Osteointegration of Tissue-Level Implants With Very Low Insertion Torque in Soft Bone: A Clinical Study on SLA Surface Treatment.

INTRODUCTION: Evidence shows lower percentage of osteointegration when implants are placed without sufficient primary stability. The present work tested the hypothesis that implants unstable at insertion could achieve osteointegration with proper implant surface treatment. MATERIALS AND METHODS: Eleven Straumann tissue-level implants with sandblasted, large-grit, acid-etched (SLA) surface treatment were placed in soft bone unfavorable to primary stability, as indicated by insertion torque lower than 10 N/cm and slight mobility on the application of a lateral load of 250 g. After 4 to 6 months of healing, a reverse torque of 35 Ncm was applied to assess osteointegration. RESULTS: All implants appeared to be clinically osseointegrated and were successfully restored and loaded with fixed partial dentures or single crowns. After 28.5 months, all implants remained functional. CONCLUSIONS: Within the limitations of the low number of implants analyzed, it can be concluded that tissue-level implants with sand-blasted and acid-etched surface treatment can achieve osteointegration, even in the absence of primary stability.

Standard Drilling Versus Ultrasonic Implant Site Preparation: A Clinical Study at 4 Weeks After Insertion of Conical Implants.

OBJECTIVE: Clinically evaluate implants placed after ultrasonic implant site preparation (UISP) and standard drilling (SD). MATERIALS AND METHODS: Ten patients received 21 implants placed using UISP (n = 11) or SD (n = 10). Bone quality was hand assessed and final insertion torque (IT), resonance frequency analysis (ISQ) at baseline and ISQ, and removal torque values (RTV) at 4 weeks were recorded and compared. RESULTS: Mean IT values were 70.91 and 72.40 N/cm in UISP and SD groups, respectively, and were not statistically different. IT significantly correlated to bone quality. Mean ISQ values at baseline and 4 weeks were not significantly different and were 74.72 and 74.73 for UISP and 76.70 and 73.20 for SD, respectively. Mean ISQ at baseline significantly correlated to IT values and bone quality in both groups. Mean RTV values in both UISP (51.32 N/cm) and SD (53.1 N/cm) were not significantly different but significantly correlated to IT values. All implants achieved osseointegration and were restored. CONCLUSION: Implant placement after ultrasonic preparation can be considered a predictable technique leading to clinical and biological responses similar to SD 4 weeks after insertion.

Piezosurgical treatment of crestal bone: quantitative comparison of post-extractive socket outcomes with those of traditional treatment.

OBJECTIVE: The study aimed to quantitatively compare, for the first time, the clinical outcomes of crestal bone volume resorption in sockets undergoing traditional extraction technique (TET) or piezosurgical extraction technique (PET), also considering the influence of buccal plate thickness. MATERIAL AND METHODS: In this prospective study, 19 sockets were randomly treated with TET, and 18 sockets were randomly treated with PET. Furthermore, patients were split into subgroup A, with buccal bone plate thickness (BPT) ≤1 mm, and subgroup B, with BPT>1 mm. Buccal (BCH) and palatal (PCH) cortex height, bucco-palatal ridge (BPR) width were monitored at tooth extraction and after the 4-month post-extractive period of natural healing. RESULTS: After 4 months, BCH, PCH and BPR width decreased more in the TET than in the PET group, but only the BPR decrease was statistically significant (P = 0.034) after ANOVA test. In both TET and PET groups, all B subgroup patients showed a lower decrease than A subgroup patients for both BCH, PCH and BPR, statistically significant for PCH (P = 0.019) and BPR (P < 0.001) of TET group, and BPR (P = 0.002) of PET group, after ANOVA. Both A and B subgroups of PET showed a statistically significant lower decrease than the corresponding subgroups of TET, comparing A (P = 0.005) and B (P = 0.037) subgroups for BPR, after ANOVA. CONCLUSIONS: With both thin and thick buccal plates, the piezosurgical extraction technique of teeth significantly decreases the horizontal resorption of the hard tissue ridge, but not the vertical resorption. Moreover, buccal plate thickness seems to be a key factor in post-extractive bone resorption: the thinner the buccal plate the greater the horizontal crestal bone loss.

In Vitro Biocompatibility Assessment and In Vivo Behavior of a New Osteoconductive ßTCP Bone Substitute.

OBJECTIVE: Beta-tricalcium phosphate (ßTCP) granules (OsproLife) exhibit a pure crystalline phase and a rough microporous surface for promoting cell adhesion and microsized intragranule porosity for improving wettability and resorption necessary for bone regeneration. OsproLife is a fully resorbable, space-maintaining, and osteoconductive synthetic material for the filling of bone defects. To asses OsproLife properties, a similar synthetic biomaterial, already on the market, has been chosen as reference: Cerasorb has the same chemical composition, but different crystal structure, surface morphology, and granule size. The aim of this study is to compare the properties of OsproLife and Cerasorb. METHODS: Chemical purity, composition and physical properties, in vitro cytotoxicity, and in vivo bone performance in a rabbit model were analyzed. ßTCP OsproLife granules (test) were compared with Cerasorb (control). Histological and µCT analyses were performed at 6, 12, and 56 weeks after implantation. RESULTS: ßTCP OsproLife and Cerasorb granules result to be both biocompatible and characterized by the same osteoconductivity and resorption rate. CONCLUSION: ßTCP OsproLife granules are a promising bone substitute for dental and orthopedic applications.

Surface microstructure of dental implants before and after insertion: an in vitro study by means of scanning probe microscopy.

INTRODUCTION: The surface microstructure of dental implants affects osseointegration, which makes their accurate topographic characterization important. We defined a procedure for evaluation of implant topography before (pre-) and after (post-) in vitro implantation test in bovine bone. MATERIALS AND METHODS: The apical morphology of ten implants was analyzed in pre- and post-conditions using atomic force microscopy or 3D profilometry. We extracted four topographical parameters (two amplitude, 1 spatial, and 1 hybrid) and assessed the differences by analysis of variance. RESULTS AND DISCUSSION: The implant with coating (Spline Twist MP-1 HA) was damaged. The two implants with highest pre-amplitude parameters (Pitt Easy VTPS, TLR3815) maintained their character on testing. Pitt Easy PURETEX and OT-F1 were the only nondamaged implants whose amplitude parameters increased. The surface area underwent minor changes even when the texture changed (Tri-Vent, Pitt Easy PURETEX, Exp #1). The implants that ranked the lowest in all parameters before implantation were DT4013TI, Tri-Vent, OT-F1, and Exp #2. On testing, DT4013TI showed the highest decrease in values, whereas Tri-Vent showed the highest increase in surface area. All the experimental implants showed similar topographic properties both pre- and post-test. CONCLUSION: For most implants, no major changes occurred in surface topography on implantation. The procedure applied seems promising to evaluate the degradation of implant surface on insertion.

Stage Characterization and Marginal Bone Loss Evaluation Up to 96 Months of Crestal Sinus Augmentation With Sequential Drills: A Retrospective Study.

INTRODUCTION: The 2-stage crestal approach to augment the maxillary sinus is a little-used technique. The aim of this retrospective study was to assess events characterizing stages of this technique after implant placement in the posterior maxilla with residual bone height less than 4 mm and evaluate the marginal bone loss (MBL) changes over time. MATERIAL AND METHODS: Thirty-three patients underwent unilateral sinus augmentations using the trancrestal technique with mineralized allograft. Six-months (6 m) after first surgery, if skeletal subsidence prevented insertion of a 10-mm-length implant, additional grafting was performed during implant (n = 33) insertion. Radiographs were taken before grafting (baseline), immediately after and at 6 months; immediately after and 6 months after implant placement; and at follow-up (24-96 m). RESULTS: One implant was lost (ISR = 96.97%). Of the remaining 32 patients, 14 (A group) underwent standard implant placement, whereas 18 (B group) underwent additional grafting immediately before implant placement. Given that B-group patients initially obtained lower crestal bone height after first surgery, additional grafting procedures provided greater crestal height in the B group. A significant relationship between ending (eMBL) and 6mMBL was found in both groups, with greater values in the B group. However, in both groups, eMBL was always greater if 6mMBL was greater than 0.44 mm. DISCUSSION: Results suggest a high and low skeletal-reactivity patient categorization. In both patient categories, MBL greatly depends upon 6-month values. Investigations are necessary to relate sinus size with results obtained by this 2-stage crestal approach. CONCLUSIONS: The 2-stage crestal sinus lift procedure not only provides predictable results, but also allows low skeletal-reactivity patient recovery.

Expanded vs. dense polytetrafluoroethylene membranes in vertical ridge augmentation around dental implants: a prospective randomized controlled clinical trial.

OBJECTIVE: This prospective randomized controlled trial was designed to test the performance of titanium-reinforced dense polytetrafluoroethylene (d-PTFE) membrane vs. titanium-reinforced expanded polytetrafluoroethylene (e-PTFE) membrane in achieving vertical bone regeneration, both associated with a composite grafting material. MATERIAL AND METHODS: The study enrolled 23 patients requiring bone augmentation with guided bone regeneration (GBR) procedures for placing implants in atrophic posterior mandibles (available bone height <7 mm). Implants were inserted and left to protrude from the bone level to achieve the programmed amount of vertical regeneration. Defects were filled with a composite bone graft (50% autologous bone and 50% mineralized bone allograft) and randomly covered with either an e-PTFE membrane (control) or a d-PTFE membrane (test). Membrane removal was performed after 6 months, and changes in bone height were recorded. RESULTS: Seventy-eight implants were inserted in 26 mandibular sites contextually to vertical ridge augmentation procedures. The healing period was uneventful in all sites, and the vertical defects were satisfactorily filled with a newly formed hard tissue. Mean defect fill after 6 months was 5.49 mm (SD ± 1.58) at test sites and 4.91 mm (SD ± 1.78) at control sites. The normalized data (percentage changes against baseline) did not show any statistically significant difference between test and control groups (P = NS). CONCLUSIONS: Based on the data from this study, both d-PTFE and e-PTFE membranes showed identical clinical results in the treatment of vertical bone defects around implants, using the GBR technique. The membrane removal procedure was easier to perform in the d-PTFE group than in the e-PTFE group.

A new HA/TTCP material for bone augmentation: an in vivo histological pilot study in primates sinus grafting.

OBJECTIVE: Synthetic calcium phosphate bone substitutes are widely used in sinus graft procedures due to their osteoconductive and biocompatible properties. Hydroxyapatite (HA), beta-tricalcium phosphate (ß-TCP), and HA/ß-TCP composite are the most applied materials. The aim of this study was to propose a new mineralogical formulation, HA/tetracalcium phosphate (TTCP), as biomaterial for bone regeneration in the maxillary sinus. METHODS: Sinus grafts were performed by using granules of a HA/TTCP blend and a collagen membrane. Bone response at time points of 14 and 17 weeks was histologically evaluated. RESULTS: After 14 weeks of healing, histomorphometric analysis showed the formation of new bone trabeculae among HA/TTCP granules. After 17 weeks, the bone trabeculae were thicker and HA/TTCP granules were still present. Histomorphometric analysis revealed a bone graft contact (BGC) of 64%. CONCLUSIONS: After 17 weeks from implantation, HA/TTCP synthetic bone graft performed very well as osteoconductive material: BGC was found very high, and bone volume and vital bone showed an ideal bone density for implant placement. HA/TTCP granules are accounted for to accelerate new bone formation and to reduce the time needed for the graft healing, thus achieving high quantity of the new bone formed.

Emerging potential of phototherapy in management of symptomatic oral lichen planus: A systematic review of randomised controlled clinical trials.

Phototherapy incorporating photobiomodulation therapy and antimicrobial photodynamic therapy has been utilised as antioxidants in symptomatic oral lichen planus (OLP) management; however, its role of intervention remains controversial. The aim of this systematic review of CRD42021227788 PROSPERO (an international prospective register of systematic reviews in health and social care) registration number was to oversee and determine phototherapy efficacy in patients with symptomatic OLP, identifying and bridging the literature gaps by proposing recommendations for future studies. A search strategy was developed in consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Various electronic databases were exercised to search for randomised controlled clinical trials (RCTs). Several search engines were employed to analyse a total of 177 studies of which nine included. A wide range of utilised laser and light-emitted diode wavelengths between 630 and 808 nm and irradiance ranged between 10 and 13 mW/cm2 were noted. 67% of studies reported a high risk of bias and a high heterogeneity obtained from numerical data for quantitative analysis, therefore meta-analysis was impossible to conduct. Despite inconsistency and diversity in phototherapy parameters, treatment protocols, photosensitiser (type, concentration and method of application) and outcome assessment tools, the majority of the studies showed positive results compared with standard care treatments. Hence, a necessity to perform well-designed RCTs with robust methodology is warranted, after acknowledging the current drawbacks and addressing the suggested recommendations highlighted in our review. Moreover, advanced knowledge in understanding further phototherapy-antioxidants molecular mechanistic in symptomatic OLP is required.

A new method for oral cancer biomarkers detection with a non-invasive cyto-salivary sampling and rapid-highly sensitive ELISA immunoassay: a pilot study in humans.

Introduction: Oral squamous cell carcinoma (OSCC) accounts for approximately 90% of oral malignancies and has a 5-year mortality rate close to 50%. A consistent part (70%) of all oral cancers is diagnosed at an advanced stage since available screening techniques are ineffective. Therefore, it would be urgent to improve them. The diagnostic gold standard is tissue biopsy with histological and immunohistochemical assessment. This method presents some limitations. Biopsy is invasive and the histopathological evaluation is semi-quantitative, and the absolute abundance of the target cannot be reliably determined. In addition, tissue is highly processed and may lead to loss of information of the natural state. The search for classical and new clinical biomarkers on fragments of tissue/cells collected with a cytobrush is a highly hopeful technique for early detection and diagnosis of OSCC, because of its non-invasive sampling and easy collection method. Methods: Here we analyzed cytobrush biopsies samples collected from the oral cavity of 15 patients with already diagnosed OSCC by applying an innovative high-sensitivity ELISA technique, in order to verify if this approach may provide useful information for detection, diagnosis, and prognosis of OSCC. To this end, we selected six biomarkers, already used in clinical practice for the diagnosis of OSCC (EGFR, Ki67, p53) or selected based on recent scientific and clinical data which indicate their presence or over-expression in cells undergoing transformation and their role as possible molecular targets in immunecheckpoints blockade therapies (PD-L1, HLA-E, B7-H6). Results: The selected tumor biomarkers were highly expressed in the tumor core, while were virtually negative in healthy tissue collected from the same patients. These differences were highly statistically significant and consistent with those obtained using the gold standard test clearly indicating that the proposed approach, i.e. analysis of biomarkers by a custom ELISA technique, is strongly reliable. Discussion: These preliminary data suggest that this non-invasive rapid phenotyping technique could be useful as a screening tool for phenotyping oral lesions and support clinical practice by precise indications on the characteristics of the lesion, also with a view to the application of new anti-tumor treatments, such as immunotherapy, aimed at OSCC patients.

Implant primary stability determined by resonance frequency analysis: correlation with insertion torque, histologic bone volume, and torsional stability at 6 weeks.

OBJECTIVE: To determine if resonance frequency analysis (RFA) correlated with insertion torque (IT), bone volume (BV), and clinical osseointegration at 6 weeks. MATERIALS AND METHODS: For 18 patients, BV was evaluated histologically by retrieving bone core biopsies before placement of 40 dental implants. Peak IT was recorded at implant placement, and RFA values (implant stability quotient [ISQ]) were noted at baseline, 3 weeks, and 6 weeks. Osseointegration was evaluated at 6 weeks when torquing abutments to 30 N. ISQ values were correlated with IT, BV and abutment torquing results. Data were statistically analyzed. RESULTS: ISQ values significantly decreased at 3 weeks and increased at 6 weeks. There was a significant positive correlation between BV and ISQ at baseline and at 3 weeks, but not at 6 weeks, and between ISQ and jaw location, implant diameter and IT at baseline, 3 weeks, and 6 weeks. There was a significant correlation between spinning/painful implants during abutment torquing and low ISQ, low BV, and low IT values. CONCLUSION: Correlations between BV and IT values, and ISQ suggest that RFA may indicate primary implant stability. BV, IT, and ISQ values may anticipate the degree of osseointegration at 6 weeks.

Peak insertion torque correlated to histologically and clinically evaluated bone density.

OBJECTIVE: : Establish a correlation between dental implant insertion torque (IT) and bone density. MATERIALS AND METHODS: : In 18 patients, implant site preparation was initiated using a trephine drill to retrieve a bone biopsy and completed with standard drills. Bone type was assessed during drilling according to surgeon's tactile sense. Forty implants were placed and peak IT values were recorded. Osseointegration was evaluated clinically at abutment connection. Data were analyzed using Pearson product-moment correlation coefficient. RESULTS: : All implants but one achieved osseointegration. D1 and D4 bone types were significantly assessed using tactile sense. IT values ranged from 15 to 150 Ncm with a mean value of 78.30 Ncm. Mean IT was significantly higher in D1 bone (126.67 Ncm) and lower in D4 bone (40.22 Ncm) (P value <0.0001), whereas intermediate values were noted in D2 and D3 bone with no significant difference between these bone types (P value = 0.462). Statistically significant correlation was found between bone volume and IT values (r = +0.771, P < 0.0001). No statistically significant correlation was found between implant length and/or diameter and IT in all bone densities. CONCLUSION: : Clinical assessment of bone density during drilling may be achieved in hard and soft bone but not in intermediate densities. Increasing peak IT values correlated with increasing bone volume. High IT does not seem to alter osseointegration process.

The effect of thread pattern upon implant osseointegration.

OBJECTIVES: Implant design features such as macro- and micro-design may influence overall implant success. Limited information is currently available. Therefore, it is the purpose of this paper to examine these factors such as thread pitch, thread geometry, helix angle, thread depth and width as well as implant crestal module may affect implant stability. SEARCH STRATEGY: A literature search was conducted using MEDLINE to identify studies, from simulated laboratory models, animal, to human, related to this topic using the keywords of implant thread, implant macrodesign, thread pitch, thread geometry, helix angle, thread depth, thread width and implant crestal module. RESULTS: The results showed how thread geometry affects the distribution of stress forces around the implant. A decreased thread pitch may positively influence implant stability. Excess helix angles in spite of a faster insertion may jeopardize the ability of implants to sustain axial load. Deeper threads seem to have an important effect on the stabilization in poorer bone quality situations. The addition of threads or microthreads up to the crestal module of an implant might provide a potential positive contribution on bone-to to-implant contact as well as on the preservation of marginal bone; nonetheless this remains to be determined. CONCLUSIONS: Appraising the current literature on this subject and combining existing data to verify the presence of any association between the selected characteristics may be critical in the achievement of overall implant success.

Preoperative evaluation of bone quality and bone density using a novel CT/microCT-based hard-normal-soft classification system.

PURPOSE: To obtain more objective presurgical measurements of clinical interest, this study proposes a new method of measuring and classifying bone density. MATERIALS AND METHODS: The density of bovine bone blocks of different qualities was first measured in Hounsfield units (HU) using computed tomography (CT). Next, bone cylinders corresponding to each examined area were retrieved. Bone quality was then measured by both histomorphometric microCT and by subjective evaluation of bone quality during drilling. RESULTS: A statistically significant correlation was found between CT and microCT measurements. Based on this evidence, a new method of classifying bone density/quality into three classes of clinical interest was developed: hard/dense, normal, and soft (HNS). These statistical data also enabled the creation of a formula to convert ordinary CT values expressed in HU into bone volume percentages (BV%) to objectively measure bone density based on the HNS system. CONCLUSION: Stable implant placement depends upon measurements of bone quality/density that are site-specific, objective, and quantitative. To meet these standards, this paper reports an innovative method of classifying bone quality/density and then objectively measuring bone density based on this HNS classification system, using a simple, innovative mathematical formula that converts HU values into measurements of bone volume.

Sinus grafting with magnesium-enriched bioceramic granules and autogenous bone: a microcomputed tomographic evaluation of 11 patients.

Eleven sinuses were grafted with a magnesium-enriched bioceramic bone substitute in granules (SINTlife) mixed with 10% autogenous bone retrieved from intraoral donor sites. Bone biopsies retrieved after 8 months were visually and quantitatively analyzed with microcomputed tomography (microCT). MicroCT evaluation of the grafted material was feasible, since the radiodensity of the bone substitute was different from the density of mineralized bone. MicroCT showed good integration of the graft in all treated cases. The tested bioceramic bone substitute, mixed with autogenous bone, seemed to have a positive effect in sinus grafting, with values of total mineralized tissue volume around 66%. Residual graft particles occupied 31% of the total volume of the specimen. Particles of the ceramic bone substitute seemed mainly unresorbed. MicroCT analysis evaluated several morphometric parameters, demonstrating that the newly formed bone could be used for placement and loading of implants.

Clinical osseointegration of bone level implants with conical shape and textured surface with low primary stability.

BACKGROUND: Evidence shows lower chance for osseointegration of implants without sufficient primary stability. The present retrospective study observed bone level conical screw implants with textured surface without primary stability. METHODS: Twenty-six Stark conical screw implants, with V-Blast (Vanish Blast) surface treatment were placed with low primary stability, (insertion torque lower than 10 N/cm and visible mobility at lateral load of 250 g). A soft diet was prescribed. osseointegration was assessed applying 30 Ncm of reverse torque 6 months after placement. RESULTS: The 26 implants that did not achieve primary stability still had a survival rate of 96% after the observation period and were classified as successful according with ICOI Pisa consensus conference success, survival, failure classification .96% of the implants showed clinical osteointegration and were successfully restored. After 12 months, all implants remained functional. CONCLUSIONS: It can be concluded that bone-level implants with V-Blast surface in absence of functional loading are able to achieve osteointegration, even with low primary stability.

Peri-implant Soft Tissue Management: Cairo Opinion Consensus Conference.

Peri-implant soft tissues play a role of paramount importance, not only on the esthetic appearance, but also on the maintenance and long-term stability of implants. The present report presents the conclusions from the Consensus Conference of the South European North African Middle Eastern Implantology & Modern Dentistry Association (SENAME) (4-6 November 2016, Cairo, Egypt). The conference focused on the topic of the soft tissue around dental implants, and in particular, on the influence of implant configurations on the marginal soft tissues, soft tissue alterations after immediate, early or delayed implant placement and immediate loading, the long-term outcomes of soft tissue stability around dental implants, and soft tissue augmentation around dental implants. Thirty world experts in this field were invited to take part in this two-day event; however, only 29 experts were in the final consensus voting process.

Early postoperative reactions following lateral sinus floor elevation using piezosurgery: A radiographic study.

BACKGROUND AND PURPOSE: Early postoperative reactions occur following lateral sinus floor elevation (LSFE). This article radiographically describes, quantifies, and measures these early postoperative changes inside grafted maxillary sinus area. MATERIALS AND METHODS: In 24 patients, 31 maxillary sinuses were performed using piezosurgery and grafted by bioceramic materials. Cone beam computed tomography was done preoperatively and then postoperatively, randomly, at either day 1 (n = 6), 2 (n = 11), 3 (n = 8), or 7 (n = 6) and at 6 months for all patients. Membrane thickening and subsequent swelling ratio, submucosal edema, and air bubbles inside grafted area were noted and measured. Inflammation was classified as mild, moderate, or severe. RESULTS: Preoperative mean membrane thickness was 0.75 mm then following LSFE it significantly increased at days 1, 2, 3, and 7 and was respectively 2.36, 4.14, 6.05, and 6.63 mm. Mean swelling ratio significantly increased over time and was 11.37, 13.73, 16.34 and 35.78 at days 1, 2, 3, and 7, respectively. Submucosal edema height was noted in 24 cases. It had a mean value of 3.35 mm and increased significantly with time. Inflammation inside grafted area was mild in 7, moderate in 15, and severe in 9 of the cases. It significantly increased with time. Apical air bubble was present in 19 cases and had mean dimensions of 6.6 × 4.6 mm. No inflammatory signs were noted at 6 months. CONCLUSIONS: Inflammatory reactions are always noted following LSFE and tend to increase with time reaching peak values at 7 days. All inflammatory changes significantly subsided at 6 months.

Piezoelectric implant surgery and immediate loading in the aesthetic zone.

BACKGROUND: Replacement of missing teeth in the anterior aesthetic zone has challenged clinicians with fixed, removable or implant prosthodontics. Problems have been encountered could void aesthetic and functional results. The aim of this study was to present a clinical case report in which clinician challenged a very strong aesthetic case with an innovative surgical and prosthetic approach. METHODS: A patient who presented to the authors with a maxillary central incisor that had a hopeless prognosis secondary to acute localized severe periodontitis. The patient was treated by extracting the tooth and replacing it immediately with a platform switched implant using piezoelectric surgery. The implant was then restored with an immediate, non-occlusal loading provisional restoration. RESULTS: The implant became osseointegrated and was ultimately restored with a definitive abutment and crown restoration. CONCLUSIONS: Innovative approaches could represent a valid alternative to restore patients functionally and aesthetically.

Micro-Scale Surface Patterning of Titanium Dental Implants by Anodization in the Presence of Modifying Salts.

The bone-implant interface influences peri-implant bone healing and osseointegration. Among various nano-engineering techniques used for titanium surface modification, anodization is a simple, high-throughput and low-cost process, resulting in a nanoporous oxide coating which can promote osseointegration and impart antimicrobial and immunomodulatory properties. We anodized rounded tip dental implants of commercial grade titanium in aqueous phosphoric acid modified with calcium and potassium acetate, and characterized the resulting surface morphology and composition with scanning electron microscopy and energy dispersive spectrometry. The appearance of nanopores on these implants confirmed successful nanoscale morphology modification. Additionally, the metal cations of the used salts were incorporated into the porous coating together with phosphate, which can be convenient for osseointegration. The proposed method for surface nanostructuring of titanium alloy could allow for fabrication of dental implants with improved biocompatibility in the next stage of research.