Search Results (28)

Objectives: The objective of this study is to evaluate the effect of 635 nm photobiomodulation on the rate and magnitude of maxillary canine distalization following extraction of the maxillary first premolars in adult patients. Materials and Methods: This randomized, controlled, split-mouth clinical trial included 18 adult patients undergoing extraction-based orthodontic treatment for Class II malocclusion. Maxillary first premolars were extracted, and canine distalization was performed using nickel–titanium closed-coil springs delivering a constant force of 150 g, supported by orthodontic mini-implants providing absolute anchorage. Photobiomodulation was applied on one randomized side using a 635 nm diode laser operating at 100 mW in continuous-wave mode, with an 8 mm handpiece diameter. Laser irradiation was delivered in contact mode to two application sites per session corresponding to the buccal and palatal aspects of the maxillary canine root, with an exposure time of 60 s per site. Irradiation was performed according to a predefined schedule over a 45-day observation period, while the contralateral side served as a sham-treated control. Tooth movement was assessed by repeated measurements of inter-bracket distance. A linear mixed-effects model was used to analyze the effects of treatment, time, and their interaction on tooth movement dynamics. Results: The linear mixed-effects model revealed a significant interaction between treatment and time (p < 0.001), indicating a greater rate of canine distalization on the photobiomodulation-treated side compared with the control side. Treatment and time also demonstrated significant main effects. After 45 days, the mean cumulative canine displacement was approximately 1.6 mm greater on the photobiomodulation side than on the control side. Age and sex did not significantly influence tooth movement. Conclusions: Photobiomodulation at a wavelength of 635 nm significantly increased the rate of maxillary canine distalization in adult extraction cases over a 45-day observation period. Full article

Objective: To evaluate the biomechanical effects of varying posterior implant inclinations and loading protocols on peri-implant stress distribution in full-arch maxillary rehabilitations using the All-on-Four concept. Methodology: A three-dimensional finite element model of an edentulous atrophic maxilla was developed from a digital point cloud. Four implants were placed according to the All-on-Four protocol: two anterior vertical implants and two posterior implants with inclinations of 0°, 15°, 30°, or 45°. Mini-abutments and a titanium bar prosthesis were included. Material properties were assumed as homogeneous, isotropic, and linearly elastic. Immediate loading was simulated using frictional contacts (µ = 0.3), whereas delayed loading assumed complete osseointegration (bonded contacts). The models were meshed using 10-node quadratic tetrahedral elements (SOLID187) in ANSYS^®. Maximum von Mises stress in cortical bone, cancellous bone, implants, abutments, and the prosthetic bar was assessed. Results: Posterior implant tilt significantly reduced peri-implant stress. Under immediate loading, the highest stress occurred at 0° inclination in the posterior left implant (82.36 MPa) and decreased progressively with increasing tilt, reaching 33.63 MPa at 45° (≈59% reduction). Delayed loading generally produces lower stress magnitudes, particularly at extreme tilts. Anterior implants experienced lower stress levels across all configurations. Comparative analysis demonstrated that immediate loading increased stress at lower angulations, while differences between loading protocols were minimal at higher inclinations. Conclusions: Posterior implant angulation and loading protocol critically influence peri-implant stress distribution. Increased posterior tilt combined with appropriate loading reduces peak cortical bone stresses, supporting biomechanical optimization in All-on-Four maxillary rehabilitations. Full article

Radial and ulnar fractures in toy-breed dogs are associated with a high risk of complications due to limited bone stock and soft tissue coverage. The aim of this retrospective study was to evaluate the postoperative clinical and radiographic outcomes in dogs undergoing radial and ulnar fracture stabilization with a titanium locking mini-plate system. Medical records and radiographs of toy-breed dogs weighing ≤5 kg treated between 2020 and 2025 were reviewed. Twenty-six dogs met the inclusion criteria. Radiographic union after primary fixation was observed in 92.9% of fractures. Implant failure occurred in 7.1% of cases and was successfully addressed with revision surgery, after which fracture healing was achieved. At final follow-up, limb function was graded as excellent in all dogs, including those requiring revision surgery. A shorter distal fragment length was significantly associated with implant failure, whereas implant length and proximal fragment length showed no significant association. These findings indicate that titanium locking mini-plates were associated with favorable clinical and radiographic outcomes. Distal fragment dimensions may influence the risk of implant failure and should be considered during surgical planning. However, the small number of implant failure events limits the robustness of statistical inferences, and the absence of a control group prevents direct comparison with alternative fixation techniques. Full article

Background/Objectives: This study evaluated the influence of key biomechanical parameters—orthodontic force magnitude, loading direction, and insertion depth—on stress and strain distribution in orthodontic mini-implants using three-dimensional finite element analysis (FEM). Methods: A three-dimensional model of a titanium orthodontic mini-implant inserted into a mandibular bone segment was developed and analyzed under varying force magnitudes (1–10 N), loading directions (30°, 45°, and 60°), and insertion depths (2–4 mm). Cortical and cancellous bone components were included, and static loading conditions were applied using simplified, linear elastic material assumptions. Results: Stress and strain levels increased with higher force magnitudes, with implant stresses approaching critical values at loads above 9 N. Cortical bone stresses remained within physiological limits, whereas cancellous bone exceeded the microdamage strain threshold at forces greater than 3 N. A 60° loading direction reduced implant bending and strain, while deeper insertion significantly decreased strain and displacement, indicating improved primary stability. Conclusions: Within the limits of this computational model, optimal mechanical behavior was observed under 1–3 N forces, a 60° loading direction, and a 2–4 mm insertion depth. Loads above 9 N approached fatigue and interfacial risk. These findings provide computational insight into the biomechanical behavior of orthodontic mini-implants under the modeled conditions. Full article

Metal additive manufacturing (AM) techniques, particularly laser powder bed fusion, are being increasingly recognized not as brand-new technologies, but as emerging technologies with their recent advancements—such as the development of optimized alloys, seamless digital workflow integration, and applications in patient-specific prostheses. With the rise in patient-specific approaches in dentistry, clinicians are seeking customized devices that precisely match individual anatomical and functional needs. AM offers various advantages, such as the fabrication of complex geometries directly from digital designs, enhanced clinical precision, reduced material waste, and simplified manufacturing workflow, and hence can uniquely address these demands. Recent advancements in AM techniques have led to the development of titanium and cobalt–chromium alloys with improved mechanical properties, corrosion resistance, and biological compatibility. These alloys show great potential for clinical applications. Additionally, AM enables precise control over the microstructures and surface topographies of these alloys during fabrication, facilitating their optimized integration with biological tissues. This mini review summarizes recent advancements in metal AM technologies relevant to personalized dentistry, highlights key material developments, discusses current clinical applications, and identifies key challenges such as high cost, materials limitations, and regulatory hurdles, and highlights future opportunities including multi-materials AM, smart implants, and AI-driven optimization for fully integrated, digitally driven personalized dental care. Full article

Background/Objectives: The structural integrity and strength of the transgingival soft tissue seal around dental implant surfaces remain critical challenges. Therefore, animal models should include all three implant/tissue interfaces: bone, connective tissue, and epithelium. Thus, we sought to explore the rabbit mandibular diastema as a site for candidate intra-oral implant placement. Methods: Ninety-six custom mini-implants (with one of four different surfaces: machined, acid-etched, and with or without a nanotube coating) made from titanium 6/4 alloy were placed in the mandibular diastemas of twenty-four 16-week-old New Zealand white rabbits, with the implant collar above the alveolar crest. After 7, 21, and 42 days, the bony and connective tissue/implant interfaces were examined by light and scanning electron microscopy (SEM). Results: Of ninety-six implants, eight implants were found exposed to the oral cavity, with no evidence of soft tissue inflammation, suggesting that transmucosal implant placement would have been feasible. No significant differences were observed in collagen fiber orientation and fibrous tissue thickness by polarized light microscopy. However, SEM images showed that at all three time points, topographically complex nanotube surfaces had a profound effect on soft tissue peri-implant deposition, although functionally oriented collagen fibers were not identified attached to the implant surface. These surfaces also showed reparative peri-implant bone in the collar region. An intramembranous form of de novo bone formation was observed, together with tartrate-resistant acid-phosphatase-positive osteoclasts and multinucleate giant cells in the peri-implant endosseous compartment. Conclusions: Our results demonstrate that the rabbit mandibular diastema provides an intra-oral method of implant placement without the necessity of an extra-oral approach, tooth extractions, or bone augmentation procedures. Furthermore, given that three implant tissue interfaces can potentially be studied (bone, connective tissue, and epithelium) this model provides advantages over more traditional implant placement sites in the appendicular skeleton. Full article

Background/Objectives: The stabilization disc (SD) for orthodontic mini-implants is a novel device designed to enhance anchorage stability and minimize the risk of mini-implant mobility. The disc features a flat structure with four prongs and is crafted from biocompatible materials such as titanium or stainless steel. It provides additional support to mini-implants by improving force distribution and reducing stress concentration around the insertion site. This study aims to evaluate the biomechanical performance of mini-implants with an SD compared to without-SD mini-implants, with a specific focus on their ability to maintain anchorage under orthodontic loading conditions. Methods: A finite element analysis (FEA) model was created for a commercially available mini-implant (2.0 mm in diameter and 12 mm in length). The mandible’s anatomical structure was reconstructed in 3D from computed tomography (CT) scans using SpaceClaim software 2023.1. To simulate real-world orthodontic conditions, forces of 10 N were applied at an angle of 30°. This retrospective study explores the role of SDs in enhancing mini-implant stability by reducing displacement and optimizing stress distribution. The evaluation included analyzing von Mises stress, cortical bone deformation, and mini-implant movement under simulated orthodontic loading. Results: The results demonstrate that the SD significantly reduces maximum total displacements by over 41% and redistributes von Mises stresses more evenly across the mini-implant and surrounding bone. Cortical bone stress and deformation were reduced in cases utilizing the SD, indicating enhanced implant stability and durability. Conclusions: The stabilization disc enhances mini-implant stability by improving stress distribution and reducing deformation without requiring permanent implant modifications. Its adaptability makes it a valuable solution for managing variable bone density and high orthodontic forces, offering a promising advancement in orthodontic anchorage. Full article

The aim of the present study was to test the sequential and simultaneous release of rhBMP2 and rhVEGF165 from poly-l-lysine-heparin (PLL-Hep) poly-electrolyte multilayer (PEM) coating on titanium surfaces for their ability to enhance peri-implant bone formation and CD31 expression around disc-shaped titanium implants (5 × 7 mm) in mini-pig mandibles. Bare titanium surfaces loaded with respective growth factor combinations served as controls. Ten different surface conditions were tested exhibiting early VEGF release, early BMP release, simultaneous VEGF and BMP release, and sole VEGF/BMP release, respectively. The implants were inserted press-fit into 5 mm trephine cavities at the lower border of the mandibles of mini-pigs and left to heal for 4 and 13 weeks. After 4 weeks, there was no significant difference in peri-implant bone formation, bone–implant contact nor CD31 expression between the different surface conditions. After 13 weeks, bone formation was significantly higher in the zone of 100 μm next to implant surfaces releasing either BMP alone or with an early release of BMP2. Expression of CD31 has significantly decreased from 4 to 13 weeks with significantly higher values in the group of implants with early release of BMP2. The results indicate that the range of released growth factors is limited to a distance of approximately 100 μm and that the sequence of early release of BMP2 followed by VEGF165 promotes peri-implant bone formation and peri-implant angiogenesis, which is in contrast to the current understanding of the temporal patterns of growth factor release for enhancement of bone formation. Full article

Objective: This study aims to investigate the mechanical behavior of titanium (Ti6Al4V) mini-implants (MIs) under varying orthodontic forces using finite element analysis (FEA) and to evaluate their performance and durability under realistic clinical conditions. Optimal orthodontic forces significantly influence the structural integrity and functional longevity of MIs while minimizing adverse effects on surrounding bone tissues. Materials and Methods: A commercially available MI (diameter: 2.0 mm, length: 12 mm) was modeled using FEA. The mandible geometry was obtained using computed tomography (CT) scanning, reconstructed in 3D using SpaceClaim software 2023.1, and discretized into 10-node tetrahedral elements in ANSYS Workbench. Material properties were assigned based on the existing literature, and the implant–bone interaction was simulated using a nonlinear frictional contact model. Orthodontic forces of 2 N and 10 N, inclined at 30°, were applied to simulate clinical loading conditions. Total displacement, von Mises stresses, equivalent strains, fatigue life, and safety factors were analyzed to assess the implant’s mechanical performance. Results: At 2 N, the MI demonstrated minimal displacement (0.0328 mm) and sustained approximately 445,000 cycles under safe fatigue loading conditions, with a safety factor of 4.8369. At 10 N, the implant’s lifespan was drastically reduced to 1546 cycles, with significantly elevated stress (6.468 × 10⁵ MPa) and strain concentrations, indicating heightened risks of mechanical failure and bone damage. The findings revealed the critical threshold beyond which orthodontic forces compromise implant stability and peri-implant bone health. Conclusions: This study confirms that maintaining orthodontic forces within an optimal range, approximately 2 N, is essential to prolong MI lifespan and preserve bone integrity. Excessive forces, such as 10 N, lead to a rapid decline in durability and increased risks of failure, emphasizing the need for calibrated force application in clinical practice. These insights provide valuable guidance for enhancing MI performance and optimizing orthodontic treatment outcomes. Full article

Temporary anchorage devices (TADs) are orthodontic mini-implants with remarkable characteristics that, once inserted, present mechanical retention (primary stability) without the process of bone osseointegration. However, interaction with the biological environment may cause changes in the morphology of the external surface of dental TADs. In this study, we used 17 TADs made of aluminum–vanadium titanium alloy, produced by two companies, which were analyzed through optical microscopy after being removed from the patients during orthodontic treatment. We evaluated the changes that appeared on the TADs’ surfaces after their use in the biological environment, depending on the morphological area in which they were inserted. In our study, we found changes in the morphology of the implant surface, and especially deposits of biological material in all study groups. On all samples examined after clinical use, regardless of the period of use, corrosion surfaces in different locations were observed. Our obtained results support the idea that the biological environment is aggressive for mini-implant structures, always producing changes to their surface during their clinical use. Full article

In the field of biomaterials for prosthetic reconstructive surgery, there is the lack of advanced innovative methods to investigate the potentialities of smart biomaterials before in vivo tests. Despite the complex osteointegration process being difficult to recreate in vitro, this study proposes an advanced in vitro tissue culture model of osteointegration using human bone. Cubic samples of trabecular bone were harvested, as waste material, from hip arthroplasty; inner cylindrical defects were created and assigned to the following groups: (1) empty defects (CTRneg); (2) defects implanted with a cytotoxic copper pin (CTRpos); (3) defects implanted with standard titanium pins (Ti). Tissues were dynamically cultured in mini rotating bioreactors and assessed weekly for viability and sterility. After 8 weeks, immunoenzymatic, microtomographic, histological, and histomorphometric analyses were performed. The model was able to simulate the effects of implantation of the materials, showing a drop in viability in CTR+, while Ti appears to have a trophic effect on bone. MicroCT and a histological analysis supported the results, with signs of matrix and bone deposition at the Ti implant site. Data suggest the reliability of the tested model in recreating the osteointegration process in vitro with the aim of reducing and refining in vivo preclinical models. Full article

The aim of this study was to assess the multi-phasic use of extracorporeal shock wave therapy (ESWT) as an adjuvant treatment to accelerate the osseointegration of titanium dental implants. Initially, twelve titanium mini-screws were inserted in femur bones of six New Zealand rabbits in three groups; the one-time treated group, the three-time treated group, and the control group (without ESWT). Then, 1800 focused shockwaves with an energy flux density of 0.3 mJ/mm² in every phase were used. Fourteen days after the last phase of ESWT, the animals were sacrificed to assess the osseointegration of screws via micro-computed tomography scan (micro-CT scan), biomechanical pull-out test, and histopathological analysis. Pull-out and histopathology analysis showed that the ESWT significantly increased bone regeneration and osseointegration around the implants compared to the control group (p < 0.05). Moreover, the pull-out test confirmed that the three-time treated screws needed more force to pull the bone out compared to the other two groups (p < 0.05). The mean bone volume fraction between the control group, the one-time treated group, and the three-time treatment group were not statistically significant (p > 0.05) according to the micro-CT scan results. Based on our results, ESWT can be suggested as a non-invasive and cost-effective adjuvant for osseointegration of dental implants. However, more in vivo studies and clinical trials are needed for validation of this finding. Full article

Titanium mini-implants are used as anchorage for orthodontic tooth movements. However, these implants present problems due to the infection of surrounding tissues. The aim of this work was to obtain a polyethylene glycol (PEG) layer by plasma in order to achieve a bacteriostatic surface. Titanium surfaces were activated by argon plasma and, after, by PEG plasma with different powers (100, 150 and 200 W) for 30 and 60 min. The roughness was determined by white light interferometer microscopy and the wettability was determined by the contact angle technique. Surface chemical compositions were characterized by X-ray photoelectron spectroscopy (XPS) and cytocompatibility and cell adhesion studies were performed with fibroblast (hFFs) and osteoblast (SAOS-2) cells. Bacterial cultures with Spectrococcus Sanguinis and Lactobacillus Salivarius were performed, and bacterial colonization was determined. The results showed that plasma treatments do not affect the roughness. Plasma makes the surfaces more hydrophilic by decreasing the contact angles from 64.2° for titanium to 5.2° for argon-activated titanium, with values ranging from 12° to 25° for the different PEG treatments. The plasma has two effects: the cleaning of the surface and the formation of the PEG layer. The biocompatibility results were, for all cases, higher than 80%. The polymerization treatment with PEG reduced the adhesion of hFFs from 7000 to 6000 and, for SAOS-2, from 14,000 to 6500, for pure titanium and those treated with PEG, respectively. Bacterial adhesion was also reduced from 600 to 300 CFU/mm² for Spetrococcuns Sanguinis and from 10,000 to 900 CFU/mm² for Lactobacillus Salivarius. The best bacteriostatic treatment corresponded to PEG at 100 W and 30 s. As a consequence, the PEG coating would significantly prevent the formation of bacterial biofilm on the surface of titanium mini-implants. Full article

The current study aimed to perceive and estimate the distribution of stress generated by the forces on the maxillary anterior teeth during orthodontic retraction using the bilateral mini screw implant. Finite element models were generated from the three-dimensional (3D) reconstruction of the maxillary arch via cone–beam computed tomography (CBCT). These models imitate the retraction of maxillary anterior teeth with the mini screw placed as the skeletal anchorage. The titanium mini screw of 1.3 mm × 8 mm dimension was placed at a height of 9 mm between the first molar and second premolar on both sides of the maxilla. A nickel titanium (NiTi) coil spring of 9 mm length was attached from the mini screw implant to the power arm which generated a force of 250 gm/side. Two different power arms were placed between the lateral incisor and canine at a height of 4 mm (group 1) and 8 mm (group 2), respectively. There were no significant differences observed when the stress values were compared to the left side and the right side in group 1 with a power arm of 4 mm. In group 2, the stresses around the lateral incisors were found to be on the higher side when compared with the central incisors and canines. The length of the power arm shows no significant difference in stress distribution pattern on the left and right sides except for stresses moving from the canine region to the lateral incisor region with the increase in power arm height. Full article

Orthodontic implants have been developed for the implementation of skeletal anchorage and are effectively used in the design of individual orthodontic devices. However, despite a significant amount of clinical research, the biomechanical aspects of the use of skeletal anchorage have not been adequately studied. The aim of this work was to numerically investigate the stress–strain state of the developed palatal orthodontic device supported by mini-implants. Four possible options for the placement of mini-implants in the bone were analyzed. The effect of a chewing load of 100 N on the bite plane was investigated. The study was carried out using biomechanical modeling based on the finite element method. The installation of the palatal orthodontic device fixed on mini-implants with an individual bite plane positioned on was simulated. The dependence of equivalent stresses and deformation changes on the number and location of the supporting mini-implants of the palatal orthodontic device was investigated. Two materials (titanium alloy and stainless steel) of the palatal orthodontic device were also investigated. The choice of a successful treatment option was based on the developed biomechanical criteria for assessing the surgical treatment success. Application of the criteria made it possible to estimate the stability and strength of fixation of each of the considered mini-implants installation options. As a result, options for the mini-implants optimal placement were identified (the first and the fourth which provide distributed front and side support of the device), as well as the preferred material (titanium alloy) for the manufacture of the palatal orthodontic device. Full article