scholarly journals Under-Drilling versus Hybrid Osseodensification Technique: Differences in Implant Primary Stability and Bone Density of the Implant Bed Walls

Materials ◽  
2020 ◽  
Vol 13 (2) ◽  
pp. 390 ◽  
Author(s):  
Rafael Delgado-Ruiz ◽  
Joshua Gold ◽  
Tanya Somohano Marquez ◽  
Georgios Romanos

The goal of this study was to evaluate the effects of two implant bed preparation techniques on the implant primary stability (IPS) and the bone density of the implant site. We completed 40 implant bed osteotomies in pig ribs using two techniques: osseodensification (OD) plus under-drilling (UD) with universal osseodensification drills (Test A), and under-drilling alone with drills of the same implant system (Test B). Implants with a 4.1 mm diameter and 10 mm length were inserted, and the IPS was evaluated with three methods: (insertion torque (IT), periotest (PTV), and resonance frequency analysis (RFA). The bone density was evaluated using micro-computed tomography. ANOVA and Tukey’s post-hoc test were used for comparison of the IPS values, and Kruskal–Wallis was used to evaluate the bone density. Statistical significance was set at p < 0.05. The tested B technique (UD) achieved a higher IPS compared to the Test A technique (OD + UD) for all the evaluation methods (p < 0.05). Bone density was higher at the apical and middle region in Test A compared to Test B and control sites (p < 0.05). We concluded that although the bone density increased with the hybrid OD technique with universal drills, implant beds prepared with UD using drills with geometry similar to that of the implant are more efficient at increasing IPS values.

Materials ◽  
2021 ◽  
Vol 14 (7) ◽  
pp. 1728
Author(s):  
Henning Staedt ◽  
Diana Heimes ◽  
Karl M. Lehmann ◽  
Peter Ottl ◽  
Monika Bjelopavlovic ◽  
...  

(1) Background: Primary stability—one fundamental criterion for the success of dental implants—is influenced by implant geometry even if the effect of apical shape modifications on implant primary stability has not yet been examined. Therefore, the aim of the ex vivo study was to compare primary stability of implants differing in apically located screw threads (J-line) or a flat tip (K-line) only. (2) Methods: 28 implants of each group of the same diameter (4.3 mm) were randomly inserted into porcine bone blocks. The first group (9, 11 and 13 mm) was inserted into “hard”, the second (11 mm) into “soft” bone, here using a normal and an undersized drilling protocol. Insertion torque (Ncm), Periotest® value, resonance frequency (implant stability coefficient, ISQ) and push-out force (N) were measured. (3) Results: In “hard” bone, primary stability increased with increasing length in both groups but it was significantly higher in J-line (p < 0.03). An undersized preparation of the implant bed in “soft” bone resulted in a significant increase in primary stability in both groups. Here, J-line also showed a significantly increased primary stability when compared to equally prepared K-line (insertion torque: 37 Ncm vs. 26 Ncm; Periotest®: −6.5 vs. −4.3; push-out force: 365 N vs. 329 N; p < 0.05 each). (4) Conclusions: Primary stability is significantly higher with increasing implant length and apically located screw threads as well as with undersized drilling protocols. When preparing the implant site and subsequently selecting the implant system, modifying factors such as implant geometry (also at the tip) should be taken into account.


Materials ◽  
2021 ◽  
Vol 14 (2) ◽  
pp. 270
Author(s):  
Ji-Hyun Kim ◽  
Young-Jun Lim ◽  
Bongju Kim ◽  
Jungwon Lee

The aim of the present study was to evaluate correlations between bone density and implant primary stability, considering various determinants such as age, gender, and geometry of implants (design, diameter). Bone density of edentulous posterior maxillae was assessed by computed tomography (CT)-derived Hounsfield units, and implant primary stability values were measured with insertion torque and resonance frequency analysis (RFA). A total of 60 implants in 30 partially edentulous patients were evaluated in the posterior maxilla with two different types of dental implants. The bone density evaluated by CT-derived Hounsfield units showed a significant correlation with primary stability parameters. The bone quality was more influenced by gender rather than age, and the type of implant was insignificant when determining primary stability. Such results imply that primary stability parameters can be used for objective assessment of bone quality, allowing surgical modifications especially in sites suspected of poor bone quality.


Materials ◽  
2020 ◽  
Vol 13 (8) ◽  
pp. 1910 ◽  
Author(s):  
M. Herrero-Climent ◽  
P. López-Jarana ◽  
B. F. Lemos ◽  
F. J. Gil ◽  
C. Falcão ◽  
...  

Post-extractional implants and immediate loading protocols are becoming much more frequent in everyday clinical practice. Given the existing literature about tapered implants, the objective of this paper was to understand whether implant shape had a direct influence on the results of the insertion torque (IT) and implant stability quotient (ISQ). Seven tapered implant prototypes were developed and distributed into three groups and compared with a control cylindrical implant—VEGA by Klockner Implant System. The implants were inserted into bovine bone type III according to Lekholm and Zarb Classification. The sample size was n = 30 for the three groups. Final IT was measured with a torquemeter, and the ISQ was measured with Penguin Resonance Frequency Analysis (RFA). Modifications done to the Prototype I did not reveal higher values of the ISQ and IT when compared to VEGA. In the second group, when comparing the five prototypes (II–VI) with VEGA, it was seen that the values of the ISQ and IT were not always higher, but there were two values of the ISQ that were statistically significantly higher with the 4.0 mm diameter Prototypes II (76.3 ± 6.1) and IV (78 ± 3.7). Prototype VII was the one with higher and significant values of the ISQ and IT. In both diameters and in both variables, all differences were statistically significant enough to achieve the higher values of primary stability values (IT and ISQ). Given the limitations of this study, it can be concluded that when there is an increase of the diameter of the implant and body taper, there is an increase of the ISQ and IT, showing that the diameter of the implant is an important criteria to obtain higher values of primary stability.


Materials ◽  
2019 ◽  
Vol 12 (15) ◽  
pp. 2398 ◽  
Author(s):  
Christian Makary ◽  
Abdallah Menhall ◽  
Carole Zammarie ◽  
Teresa Lombardi ◽  
Seung Yeup Lee ◽  
...  

Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes.


Materials ◽  
2020 ◽  
Vol 13 (24) ◽  
pp. 5615
Author(s):  
Jie Jin ◽  
Gi-Tae Kim ◽  
Jae-Sung Kwon ◽  
Sung-Hwan Choi

Miniscrews have gained recent popularity as temporary anchorage devices in orthodontic treatments, where failure due to sinus perforations or damage to the neighboring roots have increased. Issues regarding miniscrews in insufficient interradicular space must also be resolved. This study aimed to evaluate the primary stability of miniscrews shorter than 6 mm and their feasibility in artificial bone with densities of 30, 40, and 50 pounds per cubic foot (pcf). The primary stability was evaluated by adjusting the intrabony miniscrew length, based on several physical properties: maximum insertion torque (MIT), maximum removal torque (MRT), removal angular momentum (RAM), horizontal resistance, and micromotion. The MIT and micromotion results demonstrated that the intrabony length of a miniscrew significantly affected its stability in low-density cortical bone, unlike cases with a higher cortical bone density (p < 0.05). The horizontal resistance, MRT, and RAM were affected by the intrabony length, regardless of the bone density (p < 0.05). Thus, the primary stability of miniscrews was affected by both the cortical bone density and intrabony length. The effect of the intrabony length was more significant in low-density cortical bone, where the implantation depth increased as more energy was required to remove the miniscrew. This facilitated higher resistance and a lower risk of falling out.


Author(s):  
Bernardo Ferreira Lemos ◽  
Paula Lopez-Jarana ◽  
Carlos Falcao ◽  
Blanca Ríos-Carrasco ◽  
Javier Gil ◽  
...  

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant (p < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.


2021 ◽  
Author(s):  
Rafael Coutinho Mello-Machado ◽  
Suelen Cristina Sartoretto ◽  
Jose Mauro Granjeiro ◽  
José Albuquerque Calasans-Maia ◽  
Marcelo Jose Guedes Pinheiro Uzeda ◽  
...  

Abstract This study aimed to investigate in vivo the hypothesis that the osseodensification technique, through a wider osteotomy, produce healing chambers at the implant-bone interface with no impact on primary stability osseointegration in low-density bone. Twenty implants (3.5 x 10 mm) presenting nanohydroxyapatite (nHA) surface were inserted in the ilium of ten sheep, after preparation of a 2.7-mm wide implant bed with conventional subtractive drilling (SCD) or a 3.8-mm wide implant bed with an osseodensification bur system (OBS) (n = 5/group/period). The final insertion torque (IT) and implant stability quotient (ISQ) evaluated the primary implant stability. After 14 and 28 days, the bone samples containing the implants were processed for histological and histomorphometric evaluation of bone implant contact (BIC) and bone area fraction occupancy (BAFO). No significant differences occurred between the implant bed preparations regarding IT and ISQ (P > 0.05). Histological analysis showed bone remodeling, and bone growth in all samples with no inflammatory infiltrate. BIC values were higher for SCD after 14 and 28 days (p < 0.05), however BAFO values were similar on both groups (p > 0.05). It was possible to conclude that the osseodensification technique allowed a wider implant bed preparation with no prejudice on primary stability and bone remodeling.


Author(s):  
Pawan Kumar ◽  
Reecha Madaan ◽  
Shabir Sidhu

Verbena officinalis L. (Vervain; family-Verbenaceae) has been traditionally used in the treatment of various ailments especially in mental disorders, but no systematic work has been carried out to validate traditional claims of plant. Therefore, it was planned to screen antianxiety activity of extracts and fractions of V. officinalis aerial parts. Crude extracts of V. officinalis aerial parts were prepared by extracting the plant material successively with n-hexane, chloroform, methanol and water. The antianxiety activity of crude extracts was performed at the doses of 200 or 400 mg/kg, p.o., upon acute administration in mice using elevated plus maze model. The bioactive extract was partitioned using ethyl acetate, and ethyl acetate fraction (50 or 100 mg/kg, p.o.) and remaining bioactive extract (150 or 300 mg/kg, p.o.) were also screened for antianxiety activity. The statistical significance was checked by comparing with standard drug and control using one way analysis of variance (ANOVA), which was followed by post hoc analysis – StudentNewman-Keul’s test. The methanol extract and ethyl acetate fraction exhibited significant antianxiety activity at the dose of 400 mg/kg and 100 mg/kg, respectively, with respect to control and statistically equivalent to the standard drug (Diazepam, 2 mg/kg, p.o.). The bioactive ethyl acetate fraction is rich in phenolic compounds and flavonoids. Finally, it is concluded that these are major anxiolytic constituents of V. officinalis.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Nam-Hee Oh ◽  
Eun-Young Kim ◽  
Janghyun Paek ◽  
Yoon-Ah Kook ◽  
Do-Min Jeong ◽  
...  

Introduction. The purpose of this study was to investigate effects of surface treatment of mini-implants in diabetes-induced rabbits by comparing osseointegration around mini-implants.Methods. Twelve New Zealand white rabbits were divided into two groups (alloxan-induced diabetic group and control group). A total of 48 mini-implants were placed after four weeks of diabetic induction. 24 mini-implants were surface-treated with SLA (sandblasted with large grit, and acid etched) and the remaining 24 mini-implants had smooth surfaces. Four weeks after placement, 32 mini-implants were removed from 4 control and 4 diabetic rabbits. Insertion and removal torques were measured. The remaining 16 mini-implants from the two groups were histomorphometrically analyzed.Results. Maximum insertion torque showed no difference between diabetic and control groups, but total insertion energy was higher in control group. In surface-treated mini-implants, maximum removal torque was higher in both diabetic and control groups. Bone-implant contact (BIC) was increased in the control group when compared to the diabetic group. Surface-treated group had higher BIC than smooth surface group in both control and diabetic groups. However, there was no significantly statistical difference.Conclusions. Type 1 diabetes mellitus and surface treatment method of mini-implant affected primary stability of mini-implants. In addition, the use of orthodontic mini-implants in a diabetic patient is likely to show results similar to the healthy patient.


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