Surface Modification of Titanium Plate with Anodic Oxidation and Its Application in Bone Growth
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Using implants for dental applications are well-accepted procedures as one of the solutions for periodontal defect repair. Suitable design and materials, their reaction with the surrounding hard tissues and interfacial biomechanical properties are still considered to be the primary criteria which need to be addressed. The purpose of present study was to evaluate the bone repair around pure titanium implants and porous surface using anodic oxidation technique, after their insertion in tibiae of rats (n = 15). Five animals received pure titanium-surface implants in tibia, 5 rough-surface implants (TiO2/Ti) in tibia and last five acted as control group. The interfacial integrity and compositional variation along the interface were studied using scanning electron microscope (SEM) with energy dispersive analysis of X-ray (EDX) and histopathology after 2 months. The rats were sacrificed 8 weeks after surgery and fragments of the tibiae containing the implants were submitted to histological analyses to evaluate new bone formation at the implant-bone interface as well as the tibiae were radio graphed. The SEM-EDX results confirmed the initial stability for the Ti implant, but the regeneration of new bone formation was faster in the case of TiO2/Ti implant, and hence could be used for faster healing. The results of the histological analysis showed that osseointegration occurred for both types of implants with similar quality of bone tissue. In conclusion, the porous-surface implants contributed to the osseointegration because they provide a larger contact area with surface roughness at implant-bone interface can help into the formation of physico-chemical bondage with the surrounding hard tissues.Keywords:
Surface Modification
The key factor in success of dental implants is its ability to integrate with the surrounding bone, or in short, osseointegration. The events leading tosuccess or failure of osseointegration of a dental implant takes place mostly at the tissue- implant surface. It would be no doubt to say, that the implant surface offers the greatest potential to alter the process of osseointegration.Although the main purpose of surface modification of implants is to achieve better osseointegration, a shortened period of healing is desirable for both the clinician and the patient.
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The stability of dental implants is a prerequisite for osseointegration. Osseointegration is the process that involves the formation of bone around the dental implant, resulting in increased stability and its integration in the organism. Therefore, successful osseointegration contributes to a functionally optimal treatment. There is a need for a clinical method capable of measurement of bone quality at the time and following implant placement, to measure the degree of osseointegration and the ability of the implants to distribute loads to the surrounding bone. Research to date focuses on finding an ideal method to assess the osseointegration of dental implants in order to improve and broaden the clinical indications of dental implant systems. This paper aims to supply information about current methods used to assess the osseointegration of dental implants. In this regard, a literature review was conducted. Full-text scientific articles relevant to the chosen topic, written in English or whose text could be accessed in English were included.
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Objective To analyze the effect of clinical factors on implant osseointegration formation. Methods A clinical study using the Branemark dental implant system was carried out on 230 patients. The second stage procedure was performed at 3-6 months postoperatively. The status of implant osseointegration was assessed by X-ray and clinical examination. Result Among 520 dental implants inserted,503 dental implants acquired osseointegration, 17 implants failed to osseointegrate and the success rate was 96.7%. Conclusion The dental implant osseointegration formation depends on selecting indication,presurgical preparing, subtle surgical manipulation, and preventing bone burning, inflammation of operation aera and contamination of dental implants.
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The osseointegration of oral implants is of utmost importance as far as the success of implant prosthetics is concerned. In clinical practice osseointegration can only be tested indirectly. The loading of implants is usually linked to osseointegration as a condition. Under some circumstances implants can be loaded before osseointegration is completed. The present study reviews the various methods of testing osseointegration and the conditions of immediate loading. In the present study the changes in the stability of 59 implants restored with screw-retained superstructures and partly immediately loaded, were observed over a period of several years, with the help of the Periotest method. Based on the statistical evaluation of the results, a significant correlation was found between implant insertion torque and primary stability. A difference was found between the stability of implants in the upper and lower jaws. A typical curve in the temporal changes of implant stability was described.
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Osseointegration is an important factor in determining the success of a dental implant. It can be assessed from the osseointegration that occurs between the implant and the bone. The implant stability is determined by the osseous support at the implant-bone interface, which is commonly evaluated by histomorphometric analysis. This study aimed to evaluate whether the osseointegration level measured by a Low Resonance Frequency Analyzer (LRFA) gave results as good as those obtained by histomorphometric examination. Six male Macaca fascicularis were used in this study. In each animal, two types of loading were performed: immediate and delayed loading. Clinical examination and LRFA measurement were performed to determine osseointegration at the first and second weeks and at the first, second, third, and fourth months. After four months, histomorphometric examination was performed. The relationship between the histomorphometric examination and LRFA measurement was compared using the Pearson correlation coefficient. There was no significant difference in the osseointegration between immediate loading and delayed loading (p > 0.05) The bone-implant contact percentage in the first group did not differ significantly from that in the second group. Statistical analysis showed that there was a strong correlation between LRFA measurement and histomorphometric examination. Osseointegration could be evaluated through LRFA measurement as well as through histomorphometric examination.
Resonance frequency analysis
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Implant osseointegration has not been accepted over time, considering that in fact the implant integration is performed only in the soft tissue of the host. For this reason, the implant has never been sufficiently integrated into the host tissue immediately after insertion. Experiments performed in Branemark laboratories in the early 1960s, with a new type of implant, which required a direct anchorage to bone tissue for clinical function, this anchorage was called osseointegration. It has been shown that it is possible to achieve direct osseointegration if the Branemark method is considered, which was published a few years later in the first clinical report. The authors of this article come up with new contributions that validate the implant osseointegration process. Inside this article we present our methodology for evaluating the osseointegration of endosseous implants: ESEM (environmental scanning electron microscope) studies of the implant-bone tissue interface.
Endosseous implants
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Resonance frequency analysis (RFA) has been widely used to predict dental implant stability by assessing conditions surrounding the implant. The aim of this study was to investigate the influence of osseointegration degree and pattern on the resonance frequency of implant-bone structure by means of finite element analysis (FEA).A basic FEA model was created to represent a titanium implant in a portion of the maxillary bone at the left first premolar region. This model was then used to compute the vibration behaviors for 5 osseointegration degrees and 8 osseointegration pattern models using modal and harmonic analysis.In the arbitrarily set osseointegration pattern models, a significant influence of osseointegration degree on the resonance frequency (P < .001) could be expressed as the linear function R2 = 0.99. No significant influence from the osseointegration pattern could be observed (P = .89). While the coronal-osseointegration model had a slightly higher resonance frequency than others and the apical-osseointegration model had the lowest, the difference between the highest and lowest value was within 5% (P = .51). In the randomly set osseointegration models, the osseointegration degree had a statistically significant influence on the resonance frequency (P < .001); the pattern of random osseointegration for a certain osseointegration degree had little influence.It seems that RFA can detect implant-stability changes related to the increase in osseointegration degree. However, careful consideration should be given to its use in predicting the stability in vivo of loss of osseointegration at the marginal bone.
Resonance frequency analysis
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Having analysed scientific literature sources, the authors describe peculiarities in osteointegration of the bone tissue with titanium implants and examine the effect of the surface structure, porosity in particular, of titanium implants on osteointegration. The article analyses different coats, which increase osteointegrative potencies of titanium. The authors revealed directions for improving medical-biological effects of titanium implants on the basis of the study of osteointegration mechanisms.
Bone tissue
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