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Survival and failure modes: platform-switching for internal and external hexagon cemented fixed dental prostheses
Anchieta, Rodolfo B; Machado, Lucas S; Hirata, Ronaldo; Coelho, Paulo G; Bonfante, Estevam A
This study evaluated the probability of survival (reliability) of platform-switched fixed dental prostheses (FDPs) cemented on different implant-abutment connection designs. Eighty-four-three-unit FDPs (molar pontic) were cemented on abutments connected to two implants of external or internal hexagon connection. Four groups (n = 21 each) were established: external hexagon connection and regular platform (ERC); external hexagon connection and switched platform (ESC); internal hexagon and regular platform (IRC); and internal hexagon and switched platform (ISC). Prostheses were subjected to step-stress accelerated life testing in water. Weibull curves and probability of survival for a mission of 100,000 cycles at 400 N (two-sided 90% CI) were calculated. The beta values of 0.22, 0.48, 0.50, and 1.25 for groups ERC, ESC, IRC, and ISC, respectively, indicated a limited role of fatigue in damage accumulation, except for group ISC. Survival decreased for both platform-switched groups (ESC: 74%, and ISC: 59%) compared with the regular matching platform counterparts (ERC: 95%, and IRC: 98%). Characteristic strength was higher only for ERC compared with ESC, but not different between internal connections. Failures chiefly involved the abutment screw. Platform switching decreased the probability of survival of FDPs on both external and internal connections. The absence in loss of characteristic strength observed in internal hexagon connections favor their use compared with platform-switched external hexagon connections.
PMID: 27680671
ISSN: 1600-0722
CID: 2262002
The Effect of Laser-Etched Surface Design on Soft Tissue Healing of Two Different Implant Abutment Systems: An Experimental Study in Dogs
Neiva, Rodrigo; Tovar, Nick; Jimbo, Ryo; Gil, Luiz F; Goldberg, Paula; Barbosa, Joao Pm; Lilin, Thomas; Coelho, Paulo G
This study describes the early soft tissue morphology around two different implant systems that received either smooth or laser-etched abutments in a beagle dog model. Implants were placed in the healed mandibular molar region of eight beagle dogs and allowed to heal for 7 weeks. When the most apical aspect of the junctional epithelium (JE) was above or within the upper half of the laser-etched region, fibers were oriented perpendicular to the abutment surface. In contrast, JE positioned within the lower half of the laser-etched region or within or below the implant-abutment gap level presented fibers oriented parallel to the abutment surface.
PMID: 27560671
ISSN: 1945-3388
CID: 2240692
Effect of Simplified One-Step Drilling Protocol on Osseointegration
Patel, Arpita; Gil, Luiz F; Castellano, Arthur; Freitas, Gileade; Navarro, Daniel; Peredo, Ana P; Tovar, Nick; Coelho, Paulo
This study was designed to compare the combined effect of two different drilling techniques (conventional expansion and one-step) and four different implant geometries in a beagle dog model. The nondecalcified bone-implant samples underwent histologic/metric analysis at 2 and 6 weeks. Morphologic analysis showed similarities between different drilling technique groups and implant geometries. Histomorphometric parameters, bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) were analyzed, and no statistical difference between drilling groups and/or implant geometry was found. Time was the only variable that affected BIC and BAFO, suggesting that the two protocols are equally biocompatible and osseoconductive.
PMID: 27560682
ISSN: 1945-3388
CID: 2240682
Guidelines for Clinical Management of Laser-Etched (Laser-Lok) Abutments in Two Different Clinical Scenarios: A Preclinical Laboratory Soft Tissue Assessment Study
Neiva, Rodrigo; Tovar, Nick; Jimbo, Ryo; Gil, Luiz F; Goldberg, Paula; Barbosa, Joao Pm; Lilin, Thomas; Coelho, Paulo G
One-stage implants were placed in the mandibles of eight beagle dogs with laser-etched (LL) and machined abutments. After 4 weeks, half of the LL abutments were disconnected and reconnected after 10 minutes of saline storage, and the other half were replaced with a new LL abutment (impression simulation) with or without sulcus de-epithelialization. After abutment change, systems remained in vivo for 3 weeks. Results showed that LL abutments can be reconnected and that sulcus scoring prior to LL placement of one-stage implants receiving machined abutments may be beneficial.
PMID: 27100803
ISSN: 1945-3388
CID: 2240702
Surface characterization and in vivo evaluation of laser sintered and machined implants followed by resorbable-blasting media process: A study in sheep
Bowers, Michelle; Yoo, Daniel; Marin, Charles; Gil, Luiz; Shabaka, Nour; Goldstein, Matt; Janal, Malvin; Tovar, Nick; Hirata, Ronaldo; Bonfante, Estevam; Coelho, Paulo
BACKGROUND: This study aimed to compare the histomorphometric and histological bone response to laser-sintered implants followed by resorbable-blasting media (RBM) process relative to standard machined/RBM surface treated implants. MATERIAL AND METHODS: Six male sheep (n=6) received 2 Ti-6Al-4V implants (1 per surface) in each side of the mandible for 6 weeks in vivo. The histomorphometric parameters bone-implant contact (BIC) and bone area fraction occupancy (BAFO) were evaluated. RESULTS: Optical interferometry revealed higher Sa and Sq values for the laser-sintered/RBM surface in relation to standard/RBM implants. No significant differences in BIC were observed between the two groups (p>0.2), but significantly higher BAFO was observed for standard/RBM implants (p<0.01). CONCLUSIONS: The present study demonstrated that both surfaces were biocompatible and osseoconductive, and the combination of laser sintering and RBM has no advantage over the standard machined implants with subsequent RBM.
PMCID:4788801
PMID: 26827064
ISSN: 1698-6946
CID: 2240512
Evaluation of Dental Shade Guide Variability Using Cross-Polarized Photography
Gurrea, Jon; Gurrea, Marta; Bruguera, August; Sampaio, Camila S; Janal, Malvin; Bonfante, Estevam; Coelho, Paulo G; Hirata, Ronaldo
This study evaluated color variability in the A hue between the VITA Classical (VITA Zahnfabrik) shade guide and four other VITA-coded ceramic shade guides using a Canon EOS 60D camera and software (Photoshop CC, Adobe). A total of 125 photographs were taken, 5 per shade tab for each of 5 shades (A1 to A4) from the following shade guides: VITA Classical (control), IPS e.max Ceram (Ivoclar Vivadent), IPS d.SIGN (Ivoclar Vivadent), Initial ZI (GC), and Creation CC (Creation Willi Geller). Photos were processed with Adobe Photoshop CC to allow standardized evaluation of hue, chroma, and value between shade tabs. None of the VITA-coded shade tabs fully matched the VITA Classical shade tab for hue, chroma, or value. The VITA-coded shade guides evaluated herein showed an overall unmatched shade in all tabs when compared with the control, suggesting that shade selection should be made using the guide produced by the manufacturer of the ceramic intended for the final restoration.
PMID: 27560681
ISSN: 1945-3388
CID: 2240502
Physicochemical characterization of three fiber-reinforced epoxide-based composites for dental applications
Bonon, Anderson J; Weck, Marcus; Bonfante, Estevam A; Coelho, Paulo G
Fiber-reinforced composite (FRC) biomedical materials are in contact with living tissues arising biocompatibility questions regarding their chemical composition. The hazards of materials such as Bisphenol A (BPA), phthalate and other monomers and composites present in FRC have been rationalized due to its potential toxicity since its detection in food, blood, and saliva. This study characterized the physicochemical properties and degradation profiles of three different epoxide-based materials intended for restorative dental applications. Characterization was accomplished by several methods including FTIR, Raman, Brunauer-Emmett-Teller (BET) Analysis, X-ray fluorescence spectroscopy, and degradation experiments. Physicochemical characterization revealed that although materials presented similar chemical composition, variations between them were more largely accounted by the different phase distribution than chemical composition.
PMID: 27612785
ISSN: 1873-0191
CID: 2238452
Histomorphological and Histomorphometric Analyses of Grade IV Commercially Pure Titanium and Grade V Ti-6Al-4V Titanium Alloy Implant Substrates: An In Vivo Study in Dogs
Ribeiro da Silva, Jonathan; Castellano, Arthur; Malta Barbosa, Joao Pedro; Gil, Luiz F; Marin, Charles; Granato, Rodrigo; Bonfante, Estevam A; Tovar, Nick; Janal, Malvin N; Coelho, Paulo G
PURPOSE: To evaluate the bone response to grade IV commercially pure titanium (G4) relative to Ti-6Al-4V (G5). MATERIALS AND METHODS: Implant surface topography was characterized by optical interferometry and scanning electron microscopy (SEM). Thirty-six implants (Signo Vinces, n = 18 per group) were installed in the radius of 18 dogs. The animals were killed at 1, 3, and 6 weeks, resulting in 6 implants per group and time in vivo for bone morphology, bone-to-implant contact (BIC), and bone area fraction occupancy (BAFO) evaluation. RESULTS: SEM depicted a more uniform topography of G4 than G5. Surfaces were statistically homogeneous for Sa, Sq, and Sdr. At 1 week, new bone formation was observed within the healing connective tissue in contact with the implant surface. At 3 weeks, new bone in direct contact with the implant surface was observed at all bone regions. At 6 weeks, the healing chambers filled with woven bone depicted an onset of replacement by lamellar bone. No significant effect of substrate was detected. Time presented an effect on BIC and BAFO (P < 0.001). CONCLUSION: Both titanium substrates were biocompatible and osseoconductive at the bone tissue level.
PMID: 27540838
ISSN: 1538-2982
CID: 2219552
Ticagrelor regulates osteoblast and osteoclast function and promotes bone formation in vivo via an adenosine-dependent mechanism
Mediero, Aranzazu; Wilder, Tuere; Reddy, Vishnu S R; Cheng, Qian; Tovar, Nick; Coelho, Paulo G; Witek, Lukasz; Whatling, Carl; Cronstein, Bruce N
As many as 10% of bone fractures heal poorly, and large bone defects resulting from trauma, tumor, or infection may not heal without surgical intervention. Activation of adenosine A2A receptors (A2AR) stimulates bone formation. Ticagrelor and dipyridamole inhibit platelet function by inhibiting P2Y12 receptors and platelet phosphodiesterase, respectively, but share the capacity to inhibit cellular uptake of adenosine and thereby increase extracellular adenosine levels. Because dipyridamole promotes bone regeneration by an A2AR-mediated mechanism we determined whether ticagrelor could regulate the cells involved in bone homeostasis and regeneration in a murine model and whether inhibition of P2Y12 or indirect A2AR activation via adenosine was involved. Ticagrelor, dipyridamole and the active metabolite of clopidogrel (CAM), an alternative P2Y12 antagonist, inhibited osteoclast differentiation and promoted osteoblast differentiation in vitro. A2AR blockade abrogated the effects of ticagrelor and dipyridamole on osteoclast and osteoblast differentiation whereas A2BR blockade abrogated the effects of CAM. Ticagrelor and CAM, when applied to a 3-dimentional printed resorbable calcium-triphosphate/hydroxyapatite scaffold implanted in a calvarial bone defect, promoted significantly more bone regeneration than the scaffold alone and as much bone regeneration as BMP-2, a growth factor currently used to promote bone regeneration. These results suggest novel approaches to targeting adenosine receptors in the promotion of bone regeneration.-Mediero, A., Wilder, T., Reddy, V. S. R., Cheng, Q., Tovar, N., Coelho, P. G., Witek, L., Whatling, C., Cronstein, B. N. Ticagrelor regulates osteoblast and osteoclast function and promotes bone formation in vivo via an adenosine-dependent mechanism.
PMCID:5067248
PMID: 27511945
ISSN: 1530-6860
CID: 2213682
The Effect of Osteotomy Dimension on Implant Insertion Torque, Healing Mode, and Osseointegration Indicators: A Study in Dogs
Marin, Charles; Bonfante, Estevam; Granato, Rodrigo; Neiva, Rodrigo; Gil, Luiz Fernando; Marao, Heloisa Fonseca; Suzuki, Marcelo; Coelho, Paulo G
PURPOSE: This study investigated the effect of the osteotomy diameter for implant placement torque and its effect on the osseointegration. MATERIALS AND METHODS: Eight male beagle dogs received 48 implants (3.75 mm x 10 mm) in their right and left radius, 3 implants per side and allowed to heal for 3 weeks. Three experimental groups were evaluated. Group 1: implant with an undersized osteotomy of 3.0 mm; group 2: osteotomy of 3.25 mm, and group 3: osteotomy of 3.5 mm. The insertion torque was recorded for all implants. Histological sectioning and histometric analysis were performed evaluating bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). RESULTS: Implants of group 1 presented statistically higher insertion torque than those of groups 2 and 3 (P < 0.01). No differences in BIC or BAFO were observed between the groups. From a morphologic standpoint, substantial deviations in healing mode were observed between groups. CONCLUSION: Based on the present methodology, the experimental alterations of surgical technic can be clinically used with no detrimental effect over the osseointegration process.
PMID: 27513163
ISSN: 1538-2982
CID: 2213722