Materials with differing surfaces have been developed for clinical implant therapy in dentistry and orthopedics. This study was designed to evaluate bone response to titanium alloy containing Ti-32Nb-5Zr with nanostructure, anodic oxidation, heat treatment, and ibandronate coating. Rats were randomly assigned to two groups for implantation of titanium alloy (untreated) as the control group and titanium alloy group coated with ibandronate as the experimental group. Then, the implants were inserted in both tibiae of the rats for four weeks. After implantation, bone implant interface, trabecular microstructure, mechanical fixation was evaluated by histology, micro-computed tomography (${\mu}CT$) and the push-out test, respectively. We found that the anodized, heat-treated and ibandronate-coated titanium alloy triggered pronounced bone implant integration and early bone formation. Ibandronate-coated implants showed elevated values for removal torque and a higher level of BV/TV, trabecular thickness and separation upon analysis with ${\mu}CT$ and mechanical testing. Similarly, higher bone contact and a larger percentage bone area were observed via histology compared to untreated alloy. Furthermore, well coating of ibandronate with alloy was observed by vitro releasing experiment. Our study provided evidences that the coating of bisphosphonate onto the anodized and heat-treated nanostructure of titanium alloy had a positive effect on implant fixation.
Objective: This study aimed to estimate the clinical effects of different types of bone-anchored maxillary protraction devices by using a network meta-analysis. Methods: We searched seven databases for randomized and controlled clinical trials that compared bone-anchored maxillary protraction with tooth-anchored maxillary protraction interventions or untreated groups up to May 2021. After literature selection, data extraction, and quality assessment, we calculated the mean differences, 95% confidence intervals, and surface under the cumulative ranking scores of eleven indicators. Statistical analysis was performed using R statistical software with the GeMTC package based on the Bayesian framework. Results: Six interventions and 667 patients were involved in 18 studies. In comparison with the tooth-anchored groups, the bone-anchored groups showed significantly more increases in Sella-Nasion-Subspinale (°), Subspinale-Nasion-Supramentale(°) and significantly fewer increases in mandibular plane angle and the labial proclination angle of upper incisors. In comparison with the control group, Sella-Nasion-Supramentale(°) decreased without any statistical significance in all treated groups. IMPA (angle of lower incisors and mandibular plane) decreased in groups with facemasks and increased in other groups. Conclusions: Bone-anchored maxillary protraction can promote greater maxillary forward movement and correct the Class III intermaxillary relationship better, in addition to showing less clockwise rotation of mandible and labial proclination of upper incisors. However, strengthening anchorage could not inhibit mandibular growth better and the lingual inclination of lower incisors caused by the treatment is related to the use of a facemask.
Jeong-Hun Nam;Akram Abdo Almansoori;Oh-Jun Kwon;Young-Kwon Seo;Bongju Kim;Young-Kyun Kim;Jong-Ho Lee;KangMi Pang
Journal of Periodontal and Implant Science
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v.53
no.3
/
pp.218-232
/
2023
Purpose: This study evaluated the efficacy of a tube-shaped poly(ε) caprolactone - β tricalcium phosphate (PCL-TCP) scaffold with the incorporation of human umbilical cord-derived mesenchymal stem cells (hUCMSCs) and platelet-rich plasma (PRP) for bone regeneration in the procedure of single-stage sinus augmentation and dental implantation in minipigs. Methods: Implants were placed in the bilateral sides of the maxillary sinuses of 5 minipigs and allocated to a PCL-TCP+hUCMSCs+PRP group (n=5), a PCL-TCP+PRP group (n=5), and a PCL-TCP-only group (n=6). After 12 weeks, bone regeneration was evaluated with soft X-rays, micro-computed tomography, fluorescence microscopy, and histomorphometric analysis. Results: Four implants failed (2 each in the PCL-TCP+hUCMSCs+PRP and PCLTCP+hUCMSC groups). An analysis of the grayscale levels and bone-implant contact ratio showed significantly higher mean values in the PCL-TCP+hUCMSCs+PRP than in the PCL-TCP group (P=0.045 and P=0.016, respectively). In fluoromicroscopic images, new bone formation around the outer surfaces of the scaffolds was observed in the PCLTCP+hUCMSCs+PRP group, suggesting a tenting effect of the specially designed scaffolds. Bone regeneration at the scaffold-implant interfaces was observed in all 3 groups. Conclusions: Using a tube-shaped, honeycombed PCL-TCP scaffold with hUCMSCs and PRP may serve to enhance bone formation and dental implants' osseointegration in the procedure of simultaneous sinus lifting and dental implantation.
In recent years immediate implantation has been tried by a few clinicians. This study placed IMZ implants in the rabbit femur with and without bony defects around the implant for simulating fresh extraction site. And one group with bony defects used porous hydroxyapatite ganules(HA) to fill if and the other group left the bony defects around the implant. The purpose of this study was to compare the shear bond strength and the bony contact and formation around the implant. Fifteen rabbits were divided into three groups and placed 10 IMZ implants to each group. Implant sites were surgically prepared with IMZ drills kit and implants were placed(Control), artificial bony defect was created with Apaceram drills kit around the implant sites and implants were placed(Experimental I), bony defect was filled with porous hydroxyapatite granules(Experimental II). Thereafter, rabbits were sacrificed at 8th week and specimens were prepared and pushout tested for shear bond strength of bone-implant interface immediately. Undecalcified and decalcified specimens were prepared with Vilanueva and hematoxylin-eosin stain for light microscopic finding. The results of this study were as follows. 1. In the control group, mean shear strength of bone-implant interface was $2.614{\pm}0.680$ MPa, experimental I was $0.664{\pm}0.322$ MPa, and experimental II was $2.281{\pm}0.606$ MPa. There was significant difference between control and experimental I, between experimental I and experimental II, but did not show significant difference between control and experimental II statistically. 2. In the bony formation surrounding IMZ implant of the three groups, that of cortical bone is more advanced than cancellous bone area. 3. In the histological findings of undecalcified specimens, control and experimental II showed more than 50% of bony or osteoid formation at the bony-implant interface. 4. In the histological findings of undecalcified specimens, experimental I showed less than 50% of bony or osteoid formation at the interface, and observed partial bony defect in the coronal zone. 5. In the experimental II group, were observed direct bony contact to hydroxyapatite granules, and infiltration of a few giant cells. 6. No inflammatory responses were seen around the titanium implants and the hydroxyapatite granules.
Yi Yang-Jin;Yang Jae-Ho;Lee Sun-Hyung;Kim Yung-Soo;Kwon Sang-Ho
The Journal of Korean Academy of Prosthodontics
/
v.39
no.6
/
pp.659-681
/
2001
Platelet-rich plasma(PRP) has been known to increase the rate and degree of bone formation by virtue of growth factors in concentrated platelets. Although its great healing effect on bone defect or pre-implantation site preparation in conjunction with bone substitute has been reported, the effect associated with implant is unknown. The purpose of this study was to investigate the effect of PRP on rapid osseointegration of endosseous dental implants in the rabbit tibiae. Twenty two adult female New Zealand white rabbits, weighing approximately 2.7-3.3kg, were used for this study. Twelve of the 22 animals were used for histomorphometric analysis and ten of the 22 were for removal torque test. Each animal received two implants in each tibia (two treated with PRP and two as control) and was given fluorochrome intramuscularly. For histomorphometric analysis, rabbits were divided into four groups according to the healing period. At 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively, each three animals were sacrificed serially and the amount and rate of bone formation around dental implant were examined on the undecalcified sections under fluorescent microscope, polarized microscope and light microscope connected to a personal computer equipped with image analysis system. For removal torque test, rabbits were divided into two groups and removal torque tests were performed at 4 weeks, 10 weeks after implant placement. In total, 88 screw shaped, commercially pure titanium implants (Neoplant, Neobiotech, Seoul, Korea) were used in this study. Labeling pattern reflected differences of two groups in bone formation rate at each period. Histomorphometrically, PRP group showed significantly higher bone volume within threads compared to control group at 2 weeks ($70.30{\pm}4.96%$ vs. $50.68{\pm}6.33%$; P < .01) and 4 weeks ($82.59{\pm}5.94%$ vs. $72.94{\pm}4.57%$; P < .05 ). PRP group at 1, 2 and 4 weeks revealed similar degree of bone volume formation comparable to control group at 2, 4 and 8 weeks, respectively. On the other hand, while PRP group showed higher bone-implant contact ($47.37{\pm}8.09%$) than control group ($33.16{\pm}13.47%$) at 2 weeks, there were no significant differences between PRP group and control group for any experimental period. Removal torque values also showed no significant differences between PRP group and control group at any experimental period (P > .05). These findings imply that PRP could induce rapid, more bone formation around implant during early healing period and get faster secondary stability for reducing healing period, though it has not induced bone maturation enough to resist functional loading.
The orthodontic osseointegrated titanium implant, a kind of intraoral skeletal anchorage can be an alternative to tooth-borne anchorage, in case that the conventional tooth-borne anchorage is not available or the anchorage is critical. This study was conducted to elucidate the effect of early loading on the osseointegration of the orthodontic titanium implant and the healing process of the impaired bone at the site of implant after removing it. In two adult beagle dogs24 osseointegrated titanium implants were inserted into the alveolar bone, with 12 implants placed in each dog. In dog1, 6 out of 12 implants were loaded with 200-300gm of force immediately after placing, and the remaining 6 implants were not loaded for 4weeks. In dog2, all 12 implants had healing period of 4weeks, and then were loaded with 200-300gm of force for another 4weeks. Following an observation period of 4 and 8 weeks, the animals were sacrificed. Then the implants and the surrounding bone of dog1 and dog2 were removed, respectively. Undecalcified sections along the long axis of implant were made and the degree of osseointegration was examined under the light microscope. The results were as follows. 1. In the histologic features of tissues around implants anchored in dog1, there was no difference between immediately loaded implants and unloaded implants. Immature woven bone was ingrowing into the thread spaces from the original compacta and in direct contact with the implant surface in part. 2. The premature loading just after 4weeks healing period did not halt the progress of the osseointegration between bone and implant surface. The woven bone around the implants was maturing into the lamellar bone which resembled the structure of the original compacta at the end of 8weeks observation period. 3. Most implants with the inflammed surrounding mucosa were lost or mobile. The mobile implants were encapsulated by fibrous connective tissue which separated the implant surface from the bone. 4. The impaired bone at the site of the implant failed to anchor was showing recovery without inflammatory reaction 2weeks after removing, with the immaure woven bone lined by active osteoblasts and osteoid. Based on the results of this study, the integration of this orthodontic implant seemed to be impaired by the inflammation of the tissue surrounding the Implant rather than by early loading on implant, and increased with time lapsed after placing the implant. The use of implant described in this report can be recommended as an orthodontic anchorage unit immediately after insertion under the careful control of orthodontic force applied and plaque.
Purpose: This study was performed to evaluate the effect of various graft materials used with a titanium cap on the ability of new bone formation in the rabbit calvarium. Materials and Methods: A total of 32 sites of artificial bony defects were prepared on the calvaria of sixteen rabbits by using a trephine bur 8 mm in diameter. Each rabbit had two defect sites. 0.2 mm deep grooves were formed on the calvaria of sixteen rabbits by using a trephine bur 8 mm in diameter for the fixation of a titanium cap. The treatments were performed respectively as follows: without any graft for the control group (n=8), autogenous iliac bone graft for experimental group 1 (n=8), alloplastic bone graft ($SynthoGraft^{(R)}$, USA) for experimental group 2 (n=8), and xenogenic bone graft ($NuOss^{(R)}$, USA) for experimental group 3 (n=8). After the treatments, a titanium cap (8 mm in diameter, 4 mm high, and 0.2 mm thick) was fixed into the groove. At the third and sixth postoperative weeks, rabbits in each group were sacrificed for histological analysis. Results: 1. In gross examination, the surgical sites showed no signs of inflammation or wound dehiscence, and semicircular-shaped bone remodeling was shown both in the experimental and control groups. 2. In histological analysis, the control group at the third week showed bone remodeling along the inner surface of the cap and at the contact region of the calvarium without any specific infiltration of inflammation tissue. Also, there was no soft tissue infiltration. Bone remodeling was observed around the grafted bone and along the inner surface of the titanium cap in experimental group 1, 2, and 3. 3. Histologically, all groups at the sixth week showed the increased area of bone remodeling and maturation compared to those at the third week. In experimental group 2, the grafted bone was partially absorbed by multi nucleated giant cells and new bone was formed by osteoblasts. In group 3, however, resorption of the grafted bone was not observed. 4. Autogenous bone at the third and sixth week showed the most powerful ability of new bone formation. The size of newly formed bone was in decreasing order by autogenous, alloplastic, and heterogenous bone graft. There was no statistically significant difference among autogenous, alloplastic, and heterogenous bones(p>0.05). Summary: This result suggests that autogenous bone is the best choice for new bone formation, but when autogenous bone graft is in limited availability, alloplastic and xenogenic bone graft also can be an alternative bone graft material to use with a suitably guided membrane.
The expandable implant employs an inner expansion screw in order to expand several legs of implant. Compressive stresses are produced at the bone tissue surrounding the implant, and the contact area between the implant and the bone tissue is increased, which result in increased resistance to horizontal and vertical pressure loads. The stress distribution in implant is also an important factor. Three types of implant models including an existing one have been investigated by using the Finite Element Method, and an improved design model has been suggested.
Purpose: This report presents a case of an unusual and rare presentation of Stafne bone defect (SBD) with apical resorption extending from the lower right lateral incisor to the right first premolar. A systematic search of the current literature on cases where SBD affected the adjacent teeth was conducted. Materials and Methods: From 259 identified articles, 114 studies were examined, containing 12 individuals with a mean age of 41.58 years. Ten cases in the anterior mandible and 2 in the posterior mandible were found. Results: The results of SBD varied from apical blunting to severe root resorption, and some cases showed close apical contact with the lesion or involvement of the root without any effect. Conclusion: SBD is an unusual incidental finding in the anterior region of the mandible, and unexpected behavior of the lesion, such as root resorption, must be considered.
Shibani A. Nerurkar;Subramania Iyer;Arjun Krishnadas;Pramod Subash
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.50
no.2
/
pp.116-120
/
2024
External nasal splints are commonly used for immobilization following nasal fracture reduction or rhinoplasty procedures. The literature documents the use of various materials like thermoplastic materials, aluminum, Orthoplast, fiberglass, plaster of Paris, and polyvinyl siloxane. These materials are bulky, time-consuming, expensive, and cumbersome to use, and have been associated with complications including contact dermatitis and epidermolysis. Furthermore, they cannot be retained if the situation warrants prolonged stabilization and immobilization. We introduce a new technique using readily available scalp vein catheter flanges as an external nasal stent. The technique is easy to master, inexpensive, and limits edema and ecchymosis, while stabilizing the reconstructed nasal skeleton in position during the healing period.
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