Effect of controlled surface roughness and biomimetic coating on titanium implants adhesion to the bone: An experiment animal study.

Introduction: Laser micromachining of titanium and its alloys can create micro-grooves with sizes similar to cell diameter of about 10 µm. Its coating with arginine-glycine-aspartic acid (RGD) may enhance cellular spreading and adhesion. This study aimed to evaluate the effect of laser micro-grooving and laser micro-grooving combined with RGD coating on the strength of the dental implants/bone interface using destructive mechanical pullout testing in experimental animals. Materials and methods: In this study, the test groups consisted of 1.5-mm diameter, 5-mm long laser-grooved and laser-grooved/RGD coated titanium alloy (Ti-6Al-4 V) rods, and the control group included plain titanium alloy (Ti-6Al-4 V) rods. These rods were implanted in the mandibles of New Zealand white rabbits for 2, 4, and 6 weeks. After sacrifice, the test and control specimens were retrieved for mechanical pullout testing. The DMA 7-e was used to pull the titanium rods out of the bone, the probe position was plotted versus time graph to monitor the test progression, and the static modulus versus time graph was viewed; such graphs was then transformed into tables. The results were analyzed using the Mann-Whitney test. Results: The laser-grooved/RGD coated rods had significantly higher pull-out strength than the laser-grooved and control rods. Additionally, the laser-grooved rods had significantly higher pull-out strength than control rods. Conclusion: Two novel surface treatments were used: laser micro-grooving and tri peptide RGD coating, both of which had different effects on the dental implant interface. Laser grooving improved peri-implant bone healing, whereas RGD coating facilitated earlier bone-implant adhesion and better mineralization.

Effect of full arch two scanning techniques on the accuracy of overdenture conventional and CAD/CAM Co-Cr bars.

This work evaluates the internal and marginal adaptation of implant-assisted overdenture cobalt-chromium (Co-Cr) bars manufactured using conventional as well as CAD/CAM subtractive and selective laser melting (SLM) utilizing two scanning techniques. METHODS: An edentulous study model containing four dental implants placed at teeth sites 36, 33, 43, and 46 was used. The study cast was scanned and compared to the virtual casts developed from two scanning techniques, straight and zigzag motion, using the in silico superimposition process. Then, conventional techniques were used to produce full-arch bars that were compared to the bars fabricated using the two scanning techniques and CAD/CAM subtractive and additive techniques. RESULTS: The conventional impression and casting techniques had the smallest marginal gap among the groups (P-value < 0.05). The CAD/CAM subtractive milling techniques in groups II and III had significantly smaller marginal gaps than SLM technique used in groups IV and V (P-value < 0.05). The analysis of the internal gap within each group showed statistically significant differences between different implant sites in all groups (P-value < 0.001), except when using the conventional impression and casting techniques in group I (P-value = 0.20). CONCLUSION: The conventional impression and fabrication techniques were better than the digital impression and CAD/CAM subtractive and additive techniques for the fabrication of full-arch bars. However, both straight and zigzag scanning techniques and the CAD/CAM subtractive technique had marginal and internal gaps that were within clinically accepted ranges, and the SLM was found to be unsuitable for long-span framework fabrication with either scanning technique used.

The effect of osseodensification and different thread designs on the dental implant primary stability.

Background: It is difficult to achieve good primary stability of dental implants in soft bone, such as that in the posterior maxillae. Osseodensification (OD) burs, working in a non-subtractive fashion, condense the implant osteotomy bone in lateral direction and increase in the bone implant contact. Also, dental implants with deeper threads, and decreased thread pitch can increase initial bone implant anchorage. Methods: This study utilized 48 custom-made machined surface dental implants that were 13 mm long, with a major diameter of 4.5 mm and a minor diameter of 3.5 mm, a thread pitch of 1 mm, a thread depth of 0.5 mm, and a 4 mm long cutting flute at the apex.  The implants were divided into 4 groups, each group was made of 12 implants with a different thread design; V-shaped, trapezoid, buttress, and reverse buttress. The implants were inserted in 4-mm thick cancellous bone slices obtained from the head of Cow femur bone. The ostoetomies were prepared by conventional drilling and by OD drilling. Each inserted implant was then tested for primary stability using the Periotest. The Periotest values (PTVs) for the implant stability were tabulated and analyzed using a chi square test at significance level p< 0.05. Results: The results of this this study revealed no statistically significant difference between the Periotest readings for the implants in each category placed in either the OD or the regular osteotomies. However, it has been found that the implants placed in regular drilling ostoetomies had a significantly better primary stability than the implants placed in OD osteotomies. Conclusions: It was concluded that OD is not necessary in situations where there is bone of good quality and quantity.

The development of a composite bone model for training on placement of dental implants.

OBJECTIVES: It takes a lot of training on patients for both undergraduate to develop clinical sense as regards to the placement of dental implants in the jaw bones, also, the models provided by the dental implant companies for training are usually made of strengthened synthetic foams, which are far from the composition, and tactile sense provided by natural bone during drilling for clinical placement of dental implants. METHODOLOGY: This is an in-vitro experimental study which utilized bovine femur bone, where the shaft of the femur provided the surface compact layer, and the head provided the cancellous bone layer, to provide a training model similar to jaw bones macroscopic anatomy. Both the compact and cancellous bone samples were characterized using mechanical compressive testing. RESULTS: The elastic moduli of the cancellous and cortical femur bone were comparable to those of the human mandible, and the prepared training model provided a more lifelike condition during the drilling and placement of dental implants. CONCLUSION: The composite bone model developed simulated the macroscopic anatomy of the jaw bones having a surface layer of compact bone, and a core of cancellous bone, and provided a better and a more natural hands-on experience for placement of dental implants as compared to plastic models made of polyurethane.

Laser micro-grooved, Arginine-Glycine-Apspartic acid (RGD) coated dental implants, a 5 years radiographic follow-up.

OBJECTIVES: This work has utilized laser direct writing to produce 10 microns wide uniform grooves on the surface of custom made titanium (Ti-6Al-4V) dental implants, and the tri-peptide RGD coating to produce a micromechanical and a chemical union with the tissues around the implant crest module and minimize crestal bone loss. The aim of this study was to follow these implants radiographically after five years of service under a mandibular overdenture. METHODOLOGY: Standardized digital periapical radiographs and the computer software "Image J" were used to evaluate the bone density profile and vertical bone loss along the mesial and distal sides of the implants used in this study. RESULTS: The results of this study demonstrated less vertical bone loss and higher bone density profiles next to the laser microgrooved implants coated with the RGD than those only having the laser micro-grooves. CONCLUSION: The RGD coating has improved the bone density profile and reduced the vertical bone loss around the studied dental implants. However, further studies are needed to compare the effects of the laser micro-grooves versus other uniform or non uniform surface features; also, the RGD coating should be compared to other biomimetic surface coating materials.