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Dental Implants and Materials

A special issue of Materials (ISSN 1996-1944). This special issue belongs to the section "Biomaterials".

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 102849

Special Issue Editors


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Guest Editor
Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
Interests: dental implant; occlusion; bone atrophy; peri-implantitis; guided surgery
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of General Surgery and Surgical-Medical Specialties, University of Catania, Via S. Sofia 78, 95124 Catania, Italy
Interests: prosthesis; prosthodontics; material sciences; oral surgery; tissue engineering; biomaterials
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleague,

Since their introduction by Prof. Branemark in the 1960s, dental implants have become a reliable treatment option for the replacement of missing teeth in both partial and complete edentulous patients. Survival and success rates of implant-supported protheses depend on several factors, including physical and chemical properties of implant materials, such as microstructure, its surface composition and characteristics, as well as design factors. In recent years, the digital revolution has been changing the world, and dentistry is no exception. The introduction of new aesthetic materials, together with a whole range of digital devices (intraoral, extraoral, face scanners and cone beam computed tomography scans), processing software, and powerful manufacturing and prototyping tools (milling machines and 3D printers) are radically transforming the dental profession. In this vision, modern digital dentistry is changing workflows and, consequently, operating procedures. Although there is no doubt about their accuracy, there is still no evidence that new materials and digital procedures are superior to conventional workflows. The aim of this Special Issue is to provide strong evidence for modern patient-centered care. 

Dr. Marco Tallarico
Prof. Marco Cicciu
Guest Editors

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Keywords

  • dental implants
  • dental materials
  • digital workflow
  • aesthetics
  • patient-centered outcomes
  • long-term results

Published Papers (29 papers)

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Editorial

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2 pages, 179 KiB  
Editorial
Dental Implant Materials: Current State and Future Perspectives
by Marco Cicciù and Marco Tallarico
Materials 2021, 14(2), 371; https://doi.org/10.3390/ma14020371 - 14 Jan 2021
Cited by 6 | Viewed by 2009
Abstract
A dental implant is a medical device used to functionally and aesthetically rehabilitate the lack of one or more teeth, allowing the support of a prosthetic substitute through direct bone support [...] Full article
(This article belongs to the Special Issue Dental Implants and Materials)
5 pages, 214 KiB  
Editorial
Computerization and Digital Workflow in Medicine: Focus on Digital Dentistry
by Marco Tallarico
Materials 2020, 13(9), 2172; https://doi.org/10.3390/ma13092172 - 8 May 2020
Cited by 21 | Viewed by 4348
Abstract
Continuously evolving technologies make dentistry one of the most advanced sectors in the field of medicine. The digital improvements in recent years have brought many advantages to clinicians and patients, including reduced working times, lower costs and increased efficiency of performance. Some of [...] Read more.
Continuously evolving technologies make dentistry one of the most advanced sectors in the field of medicine. The digital improvements in recent years have brought many advantages to clinicians and patients, including reduced working times, lower costs and increased efficiency of performance. Some of the most important digital technologies introduced in the dental filed are cone beam computer tomography (CBCT) scan, Computer Aided Design/Computer Aided Manufacturing (CAD-CAM) systems, and intraoral scanners. All of these allow faster and more accurate rehabilitations, with the opportunity of pre-simulation of the final treatment. The evolution of computer science has brought significant advantages in the medical and dental fields, making the diagnosis and execution of even complex treatments, such as implantology and bone reconstruction, possible. The digital world is trying to supplant the traditional analog workflow, and over time, with the further advance of technologies, it should tend to be the treatment of choice of our patients. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
5 pages, 1763 KiB  
Editorial
Bioengineering Methods of Analysis and Medical Devices: A Current Trends and State of the Art
by Marco Cicciù
Materials 2020, 13(3), 797; https://doi.org/10.3390/ma13030797 - 10 Feb 2020
Cited by 11 | Viewed by 4430
Abstract
Implantology, prosthodontics, and orthodontics in all their variants, are medical and rehabilitative medical fields that have greatly benefited from bioengineering devices of investigation to improve the predictability of clinical rehabilitations. The finite element method involves the simulation of mechanical forces from an environment [...] Read more.
Implantology, prosthodontics, and orthodontics in all their variants, are medical and rehabilitative medical fields that have greatly benefited from bioengineering devices of investigation to improve the predictability of clinical rehabilitations. The finite element method involves the simulation of mechanical forces from an environment with infinite elements, to a simulation with finite elements. This editorial aims to point out all the progress made in the field of bioengineering and medicine. Instrumental investigations, such as finite element method (FEM), are an excellent tool that allows the evaluation of anatomical structures and any facilities for rehabilitation before moving on to experimentation on animals, so as to have mechanical characteristics and satisfactory load cycle testing. FEM analysis contributes substantially to the development of new technologies and new materials in the biomedical field. Thanks to the 3D technology and to the reconstructions of both the anatomical structures and eventually the alloplastic structures used in the rehabilitations it is possible to consider all the mechanical characteristics, so that they could be analyzed in detail and improved where necessary. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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Research

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13 pages, 2063 KiB  
Article
A Multi-Element-Doped Porous Bioactive Glass Coating for Implant Applications
by Christie Y. K. Lung, Mohamed M. Abdalla, Chun Hung Chu, Iris Yin, Sofiya-Roksolana Got and Jukka P. Matinlinna
Materials 2021, 14(4), 961; https://doi.org/10.3390/ma14040961 - 18 Feb 2021
Cited by 14 | Viewed by 2963
Abstract
Objectives: The objectives of the study were (1) to develop a novel multi-element-doped porous 58S bioactive glass coating for titanium implants and (2) to investigate the physiochemical, cell cytotoxic and antibacterial properties of this novel coating for titanium implants. Methods: This study employed [...] Read more.
Objectives: The objectives of the study were (1) to develop a novel multi-element-doped porous 58S bioactive glass coating for titanium implants and (2) to investigate the physiochemical, cell cytotoxic and antibacterial properties of this novel coating for titanium implants. Methods: This study employed the sol–gel method to develop a silver-, cobalt (II) oxide- and titanium dioxide-doped 58S bioactive glass coating. The surface topography and in vitro bioactivity of the new bioactive glass-coated implants were studied using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy. The surface nanohardness and coating degradation were evaluated using atomic force microscopy (AFM) and inductively coupled plasma atomic emission spectroscopy (ICP-AES), respectively. The cell cytotoxicity was assessed using cell viability of osteoblast-like mouse cells. The antibacterial property was examined using colony-forming units (CFUs) of the implant coating against Porphyromonas gingivalis. Results: The multi-element-doped porous 58S bioactive glass-coated titanium implant was synthesized. SEM showed that calcium phosphate was formed on the novel coating but not on the 58S bioactive glass coating. The mean surface nanohardness of the novel coating and the 58S coating were 124 ± 24 and 50 ± 17 MPa, respectively (p < 0.001). ICP-AES showed that the releases of Si, Ca and P ions of the novel coating were significantly higher than that of a 58S bioactive glass-coated implant. No significant difference in cell cytotoxicity was found between the novel coating and the 58S coating (p > 0.1). The mean CFUs of the novel coating and the conventional coating were 120 × 106 and 49 × 106 /mL. Conclusion: A novel multielement-doped porous bioactive glass coating for titanium implants was developed. The coating displays promising biocompatibility and antibacterial activity. Clinical significance: the coating can be used to improve the clinical success of dental implants for patient care if it shows success in clinical trials. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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11 pages, 4173 KiB  
Article
Evaluation of Antimicrobial Efficacy and Permeability of Various Sealing Materials at the Implant–Abutment Interface—A Pilot In Vitro Study
by Igor Smojver, Marko Vuletić, Dražena Gerbl, Ana Budimir, Mato Sušić and Dragana Gabrić
Materials 2021, 14(2), 385; https://doi.org/10.3390/ma14020385 - 14 Jan 2021
Cited by 10 | Viewed by 1999
Abstract
The microenvironment of the oral cavity is altered when an implant, a biocompatible foreign body, is inserted into the mouth. Bacteria settle in the tissues in and around the implant due to the passage of microorganisms through the microgap at the connection of [...] Read more.
The microenvironment of the oral cavity is altered when an implant, a biocompatible foreign body, is inserted into the mouth. Bacteria settle in the tissues in and around the implant due to the passage of microorganisms through the microgap at the connection of the implant and prosthetic abutment. To prevent colonization of the implant by microorganisms, one idea is to use sealing and antimicrobial materials to decontaminate the implant–abutment interface and close the microgap. The purpose of this study is to evaluate the antimicrobial efficacy and permeability of different types of sealing materials at the implant–abutment interface, under static conditions. Three different sealing material (GapSeal gel, Oxysafe gel and Flow.sil) were used for sealing the implant–abutment interfaces in 60 titanium dental implants, which were first contaminated with a solution containing Staphylococcus aureus and Candida albicans for 14 days under an aerobic condition. Results showed that a complete seal against bacterial infection was not formed at the implant–abutment interface, while for fungal infections, only GapSeal material helped to prevent microleakage. Findings of this in vitro study reported that application of sealing material before abutment connection may reduce peri-implant bacterial and fungal population compared with the interface without sealing material. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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14 pages, 2739 KiB  
Article
Hydroxyapatite Formation on Coated Titanium Implants Submerged in Simulated Body Fluid
by Tatiana Aviles, Shu-Min Hsu, Arthur Clark, Fan Ren, Chaker Fares, Patrick H. Carey IV and Josephine F. Esquivel-Upshaw
Materials 2020, 13(24), 5593; https://doi.org/10.3390/ma13245593 - 8 Dec 2020
Cited by 7 | Viewed by 2523
Abstract
Titanium implants are commonly used in the field of dentistry for prosthetics such as crowns, bridges, and dentures. For successful therapy, an implant must bind to the surrounding bone in a process known as osseointegration. The objective for this ongoing study is to [...] Read more.
Titanium implants are commonly used in the field of dentistry for prosthetics such as crowns, bridges, and dentures. For successful therapy, an implant must bind to the surrounding bone in a process known as osseointegration. The objective for this ongoing study is to determine the potential of different implant surface coatings in providing the formation of hydroxyapatite (HA). The coatings include titanium nitride (TiN), silicon dioxide (SiO2), and quaternized titanium nitride (QTiN). The controls were a sodium hydroxide treated group, which functioned as a positive control, and an uncoated titanium group. Each coated disc was submerged in simulated body fluid (SBF), replenished every 48 h, over a period of 28 days. Each coating successfully developed a layer of HA, which was calculated through mass comparisons and observed using scanning electron microscopy (SEM) and energy dispersive analysis x-rays (EDX). Among these coatings, the quaternized titanium nitride coating seemed to have a better yield of HA. Further studies to expand the data concerning this experiment are underway. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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12 pages, 1599 KiB  
Article
Evaluation of Milled Titanium versus Laser Sintered Co-Cr Abutments on the Marginal Misfit in Internal Implant-Abutment Connection
by Esther Gonzalo, Beatriz Vizoso, Carlos Lopez-Suarez, Pedro Diaz, Jesus Pelaez and Maria J. Suarez
Materials 2020, 13(21), 4873; https://doi.org/10.3390/ma13214873 - 30 Oct 2020
Cited by 12 | Viewed by 2430
Abstract
The precision of fit at the implant-abutment connection is an important criterion for the clinical success of restorations and implants. Several factors are involved among which are the abutment materials and manufacturing techniques. The aim of this study was to investigate the effect [...] Read more.
The precision of fit at the implant-abutment connection is an important criterion for the clinical success of restorations and implants. Several factors are involved among which are the abutment materials and manufacturing techniques. The aim of this study was to investigate the effect of two materials and methods of manufacturing implant abutments, milled titanium versus laser sintered Co-Cr, on the marginal misfit at the implant-abutment interface. Scanning electron microscopes (SEM) were used to geometrically measure the marginal vertical discrepancy of a total of 80 specimens, classified into eight categories, according to the implant system and abutment. The data were statistically analyzed by Student’s paired t test, one-way and two-way ANOVA with the Bonferroni-Holm correction at the significance level of p = 0.05. Milled titanium abutments demonstrated the lowest misfit values in the implant systems analyzed. The marginal fit of all the groups was within the clinically acceptable range for implant prostheses. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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16 pages, 1887 KiB  
Article
Relationship between Implant Geometry and Primary Stability in Different Bony Defects and Variant Bone Densities: An In Vitro Study
by Ahmad Ibrahim, Marius Heitzer, Anna Bock, Florian Peters, Stephan Christian Möhlhenrich, Frank Hölzle, Ali Modabber and Kristian Kniha
Materials 2020, 13(19), 4349; https://doi.org/10.3390/ma13194349 - 30 Sep 2020
Cited by 24 | Viewed by 3075
Abstract
Aim: This in vitro study aimed to evaluate the effects of implant designs on primary stability in different bone densities and bony defects. Methods: Five implant types (tapered-tissue-level, tissue-level, zirconia-tissue-level, bone-level, and BLX implants) were used in this assessment. The implants were inserted [...] Read more.
Aim: This in vitro study aimed to evaluate the effects of implant designs on primary stability in different bone densities and bony defects. Methods: Five implant types (tapered-tissue-level, tissue-level, zirconia-tissue-level, bone-level, and BLX implants) were used in this assessment. The implants were inserted into four different artificial bone blocks representing varying bone-density groups: D1, D2, D3, and D4. Aside from the control group, three different types of defects were prepared. Using resonance frequency analysis and torque-in and -out values, the primary stability of each implant was evaluated. Results: With an increased defect size, all implant types presented reduced implant stability values measured by the implant stability quotient (ISQ) values. Loss of stability was the most pronounced around circular defects. Zirconia and bone-level implants showed the highest ISQ values, whereas tissue level titanium implants presented the lowest stability parameters. The implant insertion without any thread cut led to a small improvement in primary implant stability in all bone densities. Conclusions: Compared with implants with no peri-implant defects, the three-wall and one-wall defect usually did not provide significant loss of primary stability. A significant loss of stability should be expected when inserting implants into circular defects. Implants with a more aggressive thread distance could increase primary stability. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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11 pages, 2358 KiB  
Article
Impact of Wound Closure on the Corrosion Rate of Biodegradable Mg-Ca-Zn Alloys in the Oral Environment
by Ali Modabber, Daniela Zander, Naemi Zumdick, Daniel Schick, Kristian Kniha, Stephan Christian Möhlhenrich, Frank Hölzle and Evgeny Goloborodko
Materials 2020, 13(19), 4226; https://doi.org/10.3390/ma13194226 - 23 Sep 2020
Cited by 3 | Viewed by 1735
Abstract
Magnesium alloys have exhibited a rapid rate of corrosion and thus early implant failure, so this study was designed to investigate the longer-term effects and in particular on wound closure. The aim of the study is to evaluate Mg-Ca-Zn Alloys as promising biodegradable [...] Read more.
Magnesium alloys have exhibited a rapid rate of corrosion and thus early implant failure, so this study was designed to investigate the longer-term effects and in particular on wound closure. The aim of the study is to evaluate Mg-Ca-Zn Alloys as promising biodegradable implants in the field of maxillofacial surgery, which have so far never been evaluated for the changing conditions from a saliva to a serum-like environment after wound closure. Magnesium-0.6/calcium-0.8 wt.% zinc alloys were either immersed for 10 days in artificial saliva or 10 days in Hank’s salt solution as control groups. The test group was transferred from artificial saliva to Hank’s salt solution after 5 days in order to simulate wound closure. Corrosion rates were determined by immersion testing. Additional electron microscopy and energy dispersive X-ray spectroscopy (EDX) were performed. Prior artificial saliva exposure led to significantly decreased (p = 0.0272) corrosion rates after transfer to Hank’s solution in comparison to sole Hank’s solution exposure (0.1703 vs. 0.6675 mg/(cm2·day)) and sole artificial saliva exposure (0.3180 mg/(cm2·day)), which both exhibit a strong increase after 5 days. The results were in accordance with the scanning electron microscopy and EDX pictures. Prior saliva exposure could protect from increasing corrosion rates after wound closure. Thus Mg-Ca-Zn Alloys are promising future implant alloys in oral surgery, whereas other surgical fields without saliva exposure have to deal with accelerated corrosion rates after 5 days. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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15 pages, 3312 KiB  
Article
Electrochemical Behavior of Ti6Al4V Alloy Used in Dental Implants Immersed in Streptococcus gordonii and Fusobacterium nucleatum Solutions
by Myriam A. De la Garza-Ramos, Francisco H. Estupiñan-Lopez, Citlalli Gaona-Tiburcio, Lucía G. Beltrán-Novelo, Patricia Zambrano-Robledo, José Cabral-Miramontes and Facundo Almeraya-Calderón
Materials 2020, 13(18), 4185; https://doi.org/10.3390/ma13184185 - 21 Sep 2020
Cited by 11 | Viewed by 2431
Abstract
The titanium alloy, Ti6Al4V, is used in dentistry for dental implants because of its excellent resistance to corrosion and its high biocompatibility. However, periimplantitis is considered the main reason for treatment failure. The Ti6Al4V alloy was used to study the corrosion behavior for [...] Read more.
The titanium alloy, Ti6Al4V, is used in dentistry for dental implants because of its excellent resistance to corrosion and its high biocompatibility. However, periimplantitis is considered the main reason for treatment failure. The Ti6Al4V alloy was used to study the corrosion behavior for dental implant applications, using an experimental arrangement of three electrodes with the bacteria Streptococcus gordonii and Fusobacterium nucleatum, in addition to Ringer’s lactate as electrolytes, at 37 °C and a pH of 5.6. Their electrochemical behavior was studied by open circuit potential (OCP) and cyclic potentiodynamic polarization (CPP) according to ASTM G3-14 and ASTM G61-11, respectively. Scanning electron microscopy (SEM) was employed to determine the morphology of the alloy studied. An experimental model, in situ, was established with the bacteria present in an oral environment to understand the electrochemical behavior of the alloy used in dental implants. The greatest corrosion in Ti6Al4V alloy was produced by the medium that contained the bacterium Streptococcus gordonii, which is considered a primary colonizer. In addition, the Ti6Al4V alloy presented uniform corrosion in the three solutions at the different exposure times showing a negative hysteresis in CPP. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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12 pages, 4204 KiB  
Article
Feasibility of Using a Prosthetic-Based Impression Template to Improve the Trueness and Precision of a Complete Arch Digital Impression on Four and Six Implants: An In Vitro Study
by Marco Tallarico, Aurea Immacolata Lumbau, Roberto Scrascia, Gianluca Demelas, Franco Sanseverino, Rocco Amarena and Silvio Mario Meloni
Materials 2020, 13(16), 3543; https://doi.org/10.3390/ma13163543 - 11 Aug 2020
Cited by 10 | Viewed by 3079
Abstract
Background: Intraoral scanners (IOSs) in implantology represent a viable approach for single teeth or partial arches. However, when used for complete edentulous arches or long-span edentulous areas, it has been demonstrated that there is a need for improvement of IOS-related techniques. Therefore, the [...] Read more.
Background: Intraoral scanners (IOSs) in implantology represent a viable approach for single teeth or partial arches. However, when used for complete edentulous arches or long-span edentulous areas, it has been demonstrated that there is a need for improvement of IOS-related techniques. Therefore, the aim of this in vitro study was to assess the trueness and precision of a complete arch digital impression on four and six implants taken with or without a customized, prosthetic-based impression template. Materials and Methods: Two experimental models were prepared, representative of a complete edentulous mandible restored with four and six implants with built-in scan abutments. Models were scanned with (test group, TG) or without (control group, CG) the prosthetic-based impression template. Eight scans were taken for each model. The time needed to take impressions, error, trueness, and precision were evaluated. A statistical analysis was performed. Results: In the case of four implants, the time needed for the impression was 128.7 ± 55.3 s in the TG and 81.0 ± 23.5 s in the CG (p = 0.0416). With six scan abutments, the time was 197.5 ± 26.8 and 110.6 ± 25.2 s in the TG and CG, respectively (p = 0.0000). In the TG, no errors were experienced, while in the CG, 13 impressions were retaken due to incorrect stitching processes. In the four-implant impression, the mean angle deviation was 0.252 ± 0.068° (95% CI 0.021–0.115°) in the CG and 0.134 ± 0.053° (95% CI 0.016–0.090°) in the TG. The difference was statistically significant (p = 0.002). In the six-implant impression, the mean angle deviation was 0.373 ± 0.117° (95% CI 0.036–0.198°) in the CG and 0.100 ± 0.029° (95% CI 0.009–0.049°) in the TG (p = 0.000). In the TG, there were no statistically significant differences in the mean angle deviation within the group (p > 0.05), but there were in the CG. A colorimetric analysis showed higher deviations from the original model for the six-implant impression without a prosthetic template. Conclusions: Although all of the impressions exhibited deviation from the original model in the range of clinical acceptability, the prosthetic-based impression template significantly improved the trueness and precision of complete edentulous arches rehabilitated with four or six implants, making the complete arch digital impression more predictable. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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13 pages, 3775 KiB  
Article
Demonstration of a SiC Protective Coating for Titanium Implants
by Chaker Fares, Shu-Min Hsu, Minghan Xian, Xinyi Xia, Fan Ren, John J. Mecholsky, Jr., Luiz Gonzaga and Josephine Esquivel-Upshaw
Materials 2020, 13(15), 3321; https://doi.org/10.3390/ma13153321 - 26 Jul 2020
Cited by 27 | Viewed by 2767
Abstract
To mitigate the corrosion of titanium implants and improve implant longevity, we investigated the capability to coat titanium implants with SiC and determined if the coating could remain intact after simulated implant placement. Titanium disks and titanium implants were coated with SiC using [...] Read more.
To mitigate the corrosion of titanium implants and improve implant longevity, we investigated the capability to coat titanium implants with SiC and determined if the coating could remain intact after simulated implant placement. Titanium disks and titanium implants were coated with SiC using plasma-enhanced chemical vapor deposition (PECVD) and were examined for interface quality, chemical composition, and coating robustness. SiC-coated titanium implants were torqued into a Poly(methyl methacrylate) (PMMA) block to simulate clinical implant placement followed by energy dispersive spectroscopy to determine if the coating remained intact. After torquing, the atomic concentration of the detectable elements (silicon, carbon, oxygen, titanium, and aluminum) remained relatively unchanged, with the variation staying within the detection limits of the Energy Dispersive Spectroscopy (EDS) tool. In conclusion, plasma-enhanced chemical vapor deposited SiC was shown to conformably coat titanium implant surfaces and remain intact after torquing the coated implants into a material with a similar hardness to human bone mass. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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16 pages, 1944 KiB  
Article
A New Insight into Coating’s Formation Mechanism Between TiO2 and Alendronate on Titanium Dental Implant
by Željka Petrović, Ankica Šarić, Ines Despotović, Jozefina Katić, Robert Peter, Mladen Petravić and Marin Petković
Materials 2020, 13(14), 3220; https://doi.org/10.3390/ma13143220 - 20 Jul 2020
Cited by 13 | Viewed by 2980
Abstract
Organophosphorus compounds, like bisphosphonates, drugs for treatment and prevention of bone diseases, have been successfully applied in recent years as bioactive and osseoinductive coatings on dental implants. An integrated experimental-theoretical approach was utilized in this study to clarify the mechanism of bisphosphonate-based coating [...] Read more.
Organophosphorus compounds, like bisphosphonates, drugs for treatment and prevention of bone diseases, have been successfully applied in recent years as bioactive and osseoinductive coatings on dental implants. An integrated experimental-theoretical approach was utilized in this study to clarify the mechanism of bisphosphonate-based coating formation on dental implant surfaces. Experimental validation of the alendronate coating formation on the titanium dental implant surface was carried out by X-ray photoelectron spectroscopy and contact angle measurements. Detailed theoretical simulations of all probable molecular implant surface/alendronate interactions were performed employing quantum chemical calculations at the density functional theory level. The calculated Gibbs free energies of (TiO2)10–alendronate interaction indicate a more spontaneous exergonic process when alendronate molecules interact directly with the titanium surface via two strong bonds, Ti–N and Ti–O, through simultaneous participation common to both phosphonate and amine branches. Additionally, the stability of the alendronate-modified implant during 7 day-immersion in a simulated saliva solution has been investigated by using electrochemical impedance spectroscopy. The alendronate coating was stable during immersion in the artificial saliva solution and acted as an additional barrier on the implant with overall resistivity, R ~ 5.9 MΩ cm2. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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12 pages, 2236 KiB  
Article
Comparative In Vitro Study of the Bond Strength of Composite to Carbon Fiber Versus Ceramic to Cobalt–Chromium Alloys Frameworks for Fixed Dental Prostheses
by Rocio Cascos-Sanchez, Pedro Molinero-Mourelle, Rocio Ortega, Ruben Agustin-Panadero, Jaime Del Rio Highsmith and Miguel Gomez-Polo
Materials 2020, 13(14), 3173; https://doi.org/10.3390/ma13143173 - 16 Jul 2020
Cited by 4 | Viewed by 2226
Abstract
Purpose: The aim of this comparative in vitro study was to assess the bond strength and mechanical failure of carbon-fiber-reinforced composites against cobalt–chrome structures with ceramic veneering. Materials and methods: A total of 24 specimens (12 per group) simulating dental prosthetic frameworks were [...] Read more.
Purpose: The aim of this comparative in vitro study was to assess the bond strength and mechanical failure of carbon-fiber-reinforced composites against cobalt–chrome structures with ceramic veneering. Materials and methods: A total of 24 specimens (12 per group) simulating dental prosthetic frameworks were fabricated. The experimental specimens were subjected to a thermocycling aging process and to evaluate bond strength. All specimens were subjected to a three-point bending test to fracture using a universal testing machine. Results: The cobalt–chrome/ceramic group yielded a bond strength value of 21.71 ± 2.16 MPa, while the carbon-fiber-reinforced composite group showed 14.50 ± 3.50 MPa. The failure assessment reported statistical significance between groups. Although carbon-fiber-reinforced composite group showed lower bond strength values, the chipping incidence in this group was as well lower. Conclusions: The chrome–cobalt/ceramic group showed greater bonding strength compared to the carbon-fiber-reinforced composite; most of the fractures within the cobalt–chrome/ceramic group, had no possibility of direct clinical repair. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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19 pages, 1899 KiB  
Article
Novel Yttria-Stabilized Zirconium Oxide and Lithium Disilicate Coatings on Titanium Alloy Substrate for Implant Abutments and Biomedical Application
by Julius Maminskas, Jurgis Pilipavicius, Edvinas Staisiunas, Gytis Baranovas, Milda Alksne, Povilas Daugela and Gintaras Juodzbalys
Materials 2020, 13(9), 2070; https://doi.org/10.3390/ma13092070 - 30 Apr 2020
Cited by 12 | Viewed by 3164
Abstract
This study aimed to create novel bioceramic coatings on a titanium alloy and evaluate their surface properties in comparison with conventional prosthetic materials. The highly polished titanium alloy Ti6Al4V (Ti) was used as a substrate for yttria-stabilized zirconium oxide (3YSZ) and lithium disilicate [...] Read more.
This study aimed to create novel bioceramic coatings on a titanium alloy and evaluate their surface properties in comparison with conventional prosthetic materials. The highly polished titanium alloy Ti6Al4V (Ti) was used as a substrate for yttria-stabilized zirconium oxide (3YSZ) and lithium disilicate (LS2) coatings. They were generated using sol-gel strategies. In comparison, highly polished surfaces of Ti, yttria-stabilized zirconium oxide (ZrO2), polyether ether ketone (PEEK) composite, and poly(methyl methacrylate) (PMMA) were utilized. Novel coatings were characterized by an X-ray diffractometer (XRD) and scanning electron microscope (SEM). The roughness by atomic force microscope (AFM), water contact angle (WCA), and surface free energy (SFE) were determined. Additionally, biocompatibility and human gingival fibroblast (HGF) adhesion processes (using a confocal laser scanning microscope (CLSM)) were observed. The deposition of 3YSZ and LS2 coatings changed the physicochemical properties of the Ti. Both coatings were biocompatible, while Ti-3YSZ demonstrated the most significant cell area of 2630 μm2 (p ≤ 0.05) and the significantly highest, 66.75 ± 4.91, focal adhesions (FAs) per cell after 24 h (p ≤ 0.05). By contrast, PEEK and PMMA demonstrated the highest roughness and WCA and the lowest results for cellular response. Thus, Ti-3YSZ and Ti-LS2 surfaces might be promising for biomedical applications. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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12 pages, 1637 KiB  
Article
Relevant Design Aspects to Improve the Stability of Titanium Dental Implants
by M. Herrero-Climent, P. López-Jarana, B. F. Lemos, F. J. Gil, C. Falcão, J. V. Ríos-Santos and B. Ríos-Carrasco
Materials 2020, 13(8), 1910; https://doi.org/10.3390/ma13081910 - 18 Apr 2020
Cited by 19 | Viewed by 3146
Abstract
Post-extractional implants and immediate loading protocols are becoming much more frequent in everyday clinical practice. Given the existing literature about tapered implants, the objective of this paper was to understand whether implant shape had a direct influence on the results of the insertion [...] Read more.
Post-extractional implants and immediate loading protocols are becoming much more frequent in everyday clinical practice. Given the existing literature about tapered implants, the objective of this paper was to understand whether implant shape had a direct influence on the results of the insertion torque (IT) and implant stability quotient (ISQ). Seven tapered implant prototypes were developed and distributed into three groups and compared with a control cylindrical implant—VEGA by Klockner Implant System. The implants were inserted into bovine bone type III according to Lekholm and Zarb Classification. The sample size was n = 30 for the three groups. Final IT was measured with a torquemeter, and the ISQ was measured with Penguin Resonance Frequency Analysis (RFA). Modifications done to the Prototype I did not reveal higher values of the ISQ and IT when compared to VEGA. In the second group, when comparing the five prototypes (II–VI) with VEGA, it was seen that the values of the ISQ and IT were not always higher, but there were two values of the ISQ that were statistically significantly higher with the 4.0 mm diameter Prototypes II (76.3 ± 6.1) and IV (78 ± 3.7). Prototype VII was the one with higher and significant values of the ISQ and IT. In both diameters and in both variables, all differences were statistically significant enough to achieve the higher values of primary stability values (IT and ISQ). Given the limitations of this study, it can be concluded that when there is an increase of the diameter of the implant and body taper, there is an increase of the ISQ and IT, showing that the diameter of the implant is an important criteria to obtain higher values of primary stability. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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11 pages, 2337 KiB  
Article
A Comparative Analysis of Implants Presenting Different Diameters: Extra-Narrow, Narrow and Conventional
by Henrique Tuzzolo Neto, Alessandra Sayuri Tuzita, Sérgio Alexandre Gehrke, Renata de Vasconcellos Moura, Márcio Zaffalon Casati and Alfredo Mikail Melo Mesquita
Materials 2020, 13(8), 1888; https://doi.org/10.3390/ma13081888 - 17 Apr 2020
Cited by 6 | Viewed by 3988
Abstract
This study aimed at performing a comparative analysis of the fracture resistance of implants, evaluating extra-narrow, narrow, and regular implants. Four groups containing 15 implants each were evaluated. Group 1 (G1): single-piece extra-narrow implants; Group 2 (G2): single-piece narrow implants; Group 3 (G3): [...] Read more.
This study aimed at performing a comparative analysis of the fracture resistance of implants, evaluating extra-narrow, narrow, and regular implants. Four groups containing 15 implants each were evaluated. Group 1 (G1): single-piece extra-narrow implants; Group 2 (G2): single-piece narrow implants; Group 3 (G3): Morse taper narrow implants with solid abutments; Group 4 (G4): Morse taper conventional implants with solid abutments. The implants were tested using a universal testing machine for their maximum force limit and their maximum bending moment. After obtaining the data, the Shapiro–Wilk, ANOVA, and Tukey (p < 0.05) statistical tests were applied. Samples from all the groups were analyzed by scanning electron microscopy and Groups 3 and 4 were analyzed by profilometry. The means and the standard deviation values for the maximum force limit (N) and the maximum bending moment (Nmm) were respectively: G1:134.29 N (10.27); G2:300.61 N (24.26); G3:360.64 N (23.34); G4:419.10 N (18.87); G1:1612.02 Nmm (100.6); G2:2945 Nmm (237.97); G3:3530.38 Nmm (228.75); G4:4096.7 Nmm (182.73). The groups behaved statistically different from each other, showing that the smallest diameter implants provided less fracture resistance, both in the tensile strength tests and in the maximum bending moment between all groups. Furthermore, single-piece implants, with 2.5 mm and 3.0 mm diameters, deformed in the implant body region area, rather than in the abutment region. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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10 pages, 2970 KiB  
Article
Fatigue of Narrow Dental Implants: Influence of the Hardening Method
by R.A. Pérez, J. Gargallo, P. Altuna, M. Herrero-Climent and F.J. Gil
Materials 2020, 13(6), 1429; https://doi.org/10.3390/ma13061429 - 20 Mar 2020
Cited by 19 | Viewed by 3292
Abstract
The use of narrow titanium dental implants (NDI) for small ridges, reduced interdental space, or missing lateral incisors can be a viable option when compared to the conventional wider dental implants. Furthermore, in many cases, standard diameter implant placement may not be possible [...] Read more.
The use of narrow titanium dental implants (NDI) for small ridges, reduced interdental space, or missing lateral incisors can be a viable option when compared to the conventional wider dental implants. Furthermore, in many cases, standard diameter implant placement may not be possible without grafting procedures, which increases the healing time, cost, and morbidity. The aim of this study was to analyze the mechanical viability of the current narrow implants and how narrow implants can be improved. Different commercially available implants (n = 150) were tested to determine maximum strength, strain to fracture, microhardness, residual stress, and fatigue obtaining the stress–number of cycles to fracture (SN) curve. Fractography was studied by scanning electron microscopy. The results showed that when the titanium was hardened by the addition of 15% of Zr or 12% cold worked, the fatigue limit was higher than the commercially pure grade 4 Ti without hardening treatment. Grade 4 titanium without hardening treatment in narrow dental implants can present fractures by fatigue. These narrow implants are subjected to high mechanical stresses and the mechanical properties of titanium do not meet the minimal requirements, which lead to frequent fractures. New hardening treatments allow for the mechanical limitations of conventional narrow implants to be overcome in dynamic conditions. These hardening treatments allow for the design of narrow dental implants with enhanced fatigue life and long-term behavior. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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9 pages, 1380 KiB  
Article
Esthetic and Physical Changes of Innovative Titanium Surface Properties Obtained with Laser Technology
by Filiberto Mastrangelo, Raimondo Quaresima, Roberto Abundo, Gianrico Spagnuolo and Gaetano Marenzi
Materials 2020, 13(5), 1066; https://doi.org/10.3390/ma13051066 - 28 Feb 2020
Cited by 8 | Viewed by 2181
Abstract
Aim: The purpose of the study was the evaluation of the esthetic and physical changes produced on colored titanium Grade 5 (Ti6Al4V) laser treated surfaces to be used in implant dentistry for esthetic success. Materials and methods: Colored titanium surfaces were obtained with [...] Read more.
Aim: The purpose of the study was the evaluation of the esthetic and physical changes produced on colored titanium Grade 5 (Ti6Al4V) laser treated surfaces to be used in implant dentistry for esthetic success. Materials and methods: Colored titanium surfaces were obtained with laser treatment. The physical and topographic properties were evaluated by stereo, light, and electron microscopy and profilometric analyses. L*a*b* colorimetric coordinates were measured by spectrometry, and the superficial chemical characteristics were evaluated by energy dispersive X-ray analysis. Results: Within the complete palette of titanium colors, pinks (P1-P2), incarnadine (I), and white (W) obtained by laser were selected. The topography, texture, hues, saturation, roughness, and porosity of the samples were compared with those of machined (M) and sand-blasted and etched (SBAE) control surfaces. P1, P2, and I, similar in hue and roughness (Ra ≅ 0.5 μm), had a microgroove spacing of 56 μm and a decreasing porosity. The W sample with a “checkerboard” texture and a light color (L* 96.31) was similar to the M samples (Ra = 0.32 μm), but different from SBAE (Ra = 1.41 μm, L* 65.47). Discussion: The aspects of hard and soft tissue could result in an esthetic failure of the dental implant by showing the dark color of the fixture or abutment. The two different pinks and incarnadine surfaces showed favorable esthetic and physical features to promote dental implant success even in the maxillary anterior area with gingival recession, asymmetry, and deficiency. Conclusion: Titanium colored laser surfaces represent a valid alternative to those currently traditionally obtained and interesting and potential perspectives in the management of dental implants’ esthetic failure. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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13 pages, 2215 KiB  
Article
Correlation between Buccal Bone Thickness at Implant Placement in Healed Sites and Buccal Soft Tissue Maturation Pattern: A Prospective Three-Year Study
by Davide Farronato, Pietro Mario Pasini, Andrea Alain Orsina, Mattia Manfredini, Lorenzo Azzi and Marco Farronato
Materials 2020, 13(3), 511; https://doi.org/10.3390/ma13030511 - 21 Jan 2020
Cited by 26 | Viewed by 3630
Abstract
Background: Optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes the influence of the residual buccal bone thickness (BBT), measured at the time of implant placement, on the soft tissue [...] Read more.
Background: Optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes the influence of the residual buccal bone thickness (BBT), measured at the time of implant placement, on the soft tissue maturation during three years of follow-up. Methods: Seventy-eight implants were enrolled in the present study. The BBT was assessed at the surgical stage and each case assigned to Group 1 (BBT values ≤0.5 mm), Group 2 (BBT values >0.5 and <1.5 mm), or Group 3 (BBT values ≥1.5 mm). Only native bone and healed sites were included. The tooth height (TH), based on the distance between the buccal free gingival margin at the zenith level and the crown incisal edge, according to the main axis of the tooth, was monitored at one, two, and three years from the final prosthodontic rehabilitation to determine any occurrence of recession or coronal repositioning of the gums over time. A Pearson Two-Tailed test was applied and the significance level set at p ≤ 0.05. Results: For BBT values ≤0.5 mm, the buccal gum at three years showed an average recession of 1.22 ± 0.41 mm. For BBT values >0.5 and <1.5 mm, the buccal gum also showed recession of 0.64 ± 0.29 mm. In contrast, for BBT values ≥1.5 mm, the buccal gum showed coronal growth of 0.77 ± 0.22 mm. The differences between the groups were significant (p ≤ 0.01) at all times. Conclusion: The BBT at the time of implant placement was found to affect the buccal gingival margin stability over three years of observation. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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14 pages, 2929 KiB  
Article
Under-Drilling versus Hybrid Osseodensification Technique: Differences in Implant Primary Stability and Bone Density of the Implant Bed Walls
by Rafael Delgado-Ruiz, Joshua Gold, Tanya Somohano Marquez and Georgios Romanos
Materials 2020, 13(2), 390; https://doi.org/10.3390/ma13020390 - 15 Jan 2020
Cited by 23 | Viewed by 3833
Abstract
The goal of this study was to evaluate the effects of two implant bed preparation techniques on the implant primary stability (IPS) and the bone density of the implant site. We completed 40 implant bed osteotomies in pig ribs using two techniques: osseodensification [...] Read more.
The goal of this study was to evaluate the effects of two implant bed preparation techniques on the implant primary stability (IPS) and the bone density of the implant site. We completed 40 implant bed osteotomies in pig ribs using two techniques: osseodensification (OD) plus under-drilling (UD) with universal osseodensification drills (Test A), and under-drilling alone with drills of the same implant system (Test B). Implants with a 4.1 mm diameter and 10 mm length were inserted, and the IPS was evaluated with three methods: (insertion torque (IT), periotest (PTV), and resonance frequency analysis (RFA). The bone density was evaluated using micro-computed tomography. ANOVA and Tukey’s post-hoc test were used for comparison of the IPS values, and Kruskal–Wallis was used to evaluate the bone density. Statistical significance was set at p < 0.05. The tested B technique (UD) achieved a higher IPS compared to the Test A technique (OD + UD) for all the evaluation methods (p < 0.05). Bone density was higher at the apical and middle region in Test A compared to Test B and control sites (p < 0.05). We concluded that although the bone density increased with the hybrid OD technique with universal drills, implant beds prepared with UD using drills with geometry similar to that of the implant are more efficient at increasing IPS values. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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13 pages, 2260 KiB  
Article
Influence of Aging on Biaxial Flexural Strength and Hardness of Translucent 3Y-TZP
by Nawal M. Moqbel, Majed Al-Akhali, Sebastian Wille and Matthias Kern
Materials 2020, 13(1), 27; https://doi.org/10.3390/ma13010027 - 19 Dec 2019
Cited by 20 | Viewed by 3111
Abstract
The purpose of this research was to evaluate the influence of aging and surface treatment on surface roughness, biaxial flexural strength (BFS), and Vickers hardness (VHN) of translucent dental zirconia. Half of 80 disc-shaped zirconia specimens (1.2 mm thickness and 12 mm diameter) [...] Read more.
The purpose of this research was to evaluate the influence of aging and surface treatment on surface roughness, biaxial flexural strength (BFS), and Vickers hardness (VHN) of translucent dental zirconia. Half of 80 disc-shaped zirconia specimens (1.2 mm thickness and 12 mm diameter) were aged (group A) in an autoclave for 20 h (134 °C and 0.2 MPa) and the other half were not aged (group N). Specimens were subjected to: no surface treatment (SIN), particle air-abrasion with 50 µm alumina particles at 1 bar (0.1 MPa) and 2.5 bar (0.25 MPa), or polishing down to 1 µm (POL). Specimens were analyzed using X-ray diffraction, laser scanning microscope, BFS, and VHN tests. Three groups (N-SIN, N-POL, and A-POL) showed almost no monoclinic phase. While other groups showed monoclinic phase ratios ranging from 7.5 vol. % ± 2.4 vol. % (N-0.1 MPa) to 41.5 vol. % ± 0.3 vol. % (A-0.1 MPa). Aging and particle air-abrasion increased significantly the BFS, ranging from 720 ± 37 MPa (N-SIN) to 1153 ± 92 MPa (N-0.1 MPa). The hardness was not influenced significantly by aging. A certain amount of monoclinic phase at the surface strengthens the high translucent dental zirconia, while hardness and roughness are not influenced. The pressure of particle air-abrasion showed no influence on the evaluated properties. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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10 pages, 1776 KiB  
Article
A Comparative 3D Finite Element Computational Study of Three Connections
by Davide Farronato, Mattia Manfredini, Andrea Stevanello, Veronica Campana, Lorenzo Azzi and Marco Farronato
Materials 2019, 12(19), 3135; https://doi.org/10.3390/ma12193135 - 26 Sep 2019
Cited by 12 | Viewed by 4246
Abstract
Masticatory overload on dental implants is one of the causes of marginal bone resorption. The implant–abutment connection (IAC) design plays a critical role in the quality of the stress distribution, and, over the years, different designs were proposed. This study aimed to assess [...] Read more.
Masticatory overload on dental implants is one of the causes of marginal bone resorption. The implant–abutment connection (IAC) design plays a critical role in the quality of the stress distribution, and, over the years, different designs were proposed. This study aimed to assess the mechanical behavior of three different types of IAC using a finite element model (FEM) analysis. Three types of two-piece implants were designed: two internal conical connection designs (models A and B) and one internal flat-to-flat connection design (model C). This three-dimensional analysis evaluated the response to static forces on the three models. The strain map, stress analysis, and safety factor were assessed by means of the FEM examination. The FEM analysis indicated that forces are transmitted on the abutment and implant’s neck in model B. In models A and C, forces were distributed along the internal screw, abutment areas, and implant’s neck. The stress distribution in model B showed a more homogeneous pattern, such that the peak forces were reduced. The conical shape of the head of the internal screw in model B seems to have a keystone role in transferring the forces at the surrounding structures. Further experiments should be carried out in order to confirm the present suppositions. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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10 pages, 2634 KiB  
Article
Peri-Implant Soft Tissue Conditioning by Means of Customized Healing Abutment: A Randomized Controlled Clinical Trial
by Mario Beretta, Pier Paolo Poli, Silvia Pieriboni, Sebastian Tansella, Mattia Manfredini, Marco Cicciù and Carlo Maiorana
Materials 2019, 12(18), 3041; https://doi.org/10.3390/ma12183041 - 19 Sep 2019
Cited by 32 | Viewed by 7739
Abstract
Introduction: An optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes a novel workflow for one-step formation of the supra-implant emergence profile. Materials and Methods: Two randomized groups were selected. [...] Read more.
Introduction: An optimal aesthetic implant restoration is a combination of a visually pleasing prosthesis and adequate surrounding peri-implant soft tissue architecture. This study describes a novel workflow for one-step formation of the supra-implant emergence profile. Materials and Methods: Two randomized groups were selected. Ten control group participants received standard healing screws at the surgical stage. Ten individualized healing abutments were Computer aided Design/Computer aided Manufacturing (CAD/CAM)-fabricated out of polyether ether ketone (PEEK) restoration material in a fully digital workflow and seated at the surgical stage in the test group. The modified healing abutment shape was extracted from a virtual library. The standard triangulation language (STL) files of a premolar and a molar were obtained considering the coronal anatomy up to the cement-enamel junction (CEJ). After a healing period ranging from 1 to 3 months depending on the location of the surgical site, namely, mandible or maxilla, a digital impression was taken. The functional implant prosthodontics score (FIPS) and the numerical rating scale (NRS) of pain were recorded and compared. Results: The mean FIPS value for the test group was 9.1 ± 0.9 while the control group mean value was 7.1 ± 0.9. In the test group, pain assessment at crown placement presented a mean value of 0.5 ± 0.7. On the contrary, the control group showed a mean value of 5.5 ± 1.6. Conclusions: Patients in the test group showed higher FIPS values and lower NRS scores during the early phases compared to the control group. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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15 pages, 2530 KiB  
Article
Primary Stability Optimization by Using Fixtures with Different Thread Depth According To Bone Density: A Clinical Prospective Study on Early Loaded Implants
by Christian Makary, Abdallah Menhall, Carole Zammarie, Teresa Lombardi, Seung Yeup Lee, Claudio Stacchi and Kwang Bum Park
Materials 2019, 12(15), 2398; https://doi.org/10.3390/ma12152398 - 27 Jul 2019
Cited by 37 | Viewed by 6413
Abstract
Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according [...] Read more.
Background: Macro- and micro-geometry are among the factors influencing implant stability and potentially determining loading protocol. The purpose of this study was to test a protocol for early loading by controlling implant stability with the selection of fixtures with different thread depth according to the bone density of the implant site. Materials and Methods: Patients needing implant therapy for fixed prosthetic rehabilitation were treated by inserting fixtures with four different thread diameters, selected based on clinical assessment of bone quality at placement (D1, D2, D3, and D4, according to Misch classification). Final insertion torque (IT) and implant stability quotient (ISQ) were recorded at baseline and ISQ measurements repeated after one, two, three, and four weeks. At the three-week measurement (four weeks after implant replacement), implants with ISQ > 70 Ncm were functionally loaded with provisional restorations. Marginal bone level was radiographically measured 12 months after implant insertion. Results: Fourteen patients were treated with the insertion of forty implants: Among them, 39 implants showing ISQ > 70 after 3 weeks of healing were loaded with provisional restoration. Mean IT value was 82.3 ± 33.2 Ncm and varied between the four different types of bone (107.2 ± 35.6 Ncm, 74.7 ± 14.0 Ncm, 76.5 ± 31.1 Ncm, and 55.2 ± 22.6 Ncm in D1, D2, D3, and D4 bone, respectively). Results showed significant differences except between D2 and D3 bone types. Mean ISQ at baseline was 79.3 ± 4.3 and values in D1, D2, D3, and D4 bone were 81.9 ± 2.0, 81.1 ± 1.0, 78.3 ± 3.7, and 73.2 ± 4.9, respectively. Results showed significant differences except between D1 and D2 bone types. IT and ISQ showed a significant positive correlation when analyzing the entire sample (p = 0.0002) and D4 bone type (p = 0.0008). The correlation between IT and ISQ was not significant when considering D1, D2, and D3 types (p = 0.28; p = 0.31; p = 0.16, respectively). ISQ values showed a slight drop at three weeks for D1, D2, and D3 bone while remaining almost unchanged in D4 bone. At 12-month follow-up, all implants (39 early loading, 1 conventional loading) had satisfactory function, showing an average marginal bone loss of 0.12 ± 0.12 mm, when compared to baseline levels. Conclusion: Matching implant macro-geometry to bone density can lead to adequate implant stability both in hard and soft bone. High primary stability and limited implant stability loss during the first month of healing could allow the application of early loading protocols with predictable clinical outcomes. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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10 pages, 4462 KiB  
Article
Effect of Simultaneous Immediate Implant Placement and Guided Bone Reconstruction with Ultra-Fine Titanium Mesh Membranes on Radiographic and Clinical Parameters after 18 Months of Loading
by Marco Tallarico, Francesco Mattia Ceruso, Leonardo Muzzi, Silvio Mario Meloni, Yong-Jin Kim, Marco Gargari and Matteo Martinolli
Materials 2019, 12(10), 1710; https://doi.org/10.3390/ma12101710 - 26 May 2019
Cited by 23 | Viewed by 4612
Abstract
Background: The aim of the present prospective case series study was to evaluate the implant and prosthetic survival rates, complications and marginal bone loss using ultra-fine titanium mesh membrane with simultaneous implant placement, to provide space maintenance mandatory for guided bone reconstruction of [...] Read more.
Background: The aim of the present prospective case series study was to evaluate the implant and prosthetic survival rates, complications and marginal bone loss using ultra-fine titanium mesh membrane with simultaneous implant placement, to provide space maintenance mandatory for guided bone reconstruction of alveolar bone defects. Materials and Methods: patients were recruited and treated at a private clinic in Rome, Italy, between March 2016 and October 2017. Self-tapping tapered implants were placed through a computer-guided template-assisted approach. Autogenous bone was placed alone over the exposed implant surface, then mixed with inorganic bovine bone material. Finally, the membrane was connected and shaped in order to securely enclose the graft area, and the healing cap was connected and screwed onto the height connector. Outcome measures were: implant and prosthetic failure, biological and mechanical complications, marginal and volumetric bone level changes, esthetic evaluation performed according to the pink aesthetic score (PES). Results: in total, seven patients (five women, two men) with a mean age of 52.7 ± 20.3 years (range: 27–71) received 10 self-tapping tapered implants and simultaneous guided bone regeneration with ultra-fine titanium mesh membranes. No implants and no prostheses failed during the entire follow-up period. One slightly membrane exposure was observed one month after implant placement in one patient. The mean marginal bone loss (MBL) at implant loading was 0.13 ± 0.09 mm (95% CI 0.08–0.19). At the 18-month follow-up examination, the mean MBL was 0.28 ± 0.33 mm (95% CI 0.07–0.50) The difference was not statistically significant (0.15 ± 0.31; 95% CI 0.05–0.35; P = 0.1888). The mean horizontal alveolar ridge width was 3.72 ± 1.08 mm (95% CI 3.22–4.22 mm). At the II-stage surgery, the mean bone width was 8.79 ± 0.98 mm (95% CI 8.51–9.07 mm). The mean bone gain was 5.06 ± 1.13 mm (95% CI 4.68–5.44 mm; P = 0.000). The mean volume of the grafted bone calculated using the superimposition technique was 0.99 ± 0.38 CC (95% CI 0.75–1.23 CC). The mean PES at implant loading was 8.2 ± 0.8 mm (95% CI 7.7–8.7). At the 18-month follow-up examination, the mean PES was 12.0 ± 0.7 mm (95% CI 11.5–12.5) The difference was statistically significant (3.8 ± 0.4; 95% CI 3.5–4.1; P = 0.0000); Conclusion: with the limitation of the present prospective study, the guided bone reconstruction using an ultra-fine titanium mesh membrane with simultaneous implant placement seems to provide good and stable results in implant/prosthesis success. Further research with a longer follow-up and a higher sample size are needed to confirm the results from this preliminary report. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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Review

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14 pages, 1895 KiB  
Review
Temperature Threshold Values of Bone Necrosis for Thermo-Explantation of Dental Implants—A Systematic Review on Preclinical In Vivo Research
by Kristian Kniha, Nicole Heussen, Eugenia Weber, Stephan Christian Möhlhenrich, Frank Hölzle and Ali Modabber
Materials 2020, 13(16), 3461; https://doi.org/10.3390/ma13163461 - 6 Aug 2020
Cited by 20 | Viewed by 3297
Abstract
Purpose: Very high or low temperatures will lead to bone damage. The objective of this review was to analyze threshold values for thermal bone necrosis. Methods: Histological animal studies evaluating thermal effects on bone necrosis were selected via electronic and hand searches in [...] Read more.
Purpose: Very high or low temperatures will lead to bone damage. The objective of this review was to analyze threshold values for thermal bone necrosis. Methods: Histological animal studies evaluating thermal effects on bone necrosis were selected via electronic and hand searches in English and German language journals until 1 November 2019. The outcome measures were temperature-exposure intervals and laser settings effecting bone damage. Furthermore, investigated parameters were the bone-to-implant contact ratios (BIC) and infrabony pockets around dental implants after thermal treatment. For quality assessment of studies, the CAMARADES study quality checklist was applied. Results: A total of 455 animals in 25 animal studies were included for data extraction after screening of 45 titles from 957 selected titles of the MEDLINE (PubMed), The Cochrane Library, Embase and Web of Science search. The threshold values for bone necrosis ranged between 47 °C and 55 °C for 1 min. A threshold value for cryoinsult and laser treatment has not yet been defined. However, temperatures in the vicinity of 3.5 °C produce a histologically proven effect on the bone and in the surrounding tissue. At 50 °C for 1 min, BIC values significantly decreased and infrabony pockets increased. Bone quality had an influence on the outcome, as cancellous bone suffered higher bone damage from thermal treatment compared to cortical bone. Conclusion: No clear threshold value for bone necrosis is available according to the current literature for warm and cold stimuli. More in-depth and clinical studies are required to provide further insights in assessing the potential of thermal necrosis for implant removal. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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Other

16 pages, 6594 KiB  
Case Report
Combination of Digital and Conventional Workflows in the CAD/CAM-Fabrication of an Implant-Supported Overdenture
by Michael Benno Schmidt, Angelika Rauch, Marcus Schwarzer, Bernd Lethaus and Sebastian Hahnel
Materials 2020, 13(17), 3688; https://doi.org/10.3390/ma13173688 - 20 Aug 2020
Cited by 4 | Viewed by 4389
Abstract
Completely digital workflows for the fabrication of implant-supported removable restorations are not yet common in clinical dental practice. The aim of the current case report is to illustrate a reliable and comfortable workflow that reasonably merges conventional and digital workflows for the CAD/CAM-fabrication [...] Read more.
Completely digital workflows for the fabrication of implant-supported removable restorations are not yet common in clinical dental practice. The aim of the current case report is to illustrate a reliable and comfortable workflow that reasonably merges conventional and digital workflows for the CAD/CAM-fabrication of implant-supported overdentures. The 53-year old patient was supplied with a digitally processed complete denture in the upper jaw and, simultaneously, with an overdenture supported by four interforaminal implants in the lower jaw. The overdenture included a completely digitally processed and manufactured alloy framework that had been fabricated by selective laser sintering. The case report indicates that digital manufacturing processes for extensive and complex removable restorations are possible. However, as it is currently not yet possible to digitally obtain functional impressions, future developments and innovations might focus on that issue. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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12 pages, 5909 KiB  
Case Report
Errors in Implant Positioning Due to Lack of Planning: A Clinical Case Report of New Prosthetic Materials and Solutions
by Marco Tallarico, Roberto Scrascia, Marco Annucci, Silvio Mario Meloni, Aurea Immacolata Lumbau, Alba Koshovari, Erta Xhanari and Matteo Martinolli
Materials 2020, 13(8), 1883; https://doi.org/10.3390/ma13081883 - 16 Apr 2020
Cited by 25 | Viewed by 4445
Abstract
The achievement of the optimal implant position is a critical consideration in implant surgery, as it can facilitate the ideal prosthesis design and allow adequate oral hygiene maintenance. The switch from bone-driven to prosthetic-driven implant placement, through a comprehensive diagnosis and adequate treatment [...] Read more.
The achievement of the optimal implant position is a critical consideration in implant surgery, as it can facilitate the ideal prosthesis design and allow adequate oral hygiene maintenance. The switch from bone-driven to prosthetic-driven implant placement, through a comprehensive diagnosis and adequate treatment plan, is a prerequisite for long-term successful implant-based therapy. The aim of the present case report is to describe a step-by-step prosthetic retreatment of a patient with primary treatment failure due to incorrect dental implant placement. Although dental implants achieve high survival rates, the success of implant prosthetic therapy significantly relies on an appropriate implant position. Malpositioned implants can cause damage to vital structures, like nerves or vessels. Moreover, improper implant positioning can result in esthetic, biological, and technical complications and can, in extreme situations, render the desired prosthetic rehabilitation impossible to achieve. Full article
(This article belongs to the Special Issue Dental Implants and Materials)
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