scholarly journals A novel fully tapered, self-cutting tissue-level implant: non-inferiority study in minipigs

Author(s):  
Edgard El Chaar ◽  
Algirdas Puisys ◽  
Itai Sabbag ◽  
Benjamin Bellón ◽  
Aikaterini Georgantza ◽  
...  

Abstract Objectives To assess the osseointegration and crestal bone level maintenance of a novel fully tapered self-cutting tissue-level implant for immediate placement (test) compared to a clinically established tissue-level implant (control) in moderate bone quality. Materials and methods Test and control implants were compared in 3 groups, i.e., small-, medium-, and large-diameter implants in an edentulous mandibular minipig model with moderate bone quality after 12 weeks of healing. Histometrically derived bone-to-implant contact (BIC) and first bone-to-implant contact (fBIC) were subjected to statistical non-inferiority testing. Maximum insertion torque values in artificial bone were assessed for comparison. Results BIC values for the tests and control implants for all 3 diameters were comparable and non-inferior: small diameter (61.30 ± 10.63% vs. 54.46 ± 18.31%) (p=0.99), medium diameter (60.91 ± 14.42 vs. 54.68 ± 9.16) (p=0.55), and large diameter (45.60 ± 14.67 vs. 52.52 ± 14.76) (p=0.31). fBIC values for test implants were higher and non-inferior compared to control implants in all three groups. Test implants further showed distinctly higher maximum insertion torque values compared to control implants. Conclusion The investigated novel tissue-level implant is able to achieve high levels of primary and secondary implant stability under simultaneous preservation of crestal bone levels. This qualifies the studied implant as an attractive candidate for immediate placement in bone of limited quality. Clinical relevance This pilot pre-clinical study investigated a novel tissue-level implant for immediate placement. With the aim of translating the studied prototype into clinical application pre-clinical models, procedures and controls have been chosen with the aim of reflecting its future clinical indication and use.

2008 ◽  
Vol 78 (6) ◽  
pp. 1065-1070 ◽  
Author(s):  
Benedict Wilmes ◽  
Yu-Yu Su ◽  
Dieter Drescher

Abstract Objective: To analyze the impact of the insertion angle on the primary stability of mini-implants. Materials and Methods: A total of 28 ilium bone segments of pigs were embedded in resin. Two different mini-implant sizes (Dual-Top Screw 1.6 × 8 mm and 2.0 × 10 mm) were inserted at seven different angles (30°, 40°, 50°, 60°, 70°, 80°, and 90°). The insertion torque was recorded to assess primary stability. In each bone, five Dual-Top Screws were used to compensate for differences in local bone quality. Results: The angle of mini-implant insertion had a significant impact on primary stability. The highest insertion torque values were measured at angles between 60° and 70° (63.8° for Dual-Top 1.6 mm and 66.7° for Dual-Top 2.0 mm). Very oblique insertion angles (30°) resulted in reduced primary stability. Conclusions: To achieve the best primary stability, an insertion angle ranging from 60° to 70° is advisable. If the available space between two adjacent roots is small, a more oblique direction of insertion seems to be favorable to minimize the risk of root contact.


2015 ◽  
Vol 41 (4) ◽  
pp. 407-413 ◽  
Author(s):  
Eduardo Rolim Teixeira ◽  
Marco Antônio Rambo Osório Torres ◽  
Kleber Ricardo Monteiro Meyer ◽  
Sabrina Rebollo Zani ◽  
Rosemary Sadami Arai Shinkai ◽  
...  

Evaluation of the influence of laser application on osseointegration around implants with different surface characteristics is limited. This study aims to evaluate the influence of low-level lasers on the early stages of osseointegration. Ninety-six external hex implants (3.75 mm × 5.0 mm) were placed in 24 rabbits—one machined and one sandblasted acid-etched per tibia. The rabbits were later divided into the laser group, which received a total dose of 24 J/cm2 of gallium-aluminum-arsenide laser over 15 days, and a control group. At 16 and 30 days after surgery, removal torque and histomorphometric analyses were performed. No statistical differences in removal torque or histomorphometric analyses were verified between laser and control groups regardless of implant surface (P > .05). Time was the only variable presenting significant differences between measurements (P < .05). Low-level laser had no significant short-term effect on bone-to-implant contact and removal torque values regardless of implant surface characteristics.


2014 ◽  
Vol 71 (5) ◽  
pp. 451-461 ◽  
Author(s):  
Rafael Delgado-Ruíz ◽  
Aleksa Markovic ◽  
Luís Calvo-Guirado ◽  
Zoran Lazic ◽  
Adriano Piattelli ◽  
...  

Background/Aim. The modification of implant surfaces could affect mechanical implant stability as well as dynamics and quality of peri-implant bone healing. The aim of this 3-month experimental study in dogs was to investigate implant stability, marginal bone levels and bone tissue response to zirconia dental implants with two laser-micro-grooved intraosseous surfaces in comparison with nongrooved sandblasted zirconia and sandblasted, high-temperature etched titanium implants. Methods. Implant surface characterization was performed using optical interferometric profilometry and energy dispersive X-ray spectroscopy. A total of 96 implants (4 mm in diameter and 10 mm in length) were inserted randomly in both sides of the lower jaw of 12 Fox Hound dogs divided into groups of 24 each: the control (titanium), the group A (sandblasted zirconia), the group B (sandblasted zirconia plus microgrooved neck) and the group C (sandblasted zirconia plus all microgrooved). All the implants were immediately loaded. Insertion torque, periotest values, radiographic crestal bone level and removal torque were recorded during the 3-month follow-up. Qualitative scanning electon micro-scope (SEM) analysis of the bone-implant interfaces of each group was performed. Results. Insertion torque values were higher in the group C and control implants (p < 0.05). Perio-test values increased in all the periods in proportion to the ex-tent of microgrooving as follows: the group C > the control > the group B > the group A (p < 0.05). Radiographic measurements showed minimal crestal bone loss at 3 months for microgrooved zirconia implants (groups C and B) and control implants compared with the group A implants (p < 0.05). The removal torque values increased with time for all the groups as follows: the group C > the control > the group B > the group A (p < 0.05). SEM showed that implant surfaces of the groups B and C had an extra bone growth inside the microgrooves that corresponded to the shape and direction of the microgrooves. Conclusion. The addition of micro-grooves to the entire intraosseous surface of zirconia dental implants enhances primary and secondary implant stability, promotes bone tissue ingrowth and preserves crestal bone levels.


2021 ◽  
Vol 12 (1) ◽  
pp. 291
Author(s):  
Virgilia Klär ◽  
Matthias Karl ◽  
Tanja Grobecker-Karl

Besides alveolar bone quality, the drilling protocol applied in conjunction with the design of an implant are the major determinants of primary implant stability. Surgical trauma and bone compression resulting from implant insertion may constitute one cause for marginal bone resorption. Inserting two current bone-level implant designs (Astra; Straumann; n = 5) in bovine ribs, primary stability, strain development on the buccal bone plate and histologic signs of bone damage were recorded. Besides comparing the implant designs (Welch t-tests), all measurement parameters were checked for potential correlations (Pearson product moment correlation coefficients) with the level of significance set at α = 0.05. Considerable numbers of crack formation and plastic deformation of bone were observed after implant insertion. Straumann implants showed slightly greater values for insertion torque (p = 0.772), strain development (p = 0.893) and implant stability (p = 0.642). Significantly greater bone to implant contact (cortical p = 0.014; trabecular p = 0.016) was observed in Straumann implants, while Astra implants caused a significantly greater number of microcracks in cortical bone (p = 0.020). In Straumann implants, insertion torque correlated with bone to implant contact in the cortical area (p = 0.029) and the number of macrocracks in trabecular bone correlated with bone to implant contact (p = 0.029). In Astra implants, insertion torque and bone to implant contact in the trabecular area correlated (p = 0.007) as well as the number of macrocracks in trabecular bone and implant stability (p = 0.016). Additionally, in the area of cortical bone, the number of macrocracks correlated with bone to implant contact (p = 0.019). Implant placement results in bone damage of varying magnitude, which is governed by the drill protocol, implant macrodesign and bone quality.


2020 ◽  
Vol 46 (3) ◽  
pp. 182-189 ◽  
Author(s):  
Davide Farronato ◽  
Mattia Manfredini ◽  
Michele Stocchero ◽  
Mattia Caccia ◽  
Lorenzo Azzi ◽  
...  

The aim of this study was to evaluate the influence of bone quality, drilling technique, implant diameter, and implant length on insertion torque (IT) and resonance frequency analysis (RFA) of a prototype-tapered implant with knife-edge threads. The investigators hypothesized that IT would be affected by variations in bone quality and drilling protocol, whereas RFA would be less influenced by such variables. The investigators implemented an in vitro experiment in which a prototype implant was inserted with different testing conditions into rigid polyurethane foam blocks. The independent variables were: bone quality, drilling protocol, implant diameter, and implant length. Group A implants were inserted with a conventional drilling protocol, whereas Group B implants were inserted with an undersized drilling protocol. Values of IT and RFA were measured at implant installation. IT and RFA values were significantly correlated (Pearson correlation coefficient: 0.54). A multivariable analysis showed a strong model. Higher IT values were associated with drilling protocol B vs A (mean difference: 71.7 Ncm), implant length (3.6 Ncm increase per mm in length), and substrate density (0.199 Ncm increase per mg/cm3 in density). Higher RFA values were associated with drilling protocol B vs A (mean difference: 3.9), implant length (1.0 increase per mm in length), and substrate density (0.032 increase per mg/cm3 in density). Implant diameter was not associated with RFA or IT. Within the limitations of an in vitro study, the results of this study suggest that the studied implant can achieve good level of primary stability in terms of IT and RFA. A strong correlation was found between values of IT and RFA. Both parameters are influenced by the drilling protocol, implant length, and substrate density. Further studies are required to investigate the clinical response in primary stability and marginal bone response.


1995 ◽  
Vol 74 (3) ◽  
pp. 1362-1366 ◽  
Author(s):  
J. A. Huwe ◽  
E. H. Peterson

1. We visualized the central axons of 32 vestibular afferents from the posterior canal by extracellular application of horseradish peroxidase, reconstructed them in three dimensions, and quantified their morphology. Here we compare the descending limbs of central axons that differ in parent axon diameter. 2. The brain stem distribution of descending limb terminals (collaterals and associated varicosities) varies systematically with parent axon diameter. Large-diameter afferents concentrate their terminals in rostral regions of the medial/descending nuclei. As axon diameter decreases, there is a significant shift of terminal concentration toward the caudal vestibular complex and adjacent brain stem. 3. Rostral and caudal regions of the medial/descending nuclei have different labyrinthine, cerebellar, intrinsic, commissural, and spinal connections; they are believed to play different roles in head movement control. Our data help clarify the functions of large- and small-diameter afferents by showing that they contribute differentially to rostral and caudal vestibular complex.


Author(s):  
Ingrid Kästel ◽  
Giles de Quincey ◽  
Jörg Neugebauer ◽  
Robert Sader ◽  
Peter Gehrke

Abstract Background There is disagreement about the optimal torque for tightening smartpegs for resonance frequency analysis (RFA). Subjective finger pressure during hand tightening could affect the reliability of the resulting values. The aim of the current study was therefore to assess whether or not the insertion torque of a smartpeg magnetic device influences the implant stability quotient (ISQ) value during RFA. Methods Thirty self-tapping screw implants (XiVE S, Dentsply Sirona Implants, Bensheim, Germany) with a diameter of 3.8 mm and a length of 11 mm were inserted in three cow ribs with a bone quality of D1. The RFA value of each implant was measured (Ostell, FA W&H Dentalwerk, Bürmoos, Austria) in two orthogonal directions (mesial and buccal) after tightening the corresponding smartpeg type 45 with a mechanically defined value of 5 Ncm (Meg Torq device, Megagen, Daegu, South Korea) (test). Additionally, 4 different examiners measured the RFA after hand tightening the smartpegs, and the results were compared (control). Insertion torque values were determined by measuring the unscrew torque of hand seated smartpegs (Tohnichi Manufacturing Co. Ltd, Tokyo, Japan). Results The ISQ values varied from 2 to 11 Ncm by hand tightening and from 2 to 6 Ncm by machine tightening. The comparison of hand and machine tightening of smartpegs displayed only minor differences in the mean ISQ values with low standard deviations (mesial 79.76 ± 2,11, buccal 77.98 ± 2,) and no statistical difference (mesial p = 0,343 and buccal p = 0,890). Conclusions Manual tightening of smartpeg transducers allows for an objective and reliable determination of ISQ values during RFA.


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.


Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1015
Author(s):  
Antonio Bulum ◽  
Gordana Ivanac ◽  
Eugen Divjak ◽  
Iva Biondić Špoljar ◽  
Martina Džoić Dominković ◽  
...  

Shear wave elastography (SWE) is a type of ultrasound elastography with which the elastic properties of breast tissues can be quantitatively assessed. The purpose of this study was to determine the impact of different regions of interest (ROI) and lesion size on the performance of SWE in differentiating malignant breast lesions. The study included 150 female patients with histopathologically confirmed malignant breast lesions. Minimal (Emin), mean (Emean), maximal (Emax) elastic modulus and elasticity ratio (e-ratio) values were measured using a circular ROI size of 2, 4 and 6 mm diameters and the lesions were divided into large (diameter ≥ 15 mm) and small (diameter < 15 mm). Highest Emin, Emean and e-ratio values and lowest variability were observed when using the 2 mm ROI. Emax values did not differ between different ROI sizes. Larger lesions had significantly higher Emean and Emax values, but there was no difference in e-ratio values between lesions of different sizes. In conclusion, when measuring the Emin, Emean and e-ratio of malignant breast lesions using SWE the smallest possible ROI size should be used regardless of lesion size. ROI size has no impact on Emax values while lesion size has no impact on e-ratio values.


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