Tissue reaction to novel customized calcium silicate cement based dental implants. A pilot study in the dog

Abstract Objectives The purpose of this study was to determine the level of periodontal tissue regeneration in a canine model following post-extraction placement of an implant molded from a composite material made from extracted tooth dentin and a calcium silicate cement (CSC) material. The investigation used autologous dentin in conjunction with a CSC material to form a composite implant designed for immediate tooth replacement. Methods Two (2) beagles had a periodontal and radiographic examination performed to rule out any pre-treatment inflammation, significant periodontal disease, or mobility. Then, ination eleven (11) teeth were extracted and polyvinyl siloxane molds were made to fabricate three different types of implants: Particulate Implant (Test Group 1, n = 4), Shell Implant Alone (Test Group 2, n = 2), Shell Implant with Emdogain® (Test Group 3, n = 3). Teeth in the control group were extracted, scaled (n = 2), and then re-implanted into their respective fresh extraction sockets. At 4 weeks, a clinical, radiographic, and histologic assessment was performed. Results Clinical evaluation revealed no mobility in any of the test or control implants and no radiographic evidence of significant bone loss or active disease. Based on the MicroCT analysis, direct bone to implant contact was observed in some areas with an apparent periodontal ligament space. Implant-related inflammation, on average, was similar among all groups, with low numbers of infiltrates. Implant-related inflammatory reaction was generally minimal and not interpreted to be adverse. Conclusion The proposed novel composite materials revealed that not only do these materials demonstrate high biocompatibility, but also their successful integration in the alveolus is likely secondary to a partial ligamentous attachment. The current investigation may lead to the use of calcium silicate-based materials as custom dental implants. Further research on this novel composite’s biomechanical properties is necessary to develop the optimal material composition for use as a load-bearing dental implant.

Download Full-text

The Bone Buttress Theory: The Effect of the Mechanical Loading of Bone on the Osseointegration of Dental Implants

Biology ◽

10.3390/biology10010012 ◽

2020 ◽

Vol 10 (1) ◽

pp. 12

Author(s):

David Chavarri-Prado ◽

Aritza Brizuela-Velasco ◽

Ángel Álvarez-Arenal ◽

Markel Dieguez-Pereira ◽

Esteban Pérez-Pevida ◽

...

Keyword(s):

Dental Implants ◽

Mechanical Loading ◽

Bone Growth ◽

Bone Matrix ◽

Test Group ◽

Control Group ◽

Group A ◽

Bone To Implant Contact ◽

The Stability ◽

Group B

Objectives: To determine the effect of mechanical loading of bone on the stability and histomorphometric variables of the osseointegration of dental implants using an experimental test in an animal model. Materials and Methods: A total of 4 human implants were placed in both tibiae of 10 New Zealand rabbits (n = 40). A 6-week osseointegration was considered, and the rabbits were randomly assigned to two groups: Group A (Test group) included 5 rabbits that ran on a treadmill for 20 min daily during the osseointegration period; Group B (Controls) included the other 5 that were housed conventionally. The monitored variables were related to the primary and secondary stability of the dental implants (implant stability quotient—ISQ), vertical bone growth, bone to implant contact (BIC), area of regenerated bone and the percentage of immature matrix. Results: The results of the study show a greater vertical bone growth (Group A 1.26 ± 0.48 mm, Group B 0.32 ± 0.47 mm, p < 0.001), higher ISQ values (Group A 11.25 ± 6.10 ISQ, 15.73%; Group B 5.80 ± 5.97 ISQ, 7.99%, p = 0.006) and a higher BIC (Group A 19.37%, Group B 23.60%, p = 0.0058) for implants in the test group, with statistically significant differences. A higher percentage of immature bone matrix was observed for implants in the control group (20.68 ± 9.53) than those in the test group (15.38 ± 8.84) (p = 0.108). A larger area of regenerated bone was also observed for the test implants (Group A 280.50 ± 125.40 mm2, Group B 228.00 ± 141.40 mm2), but it was not statistically significant (p = 0.121). Conclusions: The mechanical loading of bone improves the stability and the histomorphometric variables of the osseointegration of dental implants.

Download Full-text

Enhancement of Bone Ingrowth into a Porous Titanium Structure to Improve Osseointegration of Dental Implants: A Pilot Study in the Canine Model

Materials ◽

10.3390/ma13143061 ◽

2020 ◽

Vol 13 (14) ◽

pp. 3061 ◽

Cited By ~ 2

Author(s):

Ji-Youn Hong ◽

Seok-Yeong Ko ◽

Wonsik Lee ◽

Yun-Young Chang ◽

Su-Hwan Kim ◽

...

Keyword(s):

Porous Structure ◽

Dental Implants ◽

Bone Growth ◽

Bone Ingrowth ◽

Test Group ◽

Porous Titanium ◽

Control Group ◽

Machined Surface ◽

Significant Difference ◽

Titanium Structure

A porous titanium structure was suggested to improve implant stability in the early healing period or in poor bone quality. This study investigated the effect of a porous structure on the osseointegration of dental implants. A total of 28 implants (14 implants in each group) were placed in the posterior mandibles of four beagle dogs at 3 months after extraction. The control group included machined surface implants with an external implant–abutment connection, whereas test group implants had a porous titanium structure added to the apical portion. Resonance frequency analysis (RFA); removal torque values (RTV); and surface topographic and histometric parameters including bone-to-implant contact length and ratio, inter-thread bone area and ratio in total, and the coronal and apical parts of the implants were measured after 4 weeks of healing. RTV showed a significant difference between the groups after 4 weeks of healing (p = 0.032), whereas no difference was observed in RFA. In the test group, surface topography showed bone tissue integrated into the porous structures. In the apical part of the test group, all the histometric parameters exhibited significant increases compared to the control group. Within the limitations of this study, enhanced bone growth into the porous structure was achieved, which consequently improved osseointegration of the implant.

Download Full-text

Clinical and Radiological Evaluation of Marginal Bone Loss around Dental Implants Restored with Zirconium vis-à-vis Porcelain Fused to Metal: An In Vivo Study

Dental Journal of Advance Studies ◽

10.1055/s-0040-1709094 ◽

2020 ◽

Vol 08 (01) ◽

pp. 17-21

Author(s):

Udey Singh Wirring ◽

Tarun Kalra ◽

Manjit Kumar ◽

Ajay Bansal ◽

Aquib Javaid

Keyword(s):

Bone Loss ◽

Dental Implants ◽

Test Group ◽

Radiographic Evaluation ◽

Control Group ◽

Marginal Bone Loss ◽

Zirconia Crowns ◽

Bone Level ◽

The Difference

Abstract Introduction Marginal bone level is the criterion for implant success. Patient expectations for more natural looking implant restorations created the need to restore implants with more esthetically pleasing materials like Zirconia rather than conventional porcelain-fused to-metal (PFM) crowns. The aim of this study was to evaluate marginal bone loss around dental implants clinically and radiographically when restored with Zirconia and PFM prosthesis. Materials and Methods Two groups (control and test) were formed with 14 patients each. In the control group, the subjects were rehabilitated with PFM crowns and in the test group, the subjects were rehabilitated with Zirconia crowns. Rehabilitation was done after the healing period of 3 months. Radiographic evaluation was done at regular (baseline, 3rd, 6th, and 12th month) intervals. Results The results were statistically analyzed. Keeping in mind the limitations of the study, it was revealed that the difference in the crestal bone resorption in both the groups was not significant.

Download Full-text

Characterization of the Cellular Reaction to a Collagen-Based Matrix: An In Vivo Histological and Histomorphometrical Analysis

Materials ◽

10.3390/ma13122730 ◽

2020 ◽

Vol 13 (12) ◽

pp. 2730 ◽

Cited By ~ 1

Author(s):

Samuel Ebele Udeabor ◽

Carlos Herrera-Vizcaíno ◽

Robert Sader ◽

C. James Kirkpatrick ◽

Sarah Al-Maawi ◽

...

Keyword(s):

Mononuclear Cells ◽

Ex Vivo ◽

Test Group ◽

Tissue Reaction ◽

Implantation Site ◽

Control Group ◽

The Matrix ◽

Tissue Reactions ◽

Post Implantation

The permeability and inflammatory tissue reaction to Mucomaix® matrix (MM), a non- cross-linked collagen-based matrix was evaluated in both ex vivo and in vivo settings. Liquid platelet rich fibrin (PRF), a blood concentrate system, was used to assess its capacity to absorb human proteins and interact with blood cells ex vivo. In the in vivo aspect, 12 Wister rats had MM implanted subcutaneously, whereas another 12 rats (control) were sham-operated without biomaterial implantation. On days 3, 15 and 30, explantation was completed (four rats per time-point) to evaluate the tissue reactions to the matrix. Data collected were statistically analyzed using analysis of variance (ANOVA) and Tukey multiple comparisons tests (GraphPad Prism 8). The matrix absorbed the liquid PRF in the ex vivo study. Day 3 post-implantation revealed mild tissue inflammatory reaction with presence of mononuclear cells in the implantation site and on the biomaterial surface (mostly CD68-positive macrophages). The control group at this stage had more mononuclear cells than the test group. From day 15, multinucleated giant cells (MNGCs) were seen in the implantation site and the outer third of the matrix with marked increase on day 30 and spread to the matrix core. The presence of these CD68-positive MNGCs was associated with significant matrix vascularization. The matrix degraded significantly over the study period, but its core was still visible as of day 30 post-implantation. The high permeability and fast degradation properties of MM were highlighted.

Download Full-text

Peri-Implant Behavior of Sloped Shoulder Dental Implants Used for All-On-Four Protocols: An Histomorphometric Analysis in Dogs

Materials ◽

10.3390/ma11010119 ◽

2018 ◽

Vol 11 (1) ◽

pp. 119 ◽

Cited By ~ 1

Author(s):

Jose Calvo Guirado ◽

Aldo Lucero-Sánchez ◽

Ana Boquete Castro ◽

Marcus Abboud ◽

Sergio Gehrke ◽

...

Keyword(s):

Soft Tissue ◽

Bone Loss ◽

Dental Implants ◽

Test Group ◽

Control Group ◽

Histomorphometric Analysis ◽

Tissue Thickness ◽

Marginal Bone Loss ◽

Soft Tissue Thickness ◽

The Mean

The aim of this study was to evaluate the soft tissue thickness and marginal bone loss around dental implants with sloped micro-threaded shoulder (30° angle) in comparing with conventional design, inserted 30° degrees angulated in post extraction sockets and immediate loaded with temporary prosthesis simulating the all-on-four protocol. Materials and Methods: Six fox hound dogs received forty-eight post extraction dental implants with the different diameter and length (Medentika, Germany), but with different neck configurations. Two group of implants were inserted 1mm subcrestal. Control group has a micro-threaded neck and the Test group has a sloped microthreaded neck. Immediate loading was applied using a constructed metallic structure. After three months, soft and hard tissue levels were assessed by histomorphometric analysis. Results: The mean soft tissue thickness (STT) was 2.5 ± 0.2 mm for the Control group and 3.3 ± 0.3 mm for Test group (p = 0.036), meanwhile the mean marginal bone loss (MBL) was 1.53 ± 0.34 mm for Control group and, 1.62 ± 0.22 mm for Test group (p > 0.05). Conclusions: Within the limitations of this experimental model in dogs, the findings showed that dental implants with microthreaded and microthreaded sloped necks installed in immediate post extraction sites with immediate load, presented a comparable perimplant tissue behavior.

Download Full-text

Synergistic Effects of Growth Factor, Bone Graft, and Resorbable Barrier Membrane in Management of Dehiscence and Fenestration of Dental Implants

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1434 ◽

2017 ◽

Vol 8 (3) ◽

pp. 177-182

Author(s):

Umesh P Verma

Keyword(s):

Growth Factor ◽

Bone Graft ◽

Dental Implants ◽

Synergistic Effects ◽

Test Group ◽

Control Group ◽

Barrier Membrane ◽

Group I ◽

Significant Difference ◽

Group Ii

ABSTRACT Aim The present study was primarily designed to evaluate the outcome of guided bone graft regeneration in peri-implant defects by combining recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and granules of beta-tricalcium phosphate (B-TCP) mounted by resorbable biomesh membrane. Secondary objective was to determine the value of resorbable barrier membrane to improve the efficacy of the growth factormediated regeneration. Materials and methods A randomized controlled study comprised 14 participants (8 males and 6 females, mean age 37 years, range 19—55 years), in which a total of 15 implants (10 in maxilla and 5 in the mandible) were placed. Fifteen implant sites were randomly divided by picking a code into three groups: Test group I (n = 5) ß-TCP + rhPDGF (0.3 mg/mL) + biomesh, test group II (n = 5) ß-TCP + rhPDGF, and control (n = 5) ß-TCP + biomesh. The experimental site was examined clinically for the gingival status and radiographically for the bone status. Results Statistically significant difference in preoperative and postoperative measurements was observed for test groups I and II in all the parameters except width; in contrast, there was no significant difference observed for the control group from baseline to 5 months postoperatively. On intergroup comparison, statistically significant difference was observed between test group I vs control group and test group II vs control group, but it was not significant between test groups I and II, which was further confirmed using global performance scale score. Conclusion It concluded that rhPDGF-BB and ß-TCP mounted by resorbable biomesh membrane played a synergistic role in the management of peri-implant defects. Clinical significance Bone regenerated using ß-TCP with rhPDGF-BB in the reversal of peri-implant defects. How to cite this article Arora R, Verma UP, Dixit J, Lal N. Synergistic Effects of Growth Factor, Bone Graft, and Resorbable Barrier Membrane in Management of Dehiscence and Fenestration of Dental Implants. World J Dent 2017;8(3):177-182.

Download Full-text

The Response of the Pulp-Dentine Complex, PDL, and Bone to Three Calcium Silicate-Based Cements: A Histological Study in an Animal Rat Model

Bioinorganic Chemistry and Applications ◽

10.1155/2020/9582165 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Ranjdar Mahmood Talabani ◽

Balkees Taha Garib ◽

Reza Masaeli

Keyword(s):

Inflammatory Response ◽

Calcium Silicate ◽

Histological Study ◽

Healing Process ◽

Mineral Trioxide Aggregate ◽

Experimental Period ◽

Tissue Reaction ◽

Cortical Plate ◽

Control Group ◽

Albino Rats

Objective. The aim of this study was to histologically examine the tissue reaction of three different calcium silicate cements in the closure of perforations in rat incisor teeth. Material and Methods. An experimental lateral root perforation with pulp exposure was performed in 32 lower incisors of 16 male Wistar albino rats. They were randomly assigned into three test groups (each including eight teeth) that were filled either by Biodentine (BD) or MicroMega mineral trioxide aggregate (MM-MTA) or EndoSequence root repair material putty (ESRRM putty), besides eight unperforated incisors from the other four rats (control group). The inflammatory response and healing process were evaluated histologically and scored after one and four weeks. Differences among groups were tested by Kruskal–Wallis tests at P≤0.05. Results. In the first week, BD produced more inflammatory response in the pulpal (score 3) than other materials (score 2). Only ESRRM putty showed odontoblast-like cells in 50%, 25% dentine-like deposit, 25% evidence of bone deposition in the drilling site (score 2), and minimum periodontal ligament (PDL) necrosis and disorganization (25%, score 2). After one month, all groups had healthy pulpal tissue, but 25% of ESRRM putty retained score 1 inflammatory response, and 50% of the BD case had an incomplete palisading odontoblast layer (score 3). A thick and regular dentine bridge deposition was seen in the ESRRM putty group in comparison with MM-MTA and BD cases. The cortical plate healing in all ESRRM putty samples was complete (score 3), while an incomplete closure was seen in MM-MTA and BD groups (score 2). Both the MM-MTA and ESRRM putty groups had fully organized PDL (score 2), while in 50% of BD cases, a necrotizing area and disorganized PDL with inflammatory cells infiltration were still present. Statistically significant differences in the scores of any histologic parameters among the three tested materials were observed neither in the 1st nor in the 4th weeks of the experimental period. Conclusion. Better tissue compatibility and repair of pulpal and periodontal tissue have been detected after lateral perforation in the root of rat incisors when treated with ESRRM putty than MM-MTA and BD. However, the difference was not significant.

Download Full-text

Clinical, Histomorphometric and Radiographic Evaluation of Dental Extraction Sockets Treated with Autologous Stem Cells

Blood ◽

10.1182/blood.v116.21.2398.2398 ◽

2010 ◽

Vol 116 (21) ◽

pp. 2398-2398

Author(s):

André Pelegrini ◽

Maria Elvira P Corrêa ◽

Thiago Oliveira ◽

Carmino De Souza ◽

José Francisco Marques

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Bone Loss ◽

Dental Implants ◽

Tooth Extraction ◽

Alveolar Bone ◽

Test Group ◽

Autologous Bone Marrow ◽

Control Group ◽

Autologous Bone

Abstract Abstract 2398 Introduction: Autologous bone marrow has mesenchymals stem cells that can differentiate into osteoblasts. Therefore, the use of these cells in bone reconstruction therapy is becaming promising. Purpose: The first aim of this study was to evaluate the potential of autologous bone marrow graft aspirate containing mesenchymal stem cells in preserving the alveolar ridges following tooth extraction. A second aim was to clinically and radiographically evaluate the outcomes of dental implants installed in the healed sockets after one year in function. Methods: 13 healthy patients requiring upper anterior teeth extractions were enrolled in this study. They were randomized into two groups: Test group: 7 patients (n = 15 teeth); Control group: 6 patients (n = 15 teeth). 5 ml of autologous bone marrow from the iliac posterior crest were collected by haematologists immediately before the extractions and it was placed in alveolar sockets right after the teeth extractions in the test group. Nothing was grafted in the control sites. Following tooth extraction and evaluation of a buccal full-thickness flap, titanium screws were positioned throughout the buccal to the palatal plate and were used as reference points for measuring purposes. After 6 months, the sites were re-opened and bone loss measurements for thickness and height were taken. Additionally, prior to implant placement, bone cores were harvested and prepared for histologic and histomorphometric evaluation. Data of clinical probing and radiographic analysis were done in all sites after 1 year of follow up. Results: The test group had better results in preserving alveolar ridges for thickness showing 1.14+0.87mm of bone loss compared with the control group that showed 2.46+0.4mm (P<0.05). The test group showed also a less height of bone loss on the buccal plate, 0.62+0.51 and 1.17+0.26mm, respectively (P<0.05). Complimentary procedures were required before install the implants in five sites in the control group, but not, in the test group. The histomorphometric analysis showed similar amounts of mineralized bone in both control and test groups, 42.87+11.33% and 45.47+7.21% respectively (P>0,05). The results of 1 year clinical probing follow-up showed deeper probing depths around the control group dental implants when compared to the test group, 4.45+1.58mm and 3.78+1.58mm, respectively (P< 0,05). Radiographic analysis showed more marginal bone level loss in the control group when compared to test group, 3.44+3.39mm and 1.05+0.9mm, respectively (P<0,05). Conclusion: These findings suggest that the autologous bone marrow graft can contribute to alveolar bone repair after tooth extraction and can also minimize the dental implants attachment loss. This study indicate that the participation of mesenchymal stem cell in the alveolar bone healing should be better understanding to explain this process of repairement. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

The Impact of Nandrolone Decanoate in the Osseointegration of Dental Implants in a Rabbit Model: Histological and Micro-Radiographic Results

Materials ◽

10.3390/ma14092258 ◽

2021 ◽

Vol 14 (9) ◽

pp. 2258

Author(s):

Saturnino Marco Lupi ◽

Alessandra Nicole Sassi ◽

Alessandro Addis ◽

Ruggero Rodriguez y Baena

Keyword(s):

Dental Implants ◽

Bone Fractures ◽

Rabbit Model ◽

Test Group ◽

Control Group ◽

Clinical Effects ◽

Nandrolone Decanoate ◽

Implant Placement ◽

Increased Risk ◽

The Impact

Despite high rates of osseointegration in healthy patients, complex cases present an increased risk of osseointegration failure when treated with dental implants. Furthermore, if immediate loading of the implants is used, maximizing the response of the host organism would be desirable. Anabolic steroids, such as Nandrolone Decanoate (ND), are reported to have beneficial clinical effects on various bone issues such as osteoporosis and bone fractures. However, their beneficial effects in promoting osseointegration in dental implant placement have not been documented. The study aimed to examine histological changes induced by ND in experimental dental implants in rabbit models. Two dental implants were placed in the tibias of 24 adult rabbits. Rabbits were allocated to one of two groups: control group or test group. Rabbits in the latter group were given nandrolone decanoate (15 mg/kg, immediately after implant placement and after 1 week). Micro-radiographic and histological analyses were assessed to characterize the morphological changes promoted by the nandrolone decanoate use. Total bone volume and fluorescence were significantly higher in the control group after 2 weeks. Such a difference between the two groups might indicate that, initially, nandrolone lengthens the non-specific healing period characteristic of all bone surgeries. However, after the beginning of the reparative processes, the quantity of newly formed bone appears to be significantly higher, indicating a positive stimulation of the androgen molecule on bone metabolism. Based on micro-radiology and fluorescence microscopy, nandrolone decanoate influenced bone regeneration in the implant site. The anabolic steroid nandrolone decanoate affects the healing processes of the peri-implant bone and therefore has the potential to improve the outcomes of implant treatment in medically complex patients.

Download Full-text

Effect of 0.1% Genipin as a Crosslinking Agent to Degradability of Platelet Rich Fibrin (PRF)

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.829.258 ◽

2019 ◽

Vol 829 ◽

pp. 258-262

Author(s):

Sulistiawati ◽

Yanti Rusyanti ◽

Ina Hendiani ◽

Mas Rizky Anggun Adipurna Syamsunarno ◽

Zavani Nur Hikmah

Keyword(s):

Enzymatic Degradation ◽

Crosslinking Agent ◽

Test Group ◽

Biomechanical Properties ◽

Primary Amines ◽

Control Group ◽

Regenerative Therapy ◽

Platelet Rich Fibrin ◽

Barrier Membrane ◽

Degradation Degree

Platelet-rich fibrin (PRF) was developed as a barrier membrane in periodontal regenerative therapy. It is known that PRF has a sustained released of growth factor and expected to facilitate the tissue regeneration. Since the PRF membranes have a rapid degradability (1-2 weeks), the regenerative therapy using a PRF membrane should be increased to reduce the degradability using a crosslinking agent which could provide resistance against enzymatic degradation. The aim of this study is to analyze the effect of 0.1% genipin as a crosslinking agent to degradability of PRF. PRF membranes were prepared from 20cc blood of healthy donors and immersed in 0.1% genipin solution as a test group and Phosphate Buffer Saline (PBS) solution as a control group for 2 hours and 72 hours. In order to evaluate degradability, the sample was subjected to 0.01% trypsin. Samples were weighed and the trypsin solution was refreshed every 24 hours. The difference weight represents enzymatic degradation. Degradation degree of sample PRF-crosslinked genipin 0.1% significantly decreased when it compared to the control group. Genipin reacts with primary amines in fibrin, performed a covalent coupling that improves the degradability resistance. This crosslink had to be effective to improve biomechanical properties of PRF as a membrane. This study demonstrated that 0.1% genipin as a crosslinking agent could reduce the degradation-degree of PRF.

Download Full-text