It is well known that the apposition of bone at implant surface would be influenced by the microstructure of titanium implants. The purpose of this study was to compare bone healing around the screw-shaped titanium implant with three different surface topographies in the canine mandibles by histological and biomechanical evaluation. All mandibular premolars of six mongrel dogs were extracted and implants were placed one month later. The pure titanium implants had different surface topographies: smooth and machined ($Steri-OSS^{(R)}$: Group II); sandblasted and acid-etched ($ITI^{(R)}$, SLA: Group III) surface. The fluorescent dyes were injected on the 2nd (calcein), 4th (oxytetracycline HCI) and 12th (alizarin red) weeks of healing. Dogs were sacrificed at 4 and 12 weeks after implantation. The decalcified and undecalcified specimens were prepared for histological and histo-metrical evaluation of implant-bone contact. Some specimens at 12 weeks after implantation were used for removal torque testing. Histologically, direct bone apposition to implant surface was found in all of the treated groups. More mature and dense bone was observed at the implant-bone interface at 12 weeks than that at 4 weeks after implantation. Under the fluorescent microscope, thick regular green fluorescent lines which mean early bone apposition were observed at the implant-bone interface in Group III, while yellow and red fluorescent areas were found at the implant-bone interface in Group I and II. The average implant-bone contact ratios at 4 weeks of healing were 54.3% in Group I, 57.7% in Group II and 66.2% in Group III. In Group I, implant-bone contact ratio was significantly lower than Group II and III(p<0.05). The average implant-to-bone contact ratios at 12 weeks after implantation were 64.3% in Group I, 66.7% in Group II and 71.2% in Group III. There was no significant difference among the three groups. In Group I and II, the implant-bone contact ratio at 12 weeks increased significantly in comparison to ratio at 4 weeks(p<0.05). The removal torque values at 12 weeks after implantation were 90.9 Ncm in Group I, 81.6 Ncm in Group II and 77.1 Ncm in Group III, which were significantly different(p<0.05). These results suggest that bone healing begin earlier and be better around the surface-treated implants compared to the smooth surface implants. The sandblasted and acid-etched implants showed the most favorable bone response among the three groups during the early healing stage and could reduce the waiting period prior to implant loading.
Following the extensive use of implant, the incidence of peri-implantitis increases. Guided bone regeneration has been used for the optimal treatment of this disease. Because implant surface was contaminated with plaque and calculus, cleaning and detoxification were needed for the reosseointegration when guided bone regeneration was performed. Various mechanical and chemical methods have been used for cleaning and detoxification of implant surface, air-powder abrasive and oversaturated citrate were known to be most effective among these methods. However, these methods were incomplete because these could not thoroughly remove bacteria of implant surface, moreover deformed implant surface. Recent studies for detoxification of the implant surface using laser were going on, $CO_2$ laser and Soft Diode laser were known to be effective among these methods. The purpose of this study was to obtain clinical guide by application these laser to implant surface. 15 experimental machined pure titanium cylinder models were fabricated. The $CO_2$ laser treatment under dry, wet and hydrogen peroxide condition or the Soft Diode laser treatment under Toluidine blue O solution condition was performed on the each of models. Each groups were examined with SPM and SEM to know whether their surface was changed. The results were as follows : 1. Surface roughness and surface form weren't changed when $CO_2$ laser was usedunder dry condition(P>0.05). 2. Surface roughness and surface form weren't changed when $CO_2$ laser was used under wet condition(P>0.05). 3. Surface roughness and surface form weren't changed when $CO_2$ laser was used under hydrogen peroxide condition(P>0.05). 4. Surface roughness and surface form weren't changed when Soft Diode laser was used under toluidine blue O solution condition(P>0.05). From the result of this study, it may be concluded that the $CO_2$ laser having relatively safe pulse mode and the Soft Diode laser used with photosensitizer can be used safely to treat peri-implantitis.
Pitchaya Aneksomboonpol;Basel Mahardawi;Pheeradej Na Nan;Palawat Laoharungpisit;Thongnard Kumchai;Natthamet Wongsirichat;Napapa Aimjirakul
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제49권3호
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pp.114-124
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2023
Dental implants have been utilized for many years to treat individuals with missing teeth. To optimize the long-term success rate of such implants, new designs, surfaces, and materials have been analyzed. It is important for the clinician to have a background in the field of implant surface design, to be familiar with the strengths and limitations of the available options, and to be aware of the alterations in surface structure that may occur following installation. This article provides a detailed review of the structure and the surface characteristics of dental implants, the modifications of implant surface, as well as the methods of evaluating implant surface structure. Moreover, it provides information concerning the structural changes that may take place at the time of dental implant placement. It is important for clinicians to be aware of such changes to plan and execute implant procedures with the highest possible success and implant survival rates.
Mechanical and chemical methods are the two ways to treat the implant surfaces. By using mechanical method, it is difficult to eliminate bacteria and by-products from the rough implant surface and it can also cause the structural change to the implant surface. Therefore, chemical method is widely used in order to preserve and detoxicate the implant surface more effectively. The purpose of this study is to evaluate the effect of tetracylcline-hydrochloride(TC-HCI) on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface, SLA surface and porous surface were used in this study. Implant surface was rubbed with sponge soaked in 50mg/ml TC-HCI solution for $\frac{1}{2}$ min., 1 min., $1\frac{1}{2}$ min., 2 min., and $2\frac{1}{2}$ min. respectively in the test group and with no treatment in the control group. Then, specimens were processed for scanning electron microscopic observation. 1. Both test and control group showed a few shallow grooves and ridges in pure titanium machined surface implants. There were not significant differences between two groups. 2. In the SLA surfaces, the control specimen showed that the macro roughness was achieved by large-grit sandblasting. Subsequently, the acid-etching process created the micro roughness, which thus was superimposed on the macro roughness. Irrespective of the application time of 50mg/ml TC-HCI solution, in general, test specimens were similar to control. 3. In the porous surfaces, the control specimen showed spherical particles of titanium alloy and its surface have a few shallow ridges. The roughness of surfaces conditioned with tetracycline-HCI was lessened and seen crater-like irregular surfaces relative to the application time. In conclusion, pure titanium machined surfaces and SLA surfaces weren't changed irrespective of the application time of tetracycline-HCI solution. But the porous surfaces conditioned with tetracycline-HCI solution began to be slightly changed from 2 min. This results are expected to be applied to the regenerative procedures for peri-implantitis treatment.
Purpose: This study aimed to evaluate the effects of fibronectin and oxysterol immobilized on machined-surface dental implants for the enhancement of cell attachment and osteogenic differentiation, on peri-implant bone healing in the early healing phase using an experimental model in dogs. Methods: Five types of dental implants were installed at a healed alveolar ridge in five dogs: a machined-surface implant (MI), apatite-coated MI (AMI), fibronectin-loaded AMI (FAMI), oxysterol-loaded AMI (OAMI), and sand-blasted, large-grit, acid-etched surface implant (SLAI). A randomly selected unilateral ridge was observed for 2 weeks, and the contralateral ridge for a 4-week period. Histologic and histometric analyses were performed for the bone-to-implant contact proportion (BIC) and bone density around the dental implant surface. Results: Different bone healing patterns were observed according to the type of implant surface 2 weeks after installation; newly formed bone continuously lined the entire surfaces in specimens of the FAMI and SLAI groups, whereas bony trabecula from adjacent bone tissue appeared with minimal new bone lining onto the surface in the MI, AMI, and OAMI groups. Histometric results revealed a significant reduction in the BIC in MI, AMI, and OAMI compared to SLAI, but FAMI demonstrated a comparable BIC with SLAI. Although both the BIC and bone density increased from a 2- to 4-week healing period, bone density showed no significant difference among any of the experimental and control groups. Conclusions: A fibronectin-coated implant surface designed for cell adhesion could increase contact osteogenesis in the early bone healing phase, but an oxysterol-coated implant surface designed for osteoinductivity could not modify early bone healing around implants in normal bone physiology.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제42권6호
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pp.345-351
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2016
Objectives: This study compared the impact of implant surface treatment on the stability and osseointegration of implants in dog mandibles. Materials and Methods: Six adult dogs received a total of 48 implants that were prepared using four different surface treatments; resorbable blast media (RBM), hydroxyapatite (HA), hydrothermal-treated HA, and sand blasting and acid etching (SLA). Implants were installed, and dogs were separated into 2- and 4-week groups. Implant stability was evaluated via Periotest M, Osstell Mentor, and removal torque analyzers. A histomorphometric analysis was also performed. Results: The stability evaluation showed that all groups generally had satisfactory values. The histomorphometric evaluation via a light microscope revealed that the HA surface implant group had the highest ratio of new bone formation on the entire fixture. The hydrothermal-treated HA surface implant group showed a high ratio of bone-to-implant contact in the upper half of the implant area. Conclusion: The hydrothermal-treated HA implant improved the bone-to-implant contact ratio on the upper fixture, which increased the implant stability.
The purpose of this study was to compare surface roughness and bone formation around two types of threaded commercially pure titanium implants manufactured by two different companies. The test implants were manufactured by Sumin synthesis dental materials Co. (Avana, Busan, Korea), while the controls were manufactured by Nobel Biocare (MK II, Goteborg, Sweden). To compare bone formation adjacent to newly product implant with $Br{\aa}nemark$ MK II implant, surface roughness was measured by Accurate 1500M and histomorphometric analysis was done. The results were as follows: 1. Measurement of surface roughness showed that Avana implant had a slightly more irregular surface compared with $Br{\aa}nemark$ implant. 2. In the light microscopic studies, no infiltration of inflammatory cells nor the giant cells were observed on both groups. 3. In the light and fluorescent microscopic studies, the amount of osseointegration and the extent and the timing of bone formation were similar. 4. There were no statistically difference between two groups in the average bone to implant con-tacts. Branemark implant; 67% (SD 23%), Avana implant; 70% (SD 16%). Comparing with $Br{\aa}nemark$ implant, Avana implant made of CP grade II titanium showed similar good bone healing, formation and osseointegration.
Background: A compact passive oxide layer can grow on tantalum (Ta). It has been reported that this oxide layer can facilitate bone ingrowth in vivo though the development of bone-like apatite, which promotes hard and soft tissue adhesion. Thus, Ta surface treatment on facial implant materials may improve the tissue response, which could result in less fibrotic encapsulation and make the implant more stable on the bone surface. The purposes of this study were to verify whether surface treatment of facial implant materials using Ta can improve the biohistobiological response and to determine the possibility of potential clinical applications. Methods: Two different and commonly used implant materials, silicone and expanded polytetrafluoroethylene (ePTFE), were treated via Ta ion implantation using a Ta sputtering gun. Ta-treated samples were compared with untreated samples using in vitro and in vivo evaluations. Osteoblast (MG-63) and fibroblast (NIH3T3) cell viability with the Ta-treated implant material was assessed, and the tissue response was observed by placing the implants over the rat calvarium (n = 48) for two different lengths of time. Foreign body and inflammatory reactions were observed, and soft tissue thickness between the calvarium and the implant as well as the bone response was measured. Results: The treatment of facial implant materials using Ta showed a tendency toward increased fibroblast and osteoblast viability, although this result was not statistically significant. During the in vivo study, both Ta-treated and untreated implants showed similar foreign body reactions. However, the Ta-treated implant materials (silicone and ePTFE) showed a tendency toward better histological features: lower soft tissue thickness between the implant and the underlying calvarium as well as an increase in new bone activity. Conclusion: Ta surface treatment using ion implantation on silicone and ePTFE facial implant materials showed the possibility of reducing soft tissue intervention between the calvarium and the implant to make the implant more stable on the bone surface. Although no statistically significant improvement was observed, Ta treatment revealed a tendency toward an improved biohistological response of silicone and ePTFE facial implants. Conclusively, tantalum treatment is beneficial and has the potential for clinical applications.
Titanium implant is used as the most popular dental material for replacement of missing teeth recently. A lot of studies on the surface modification of titanium implant have been carried out for enhancing osseointegration. The surface modification techniques could be classified as follows; topographic modifications which provide roughness and porosity, chemical surface modificationss or deposition of osseoconductive materials, and biochemical modifications to immobilize bone growth factors on titanium surface. In this study, the current and ongoing surface modification techniques and its typical characteristics used in clinics were reviewed. In the future, study and implication about biochemical modifications including patient' s individual characteristics will be important.
Mechanical and chemical methods are the two ways to treat the implant surfaces. By using mechanical method, it is difficult to eliminate bacteria and by-products from the rough implant surface and it can also cause the structural change to the implant surface. Therefore, chemical method is widely used in order to preserve and detoxicate the implant surface more effectively. The purpose of this study is to evaluate the effect of tetracylcline- HCl on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface, SLA surface and $TiO_2blasted$ surface were used in this study. Implant surface was rubbed with sponge soaked in 50mg/ml tetracycline - HCl solution for $\frac{1}{2}$ min., 1min., $1\frac{1}{2}$ min., 2 min., and $2\frac{1}{2}min.$ respectively in the test group and with no treatment in the control group. The sponge was soaked in every 30 seconds. Then, the specimens were processed for scanning electron microscopic observation. Based upon the analysis of photographs by three dentists who are not related with this study, the results were obtained as follows; 1. In the pure titanium machined surfaces, the control specimen showed a more or less rough machined surface composed of alternating positive and negative lines corresponding to grooves and ridges. After treatment, machining line was more pronounced for the control specimens. but in general, test specimens were similar to control. 2. In the SLA surfaces, the control specimen showed that the macro roughness was achieved by large-grit sandblasting. Subsequently, the acid-etching process created the micro roughness, which thus was superimposed on the macro roughness. Irrespective of the application time of 50mg/ml tetracycline - HCl solution, in general, test specimens were similar to control. 3. In the $TiO_2blasted$ surfaces, the control specimen showed the rough surface With small pits. The irregularity of the $TiO_2blasted$ surfaces with 50mg/ml tetracycline - HCl solution was lessened and the flattened areas got wider after 1 minute.
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