM views show the inside microstructures of the prototype pure type I colla...
Materials and Methods
Synthesis of the Col-HA composites by direct precipitation in situ
Solutions of calcium salt and phosphoric acid (Ca/P = 1.66 mol) were used to synthesize HA particles and incorporate them on bovine type I collagen fibrils by a direct precipitation technique in situ. This technique was optimized to produce 3 different ratios of Col-HA composites (20%Col-80%HA; 50%Col-50%H...
Introduction
Combining a scaffold and living cells to form a tissue-engineering construct is an important concept for promoting the repair and regeneration of bone tissues. Mesenchymal stem cells are often used in such constructs due to their abilities to proliferate and differentiate toward bone-forming cells. The design and fabrication of scaffolds, stem cell isolation and characterization, and...
Abstract
Current bone grafting materials have significant limitations for repairing maxillofacial and dentoalveolar bone deficiencies. An ideal bone tissue-engineering construct is still lacking. The purpose of the present study was first to synthesize and develop a collagen-hydroxyapatite (Col-HA) composite through controlled in situ mineralization on type I collagen fibrils with nanometer-sized...
RESEARCH
Porous Collagen-Hydroxyapatite Scaffolds With Mesenchymal Stem Cells for Bone Regeneration
Li Ning, DDS, PhD , Hans Malmström, DDS , Yan-Fang Ren, DDS, MPH, PhD
Correspondence:
* Corresponding author, e-mail: yanfang_ren@urmc.rochester.edu
Article Citation:
Li Ning, Hans Malmström, Yan-Fang Ren, Porous Collagen-Hydroxyapatite Scaffolds With Mesench...