scholarly journals Bone Damage during Dental Implant Insertion: A Pilot Study Combining Strain Gauge and Histologic Analysis

2021 ◽  
Vol 12 (1) ◽  
pp. 291
Author(s):  
Virgilia Klär ◽  
Matthias Karl ◽  
Tanja Grobecker-Karl
Keyword(s):  
Trabecular Bone ◽  
Cortical Bone ◽  
Bone Quality ◽  
Alveolar Bone ◽  
Insertion Torque ◽  
Surgical Trauma ◽  
Implant Stability ◽  
Strain Development ◽  
Bone Damage ◽  
Bone To Implant Contact

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.

scholarly journals New Implant Design with Midcrestal and Apical Wing Thread for Increased Implant Stability in Single Postextraction Maxillary Implant

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Scarano ◽  
Bartolomeo Assenza ◽  
Francesco Inchingolo ◽  
Filiberto Mastrangelo ◽  
Felice Lorusso
Keyword(s):  
Cortical Bone ◽  
Dental Implant ◽  
Alveolar Bone ◽  
Primary Stability ◽  
Implant Design ◽  
Insertion Torque ◽  
Fixture Design ◽  
Implant Stability ◽  
Implant Placement ◽  
Immediate Placement

Background. The immediate placement of a dental implant could represent an option treatment for the rehabilitation of a postextractive missing tooth socket to replace compromised or untreatable teeth, with the advantage of single-session surgery. In this way, the anatomy of the alveolar bone defect, the preservation of the buccal cortical bone, and the primary stability of the fixture represent the critical factors that consent a precise implant placement. Objective. This case report describes a novel fixture design for postextractive alveolar socket immediate implant. Methods. Two patients (25 and 31 years old) were treated for postextractive dental implant placement to replace both central upper incisor teeth with four implants. The residual bone implant gap was not filled with graft or bone substitute. The restoration was provided following a standard loading protocol by a cement-sealed prosthetic abutment. Results. Clinically, all implants positioned showed an excellent insertion torque. No postoperative complications were reported. At 6 months of healing, the buccal cortical bone and the implant stability were present and well maintained. Conclusion. The evidence of this study allows us to underline the possible advantages of this new fixture design for postextractive implant technique.

Relative Contribution of Trabecular and Cortical Bone to Primary Implant Stability: An In Vitro Model Study

2016 ◽  
Vol 42 (2) ◽  
pp. 145-152 ◽  
Author(s):  
Russell Wang ◽  
Steven J. Eppell ◽  
Christian Nguyen ◽  
Nathan Morris
Keyword(s):  
Trabecular Bone ◽  
Cortical Bone ◽  
Quantitative Information ◽  
Cortical Layer ◽  
Insertion Torque ◽  
Implant Stability ◽  
Relative Contribution ◽  
Primary Implant ◽  
Torque Values

The specific aim of this study was to examine the relative contributions to the implant insertion torque value (ITV) by cortical and trabecular components of an in vitro bone model. Simulated bone blocks of polyurethane were used with 2 densities of foam (0.08 g/cm3 to mimic trabecular bone and 0.64 g/cm3 to mimic cortical bone). We have developed a new platform technology to collect data that enables quantitative evaluation of ITV at different implant locations. Seven groups were used to model varying thicknesses of cortical bone over a lower-quality trabecular bone that have clinical significance: a solid 0.08 g/cm3 block; 1 mm, 2 mm, and 3 mm thick 0.64 g/cm3 sheets with no underlayer; and 1 mm, 2 mm, and 3 mm thick 0.64 g/cm3 sheets laminated on top of a 4 cm thick 0.08 g/cm3 block. The ITVs were recorded as a function of insertion displacement distance. Relative contributions of ITV ranged from 3% to 18% from trabecular bone, and 62% to 74% from cortical bone depending on the thickness of the cortical layer. Inserting an implant into 2-mm and 3-mm cortical layers laminated atop trabecular blocks had a synergistic effect on ITVs. Finally, an implant with a reverse bevel design near the abutment showed final average torque values that were 14% to 34% less than their maximum torque values. This work provides basic quantitative information for clinicians to understand the influence of composite layers of bone in relation to mechanical torque resistances during implant insertion in order to obtain desired primary implant stability.

scholarly journals Similarities and differences between bone quality parameters, trabecular bone score and femur geometry

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0260924
Author(s):  
Kyong Young Kim ◽  
Kyoung Min Kim
Keyword(s):  
Trabecular Bone ◽  
Cortical Bone ◽  
Bone Quality ◽  
Cortical Thickness ◽  
Trabecular Bone Score ◽  
Quality Parameters ◽  
Mineral Density ◽  
Men And Women ◽  
Similarities And Differences ◽  
Femur Geometry

Bone quality is a critical factor that, along with bone quantity, determines bone strength. Image-based parameters are used for assessing bone quality non-invasively. The trabecular bone score (TBS) is used to assess quality of trabecular bone and femur geometry for cortical bone. Little is known about the associations between these two bone quality parameters and whether they show differences in the relationships with age and body mass index (BMI). We investigated the associations between the trabecular bone score (TBS) and femur cortical geometry. Areal bone mineral density (BMD) was assessed using dual energy X-ray absorptiometry (DXA) and the TBS was assessed using iNsight software and, femur geometry using APEX (Hologic). A total of 452 men and 517 women aged 50 years and older with no medical history of a condition affecting bone metabolism were included. Z-scores for TBS and cortical thickness were calculated using the age-specific mean and SD for each parameter. A ‘discrepancy group’ was defined as patients whose absolute Z-score difference between TBS and cortical thickness was > 1 point. TBS and cortical thickness correlated negatively with age both in men and women, but the associations were stronger in women. Regarding the associations with BMI, TBS provided significant negative correlation with BMI in the range of BMI > 25 kg/m2. By contrast, cortical thickness correlated positively with BMI for all BMI ranges. These bone quality-related parameters, TBS and cortical thickness, significantly correlated, but discordance between these two parameters was observed in about one-third of the men and women (32.7% and 33.4%, respectively). Conclusively, image-based bone quality parameters for trabecular and cortical bone exhibit both similarities and differences in terms of their associations with age and BMI. These different profiles in TBS and FN cortical thickness might results in different risk profiles for the vertebral fractures or hip fractures in a certain percentage of people.

scholarly journals Bone mineral density

2011 ◽  
Vol 82 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Mariana Marquezan ◽  
Thiago Chon Leon Lau ◽  
Claudia Trindade Mattos ◽  
Amanda Carneiro da Cunha ◽  
Lincoln Issamu Nojima ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Cortical Bone ◽  
Bone Mineral ◽  
Primary Stability ◽  
Bone Block ◽  
Insertion Torque ◽  
Bovine Bone ◽  
Mineral Density ◽  
Pull Out

Abstract Objective: To verify whether bone mineral density (BMD) of cortical bone, trabecular bone, and total bone influence the primary stability of orthodontic miniscrews and to verify whether there is a correlation between the measurement of BMD by cone-beam computed tomography (CBCT) and central dual-energy x-ray absorptiometry (DEXA). Materials and Methods: Twenty bovine bone sections were extracted from the pubic and iliac bones from regions with cortical thicknesses of approximately 1 mm. The BMD of the total bone block was evaluated using two methods: CBCT and DEXA. The BMD of cortical, trabecular, and total bone in the region of interest (ROI) were also evaluated by CBCT. After scanning the bone blocks, 20 self-drilling miniscrews (INP®) 1.4 mm in diameter and 6 mm long were inserted into them. The peak implant insertion torque (IT) was registered. After this, the pull-out test (PS) was performed and the maximum force registered. The Pearson correlation test was applied to verify the correlations between variables. Results: The BMD of the total bone block verified by CBCT and DEXA showed a positive and strong correlation (r  =  0.866, P  =  .000). The BMD of the ROI for cortical bone influenced the IT (r  =  0.518, P  =  .40) and the PS of miniscrews (r  =  0.713, P  =  .001, Table 2). However, the total bone BMD (verified by CBCT and DEXA) and trabecular bone BMD presented weak and not statistically significant correlations with primary stability. Conclusions: There was a positive correlation between total bone block BMD measured by DEXA and CBCT. The cortical BMD influenced the IT and PS.

Use of Osteotomes for Implant Bed Preparation—Effect on Material Properties of Bone and Primary Implant Stability

2013 ◽  
Vol 39 (S1) ◽  
pp. 241-247 ◽  
Author(s):  
Tim Krafft ◽  
Friedrich Graef ◽  
Werner Winter ◽  
Manfred Wichmann ◽  
Matthias Karl
Keyword(s):  
Bone Quality ◽  
Pearson Correlation ◽  
Initial Density ◽  
Insertion Torque ◽  
Preparation Technique ◽  
Implant Stability ◽  
Cellular Solid ◽  
Primary Implant ◽  
Compressive Testing ◽  
Implant Bed

The aim of this study was to evaluate the efficacy of osteotomes in enhancing bone quality as compared to conventional implant bed preparation using burrs. Polyurethane foam blocks differing in density (10 pcf, 20 pcf) and structure (cellular, solid) were used. Ten implant sockets were prepared in each of the materials by means of drilling and by using osteotomes. Bone quality was assessed by measuring implant insertion torque and primary implant stability (resonance frequency analysis). Additionally, a newly designed device (BoneProbe) for bone quality testing during dental implant surgery based on intraoperative compressive tests was applied. Multivariate analysis of variance with Pillai's trace was used as test statistic (level of significance: α = 0.05) and Pearson correlation coefficients were calculated for all combinations of parameters. Whereas a significant influence of bone type on all measurement results (P = 0) could be found, the factor preparation technique only showed a significant effect on BoneProbe measurements in the cortical area (P = 0) and on implant insertion torque (P = 0). The interaction of bone type and preparation technique showed a significant effect on BoneProbe measurements in the trabecular area (P = .002) and on implant insertion torque (P = 0). Significant correlations between all parameters were found. The application of osteotomes leads to higher values for compressive testing of bone in the apical part of an osteotomy depending on the initial density of the bone. Intraoperative compressive testing appears to be sensitive enough for quantifying localized changes in bone quality.

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

2021 ◽  
Author(s):  
Edgard El Chaar ◽  
Algirdas Puisys ◽  
Itai Sabbag ◽  
Benjamin Bellón ◽  
Aikaterini Georgantza ◽  
...  
Keyword(s):  
Bone Quality ◽  
Large Diameter ◽  
Small Diameter ◽  
Tissue Level ◽  
Clinical Indication ◽  
Insertion Torque ◽  
Immediate Placement ◽  
Bone To Implant Contact ◽  
Torque Values ◽  
And Control

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.

scholarly journals Microcomputed tomography cortical bone evaluation for craniofacial implantology

2020 ◽  
pp. 56-56
Author(s):  
Filip Ivanjac ◽  
Vitomir Konstantinovic
Keyword(s):  
Cortical Bone ◽  
Bone Quality ◽  
Cortical Thickness ◽  
Pore Diameter ◽  
Cortical Porosity ◽  
Implant Stability ◽  
Implant Placement ◽  
Implant Therapy ◽  
Pore Separation ◽  
Craniofacial Implants

Introduction/Objective. Good implant stability is one of the most important factors for successful implant therapy. This precondition is important to all kind of implants, oral and extra-oral (EO) ie. Craniofacial implants as well. One of the most important factors for satisfactory implant stability is the bone quality, particularly of the cortical bone, which is determined by its microarchitectural parameters. The aim of this paper was to assess cortical bone microarchitectural parameters in the targeted regions for craniofacial implant placement. Methods. Bone quality on targeted localisations was determined by Micro CT method on cadaver model. The target places for implant placement were: periorbital, perinasal and periauricular region. Microarchitectural parameters included cortical thickness (Ct.Th), cortical porosity (Ct.Po), pore diameter (Po.Dm) and pore separation (Po.Sp). Results. The smallest cortical porosity, (Ct.Po. 4.1 %) and the largest pore separation (Po.Sp. 0.5 mm), were determined in glabella. The maximum cortical thickness was found in the zygomatic region (Ct.Th. 2.7 mm) as well as pore diameter (Po.Dm. 0.2 mm). The mastoid part of the temporal bone showed the smallest cortical thickness (Ct.Th.1.2 mm) and pore separation (Po.Sp. 0.3 mm). Highest cortical porosity was in the perinasal region (Ct.Po. 8.5%). Conclusion. The bone quality measured through microarchitectural parameters was good in all the regions of interest for the disk and screw shape EO implant anchorage.

scholarly journals Is trabecular bone related to primary stability of miniscrews?

2013 ◽  
Vol 84 (3) ◽  
pp. 500-507 ◽  
Author(s):  
Mariana Marquezan ◽  
Inayá Lima ◽  
Ricardo Tadeu Lopes ◽  
Eduardo Franzotti Sant'Anna ◽  
Margareth Maria Gomes de Souza
Keyword(s):  
Trabecular Bone ◽  
Cortical Bone ◽  
Cortical Thickness ◽  
Primary Stability ◽  
Pelvic Bone ◽  
Insertion Torque ◽  
Trabecular Thickness ◽  
Pull Out ◽  
Intergroup Comparison ◽  
Trabecular Number

ABSTRACT Objective: To compare the primary stability of miniscrews inserted into bone blocks of different bone mineral densities (BMDs) with and without cortical bone, and investigate whether some trabecular properties could influence primary stability. Materials and Methods: Fifty-two bone blocks were extracted from fresh bovine pelvic bone. Four groups were created based on bone type (iliac or pubic region) and presence or absence of cortical bone. Specimens were micro-computed tomography imaged to evaluate trabecular thickness, trabecular number, trabecular separation, bone volume density (BV/TV), BMD, and cortical thickness. Miniscrews 1.4 mm in diameter and 6 mm long were inserted into the bone blocks, and primary stability was evaluated by insertion torque (IT), mini-implant mobility (PTV), and pull-out strength (PS). Results: Intergroup comparison showed lower levels of primary stability when the BMD of trabecular bone was lower and in the absence of cortical bone (P ≤ .05). The Pearson correlation test showed correlation between trabecular number, trabecular thickness, BV/TV, trabecular BMD, total BMD, and IT, PTV, and PS. There was correlation between cortical thickness and IT and PS (P ≤ .05). Conclusion: Cancellous bone plays an important role in primary stability of mini-implants in the presence or absence of cortical bone.

EFFECT OF BONE QUALITY ON INITIAL STABILITY OF ORTHODONTIC MINISCREWS

2019 ◽  
Vol 19 (02) ◽  
pp. 1940013
Author(s):  
MING-TZU TSAI ◽  
WAN-PING YU ◽  
HENG-LI HUANG ◽  
JUI-TING HSU
Keyword(s):  
Bone Quality ◽  
Three Dimensional ◽  
3D Models ◽  
Microcomputed Tomography ◽  
Insertion Torque ◽  
Implant Stability ◽  
Bonferroni Adjustment ◽  
Initial Stability ◽  
Wilcoxon Rank Sum Test ◽  
Artificial Bones

Purpose: This study investigated the effects of the contact percentage (BMC%) of three-dimensional (3D) bone-to-miniscrew specimens in relation to host bone quality on initial miniscrew stability. Furthermore, their correlations were evaluated.Methods: Orthodontic miniscrews (1.6[Formula: see text]mm in diameter and 11[Formula: see text]mm in length) were inserted into four types of artificial bones to measure the maximum insertion torque value (ITV). The miniscrew and artificial foam bone specimens were also scanned using microcomputed tomography, and the obtained images were imported into Mimics software to reconstruct the 3D models and calculate the BMC%. The Kruskal–Wallis test, Wilcoxon rank-sum test with Bonferroni adjustment, and Spearman correlations were applied for statistical and correlation analyses.Results and Conclusions: Inserting the orthodontic miniscrew into artificial foam bone exhibiting higher bone quality resulted in higher maximum ITV and BMC%. The initial implant stability, quantified using ITV, was strongly positively ([Formula: see text]) and correlated with BMC%, as measured from microcomputed tomography images.

Sign in / Sign up

Export Citation Format

Share Document