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Comparative study between dense and porous hydroxyapatite using light and scanning electron microscopy

Pohchi A, Suzina AH, Samsudin AR, Al-Salihi KA

Med J Malaysia, 2004 May;59 Suppl B:151-2.
PMID: 15468863

This in vivo study revealed that porous hydroxyapatite (PHA) and dense hydroxyapatite (DHA) are good implant materials that can accelerate bone healing and resorbed in acceptable time. But there were differences in the mechanism of the resorption of DHA and PHA due to variability in the physical properties and osteogenicity.

Matched MeSH terms: Osseointegration/physiology
Periodic Assessment of Peri-implant Tissue Changes: Imperative for Implant Success

Rahman SA, Muhammad H, Haque S, Alam MK

J Contemp Dent Pract, 2019 Feb 01;20(2):173-178.
PMID: 31058631

AIM: The aim of this study was to evaluate the changes in the peri-implant hard and soft tissues and implant stability and to assess the correlation of bone loss and peri-implant probing depth with implant stability.
MATERIALS AND METHODS: Twenty-one patients with implants were included in this study and implants were assessed by resonance frequency analysis (RFA). Bone levels of the implants were assessed by measuring mesial and distal bone levels from the periapical radiograph, and soft tissue was assessed from probing depth using a periodontal probe. Implants were assessed for stability and probing depth at pre-loading, at 3 months and 6 months post-loading. RFA and probing depth were statistically compared from different time points. Correlation of probing depth and marginal bone loss with implant stability was also determined.
RESULTS: The average change in implant stability quotient (ISQ) measurements from pre-loading to 6 months post-loading was found to be statistically significant (p <0.005). The average probing depth reduced from 1.767 mm at pre-loading to 1.671 mm at post-loading 3 months, and 1.600 mm at post-loading 6 months. At 6 months of function, radiographic examination yielded 0.786 mm mesial bone loss and 0.8 mm distal bone loss. It was found to be statistically significant (p <0.005) but within an acceptable range. No significant correlation was found between implant stability and bone loss; and implant stability and probing depth.
CONCLUSION: The study revealed an increasing trend in implant stability values with the time that indicates successful osseointegration. Increasing mean values for mesial and distal bone loss were also found.
CLINICAL SIGNIFICANCE: The success of dental implants is highly dependent on the quality of bone and implant-bone interface, i.e., osseointegration. The most important factors that influence the survival rate of an implant is initial stability. The present study found the changes in the peri-implant hard and soft tissues and implant stability. This article, while being a prospective study, may show the evidence of successful osseointegration by increasing trend in implant stability (RFA) values with time which can help to the clinician in the long-term management of implants.

Matched MeSH terms: Osseointegration
Fulltext Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients-A 3-Year Retrospective Study

Sghaireen MG, Alduraywish AA, Srivastava KC, Shrivastava D, Patil SR, Al Habib S, et al.

Int J Environ Res Public Health, 2020 07 21;17(14).
PMID: 32708165 DOI: 10.3390/ijerph17145253

Diabetes mellitus is known to compromise the various aspects of homeostasis, including the immune response and the composition of oral microflora. One of the oral manifestations of diabetes mellitus is tooth loss and the survival rate of dental implants chosen as a treatment modality for its rehabilitation is controversial. The current study aims to evaluate and compare the failure rate of dental implants between well-controlled diabetic and healthy patients. A retrospective study of case-control design was conceptualized with 121 well-controlled diabetic and 136 healthy individuals. Records of subjects who had undergone oral rehabilitation with dental implants between the periods of January 2013 to January 2016 were retrieved. Post-operative evaluation was carried out for all patients for about three years to assess the immediate and long-term success of the procedure. From a total of 742 dental implants, 377 were placed in well-controlled diabetic patients (case group) and 365 in healthy subjects (control group). A comparable (9.81%), but non-significant (p = 0.422) failure rate was found in the case group in comparison to the control group (9.04%). A non-significant (p = 0.392) raised number (4.98%) of failure cases were reported among females in comparison to males (4.44%). In respect to arch, the mandibular posterior region was reported as the highest failure cases (3.09%; p = 0.411), with 2.29% of cases reported in the mandibular anterior (p = 0.430) and maxillary posterior (p = 0.983) each. The maxillary anterior region was found to have the least number (1.75%; p = 0.999) of failure cases. More (4.98%; p = 0.361) cases were reported to fail during the functional loading stage in contrast to osseointegration (4.44%; p = 0.365). A well-controlled diabetic status does not impose any additional risk for individuals undergoing dental implant therapy.

Matched MeSH terms: Osseointegration
Gross, radiology and ultrasonographic evaluation of coral post-implantation in sheep femur

Fadilah A, Zuki AB, Loqman MY, Zamri-Saad M, Norimah Y, Asnah H

Med J Malaysia, 2004 May;59 Suppl B:178-9.
PMID: 15468876

The study was carried out to evaluate macroscopically the ability of coral to repair a large size bone defect. A total 12 adult, male sheep were used in the study. The large bone defect (2.5cm x 0.5cm x 0.5cm) was created surgically on the left proximal femur and replaced by a block of coral (Porites sp.). Radiographs were obtained immediately after surgery and at 2, 4, 8 and 12 weeks post-implantation. Ultrasonographic examinations were carried out every 2 weeks after implantation up to 12 weeks using ultrasound machine (TOSHIBA Capasee II) connected with 7MHz frequency transducer. The sheep were euthanased at 2, 4, 8, and 12 weeks post-implantation and the bone examined grossly. Both ultrasonographs and radiographs taken at 8 and 12 weeks showed that the implants had been resorbed and left the space that much reduced in size. There was no sign of implant rejection observed in all animals. The results showed that processed coral has potential to become bone substitute for reconstructive bone surgery.

Matched MeSH terms: Osseointegration/physiology*
A "healthy apatite" for bone repair

Best SM, Patel N, Porter AE, Bonfield W

Med J Malaysia, 2004 May;59 Suppl B:129-30.
PMID: 15468852

Bone is unique in its ability to adapt structure to functional requirements, but as is all too obvious in an ever-ageing population it is susceptible to a number of degenerative diseases. Therefore there is an increasing need for materials for bone replacement. Clearly, the ideal material with which to replace bone, would be bone itself, but the major problem now facing us is that there is an insufficient supply of the natural bone to satisfy the clinical requirements. Hence, there is a need for the development of chemically synthesised bone graft substitutes

Matched MeSH terms: Osseointegration/physiology*
Primary stability of self-tapping dual etched implants

Kassim ZH, Nor Hisham ND, Dardiri NA, Goot Heah K, Hazwani Baharuddin I, De Angelis N

Minerva Stomatol, 2019 Dec;68(6):291-296.
PMID: 32052617 DOI: 10.23736/S0026-4970.19.04242-0

BACKGROUND: The aims of this study were to enumerate the primary implant stability quotient (ISQ) value of self-tapping dual etched implants and to explore the influence of parameters such as implant length, implant diameter, age, gender, implant location and osteotomy preparation on the ISQ value.
METHODS: Retrospective data from clinical worksheets given to participants during two implant courses held between the periods of 2013 to 2014 were evaluated. A total of 61 implants were considered based on the inclusion criteria. The effects of parameters such as implant diameter, implant length, age, gender, implant location and osteotomy protocol on ISQ values were analyzed.
RESULTS: Mean ISQ value for all implants was 67.21±9.13. Age of patients (P=0.016) and location of implants (P=0.041) had a significant linear relationship with the ISQ values. Within the age limit of the patients in this study, it was found that an increase in one year of patient's age results in 0.20 decrease in ISQ value (95% CI: -0.36, -0.04). However, placing an implant in the posterior maxilla may negatively affect the ISQ with a likely decrease in primary stability by 6.76 ISQ value (95% CI: -13.22, -0.30).
CONCLUSIONS: The results suggest that the mean ISQ achieved by the participants were comparable with the range reported for this particular type of implants. The patient's age and location of implants were elucidated as the determinant factors of primary implant stability.

Matched MeSH terms: Osseointegration
Evaluation of suitable biodegradable scaffolds for engineered bone tissue

Phang MY, Ng MH, Tan KK, Aminuddin BS, Ruszymah BH, Fauziah O

Med J Malaysia, 2004 May;59 Suppl B:198-9.
PMID: 15468886

Tricalcium phosphate/hydroxyapatite (TCP/HA), hydroxyapatite (HA), chitosan and calcium sulphate (CaSO4) were studied and evaluated for possible bone tissue engineered construct acting as good support for osteogenic cells to proliferate, differentiate, and eventually spread and integrate into the scaffold. Surface morphology visualized by SEM showed that scaffold materials with additional fibrin had more cell densities attached than those without, depicting that the presence of fibrin and collagen fibers were truly a favourite choice of cells to attach. In comparison of various biomaterials used incorporated with fibrin, TCP/HA had the most cluster of cells attached.

Matched MeSH terms: Osseointegration/physiology
Fulltext Surgical outcome of bone anchored hearing aid (baha) implant surgery: a 10 years experience

Asma A, Ubaidah MA, Hasan SS, Wan Fazlina WH, Lim BY, Saim L, et al.

Indian J Otolaryngol Head Neck Surg, 2013 Jul;65(3):251-4.
PMID: 24427576 DOI: 10.1007/s12070-013-0621-2

Bone anchored hearing aid (Baha) implant is an option for patient with canal atresia, single sided deafness(SSD) and chronically discharging ears despite treatments. This retrospective study was conducted from 2001 to 2011 to evaluate the surgical outcome of Baha implant surgery. Thirty-three patients were identified during this study period. Their age at implantation ranged from 5 to 40 years. Of 33 patients, 29 (87.9 %) patients had bilateral microtia and canal atresia, 3 (9.1 %) patients had unilateral microtia and canal atresia and 1 (3.0 %) patients have SSD following labyrinthitis. One patient (3.2 %) had major complication which is lost of implant due to failure of osseointegration. Soft tissue reactions were seen 7 patients (21.1 %). Of these 7 patients, 4 patients required 3-4 procedures as day care operation for excision of the skin overgrowth surrounding the abutment. Recurrent antibiotic treatment was required in 3 patients (9.7 %). None of our patient had history of intraoperative or peri-operative complication following Baha surgery. The commonest complications are local infection and inflammation at the implant site. None of our patient had history of intraoperative or peri-operative complication following Baha implant surgery.

Matched MeSH terms: Osseointegration
Microstructure and properties of crystalline bioglass compositions prepared by polymeric route

Doreya MI, Mona EW, Afaf ES, Hanan HB

Med J Malaysia, 2004 May;59 Suppl B:21-2.
PMID: 15468799

The standard bioglass composition GS45 as well as with excess silica GS50 or with the addition of 5% titanium oxide GS45+Ti5, were prepared by the polymeric route. The different glass components were added to the formed polymer. Firing at 700 degrees C gave an amorphous product with microporous texture that readily crystallizes out at 900 degrees C. The prepared materials were highly porous with two modes of pore system micro-pores and macro-pores with a size ranging between 100 microm to 0.006 microm and a porosity reaching 73%. The measured bulk density was between 0.36 to 1.1g/cm3. The fired material preserved the former structure of the polymer precursor. Biocompatibility was verified in vitro and vivo. IR of the specimens previously immersed in SBF revealed the formation of apatite like layer. While the histology sections of implants in rate femurs showed new bone tissue or bone trabeculae after 21 days.

Matched MeSH terms: Osseointegration/physiology
The correlation between crestal bone resorption and implant stability during healing period using resonance frequency analysis

Al-Juboori MJ, AbdulRahaman SB, Hassan A

Implant Dent, 2013 Aug;22(4):351-5.
PMID: 23811720 DOI: 10.1097/ID.0b013e318296583d

To detect the correlation between crestal bone resorption and implant stability during healing period using resonance frequency analysis (RFA).

Matched MeSH terms: Osseointegration/physiology*
Fulltext Dental Implants : Biomaterial, Biomechanical And Biological Considerations.

Isa, Z.M., Hobkirk, J.A.

Ann Dent, 2000;7(1):-.
MyJurnal

Currently many dental implant systems with varied and numerous components are available commercially, and with new implant systems and designs emerging, it is essential that the user understands that any system selected should be based on sound scientific principles and capable of osseoil!tegration. This has been defined in many different ways, with biomaterial, biological and biomechanical factors being the main considerations. The final restoration is based on both biological tissue and mechanical components. As the success of osseointegration is based on the clinical outcome, clinicians must ensure that the stresses that the superstructure, implant, and surrounding bone are subjected to are within the tolerable limits of the various components, even though the degree of tolerance has not yet been fully defined.

Matched MeSH terms: Osseointegration
Histological evaluation of the early bone response to hydroxyapatite (HA) implanted in rabbit tibia

Khadijah K, Mashita M, Saidu MF, Fazilah F, Khalid KA

Med J Malaysia, 2004 May;59 Suppl B:123-4.
PMID: 15468849

This study is to qualitatively evaluate a locally produced hydroxyapatite (HA), made by AMREC-SIRIM in an experimental animal bone defect using New Zealand White (NZW) rabbits. HA cylindrical blocks measuring 2.5 mm (D) x 1.0 mm (H) were implanted in the rabbits' left tibia. The tibias were harvested within one to three weeks post-implantation. The implantion site was cut into thin undecalcified sections of about 30 microm to 60 microm and stained with Toluidine Blue and Goldner's Masson Trichrome. Microscopic examinations using standard light microscopy of these slides were performed.

Matched MeSH terms: Osseointegration/physiology*
The effect of chicken, pigeon, and turkey demineralized bone matrix (DBM) implanted in ulnar defects fixed with the intramedullary-external skeletal fixator (IM-ESF) tie-in in pigeons (Columba livia): histological evaluations

Jalila A, Redig PT, Wallace LJ, Ogema TR, Bechtold JE, Kidder L

Med J Malaysia, 2004 May;59 Suppl B:125-6.
PMID: 15468850

Avian demineralized bone matrix (ADBM) powder prepared from chicken, pigeon, and turkey sources induced bone formation via endochondral and intramembranous processes, as in mammalian studies. There were no significant differences in percentage of new bone, percentage of cartilage, surface-forming osteoblast area, or osteoclast count between gaps treated with chicken, pigeon, and turkey DBM. However, there was a significantly (p<0.05) higher percentage of inflammatory area in gaps treated with chicken DBM than in gaps treated with pigeon DBM.

Matched MeSH terms: Osseointegration/physiology*
Metallic materials stimulating bone formation

Kokubo T

Med J Malaysia, 2004 May;59 Suppl B:91-2.
PMID: 15468833

Metallic materials implanted into bone defects are generally encapsulated by a fibrous tissue. Some metallic materials such as titanium and tantalum, however, have been revealed to bond to the living bone without forming the fibrous tissue, when they were subjected to NaOH solution and heat treatments. Thus treated metals form bone tissue around them even in muscle, when they take a porous form. This kind of osteoconductive and osteoinductive properties are attributed to sodium titanate or tantalate layer on their surfaces formed by the NaOH and heat treatments. These layers induce the deposition of bonelike apatite on the surface of the metals in the living body. This kind of bioactive metals are useful as bone substitutes even highly loaded portions, such as hip joint, spine and tooth root.

Matched MeSH terms: Osseointegration/physiology*
Fulltext Minimal guided bone regeneration procedure for immediate implant placement in the esthetic zone

Kumar NS, Sowmya N, Mehta DS, Kumar PS

Dent Res J (Isfahan), 2013 Jan;10(1):98-102.
PMID: 23878571 DOI: 10.4103/1735-3327.111808

The anterior maxilla presents a challenging milieu interior for ideal placement of implants because of the compromised bone quality. With the advent of intraoral bone harvesting and augmentation techniques, immediate implant placement into fresh extraction sockets have become more predictable. Immediate implant placement has numerous advantages compared to the delayed procedure including superior esthetic and functional outcomes, maintenance of soft and hard tissue integrity and increased patient compliance. This case report exhibits immediate implant placement in the maxillary esthetic zone by combining a minimal invasive autogenous block bone graft harvest technique for ensuring successful osseointegration of the implant at the extraction site.

Matched MeSH terms: Osseointegration
Fulltext Morphological study of the newly designed cementless femoral stem

Baharuddin MY, Salleh ShH, Zulkifly AH, Lee MH, Mohd Noor A

Biomed Res Int, 2014;2014:692328.
PMID: 25025068 DOI: 10.1155/2014/692328

A morphology study was essential to the development of the cementless femoral stem because accurate dimensions for both the periosteal and endosteal canal ensure primary fixation stability for the stem, bone interface, and prevent stress shielding at the calcar region. This paper focused on a three-dimensional femoral model for Asian patients that applied preoperative planning and femoral stem design. We measured various femoral parameters such as the femoral head offset, collodiaphyseal angle, bowing angle, anteversion, and medullary canal diameters from the osteotomy level to 150 mm below the osteotomy level to determine the position of the isthmus. Other indices and ratios for the endosteal canal, metaphyseal, and flares were computed and examined. The results showed that Asian femurs are smaller than Western femurs, except in the metaphyseal region. The canal flare index (CFI) was poorly correlated (r < 0.50) to the metaphyseal canal flare index (MCFI), but correlated well (r = 0.66) with the corticomedullary index (CMI). The diversity of the femoral size, particularly in the metaphyseal region, allows for proper femoral stem design for Asian patients, improves osseointegration, and prolongs the life of the implant.

Matched MeSH terms: Osseointegration*
Peri-implant soft tissue integration of immediately loaded implants in the posterior macaque mandible: a histomorphometric study

Siar CH, Toh CG, Romanos G, Swaminathan D, Ong AH, Yaacob H, et al.

J. Periodontol., 2003 May;74(5):571-8.
PMID: 12816287

Today, one critical goal in implant placement is the achievement of optimal soft tissue integration. Reports thus far have demonstrated successful soft tissue preservation in delayed loaded implants placed in anterior jaws. The aim of this study was to histomorphometrically examine the soft tissues around immediately loaded implants placed in the macaque posterior mandible.

Matched MeSH terms: Osseointegration
Fulltext Unsplinted metal reinforced implant retained overdenture for an edentulous arch

Nur Hafizah Kamar Affendi, Nor Faharina Bt Abd Hamid

Compendium of Oral Science, 2017;4(1):40-46.
MyJurnal

Objective: This article discuss a clinical case of implant retained overdenture as a predictable and effective treatment for completely edentulous arch. Material and method: A patient with an edentulous maxilla and periodontically compromised teeth in the mandible was treated using a specific surgical and prosthodontic protocol. Patient was followed for 12 months postloading. Result: The implants are still osseointegrated and able to maintain healthy mucosa surrounding implants. The patient have verbally indicated that she is satisfied with the design that gives her comfort and function. Conclusions: It appears that unsplinted freestanding implants can be used as a predictable treatment for edentulous arch.

Matched MeSH terms: Osseointegration
Fulltext Interleukin 6 and Interleukin 17a enhance proliferation and differentiation of murine osteoblast and human foetal osteoblast cell lines

Shaminea S, Kannan TP, Norazmi MN, Nurul AA

International Medical Journal Malaysia, 2014;13(2):35-40.
MyJurnal

Introduction: Cytokines have been gaining great focus due to their role in enhancing osseointegration as well as their potential in bone reconstruction. Osseointegration often faces complications in its compatibility with the implant due to rejection by the recipients own immune system. Therefore, extensive studies are being carried out to enhance osteoblast development to minimize such complication. The aim of this study was to determine the effect of different concentrations of Interleukin 6 (IL-6) and Interleukin 17a (IL-17A) in the proliferation and differentiation of murine and human osteoblasts.

Methods: Various concentrations (5, 10, 25 and 50 ng/ml) of rIL-6 and rIL-17A were tested on both murine osteoblast (MC3T3-E1) and human feotal osteoblast (hFOB) cell lines using [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] (MTS) and alkaline phosphatise (ALP) assays. MTS was carried out at 24, 48, 72, 96 and 120 hours while ALP assay was done on day 1, 3, 7, 10 and 14.

Results: MC3T3-E1 cells showed steadier proliferation and differentiation compared to hFOB. Both cell lines expressed responses in dose-dependent manner. The concentration of 10ng for IL-6 and IL-17A in the case of MC3T3-E1 cell line was found to be the most suitable for further studies.

Conclusion: IL-6 and IL-17A enhance proliferation and ALP activity of both MC3T3-E1 and hFOB cell lines.

Matched MeSH terms: Osseointegration
The synergistic effects of IL-6/IL-17A promote osteogenic differentiation by improving OPG/RANKL ratio and adhesion of MC3T3-E1 cells on hydroxyapatite

Sritharan S, Kannan TP, Norazmi MN, Nurul AA

J Craniomaxillofac Surg, 2018 Aug;46(8):1361-1367.
PMID: 29805067 DOI: 10.1016/j.jcms.2018.05.002

OBJECTIVE: In this study, we evaluated the potential role of IL-6 and/or IL-17A in regulating the OPG/RANKL (osteoprotegerin/receptor activator of nuclear factor kappa b ligand) system of murine osteoblast cell line (MC3T3-E1) cultured on hydroxyapatite (HA).
METHODS: MC3T3-E1 cells were seeded on HA and treated with recombinant IL-6 or rIL-17A or combination of the two cytokines. Cell proliferation and differentiation activity were measured by MTS and alkaline phosphatase assays respectively. Observation of cell adhesion and proliferation was examined by scanning electron microscopy. Gene and protein expressions were performed on RANKL and OPG using qPCR, Western blot and ELISA.
RESULTS: We demonstrated that treatment with recombinant IL-17A (rIL-17A) and the combination rIL-6/rIL-17A promoted better adhesion and higher proliferation of cells on HA. Cells treated with rIL-17A and the combination cytokines showed a significant increase in differentiation activity on day 7, 10 and 14 as indicated by ALP activity (p

Matched MeSH terms: Osseointegration/drug effects

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