Search Results (2,474)

Background and Objectives: The aim of this study was to evaluate the influence of abutment angulation, types, and bone quality on fatigue performance in dental implant systems. Materials and Methods: Three-dimensional models of maxillary 3-unit fixed implant-supported prostheses were analyzed. Abutments with different angles and types were used. Healthy bone (Hb) and resorbed bone (Rb) were used. Conducted on implants, a force of 150 N was applied obliquely, directed from the palatal to the buccal aspect, at a specific angle of 30 degrees. The stress distribution and fatigue performance were then evaluated considering the types of bone used and the angles of the three different abutments. The simulation aspect of the research was carried out utilizing Abaqus 2020 software. Results: In all models, fatigue strengths in healthy bone were higher than in resorbed bone. Maximum stress levels were seen in models with angled implants. In almost all models with resorbed bone, fatigue performances were slightly lower. Conclusions: Increasing the abutment angle has been shown to increase stress levels and decrease fatigue performance in the adjacent bone and along the implant–abutment interface. In general, implants applied to healthy bone were found to have a higher success rate. It has also been suggested that multiunit abutments have beneficial effects on stress distribution and fatigue performance compared to resin cemented abutments. The type or angle of abutment and the quality of the bone can lead to biomechanical changes that affect the force distribution within the bone structure surrounding the implant. Clinicians can influence the biomechanical environment of the implant site by varying the abutment angle and type to suit the condition of bone health, potentially affecting the long-term success of implant treatment. Full article

This systematic review of RCTs aimed to characterize short- and long-term changes in peri-implantitis-associated microbiota (total biofilm microbial load and predominant pathogens’ counts) following (any) peri-implantitis treatment in systemically healthy, non-smoking, partially/totally edentulous adults. The study protocol, compliant with the PRISMA statement, was registered on PROSPERO (CRD42024514521) before the literature search. Data from 11 RCTs, assessed through the ROBINS-2 tool, were qualitatively synthesized. No data were retrieved on total edentulism, healthy peri-implant/periodontal sites, treated mucositis, gingivitis, and periodontitis sites. Shortly after treatment, Prevotella intermedia, Fusobacterium nucleatum, and Peptostreptococcus micros prevailed, indicating early colonization, as after implant placement. After both surgical and non-surgical approaches, although not eradicated, the peri-implant total biofilm load, red- and orange-complex species, and Aggregatibacter actinomycetemcomitans counts generally decreased for up to about three months. However, one month after treatment, red-complex species and Prevotella intermedia increased, likely due to persistent tissue-invasive bacteria, unresolved pathological conditions (high probing depth values) favoring anaerobiosis and dysbiosis, and a qualitatively and quantitatively decreased biofilm community, competing and balancing the predominant pathogens (biofilm “competitive balancing” effect), thus allowing recolonization by more virulent bacteria. Red-complex bacteria gradually leveled off to baseline at the six- and twelve-month follow-ups. Fusobacterium nucleatum remained almost unchanged after treatment. Full article

The colonization of microbes and the resulting formation of biofilms on dental implants are significant contributors to peri-implantitis and the failure of these implants. The aim of the research was to analyze the impact of density and depth of laser texturing of the Ti-6Al-7Nb alloy surface on the colonization of selected microorganisms and biofilm formation. Standard strains of Gram-negative and Gram-positive bacteria and yeasts from the American Type Culture Collection—ATCC—were used to demonstrate the ability to form single-species biofilms in vitro. The study evaluated three types of titanium samples with different texture density and depth. The colonization and biofilm formation abilities of the tested microorganisms were assessed. The obtained results were subjected to statistical analysis. Among the analyzed strains, L. rhamnosus showed the highest colonization of the tested surfaces. It was found that there is no relationship between the texture parameters and the number of colony-forming units (CFU/mL) for C. albicans, S. mutans, and L. rhamnosus. For the F. nucleatum strain, it was shown that the number of colony-forming bacteria is related to the texture density. Full article

The aim of the present in vitro comparative study is to validate a novel composite polymer, named “ONLY”, developed to overcome the mechanical drawbacks of conventional, metal-reinforced poly(methyl methacrylate) (PMMA) interim restoration. Ten interim restorations were designed and fabricated (five in the composite “ONLY” group, and five in the metal-reinforced PMMA group). All the samples were screwed into the prototype models, simulating a complete edentulous mandible rehabilitated with six straight implants. Outcome measures were break point (load, N) and displacement (mm) through a static compression test, and material behavior through a dynamic cyclic test method (fatigue test). A total of 20 samples were tested (10 for static and 10 for dynamic). In each group, five samples (test and control) were used. All the specimens completed the mechanical tests, as planned. There was no statistically significant difference between groups for any test. In the test group, the break point was 1953.19 ± 543.73 N, while it was 2031.10 ± 716.68 N in the control group (p = 0.775). The displacement was 1.89 ± 0.34 mm in the test group and 1.98 ± 0.75 mm in the control group (p = 0.763). Using the dynamic cyclic test method, in the control group the mean load was 2504.60 ± 972.15 N, while in the test group the mean load was 3382.00 ± 578.50 N. The difference between groups was 877.40 ± 579.30 N (p value = 0.121). Within the limitations of this in vitro study, the novel composite polymer can be used to immediately load dental implants. Further clinical research is needed to confirm these preliminary results. Full article

While zirconia implants exhibit osseointegration comparable to that of titanium, concerns arise regarding low-temperature degradation and its potential impact on fracture strength. This study investigated the phase transformation and fracture characteristics of zirconia dental implants after aging through chewing simulation and subsequent static loading. The experimental setup involved 48 one-piece monobloc zirconia implants with diameters of 3.0 mm and 3.7 mm that had straight or angled abutments, with crown restorations, which were divided into six groups based on intraoral regions. The specimens underwent chewing simulation equal to five years of oral service, which was followed by static loading. Statistical analyses were performed for the data obtained from the tests. After dynamic and static loadings, the fractured samples were investigated by Raman spectroscopy to analyze the phase composition and micro-CT to evaluate fracture surfaces and volume changes. According to the results, narrow-diameter zirconia implants have low mechanical durability. The fracture levels, fracture patterns, total porosity, and implant fracture volume values varied according to the implant diameter and phase transformation grade. It was concluded that phase transformation initially guides the propagation of microcracks in zirconia implants, enhancing fracture toughness up to a specific threshold; however, beyond that point, it leads to destructive consequences. Full article

The 1st International Online Conference on Functional Biomaterials (IOCFB2024) was held from 10 to 12 July 2024. The conference covered a wide range of implantable biomaterials development topics, such as drug delivery, tissue engineering, antibacterial, dental, bone, and therapy. It sought to advance fresh approaches to the development of clinical biomaterials and broaden the scientific perspectives of biomaterials scientists. In order to foster interactions without the constraint of location or travel restrictions, the conference adopted an open online forum. Oral and poster presentations were featured in live broadcasts, enabling participants to take part in interactive discussions and sessions. Full article

Hydroxyapatite (HA) forms an essential constituent of human teeth and bone. Its distinctive characteristic features, such as bioactivity and osteoconductivity, make it an ideal candidate to be used as an implant coating in restorative dentistry and maxillofacial surgery for bone regeneration. However, low fracture toughness and brittleness are a few of the inherent features of HA, which limit its application in load-bearing areas. The potential of HA to engage its lattice structure with either partial or complete substitution with external ions has become an increasing area of research as this phenomenon has the potential to enhance the biological and functional properties of the material. Consequently, this review aimed to highlight the role of various substituted ions in dental applications. Data indicate that the newly formed HA-substituted biomaterials demonstrate enhanced remineralization and antimicrobial activity along with improved hardness. Ion-substituted HA offers a promising strategy for future clinical research as these materials may be incorporated into various dental products for therapeutic treatments. Full article

Background: Photobiomodulation (PBM) is a non-invasive procedure used to manage pain and inflammation. The aim of this study is to quantitatively measure pain and inflammation and to compare the proposed PBM treatment with a simulated treatment (PBM-SHAM) in patients with dental implants. Materials and Methods: A total of 62 patients were included and randomized into two groups. Group 1 (PBM) consisted of 31 patients subjected to the insertion of dental implants and a single intraoral PBM session with an EPIC X Biolase (0.5 W and 15 J/cm²) diode laser. Group II (PBM-SHAM) included 31 patients subjected to dental implants and a simulated PBM. Each patient was given a document with visual analog scales (VASs) to record pain and inflammation during the 7 days post-surgery. The patients were assessed at the end of the week to remove the sutures, to collect the VASs, and to re-evaluate the surveys. Results: Through the use of mixed effects models, it was found that the length of time after the surgery and the number of implants placed during the intervention were important variables that had an influence on pain and inflammation. Conclusions: PBM is a non-invasive and safe treatment. Postoperative pain and inflammation associated with implant surgery decreased in a similar manner over time, independently of the application of PBM. Therefore, more randomized studies are needed with a standardized methodology to adequately assess the efficacy of this therapy. Full article

Background: The new frontiers of computer-based surgery, technology, and material advances, have allowed for customized 3D printed manufacturing to become widespread in guided bone regeneration (GBR) in oral implantology. The shape, structural, mechanical, and biological manufacturing characteristics achieved through 3D printing technologies allow for the customization of implant-prosthetic rehabilitations and GBR procedures according to patient-specific needs, reducing complications and surgery time. Therefore, the present narrative review aims to elucidate the 3D-printing digital radiographic process, materials, indications, 3D printed manufacturing-controlled characteristics, histological findings, complications, patient-reported outcomes, and short- and long-term clinical considerations of customized 3D printed mesh, membranes, bone substitutes, and dental implants applied to GBR in oral implantology. Methods: An electronic search was performed through MEDLINE/PubMed, Scopus, BioMed Central, and Web of Science until 30 June 2024. Results: Three-dimensionally printed titanium meshes and bone substitutes registered successful outcomes in vertical/horizontal bone defect regeneration. Three-dimensionally printed polymeric membranes could link the advantages of conventional resorbable and non-resorbable membranes. Few data on customized 3D printed dental implants and abutments are available, but in vitro and animal studies have shown new promising designs that could improve their mechanical properties and tribocorrosion-associated complications. Conclusions: While 3D printing technology has demonstrated potential in GBR, additional human studies are needed to evaluate the short- and long-term follow-up of peri-implant bone levels and volumes following prosthetic functional loading. Full article

This study involved a randomized clinical trial that included 140 patients. Alveolar ridge preservation was performed with xenografts. Sealing in the control group consisted of a collagen membrane versus cyanoacrylate in the test group. The dental implants were placed immediately after extraction. The variables were evaluated at 3, 12, and 18 months of follow-up. Pearson’s chi-squared test was used for qualitative variables and the Student t-test for related samples was used for quantitative variables. The change in buccolingual alveolar bone width was significantly greater in the CMX group than in the CX group after three months (p < 0.005). However, significance was not reached at the other follow-up timepoints (p > 0.005). CAL showed significantly greater values in the CMX group than in the CX group (p < 0.005), and MBL proved greater in the CMX group than in the CX group, with p < 0.001. Five membrane exposures were recorded in the CMX group. Cyanoacrylate as a sealing method for alveolar ridge preservation seems to afford better clinical and radiological results than collagen membrane. Full article

Previous studies have highlighted the need for post-treatment of implants due to surface aging. This study investigated the effect of vacuum plasma (VP) treatment on the osseointegration of sandblasted, large grit, acid-etched (SLA) implant surfaces. The hypothesis was that VP might enhance implant stability, measured by implant stability quotient (ISQ) and histological osseointegration through bone-to-implant contact (BIC) and bone area ratio (BA) in rabbit models. Eighteen implants were either untreated or treated with VP and installed into the femurs of six rabbits, which were sacrificed after four weeks. Histological analyses of BIC and BA, along with micro-CT analysis of bone volume and ISQ, were performed. The VP-treated group showed higher levels of BA, bone volume, and ISQ, but no statistically significant differences were observed between the control and experimental groups. Despite limitations, both groups achieved better osseointegration and regeneration, warranting further studies on plasma treatment effects over varying implantation periods. Full article

Background/Objectives: Dental implants have emerged as a modern solution for edentulous jaws, showing high success rates. However, the implant’s success often hinges on the patient’s bone quality and quantity, leading to higher failure rates in poor bone sites. To address this issue, short implants have become a viable alternative to traditional approaches like bone sinus lifting. Among these, Bicon^® short implants with a plateau design are popular for their increased surface area, offering potential advantages over threaded implants. Despite their promise, the variability in patient-specific bone quality remains a critical factor influencing implant success and bone turnover regulated by bone strains. Excessive strains can lead to bone loss and implant failure according to Frost’s “Mechanostat” theory. To better understand the implant biomechanical environment, numerical simulation (FEA) is invaluable for correlating implant and bone parameters with strain fields in adjacent bone. The goal was to establish key relationships between short implant geometry, bone quality and quantity, and strain levels in the adjacent bone of patient-dependent elasticity to mitigate the risk of implant failure by avoiding pathological strains. Methods: Nine Bicon Integra-CP™ implants were chosen. Using CT scans, three-dimensional models of the posterior maxilla were created in Solidworks 2022 software to represent the most challenging scenario with minimal available bone, and the implant models were positioned in the jaw with the implant apex supported by the sinus cortical bone. Outer dimensions of the maxilla segment models were determined based on a prior convergence test. Implants and abutments were considered as a single unit made of titanium alloy. The bone segments simulated types III/IV bone by different cancellous bone elasticities and by variable cortical bone elasticity moduli selected based on an experimental data range. Both implants and bone were treated as linearly elastic and isotropic materials. Boundary conditions were restraining the disto-mesial and cranial surfaces of the bone segments. The bone–implant assemblies were subjected to oblique loads, and the bone’s first principal strain fields were analyzed. Maximum strain values were compared with the “minimum effective strain pathological” threshold of 3000 microstrain to assess the implant prognosis. Results: Physiological strains ranging from 490 to 3000 microstrain were observed in the crestal cortical bone, with no excessive strains detected at the implant neck area across different implant dimensions and cortical bone elasticity. In cancellous bone, maximum strains were observed at the first fin tip and were influenced by the implant diameter and length, as well as bone quality and cortical bone elasticity. In the spectrum of modeled bone elasticity and implant dimensions, increasing implant diameter from 4.5 to 6.0 mm resulted in a reduction in maximum strains by 34% to 52%, depending on bone type and cortical bone elasticity. Similarly, increasing implant length from 5.0 to 8.0 mm led to a reduction in maximum strains by 15% to 37%. Additionally, a two-fold reduction in cancellous bone elasticity modulus (type IV vs. III) corresponded to an increase in maximum strains by 16% to 59%. Also, maximum strains increased by 86% to 129% due to a decrease in patient-dependent cortical bone elasticity from the softest to the most rigid bone. Conclusions: The findings have practical implications for dental practitioners planning short finned implants in the posterior maxilla. In cases where the quality of cortical bone is uncertain and bone height is insufficient, wider 6.0 mm diameter implants should be preferred to mitigate the risk of pathological strains. Further investigations of cortical bone architecture and elasticity in the posterior maxilla are recommended to develop comprehensive clinical recommendations considering bone volume and quality limitations. Such research can potentially enable the placement of narrower implants in cases of insufficient bone. Full article

Peri-implantitis disease has increased significantly over the last years, resulting in increased failure of implants. Many factors may play a role in implant complications and failure, including ones related to the oral microbiota. This literature review aims to summarize the current knowledge of microbiome of implants in health and disease, focusing not only on the presence/absence of specific microbiota or on their relative abundance, but also on their phenotypic expression and their complex relationships with the host. The authors examined the MEDLINE database and identified key topics about peri-implant oral microbiome in health and disease. The peri-implant microbiome differs from that of the tooth, both in health and disease, as they are structurally and chemically different. The adhesion and formation of the peri-implant biofilm can be affected by the surface energy, topography, wettability, and electrochemical charges of the implant surface. In addition, the morphogenesis of the tissues surrounding the dental implant also differs from the tooth, making the dental implant more susceptible to bacterial infection. This interplay between the microbiome and the host immune system in peri-implant infections still needs to be elucidated. Full article

Introduction: Peri-implantitis poses a significant challenge for implant dentistry due to its association with bacterial colonization on implant surfaces and the complexity of its management. This systematic review aims to assess evidence from in vivo studies regarding the antimicrobial efficacy of titanium (Ti) dental implant surfaces following physical/chemical modifications or the application of various metal element coatings in preventing bacterial growth associated with peri-implantitis. Materials and Methods: A literature review was conducted across four scientific databases (PubMed, Embase, Scopus, Web of Science), encompassing in vivo studies published between 2013 and 2024, and 18 reports were included in the systematic review. Results: The findings suggest that titanium dental implant surfaces, following physical/chemical modifications and metal element coatings, exhibit antimicrobial effects against bacteria associated with peri-implantitis in humans and various animal models. Conclusions: The reviewed studies indicated a reduction in bacterial colonization, diminished biofilm formation, and decreased signs of inflammation in the peri-implant tissues, which provides evidence that physical/chemical alterations on titanium dental implant surfaces or metal element coatings, like silver (Ag), zinc (Zn), magnesium (Mg), and copper (Cu), demonstrate antimicrobial properties in in vivo studies. However, caution is warranted when translating findings to clinical practice due to methodological disparities and high bias risks. Further larger-scale clinical trials are imperative to assess their long-term efficacy and validate their clinical applicability. Full article

Background and Objectives: The aim of this study was to clinically evaluate the primary and secondary stability of dental implants with different macrodesigns using resonance frequency analysis and to determine whether implant design and length influence implant stability. Materials and methods: This study included 48 healthy patients receiving dental implants, and a pre-implant planning protocol was used, which involved detailed bone analysis, clinical examinations, and Cone beam computed tomography (CBCT) analysis. The implants were of various types and dimensions (Alpha-Bio Tec (Israel), DFI, SPI, and NEO), and the surgical procedures were performed using standard methods. Implant stability was measured using resonance frequency analysis (RFA) immediately after placement and after 3, 6, and 12 months. The total number of implants placed in all patients was 96. Results: The average primary stability value for 10 mm SPI implants placed in the maxilla was 68.2 ± 1.7 Implant Stability Quotient (ISQ) units, while for 10 mm NEO implants, it was 74.0 ± 0.9. The average primary stability value for a 10 mm DFI implant placed in the mandible was 72.8 ± 1.2 ISQ, while for a 10 mm NEO implant placed in the mandible, it was 76.3 ± 0.8 ISQ. Based on the Friedman ANOVA test, the differences in the stability measurements for the 10 mm and 11.5 mm SPI implants and for the 10 mm and 11.5 mm NEO implants in the maxilla on day 0 and after 3, 6, and 12 months were significant at p < 0.05. Similarly, based on the Friedman ANOVA test, the differences in the stability measurements for the 10 mm and 11.5 mm DFI implants and for the 10 mm and 11.5 mm NEO implants in the mandible on day 0 and after 3, 6, and 12 months were significant at p < 0.05 (p = 0.00000). Conclusions: Universal tapered implants of the NEO type stood out as the optimal choice, as they provided statistically significantly higher primary stability in both soft and hard bone types compared to other implants. The implant length did not significantly affect this stability. Full article