Faculty Bibliography

PURPOSE: The aim of this study was to assess the effect of implant coating with laminin-1 on the early stages of osseointegration in vivo. MATERIALS AND METHODS: Turned titanium implants were coated with the osteoprogenitor-stimulating protein, laminin-1 (TL). Their osteogenic performance was assessed with removal torque, histomorphometry, and nanoindentation in a rabbit model after 2 and 4 weeks. The performance of the test implants was compared with turned control implants (T), alkali- and heat-treated implants (AH), and AH implants coated with laminin-1. RESULTS: After 2 weeks, TL demonstrated significantly higher removal torque as compared with T and equivalent to AH. Bone area was significantly higher for the test surface after 4 weeks, while no significant changes were detected on the micromechanical properties of the surrounding bone. CONCLUSIONS: Within the limitations of this study, our results suggest a great potential for laminin-1 as a coating agent. A turned implant surface coated with laminin-1 could enhance osseointegration comparable with a bioactive implant surface while keeping the surface smooth.

This study investigated the effect of undersized preparations with two different implant macrogeometries. There were four experimental groups: group 1, conical implant with an undersized osteotomy of 3.2mm; group 2, conical implant with an undersized osteotomy of 3.5mm; group 3, cylindrical implant with an undersized osteotomy of 3.2mm; group 4, cylindrical implant with an undersized osteotomy of 3.5mm. Implants were placed in one side of the sheep mandible (n=6). After 3 weeks, the same procedure was conducted on the other side; 3 weeks later, euthanasia was performed. All implants were 4mmx10mm. Insertion torque was recorded for all implants during implantation. Retrieved samples were subjected to histological sectioning and histomorphometry. Implants of groups 1 and 2 presented significantly higher insertion torque than those of groups 3 and 4 (P<0.001). No differences in bone-to-implant contact or bone area fraction occupied were observed between the groups at 3 weeks (P>0.24, and P>0.25, respectively), whereas significant differences were observed at 6 weeks between groups 1 and 2, and between groups 3 and 4 (P<0.01). Undersized drilling affected the biological establishment of bone formation around both dental implant macrogeometries.

In this study, the physicochemical characteristics of calcium phosphate based bioactive ceramics of different compositions and blends presenting similar micro/nanoporosity and micrometer scale surface texture were characterized and evaluated in an in vivo model. Prior to the animal experiment, the porosity, surface area, particle size distribution, phase quantification, and dissolution of the materials tested were evaluated. The bone regenerative properties of the materials were evaluated using a rabbit calvaria model. After 2, 4, and 8weeks, the animals were sacrificed and all samples were subjected to histologic observation and histomorphometric analysis. The material characterization showed that all materials tested presented variation in particle size, porosity and composition with different degrees of HA/TCP/lower stoichiometry phase ratios. Histologically, the calvarial defects presented temporal bone filling suggesting that all material groups were biocompatible and osteoconductive. Among the different materials tested, there were significant differences found in the amount of bone formation as a function of time. At 8weeks, the micro/nanoporous material presenting ~55%TCP:45%HA composition ratio presented higher amounts of new bone regeneration relative to other blends and a decrease in the amount of soft tissue infiltration.

BACKGROUND: The primary aim is to evaluate clinical, radiographic, and histologic parameters of novel implants with "three roots" design that were inserted into fresh multirooted extraction sockets. A secondary aim is to compare this new implant to standard root-form dental implants. METHODS: Immediate implantation of novel or standard design 6 x 6-mm implants was performed bilaterally into multirooted sockets in mandibles of mini-pigs. Twelve weeks later, clinical, radiographic, stability, histomorphometric, and microcomputed tomography (micro-CT) analyses were performed. RESULTS: Survival rates were significantly higher in the test implants compared with control (92.8% versus 33.3%, respectively; P <0.001). Bone loss was greater in the control compared with the test by sounding (mean 3.42 +/- 0.68 versus 1.96 +/- 0.34 mm) and radiography (mean 3.35 +/- 0.62 versus 2.27 +/- 0.33 mm). Histologic and micro-CT analyses demonstrated bone fill in the inner part of the test implants. Moreover, bone-to-implant contact was higher in the test implants (55.50% +/- 3.68% versus 42.47% +/- 9.89%). Contrary to the clinical, radiographic, and histomorphometric results, resonance frequency analysis measurements were greater in the control group (77.74 +/- 3.21 implant stability quotient [ISQ]) compared with the test group (31.09 +/- 0.28 ISQ), P = 0.008. CONCLUSIONS: The novel design implants resulted in significantly greater survival rate in multirooted extraction sites. Further studies will be required to validate these findings.

STRUCTURED ABSTRACT: Study Design. Animal modelObjective. Determine whether Amicar and TXA inhibit spine fusion volumeSummary of Background Data. Amicar and TXA are antifibrinolytics used to reduce perioperative bleeding. Prior in vitro data showed that antifibrinolytics reduce osteoblast bone mineralization. This study tested whether antifibrinolytics Amicar and TXA inhibit spine fusion.Methods. Posterolateral L4-L6 fusion was performed in fifty mice, randomized into groups of ten, that received the following treatment before and after surgery: (1) Saline; (2) TXA 100mg/kg; (3) TXA 1000mg/kg; (4) Amicar 100 mg/kg; (5) Amicar 1000 mg/kg. High-resolution plane radiography was performed after 5 weeks and micro-CT was performed at the end of the 12-week study. Radiographs were graded using the Lenke scale. Micro-CT was used to quantify fusion mass bone volume. One-way analysis of variance (ANOVA) by ranks with Kruskal-Wallis testing was used to compare the radiographic scores. One-way ANOVA with least-significant differences (LSD) post-hoc testing was used to compare the micro-CT bone volume.Results. The average (+/- SD) bone volume/total volume (%) measured in the saline, TXA 100 mg/kg, TXA 1000 mg/kg, Amicar 100 mg/kg and Amicar 1000 mg/kg groups were 10.8+/-2.3, 9.7+/-2.2, 13.4+/-3.2, 15.5+/-5.2 and 17.9+/-3.5%, respectively. There was a significant difference in the Amicar 100 mg/kg (p < 0.05) and Amicar 1000 mg/kg (p < 0.001) groups compared to saline. There was greater bone volume in the Amicar groups compared to the TXA group (p < 0.001). There was more bone volume in the TXA 1000 mg/kg group compared to TXA 100 mg/kg (p < 0.05) but the bone volume in neither of the TXA groups was different to saline (p = 0.49). There were no between-group differences observed using plane radiographic scoring.Conclusions. Amicar significantly enhanced the fusion bone mass in a dose-dependent manner while TXA did not have a significant effect on fusion compared to saline control.These data are in contrast to prior in vitro data that antifibrinolytics inhibit osteoblast bone mineralization.

OBJECTIVES: To evaluate the influence of instrumentation technique on the early osseointegration histomorphometrics and biomechanical fixation of fully laser-etched microgrooves implant surfaces in a sheep model. MATERIAL AND METHODS: Six sheep were subjected to bilateral hip surgeries 3 and 6 weeks before euthanasia. A total of 48 implants (slashed circle4.5 mm, 8 mm in length) were distributed among four sites (8 per animal) and placed in bone sites drilled to 4.6 mm (reamer), 4.1 mm (loose), 3.7 mm (medium) and 3.2 mm (tight) in diameter. After healing, the animals were euthanized and half of the implants were biomechanically tested, while the remainder was subjected to non-decalcified histologic processing. The histomorphometric parameters assessed were bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Statistical analysis was performed using a mixed-model analysis of variance with significance level set at P < 0.05. RESULTS: A general increasing trend is present from 3 to 6 weeks for most of the variables. The groups prepared to be press fit seemed to present higher values, which were maintained throughout the observation period. The reamer group presented the lowest BIC probably due to the drilling technique; however qualitatively, more new bone seemed to be in contact to the implant surface, at 3 weeks, whereas the implants placed in press-fit situations were mainly supported by cortical bone. CONCLUSION: The laser-etched microgrooved implant presented osteoconductive and biocompatible properties for all surgical procedures tested. However, procedures providing increasingly higher press-fit scenarios presented the strongest histomorphometric and biomechanical responses at 3 and 6 weeks.

Micro- and nanoscale surface modifications have been the focus of multiple studies in the pursuit of accelerating bone apposition or osseointegration at the implant surface. Here, we evaluated histological and nanomechanical properties, and gene expression, for a microblasted surface presenting nanometer-scale texture within a micrometer-scale texture (MB) (Ossean Surface, Intra-Lock International, Boca Raton, FL) versus a dual-acid etched surface presenting texture at the micrometer-scale only (AA), in a rodent femur model for 1, 2, 4, and 8weeks in vivo. Following animal sacrifice, samples were evaluated in terms of histomorphometry, biomechanical properties through nanoindentation, and gene expression by real-time quantitative reverse transcription polymerase chain reaction analysis. Although the histomorphometric, and gene expression analysis results were not significantly different between MB and AA at 4 and 8weeks, significant differences were seen at 1 and 2weeks. The expression of the genes encoding collagen type I (COL-1), and osteopontin (OPN) was significantly higher for MB than for AA at 1week, indicating upregulated osteoprogenitor and osteoblast differentiation. At 2weeks, significantly upregulated expression of the genes for COL-1, runt-related transcription factor 2 (RUNX-2), osterix, and osteocalcin (OCN) indicated progressive mineralization in newly formed bone. The nanomechanical properties tested by the nanoindentation presented significantly higher rank hardness and elastic modulus for the MB compared to AA at all time points tested. In conclusion, the nanotopographical featured surfaces presented an overall higher host-to-implant response compared to the microtextured only surfaces. The statistical differences observed in some of the osteogenic gene expression between the two groups may shed some insight into the role of surface texture and its extent in the observed bone healing mechanisms.

PURPOSE:: This clinical and histological study evaluated the healing of extraction sockets after implantation of a biphasic calcium sulfate (CS) alone or in combination with a gamma-radiated human mineralized allograft. MATERIALS AND METHODS:: Ten healthy adult patients participated in the study. A minimum of 2 teeth, per patient, extracted for different reasons were evaluated. Each socket was randomly filled to the crest with either (a) a biphasic CS or (b) large particulate gamma-radiated human mineralized allograft in combination with a biphasic CS. RESULTS:: No complications during reentry of the socket site during bone core retrieval, such as inflammation/immunogenic response, were observed. Histological findings showed a mean new bone (NB) of 33% for sockets filled with biphasic CS and 31% for sockets filled with biphasic CS in combination with allograft material. There was no statistically significant difference in the percentage of NB and the presence of soft tissue between graft materials. CONCLUSION:: Biphasic CS used alone or in combination with an allograft resulted in the same amount of NB formation in alveolar ridge preservation procedures.

AIMS: It has been accepted that bone damage and subsequent resorption occurs in cases of adverse interfacial bone strain. Fractured implants represents an important opportunity for evaluating the bone response to overstrain. The objective of the study was to analyze the bone morphology and morphometry around retrieved fractured implants in humans. Five fractured implants retrieved after 22.4 (+/- 2.8) years were used in the present study. The investigation was conducted in a transmitted brightfield and circularly polarized light Microscope. The parameters considered were the total bone area, total bone remodeling area, bone-remodeling rate (BRR), and bone transverse collagen fibers orientation (CFO). FINDINGS: For grouped samples, the BRR was 51.9% (+/- 10) while the transverse CFO was 13.0% (+/- 9.7). The interthread BRR was 58.1% (+/- 4.0) for level 1 and 40.4% (+/- 12.8) for level 2 with a significant decrease in BRR (p = 0.019) as a function of depth along the implant length. CONCLUSIONS: Both bone level and bone quality attains stability to a certain level with respect to implant neck fracture following physiologic interaction between mechanical and biological inputs. The BRR significantly decrease as function of threads depth. (c) 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 102B: 1342-1352, 2014.

Information concerning the effects of the implant cutting flute design on initial stability and its influence on osseointegration in vivo is limited. This study evaluated the early effects of implants with a specific cutting flute design placed in the sheep mandible. Forty-eight dental implants with two different macro-geometries (24 with a specific cutting flute design - Blossom group; 24 with a self-tapping design - DT group) were inserted into the mandibular bodies of six sheep; the maximum insertion torque was recorded. Samples were retrieved and processed for histomorphometric analysis after 3 and 6 weeks. The mean insertion torque was lower for Blossom implants (P<0.001). No differences in histomorphometric results were observed between the groups. At 3 weeks, P=0.58 for bone-to-implant contact (BIC) and P=0.52 for bone area fraction occupied (BAFO); at 6 weeks, P=0.55 for BIC and P=0.45 for BAFO. While no histomorphometric differences were observed, ground sections showed different healing patterns between the implants, with better peri-implant bone organization around those with the specific cutting flute design (Blossom group). Implants with the modified cutting flute design had a significantly reduced insertion torque compared to the DT implants with a traditional cutting thread, and resulted in a different healing pattern.