Micro-CT Analysis of Microgap at a Novel Two-Piece Dental Implant Comprising a Replaceable Sleeve In Vitro.

PURPOSE: Microcomputed tomography (micro-CT) is a relatively new modality to investigate mechanical deformations. The purpose of this study was to assess the microgap at the implant-sleeve connection of a new two-piece dental implant with a replaceable sleeve. MATERIALS AND METHODS: Implants were assembled with 25-degree angulated abutments. Micro-CT was used to assess implant-sleeve connection gaps under the following mechanical conditions: (1) unloading; (2) compressive 10,000 cyclic loading with 400 N; (3) static compressive load of 200 N or 400 N for 24 hours. RESULTS: The mean gap in the unloaded sample was 2.9 ± 0.9 µm. The mean gap difference after cyclic compressive load was 0.3 ± 0.15 µm, demonstrating a negligible effect for the cyclic loading. Under static compressive load, there was no increase in microgap size at 200 N. At 400 N, a significant (P < .05) increase was noted. While the mean values increased by 1.9 µm, the most pronounced significant increase in mean microgap was noted in the direction of force application (5.1 ± 2.14 µm), while a significant decrease in mean microgap (1.2 ± 1.47 µm) was noted on the opposite side. CONCLUSION: The mechanical behavior of the implant-sleeve connection under static and dynamic loads was found to be within the previously reported range of implant dentistry.

A two-piece dental implant comprising a replaceable thin titanium sleeve may be a new approach to re-osseointegration following peri-implant disease.

Bacteria initiated peri-implantitis can lead to bone destruction around a dental implant, modifying its surface and preventing re-osseointegration. Consequently, all available methods for treating periimplantitis have disappointing long-term results. Implant failure will lead to loss of the prosthetic reconstruction as well. A fresh new implant surface enables re-osseointegration. Our hypothesis is that a fresh new surface replacing a contaminated implant surface may be a new treatment approach for peri-implantitis and may allow re-osseointegration. A new two-piece dental implant, having a replaceable thin titanium sleeve may be designed. The replacement of a contaminated sleeve by a fresh new sleeve will solve the peri-implant disease by removing the contaminated surface, enabling re-osseointegration and ensuring long-term stability of the implant without endangering the prosthetic reconstruction. This minimally-invasive therapy is expected to be conducted in a simple manner, by every practicing dentist, during supportive periodontal treatment, thereby facilitating the treatment of peri-implantitis.