Faculty Bibliography

A study was conducted to characterize the dissolution, morphology, and chemical composition of a calcium sulfate/poly (L-lactic acid) (CS/PLLA) composite material before and after immersion in simulated body fluid (SBF). Twelve groups of experimental samples were prepared by coating CS pellets 1, 2, 3, or 4 times with one of three concentrations of a PLLA solution and wrapping them in mesh; CS pellets for use as controls were similarly prepared but not coated. The PLLA coating added from 1 to 22% to the weight of experimental pellets; scanning electron microscopy revealed that the coating thickness ranged from 2 to 50 microm depending on the concentration of the coating solution and the number of coatings. All samples were immersed in SBF for up to 97 days. After immersion, the experimental coatings thinned out, small cracks and holes formed in the coating, and the coating became roughened. Mean dissolution rates for each of the 12 CS/PLLA groups were significantly lower than those of uncoated CS pellets; among CS/PLLA groups, dissolution rates varied according to concentration of the coating solution and number of coatings. The half-life of pure CS pellets was 19 days whereas the half-life of CS/PLLA composite pellets ranged from 30 to 70 days. X-ray microprobe analysis of experimental pellets after immersion in SBF revealed that mineralization occurred in the CS portion of these pellets as well as on the coating; most of the mineral was calcium phosphate, most of which was on the coating. Further studies will be required to confirm this composite's promise as a clinically effective osteoconductive material.

Creation of bone to restore form and function following disease, growth disorders, and trauma is possible with bone-replacement scaffolds by controlling the complex sequence of new bone formation at the scaffold interface with the surrounding biologic milieu. Much is known about the influence of scaffold nano-scale (< 1 mu m) features on biocompatibility and the influence of micro-scale (1-20 mu m) features on the type of tissue that develops. Meso-scale (20-1000 mu m) features have been less well characterized, in part because it was not possible to regulate this feature size until solid freeform fabrication techniques became available. Experimental results of animal studies of bone ingrowth into scaffolds fabricated using these technologies confirm that meso-scale features can have profound effects on the extent and pattern of bone formation. They also indicate that we do not yet have sufficient information to optimize the size of these features. Macro-scale features (> 1 mm) provide anatomic form and delimit the extent of the scaffold, serving as a platform to integrate other length-scale features. Many of the main effects of features at each length scale are understood but interactions across length scales still need investigation. Major improvements in bone replacement are now possible-but optimization of the process remains an as-yet unrealized goal

Loosening of the abutment screw can present a problem for the stability of the implant-supported crown or prosthesis. The purpose of this study was to understand the parameters of screw loosening, using an in vitro model, including loss of torque, screw head rotation, changes in screw dimension, and distortion of the implant-abutment joint. Implants (4 x 10 mm) were potted in autopolymerizing blocks. Abutments were placed with screws tightened with a 35-Ncm torque and standardized crowns fabricated. There were 3 implant systems used: Nobel Biocare USA, Inc. (Yorba Linda, CA), 3i Implant Innovations, Inc. (Palm Beach Gardens, FL), and Bio-Lok International, Inc. (Deerfield Beach, FL). Seven samples were tested for each system. Samples were loaded with 300-N loads for 50,000 cycles at 1 Hz. Torque turn audits were performed at 10,000, 25,000, and 50,000 cycles. At the conclusion of the loading, counterclockwise rotation of the abutment screw was measured. The screws were retrieved and measurements made compared with the controls. Finally, 1 sample from each group was embedded in resin, sectioned longitudinally, and examined under the standard error of the mean. The Nobel Biocare system showed a 9.4-Ncm loss of torque from the loading protocol. This result was accompanied by a counterclockwise rotation of 7 degrees and a 200-im elongation of the screw. Finally, there was compression and distortion of the longitudinally sectioned joint architecture observed with the standard error of the mean. From the 3i and Bio-Lok International groups, no loss of torque, counterclockwise rotation, or lengthening of the screws was observed. Intimate adaptation of the joint without distortion was seen in the longitudinal sections. Screw loosening appears to follow specific parameters that include counterclockwise rotation, lengthening of the screw, and distortion of the screw joint. This process is likely associated with both the physical properties of the screw as well as its configuration.

PURPOSE: To compare the debonding/crack initiation strength (D/CIS) of a low-fusing pressable leucite-based glass ceramic (PC) fused to metal to a feldspathic porcelain (FP) fused to metal. MATERIALS & METHODS: As per ISO 9693:1999, 40 rectangular metal specimens (25.0 mm x 0.5 mm x 3.0 mm) were prepared. Twenty of the specimens were cast in a base metal nickel-chromium alloy (BA), and 20 were cast in a noble metal palladium-silver alloy (NA). Ten randomly selected NA and BA alloy specimens had FP applied. The remaining 10 NA and BA alloy specimens had ash-free wax patterns applied, the metal-wax complexes invested, and were pressed with a PC. The dimensions of the ceramic specimens were 8.0 mm x 1.0 mm x 3.0 mm, creating a combined metal-ceramic complex thickness of 1.5 mm. All specimens were subject to a three-point bending test at a crosshead speed of 1.5 mm/min. Fracture loads were recorded in Newtons and D/CISs calculated by the formula tau(b)=k x F(fail). RESULTS: Mean D/CISs, measured in MPa (standard deviations): NA-FP 32.56 (4.62), NA-PC 30.23 (5.06), BA-FP 30.98 (4.41), and BA-PC 31.81 (3.48). A two-way ANOVA (p > 0.05) did not demonstrate significant difference between groups. CONCLUSION: The debonding/crack initiation strength of a low-fusing pressable leucite-based glass ceramic fused to metal was equivalent to that of a feldspathic porcelain fused to metal.

OBJECTIVES: The objective of this pilot study was to investigate the feasibility of periodontal ligament (PDL) generation on an implant surface by approximating a tooth-to-implant contact using orthodontics. METHODS: Maxillary second premolars of six beagle dogs were extracted bilaterally. After 2 weeks of healing, hydroxyapatite (HA) coated titanium implants, 5 mm in length and 3.3 mm in diameter, were placed in the extraction sites. One side of the arch was used as control. Orthodontic tooth movement was initiated following implant placement to tip the first premolar roots into contact with the implant. This was achieved in 4-6 weeks as confirmed radiographically. Tooth-to-implant contact was maintained for further 6 weeks after which time, teeth were separated from implant contact orthodontically. After further 2 weeks of stabilization, the animals were sacrificed. Samples were analyzed by Faxitron radiographs before histology. Histology samples were prepared with Stevenel's Blue and Van Gieson stain and were subjected to polarized light microscopy. RESULTS: Histologic analysis revealed transfer and formation of PDL-like structure with formation of cellular cementum on the implant surfaces, in four out of six animals, where tooth-to-implant contact had been achieved. Direct bone-to-implant contact was noted in the areas coronal to the PDL-like tissue, an important sign to distinguish between PDL-like tissue and connective tissue that could originate from the coronal portion of a failing implant. Additionally, at the site of contact, the implant surface revealed some resorption of the HA coating. CONCLUSION: An animal model was established in which the proximity of tooth-to-implant contact lead to partial generation of PDL on a bioactive implant surface in four out of six animals.