Search Results (102)

Background: Osseointegration is the cornerstone of long-term implant success, and systemic factors such as nutritional status may influence the biological cascade of peri-implant bone healing. Nutraceuticals have been proposed as adjuvant strategies to enhance bone metabolism, but clinical evidence remains scarce. This study aimed to evaluate the effect of a novel nutraceutical formulation (Osteo-therapy^®, Laboratorio Farmaceutico ERFO S.p.A., Messina, Italy; composed of spirulina standardized with 40% phycocyanin, quercetin, vitamin D3, and calcium) on early implant stability. Methods: A prospective, randomized clinical trial (RCT) was conducted in accordance with CONSORT guidelines (PLATFORM Project OR12.1). Sixty healthy patients requiring mandibular implants were enrolled (test n = 30 with Osteo-therapy^®; control n = 30). Stability was assessed via RFA (ISQ values) at baseline (T0), 1 month (T1), 2 months (T2), and 3 months (T3). Results: Both groups showed increases in ISQ. No significant differences were found at T0 and T1 (p = 0.149 and p = 0.737). From T2 onward, the test group exhibited significantly higher ISQ values (T2: 73.17 vs. 69.50, p < 0.001; T3: 78.37 vs. 76.63, p = 0.006). Conclusions: Osteo-therapy^® significantly enhanced early implant stability, indicating an accelerated transition from primary to secondary stability, potentially supporting earlier loading protocols. Full article

Background: The macrogeometry and shape of dental implants strongly influence primary stability, which may at times result in excessively high insertion torque. This in vitro study aimed to evaluate whether increasing coronal thread density could reduce insertion torque without compromising primary stability. Methods: Two conical implants with identical macrogeometry and surface characteristics (Ø 4.2 × 11.5 mm) differed only in the thread pitch of the coronal 3 mm: a modified version (27% more coronal threads; Group 1) and a standard, commercially available version (Group 2). Thirty implants of each design were inserted into high-density (D1; 40 PCF; pounds per cubic foot) and low-density (D3; 20 PCF) polyurethane blocks (n = 120). Insertion torque (IT) and implant stability quotient (ISQ, measured by resonance frequency analysis) were recorded. Group comparisons used the Kruskal–Wallis test, and a generalized linear model (GLM) assessed the independent effects of IT and design on ISQ in D1 bone. Results: In D1 bone, Group 2 showed higher IT (median 74.0 vs. 63.5 N·cm; p < 0.001) and ISQ (mean 79.1 vs. 77.4; p ≤ 0.030). The GLM identified IT as a negative predictor of ISQ (β = −0.267 per 1 N·cm; p < 0.001), and Group 2 was associated with higher ISQ (+3.90; p < 0.001). In D3 bone, Group 2 again exhibited higher IT (median 37.5 vs. 33.0 N·cm; p < 0.001), while ISQ values were similar between designs (all p > 0.35). Conclusions: Increasing coronal thread density lowers insertion torque without reducing stability in softer bone and maintains sufficient ISQ for immediate loading in dense bone, making the design advantageous for varied bone qualities. Full article

Background and Objectives: Implant-supported rehabilitation after oral cancer surgery remains technically and biologically demanding due to altered anatomy, scar tissue, and prior radiotherapy. Digital workflows and hospital-based point-of-care (POC) manufacturing now enable personalized, prosthetically driven implant placement with static surgical guides fabricated within the clinical environment. This study reports the initial clinical experience of an academic POC manufacturing unit (UPAM3D) implementing static guided implant surgery in oral cancer patients and compares this approach with conventional outsourcing and dynamic navigation methods. Materials and Methods: A retrospective review of 30 consecutive cases (2021–2024) treated with POC-manufactured static guides was conducted using data from the UPAM3D registry. Each record included design, fabrication, and sterilization parameters compliant with ISO 13485 standards. Demographic, surgical, and prosthetic variables were analyzed, including anatomical site (maxilla or mandible), guide type, material, radiotherapy history, number of Ticare Implants^®, and loading strategy. Results: All surgical guides were designed and 3D printed in-house using biocompatible resins (BioMed Clear, Dental SG, or LT Clear). The annual number of POC procedures increased progressively (2 → 6 → 6 → 16). Most cases involved oncologic reconstructions of the maxilla or mandible, including irradiated fields. When recorded, primary stability values (mean ISQ ≈ 79) allowed immediate or early loading (ISQ ≥ 70). No major intraoperative or postoperative complications occurred, and all guides met sterilization and traceability standards. Conclusions: Point-of-care manufacturing enables efficient, accurate, and patient-specific guided implant rehabilitation after oral cancer surgery, optimizing functional and esthetic outcomes while reducing procedural time and dependence on external providers. Integrating this process into clinical workflows supports personalized treatment planning and broadens access to advanced implant reconstruction within multidisciplinary oncology care. Full article

Background/objectives: Zirconia dental implants are increasingly recognised as an alternative to titanium implants due to their biocompatibility and aesthetics. Initially developed as one-piece systems, zirconia implants have evolved into two-piece designs with different platform levels; however, comparative data on their primary and secondary stability– particularly as assessed by resonance frequency analysis (RFA)—and marginal bone dynamics remain limited. This case series aimed to evaluate the implant stability and marginal bone changes of two-piece zirconia implants with bone-level (BL) and tissue-level (TL) platforms in patients missing maxillary premolars. Methods: Thirteen zirconia implants (n = 13; 7 BL, 6 TL; Z5-TL/Z5-BL, Z-Systems, Switzerland) were placed in 11 patients with healed ridges. The implant stability quotient (ISQ) was measured immediately after insertion and before prosthetic loading. Lithium disilicate crowns were cemented after four months, and follow-ups were conducted for an average of 35 months (SD = 12). Results: Initial ISQ values ranged from 73 to 79, increasing to 76–84 at 3–4 months, indicating high implant stability for both BL and TL implants. The extent of marginal bone loss (MBL) after two years was greater around BL implants (mean 0.46 mm) compared to TL implants (mean 0.2 mm), although probing depths and bleeding on probing remained minimal in both groups, with only one TL implant showing gingival recession. Conclusions: Over a short observation period, two-piece zirconia implants with tissue-level platforms appeared to demonstrate superior marginal tissue stability. Further, larger-scale controlled studies are required to confirm these preliminary observations. Full article

Introduction: The split crest (SC) is a technique for horizontal ridge augmentation that enables simultaneous implant placement. While the use of bone grafts within the osteotomy gap is well-documented, the efficacy of dentin as a graft material in SC procedures has not been thoroughly evaluated. Objective: This study aimed to assess whether the addition of bone graft or dentin to the osteotomy gap during the SC procedure improves bone width, density, and implant stability compared to SC without grafting. Materials and Methods: A partially randomized prospective study was conducted on 24 implants divided into three groups: SC only, SC and bone graft, and SC and dentin graft. Clinical and radiographic evaluations, including CBCT-based bone measurements and implant stability (ISQ) values, were performed preoperatively, immediately postoperatively, and three months after surgery. All patients were followed for one year. Results: Significant increases in bone width were recorded in all groups, with gains exceeding 2 mm in the SC and SC and bone graft groups. The SC and dentin group showed the least bone gain and the greatest horizontal bone resorption (p < 0.05). Conclusions: While bone grafting may offer modest advantages in bone preservation, the use of dentin grafting may not demonstrate significant benefits. Full article

Background: Primary stability of dental implants depends on bone quality, bone quantity, and implant design. In cases of large defects, such as periapical lesions, the selection of an appropriate alveolar ridge preservation (ARP) material is crucial for bone regeneration and preparation for implant placement. Objective: The aim of this study was to evaluate clinical and histological outcomes of a novel ARP material hydroxyapatite and sugar cross-linked collagen (HSCC) combined with a knife-edge thread implant (KTI) design. Methods: Thirty patients were divided into two groups: a control group treated with KTI after spontaneous alveolar ridge healing, and an experimental group that underwent ARP using HSCC, and six months later, KTIs were placed in newly formed bone. Clinical parameters including insertion torque value (ITV), resonance frequency analysis (RFA), implant stability quotient (ISQ), and horizontal bone dimension were evaluated. Histological analysis was also performed. Results: No significant differences were observed between groups in ITV, ISQ, or horizontal bone dimension (p > 0.05). However, histological analysis demonstrated a significantly higher number of active osteoblasts in the ARP group compared to the control (p < 0.001), whereas collagen deposition was significantly greater in the control group (p < 0.001). Conclusions: ARP using HSCC, combined with KTI, provides favorable conditions for primary stability and successful graft integration, supporting reliable implant placement in sites with bone defects. Full article

Achieving reliable implant stability in type IV (D4) bone remains a clinical challenge due to its thin cortical plates and low trabecular density, which increase the risk of early failure. Novel osteotomy techniques such as osseodensification and the OsseoShaper have been proposed, yet their effects when combined with different implant macrogeometries are not fully understood. This in vitro study evaluated forty osteotomies in standardized polyurethane foam blocks simulating D4 bone density. Three site preparation protocols—conventional osteotomy, osseodensification, and OsseoShaper—were combined with two implant macrogeometries (parallel-walled conical and tri-oval tapered designs). Insertion torque (IT) was measured using a calibrated digital torque meter, and implant stability was assessed by resonance frequency analysis (ISQ). Intraoperative thermal changes were monitored with infrared thermography under constant irrigation. Statistically significant differences were observed among groups (p < 0.05). Osseodensification with parallel-walled implants achieved the highest stability, whereas osseodensification with tri-oval implants showed the lowest. Although osseodensification produced the greatest thermal increase, all values remained below the 47 °C osteonecrosis threshold. Within the study’s limitations, both the osteotomy technique and implant macrogeometry significantly affected stability and thermal outcomes, with osseodensification plus parallel-walled implants providing the most predictable performance in D4 bone. Full article

Background/Objectives: Horizontal alveolar ridge deficiency is a common clinical challenge in dental implant placement. The osseodensification (OD) technique has been proposed as a minimally invasive alternative to conventional osteotomy. This study aimed to compare the outcomes of OD and conventionally performed ridge-split procedures in terms of implant stability and horizontal bone gain. Methods: In this retrospective study, 65 patients (a total of 268 implants) who underwent simultaneous implant placement with ridge-split procedures were evaluated. Cases were divided into two groups: OD burs (n = 133 implants) and the conventional Esset kit (n = 135 implants). Ridge width was measured at coronal and apical levels using cone-beam computed tomography (CBCT) preoperatively and four months postoperatively. Implant stability was assessed at the time of placement (primary stability) and at four months (secondary stability) using resonance frequency analysis (RFA). Results: Both techniques achieved comparable horizontal bone gain (1.1–1.6 mm; p > 0.05). In the maxilla, the OD group demonstrated a tendency toward higher primary and secondary stability values (p < 0.01). A similar trend was observed for secondary stability in the mandibular posterior region (p < 0.01). The mean Implant Stability Quotient (ISQ) values in the OD group generally exceeded the threshold of 65, considered sufficient for prosthetic loading. Conclusions: The findings suggest that the OD technique may have a favorable effect on implant stability, particularly in regions with low-to-moderate bone density, while providing comparable horizontal bone gain to the conventional method. These results indicate that OD could serve as a potentially useful alternative in the management of horizontal ridge deficiencies; however, its long-term efficacy should be further evaluated in larger, prospective clinical studies. Full article

Background: The morphology of implant threads plays a crucial role in achieving primary stability, which is essential for successful osseointegration and immediate loading of dental implants. This study aimed to evaluate how different implant thread pitches and an under-preparation drilling technique impact primary stability using an in vitro model. Methods: The study was conducted on low-density polyurethane bone models with and without cortical layers. The following three different implant thread profiles were tested: CYROTH 0.40 (0.40 mm), CYROTH 0.45 (0.45 mm), and CYROTH T (0.35 mm). Two different drilling procedures were utilized, with diameters of 3.4 mm and 3.7 mm, at a low rotational speed of 30 rpm. Primary stability was assessed by measuring insertion torque (IT), removal torque (RT), and resonance frequency analysis (RFA). Results: The low rotational speed of 30 rpm was found to be effective for achieving favorable fixation parameters in all scenarios. The 0.45 mm thread consistently exhibited higher implant stability quotient (ISQ) values (from two to six points higher) compared to the 0.40 mm and standard 0.35 mm threads, while also requiring lower IT. The highest ISQ values were recorded in the 20 pounds per cubic foot (PCF) block with a cortical layer using the 0.45 mm thread and a 3.4 mm drill. The under-preparation using the 3.4 mm drill resulted in higher IT and RT values than the 3.7 mm drill. Conclusions: This study demonstrated that implant thread pitch and drilling technique are critical factors influencing primary stability. Utilizing a wider thread pitch (0.45 mm) along with an under-preparation drilling protocol can significantly improve implant stability, even in low-density bone, without the need for excessive IT. These findings suggest that selecting the appropriate implant macrogeometry and surgical technique can optimize the primary stability of dental implants. Full article

Even though the foundations of diamond burnishing as a research topic were laid long ago, numerous scientific papers still deal with examining various aspects of the burnishing process today. One such aspect is the investigation of the 3D roughness parameters related to the tribological characteristics of the machined surface, which is detailed in the present study. In this study, the positive properties of slide friction diamond burnishing are presented through the examination of surface quality, which plays a key role in tribological assessment. This study analyzed the surface layer condition of X5CrNi18-10 stainless austenitic chromium–nickel steel test pieces after burnishing. Among the finishing operations, burnishing is an economical and low-environmental impact process. The study includes a description of the technological characteristics of turning and diamond burnishing processes. The main characteristics of the Abbott–Firestone curve are described, and parameter improvement factors are introduced. The experimental results and their evaluations are presented by analyzing the values of the Abbott–Firestone surface curves. The study concludes that the best improvement ratios of S_a (arithmetical mean height), S_q (root mean square height), S_z (maximum height) IS_a, IS_q, and IS_z roughness improvements were achieved when using the parameter combination v₂ = 55.578 m/min, f₂ = 0.050 mm/rev and F₄ = 50 N. Full article

Background: This prospective clinical study aimed to evaluate the effectiveness of platelet-rich fibrin (PRF) in guided bone regeneration (GBR) prior to dental implant placement. Material and methods: Sixty-five patients with alveolar bone defects were randomly assigned to three groups. All groups received a composite graft consisting of 70% allograft and 30% xenograft. Group A received the graft combined with PRF. Group B received the graft with PRF and a resorbable collagen membrane. Group C (control) received the same graft and membrane without PRF. Cone-beam computed tomography (CBCT) was used to assess bone regeneration at baseline and 6 months postoperatively. Implant stability was evaluated using ISQ values at the time of implant placement (6 months after grafting) and again at 3 to 4 months during the second-stage uncovering procedure. Soft tissue healing, postoperative complications, and pain scores were also recorded. Results: Group B showed the best outcomes, with the highest mean vertical bone gain (3.0 ± 0.4 mm), greatest implant stability (ISQ: 74.2 ± 1.8), and no complications. Group A achieved moderate bone gain (2.3 ± 0.4 mm) and good ISQ values (71.5 ± 2.3), with favorable soft tissue healing. In contrast, Group C had the lowest bone gain (2.1 ± 0.5 mm), reduced ISQ values (68.9 ± 2.9), and the highest incidence of complications, including dehiscence and minor infections. Conclusions: These results suggest that PRF enhances both hard and soft tissue regeneration, particularly when used with grafts and membranes. PRF may reduce healing time and postoperative discomfort, improving the overall success of regenerative implant procedures. Full article

Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread’s crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone–implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS’s cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, p = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (p = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density. Full article

Background: Wettability of dental implant surfaces is a key factor in the osteointegration process. This study aimed to evaluate the effect of a new hydrophilic surface on implant stability in posterior maxilla rehabilitations. Materials and Methods: A 6-month, single-center, parallel-group clinical trial following STROBE guidelines was reported. Implant Stability Quotient (ISQ) changes were compared between implants with a moderately rough surface (MultiNeO CS, Alpha-Bio Tec, Israel, Control Group–CG) and those with the same surface and, in addition, nano-scale roughness and hydrophilic properties (MultiNeO NH CS, Alpha-Bio Tec, Israel, Test Group–TG) placed using a crestal sinus lift technique. ISQ values at bucco-lingual (ISQBL) and mesio-distal (ISQMD) sides were measured at insertion (t0), 4 months (t4), and 6 months (t6). Repeated measures ANOVA (RMA) was performed for statistical evaluation. Results: The study included 35 participants (18 TG, 17 CG). Mean ISQBL0 was 69.45 (SD = 12.62), increasing to 71.72 (SD = 6.74) at t4 and 75.21 (SD = 4) at t6. ISQMD0 mean was 67.54 (SD = 12.54), rising to 72.32 (SD = 6.90) at t4 and 75.67 (SD = 4.60) at t6. No statistically significant differences were found between groups, though TG showed a significant increase in ISQBL at t6 vs. t4 and ISQMD at t6 vs. t0. One-way ANOVA revealed no significant variations between mean ISQ differences over time. Conclusion: Both groups exhibited an increasing ISQ trend, but no significant differences were observed between t4–t0 and t6–t4 periods. Further research is required to assess the impact of hydrophilia on early loading, osteointegration, and long-term outcomes. Full article

Objectives: We wished to compare the primary and secondary stability of dental implants with a progressive design (PL) versus a conventional thread design (SL) across various clinical settings. Methods: A total of 100 implants (50 PL and 50 SL) were placed in 62 patients. The stability of the implants was assessed using a resonance frequency analysis (RFA) at the time of placement (T1) and 20 weeks postoperatively before prosthetic loading (T2). Bone density was measured in Hounsfield units (HU) using cone-beam computed tomography (CBCT). The ISQ values were recorded for each group and anatomical region, including both inter- and intragroup comparisons over time. Results: Both implant designs showed a significant increase in stability during the healing period. At T1, the ISQ values were comparable between groups (SL: 71.3 ± 8.6; PL: 71.1 ± 8.7). At T2, the ISQ values increased significantly in both groups (SL and PL: p < 0.01), with no statistically significant difference in the degree of the gain in stability. The ISQ values were generally lower in the maxilla compared to those in the mandible. In the posterior mandible, the SL implants demonstrated a greater increase in stability compared to that with the PL implants. A strong positive correlation between the HU and ISQ values was observed for both groups (SL: r = 0.95; PL: r = 1.00), without reaching statistical significance. Conclusions: While the progressive thread design aims to enhance the primary stability, it did not outperform the conventional design in this study. Both implant types proved effective in achieving stable and predictable clinical outcomes. Full article

This study aimed to utilize finite element analysis (FEA) to evaluate the primary stability of Cyroth dental implants (AoN Implants Srl, Grisignano di Zocco, Italy) under various biomechanical conditions, including different implant inclinations (0°, 15°, and 20°) and bone densities (D3 and D4). By comparing these results with those obtained from in vitro tests on polyurethane blocks, the study sought to determine whether FEA could provide stability information more quickly and efficiently than in vitro methods. The research involved correlating dental implant micro-mobility with the implant stability quotient (ISQ) using FEA to simulate the mechanical behavior of implants and the surrounding bone tissue. Additionally, the study assessed the error in ISQ value detection by comparing FEA results with in vitro tests on polyurethane blocks conducted under the same experimental conditions. Both the FEA simulations and in vitro experiments demonstrated similar trends in ISQ values. For the D3 bone block simulated by FEA, the difference from the in vitro test was only 1.27%, while for the D2 bone, the difference was 2.86%. The findings also indicated that ISQ increases with implant inclination and that bone quality significantly affects primary stability, with ISQ decreasing as bone density diminishes. Overall, this study showed that ISQ evaluation for dental implants can be effectively performed through FEA, particularly by examining micro-movements. The results indicated that FEA and in vitro polyurethane testing yielded comparable outcomes, with FEA providing a faster and more cost-effective means of assessing ISQ across various clinical scenarios compared to in vitro testing. Full article