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 Dental implants characteristics, stability and designs

2018 ◽  
Vol 5 (10) ◽  
pp. 4625
Author(s):  
Alaa Almalki ◽  
Mohammed Albati ◽  
Mohammed Alhijaili ◽  
Ahmad Hariri ◽  
Hydar Alnowaisser ◽  
...  
Keyword(s):  
Dental Implants ◽  
Body Shape ◽  
Daily Routine ◽  
Dental Practice ◽  
Implant Stability ◽  
Dental Implantation ◽  
Implant Size ◽  
Natural Teeth ◽  
Considerable Impact

One of the recent advances in the field of dentistry is to provide prothesis that can replace lost natural teeth. Over several decades, researches were endeavouring to create dental implants with optimized criteria that allow long-term function and stability. After notable success, the use of dental implant has become an almost daily routine in dental practice. However, many factors can influence the success of dental implantation procedures. Primary implant stability remains the most reliable predictor of dental implants success, and many factors are known to have a considerable impact on the implant stability such as the thread morphology, the implant size and length, the implant body shape, the surgical technique use, and the underlying bone heath. Knowledge of these factors is essential for optimizing the outcome of dental implantation procedures even in unfavourable conditions. Therefore, this article aims at reviewing and discussing the various dental implants designs, characteristics, and stability.

An Analytical Approach to Investigate the Evolution of Bone Volume Fraction in Bone Remodeling Simulation at the Tissue and Cell Level

2014 ◽  
Vol 136 (3) ◽  
Author(s):  
Michele Colloca ◽  
Keita Ito ◽  
Bert van Rietbergen
Keyword(s):  
Bone Density ◽  
Bone Remodeling ◽  
Analytical Model ◽  
Bone Microarchitecture ◽  
Bone Diseases ◽  
Patient Specific ◽  
Numerical Density ◽  
Fe Model ◽  
Cell Level ◽  
Good Agreement

Simulation of bone remodeling at the bone cell level can predict changes in bone microarchitecture and density due to bone diseases and drug treatment. Their clinical application, however, is limited since bone microarchitecture can only be measured in the peripheral skeleton of patients and since the simulations are very time consuming. To overcome these issues, we have developed an analytical model to predict bone density adaptation at the organ level, in agreement with our earlier developed bone remodeling theory at the cellular level. Assuming a generalized geometrical model at the microlevel, the original theory was reformulated into an analytical equation that describes the evolution of bone density as a function of parameters that describe cell activity, mechanotransduction and mechanical loading. It was found that this analytical model can predict changes in bone density due to changes in these cell-level parameters that are in good agreement with those predicted by the earlier numerical model that implemented a detailed micro-finite element (FE) model to represent the bone architecture and loading, at only a fraction of the computational costs. The good agreement between analytical and numerical density evolutions indicates that the analytical model presented in this study can predict well bone functional adaptation and, eventually, provide an efficient tool for simulating patient-specific bone remodeling and for better prognosis of bone fracture risk.

scholarly journals Predicting Bone Remodeling in Response to Orthopedic Implantations: Computational Study Using a Mechano-Biochemical Model

2021 ◽  
Author(s):  
Pouria Tavakkoli Avval
Keyword(s):  
Bone Density ◽  
Bone Loss ◽  
Bone Remodeling ◽  
Bone Fracture ◽  
Mineral Density ◽  
Periprosthetic Bone ◽  
Premature Failure ◽  
Gruen Zone ◽  
Periprosthetic Bone Loss

Periprosthetic bone loss following orthopedic implantations is a serious concern leading to the premature failure of the implants. Therefore, investigating bone remodeling in response to orthopedic implantations is of paramount importance for the purpose of designing long lasting prostheses. In this study, a predictive bone remodeling model (Thermodynamic-based model) was employed to simulate the long-term response of femoral density to total hip arthroplasty (THA), bone fracture plating and intramedullary (IM) nailing. The ability of the model in considering the coupling effect between mechanical loading and bone biochemistry is its unique characteristic. This research provided quantitative data for monitoring bone density changes throughout the femoral bone. The results obtained by the thermodynamic-based model agreed well with the bone morphology and the literature. The study revealed that the most significant periprosthetic bone loss in response to THA occurred in calcar region (Gruen zone 7). Conversely, the region beneath the hip stem (Gruen zone 4) experienced the lowest bone mineral density (BMD) changes. It was found that the composite hip implant and IM nail were more advantageous over the metallic ones as they induced less stress shielding and provided more uniform bone density changes following the surgery. The research study also showed that, due to plating, the areas beneath the bone fracture plate experienced severe bone loss. However, some level of bone formation was observed at the vicinity of the most proximal and distal screw holes in both lateral and anterior plated femurs. Furthermore, in terms of long-term density distributions, the anterior plating was not superior to the lateral plating.

scholarly journals Alveolar Bone Resorption Evaluation Around Single-piece Designed Bicortical Implants, Using Immediate Loading Protocol, Based on Orthopantomographs

2017 ◽  
Vol 2 (4) ◽  
pp. 328-331 ◽  
Author(s):  
Dániel-Tamás Száva ◽  
Alina Ormenișan ◽  
Emese Markovics ◽  
Bálint Bögözi ◽  
Krisztina Mártha
Keyword(s):  
Bone Resorption ◽  
Dental Implants ◽  
Alveolar Bone ◽  
Implant Design ◽  
Immediate Loading ◽  
Long Term Effects ◽  
Number Of Patients ◽  
Functional Loading ◽  
Short Diameter

AbstractBackground:Inserting dental implants in severely atrophied jawbones is a great challenge for the dental practitioner. There are an increasing number of patients who choose dental implantanchored prosthetic restorations despite compromised bone quality and quantity. There have been numerous attempts in adapting implant design for the atrophic crestal bone. One-piece, needle-type basal implant design is a typical design for these cases. These implants are inserted in the remaining compact bone located in the basal aspect of the jawbones. If high primary stability is achieved, these implants are used for immediate loading protocol. From many points of view, this technique is based on contradictory principles compared to classic implant surgery and loading protocols. Theaimof this study was to investigate the long-term success of basal one-piece short-diameter dental implants used for immediate loading protocol.Materials and methods:A total of 56 dental implants were included in this study. Peri-implant bone loss was measured on orthopantomographs. Bone resorption was measured in millimeters in the first 6 and 12 months of functional loading.Results:There were no failing implants in this period; average bone resorption was 1.59 mm after 6 months of functional loading and 2.05 mm after 12 months. Bone resorption was slightly higher in the mandible than in the maxilla.Conclusions:Immediate implant loading protocol might be an attractive solution for fixed fullarch restoration using short-diameter one-stage basal implants, but long-term effects require further investigations.

scholarly journals Creating a normative database of age-specific 3D geometrical data, bone density, and bone thickness of the developing skull: a pilot study

2015 ◽  
Vol 16 (6) ◽  
pp. 687-702 ◽  
Author(s):  
Hans Delye ◽  
Tim Clijmans ◽  
Maurice Yves Mommaerts ◽  
Jos Vnder Sloten ◽  
Jan Goffin
Keyword(s):  
Bone Density ◽  
Material Properties ◽  
Patient Specific ◽  
Skull Bone ◽  
Bone Thickness ◽  
3D Measurements ◽  
Long Term Follow Up ◽  
Skull Thickness

OBJECT Finite element models (FEMs) of the head are used to study the biomechanics of traumatic brain injury and depend heavily on the use of accurate material properties and head geometry. Any FEM aimed at investigating traumatic head injury in children should therefore use age-specific dimensions of the head, as well as age-specific material properties of the different tissues. In this study, the authors built a database of age-corrected skull geometry, skull thickness, and bone density of the developing skull to aid in the development of an age-specific FEM of a child’s head. Such a database, containing age-corrected normative skull geometry data, can also be used for preoperative surgical planning and postoperative long-term follow-up of craniosynostosis surgery results. METHODS Computed tomography data were processed for 187 patients (age range 0–20 years old). A 3D surface model was calculated from segmented skull surfaces. Skull models, reference points, and sutures were processed into a MATLAB-supported database. This process included automatic calculation of 2D measurements as well as 3D measurements: length of the coronal suture, length of the lambdoid suture, and the 3D anterior-posterior length, defined as the sum of the metopic and sagittal suture. Skull thickness and skull bone density calculations were included. RESULTS Cephalic length, cephalic width, intercoronal distance, lateral orbital distance, intertemporal distance, and 3D measurements were obtained, confirming the well-established general growth pattern of the skull. Skull thickness increases rapidly in the first year of life, slowing down during the second year of life, while skull density increases with a fast but steady pace during the first 3 years of life. Both skull thickness and density continue to increase up to adulthood. CONCLUSIONS This is the first report of normative data on 2D and 3D measurements, skull bone thickness, and skull bone density for children aged 0–20 years. This database can help build an age-specific FEM of a child’s head. It can also help to tailor preoperative virtual planning in craniosynostosis surgery toward patient-specific normative target values and to perform objective long-term follow-up in craniosynostosis surgery.

Load Transfer Along the Bone-Dental Implant Interface

2009 ◽  
Author(s):  
Samira Faegh ◽  
Sinan Müftü
Keyword(s):  
Dental Implants ◽  
Load Transfer ◽  
Surface Characteristics ◽  
Systematic Investigation ◽  
Long Term Results ◽  
Implant Design ◽  
Patient Specific ◽  
Success Rates ◽  
Bone Implant ◽  
Patient Specific Implants

Endosseous dental implants are used as prosthetic treatment alternatives for treating partial edentulism [1]. Excellent long term results and high success rates have been achieved using dental implants during the past decades. Further improvements in implant protocols will include immediate loading, patient specific implants, applications for patients with extreme bone loss and extreme biting habits such as bruxism. The implant designs available in the market vary in size, shape, materials and surface characteristics [2], and address some of these concerns. An important factor in the implant design is the load transfer from the implant to bone during occlusal loading.[2,3] Load transfer starts along the bone-implant interface, and is affected by the loading type, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface [4]. While many studies using the finite element method (FEM) have been carried out [2–5], a systematic investigation of the load transfer at the bone implant interface, and the effects of various parameters that make the implant contour is lacking. The goal of this paper is to investigate one aspect of this multivariable problem, namely the effect of external implant threads on the load transfer along the bone-implant interface.

scholarly journals Antifracture Efficacy of Antiresorptive Agents Are Related to Changes in Bone Density

2000 ◽  
Vol 85 (1) ◽  
pp. 231-236 ◽  
Author(s):  
Richard D. Wasnich ◽  
Paul D. Miller
Keyword(s):  
Fracture Risk ◽  
Conceptual Model ◽  
Bone Strength ◽  
Measurement Errors ◽  
Current Debate ◽  
Mineral Density ◽  
Short Term ◽  
Antiresorptive Agents ◽  
Antiresorptive Drugs

There is a current debate about the extent to which antifracture efficacy of antiresorptive drugs are related to changes in bone mineral density (BMD). In vitro studies show that most of the variability in bone strength is related to BMD, and prospective studies have shown that low BMD is an important predictor of fracture risk. It seems that higher levels of bone turnover are also associated with increased fracture risk. Over the short term, a reduction in activation frequency or resorption depth would lead to fewer (and/or shallower) resorption sites and refilling of existing sites initially. There is also evidence that inhibiting resorption allows bone to respond to mechanical demands, preferentially thickening critical trabeculae, and this may help compensate for reduced connectivity. Each of these mechanisms would increase BMD and would disproportionately improve bone strength. Over the long term, maintaining bone mass and preventing loss of structural elements would result in progressively greater differences in BMD and fracture risk over time, relative to untreated women. The conceptual model predicts that both the short- and long-term antifracture efficacy of antiresorptive drugs will depend on the extent to which treatment can increase and maintain BMD. To examine this issue, we compiled data from clinical trials of antiresorptive agents and plotted the relative risk of vertebral fractures against the average change in BMD for each trial. The confidence intervals are large for individual trials, and there was substantial variability in antifracture efficacy at any given level of change in BMD. Overall, however, trials that reported larger increases in BMD tended to observe greater reductions in vertebral fracture risk. Poisson regression was used to quantify this relationship. The model predicts that treatments that increase spine BMD by 8% would reduce risk by 54%; most of the total effect of treatment was explained by the 8% increase in BMD (41% risk reduction). These findings are consistent with the short-term predictions of the conceptual model and with reports from randomized trials. The small but significant reductions in risk that were not explained by measurable changes in BMD might be related to publication bias, measurement errors, or limitations of current BMD technology.

scholarly journals Augmentation the width of a keratinized attached gingiva in patients with dental implantation

2018 ◽  
pp. 5-15
Author(s):  
T. V. Brailovskaya ◽  
A. P. Vedyaeva ◽  
R. V. Kalinin ◽  
E. A. Garibyan ◽  
Z. A. Tangieva ◽  
...  
Keyword(s):  
Dental Implants ◽  
Soft Tissues ◽  
Scientific Interest ◽  
Mucogingival Surgery ◽  
Dental Implantation ◽  
Attached Gingiva ◽  
Long Term Prognosis ◽  
Dermal Matrices ◽  
Implant Treatment

To date, there has been an increase in the scientific interest in the state of soft tissues surrounding dental implants and their influence on the long-term prognosis of implant treatment. It is known, that the risk factors for the development of periimplantitis include a deficiency or complete absence of an attached keratinized gingiva in the area of implants. The article provides a comparative analysis of various methods of mucogingival surgery in the field of dental implants using free gingival autografts and xenogenic dermal matrices.

scholarly journals FEATURES OF DENTAL IMPLANTS IN THE COMPLEX TREATMENT OF PERIODONTAL DISEASE

2017 ◽  
Vol 6 ◽  
pp. 28-35
Author(s):  
Galina Prots ◽  
Mykola Rozhko ◽  
Vasyl Pjuryk ◽  
Irina Prots
Keyword(s):  
Bone Resorption ◽  
Bone Formation ◽  
Bone Tissue ◽  
Bone Remodeling ◽  
Dental Implants ◽  
Surgical Intervention ◽  
High Rate ◽  
Medication Prescription ◽  
Periodontal Tissues ◽  
Dental Implantation

Aim: To Improve the treatment of patients with partial edentia and chronic generalized periodontitis by including dental implantation to the complex of therapeutic measures. Materials and methods: There have been presented the results of 240 patients with varying severity degrees of generalized periodontitis who underwent surgery on periodontal tissues with dental implantation. The research was conducted at the OCH of Ivano-Frankivsk 2007–2017.To improve the efficiency for dental implants and periodontal surgical intervention is necessary to determine the quality of bone remodeling, identifying markers of bone tissue metabolism. Results: It was established that in 40,81 % patients the results of research showed markers of bone remodeling indicating a high rate of bone formation (25,12±2,23 ng / ml) and a slight increase in rate of resorption marker, which results in low rates of bone resorption (8,54±1,23 nmol/L). These patients were not prescribed with osteotropic drugs. 50,83 % of patients with osteopenia were noticed to manifest the formation of bone possible raise of bone resorption (10.82±1.34n/mole), which was the indication for antiresorptive medication prescription. In 8,36 % of patients with osteoporosis was observed inhibition of bone formation processes (18,05±2,08 ng / ml) and increased resorption indices (15,34±1,87 nmol/L). Medications that stimulate osteogenesis and prevent bone resorption were prescribed. Conclusions: When planning dental implants and periodontal surgical intervention it is necessary to identify markers of bone remodeling to assess the structural and functional state of bone tissue and prescribe osteotrophic drugs that promote positive postoperative period.

scholarly journals Biomechanical evaluation of the human mandible after temporomandibular joint replacement under different biting conditions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manuel Pinheiro ◽  
Robin Willaert ◽  
Afaq Khan ◽  
Anouar Krairi ◽  
Wim Van Paepegem
Keyword(s):  
Temporomandibular Joint ◽  
Animal Studies ◽  
Principal Strain ◽  
Implant Design ◽  
Study Patient ◽  
Patient Specific ◽  
Functional Changes ◽  
Masticatory Function ◽  
The Impact

AbstractTemporomandibular joint (TMJ) replacement with an implant is only used when all other conservative treatments fail. Despite the promising short-term results, the long-term implications of TMJ replacement in masticatory function are not fully understood. Previous human and animal studies have shown that perturbations to the normal masticatory function can lead to morphological and functional changes in the craniomaxillofacial system. A clearer understanding of the biomechanical implications of TMJ replacement in masticatory function may help identify design shortcomings that hinder their long-term success. In this study, patient-specific finite element models of the intact and implanted mandible were developed and simulated under four different biting tasks. In addition, the impact of re-attaching of the lateral pterygoid was also evaluated. The biomechanics of both models was compared regarding both mandibular displacements and principal strain patterns. The results show an excessive mediolateral and anteroposterior displacement of the TMJ implant compared to the intact joint in three biting tasks, namely incisor (INC), left moral (LML), and right molar (RML) biting. The main differences in principal strain distributions were found across the entire mandible, most notably from the symphysis to the ramus of the implanted side. Furthermore, the re-attachment of the lateral pterygoid seems to increase joint anteroposterior displacement in both INC, LML and RML biting while reducing it during LGF. Accordingly, any new TMJ implant design must consider stabilising both mediolateral and anteroposterior movement of the condyle during biting activities and promoting a more natural load transmission along the entire mandible.

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