Bone Remodeling in Immediately Loaded and Unloaded Titanium Dental Implants: A Histologic and Histomorphometric Study in Humans

2005 ◽  
Vol 31 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Marco Degidi ◽  
Antonio Scarano ◽  
Maurizio Piattelli ◽  
Vittoria Perrotti ◽  
Adriano Piattelli
Keyword(s):  
Bone Remodeling ◽  
Dental Implants ◽  
Lamellar Bone ◽  
Implant Surface ◽  
Histomorphometric Study ◽  
Woven Bone ◽  
Time Period ◽  
Microdamage Accumulation ◽  
Repetitive Loading ◽  
Tetracycline Labeling

Abstract Remodeling is thought to prevent microdamage accumulation caused by repetitive loading and to increase the fatigue life of bone. The bone remodeling rate (BRR) is the period of time needed for new bone to replace the existing bone and to allow for the adaptation of bone to its environment. BRR is expressed as a percentage or volume of new bone within a specific time period. The aim of the present study was to evaluate bone remodeling events on submerged and immediately loaded dental implants. Twelve patients with edentulous mandibles participated in this study. All patients were rehabilitated with fixed mandibular prostheses, with 10 dental implants per patient. An additional implant was inserted in the most distal posterior mandibular jaw region. In 6 patients, these additional implants were loaded with a fixed provisional prosthesis the same day of the implant surgery and loaded. In the other 6 patients, the additional implants were left submerged and not loaded. After 6 months, all the additional implants were retrieved with a trephine. The percentage of woven and lamellar bone, number of osteoclasts and osteoblasts, and percentage of bone labeled by tetracycline at 0.5 mm and 2 mm from the implant surface were evaluated. The percentage of lamellar bone, number of osteoblasts, and percentage of bone tetracycline labeling was significantly higher in the loaded implants than in the unloaded implants (P = .0001). Also in the loaded implants, the percentage of woven and lamellar bone, number of osteoclasts and osteoblasts, and percentage of bone tetracycline labeling was significantly higher at 0.5 mm than at 2 mm from the implant surface (P = .0001). No such differences were found in unloaded implants (P = .377). In conclusion, we found that (1) loading appeared to stimulate bone remodeling at the interface, (2) a higher percentage of lamellar bone was found in loaded implants, (3) the percentage of bone labeling was higher at the interface of loaded implants, (4) no differences were found in the BRRs between immediately loaded and unloaded implants, and (5) immediate loading had not interfered on the lamellar bone formation at the interface and had not produced formation of woven bone at the interface.

scholarly journals Macrophagic Inflammatory Response Next to Dental Implants with Different Macro- and Micro-Structure: An In Vitro Study

2021 ◽  
Vol 11 (12) ◽  
pp. 5324
Author(s):  
Maria Menini ◽  
Francesca Delucchi ◽  
Domenico Baldi ◽  
Francesco Pera ◽  
Francesco Bagnasco ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Dental Implants ◽  
In Vitro Study ◽  
Titanium Implants ◽  
Implant Surface ◽  
Bone Implant ◽  
Optimal Outcomes ◽  
Negative Controls ◽  
Inflammatory Effect

(1) Background: Intrinsic characteristics of the implant surface and the possible presence of endotoxins may affect the bone–implant interface and cause an inflammatory response. This study aims to evaluate the possible inflammatory response induced in vitro in macrophages in contact with five different commercially available dental implants. (2) Methods: one zirconia implant NobelPearl® (Nobel Biocare) and four titanium implants, Syra® (Sweden & Martina), Prama® (Sweden & Martina), 3iT3® (Biomet 3i) and Shard® (Mech & Human), were evaluated. After 4 h of contact of murine macrophage cells J774a.1 with the implants, the total RNA was extracted, transcribed to cDNA and the gene expression of the macrophages was evaluated by quantitative PCR (qPCR) in relation to the following genes: GAPDH, YWHAZ, IL1β, IL6, TNFα, NOS2, MMP-9, MMP-8 and TIMP3. The results were statistically analyzed and compared with negative controls. (3) Results: No implant triggered a significant inflammatory response in macrophages, although 3iT3 exhibited a slight pro-inflammatory effect compared to other samples. (4) Conclusions: All the samples showed optimal outcomes without any inflammatory stimulus on the examined macrophagic cells.

scholarly journals On the effect of antiresorptive drugs on the bone remodeling of the mandible after dental implantation: a mathematical model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mehran Ashrafi ◽  
Farzan Ghalichi ◽  
Behnam Mirzakouchaki ◽  
Manuel Doblare
Keyword(s):  
Mathematical Model ◽  
Bone Density ◽  
Bone Remodeling ◽  
Dental Implants ◽  
Implant Design ◽  
Patient Specific ◽  
Dental Implantation ◽  
Antiresorptive Agents ◽  
Antiresorptive Drugs

AbstractBone remodeling identifies the process of permanent bone change with new bone formation and old bone resorption. Understanding this process is essential in many applications, such as optimizing the treatment of diseases like osteoporosis, maintaining bone density in long-term periods of disuse, or assessing the long-term evolution of the bone surrounding prostheses after implantation. A particular case of study is the bone remodeling process after dental implantation. Despite the overall success of this type of implants, the increasing life expectancy in developed countries has boosted the demand for dental implants in patients with osteoporosis. Although several studies demonstrate a high success rate of dental implants in osteoporotic patients, it is also known that the healing time and the failure rate increase, necessitating the adoption of pharmacological measures to improve bone quality in those patients. However, the general efficacy of these antiresorptive drugs for osteoporotic patients is still controversial, requiring more experimental and clinical studies. In this work, we investigate the effect of different doses of several drugs, used nowadays in osteoporotic patients, on the evolution of bone density after dental implantation. With this aim, we use a pharmacokinetic–pharmacodynamic (PK/PD) mathematical model that includes the effect of antiresorptive drugs on the RANK/RANK-L/OPG pathway, as well as the mechano-chemical coupling with external mechanical loads. This mechano-PK/PD model is then used to analyze the evolution of bone in normal and osteoporotic mandibles after dental implantation with different drug dosages. We show that using antiresorptive agents such as bisphosphonates or denosumab increases bone density and the associated mechanical properties, but at the same time, it also increases bone brittleness. We conclude that, despite the many limitations of these very complex models, the one presented here is capable of predicting qualitatively the evolution of some of the main biological and chemical variables associated with the process of bone remodeling in patients receiving drugs for osteoporosis, so it could be used to optimize dental implant design and coating for osteoporotic patients, as well as the drug dosage protocol for patient-specific treatments.

scholarly journals The osseointegration and stability of dental implants with different surface treatments in animal models: a network meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chun-Ping Hao ◽  
Nan-Jue Cao ◽  
Yu-He Zhu ◽  
Wei Wang
Keyword(s):  
Dental Implants ◽  
Early Stage ◽  
Meta Analysis ◽  
Critical Role ◽  
Cochrane Library ◽  
Missing Teeth ◽  
Treatment Technology ◽  
Implant Surface ◽  
Randomized Controlled ◽  
Early Healing

AbstractDental implants are commonly used to repair missing teeth. The implant surface plays a critical role in promoting osseointegration and implant success. However, little information is available about which implant surface treatment technology best promotes osseointegration and implant stability. The aim of this network meta-analysis was to evaluate the osseointegration and stability of four commonly used dental implants (SLA, SLActive, TiUnite, and Osseotite). The protocol of the current meta-analysis is registered in PROSPERO (International Prospective Register of Systematic Reviews) under the code CRD42020190907 (https://www.crd.york.ac.uk). We conducted a systematic review following PRISMA and Cochrane Recommendations. Medline (PubMed), Cochrane Library, Embase, and the Web of Science databases were searched. Only randomized controlled trials were considered. Twelve studies were included in the current network meta-analysis, eleven studies were included concerning the osseointegration effect and five studies were included for stability analysis (four studies were used to assess both stability and osseointegration). Rank possibility shows that the SLActive surface best promoted bone formation at an early healing stage and TiUnite seemed to be the best surface for overall osseointegration. For stability, TiUnite seemed to be the best surface. The present network meta-analysis showed that the SLActive surface has the potential to promote osseointegration at an early stage. The TiUnite surface had the best effect on osseointegration regarding the overall healing period. The TiUnite surface also had the best effect in stability.

Effects of sialoadenectomy and exogenous EGF on molar drift and orthodontic tooth movement in rats

1994 ◽  
Vol 266 (5) ◽  
pp. E731-E738 ◽  
Author(s):  
C. Dolce ◽  
J. Anguita ◽  
L. Brinkley ◽  
P. Karnam ◽  
M. Humphreys-Beher ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Remodeling ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Alveolar Bone Remodeling ◽  
Tooth Roots ◽  
Epidermal Growth ◽  
Tetracycline Labeling ◽  
Distal Aspect

Effects on bone remodeling have been attributed to epidermal growth factor (EGF). Sialoadenectomy (SX) removes the major source of EGF in rodents and decreases both salivary and serum EGF levels. EGF effects on rat alveolar bone remodeling manifested by molar drift (MD) and orthodontic tooth movement (OTM) were examined using the following two approaches: 1) EGF depletion by SX and replacement by orally administered EGF (50 micrograms.animal-1.day-1); 2) sham rats supplemented with matching amounts of EGF. MD and OTM were measured using cephalometric radiographs; bone formation was measured histomorphometrically using tetracycline labeling. Normal MD was not detected after SX, and alveolar bone formation was significantly reduced both around the tooth and in nondental sites. Replacement EGF given to SX rats and supplemental EGF administered to sham rats changed the direction and enhanced the rate of MD. A mesially directed orthodontic force applied to the molars of SX animals increased bone formation on the distal aspect of the tooth roots. Supplemental EGF did not significantly affect OTM. EGF affects alveolar bone remodeling, as manifested clinically by alterations in normal maxillary MD.

scholarly journals Biomechanics in dental implants

2021 ◽  
Vol 7 (3) ◽  
pp. 131-136
Author(s):  
Poonam Prakash ◽  
Ambika Narayanan
Keyword(s):  
Dental Implants ◽  
Fibrous Tissue ◽  
Primary Stability ◽  
Biological Tissues ◽  
Implant Design ◽  
Implant Fixation ◽  
Implant Surface ◽  
Bone Apposition ◽  
Functional Connection ◽  
Secondary Stage

Achieving primary stability in dental implants is crucial factor for accomplishing successful osteointegration with bone. Micro-motions higher than the threshold of 50 to 100 μm can lead to formation of fibrous tissue at the bone-to-implant interface. Therefore, osteointegration may be vitiated due to insufficient primary stability. Osseointegration is defined as a direct and functional connection between the implant biomaterial and the surrounding bone tissue. Osseointegration development requires an initial rigid implant fixation into the bone at the time of surgery and a secondary stage of new bone apposition directly onto the implant surface. Dental implants function to transfer the load to the surrounding biological tissues. Due to the absence of a periodontal ligament, its firm anchorage to bone, various forces acting on it and the presence of prosthetic components, they share a complex biomechanical relationship. The longevity of these osseointegrated implants depend on optimizing these complex interactions. Hence, the knowledge of forces acting on implant, design considerations of implant and bone mechanics is essential to fabricate an optimized implant supported prosthesis.

scholarly journals Maxillary Ridge Vertical Augmentation Based on a Mixture of Xenogenic and Allogenic Bone Supported by Resorbable Membrane: One Case Report

2019 ◽  
pp. 94-100
Author(s):  
Gonzalez-Menendez M ◽  
Gonzalez-Tuñon J ◽  
Ordoñez S ◽  
Junquera L ◽  
Vega JA
Keyword(s):  
Case Report ◽  
Bone Remodeling ◽  
Dental Implants ◽  
Radiological Evaluation ◽  
Allogenic Bone ◽  
Ridge Augmentation ◽  
Good Level ◽  
Left Posterior ◽  
Xenogenic Bone

One 60 years-old patient was scheduled for left posterior maxillary ridge augmentation due to failure of standard implants, followed by successful maxillary dental implants. We used an unproved technique consisting in a mixture of 50% allogenic and 50% xenogenic bone supported by reabsorbable membrane. No complications were found at the different stages of the treatment, and at the ending the patient showed a good level of satisfactory outcomes. Radiological evaluation demonstrated ridge augmentation able to support implant, and within the graft islands of connective and bone-like tissue was found. Within these tissues osteoclasts and osteoblast putative cells were found. Results demonstrate that the used method in addition to support implants has osteogenic and bone remodeling activity.

The Effect of Number of Cycles on Microdamage Accumulation in Bovine Trabecular Bone

2001 ◽  
Author(s):  
Tara L. Arthur Moore ◽  
Lorna J. Gibson
Keyword(s):  
Trabecular Bone ◽  
Bone Remodeling ◽  
Low Cycle Fatigue ◽  
Cycle Fatigue ◽  
Repetitive Motion ◽  
Microdamage Accumulation ◽  
Lower Load ◽  
Small Cracks ◽  
Number Of Cycles ◽  
Fatigue Microdamage

Abstract Microdamage, in the form of small cracks, exists in healthy bone. Microdamage can be created by an overload or by repetitive motion (fatigue) during daily activities. Usually, microdamage is repaired during bone remodeling and a steady state is maintained. However, in cases of excessive microdamage creation or slowed bone remodeling, microdamage can coalesce to create a fracture. Our previous work [1,2] has investigated microdamage accumulation with increasing strain in bovine trabecular bone loaded in monotonic compression and compressive fatigue. Specimens fatigued at relatively high load levels fail after a few loading cycles, while specimens fatigued at lower load levels may undergo thousands of cycles before failure. During high cycle fatigue, microdamage may accumulate by the growth of pre-existing microcracks, as well as by the crack initiation seen in low cycle fatigue.

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