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.
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.
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.
In this study the surface properties of two particulate coral and polyhydroxybutrate (PHB) were studied in order to characterize them prior to use in composite production. Coral powder and PHB particle were evaluated using scanning electron microscopy and confocal laser scanning microscopy, to measure surface porosity and pores size. The results showed that coral powder has multiple pleomorphic micropores cross each others give appearance of micro-interconnectivity. Some pore reached to 18 microm with an average porosity of 70%. PHB revealed multiple different size pores extended to the depth, with an average some times reach 25 microm and porosity 45%. These findings demonstrate that both coral and PHB have excellent pores size and porosity that facilitate bone in growth, vascular invasion and bone development. We believe that incorporation of coral powder into PHB will make an excellent composite scaffold for tissue engineering.
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.
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.
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
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.
Defects were created in the mandible of a rabbit model whereby the right side was implanted with hydroxyapatite (HA) while the left side was left empty to act as control. Both the implant and control sites were evaluated clinically and histologically at 4,12,20,22 weeks. Decalcified sections were studied under confocal laser scanning microscope. No reactive cells were evident microscopically in all sections. There was bone ingrowth as early as 4 weeks when viewed by the topographic method. Enhancement of osteoconduction was evident by the presence of abundant capillaries, perivascular tissue and osteoprogenitor cells of the host. At 22 weeks, the implanted defect showed mature bone formation filling almost the whole field. This study demonstrated that the dense HA exhibits excellent biocompatibility as noted by the complete absence of reactive cells. It also promotes osteoconduction.
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.
There was a significant increased in Absolute Contact Length measurements of endosteal bone growth along the Nickel-Titanium (NiTi) implant coated with the natural coral powder and Hydroxyapatite (HA) compared to the non-calcium coated implants. This study demonstrated that coated implants seemed to show earlier and higher osseointergration phenomena compared to non coated ones. Furthermore, there was significantly greater bone-to-implant contact at the apical 1/3rd of the coated implants.
The main objective of the study was to determine the biodegradability, resorption and osteoconductivity potency of coral implant. Coral blocks (CORAGRAF) were prepared from sea coral Porites species. The blocks were implanted in the right mandible of rabbit model. Implants were harvested at 2 and 4 weeks intervals and subjected for light and scanning electron microscopy. Dense hydroxyapatite (DHA) was implanted in the left mandible as a control. The results of this study demonstrated that CORAGRAF is a good implant material that can accelerates bone healing and be resorbed in an acceptable time. The mechanisms of the resorption seemed to be the same (crumbling process), a first step where the edge of the coral become powdery then a second step which could be phagocytosis and dissolution in extracellular fluid.
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.
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.
The Fitmore titanium mesh cementless acetabular component in 115 hip arthroplasties was reviewed at an average of 33 months of follow-up. None were revised nor had infection. One hip dislocated 4 years postoperatively. Two femoral components were revised. The average Harris Hip Score at the last follow-up was 90 points. In the 96 sets of radiographs available, there was no loosening or new radiolucency. One hip had nonprogressive osteolysis adjacent to a screw. This press-fit cup has its polar region flattened and is rim loading. Noncontact (gaps) at the acetabular floor is expected and is not critical for fixation. In all but 6 hips, these gaps filled. In 5 hips, a minimal gap (
The purpose of this study was to review the results of our patients with congenital canal atresia after implantation of bone-anchored hearing aids (BAHA). The occurrence of complications was also reviewed.
The purpose of this study was to compare bone healing and coronal bone remodeling following both immediate and delayed placement of titanium dental implants in extraction sockets.
Hydroxyapatite (HA) used for bone replacement is one of the most active areas of ceramic biomaterials research currently. It has been used clinically for the last 20 years due to its excellent biocompatibility, osseoconduction and osseointegration. Many modifications have been done to develop a stronger, tougher and biocompatible ceramic biomaterial because pure HA is brittle. Researchers in Universiti Sains Malaysia had developed this value added HA that is stronger and less brittle compared to pure HA. The objective of this in vitro study was to evaluate the genotoxic characteristic of the value added HA based material by using Bacterial Reverse Mutation Assay (Ames test). The Bacterial Reverse Mutation Assay of HA was performed on Salmonella typhimurium strains TA98, TA100, TA1535, TA1537 and Escherichia coli strain WP2 uvrA using the preincubation method in the presence and absence of an exogenous metabolic activation system. All the bacterial tester strains treated with and without S9 Mix showed no increase of revertant colonies with increase in concentration of test substance for both the dose finding test and the main test. The number of revertant colonies was less than twice that of the solvent control for all the five bacterial strains and this was reproducible for both the dose finding test and the main test. The numbers of revertant colonies in the negative and positive controls were within the background data of our laboratory. In conclusion the results of the tests showed that the value added HA was considered to have no reverse mutagenic potential under the present test conditions.
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.