Preoperative assessment of bone density for dental implantation: a comparative study of three different ROI methods.

BACKGROUND: Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. METHODS: Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. RESULTS: The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). CONCLUSIONS: The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. TRIAL REGISTRATION: This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study.

Analysis of mandibular molar anatomy in Taiwanese individuals using cone beam computed tomography.

Background/purpose: Before periapical surgery in the mandibular posterior teeth is performed, the thicknesses of the buccal alveolar bone wall and buccolingual root might be a critical issue. This study aimed to assess the anatomical structure of the posterior region of the mandible in Taiwanese individuals using cone-beam computed tomography (CBCT). Materials and methods: The CBCT images of 96 Taiwanese individuals (51 male and 45 female), which included 192 mandibular first molars and 192 mandibular second molars, were imported into medical imaging software to measure the buccal alveolar bone thickness and buccolingual root thickness at 3 mm above the root apex. Statistical analysis was conducted to examine the impact of tooth position, gender, and age on the anatomical position of mandibular molars. Results: The buccal alveolar bone thickness at 3 mm above the root apex of the mandibular second molar demonstrates a significantly higher value when compared to that of the first molar. Nonetheless, concerning the buccolingual root thickness, no significant differences were observed between these two teeth. In addition, the buccal alveolar bone thickness and buccolingual root thickness at 3 mm above the root apex may not be influenced by gender and age. Conclusion: The anatomical structures of the posterior region of the mandible in Taiwanese individuals exhibited variations between the mandibular first and second molars. However, these differences were not influenced by gender or age.

The Effects of Insertion Approach on the Stability of Dental Implants.

Dental implant surgery involves the insertion of a dental implant into the alveolar bone; the success of the surgery depends on the initial stability of the implant. The objective of this study was to examine the effects of dental implant insertion approaches in clinical surgery and in accordance with the standards of American Society for Testing and Materials on initial implant stability. Three insertion approaches were used for dental implant placement (Branemark Systems NobelSpeedy Groovy, Nobel Biocare AB, Gothenburg, Sweden) in two types of artificial bone-good bone (GB) and poor bone (PB). The three insertion approaches were as follows: (1) continuous rotation insertion (CRI): using a torque testing machine to continuously screw in an implant to completion and (2 and 3) intermittent rotation insertion (IRI)_90 and IRI_80: using CRI to bury an implant to 90% and 80% of its full length followed by IRI to complete the implantation, respectively. The maximum insertion torque value (ITV), periotest value (PTV), and implant stability quotient (ISQ) were measured and compared. The results indicated that bone quality and insertion approach both affected implant stability. Insertion approaches affected all three implant stability indicators differently in the GB and PB groups (p = 0.008). In GB groups, the insertion approach primarily affected ITV, whereas in PB groups, it primarily affected PTV. The effect of the insertion approach was less apparent for ISQ. Overall, in both the GB and PB groups, the implant stability for IRI_80 was greater than that for IRI_90, and the implant stability for IRI_90 was greater than that for CRI. Future in vitro studies should adopt an insertion approach that complies with the clinical practice for dental implant surgery. Dentists should adjust the timing for IRI in dental implant surgery to achieve greater initial dental implant stability.

Biomechanical Analyses of Porous Designs of 3D-Printed Titanium Implant for Mandibular Segmental Osteotomy Defects.

Clinically, a reconstruction plate can be used for the facial repair of patients with mandibular segmental defects, but it cannot restore their chewing function. The main purpose of this research is to design a new three-dimensionally (3D) printed porous titanium mandibular implant with both facial restoration and oral chewing function reconstruction. Its biomechanical properties were examined using both finite element analysis (FEA) and in vitro experiments. Cone beam computed tomography images of the mandible of a patient with oral cancer were selected as a reference to create 3D computational models of the bone and of the 3D-printed porous implant. The pores of the porous implant were circles or hexagons of 1 or 2 mm in size. A nonporous implant was fabricated as a control model. For the FEA, two chewing modes, namely right unilateral molar clench and right group function, were set as loading conditions. Regarding the boundary condition, the displacement of both condyles was fixed in all directions. For the in vitro experiments, an occlusal force (100 N) was applied to the abutment of the 3D-printed mandibular implants with and without porous designs as the loading condition. The porous mandibular implants withstood higher stress and strain than the nonporous mandibular implant, but all stress values were lower than the yield strength of Ti-6Al-4V (800 MPa). The strain value of the bone surrounding the mandibular implant was affected not only by the shape and size of the pores but also by the chewing mode. According to Frost's mechanostat theory of bone, higher bone strain under the porous implants might help maintain or improve bone quality and bone strength. The findings of this study serve as a biomechanical reference for the design of 3D-printed titanium mandibular implants and require confirmation through clinical investigations.

Biomechanical Evaluation and Factorial Analysis of the 3-Dimensional Printing Self-Designed Metallic Reconstruction Plate for Mandibular Segmental Defect.

PURPOSE: Reconstruction plates are frequently used to treat mandibular segmental defects. The aim of this study is to compare the biomechanical performance of a 3-dimensional-printed self-designed titanium alloy reconstruction plate with that of the traditional reconstruction plate in mandible reconstruction. The analyzed parameters of the self-designed reconstruction plate, including plate length (100 mm and 125 mm), plate thickness (2.1, 2.4, and 2.7 mm), and bone mass (100, 75, and 50%), were also evaluated. METHODS: An artificial mandible with anatomical geometry was used to develop the self-designed reconstructed plate. Both in vitro experiments and finite element simulations were performed for the biomechanical comparison of the self-designed and traditional reconstruction plates. In finite element analysis, 3 major muscle forces of mandible movement were set as the loading condition, and the displacement of the condyle was fixed in all directions as the boundary condition. RESULTS: The biomechanical performances (stresses in the plate and strains in bone) of the self-designed reconstruction plate were superior to those of the traditional plate. Factorial analysis indicated that plate length and thickness had significant effects on decreasing stresses of the plate and mandibular bone. CONCLUSIONS: The self-designed reconstruction plate might have a benefit to reduce the stresses/strains in plate itself and surrounding bone.

Assessment of the Retromolar Canal in Taiwan Subpopulation: A Cross-Sectional Cone-Beam Computed Tomography Study in a Medical Center.

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.

Can Male Patient's Age Affect the Cortical Bone Thickness of Jawbone for Dental Implant Placement? A Cohort Study.

Dental implants are among the most common treatments for missing teeth. The thickness of the crestal cortical bone at the potential dental implant site is a critical factor affecting the success rate of dental implant surgery. However, previous studies have predominantly focused on female patients, who are at a high risk of osteoporosis, for the discussion of bone quality and quantity at the dental implant site. This study aimed to investigate the effect of male patients' age on the crestal cortical bone of the jaw at the dental implant site by using dental cone-beam computed tomography (CBCT). This study performed dental CBCT on 84 male patients of various ages to obtain tomograms of 288 dental implant sites at the jawbone (41 sites in the anterior maxilla, 95 in the posterior maxilla, 59 in the anterior mandible, and 93 in the posterior mandible) for measuring the cortical bone thickness. A one-way analysis of variance and Scheffe's test were performed on the measurement results to compare the cortical bone thickness at implant sites in the four jaw areas. The correlation between male patient age and cortical bone thickness at the dental implant site was determined. The four jaw areas in order of the cortical bone thickness were as follows: posterior mandible (1.07 ± 0.44 mm), anterior mandible (0.99 ± 0.30 mm), anterior maxilla (0.82 ± 0.32 mm), and posterior maxilla (0.71 ± 0.27 mm). Apart from dental implant sites in the anterior and posterior mandibles, no significant correlation was observed between male patients' age and the cortical bone thickness at the dental implant site.

Biocompatibility and Microstructure-Based Stress Analyses of TiNbZrTa Composite Films.

BACKGROUND: the clinical application of orthopedic or dental implants improves the quality of the lives of patients. However, the long-term use of implants may lead to implant loosening and related complications. The purpose of this study is to deposit titanium (Ti)-niobium (Nb)-zirconium (Zr)-tantalum (Ta) alloys on the surface of Ti-6Al-4V to increase structural strength and biocompatibility for the possible future application of implants. MATERIALS AND METHODS: Ti, Nb, Zr, and Ta served as the materials for the surface modification of the titanium alloy. TiNbZr and TiNbZrTa coatings were produced using cathodic arc evaporation, and a small amount of nitrogen was added to produce TiNbZrTa(N) film. Annealing and oxidation were then conducted to produce TiNbZrTa-O and TiNbZrTa(N)-O coatings. In this study, biological tests and finite element analyses of those five alloy films, as well as uncoated Ti-6Al-4V, were performed. Human osteosarcoma cells (MG-63) and mouse fibroblast cells (L-929) were used to analyze cytotoxicity, cell viability, and cell morphology, and the bone differentiation of MG-63 was evaluated in an alkaline phosphatase experiment. Furthermore, for measuring the gene expression level of L-929, reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was conducted. The three-dimensional (3D) computational models of the coated and uncoated sample films were constructed using images of transmission electron microscopy and computer-aided design software and, then, the stress distributions of all models were evaluated by finite element analysis. RESULT: the cytotoxicity test revealed that the surface treatment had no significant cytotoxic effects on MG-63 and L-929 cells. According to the results of the cell viability of L-929, more cell activity was observed in the surface-treated experimental group than in the control group; for MG-63, the cell viability of the coated samples was similar to that of the uncoated samples. In the cell morphology analysis, both MG-63 and L-929 exhibited attached filopodia and lamellipodia, verifying that the cells were well attached. The alkaline phosphatase experiment demonstrated that the surface treatment did not affect the characteristics of early osteogenic differentiation, whereas RT-qPCR analysis showed that surface treatment can promote better performance of L-929 cells in collagen, type I, α1, and fibronectin 1. Finally, the results of the finite element analysis revealed that the coated TiNb interlayer can effectively reduce the stress concentration inside the layered coatings. CONCLUSIONS: TiNbZrTa series films deposited using cathodic arc evaporation had excellent biocompatibility with titanium alloys, particularly in regard to soft tissue cells, which exhibited an active performance. The finite element analysis verified that the TiNb interlayer can reduce the stress concentration inside TiNbZrTa series films, increasing their suitability for application in biomedical implants in the future.

Relationship between Cortical Bone Thickness and Cancellous Bone Density at Dental Implant Sites in the Jawbone.

Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to evaluate dental implant sites for (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness among four regions of the jawbone. In total, 315 dental implant sites (39 in the anterior mandible, 42 in the anterior maxilla, 107 in the posterior mandible, and 127 in the posterior maxilla) were identified in dental CBCT images from 128 patients. All CBCT images were loaded into Mimics 15.0 to measure cancellous bone density (unit: grayscale value (GV) and cortical bone thickness (unit: mm)). Differences among the four regions of the jawbone were evaluated using one-way analysis of variance and Scheffe's posttest. Pearson coefficients for correlations between cancellous bone density and cortical bone thickness were also calculated for the four jawbone regions. The results revealed that the mean cancellous bone density was highest in the anterior mandible (722 ± 227 GV), followed by the anterior maxilla (542 ± 208 GV), posterior mandible (535 ± 206 GV), and posterior maxilla (388 ± 206 GV). Cortical bone thickness was highest in the posterior mandible (1.15 ± 0.42 mm), followed by the anterior mandible (1.01 ± 0.32 mm), anterior maxilla (0.89 ± 0.26 mm), and posterior maxilla (0.72 ± 0.19 mm). In the whole jawbone, a weak correlation (r = 0.133, p = 0.041) was detected between cancellous bone density and cortical bone thickness. Furthermore, except for the anterior maxilla (r = 0.306, p = 0.048), no correlation between the two bone parameters was observed (all p > 0.05). Cancellous bone density and cortical bone thickness varies by implant site in the four regions of the jawbone. The cortical and cancellous bone of a jawbone dental implant site should be evaluated individually before surgery.

Association between Age of Menopause and Thickness of Crestal Cortical Bone at Dental Implant Site: A Cross-Sectional Observational Study.

Satisfactory host bone quality and quantity promote greater primary stability and better osseointegration, leading to a high success rate in the use of dental implants. However, the increase in life expectancy as a result of medical advancements has led to an aging population, suggesting that osteoporosis may become a problem in clinical dental implant surgery. Notably, relative to the general population, bone insufficiency is more common in women with post-menopausal osteoporosis. The objective of this study was to compare the thickness of the crestal cortical bone at prospective dental implant sites between menopausal and non-menopausal women. Prospective dental implant sites in the jawbone were evaluated in two groups of women: a younger group (<50 years old), with 149 sites in 48 women, and an older group (>50 years old) with 191 sites, in 37 women. The thickness of the crestal cortical bone at the dental implant site was measured based on each patient's dental cone-beam computed tomography images. For both groups, one-way analysis of variance and Tukey's post-test were used to assess the correlation between cortical bone thickness and the presence of implants in the four jawbone regions. Student's t-test was further used to compare differences between the older and younger groups. From the retrospective study results, for both groups, thickness of the crestal cortical bone was the highest in the posterior mandible, followed by anterior mandible, anterior maxilla, and posterior maxilla. Compared with the younger group, the older group had a lower mean thickness of the crestal cortical bone. Among the four regions, however, only in the posterior maxilla was the crestal cortical bone significantly thinner in the older group than in the younger group.

Risk Factors related to Late Failure of Dental Implant-A Systematic Review of Recent Studies.

Resolving late failure of dental implant is difficult and costly; however, only few reviews have addressed the risk factors associated with late failure of dental implant. The aim of this literature review was to summarize the influences of different potential risk factors on the incidence of late dental implant failure. The protocol of this systematic review was prepared and implemented based on the PRISMA (Preferred reporting items for systematic reviews and meta-analyses) guideline. In December 2018, studies published within the previous 10 years on late dental implant failure were selected by fulfilling the eligibility criteria and the risk factors identified in qualified studies were extracted by using a predefined extraction template. Fourteen eligible studies were assessed. The common risk factors for late failure were divided into three groups according to whether they were related to (1) the patient history (radiation therapy, periodontitis, bruxism and early implant failure), (2) clinical parameters (posterior implant location and bone grade 4) or (3) decisions made by the clinician (low initial stability, more than one implant placed during surgery, inflammation at the surgical site during the first year or using an overdenture with conus-type connection). Clinicians should be cautions throughout the treatment process of dental implant-from the initial examination to the treatment planning, surgical operation and prosthesis selection-in order to minimize the risk of late failure of dental implant.

New fixation approach for transverse metacarpal neck fracture: a biomechanical study.

BACKGROUND: Fifth metacarpal neck fracture, also known as boxer's fracture, is the most common metacarpal fracture. Percutaneous Kirschner-wire (K-wire) pinning has been shown to produce favorable clinical results. However, the fixation power of K-wires is a major concern. Plate fixation is also a surgical option, but it has the disadvantages of tendon adhesion, requirement of secondary surgery for removal of the implant, and postoperative joint stiffness. A fixation method that causes little soft tissue damage and provides high biomechanical stability is required for patients with fifth metacarpal neck fracture for whom surgical intervention is indicated. The present study proposed fixation using K-wires and a cerclage wire to treat fifth metacarpal neck fracture. The fixation power of this new method was compared with that of K-wires alone and plates. METHODS: We used a saw blade to create transverse metacarpal neck fractures in 16 artificial metacarpal bone specimens, which were then treated with four types of fixation as follows: (1) locking plate with five locking bicortical screws (LP group), (2) regular plate with five bicortical screws (RP group), (3) two K-wires (K group), and (4) two K-wires and a figure-of-eight cerclage wire (KW group). The specimens were tested by using cantilever bending testing on a material testing system. The stiffness of the four fixation types was determined by observing force-displacement curves. Finally, the Kruskal-Wallis test was adopted to process the data, and the Mann-Whitney exact test was performed to conduct paired comparison between the fixation types. RESULTS: The fixation strength levels of the four fixation approaches for treating fifth metacarpal neck fracture were ranked in a descending order of LP group (24.6 ± 5.1 N/mm, median ± interquartile range) > RP group (22.2 ± 5.8 N/mm) â‰… KW group (20.1 ± 3.2 N/mm) > K group (16.9 ± 3.0 N/mm). CONCLUSION: The fixation strength of two K-wires was significantly higher when reinforcement was provided using a figure-of-eight cerclage wire. The strength of the proposed approach is similar to that of a regular plate with five bicortical screws but weaker than that of a locking plate with the same amount of bicortical screws. Cerclage wire-integrated K-wires can be an alternative method that avoids the excessive soft tissue dissection required for plating in open reduction internal fixation for fifth metacarpal neck fracture.

Biomechanical analysis of a temporomandibular joint condylar prosthesis during various clenching tasks.

The objective of this study was to evaluate the effect of clenching tasks on the stress and stability of a temporomandibular joint (TMJ) condylar prosthesis, as well as on the stress and strain in the whole mandible and bone surrounding three screws. Three-dimensional finite element models of the mandible and a TMJ condylar prosthesis using three screws were established. Six static clenching tasks were simulated in this study: incisal clench (INC), intercuspal position (ICP), right unilateral molar clench (RMOL), left unilateral molar clench (LMOL), right group function (RGF), and left group function (LGF). Based on the simulation of the six clenching tasks, none of the inserted screws or the TMJ condylar prosthesis were broken. In addition, the stability of the TMJ condylar prosthesis was sufficiently high for bone ongrowth. For the whole mandibular bone, the maximum von Mises stress and von Mises strain observed in the cortical bone and cancellous bone were yielded by the ICP and RMOL, respectively. For the bone surrounding the inserted screws, the maximum von Mises stress and von Mises strain in both the cortical bone and cancellous bone were yielded by the LMOL. Clenching tasks had significant effects on the stress distribution of the TMJ condylar prosthesis, as well as on the stress and strain distribution of the whole mandible and the bone surrounding the inserted screws.

Biological characteristics of the MG-63 human osteosarcoma cells on composite tantalum carbide/amorphous carbon films.

Tantalum (Ta) is a promising metal for biomedical implants or implant coating for orthopedic and dental applications because of its excellent corrosion resistance, fracture toughness, and biocompatibility. This study synthesizes biocompatible tantalum carbide (TaC) and TaC/amorphous carbon (a-C) coatings with different carbon contents by using a twin-gun magnetron sputtering system to improve their biological properties and explore potential surgical implant or device applications. The carbon content in the deposited coatings was regulated by controlling the magnetron power ratio of the pure graphite and Ta cathodes. The deposited TaC and TaC/a-C coatings exhibited better cell viability of human osteosarcoma cell line MG-63 than the uncoated Ti and Ta-coated samples. Inverted optical and confocal imaging was used to demonstrate the cell adhesion, distribution, and proliferation of each sample at different time points during the whole culture period. The results show that the TaC/a-C coating, which contained two metastable phases (TaC and a-C), was more biocompatible with MG-63 cells compared to the pure Ta coating. This suggests that the TaC/a-C coatings exhibit a better biocompatible performance for MG-63 cells, and they may improve implant osseointegration in clinics.

Microcomputed tomography analysis of particular autogenous bone graft in sinus augmentation at 5 months: differences on bone mineral density and 3D trabecular structure.

OBJECTIVES: This study investigated the effects of gender on the three-dimensional (3D) bone mineral density (BMD) and micromorphology of the trabeculae of matured autogenous bone grafts after sinus floor augmentation, and compared them to those of adjacent native bone. MATERIALS AND METHODS: Ten bone biopsy samples were removed from the implant placement areas of patients who had received second-stage sinus floor augmentation, and analyzed by microcomputed tomography. BMD phantoms with two calcium hydroxyapatite densities (0.25 and 0.75 g/cm(3)) were used to determine the BMD of the grafted and native bone samples. The 3D structural parameters of the trabeculae, including percentage of bone volume (bone volume/tissue volume, BV/TV), trabecular thickness (Tb.Th), trabecular number, trabecular separation, trabecular pattern factor (Tb.Pf), and structure model index, were analyzed between males and females and between grafted bone and native bone. RESULTS: No significant gender-specific differences in BMD and 3D trabecular structure of either native or grafted bone were found (P > 0.05). Compared to the adjacent native bone, the autogenous grafted bone exhibited lower BV/TV and Tb.Th as well as a higher Tb.Pf (P < 0.05). Additionally, there was a weak positive correlation between the Tb.Th values of grafted and native bone (R (2) = 0.58). CONCLUSIONS: In the maxillary sinus, autogenous grafted bone exhibited lower BV/TV, Tb.Th, and trabecular connectivity than the adjacent native bone. No significant gender-specific differences were found for either the BMD or 3D trabecular structure of grafted bone. CLINICAL RELEVANCE: After bone remodeling, autogenous grafted bone revealed different 3D trabecular structure as compared to native bone.

Lysyl oxidase and enhancement of cell proliferation and angiogenesis in oral squamous cell carcinoma.

BACKGROUND: Lysyl oxidase (LOX) is a copper-dependent enzyme that cross-links collagen and elastin in the extracellular matrix. LOX overexpressed in various tumors. The manner in which LOX affects tumor growth remains controversial. METHODS: Chemical treatment and gene transfection were used to induce LOX overexpression or inhibition in cell lines SAS and SVEC4-10. LOX mRNA, protein, and activity were confirmed before tube formation assay and tumorigenesis. The microvessels in the tumor section were detected by immunostaining CD31-positive endothelial cells. RESULTS: LOX overexpression and copper induction of LOX activity increased SVEC4-10 tube formation. LOX silencing and ß-aminopropionitrile inhibition of LOX activity had opposite effects. LOX overexpression increased proliferation and proliferating cell nuclear antigen expression. High LOX expression clones increased tumor size in a tumorigenesis model. The microvascular numbers were higher in LOX overexpression tumors than in control tumors. CONCLUSION: LOX can induce cell proliferation and angiogenesis in oral squamous cell carcinoma.

Relation between initial implant stability quotient and bone-implant contact percentage: an in vitro model study.

OBJECTIVE: This study evaluated the correlation between the initial stability of a dental implant, quantified as the implant stability quotient (ISQ), and the bone-implant contact percentage ( BIC%). STUDY DESIGN: Dental implants were inserted into specimens comprising an artificial cortical shell representing cortical bone and foam bone representing cancellous bone with 4 elastic moduli. Each specimen with an implant was subjected to microcomputed tomography (micro-CT) scanning, from which the 2D and 3D BIC% values were calculated. The values of the Spearman correlation coefficient (r) were calculated between the ISQ and the 2D and 3D BIC% values. RESULTS: Increasing the elasticity of the specimen enhanced the ISQ. There was statistically significant correlation between the ISQ and 3D BIC% values (r = 0.85, P < .0001). However, the correlation between ISQ and 2D BIC% values was not statistically significance (r = 0.42, P = .062). CONCLUSIONS: The initial implant stability was strongly positively correlated with the 3D BIC%.

Three-dimensional bone structure and bone mineral density evaluations of autogenous bone graft after sinus augmentation: a microcomputed tomography analysis.

OBJECTIVE: The purpose of this study was to determine the relationships and differences in three-dimensional (3D) bone mineral density (BMD) and microtrabecular structures between autogenous bone grafts and their adjacent native bone after a healing period following maxillary sinus augmentation. MATERIALS AND METHODS: Nine rod-shaped human bone biopsy samples were taken from patients receiving two-stage sinus augmentation therapy in implantation areas and analyzed using microcomputed tomography (micro-CT). Before micro-CT scanning, two BMD phantoms were placed near to the bone biopsy samples for executing BMD calculations of the grafted and native bone samples. In addition, 3D structural parameters of the trabeculae were analyzed for both the grafted and native bone, including percentage of bone volume [bone volume (BV)/tissue volume (TV)], bone-specific surface [bone surface (BS)/BV], trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation (Tb.Sp), trabecular pattern factor (Tb.Pf), and structure model index (SMI). RESULTS: No significant correlations with regard to BMD and trabecular-structure parameters were found between native bone and grafted bone; however, BS/BV and Tb.Pf were higher and Tb.Th and Tb.Sp were 37.35% and 12.74% lower in grafted bone than in native bone. For grafted bone, there were significant correlations (P < 0.05) between BMD and BV/TV, and Tb.N. CONCLUSIONS: When using autogenous bone as a graft material, BMD and micromorphological conditions of grafted bone were not influenced by the condition of the native bone in the maxilla. Differences were found in surface complexity, trabecular thickness, trabecular separation, and the connectivity of trabeculae between grafted and native bone. The BMD in grafted bone was affected by the quantity of the trabeculae.

Effect of screw fixation on temporomandibular joint condylar prosthesis.

PURPOSE: The objective of the present study was to evaluate the effect of the number of screws on the stress and stability of the temporomandibular joint (TMJ) condylar prosthesis and on the strain distribution in the bone. MATERIALS AND METHODS: Three-dimensional, finite element models of the mandible and a TMJ condylar prosthesis with fixations involving different numbers of screws in 8 configurations were established to investigate the effect of the number of fixed screws on the stress and stability of the implant and strain in cortical and cancellous bone. RESULTS: The simulations showed that increasing the number of screws beyond 3 only slightly enhanced the implant stability and reduced the implant stress. The position of the inserted screws significantly affected the strain distributions in cortical and cancellous bone tissues. CONCLUSIONS: The results of our study have shown that 3 staggered screws can provide optimal implant stability and bone stress and strain distributions in a TMJ condylar prosthesis.

Effect of bone quality on the artificial temporomandibular joint condylar prosthesis.

OBJECTIVE: This study evaluated the effect of bone quality on the stability of and stress in the artificial temporomandibular joint (TMJ) condylar prosthesis as well as on the stress and strain distributions in the bone. STUDY DESIGN: Three-dimensional finite element models of the mandible and an artificial TMJ condylar prosthesis using 3 screws were established. Four types of bone were modeled by varying the elastic modulus of cancellous bone. RESULTS: Increasing the bone quality from type IV to type I reduced the maximum relative micromotion between implant and bone, maximum von Mises stresses in the implant and surrounding cortical bone, and maximum von Mises strain in the surrounding cancellous bone by 17.5%, 10.5%, 12.0%, and 39.4%, respectively. CONCLUSION: The bone quality of the mandible has only a minor effect on the stability of and stress in an artificial TMJ implant and cortical bone, but it greatly affects the microstrain in cancellous bone.