Finite Element Analysis of an Osseointegrated Stepped Screw Dental Implant
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Abstract An osseointegrated stepped screw dental implant was evaluated using 2-dimensional finite element analysis (FEA). The implant was modeled in a cross section of the posterior human mandible digitized from a computed tomography (CT) generated patient data set. A 15-mm regular platform (RP) Branemark implant with equivalent length and neck diameter was used as a control. The study was performed under a number of clinically relevant parameters: loading at the top of the transmucosal abutment in vertical, horizontal, and 45° oblique 3 orientations. Elastic moduli of the mandible varied from a normal cortical bone level (13.4 GPa) to a trabecular bone level (1.37 GPa). The study indicated that an oblique load and elastic moduli of the cortical bone are important parameters to the implant design optimization. Compared with the cylindrical screw implant, the maximum von Mises stress of the stepped screw implant model was 17.9% lower in the trabecular bone-implant area. The study also showed that the stepped screw implant is suitable for the cortical bone modulus from 10 to 13.4 GPa, which is not necessarily as strict as the Branemark implant, for which a minimum 13.4 GPa cortical bone modulus is recommended.Implant stability can be defined as an absence of clinical implant mobility and consists of primary and secondary implant stability. It has been recognised as one of the most important and useful factors when it comes to predicting implant anchorage. Primary stability includes the mechanical attachment of an implant in the surrounding bone at the insertion, whereas secondary implant stability is the tissue response to the implant and subsequent bone remodelling processes. It is known to be a crucial factor for successful osseointegration of dental implants. There is sufficient evidence to accept a positive correlation between primary implant stability and implant success, as the success relies on the sustainable integration of the implants into hard and soft tissues. This review extensively focuses on different factors affecting primary stability such as implant design and characteristics, bone quality and methods to measure implant stability. KEYWORDS: bone density, dental implants, implant stability, osseodensification, osseointegration
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Succes of dental implants relies amongst other factors, on implant surface as it is known that it helps osseointegration. An important challenge in the field of implantology is development of implant coatings which mimic native bone and therefore increase bone in growth. Pubmed was searched in order to find out novelties regarding dental implant surfaces and success of osseointegration. Forty-nine articles were included which were published. Although various dental implant surface technologies are commercially available, new studies are needed as there are no sufficient data which surface treatment is the most suitable one.
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Bone metabolism is a key factor for successful osseointegration, and low vitamin D levels may negatively impact the process of osseointegration after implant placement. The study was aimed at evaluating the relation of vitamin D levels with dental implant osseointegration and subsequently the success or failure of the implant. The focused questions were-What is the effect of vitamin D levels on successful dental implant osseointegration and what is the effect of vitamin D supplementation on successful implant osseointegration? A search was conducted on PubMed and Google Scholar using the terms "vitamin D," "cholecalciferol," "1,25(OH) D," "dental implant," "osseointegration," and "bone implant contact" for a period of 10 years from 2011 to 2020. Clinical trials, cross-sectional studies, case series, and case reports were included. A total of ten studies were included after the screening process. Five of these studies evaluated the effect of vitamin D supplementation on osseointegration, whereas five only evaluated the effect of vitamin D deficiency on dental implant osseointegration. Only five of these studies reported dental implant failure varying from 7% to 13% in vitamin D deficient/insufficient groups. Positive relationship exists between serum vitamin D levels and dental implant osseointegration; however, few studies failed to report any relation. More prospective clinical research studies as well as randomized controlled trials are needed to show a significant correlation between decreased serum levels of vitamin D and increased risk of dental implant failure in perspective of vitamin D supplementation which can promote the osseointegration of dental implants.
Bone remodeling
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Apposition
Biocompatible material
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Abstract Objectives The overall aim of the study was to investigate a biofunctionalized implant surface with electrochemically deposition of hydroxyapatite and the synthetic peptide (P‐15) and its effect on osseointegration. Material and methods Three modified implant types of ANKYLOS ® C/X implants were used; (1) machined implants used as negative control (M, n = 20), (2) implants with the FRIADENT ® plus surface (grit blasted and acid‐etched) used as positive control (P, n = 20), and (3) implants with a biomimetic surface consisting of hydroxyapatite and the synthetic 15 aminoacids containing peptide P‐15 ( BP , n = 40). The implants were randomly inserted in the mandibles of 10 beagle dogs following 4 months after tooth extraction (P1‐P4). Three animals were sacrificed 2 and 7 days after implant insertion, respectively, and four animals were sacrificed 6 months post implant insertion. Bone‐to‐implant contacts ( BIC s) were analyzed via histomorphometrical analyses at five different region of interests ( ROI s); two at the middle part on either side of the implant ( ROI 1/4), two at the apical part of the implant at each side ( ROI 2/3), and one at the tip of the implant ( ROI 5). Results All implant surfaces showed a high level of osseointegration and osteoconductivity. The cumulative implant survival rate ( CSR ) was 93.8%, 100% in the M, 85% in the P, and 95% in the BP group. No statistical difference in BIC s at ROI 1/4, 2/3, and 5 could be shown between implant types following 2 and 7 days of healing. BIC values increased in all groups over time. After 6 months of healing the BP group showed superiority in BIC in ROI 2/3 (73.2 ± 15.6%) compared to the P (48.3 ± 10.6%) and M group (66.3 ± 30.2%) with a significant difference between BP and P ( P = 0.002). Conclusion It is hypothesized, that the surface biofunctionalization improves peri‐implant bone formation and remodeling, leading to an increased bone‐to implant contact. However, within the limitations of the study set‐up no benefit in the early phase of osseointegration could be established for dental implants with P‐15 containing surface in this study.
Beagle
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Joint replacement
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The effect of osteoporosis on implant osseointegration has been widely investigated, whereas osteoporosis may also newly occur in patient with previously osseointegrated implant. This study was designed to investigate the effect of osteoporosis on implant fixation in rats after successful osseointegration had been obtained. Seventy female Sprague-Dawley rats were included, and each animal received two titanium implants in the distal metaphysis of femur bilaterally. Eight weeks later, ten rats were sacrificed to confirm the establishment of implant osseointegration. All left rats were randomly subjected to bilateral ovariectomy (OVX) or sham operation. Three, six, and twelve weeks later, implant osseointegration, peri-implant bone tissue, and biomechanical properties of implant were analyzed. Right femurs with implants were used for micro-CT and histological analysis, and left femurs with implants were used for biomechanical test. Micro-CT, histology, and biomechanical test confirmed the destructive effect of OVX on previously osseointegrated implant in rats; when compared to sham-operated rats, peri-implant bone volume, trabecular architecture, bone-to-implant contact ratio, as well as biomechanical parameters decreased progressively within 12 weeks. Results also indicated that the effect of OVX on undisturbed bone (proximal tibiae) was much stronger than that on peri-implant bone. Osteoporosis produced a progressive negative effect on previously osseointegrated implant in distal femora of rats during 12 weeks. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2426-2432, 2017.
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Abstract Purpose The purpose of this study was to compare the clinical performance of two dental implant types possessing a different macro‐design in the in vivo pig model. Materials and Methods Titanium Aadva TM implants ( GC , T okyo, J apan) were compared with OsseoSpeed TM implants ( A stra, M ölndal, S weden), with the Aadva implant displaying significant larger inter‐thread dimensions than the OsseoSpeed implant. Implants were installed in the parietal bone of 12 domestic pigs and left for healing for either 1 or 3 months. Implant osseointegration was evaluated by quantitative histology (bone volume relative to the tissue volume [ BV / TV ]; bone‐to‐implant contact [ BIC ]) for distinct implant regions (collar, body, total implant length) with specific implant thread features. The W ilcoxon– M ann– W hitney nonparametric test with α = 0.05 was performed. Results An inferior amount of bone enveloping the Aadva implant compared with the OsseoSpeed implant was observed, in particular at the implant body part with its considerable inter‐thread gaps ( p < .05). Concomitantly, the Aadva macro‐design negatively affected the amount of bone in direct contact with the implant for this specific implant part ( p < .05), and resulted in an overall impaired implant osseointegration at the initial healing stage (total implant length; 1‐month healing; p < .05). Conclusion Although the Aadva implant displayed a clinically acceptable level of osseointegration, the findings demonstrate that implant macro‐design features can impact the dynamics of implant osseointegration. Consideration of specific implant macro‐design features should be made relative to the biological and mechanical microenvironment.
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