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Fulltext Zirconia in dental implantology: A review

Apratim A, Eachempati P, Krishnappa Salian KK, Singh V, Chhabra S, Shah S

J Int Soc Prev Community Dent, 2015 May-Jun;5(3):147-56.
PMID: 26236672 DOI: 10.4103/2231-0762.158014

Titanium has been the most popular material of choice for dental implantology over the past few decades. Its properties have been found to be most suitable for the success of implant treatment. But recently, zirconia is slowly emerging as one of the materials which might replace the gold standard of dental implant, i.e., titanium.

Matched MeSH terms: Osseointegration
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
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*
An in vivo study of a locally-manufactured hydroxyapatite-based material as bone replacement material

Abdul Razak NH, Al-Salihi KA, Samsudin AR

Med J Malaysia, 2004 May;59 Suppl B:119-20.
PMID: 15468847

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.

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 Passive Fit in Screw Retained Multi-unit Implant Prosthesis Understanding and Achieving: A Review of the Literature

Buzayan MM, Yunus NB

J Indian Prosthodont Soc, 2014 Mar;14(1):16-23.
PMID: 24604993 DOI: 10.1007/s13191-013-0343-x

One of the considerable challenges for screw-retained multi-unit implant prosthesis is achieving a passive fit of the prosthesis' superstructure to the implants. This passive fit is supposed to be one of the most vital requirements for the maintenance of the osseointegration. On the other hand, the misfit of the implant supported superstructure may lead to unfavourable complications, which can be mechanical or biological in nature. The manifestations of these complications may range from fracture of various components in the implant system, pain, marginal bone loss, and even loss of osseointegration. Thus, minimizing the misfit and optimizing the passive fit should be a prerequisite for implant survival and success. The purpose of this article is to present and summarize some aspects of the passive fit achieving and improving methods. The literature review was performed through Science Direct, Pubmed, and Google database. They were searched in English using the following combinations of keywords: passive fit, implant misfit and framework misfit. Articles were selected on the basis of whether they had sufficient information related to framework misfit's related factors, passive fit and its achievement techniques, marginal bone changes relation with the misfit, implant impression techniques and splinting concept. The related references were selected in order to emphasize the importance of the passive fit achievement and the misfit minimizing. Despite the fact that the literature presents considerable information regarding the framework's misfit, there was not consistency in literature on a specified number or even a range to be the acceptable level of misfit. On the other hand, a review of the literature revealed that the complete passive fit still remains a tricky goal to be achieved by the prosthodontist.

Matched MeSH terms: Osseointegration
Fulltext Osseointegration: an update

Parithimarkalaignan S, Padmanabhan TV

J Indian Prosthodont Soc, 2013 Mar;13(1):2-6.
PMID: 24431699 DOI: 10.1007/s13191-013-0252-z

Osseointegration, defined as a direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant, is critical for implant stability, and is considered a prerequisite for implant loading and long-term clinical success of end osseous dental implants. The implant-tissue interface is an extremely dynamic region of interaction. This complex interaction involves not only biomaterial and biocompatibility issues but also alteration of mechanical environment. The processes of osseointegration involve an initial interlocking between alveolar bone and the implant body, and later, biological fixation through continuous bone apposition and remodeling toward the implant. The process itself is quite complex and there are many factors that influence the formation and maintenance of bone at the implant surface. The aim of this present review is to analysis the current understanding of clinical assessments and factors that determine the success & failure of osseointegrated dental implants.

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
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
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*
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
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*
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*
A comparative study of osseointegration phenomenon in coated and non-coated NiTi implants in a rabbit model

Najafpour HD, Suzina AH, Nizam A, Samsudin AR

Med J Malaysia, 2004 May;59 Suppl B:121-2.
PMID: 15468848

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.

Matched MeSH terms: Osseointegration/physiology*
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
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 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
An in vitro study to evaluate the genotoxicity of value added hydroxyapatite as a bone replacement material

Akram Hassan, Swaminathan D

Sains Malaysiana, 2011;40.

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.

Matched MeSH terms: Osseointegration
Fulltext In Situ Controlled Surface Microstructure of 3D Printed Ti Alloy to Promote Its Osteointegration

Shan L, Kadhum AAH, Al-Furjan MSH, Weng W, Gong Y, Cheng K, et al.

Materials (Basel), 2019 Mar 10;12(5).
PMID: 30857349 DOI: 10.3390/ma12050815

It is well known that three-dimensional (3D) printing is an emerging technology used to produce customized implants and surface characteristics of implants, strongly deciding their osseointegration ability. In this study, Ti alloy microspheres were printed under selected rational printing parameters in order to tailor the surface micro-characteristics of the printed implants during additive manufacturing by an in situ, controlled way. The laser path and hatching space were responsible for the appearance of the stripy structure (S), while the bulbous structure (B) and bulbous⁻stripy composite surface (BS) were determined by contour scanning. A nano-sized structure could be superposed by hydrothermal treatment. The cytocompatibility was evaluated by culturing Mouse calvaria-derived preosteoblastic cells (MC3T3-E1). The results showed that three typical microstructured surfaces, S, B, and BS, could be achieved by varying the 3D printing parameters. Moreover, the osteogenic differentiation potential of the S, B, and BS surfaces could be significantly enhanced, and the addition of nano-sized structures could be further improved. The BS surface with nano-sized structure demonstrated the optimum osteogenic differentiation potential. The present research demonstrated an in situ, controlled way to tailor and optimize the surface structures in micro-size during the 3D printing process for an implant with higher osseointegration ability.

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*

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