Bone cement grafting increases implant primary stability in circumferential cortical bone defects

Abstract

PurposeImplant beds with an insufficient amount of cortical bone or a loss of cortical bone can result in the initial instability of a dental implant. Thus, the objective of this study was to evaluate the effect of bone cement grafting on implant initial stability in areas with insufficient cortical bone.MethodsTwo different circumferential defect depths (2.5 mm and 5 mm) and a control (no defect) were prepared in six bovine rib bones. Fourteen implants of the same type and size (4 mm×10 mm) were placed in each group. The thickness of the cortical bone was measured for each defect. After the implant stability quotient (ISQ) values were measured three times in four different directions, bone cement was grafted to increase the primary stability of the otherwise unstable implant. After grafting, the ISQ values were measured again.ResultsAs defect depth increased, the ISQ value decreased. In the controls, the ISQ value was 85.45±3.36 (mean±standard deviation). In circumferential 2.5-mm and 5-mm defect groups, the ISQ values were 69.42±7.06 and 57.43±6.87, respectively, before grafting. These three values were significantly different (P<0.001). After grafting the bone cement, the ISQ values significantly increased to 73.72±8.00 and 67.88±10.09 in the 2.5-mm and 5.0-mm defect groups, respectively (P<0.05 and P<0.001). The ISQ value increased to more than double that before grafting in the circumferential 5-mm defect group. The ISQ values did not significantly differ when measured in any of the four directions.ConclusionsThe use of bone cement remarkably increased the stability of the implant that otherwise had an insufficient level of stability at placement, which was caused by insufficient cortical bone volume.Graphical Abstract

Nanohydroxyapatite Silicate-Based Cement Improves the Primary Stability of Dental Implants: An In Vitro Study

“…Nano-HA grafting did not affect the low primary stability. These results are in line with the results obtained by Poly bone [6,20] and Dental Implant Bone Cement [21].…”

“…Insufficient cortical bone volume when placing implants can lead to lack of primary stability. Using a bone graft material around the arranged implant beds was also suggested as a technique to overcome insufficient primary stability of the dental implant [6]. Some materials were assessed for this purpose and they demonstrated encouraging results [6,7].…”

“…Using a bone graft material around the arranged implant beds was also suggested as a technique to overcome insufficient primary stability of the dental implant [6]. Some materials were assessed for this purpose and they demonstrated encouraging results [6,7]. Calcium-silicate cements, like MTA (mineral trioxide aggregate) and other Portlandderived materials, are hydraulic cements mainly composed of tricalcium and dicalcium silicate, tricalcium aluminate, and calcium sulphate.…”

Impact of particulate deproteinized bovine bone mineral and porous titanium granules on early stability and osseointegration of dental implants in narrow marginal circumferential bone defects

“…Bone graft substitute materials for this indication should preferably enhance early stability and proliferate osseous support for the implants. 4 White porous titanium granules (WPTG), a synthetic bone graft substitute material, may be a candidate material. WPTG is derived from heat treatment and oxidation of porous titanium granules (PTG) and the process alters its physical characteristics and colour, which according to the manufacturer is intended for use in aesthetically sensitive areas.…”

Histomorphometric analysis of microcrack healing after the installation of mini-implants

“…The primary stability of an MI is achieved by mechanical coherence between the bone and the MI immediately after installation, while secondary stability is achieved after healing, by means of a process in which osteoblasts form fibrous and lamellar bone around the inserted MI. The factors affecting primary stability are bone density, surgical technique, and the morphology of the MI [ 7 , 8 , 9 , 10 ], which have also been studied in the context of dental implants [ 11 , 12 , 13 ]. After a certain period of healing, secondary stability plays a more important role.…”