Zirconia vs. Titanium Dental Implants: Primary Stability In-Vitro Analysis

The present experimental trial uses two types of dental implants, one made of titanium (Ti6Al4V) and the other one of zirconia (ZrO2), but both of identical design, to compare their stability and micro-movements values under load. One of each type of implant (n = 42) was placed into 21 cow ribs, recording the insertion torque and the resonance frequency using a specific transducer. Subsequently, a prosthetic crown made of PMMA was screwed onto each of the implants in the sample. They were then subjected to a static compression load on the vestibular cusp of the crown. The resulting micromovements were measured. The zirconia implants obtained a higher mean of both IT and RFA when compared with those of titanium, with statistically significant differences in both cases (p = 0.0483 and p = 0.0296). However, the micromovement values when load was applied were very similar for both types, with the differences between them (p = 0.3867) not found to be statistically significant. The results show that zirconia implants have higher implant stability values than titanium implants. However, the fact that there are no differences in micromobility values implies that caution should be exercised when applying clinical protocols for zirconia based on RFA, which only has evidence for titanium.

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Direct Metal Laser Sintering Titanium Dental Implants: A Review of the Current Literature

International Journal of Biomaterials ◽

10.1155/2014/461534 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 47

Author(s):

F. Mangano ◽

L. Chambrone ◽

R. van Noort ◽

C. Miller ◽

P. Hatton ◽

...

Keyword(s):

Dental Implants ◽

Methodological Quality ◽

Meta Analysis ◽

Three Dimensional ◽

Laser Sintering ◽

Titanium Implants ◽

Human Studies ◽

Direct Metal Laser Sintering ◽

Titanium Dental Implants

Statement of Problem. Direct metal laser sintering (DMLS) is a technology that allows fabrication of complex-shaped objects from powder-based materials, according to a three-dimensional (3D) computer model. With DMLS, it is possible to fabricate titanium dental implants with an inherently porous surface, a key property required of implantation devices.Objective. The aim of this review was to evaluate the evidence for the reliability of DMLS titanium dental implants and their clinical and histologic/histomorphometric outcomes, as well as their mechanical properties.Materials and Methods. Electronic database searches were performed. Inclusion criteria were clinical and radiographic studies, histologic/histomorphometric studies in humans and animals, mechanical evaluations, andin vitrocell culture studies on DMLS titanium implants. Meta-analysis could be performed only for randomized controlled trials (RCTs); to evaluate the methodological quality of observational human studies, the Newcastle-Ottawa scale (NOS) was used.Results. Twenty-seven studies were included in this review. No RCTs were found, and meta-analysis could not be performed. The outcomes of observational human studies were assessed using the NOS: these studies showed medium methodological quality.Conclusions. Several studies have demonstrated the potential for the use of DMLS titanium implants. However, further studies that demonstrate the benefits of DMLS implants over conventional implants are needed.

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In vitro analysis of the influence of surface treatment of dental implants on primary stability

Brazilian Oral Research ◽

10.1590/s1806-83242012005000006 ◽

2012 ◽

Vol 26 (4) ◽

pp. 313-317 ◽

Cited By ~ 6

Author(s):

Carla Rodrigues Mazzo ◽

Andréa Cândido dos Reis ◽

Antonio Carlos Shimano ◽

Mariana Lima da Costa Valente

Keyword(s):

Surface Treatment ◽

Dental Implants ◽

Primary Stability ◽

Vitro Analysis ◽

In Vitro Analysis

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Effect of Zirconia Dental Implant Surfaces on Bone Integration: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2017/9246721 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 20

Author(s):

Ali Hafezeqoran ◽

Roodabeh Koodaryan

Keyword(s):

Systematic Review ◽

Dental Implants ◽

Meta Analysis ◽

Titanium Implants ◽

Removal Torque ◽

Significant Difference ◽

Modified Surface ◽

Bone To Implant Contact ◽

Titanium Dental Implants ◽

Zirconia Implants

Background. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from sufficient.Objective. The purpose of this systematic review and meta-analysis was to evaluate and compare zirconia dental implants with different surface topographies, with a focus on bone to implant contact and removal torque.Methods. The systematic review of the extracted publications was performed to compare the bone to implant contact (BIC) with removal torque (RT) values of titanium dental implants and machined and surfaced modified zirconia implants.Results. A total of fifteen articles on BIC and RT values were included in the quantitative analysis. No significant difference in the BIC values was observed between titanium and machined zirconia implants (p=0.373; 95% CI:-0.166 to 0.443). However, a significantly better BIC values were observed for acid etched zirconia implants compared with those of titanium implants (p=0.032; 95% CI: 0.068 to 1.461). Unmodified zirconia implants showed favorable BIC values compared to modified-surface zirconia implants (p=0.021; 95% CI:-0.973 to-0.080).Conclusion. Acid etched zirconia implants may serve as a possible substitute for successful osseointegration.

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An In Vitro Analysis on Polyurethane Foam Blocks of the Insertion Torque (IT) Values, Removal Torque Values (RTVs), and Resonance Frequency Analysis (RFA) Values in Tapered and Cylindrical Implants

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18179238 ◽

2021 ◽

Vol 18 (17) ◽

pp. 9238

Author(s):

Luca Comuzzi ◽

Margherita Tumedei ◽

Camillo D’Arcangelo ◽

Adriano Piattelli ◽

Giovanna Iezzi

Keyword(s):

Dental Implants ◽

Frequency Analysis ◽

Primary Stability ◽

Cortical Layer ◽

Insertion Torque ◽

Low Density ◽

Resonance Frequency Analysis ◽

Removal Torque ◽

Torque Values

Background: Several different dental implant microgeometries have been investigated in the literature for use in low-density bone sites. The polyurethane solid rigid blocks represent an optimal in vitro study model for dental implants, because their composition is characterized by symmetrical linear chains of monomers of hexa-methylene sequences producing a self-polymerization process. The aim of the present investigation was to evaluate the primary stability of cylindrical and tapered implants positioned into low-density polyurethane solid rigid blocks. Materials and Methods: Two different macrogeometries, cylindrical (4 mm diameter and 10 mm length) and tapered dental implants (4.20 mm diameter and 10 mm length), were investigated in the present study. The implants were inserted into 10 PCF and 20 PCF polyurethane blocks, with and without an additional cortical layer. The insertion torque (IT) values, the removal torque values (RTVs), and the resonance frequency analysis (RFA) values were measured and recorded. Results: A total of 80 sites were tested, and a significant increased primary stability (PS) was detected in favour of tapered dental implants when compared to cylindrical implants in all experimental conditions (p < 0.05). Higher IT, RT, and RFA values were measured in tapered implants in 10 and 20 PCF polyurethane blocks, both with and without the additional cortical layer. Conclusions: Both implants showed sufficient primary stability in poor density substrates, while, on the other hand, the tapered microgeometry showed characteristics that could also lead to clinical application in low-density posterior maxillary sites, even with a drastically decreased bone cortical component.

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Zirconia Dental Implants: A Literature Review

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-09-00079 ◽

2011 ◽

Vol 37 (3) ◽

pp. 367-376 ◽

Cited By ~ 150

Author(s):

Zeynep Özkurt ◽

Ender Kazazoğlu

Keyword(s):

Mechanical Properties ◽

Literature Review ◽

Dental Implants ◽

Titanium Implants ◽

Research Articles ◽

Clinical Use ◽

Success Rates ◽

Novel Technologies ◽

Titanium Dental Implants ◽

Zirconia Implants

Abstract Titanium and titanium alloys are widely used for fabrication of dental implants. Because of potential immunologic and possible esthetic compromises with titanium implants, novel implant technologies are being developed. However, these novel technologies must maintain the characteristics that provide titanium implants with their high success rates. Zirconia implants were introduced into dental implantology as an alternative to titanium implants. Zirconia seems to be a suitable implant material because of its toothlike color, mechanical properties, biocompatibility, and low plaque affinity. The aim of this study is to review clinical and research articles conducted on zirconia dental implants, compare them with titanium dental implants, and provide information on zirconia dental implant osseointegration and mechanical strength. Zirconia dental implants have the potential to become alternative dental implants to titanium dental implants, but they are not yet in routine clinical use.

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Surface Activation of Titanium Dental Implants by Using UVC-LED Irradiation

International Journal of Molecular Sciences ◽

10.3390/ijms22052597 ◽

2021 ◽

Vol 22 (5) ◽

pp. 2597

Author(s):

Nagore Arroyo-Lamas ◽

Iciar Arteagoitia ◽

Unai Ugalde

Keyword(s):

Dental Implants ◽

Photoelectron Spectroscopy ◽

Organic Contaminants ◽

Light Emitting Diode ◽

In Vitro Study ◽

Sem Analysis ◽

Titanium Implants ◽

Chemical Compositions ◽

Titanium Dental Implants

Organic contaminants significantly limit the bioactivity of titanium implants, resulting in the degradation known as the ageing of titanium. To reactivate the surfaces, they can be photofunctionalized, i.e., irradiated with C-range ultraviolet (UVC) light. This descriptive in vitro study compares the effectiveness of novel light-emitting diode (LED) technology to remove contaminant hydrocarbons from three different commercially available titanium dental implants: THD, TiUnite, and SLA. The surface topography and morphology were characterized by scanning electron microscopy (SEM). The chemical compositions were analyzed by X-ray photoelectron spectroscopy (XPS), before and after the lighting treatment, by a pair of closely placed UVC (λ = 278 nm) and LED devices for 24 h. SEM analysis showed morphological differences at the macro- and micro-scopic level. XPS analysis showed a remarkable reduction in the carbon contents after the UVC treatment: from 25.6 to 19.5 C at. % (carbon atomic concentration) in the THD; from 30.2 to 20.2 C at. % in the TiUnite; from 26.1 to 19.2 C at. % in the SLA surface. Simultaneously, the concentration of oxygen and titanium increased. Therefore, LED-based UVC irradiation decontaminated titanium surfaces and improved the chemical features of them, regardless of the kind of surface.

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Influence of Bone Quality, Drilling Protocol, Implant Diameter/Length on Primary Stability: An In Vitro Comparative Study on Insertion Torque and Resonance Frequency Analysis

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00145 ◽

2020 ◽

Vol 46 (3) ◽

pp. 182-189 ◽

Cited By ~ 1

Author(s):

Davide Farronato ◽

Mattia Manfredini ◽

Michele Stocchero ◽

Mattia Caccia ◽

Lorenzo Azzi ◽

...

Keyword(s):

Resonance Frequency ◽

Bone Quality ◽

Frequency Analysis ◽

Primary Stability ◽

Mean Difference ◽

Insertion Torque ◽

Resonance Frequency Analysis ◽

Bone Response ◽

Implant Length

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.

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Macrophagic Inflammatory Response Next to Dental Implants with Different Macro- and Micro-Structure: An In Vitro Study

Applied Sciences ◽

10.3390/app11125324 ◽

2021 ◽

Vol 11 (12) ◽

pp. 5324

Author(s):

Maria Menini ◽

Francesca Delucchi ◽

Domenico Baldi ◽

Francesco Pera ◽

Francesco Bagnasco ◽

...

Keyword(s):

Inflammatory Response ◽

Dental Implants ◽

In Vitro Study ◽

Titanium Implants ◽

Implant Surface ◽

Bone Implant ◽

Optimal Outcomes ◽

Negative Controls ◽

Inflammatory Effect

(1) Background: Intrinsic characteristics of the implant surface and the possible presence of endotoxins may affect the bone–implant interface and cause an inflammatory response. This study aims to evaluate the possible inflammatory response induced in vitro in macrophages in contact with five different commercially available dental implants. (2) Methods: one zirconia implant NobelPearl® (Nobel Biocare) and four titanium implants, Syra® (Sweden & Martina), Prama® (Sweden & Martina), 3iT3® (Biomet 3i) and Shard® (Mech & Human), were evaluated. After 4 h of contact of murine macrophage cells J774a.1 with the implants, the total RNA was extracted, transcribed to cDNA and the gene expression of the macrophages was evaluated by quantitative PCR (qPCR) in relation to the following genes: GAPDH, YWHAZ, IL1β, IL6, TNFα, NOS2, MMP-9, MMP-8 and TIMP3. The results were statistically analyzed and compared with negative controls. (3) Results: No implant triggered a significant inflammatory response in macrophages, although 3iT3 exhibited a slight pro-inflammatory effect compared to other samples. (4) Conclusions: All the samples showed optimal outcomes without any inflammatory stimulus on the examined macrophagic cells.

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Comparative In Vitro Evaluation of the Primary Stability in D3 Synthetic Bone of Two Different Shapes and Pitches of the Implant Threads

Applied Sciences ◽

10.3390/app11125612 ◽

2021 ◽

Vol 11 (12) ◽

pp. 5612

Author(s):

Stefano Fanali ◽

Margherita Tumedei ◽

Pamela Pignatelli ◽

Alessandra Lucchese ◽

Francesco Inchingolo ◽

...

Keyword(s):

Surgical Techniques ◽

Primary Stability ◽

Implant Design ◽

Insertion Torque ◽

Synthetic Bone ◽

One Stage ◽

Prosthetic Joint ◽

Joint Connection ◽

The One

Background: Implant primary stability can be affected by several factors related to implant macrogeometry, local anatomy, and surgical techniques. The aim of this research was to study primary stability on polyurethane foam sheets of wide-threaded implant design compared to narrow-threaded implants. Materials and methods: Two different implant designs were positioned on D3 density polyurethane blocks in a standardized environment: the wide-threaded implant and the narrow-threaded implant, for a total of 160 specimens. Moreover, for each group, two different sizes were considered: 3.8mm × 12mm and 4.8mm × 12 mm. The insertion torque (IT) values, the removal strength (RT), and the Periotest analyses were evaluated. Results: A significantly higher IT and RT was reported for wide-threaded implants and two-stage implants (p < 0.01), compared to the narrow-threaded implants. The diameters seemed to provide a significant effect on the primary stability for both implants’ geometry (p < 0.01). A higher mean of the one-stage implant was evident in the Periotest measurements (p < 0.01). Conclusions: Both of the implants showed sufficient stability in polyurethane artificial simulation, while the wide-threaded implant design showed a higher primary stability on alveolar cancellous synthetic bone in vitro. Additionally, the prosthetic joint connection seemed to have a determinant effect on Periotest analysis, and the one-stage implants seemed to provide a high stability of the fixture when positioned in the osteotomy, which could be important for the immediate loading protocol.

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