Biomolecular, Histological, Clinical, and Radiological Analyses of Dental Implant Bone Sites Prepared Using Magnetic Mallet Technology: A Pilot Study in Animals

Background. A new instrumentation exploiting magneto-dynamic technology (mallet) proposed for implant site preparation was investigated. Methods. In the tibias of three minipigs, two sites were prepared by mallet and two by drill technique. Primary stability (ISQ) was detected after implant positioning (T0) and at 14 days (T14). X-rays and computed tomography were performed. At T14, bone samples were utilized for histological and biomolecular analyses. Results. In mallet sites, histological evaluations evidenced a significant increase in the newly formed bone, osteoblast number, and a smaller quantity of fibrous tissue. These results agree with the significant BMP-4 augmentation and the positive trend in other osteogenic factors (biological and radiological investigations). Major, albeit IL-10-controlled, inflammation was present. For both techniques, at T14 a significant ISQ increase was evidenced, but no significant difference was observed at T0 and T14 between the mallet and drill techniques. In mallet sites, lateral bone condensation was observed on computed tomography. Conclusions. Using biological, histological, clinical, and radiological analyses, this study first shows that the mallet technique is effective for implant site preparation. Based on its ability to cause osseocondensation and improve newly formed bone, mallet technology should be chosen in all clinical cases of poor bone quality.

The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis

Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis—11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.

Comparison of Time Required for Guided Implant Site Preparation with Two Different Template Designs and Dedicated Surgical Kits: An In Vitro Study

Both types of surgical guides – with and without metal sleeves are founded beneficial in clinical studies. The aim of this in vitro study was to compare time of surgical procedure in dental implantology depending of used type of the surgical guide. Ten three dimensional (3D) printed models of lower jaws were prepared based on complete virtual model of patient clinical conditions with missing teeth 37, 46 and 47. Five of this models were used for implant sites preparation performed with use of surgical guide without metal sleeves and dedicated surgical kit, and next five were used for the same procedure performed with surgical guide with metal sleeves and dedicated surgical kit. Time of implant site preparation were measured and noted. Statistical analysis was performed using Student’s t test for independent samples. Difference of time in both groups were founded as statistically significant (t=-9.94; df =28; p=0.0000). Type of surgical guide is important factor which can impact on time of implant site preparation and all surgical procedure.

Peri-Implant Bone Damage Procured by Piezoelectric and Conventional Implant Site Preparation: An In Vitro Comparison

Background: The conventional drill technique is the most commonly used for the implant site preparation of the desired diameter and length. Ultrasonic implant site preparation (UISP) can also be used to perform an implant site preparation of the desired dimensions. Methods: Implant sites were prepared in fresh bone ribs with two different implant site preparation techniques: implant surgical drills and piezoelectric tips. Samples were analyzed with scanning electron microscopy (SEM) for evaluating the peri-implant bone damage. Result: In the surgical drills group, the cortical bone surface showed several cracks and the bone vascular canals were hidden by a dense smear layer. Cancellous bone showed large irregularities and trabecular fractures. The piezoelectric group showed a clean and smooth cortical bone surface with opened bone vascular canals; the cancellous bone presented a regular morphology, and the trabecular spaces, clearly visible, were free of debris. Conclusions: Ultrasonic implant site preparation showed cleaner bone surfaces and lower bone trauma compared with the preparation using implant surgical drills.

Pre-prosthetic Orthodontic Implant for an Aesthetic Rehabilitation : A Case Report

A combination of dental problems such as missing teeth, proclination of teeth and occlusal problems cannot be satisfactorily treated by prosthodontic approach alone. The rehabilitation of patients requiring an esthetic smile demands the collaboration of multiple dental specialists. the need for orthodontic tooth movement prior to restorative treatment is necessary for some patients, in order to optimize both esthetic and functional aspects of dental treatment.The present case report achieved successful implant based oral rehabilitation in a patient with absence of the right maxillary central incisor utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.

Pre-prosthetic Orthodontic Implant for an Aesthetic Rehabilitation : A Case Report

A combination of dental problems such as missing teeth, proclination of teeth and occlusal problems cannot be satisfactorily treated by prosthodontic approach alone. The rehabilitation of patients requiring an esthetic smile demands the collaboration of multiple dental specialists. the need for orthodontic tooth movement prior to restorative treatment is necessary for some patients, in order to optimize both esthetic and functional aspects of dental treatment.The present case report achieved successful implant based oral rehabilitation in a patient with absence of the right maxillary central incisor utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.