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Advances in Experimental Medicine and... 2022While implant surgical interventions are now routinely performed, failures still occur and may have dramatic consequences. The clinical outcome depends on the evolution...
While implant surgical interventions are now routinely performed, failures still occur and may have dramatic consequences. The clinical outcome depends on the evolution of the biomechanical properties of the bone-implant interface (BII). This chapter reviews studies investigating the use of quantitative ultrasound (QUS) techniques for the characterization of the BII.First, studies on controlled configurations evidenced the influence of healing processes and of the loading conditions on the ultrasonic response of the BII. The gap of acoustical properties at the BII increases (i) during healing and (ii) when stress at the BII increases, therefore inducing a decrease of the reflection coefficient at the BII.Second, an acoustical model of the BII is proposed to better understand the parameters influencing the interaction between ultrasound and the BII. The reflection coefficient is shown to decrease when (i) the BII is better osseointegrated, (ii) the implant roughness decreases, (iii) the frequency of QUS decreases and (iv) the bone mass density increases.Finally, a 10 MHz device aiming at assessing dental implant stability was validated in vitro, in silico and in vivo. A comparison between QUS and resonance frequency analysis (RFA) techniques showed a better sensitivity of QUS to changes of the parameters related to the implant stability.
Topics: Bone-Implant Interface; Dental Implants; Finite Element Analysis; Osseointegration; Prostheses and Implants; Ultrasonics
PubMed: 35508884
DOI: 10.1007/978-3-030-91979-5_17 -
The Journal of Prosthetic Dentistry Mar 2021Infection of a dental implant is undesirable and decreases the success rate of the dental prosthesis; however, systematic reviews on the issue are lacking. (Review)
Review
STATEMENT OF PROBLEM
Infection of a dental implant is undesirable and decreases the success rate of the dental prosthesis; however, systematic reviews on the issue are lacking.
PURPOSE
The purpose of this systematic review was to evaluate studies that dealt with inherent factors or those applied to the titanium surface or alloys to provide an antimicrobial action.
MATERIAL AND METHODS
SCOPUS, PubMed/Medline, Web of Science, EMBASE, and Science Direct databases were searched and manual searches made between June and July 2019 using the keywords "titanium," "surface," "implants," "photoelectron spectroscopy," and "fourier transform infrared spectroscopy." The criteria included in vitro studies evaluating the titanium surface and describing hydrophobicity, surface crystalline phase, nanotopography, surface charges, and their relationship with bacteria and/or osseointegration.
RESULTS
A comprehensive search identified 767 articles that were selected by the title and/or abstract as per the inclusion criteria. Of the 58 studies selected for full reading, 7 were used for this systematic review. Another 6 studies were added by further research, resulting in 13 articles, all in vitro studies. As the selected studies had a high heterogeneity that precluded any statistical analysis of the data, a descriptive analysis of these topics was performed: hydrophilicity, surface crystalline phase, nanotopography, and surface charges.
CONCLUSIONS
The articles analyzed in this systematic review suggest that hydrophilicity, crystalline phase, surface topography, and surface titanium charge, when altered, may provide an antimicrobial surface. However, the strategy used resulted in heterogeneous articles, making it impossible to demonstrate the unique effect of the electrostatic surface of titanium or titanium alloy used for implants and its effect on bacterial control.
Topics: Bacterial Adhesion; Dental Implants; Osseointegration; Static Electricity; Surface Properties; Titanium
PubMed: 32247513
DOI: 10.1016/j.prosdent.2020.02.003 -
Ultrasound in Medicine & Biology Jun 2020Ultrasound techniques can be used to characterize and stimulate dental implant osseointegration. However, the interaction between an ultrasonic wave and the implant-bone...
Ultrasound techniques can be used to characterize and stimulate dental implant osseointegration. However, the interaction between an ultrasonic wave and the implant-bone interface (IBI) remains unclear. This study-combining experimental and numerical approaches-investigates the propagation of an ultrasonic wave in a dental implant by assessing the amplitude of the displacements along the implant axis. An ultrasonic transducer was excited in a transient regime at 10 MHz. Laser interferometric techniques were employed to measure the amplitude of the displacements, which varied 3.2-8.9 nm along the implant axis. The results demonstrated the propagation of a guided wave mode along the implant axis. The velocity of the first arriving signal was equal to 2110 m.s, with frequency components lower than 1 MHz, in agreement with numerical results. Investigating guided wave propagation in dental implants should contribute to improved methods for the characterization and stimulation of the IBI.
Topics: Bone-Implant Interface; Dental Implantation, Endosseous; Dental Implants; Finite Element Analysis; Humans; Interferometry; Lasers; Osseointegration; Surface Properties; Transducers; Ultrasonic Waves
PubMed: 32139153
DOI: 10.1016/j.ultrasmedbio.2020.01.025 -
Journal of Biological Regulators and... 2021With the beginning of the twenty-first century, population aging has emerged as a major worldwide phenomenon. The dentist must respond to this demographic change by... (Review)
Review
With the beginning of the twenty-first century, population aging has emerged as a major worldwide phenomenon. The dentist must respond to this demographic change by taking into consideration the possibility of restoring oral function in the elderly patient with the use of dental implants. This article aims to provide a narrative review of the literature regarding the implant survival rate in geriatric patients and the relative importance and advantages of implant-prosthetic rehabilitation through a scientific analysis of the literature through online databases and dental journals. Tooth loss can have a significant impact on patients' oral function and significantly affects quality of life, self-esteem, and nutritional status. Although many studies in the past have reported that implant success is age-dependent, more recent studies suggest that they are safe and predictable for geriatric patients, improving quality of life, with similar results to those of younger age groups. Advanced age does not necessarily represent a contraindication for implant placement and osseointegration and success is influenced by patient and site-specific factors. Aging is a process that affects each patient differently, consequently, there should be a specific therapeutic approach for everyone, which must consider the functional and cognitive status of the patient, his medical condition, and his social situation-economic and motivational.
Topics: Aged; Humans; Osseointegration; Prostheses and Implants; Quality of Life
PubMed: 34425667
DOI: 10.23812/21-4supp1-11 -
Biomaterials Advances Apr 2023Many studies have found that the threshold of occlusal force tolerated by titanium-based implants is significantly lower than that of natural teeth due to differences in... (Review)
Review
Many studies have found that the threshold of occlusal force tolerated by titanium-based implants is significantly lower than that of natural teeth due to differences in biomechanical mechanisms. Therefore, implants are considered to be susceptible to occlusal trauma. In clinical practice, many implants have shown satisfactory biocompatibility, but the balance between biomechanics and biofunction remains a huge clinical challenge. This paper comprehensively analyzes and summarizes various stress distribution optimization methods to explore strategies for improving the resistance of the implants to adverse stress. Improving stress resistance reduces occlusal trauma and shortens the gap between implants and natural teeth in occlusal function. The study found that: 1) specific implant-abutment connection design can change the force transfer efficiency and force conduction direction of the load at the BII; 2) reasonable implant surface structure and morphological character design can promote osseointegration, maintain alveolar bone height, and reduce the maximum effective stress at the BII; and 3) the elastic modulus of implants matched to surrounding bone tissue can reduce the stress shielding, resulting in a more uniform stress distribution at the BII. This study concluded that the core BII stress distribution optimization lies in increasing the stress distribution area and reducing the local stress peak value at the BII. This improves the biomechanical adaptability of the implants, increasing their long-term survival rate.
Topics: Humans; Bone-Implant Interface; Dental Occlusion, Traumatic; Stress, Mechanical; Osseointegration; Bone and Bones
PubMed: 36841109
DOI: 10.1016/j.bioadv.2023.213342 -
Journal of Biomedical Materials... Nov 2021As life expectancy and the age of the general population increases so does the need for improved implants. A major contributor to the failure of implants is poor... (Review)
Review
As life expectancy and the age of the general population increases so does the need for improved implants. A major contributor to the failure of implants is poor osseointegration, which is typically described as the direct connection between bone and implant. This leads to unnecessary complications and an increased burden on the patient population. Modification of the implant surfaces through novel techniques, such as varying topography and/or applying coatings, has become a popular method to enhance the osseointegration capability of implants. Recent research has shown that particular surface features influence how bone cells interact with a material; however, it is unknown which exact features achieve optimal bone integration. In this review, current methods of modifying surfaces will be highlighted, and the resulting surface characteristics and biological responses are discussed. Review of the current strategies of surface modifications found that many coating types are more advantageous when used in combination; however, finding a surface modification that utilizes the mutual beneficial effects of important surface characteristics while still maintaining commercial viability is where future challenges exist.
Topics: Animals; Coated Materials, Biocompatible; Humans; Osseointegration; Prostheses and Implants; Surface Properties
PubMed: 33871951
DOI: 10.1002/jbm.b.34835 -
Journal of Applied Biomaterials &... 2021Here, we present a bone implant system of phase-oriented titanium dioxide (TiO) fabricated by the micro-arc oxidation method (MAO) on β-Ti to facilitate improved...
Here, we present a bone implant system of phase-oriented titanium dioxide (TiO) fabricated by the micro-arc oxidation method (MAO) on β-Ti to facilitate improved osseointegration. This (101) rutile-phase-dominant MAO TiO (R-TiO) is biocompatible due to its high surface roughness, bone-mimetic structure, and preferential crystalline orientation. Furthermore, (101) R-TiO possesses active and abundant hydroxyl groups that play a significant role in enhancing hydroxyapatite formation and cell adhesion and promote cell activity leading to osseointegration. The implants had been elicited their favorable cellular behavior in vitro in the previous publications; in addition, they exhibit excellent shear strength and promote bone-implant contact, osteogenesis, and tissue formation in vivo. Hence, it can be concluded that this MAO R-TiO bone implant system provides a favorable active surface for efficient osseointegration and is suitable for clinical applications.
Topics: Coated Materials, Biocompatible; Osseointegration; Surface Properties; Titanium
PubMed: 33909530
DOI: 10.1177/22808000211006878 -
Medicina (Kaunas, Lithuania) Jun 2022Background and Objectives: The gold standard for a successful prosthetic approach is the osseointegration of an implant. However, this integration can be a problem in...
Background and Objectives: The gold standard for a successful prosthetic approach is the osseointegration of an implant. However, this integration can be a problem in cases where the implant needs to be removed. Removing the implant with minimal damage to the surrounding tissues is important. Osteocytes cannot survive below −2 °C, but epithelial cells, fibroblasts, and other surrounding tissue cells can. Remodeling can be triggered by cryotherapy at temperatures that specifically affect osteocyte necrosis. In this study, we aimed to develop a method for reversing the osseointegration mechanism and for protecting the surrounding tissues by bone remodeling induced by CO2 cryotherapy. Materials and Methods: In this study, eight 2.8 mm diameter, one-piece mini implants were used in New Zealand rabbit tibias. Two control and six implants were tested in this study. After 2 months of osseointegration, a reverse torque force method was used to remove all osseointegrated implants at 5, 10, 20, and 30 Ncm. The osseointegration of the implants was proven by periotest measurements. Changes in bone tissue were examined in histological sections stained with toluidine blue after rabbit sacrifice. The number of lacunae with osteocyte, empty lacunae, and lacunae greater than 5 µm and the osteon number in a 10,000 µm2 area were calculated. Cryotherapy was applied to the test implants for 1 min, 2 min, and 5 min. Three implants were subjected to cryotherapy at −40 °C, and the other implants were subjected to cryotherapy at −80 °C. Results: Empty lacunae, filled osteocytes, lacunae >5 µm, and the osteon count around the implant applied at −40 °C were not significantly different from the control implants. The application of −40 °C for 1 min was found to cause minimal damage to the bone cells. The implants, which were applied for 1 min and 2 min, were successfully explanted on the 2nd day with the 5 Ncm reverse torque method. Test implants, which were applied cold for 5 min, were explanted on day 1. Tissue damage was detected in all test groups at −80 °C. Conclusions: The method of removing implants with cryotherapy was found to be successful in −40 °C freeze−thaw cycles applied three times for 1 min. To prove implant removal with cryotherapy, more implant trials should be conducted.
Topics: Animals; Dental Implants; Osseointegration; Rabbits; Tibia; Titanium; Torque
PubMed: 35888569
DOI: 10.3390/medicina58070849 -
Periodontology 2000 Oct 2019The occlusal forces and their influence on the initiation of peri-implant bone loss or their relationship with peri-implantitis have created discussion during the past... (Review)
Review
The occlusal forces and their influence on the initiation of peri-implant bone loss or their relationship with peri-implantitis have created discussion during the past 30 years given the discrepancies observed in clinical, animal, and finite element analysis studies. Beyond these contradictions, in the case of an osseointegrated implant, the occlusal forces can influence the implant-bone interface and the cells responsible for the bone remodeling in different ways that may result in the maintenance or loss of the osseointegration. This comprehensive review focuses on the information available about the forces transmitted through the implant-crown system to the implant-bone interface and the mechano-transduction phenomena responsible for the bone cells' behavior and their interactions. Knowledge of the basic molecular biology of the peri-implant bone would help clinicians to understand the complex phenomenon of occlusal forces and their effects on the implant-bone interface, and would allow better control of the negative effects of mechanical stresses, leading to therapy with fewer risks and complications.
Topics: Animals; Bite Force; Dental Implants; Dental Stress Analysis; Finite Element Analysis; Humans; Osseointegration; Peri-Implantitis
PubMed: 31407438
DOI: 10.1111/prd.12291 -
International Journal of Nanomedicine 2023Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone... (Review)
Review
Three-dimensional (3D) printing is serving as the most promising approach to fabricate personalized titanium (Ti) implants for the precise treatment of complex bone defects. However, the bio-inert nature of Ti material limits its capability for rapid osseointegration and thus influences the implant lifetime in vivo. Despite the macroscale porosity for promoting osseointegration, 3D-printed Ti implant surface morphologies at the nanoscale have gained considerable attention for their potential to improve specific outcomes. To evaluate the influence of nanoscale surface morphologies on osseointegration outcomes of 3D-printed Ti implants and discuss the available strategies, we systematically searched evidence according to the PRISMA on PubMed, Embase, Web of Science, and Cochrane (until June 2022). The inclusion criteria were in vivo (animal) studies reporting the osseointegration outcomes of nanoscale morphologies on the surface of 3D-printed Ti implants. The risk of bias (RoB) was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE's) tool. The quality of the studies was evaluated using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. (PROSPERO: CRD42022334222). Out of 119 retrieved articles, 9 studies met the inclusion criteria. The evidence suggests that irregular nano-texture, nanodots and nanotubes with a diameter of 40-105nm on the surface of porous/solid 3D-printed Ti implants result in better osseointegration and vertical bone ingrowth compared to the untreated/polished ones by significantly promoting cell adhesion, matrix mineralization, and osteogenic differentiation through increasing integrin expression. The RoB was low in 41.1% of items, unclear in 53.3%, and high in 5.6%. The quality of the studies achieved a mean score of 17.67. Our study demonstrates that nanostructures with specific controlled properties on the surface of 3D-printed Ti implants improve their osseointegration. However, given the small number of studies, the variability in experimental designs, and lack of reporting across studies, the results should be interpreted with caution.
Topics: Animals; Osseointegration; Osteogenesis; Titanium; Prostheses and Implants; Printing, Three-Dimensional; Surface Properties; Porosity
PubMed: 37525692
DOI: 10.2147/IJN.S409033