Faculty Bibliography

This study characterized the interplay between topography/chemistry and early bone response of etched and no-etched resorbable blasted media (RBM) processed surfaces. Screw-root form Ti-6Al-4V implants treated with alumina blasting/acid-etching (AB/AE), RBM alone (RBM), and RBM + acid-etching (RBMa) were evaluated. The surface was characterized by scanning electron microscopy, atomic force microscopy, and X-ray photoelectron spectroscopy. Implants placed in the tibia of dogs remained 3 and 5 weeks in vivo. Following euthanasia, half of the specimens were torqued to interface failure and the remaining subjected to bone-to-implant contact (BIC) and bone area fraction occupied (BAFO) between threads evaluation. The AB/AE surface was rougher than the RBM and RBMa. Higher levels of calcium and phosphorous were observed for the RBM surface compared to the RBMa. No significant differences were observed in torque, BIC, and BAFO between surfaces. Woven bone formation at 3 weeks and its initial replacement by lamellar bone at 5 weeks were observed around all implants' surfaces.

PURPOSE: This study tested the null hypothesis that differences in surgical instrumentation, macrogeometry, and surface treatment imposed by different implant systems do not affect early biomechanical fixation in a canine mandible model. MATERIALS AND METHODS: The lower premolars of 6 beagle dogs were extracted and the ridges allowed to heal for 8 weeks. Thirty-six (n = 12 each group) implants were bilaterally placed, remaining for 1 and 3 weeks in vivo. The implant groups were as follows: group 1, Ti-6Al-4V with a dual acid-etched surface with nanometer scale discrete crystalline deposition (Nanotite; Certain Biomet-3i, West Palm Springs, FL); group 2, Ti-6Al-4V with a titanium oxide-blasted fluoride-modified surface chemistry (Osseospeed 4.0 S; Astra Tech, Molndal, Sweden); group 3: Ti-6Al-4V with a bioceramic microblasted surface (Ossean; Intra-Lock International, Boca Raton, FL). Following euthanasia, implants were torqued to interface failure and histologically evaluated. General linear modeling (ANOVA) at 95% level of significance was performed. RESULTS: Histology showed that interfacial bone remodeling and initial woven bone formation were observed around all implant groups at 1 and 3 weeks. Torque values were significantly affected by time in vivo, implant group, and their interaction (P = .016, P < .001, and P = .001, respectively). Regarding torque values, group 3, group 2, and group 1 ranked highest, intermediate, and lowest, respectively. CONCLUSION: Early biomechanical fixation at 1 and 3 weeks was affected by surgical instrumentation, macrogeometry, and surface treatment present for one of the implant systems tested. The null hypothesis was rejected.

This study evaluated the effect of a bioactive ceramic coating, in the nanothickness range, onto a moderately rough surface on the osteogenic behavior of human bone cells. The cells were harvested from the mandibular mental region and were cultured over Ti-6Al-4V disks of different surfaces: as-machined (M), alumina-blasted/acid etched (AB/AE), and alumina-blasted/acid-etched + 300-500 nm thickness amorphous Ca- and P-based coating obtained by ion beam-assisted deposition (Nano). The culture was then evaluated regarding cell viability, adhesion, morphology, immunolocalization of osteopontin (OPN) and alkaline phosphatase (ALP). The results showed that the surface treatment did not interfere with cell viability. At 1 day, AB/AE and Nano showed higher adhesion than the M surface (p < 0.001). Higher adhesion was observed for the M than the Nano surface at 7 days (p < 0.005). The percentage of cells showing intracellular labeling for OPN at day 1 was significantly higher for the Nano compared to M surface (p < 0.03). The percentage of ALP intracellular labeling at 7 days was significantly higher for the AB/AE compared to the M surface (p < 0.0065); no differences were detected at 14 days. Our results suggest that the presence of a thin bioactive ceramic coating on a rough substrate did not favor the events related to in vitro osteogenesis. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010.

PURPOSE: The objective of the present study was to evaluate the biomechanical fixation and bone-to-implant contact (BIC) of plateau root form implants of varied surfaces. MATERIALS AND METHODS: Plateau root form implants, 3.5 mm in diameter, 8 mm in length, with 4 surfaces (n = 16 each)--machined, alumina-blasted/acid-etched, alumina-blasted/acid-etched plus nanothickness bioceramic coating, and plasma-sprayed calcium-phosphate--were used. They were bilaterally placed at the distal femur of 16 New Zealand rabbits and remained in place for 2 and 4 weeks in vivo. After euthanizing the rabbits, the implants were subjected to torque to interface fracture and were subsequently processed as nondecalcified approximately 30-microm-thickness slides for histomorphologic analysis and BIC determination. Statistical analysis was performed using analysis of variance at the 95% level of significance, considering implantation time and implant surface as independent variables and the torque-to-interface fracture and BIC as dependent variables. RESULTS: The torque-to-interface fracture was significantly affected by the implant surface (P < .001) but was not affected by the implantation time (P > .20). The implantation time and implant surface had significant effects on the BIC (P < .04 and P < .001, respectively). The greatest torque-to-interface fracture and BIC was observed for the plasma-sprayed calcium-phosphate. CONCLUSION: The implant surface significantly influenced early bone healing around plateau root form implants.

Metallic ion release has raised concerns for the utilization of titanium and titanium alloys in implant dentistry. As an alternative, yttriastabilized tetragonal zirconia (Y-TZP) has been considered the material of choice due to its favorable biological and mechanical properties. Zirconia has been shown both in vitro and in vivo experiments to exhibit desirable osseointegration, cell metabolism, and soft tissue response. According to the mechanical testing of unaged Y-TZP onepiece implants, catastrophic failure of ceramic implants in anterior esthetic regions is unlikely. The utilization of a one-piece Y-TZP implant might be an option to fulfill the esthetic and mechanical needs in oral implant treatments when esthetics is the major concern.

AIM: The objective of this study was to evaluate the early healing of endosseous implants presenting various healing chamber configurations in a beagle dog mandible model. METHODS: The four premolars of 12 beagle dogs were extracted and allowed to heal for a period of 8 weeks. Implants allowing six different healing chamber configurations were placed in each dog (three per side, six configurations per dog). The animals were sacrificed after 3 and 5 weeks in vivo (n=6 per time in vivo), and the implants were non-decalcified processed to slides of approximately 30 microm thickness. Bone-to-implant contact (BIC) and bone area fraction occupied (BAFO) within the healing chamber were quantified. Statistical analysis was performed by a GLM ANOVA model at 5% significance level. RESULTS: Osseointegration and healing with woven bone filling throughout all healing chambers was observed. Replacement of woven bone by lamellar bone showing primary osteonic structures was observed at 5 weeks. BIC was significantly affected by healing chamber configuration (P<0.001) and was not affected by time in vivo (P>0.42) at 3 and 5 weeks in vivo. BAFO was not affected by healing chamber configuration (P>0.14) however significantly increased over implantation time (P<0.001). CONCLUSION: Regardless of healing chamber design and dimensions considered, healing allowed the devices osseointegration. However, healing chamber configuration significantly affected osseointegration measurable parameters such as BIC.

OBJECTIVE: To evaluate the early bone response to plateau root form dental implants with 4 different surface treatments. STUDY DESIGN: Surface treatments comprised (n = 12 each): as-machined (M), alumina-blasted/acid-etched (AB/AE), alumina-blasted/acid-etched + nanothickness bioceramic coating (Nano), and plasma-sprayed calcium phosphate (PSCaP). Implants were placed in the radius diaphyses of 12 beagle dogs, remaining in vivo for 3 and 5 weeks. After euthanasia, the implants were subjected to torque to interface fracture and subsequently nondecalcified for histomorphology. Statistical analysis was performed by a GLM analysis of variance model at 5% significance level. RESULTS: Torque to interface fracture was significantly greater for the PSCaP group than for other groups (P < .001). Histomorphologic analysis showed woven bone formation around all implant surfaces at 3 weeks, and its replacement by lamellar bone at 5 weeks. Time in vivo did not affect torque measures. CONCLUSION: The PSCaP surface increased the early bone biomechanical fixation of plateau root form implants.

In a crown system, core fracture requires replacement of the restoration. Understanding maximum principal stress concentration in the veneered core of a tooth-crown system as a function of variations in clinically relevant parameters is crucial in the rational design of crown systems. This study evaluated the main and interacting effects of a set of clinical variables on the maximum principal stress (MPS) in the core of an anatomically correct veneer-core-cement-tooth model. A 3D CAD model of a mandibular first molar crown was generated; tooth preparation was modeled by reducing the proximal walls by 1.5 mm and the occlusal surface by 2.0 mm. A cemented veneered core crown was modeled on the preparation. This 'crown system' permitted finite element model investigation of the main and interacting effects of proximal wall height reduction, core material, core thickness, cement modulus, cement thickness, and load position on the maximum stress distribution in a factorial design. Analysis of variance was used to identify the main and interacting influences on the level of MPS in the crown core. Statistical significance was set at p<0.05. MPS levels varied as a function of two-way interactions between the following: core thickness and load position; cement thickness and load position; cement modulus and load position; cement thickness and core thickness; and cement thickness and cement modulus; and also three-way interactions among the load position, core material, and proximal wall height reduction, and among the core thickness, cement thickness, and cement modulus. MPS in the crown-tooth system is influenced by the design parameters and also by the interaction among them. Hence, while the geometry of molar crowns is complex, these analyses identify the factors that influence MPS and suggest levels that will minimize the core MPS in future studies of crown design

OBJECTIVES: This study compared the reliability and fracture patterns of zirconia cores veneered with pressable porcelain submitted to either axial or off-axis sliding contact fatigue. METHODS: Forty-two Y-TZP plates (12mm x 12mm x 0.5mm) veneered with pressable porcelain (12mm x 12mm x 1.2mm) and adhesively luted to water aged composite resin blocks (12mm x 12mm x 4mm) were stored in water at least 7 days prior to testing. Profiles for step-stress fatigue (ratio 3:2:1) were determined from single load to fracture tests (n=3). Fatigue loading was delivered on specimen either on axial (n=18) or off-axis 30 degrees angulation (n=18) to simulate posterior tooth cusp inclination creating a 0.7mm slide. Single load and fatigue tests utilized a 6.25mm diameter WC indenter. Specimens were inspected by means of polarized-light microscope and SEM. Use level probability Weibull curves were plotted with 2-sided 90% confidence bounds (CB) and reliability for missions of 50,000 cycles at 200N (90% CB) were calculated. RESULTS: The calculated Weibull Beta was 3.34 and 2.47 for axial and off-axis groups, respectively, indicating that fatigue accelerated failure in both loading modes. The reliability data for a mission of 50,000 cycles at 200N load with 90% CB indicates no difference between loading groups. Deep penetrating cone cracks reaching the core-veneer interface were observed in both groups. Partial cones due to the sliding component were observed along with the cone cracking for the off-axis group. No Y-TZP core fractures were observed. CONCLUSIONS: Reliability was not significantly different between axial and off-axis mouth-motion fatigued pressed over Y-TZP cores, but incorporation of sliding resulted in more aggressive damage on the veneer

This study evaluated the stress levels at the core layer and the veneer layer of zirconia crowns (comprising an alternative core design vs. a standard core design) under mechanical/thermal simulation, and subjected simulated models to laboratory mouth-motion fatigue. The dimensions of a mandibular first molar were imported into computer-aided design (CAD) software and a tooth preparation was modeled. A crown was designed using the space between the original tooth and the prepared tooth. The alternative core presented an additional lingual shoulder that lowered the veneer bulk of the cusps. Finite element analyses evaluated the residual maximum principal stresses fields at the core and veneer of both designs under loading and when cooled from 900 degrees C to 25 degrees C. Crowns were fabricated and mouth-motion fatigued, generating master Weibull curves and reliability data. Thermal modeling showed low residual stress fields throughout the bulk of the cusps for both groups. Mechanical simulation depicted a shift in stress levels to the core of the alternative design compared with the standard design. Significantly higher reliability was found for the alternative core. Regardless of the alternative configuration, thermal and mechanical computer simulations showed stress in the alternative core design comparable and higher to that of the standard configuration, respectively. Such a mechanical scenario probably led to the higher reliability of the alternative design under fatigue