Effect of nanoscale topography of titanium implants on bone vessel network, osteocytes, and mineral densities.

BACKGROUND: Chemical and physical properties of an implant surface have a major influence on the structure of peri-implant bone and thus may influence the clinical performance of the implant. This study aims to evaluate the bone microstructure around implants with and without added nanometer-sized calcium phosphate particles. METHODS: An implant with dual acid-etched surface (control) and an implant with dual acid-etched surface and CaP nanoparticles (test) were placed in the posterior maxilla of 15 patients. Bone microstructure was evaluated for osteocyte density (OD), bone vessel volume density (BVVD), and bone mineral density (BMD). RESULTS: BVVD was 1.806 ± 0.05 for test implants and 1.533 ± 0.10 for control implants (P <0.001). BMDlow was 17.4 × 10(4) µm(2) for test implants and 15.0 × 10(4) µm(2) for control implants (P = 0.025). Results from the BMDhigh comparison, test versus control, were not statistically significant (P >0.05). OD was 575.6 ± 63.7 mm(2) for test implants and 471.2 ± 61.9 mm(2) for control implants (P <0.001). CONCLUSIONS: After 8 weeks of healing, the bone microstructure around test implants appeared to be significantly more organized. Clinical implications of these results include shortened healing time and indication for earlier loading protocols.

Histologic and histomorphometric results of three bone graft substitutes after sinus augmentation in humans.

The aim of this study was to compare the histological behavior of three bone graft materials placed in human. The comparison was made among Bio-Oss® (BO), Engipore® (EP), and PepGen P-15® (P-15). Five biopsies for each group of biomaterial, retrieved 6 months after sinus lift augmentation, were analyzed. The investigation was carried out using light microscope (LM), scanning electron microscope (SEM) with an energy dispersive spectrometer (EDS), and circularly polarized light microscope (CPLM). Under LM, the amount of newly formed bone was significantly higher in BO than P-15 (P < .05), while the amount of residual graft material was significantly higher in P-15 than BO (P < .05). The extension of marrow spaces was significantly higher in EP than both BO and P-15 (P < .05). SEM-EDS analysis showed a Ca/P ratio of 1.8 for BO, 2.2 for EP, and 1.5 for P-15. Under CPLM, BO showed no significant difference for transverse (18.4 ± 2.7%) and longitudinal (16.3 ± 1.8%) bone collagen fibers (P = .195); EP showed a significant difference between transverse (4 ± 0.7%) and longitudinal (7.6 ± 2.5%) bone collagen fibers (P = .015); finally, P-15 showed no significant difference for transverse (3.8 ± 1.6%) and longitudinal (4.9 ± 1.2%) bone collagen fibers (P = .279). No investigated biomaterial was completely resorbed, but all the residual particles demonstrated a close bone integration to form a hybrid tissue. BO particles appeared perfectly osseointegrated in the trabecular bone. EP showed a tendency to concentrate the bone apposition into the microporosities; P-15 particles appeared bridged by newly formed bone trabeculae.

Esthetic outcome of an immediately placed maxillary anterior single-tooth implant restored with a custom-made zirconia-ceramic abutment and crown: a staged treatment.

This article describes the high esthetic value of a single-tooth implant immediately placed in the anterior region using a flapless approach and a custom-made zirconia-ceramic abutment and crown. The case reported illustrates the practical procedure involved in developing natural esthetics with a custom-made zirconia-ceramic prosthesis and abutment. The technique is relatively simple, can be used in a variety of clinical situations, and provides excellent results from an esthetic point of view, which is demonstrated by the results of pink esthetic scores (PES) (9 ± 0.2) and white esthetic scores (WES) (7 ± 0.5) after 4 years.