Mechanical aspects of dental implants and osseointegration: A narrative review

Li, Jinmeng; Jansen, John A.; Walboomers, X. Frank; Beucken, Jeroen Jjp. van den

doi:10.1016/j.jmbbm.2019.103574

Cited by 161 publications

(113 citation statements)

References 124 publications

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“…Among the materials used in orthopedics with these fines, titanium and its alloys play an important role, due to their excellent mechanical and corrosion resistance and their adequate biological behavior [3][4][5][6][7][8][9][10]. However, this presents two important disadvantages, among others: on the one hand, the stiffness of titanium (Ti) is higher (100-110 GPa) than the cortical bone (20)(21)(22)(23)(24)(25), which produces the stress-shielding phenomenon, promoting bone resorption surrounding the implant and compromising, in these cases, the functionality of the implants [11]; on the other hand, the inert biological character of titanium surfaces results in a poor cellular interaction between Ti and host bone tissue-an outcome that can affect the proper reconstruction of bone, resulting in implant loosening [12]. For these reasons, the development of Ti implants with satisfactory Young's modulus and best cellular interaction for bone tissue replacement remains a challenge to be addressed.…”

Section: Introductionmentioning

confidence: 99%

Use of Impedance Spectroscopy for the Characterization of In-Vitro Osteoblast Cell Response in Porous Titanium Bone Implants

Giner

Olmo

Hernández

et al. 2020

Metals

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The use of titanium implants with adequate porosity (content, size and morphology) could solve the stress shielding limitations that occur in conventional titanium implants. Experiments to assess the cellular response (adhesion, proliferation and differentiation of osteoblasts) on implants are expensive, time-consuming and delicate. In this work, we propose the use of impedance spectroscopy to evaluate the growth of osteoblasts on porous titanium implants. Osteoblasts cells were cultured on fully-dense and 40 vol.% porous discs with two ranges of pore size (100–200 μm and 355–500 μm) to study cell viability, proliferation, differentiation (Alkaline phosphatase activity) and cell morphology. The porous substrates 40 vol.% (100–200 µm) showed improved osseointegration response as achieved more than 80% of cell viability and higher levels of Cell Differentiation by Alkaline Phosphatase (ALP) at 21 days. This cell behavior was further evaluated observing an increase in the impedance modulus for all study conditions when cells were attached. However, impedance levels were higher on fully-dense due to its surface properties (flat surface) than porous substrates (flat and pore walls). Surface parameters play an important role on the global measured impedance. Impedance is useful for characterizing cell cultures in different sample types.

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Section: Introductionmentioning

confidence: 99%

Use of Impedance Spectroscopy for the Characterization of In-Vitro Osteoblast Cell Response in Porous Titanium Bone Implants

Giner

Olmo

Hernández

et al. 2020

Metals

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“…In general, most studies recommend curettage of the implant site before placement or suggest antibiotics to aid the success rate of immediate implant placement [ 44 ]. During the primary stability, the outer implant threads are in close proximity with the surrounding bone, providing mechanical interlocking between the bone and implant [ 45 , 46 ]. However, the inner surfaces of the threads are unable to have an implant-to-bone contact and the void formed will be occupied with blood, subsequently forming into a blood clot characterized by a fibrin coagulum with thrombocytes, neutrophils, erythrocytes and macrophages/monocytes [ 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…The fibrin coagulum network will progressively form into granulation tissue when penetration of vascular units and fibroblast-like cells is initiated. This initial wound healing response will start the bone apposition between the implant and the surrounding bone, indicating the build-up of the secondary stability [ 45 , 46 ]. On the contrary, when in presence of infection, sites showing pathology may increase the risk of microbial interference with the initial wound healing [ 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

Immediate Implant Placement in Non-Infected Sockets versus Infected Sockets: a Systematic Review and Meta-Analysis

Saijeva¹,

Juodžbalys

2020

JOMR

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Objectives The aim of this systematic review is to compare immediate implant placement in infected extraction sockets with non-infected extraction sockets in terms of implant survival and function. Material and Methods An electronic search was conducted in PubMed, ScienceDirect, ISI Web of Knowledge and Google Scholar between January 2010 and February 2020. Studies evaluating implant survival rate and main clinical parameters were included for a qualitative and quantitative analysis. Results In total, nine studies were included and a pool of 2281 sockets were analysed. Compared with the non-infected group, the infected group showed no significant differences in implant survival rates (risk ratio [RR] = 0.99; 95% confidence interval [CI] = 0.98 to 1; P = 0.08). No significant statistical differences were found in marginal bone level (mean difference [MD] = -0.03; 95% CI = -0.1 to 0.04; P = 0.41), marginal gingival level (MD = -0.07; 95% CI = -0.17 to 0.04; P = 0.23), probing depth (MD = 0.06; 95% CI = -0.24 to 0.36; P = 0.7), modified bleeding index (MD = -0.00162196; 95% CI = -0.09 to 0.09; P = 0.97) and slight but significant changes were seen in width of keratinized gingiva (MD = 0.25; 95% CI = -0.3 to 0.8; P = 0.38) between the groups at the latest follow-up. Conclusions There were no significant difference in implant survival rates, marginal bone level, marginal gingival level, modified bleeding index and probing depth between infected sockets and non-infected sockets. However, slight but significant changes were seen in width of keratinized gingiva favouring the non-infected group.

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“…However, poor bone ingrowth, linked for instance to increased implant micromotion, still compromises the long-term stability of the implant and leads to loosening and secondary surgery ( Mathieu et al, 2014 ). Understanding the integration process and the strength of the newly formed bone-implant interface may help improve implant designs and surgical strategies in order to enhance prosthesis integration ( Alenezi et al, 2018 ; Hanawa, 2019 ; Li et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Bone Damage Evolution Around Integrated Metal Screws Using X-Ray Tomography — in situ Pullout and Digital Volume Correlation

Cann

Tudisco

Tägil

et al. 2020

Front. Bioeng. Biotechnol.

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Better understanding of the local deformation of the bone network around metallic implants subjected to loading is of importance to assess the mechanical resistance of the bone-implant interface and limit implant failure. In this study, four titanium screws were osseointegrated into rat tibiae for 4 weeks and screw pullout was conducted in situ under x-ray microtomography, recording macroscopic mechanical behavior and full tomographies at multiple load steps before failure. Images were analyzed using Digital Volume Correlation (DVC) to access internal displacement and deformation fields during loading. A repeatable failure pattern was observed, where a ∼300-500 µmthick envelope of bone detached from the trabecular structure. Fracture initiated close to the screw tip and propagated along the implant surface, at a distance of around 500 µm. Thus, the fracture pattern appeared to be influenced by the microstructure of the bone formed closely around the threads, which confirmed that the model is relevant for evaluating the effect of pharmacological treatments affecting local bone formation. Moreover, cracks at the tibial plateau were identified by DVC analysis of the tomographic images acquired during loading. Moderate strains were first distributed in the trabecular bone, which localized into higher strains regions with subsequent loading, revealing crack-formation not evident in the tomographic images. The in situ loading methodology followed by DVC is shown to be a powerful tool to study internal deformation and fracture behavior of the newly formed bone close to an implant when subjected to loading. A better understanding of the interface failure may help improve the outcome of surgical implants.

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Mechanical aspects of dental implants and osseointegration: A narrative review

Cited by 161 publications

References 124 publications

Use of Impedance Spectroscopy for the Characterization of In-Vitro Osteoblast Cell Response in Porous Titanium Bone Implants

Use of Impedance Spectroscopy for the Characterization of In-Vitro Osteoblast Cell Response in Porous Titanium Bone Implants

Immediate Implant Placement in Non-Infected Sockets versus Infected Sockets: a Systematic Review and Meta-Analysis

Bone Damage Evolution Around Integrated Metal Screws Using X-Ray Tomography — in situ Pullout and Digital Volume Correlation

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