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Background/purpose Although several mechanical and chemical debridement techniques have been reported for the management of peri-implantitis, there is no consensus on the most effective method at present. This in vitro study aimed to examine the effects of different mechanical instrumentation techniques on the debridement of hard calcified materials, which are present on the implant surface, as well as the effect of the defect morphology. Materials and methods From a total of 15 implants, five each were assigned to one of three decontamination groups (Rotary titanium brush [Ti], tricalcium phosphate air powder abrasive treatment [Air], and titanium ultrasonic scaler [US] groups); the exposed hydroxyapatite (HA)-coated portion was divided into three 1-mm sections (coronal, middle, and apical). The residual-HA of each portion was measured using a digital microscope. Results The overall percentage of residual HA coating was significantly lower in the US group than in the Ti or Air groups (p Conclusion Ti and US were more effective for shallow defects, whereas US was more effective for deeper defects.

© 2021 American Academy of PeriodontologyBackground: Peri-implantitis (PI) is a growing concern in the dental community worldwide. The study aimed to compare U.S. versus European periodontists’ considerations of risk factors, diagnostic criteria, and management of PI. Methods: A total of 393 periodontists from the United States and 100 periodontists from Europe (Germany, Greece, Netherlands) responded to anonymous surveys electronically or by mail. Results: Compared to U.S. periodontists, European respondents were younger, more likely to be female and placed fewer implants per month (9.12 vs 13.90; P = 0.003). Poor oral hygiene, history of periodontitis, and smoking were considered as very important risk factors by both groups (rated > 4 on 5-point scale). European periodontists rated poor oral hygiene (4.64 vs 4.45; P = 0.005) and history of periodontitis (4.36 vs 4.10; P = 0.006) as more important and implant surface (2.91 vs 3.18; P = 0.023), occlusion (2.80 vs 3.75; P < 0.001) and presence of keratinized tissue (3.27 vs 3.77; P < 0.001) as less important than did U.S. periodontists. Both groups rated clinical probing, radiographic bone loss, and presence of bleeding and suppuration as rather important diagnostic criteria. They rated implant exposure/mucosal recession as relatively less important with U.S. periodontists giving higher importance ratings than European periodontists (3.99 vs 3.54; P = 0.001). Both groups nearly always used patient education, plaque control and mechanical debridement when treating PI. U.S. periodontists were more likely to use antibiotics (3.88 vs 3.07; P < 0.001), lasers (2.11 vs 1.68; P = 0.005), allograft (3.39 vs 2.14; P < 0.001) and regenerative approaches (3.57 vs 2.56; P < 0.001), but less likely to use resective surgery (3.09 vs 3.53; P < 0.001) than European periodontists. Conclusions: U.S. and European periodontists’ considerations concerning risk factors, diagnosis and management of PI were evidence-based. Identified differences between the two groups can inform future educational efforts.

Dental implants are a proven therapeutic option for replacing missing teeth, with positive long-term health outcomes. Dental implant performance is largely determined by the implant’s primary durability, which is affected by surgical procedure, bone quality and quantity, implant surface characteristics, implant geometry, and implant surface characteristics. The implant’s geometry and surface can be modified. The implant geometry and surface can be changed if needed to achieve good primary stability and long-term implant therapy effectiveness. Implant architecture refers to the implant’s three-dimensional structure, as well as all of the components and elements that make it up. Different surface topographies can affect a sequence of coordinated actions such cell proliferation, osteoblast transformation, and the production of bone tissue. At the macro, micro, and increasingly nano sizes, surface topography of implants may be detected. The surgical location of end osseous oral implants is influenced by the prosthetic architecture, as well as the shape and quality of the alveolar bone. There are several alternatives for replacing missing teeth, but within the past few decades, dental implants have been one of the most common biomaterials for replacing one (or more) missing teeth. In a substantial number of patients, titanium dental implants have been shown to be secure and reliable. This study examines the most important historical information of dental implants, as well as the various vital factors that will ensure successful Osseo-integration and a safe prosthesis anchorage. Not only

Objective In this study we aimed to investigate bone–implant connections (BICs) with Ti–Al6V4 and Ti–Al6Nb7 alloys. Two types of surface morphology, resorbable blast material (RBM) and sandblasted and acid-etched surfaces (SLA), were used for implants. Materials and methods Thirty female Sprague Dawley rats aged 0.5–1 year were used. The rats were randomly separated into three groups: 1) Ti–Al6V4 RBM surface (n = 10), 2), Ti–Al6Nb7 RBM surface (n = 10), and 3) Ti–Al6Nb7 SLA (n = 10) surface implants were surgically integrated in femoral bones. The average roughness (Ra) values for these implants were 1–2 Ra. The rats were sacrificed four weeks after the surgical procedure. For each section, the BIC ratio (%) was determined as a percentage of the total implant surface that was in direct contact with the bone. Results The BIC ratio was found to be higher in the Ti–Al6Nb7 RBM and Ti–Al6Nb7 SLA groups than in the Ti–Al6V4 RBM group (p 0.05). Conclusion Ti–Al6Nb7 exhibited good biocompatibility with bone cells. Ti–Al6Nb7 alloy could be a candidate material for dental implant production.

Background The association between textured surface breast implants and breast implant-associated anaplastic large cell lymphoma has led to an increase in surgical procedures to exchange textured devices to smooth surface implants. Because patient satisfaction is an integral part of breast reconstruction, the purpose of this study was to compare patient-reported outcomes between smooth and textured implant recipients. Methods Patients aged 18 years or older who underwent implant-based postmastectomy breast reconstruction with either smooth or textured devices from 2009 to 2017 and completed the BREAST-Q patient-reported outcome measure following reconstruction were included in this analysis. The primary outcomes of interest were mean and median BREAST-Q scores and postoperative complications. Results Overall, 1077 patients were included-785 who underwent breast reconstruction with smooth implants and 292 who underwent breast reconstruction with textured implants. No statistical differences were observed between the textured and smooth implant groups for any of the BREAST-Q domain scores at any of the early (3-month) to late (2-year) postoperative time points. Smooth implant recipients reported significantly more rippling (p = 0.003) than textured implant recipients. In contrast, textured implant recipients had a higher rate of cellulitis than smooth implant recipients (p = 0.016). Conclusions These data suggest that postoperative satisfaction with breasts or health-related quality of life following immediate postmastectomy implant-based breast reconstruction is likely independent of implant surface type. However, smooth breast implants may result in more rippling. The authors' findings represent an important aid in counseling patients who have questions about the risks and benefits of replacing their textured implants with smooth surface devices. Clinical question/level of evidence Therapeutic, III.

Purpose After some initial setbacks in the 1970s, ceramic implants seem to be a promising alternative to titanium implants. Since the surface of an implant system represents the interface to surrounding biologic structures, the study focuses on cleanliness and surface topography. Clinical documentation of the corresponding systems completes the picture and allows a better evaluation of zirconia implant systems. Materials and methods Five different ceramic implant systems were selected randomly and purchased via blind-shopping: Z5s (Z-Systems), ZiBone (COHO), W implant (TAVDental), ceramic. implant (vitaclinical), and BioWin!/Standard Zirkon Implantat (Champions-Implants/ZV3 system). Three samples of each implant system underwent scanning electron microscopy (SEM) imaging and elemental analysis (EDS). Where appropriate, subsequent Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS) was performed to identify the chemical nature of impurities. Surface topography was evaluated, and a search for clinical trials in the PubMed database, on the websites and by written request to each dental implant manufacturer, was performed. Results Surfaces of Champions implants (ZV3) and Z-Systems implants were relatively clean, whereas the other investigated surfaces of vitaclinical, TAV Dental, and ZiBone implants all displayed organic contaminations on their surfaces. Four of the investigated ceramic implants showed a moderately rough implant surface. Only the vitaclinical ceramic.implant had minimal surface roughness. Three ceramic designs-vitaclinical, ZV3, and Z-Systems-had clinical trials documented with up to 3 years of follow-up and results varying between 82.5% and 100% survival. TAV Dental W and ZiBone implant systems lacked properly conducted clinical recording of results. Conclusion The results of this study showed that it is technically possible to produce zirconia implants that are largely residue-free. On the other hand, the variety of significant residues found in this analysis raises concerns, as contamination may lead to undesirable biologic effects. The lack of clinical studies in peer-reviewed journals does not seem to be relevant for the approval of marketing, nor does the lack of surface cleanliness. In the authors' opinion, a critical analysis of these aspects should be included in a more stringent future analysis prior to the marketing of oral implant systems.

A double capsule is a recently described rare occurrence following breast implant placement in which an inner capsule envelope totally or partially adheres to the implant surface while a distinct outer capsule adheres to surrounding tissues, with an intercapsular space developing between the two. The objective of this study is to review all available literature related to formation of double capsules and propose a treatment algorithm. A systematic review of the literature was conducted using Embase, Medline, and Cochrane databases. Articles reporting management of breast implant-associated double capsules were included in this review. A total of 9 studies (68 implants) were included in the review. 94.1% of double capsules occurred with textured Biocell shaped and round implants independently from implant pocket (p value=0.64). In all cases, double capsules were diagnosed fortuitously intra-operatively for another surgical indication. Capsular contracture was present in 50% of double capsules patients and was the most common indication for secondary breast surgery, 81.5% of which being clinically evident (p value

Made available in DSpace on 2022-04-28T19:44:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Purpose: The aim of this split-mouth randomized clinical trial was to evaluate the primary and secondary stability of implants with hydrophilic surfaces in comparison to implants with conventional surfaces in the posterior region of the maxilla. Materials and Methods: Twenty patients with a bilateral edentulous ridge in the posterior area of the maxilla randomly received implants with two types of surfaces: (1) implants with the surface modified by double acid-etching and sandblasting (DAS, n = 20); and (2) implants with the surface modified by double acid-etching and sandblasting, stored in 0.9% saline solution to confer highly hydrophilic properties (DAS-H, n = 20) on the surface. The implants presented the same macrostructure with a hybrid design. The resonance frequency analysis was performed in order to obtain the implant stability quotient (ISQ) using Osstell. The ISQ analyses were performed just after placement of the implant (primary stability) and at 28, 40, and 90 days after the surgical procedure (secondary stability). Results: There were no differences between the DAS and DAS-H surfaces in the primary stability or during the conversion of the primary to the secondary stability; however, there was a reduction in the stability of the implants at 28 days, which increased significantly at 40 and 90 days in both surfaces. Conclusion: It can be concluded that the surface wettability of implants with a hybrid macrostructure did not increase the primary and secondary implant stability in the posterior region of the maxilla Department of Periodontology and Implantodontology Federal University of Uberlandia (UFU) Department of Periodontology School of Dentistry University Center of Santa Fé do Sul (Unifunec) School of Dentistry University Center of the Educational Foundation of Barretos (UNIFEB) Department of Diagnosis and Surgery School of Dentistry State of São Paulo University (Unesp) Department of Specific Formation School of Dentistry Fluminense Federal University (UFF) Department of Diagnosis and Surgery School of Dentistry State of São Paulo University (Unesp)

Different titanium implant surfaces are prone to microbial colonization and dental plaque accumulation contributing to peri-implantitis pathogens adherence and growth. In conjunction with systemic, local, and implant-based factors such as micro- and macro-designs, implant location, and region, these pathogens can cause a complex inflammatory response resulting in peri-implantitis and deleterious bone loss. Implant surface decontamination plays a crucial and important step in peri-implantitis therapy. The primary goal of implant surface decontamination is to eradicate bacteria and their products outside of implant pits and grooves reducing inflammation and promoting tissue regeneration and/or reparation. Various implant surface decontamination methods such as mechanical, chemical or physical methods have been proposed to prevent bacterial resistance development or/and surface damage. The chapter aimed to assess if implant microdesign could influence the decontamination method choice.

Spinal fusion has undergone significant evolution and improvement over the past 50 yr. Historically, spine fusion was noninstrumented and arthrodesis was based entirely on autograft. Improved understanding of spinal anatomy and materials science ushered in a new era of spinal fusion equipped with screw-based technologies and various interbody devices. Osteobiologics is another important realm of spine fusion, and the evolution of various osteobiologics has perhaps undergone the most change within the past 20 yr. A new element to spinal instrumentation has recently gained traction-namely, surface technology. New data suggest that surface treatments play an increasingly well-recognized role in inducing osteogenesis and successful fusion. Until now, however, there has yet to be a unified resource summarizing the existing data and a lack of consensus exists on superior technology. Here, authors provide an in-depth review on surface technology and its impact on spinal arthrodesis.

Objectives In the microbiological diagnosis of periprosthetic joint infection (PJI), there is much discussion about the methodology of obtaining proper specimens, the processing technique, and suitable culture media. This retrospective study was conducted to analyse the accuracy of our culture techniques. Methods Tissue samples and components from 258 patients after revision arthroplasty of the hip, knee, and shoulder were investigated, and the results of tissue cultures (TC) were compared to those of sonicate fluid cultures (SFC). Furthermore, an evaluation was performed of the influence of different culture media on the detection rate. Results PJI was confirmed in 186 patients. The overall sensitivity of TC was no different to that of SFC (91.3% vs 90.8%, P = 1). In 153 cases (82.3%), TC and SFC showed concordant positive results. Results were discordant in 33 cases (17.7%). When differentiated according to the type of infection, TC showed significantly better results than SFC in detecting polymicrobial infections (97.0% vs 67.0%, P = 0.004). There were also significant differences between the culture media regarding the yield of microorganisms. Conclusions TC was more effective in detecting co-infections. The best results were obtained using both TC and SFC. The choice of culture media has a significant influence on the quality of results.

Despite advanced implant sterilization and aseptic surgical techniques, periprosthetic bacterial infection remains a major challenge for orthopedic and dental implants. Bacterial colonization/biofilm formation around implants and their invasion into the dense skeletal tissue matrices are difficult to treat and could lead to implant failure and osteomyelitis. These complications require major revision surgeries and extended antibiotic therapies that are associated with high treatment cost, morbidity, and even mortality. Effective preventative measures mitigating risks for implant-related infections are thus in dire need. This review focuses on recent developments of anti-periprosthetic infection strategies aimed at either reducing bacterial adhesion, colonization, and biofilm formation or killing bacteria directly in contact with and/or in the vicinity of implants. These goals are accomplished through antifouling, quorum-sensing interfering, or bactericidal implant surface topographical engineering or surface coatings through chemical modifications. Surface topographical engineering of lotus leaf mimicking super-hydrophobic antifouling features and cicada wing-mimicking, bacterium-piercing nanopillars are both presented. Conventional physical coating/passive release of bactericidal agents is contrasted with their covalent tethering to implant surfaces through either stable linkages or linkages labile to bacterial enzyme cleavage or environmental perturbations. Pros and cons of these emerging anti-periprosthetic infection approaches are discussed in terms of their safety, efficacy, and translational potentials.

Amac: Implant materyallerinin hucre canliligi ve hucre adezyonu uzerindeki in vitro etkilerinin degerlendirilmesi, implantlarin biyo-uyumluluklarinin tahmin edilmesi yonunde degerli bilgiler saglayabilir. Bu nedenle, basit ve maliyetli olmayan bir yontem kullanilarak, farkli yuzey ozelliklerine sahip implantlarin hucre canliligi ve adezyonunu etkileyip etkilemeyeceginin arastirilmasi amaclanmistir. Gerec ve Yontemler: Farkli dis implant yuzeylerinin (anotlanmis (AN), patlatilmis burusuk (BW), kum/asitle asindirilmis (GA), puskurtulmus hidroksi apatit yuzey (HB)) yapisma ve canlilik uzerindeki etkileri, adherent insan osteoblast hucre soyunda agar bazli bir in vitro teknik kullanilarak karsilastirilmistir. Hucre canliliklarinin belirlenmesinde, 3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazolium bromid (MTT) ve tripan mavisi boyama teknikleri uygulanmistir. Bulgular: Hucre adezyonunun, dental implantlarin yuzey ozelliklerindeki farkliliklardan onemli olcude etkilenmedigi gorulmustur (AN: 78,21±0,52; BW: 78,22±0,48; GA: 78,44±0,85; HB: 77,26±0,96). Ancak, dis implantlarinin yuzey ozelliklerinin, implantlara tutunan hucrelerin canliligi uzerinde etkisi oldugu tespit edilmistir. Tutunan hucrelerin canliliginin, HB yuzeyine kiyasla AN, BW, GA yuzeylerinde anlamli olarak daha yuksek oldugu bulunmustur (AN: 72,28±6,04, BW: 67,02±3,47, GA: 85,82±5,05 ve HB: 27,98±10,47). Sonuclar: Calisma kapsaminda yapilan in vitro deneylerden elde edilen bulgular; AN, BW, GA yuzeylerinin adherent hucrelerin canliligini korumalari icin HB yuzeylerinden daha iyi bir platform saglayabilecegini gostermektedir.

Purpose: To compare the temperature changes during the setting process of two provisional crown materials, polymethyl methacrylate (PMMA)-based acrylic resin (Ac) and bis-acryl composite resin (Co), at the first thread surface of one-piece implants. Materials and methods: Twenty-two 3.3-mm-diameter one-piece implants were divided into two groups according to the provisional restoration material. Implants were mounted on a Plexiglas apparatus. A K-type thermocouple was fixed at the most coronal thread. Baseline (Bl Temp) and maximal (Max Temp) temperatures of both groups were recorded during the curing process. Total heat flux (THF) at the implant surface and thermal amplitude (Temp-Amp) were calculated. Differences between groups were compared using a t test for unpaired observations. Results: Upon curing, a statistically significant increase in the Max Temp from the Bl Temp was detected in both groups, with a greater increase in the Ac compared with the Co group. The Temp-Amp and the THF were two times greater in the Ac group than the Co group. Conclusion: Significant heat is produced during the polymerization of PMMA-based resin and bis-acryl composite resin provisional crowns in one-piece implants. To decrease the risk of thermal challenge at the implant cervical aspect associated with restoration of immediately loaded implants, bis-acryl composite resin should be used.

Background: osseointegration of dental implants refers to direct structural and functional link between living bone and the surface of non-natural implants. It follows bonding up of an implant into jaw bone when bone cells fasten themselves directly onto the titanium surface.it is the most investigated area in implantology in recent times. Evidence based data revels that osseointegrated implants are predictable and highly successful. This process is relatively complex and is influenced by various factors in formation of bone neighbouring implant surface. Keywords: Osseointegration, Implant, Bone.

Objective Implantology is one of the most investigated topics in modern dentistry. The current review was planned to systematically summarise all industrial, mass production and experimental trends in dental implant manufacturing relative primarily to their surface modification conducted between January 2017 and January 2020. Materials and methods The review was conducted in Army Medical College, National University of Medical Sciences, Rawalpindi, Armed Forces Institute Of Dentistry, Combined Military Hospital, Rawalpindi, Foundation University College of Dentistry, Fauji Foundation Hospital, Islamabad, and the Higher Education Commission Library, Islamabad. Literature was searched on PubMed, Scopus, Medline, Cochrane and Science Direct databases. The key words employed were "dental Implants", "surface modification", "surface morphology", "surface treatment" and "surface augmentation". Results A total of 38 articles were short-listed and reviewed in detail. There was abundant evidence suggesting the importance of these surface modifications on improving the implant success. Several strategies have been suggested to modify the implant surface topography as well as surface chemistry in order to achieve a micro-porous structure with nano-scale architecture, with increased bio-activity; hydrophilicity and anti-bacterial properties. Conclusions There has been commendable success with many of these strategies in laboratories. However, following the success in ex-vivo studies, very few of these surface modalities have found their way to clinical set-ups.

Background: Aseptic loosening of the acetabular component remains one of the leading causes of early failure of total hip arthroplasty. Poor apposition of bone onto the implant surface can be due to inaccurate reaming and osteonecrosis of the acetabular bone due to the heat generated while reaming. Methods: New and used acetabular reamers were tested on an MTS system using a clinically relevant force of 87.6 N. A thermal profile and depth achieved by the reamers were analyzed and compared between the 2 cohorts. Heat generated and force required for the community used reamers to achieve the same depth as the new reamers were subsequently analyzed. Results: The new reamers achieved a depth 3.4 mm deeper than the community reamers (P < .001). The new reamers generated 4.1°C less heat than the community reamers (P = .007) under the same force and time. When programmed to ream to the average depth of the new reamers, the community reamers generated 16.8°C more heat (P = .002) and required forces 95-318% greater than the 87.6 N force used by the new reamers. Conclusions: Community use of reamers will cause variations in depth of penetration and increased temperatures at a clinically generated force vs new reamers. When community reamers were forced to the same depths the new reamers achieved, a significantly greater amount of heat was generated, and an increased amount of time was needed, both of which are known risk factors for osteonecrosis.

Introduction: Dental implant therapy is one of the best treatment modalities for restoration of the missing teeth. It's been available as a treatment option for more than over thirty years. There are many types of implant systems available and clinicians are facing the dilemma of choosing an implant system from a large number of options. The main goal of modern dental treatment is to restore the patient’s normal function, speech, esthetics, as well as health. Aim: The aim of this study was to evaluate the different types of implant systems used and most commonly employed implant systems in replacing the missing teeth among the patients attending a teaching institution. Materials and Methods: Case records of patients who underwent implant placement were retrieved. A total number of one thousand one hundred and twenty eight implants were placed in five hundred and eighty five patients with a mean age of 39.9 ± 12.5. Descriptive statistics such as frequency, percentage and chi square test was done for association. Results: The common implant site was found to be mandibular posteriors. There were three implant systems used namely, Equinox, Nobel Biocare and Straumann; under nobel biocare and straumann there were different types of implants used. Majority of the implants placed were from the nobel biocare system 45.12%. Association between age, site of implant placement with implant systems showed statistical significance(P0.05). Conclusion: Within the limitations of this study, the most common implant system used to replace the missing teeth of the patients who attended a teaching institution was found to be Nobel Biocare, in which male patients were mostly treated with dental implants and mandibular posterior teeth were the most common site of implant placement. Clinical Significance: Nobel biocare is the most preferred implant system in the hospital where a majority of the patients were males.

Aim: The aim of the present study was to evaluate the microbial contamination in internal and external walls of cone morse implant walls. Methods: Eleven patients with edentulous mandibular posterior area were selected to received dental implants, divided into groups: submerged (S), non-submerged (NS), and immediately loaded (IL). Microbiological evaluations (microorganisms’ number, aerobic and anaerobic colony forming units (CFU) number and microorganisms’ qualification) were divided into internal and external collection of the implant walls, at different stages: T0 (surgical procedure), T2 (suture removal), T4 (reopening S group), T6 (suture removal S group), and T8 (abutment placement in S and NS). All data were submitted to statistical analyses, with confidence level of 0.05. Results: There was difference in number of microorganisms observed over time within the same group (p < 0.05). A difference was observed in CFU when evaluated within the same group over time (p < 0.05), except for the IL group. In internal collection, a predominance of non-formation of microorganisms was observed at T0 in all groups, while formation of Gram-positive Diplococci and Gram-positive Bacilli was observed at T8 (p>0.05). In external collection, an increase in number of microorganisms was observed at T0. Conclusion: There was no difference in microbial contamination among the evaluated groups. The microorganism’s colonization changed over time.

PURPOSE The hydrophilic implant surface (INICELL) is a chemical alteration of a sandblasted and thermally acid-etched surface that should lead to long-term osseointegration. This study investigated 3-year results after early loading of implants with a hydrophilic, moderately rough surface in occlusal contact. MATERIALS AND METHODS This prospective case series study was conducted in subjects with partially edentulous mandibles. Implants were placed on day 21 and loaded with a provisional reconstruction after at least 21 days of healing (baseline, day 0) if their implant stability quotient (ISQ) was ≥ 70 (mean of three measurements) and were replaced by definitive porcelain-fused-to-metal prostheses at the 6-month follow-up visit. Follow-up examinations were planned 1, 3, 6, 12, and 36 months after baseline. RESULTS A total of 20 implants were placed in 15 patients (mean age: 51 years, range: 32 to 67 years). After 36 months, all implants were osseointegrated, and no suppuration was recorded. Small changes of bone level were observed between 3 months and 36 months. At 36 months, the median values of the 20 implants were 0.25 (range: 0 to 0.5, SD: 0.17), 0.25 (range: 0 to 1, SD: 0.27), and 4 (range: 2 to 7.25, SD: 1.17) for the mean modified Plaque Index (mPI), mean modified Sulcus Bleeding Index (mSBI), and mean probing pocket depth, respectively. The pairwise analysis between 3 and 36 months showed an improvement in the mean mPI (P = .0126) and mean mSBI (P = .0059). After 36 months, all patients (n = 15) were fully satisfied with a mean of 9.43 (range: 8 to 10, SD: 0.678) at the visual analog scale. CONCLUSION Early functional loading of implants with a hydrophilic, moderately rough outer surface in occlusal contact 21 days after healing appears to be a safe and feasible treatment option when placed in the posterior mandible of partially edentulous patients.

To compare osseointegration and marginal bone level at implants placed in osteotomies prepared with either conventional drills or a piezoelectric device. Three months after the extraction of all mandibular premolars and first molars, two recipient sites were selected. The osteotomies were randomly prepared with either conventional drills (drill sites) or a piezoelectric device (piezoelectric sites). Implants were installed and a submerged healing was allowed. The animals were euthanized in groups of six after 4 and 8 weeks of healing. Biopsies were obtained for histological preparation. Coronal level of osseointegration (bone level) and bone-to-implant contact percentage (BIC%) were evaluated. After 4 weeks of healing, the bone level was 0.6 ± 0.9 mm for the piezoelectric sites and 1.6 ± 0.7 mm for the drill sites (p = 0.173). After 8 weeks, the respective measures were 0.9 ± 0.3 mm and 1.0 ± 1.1 mm (p = 0.917). After 4 weeks of healing, a new bone apposed onto the implant surface was found at fractions of 54.9 ± 6.7% and 55.1 ± 16.6% for the piezoelectric and the drill sites, respectively (p = 0.674). The respective total bone fractions, including new and old bone, was 64.0 ± 4.8% and 63.4 ± 20.4% (p = 0.917). After 8 weeks, a new bone increased to 67.4 ± 6.7% and 62.9 ± 12.5% for the piezoelectric and the drill sites, respectively (p = 0.463). The respective total bone fractions were 70.4 ± 5.5% and 67.8 ± 12.1% (p = 0.753). The use of a piezoelectric device for implant site preparation is a safe procedure that allows a proper integration since the early periods of healing similar to that observed using conventional drills.

To evaluate histologically the early healing at implants installed with different insertion torques Three months after the extraction of the mandibular premolars and of the first molars, two implants were installed monolaterally in the premolar and two in the molar regions of the edentulous alveolar ridge of twelve dogs. The recipient sites were prepared using drills of different diameter to obtain insertion torque of different values, i.e., 30 Ncm (control) or ~ 70 Ncm (test) in the premolar region, and

In this narrated review, we shall study the commonality and discord in the anatomy, bacterial flora, immune response, rate of progression, and response to therapy. Finally, we shall explore the unique, periimplantitis-related risk factors. The absence of PDL around implants, combined with poor periimplant vascularization and weaker attachment apparatus, might account for the poor cellular response to bacterial implant in periimplantitis. Using 16S ribosomal gene sequencing, it has been recently shown that although certain known periodontal pathogens may also be found around dental implants with periimplantitis, apparently, the multiplicity of bacterial flora in this condition is great with some distinct microorganisms associated with periimplantitis. The inflammatory cell infiltrate is more pronounced than in periodontitis and extended more apically. Mean bone loss in periimplantitis is generally much greater than around natural teeth with periodontitis. Risk factors that are uniquely associated with dental implants include bone type, prosthetic and surgical variables, and implant surface characteristics. The role of titanium particles found in the periimplantitis lesion is yet unclear. Lastly, the possibility of foreign body reaction being the trigger for periimplantitis is plausible but as of yet requires further substantiation. The search to improve our treatment strategies in periimplantitis should first focus on establishing or declining the primary mode of breakdown. The results of such studies will help guide us to either improve our current anti-infective therapies targeting the unique characteristics of periimplantitis or else put us on a new road to understanding how to modify or restrict the natural immunological response as might be the case for a foreign body response.

Successful surgeries involving orthopedic implants depend on the avoidance of biofilm development on the implant surface during the early postoperative period. Here, we investigate the potential of novel antibacterial compounds-second-generation lipophosphonoxins (LPPOs II)-as additives to surgical bone cements. We demonstrate (i) excellent thermostability of LPPOs II, which is essential to withstand elevated temperatures during exothermic cement polymerization; (ii) unchanged tensile strength and elongation at the break properties of the composite cements containing LPPOs II compared to cements without additives; (iii) convenient elution kinetics on the order of days; and (iv) the strong antibiofilm activity of the LPPO II-loaded cements even against bacteria resistant to the medicinally utilized antibiotic, gentamicin. Thus, LPPOs II display promising potential as antimicrobial additives to surgical bone cements.

One third of all cases of head and neck carcinoma (CA) concern the oral mucosa. The use of dental implants (DI) for dental rehabilitation is widely extended. However, a few studies have reported some cases with neoplasic alterations, among the tissue surrounding implants. Our aim was to analyze possible alterations at the bone-implant interface in patients with oral squamous cell carcinoma (SCC), providing new evidence that could relate or discard a possible link between these factors. We used, for the first time, different techniques, including electron microscopy and histology, to analyze the implant ´s surface and the surrounding tissue from four clinical cases with neoplasic alterations surrounding DI. Histologically, ample inflammatory tissue was found in direct contact with the implant surface. Surface analysis of this tissue, revealed titanium percentages. According to our study, no oncological relation with deterioration of the implant surface was found, although DI were constantly related with peri-implantitis, a chronic trauma of the oral mucosa that could involve a neoplastic factor. Key words:Dental implants, carcinoma, peri-implantitis.

Objective Obesity induced by a high fat diet is associated with chronic up-regulation of inflammatory cytokines which stimulate osteoclast activity and bone resorption. However, the role of high-fat diet on bone-implant connectivity has not been studied in detail. In this study, we investigated whether a high-fat diet (HFD) affects bone implant connection (BIC) in periimplant bone. Methods Twenty female Sprague Dawley rats were divided in two groups: 1) Control rats were fed with normal chow and titanium implants were integrated into tibial bones at the end of 3rd month and no treatment was applied 2) HFD group; rats were fed a high-fat diet (42 % of calories as fat), then the titanium implants were integrated into tibial bones at the end 3rd month. Following surgical integration of the implants, the rats were fed with control and HFD diets for 3 months. After the 6 months experimental period all rats were sacrificed and the implants and surrounded bone tissues were collected and the BIC was assessed histomorphometrically after the non-decalcifiing histological methods. Bone implant connection was detected with the ratio of the implant surface directly connected with the peri-implant bone tissues to the total implant surface length. Results Histologic analysis showed that HFD was not impaired BIC (p>0.05). Conclusion In conclusion, within the limitation of this research, HFD did not effect the BIC rat tibias (Tab. 2, Fig. 2, Ref. 26). Text in PDF www.elis.sk.

Purpose To evaluate histomorphometrically early healing at implants placed in sites prepared with either a sonic device or conventional drills. Materials and methods Sixteen volunteer patients were recruited. Two titanium mini-implants were placed in the distal segments of the maxilla in recipient sites prepared with either a sonic device or conventional drills. Biopsy specimens containing the mini-implants were retrieved after 2 weeks in eight patients, and after 6 weeks in the other eight patients. Histomorphometric analyses were performed. Results Histologic slides were available from seven patients for both 2-week and 6-week periods. After 2 weeks of healing, small amounts of new bone were found in contact with the implant surface, with 5.5% ± 7.3% and 3.8% ± 10.0% at the sonic and drill groups, respectively. After 6 weeks of healing, new bone was 46.9% ± 15.5% at the sonic group, and 46.4% ± 14.9% at the drill group. None of the differences was statistically significant. Conclusion The percentage of new bone in contact with the implant surface was similar in the sonic and drill groups.

The aim of the study: was to evaluate the influence of the surface treatment of implant retained mandibular overdenture on peri-implant bone density.Resorbable Blast Media (RBM) implant surface treatment and acidetched implant surface treatment was used.Materials and Methods: Ten completely edentulous male patients wererehabilitated by mandibular overdenture retained by two dental implantsin the interforaminal region, the one on the right side was acid etched andthe left side was with resorbable blast media (RBM). Peri-implant bonedensity was assessed with cone beam computed tomography at the timeof implant loading, six months and twelve months after denture insertion.Results: There was no significant difference between Acid etched andRBM dental implants on the peri-implant bone density during the followup period. Conclusion: Within the limitations of the number of studiedpatients it could be stated that Acid etched and RBM dental implantsfulfill the criteria of dental implant success and are recommended to beused.

Mechanical fixation of the implant to host bone is an important contributor to orthopaedic implant survivorship. The relative importance of bone-implant contact, trabecular bone architecture, and cortical bone geometry to implant fixation strength has never been directly tested, especially in the settings of differential implant surface properties. Thus, using a rat model where titanium rods were placed into the intramedullary canal of the distal femur, we determined the relative contribution of bone-implant contact and peri-implant bone architecture to the fixation strength in implants with different surface roughness: highly polished and smooth (As-received) and dual acid etched (DAE) implants. Using a training set that maximized variance in implant fixation strength, we initially examined correlation between implant fixation strength and outcome parameters from microcomputed tomography and found that osseointegration volume per total volume (OV/TV), trabecular bone volume/total volume (BV/TV), and cortical thickness (Ct.Th) were the single best compartment-specific predictors of fixation strength. We defined separate regression models to predict implant fixation strength for As-received and DAE implants. When the training set models were applied to independent validation sets, we found strong correlations between predicted and experimentally measured implant fixation strength, with r(2) = 0.843 in As-received and r(2) = 0.825 in DAE implants. Interestingly, for As-received implants, OV/TV explained more of the total variance in implant fixation strength than the other variables, whereas in DAE implants, Ct.Th had the most explanatory power, suggesting that surface topography of implants affects which bone compartment is most important in providing implant fixation strength.

Relevance. Unsatisfactory effectiveness of treatment of chronic periimplantitis, which makes 40-60%, is associated with a persistence of a bacterial film on the implant surface, as well as with inconsistency of stages of anti-inflammatory, restorative and supportive treatment. Purpose. To discuss an improved approach to restorative treatment of chronic periimplantitis using modified reconstructive technique. Materials and methods. The technique was substantiated using axiomatic method of theoretical analysis. The modified reconstructive technique is based on application of split-thickness submucosal-periosteal flap with blood supply base, which has sufficient reparative-regenerativepotentialand stability in conditions of inflammatory macro-and microenvironment. We have carried out treatment of chronic periimplantitis in two patients using the modified reconstructive technique at the recovery stage. Results. Preliminary assessment of the obtained results of use the modified reconstructive technique showed normal postoperative course and favorable outcome: low surgical stress response under conditions of primary chronic inflammation in the area of the implanted structure; low level of biological response of the submucosal-periosteal autograft with blood supply base as opposed to free grafts and osteoplastic materials; good condition of sutures in the early and medium postoperative period. Conclusion . Application of the modified reconstructive technique can enhance the success of rehabilitation treatment inpatients in chronic periimplantitis.

The aim of this study was to explore the literature for clinical and histological data of an unconventional treatment with implants placement in contact with dental tissue (IPICDT) and to try to clarify its indications and surgical procedure particularities.Relevant publications published until May 2019 on the IPICDT were thoroughly reviewed. Search strategy was developed using a controlled vocabulary combination.Medline’s exploration and manual research identified 397 articles; 15 of these were selected after screening. IPICDT was indicated in three clinical situations: impacted teeth, ankylosed teeth, or residual roots. Clinical and radiological follow-up were satisfied except for implants placed in contact with (and not through) roots. Histological analysis revealed different mineralized tissues formed on the implant surface: cementum on removed implants in human and osteodentin on implants placed in contact with animal teeth dentin and pulp. These findings were described as new concept of implants’ “Mineral integration.”According to this study, the follow-up results of implants placed in contact with roots were controversial. Some implants were stable and others were either removed or kept and disinfected after root extraction because of bacterial infection. However, implants placed through ankylosed or impacted teeth were stable. These findings suggest that the clinicians have to be cautious when applying this unconventional approach. Further studies are recommended to explore its long follow-up. It is also interesting to explore this technique in cases of syndromic dental diseases with several impacted teeth (such as cleidocranial dysplasia; or amelogenesis imperfecta).

A timely and accurate diagnosis of periprosthetic joint infection (PJI) is crucial to plan adequate treatment. Purpose of the study. To evaluate the performance of new diagnostic tests for the diagnosis of PJI. Material and Methods. The performance of novel biomarkers in synovial fluid (i.e. D-lactate and alfa-defensin), molecular test (i.e. PCR of synovial fluid and sonication fluid), new methods to dislodge biofilm from implant surface (i.e. MicroDTTect) and sonication of explanted prosthesis were investigated in patients with PJI and aseptic loosening of the prosthesis. Results. D-lactate showed better sensitivity for the diagnosis of PJI compared to leukocyte count (86% and 80%, respectively). The optimal D-lactate cut-off value was calculated at 1.26 mmol/l. The ADLF test showed sensitivity of 84%, 67% and to 54% depending on classification criteria used for the diagnosis of PJI (Musculoskeletal Infection Society (MSIS), The Infectious Diseases Society of America (IDSA) and proposed European Bone and Joint Infection Society (EBJIS) criteria, respectively). Using the proposed EBJIS definition criteria, the sensitivity of the leukocyte count was significantly higher than that of the ADLF test (86% compared with 54%; p0,001), particularly in chronic PJI (81% compared with 44%, respectively; p0,001). The sensitivity of synovial fluid PCR was 60% and herewith comparable with synovial fluid culture (52%, p = 0,239). The sensitivity and specificity of sonication fluid culture were 58% and 100%, which was comparable to sonication fluid PCR 51% and 94%, respectively. DTT-based method showed low sensitivity for diagnosis of PJI (40%) compared to sonication (80%, p0,01). Conclusion. Synovial fluid D-lactate demonstrated good analytical performance and diagnostic value for the diagnosis of PJI. In particular, the high sensitivity for diagnosing infection and rapid availability of the test result make synovial fluid D-lactate suitable as screening test, whereas ADLF had limited sensitivity (54%) but high specificity (95%) and it should therefore not be used for screening, but rather as a confirmatory test for PJI. Multiplex PCR of synovial fluid and sonication fluid has similar sensitivity and specificity compared to synovial fluid culture, having the advantage of rapid availability of results (within 5 hours) and fully automated process. With further improvement of its performance and inclusion of additional primers, multiplex PCR may complement conventional cultures, especially for rapid and accurate diagnosis of low-grade PJI. Culture of samples obtained by sonication of prostheses showed better sensitivity for the microbiologic diagnosis of prosthetic hip and knee infection compared to chemical based dislodgement such as MicroDTTect.