Esthetic evaluation of single implant restorations, adjacent single implant restorations, and implant-supported fixed partial dentures: A 1-year prospective study.

BACKGROUND: Peri-implant soft tissues esthetics varies and depends on the restoration type such as implant-supported single crowns, adjacent multiple single crowns, and fixed partial dentures (FPD). PURPOSE: The aim of this prospective study was to assess the esthetic outcome of the peri-implant soft tissues of (NobelBiocare™) implant-supported single crowns, adjacent multiple single crowns, and FPD. A potential association between the esthetic risk profile and the esthetic outcome was assessed. MATERIALS AND METHODS: Between 03/11 and 03/17, 300 NobelActive implants were installed in 153 partially edentulous patients. Prior to the fabrication of the final restoration, the esthetic risk profile (ERP) of the patient was determined. The pink esthetic score (PES) and white esthetic score (WES) were assessed by three investigators at 6 and 12 months post-insertion of the final restoration. Patients' appreciation was assessed on a visual analogue scale (VAS) at the 1-year follow-up. RESULTS: The clinical acceptable limit for PES (≥6) was achieved in 56% to 68% of the single crowns at 6 and 12 months, respectively. Clinically unacceptable PES scores were recorded for 48% of the adjacent multiple single crowns and 63% of the FPDs at both time points. The association of a high ERP with WES and PESWES was noticed for single implant-supported crowns. For the latter restoration type, a ≤5 mm distance between the crestal bone level and the proximal contact positively influenced the PES and combined PESWES scores. No correlation was found between PES or WES and patient satisfaction. Mesial papilla formation was more pronounced compared to the distal one for the single implant crowns and for implant-supported FPD. CONCLUSION: When high esthetic demands are expected, assessment of ERP prior to implant treatment is advised in order to estimate a realistic outcome.

Controlled release of chlorhexidine from a mesoporous silica-containing macroporous titanium dental implant prevents microbial biofilm formation.

Roughened surfaces are increasingly being used for dental implant applications as the enlarged contact area improves bone cell anchorage, thereby facilitating osseointegration. However, the additional surface area also entails a higher risk for the development of biofilm associated infections, an etiologic factor for many dental ailments, including peri-implantitis. To overcome this problem, we designed a dental implant composed of a porous titanium-silica (Ti/SiO2) composite material and containing an internal reservoir that can be loaded with antimicrobial compounds. The composite material consists of a sol-gel derived mesoporous SiO2 diffusion barrier integrated in a macroporous Ti load-bearing structure obtained by powder metallurgical processing. The antimicrobial compounds can diffuse through the porous implant walls, thereby reducing microbial biofilm formation on the implant surface. A continuous release of µM concentrations of chlorhexidine through the Ti/SiO2 composite material was measured, without initial burst effect, over at least 10 days and using a 5 mM chlorhexidine solution in the implant reservoir. Metabolic staining, CFU counting and visualisation by scanning electron microscopy confirmed that Streptococcus mutans biofilm formation on the implant surface was almost completely prevented due to chlorhexidine release (preventive setup). Moreover, we demonstrated efficacy of released chlorhexidine against mature Streptococcus mutans biofilms (curative setup). In conclusion, we provide a proof of concept of the sustained release of chlorhexidine, one of the most widely used oral antiseptics, through the Ti/SiO2 material thereby preventing and eradicating biofilm formation on the surface of the dental implant. In principle, our flexible design allows for the use of any bioactive compound, as discussed.

Can the alendronate dosage be altered when combined with high-frequency loading in osteoporosis treatment?

Alendronate therapy has been associated with serious side effects. Altering the alendronate concentration and combining with high-frequency loading as mechanical intervention was explored in this animal study as a treatment for osteoporosis. The bone anabolic potency of high-frequency loading was overruled by the different alendronate dosages applied in the present study. Further exploration of reduced hormonal therapy associated with mechanical interventions in osteoporosis treatment should be sought. INTRODUCTION: The aim of the present study was to investigate the effect of alendronate (ALN) administration at two different dosages, associated or not with high-frequency (HF) loading, on the bone microstructural response. METHODS: Sixty-four female Wistar rats were used, of which 48 were ovariectomized (OVX) and 16 were sham-operated (shOVX). The OVX animals were divided into three groups: two groups were treated with alendronate, at a dosage of 2 mg/kg (ALN(2)) or at a reduced dosage of 1 mg/kg (ALN(1)) three times per week. A third OVX group did not receive pharmaceutical treatment. All four groups were mechanically stimulated via whole body vibration (WBV) at HF (up to 150 Hz) or left untreated (shWBV). ALN and HF were administered for 6 weeks, starting at 10-week post-(sh)OVX. Tibia bone structural parameters were analyzed using ex vivo microcomputed tomography. RESULTS: Trabecular bone loss and structural deterioration resulting from ovariectomy were partially restored by ALN administration, demonstrated by the improvement of trabecular patter factor (Tb.Pf), trabecular separation (Tb.Sp), and structure model index (SMI) of the ALN groups compared to that of the OVX group, regardless of the applied dosage [ALN(2) or ALN(1)] or mechanical loading regime (shWBV or WBV). However, a significant positive effect of the ALN(1) administration on trabecular (decrease of Tb.Sp and SMI) and cortical bone (increase of cortical thickness) microarchitecture compared to that of the OVX status group was observed for both loading regimes was not seen for ALN(2). Furthermore, HF loading resulted in cortical bone changes, with an increased trabeculary area and endocortical perimeter. Finally, the benefits of a combined therapy of ALN with HF loading could not be discerned in the present experimental conditions. CONCLUSIONS: The bone anabolic potency of HF loading was overruled by the ALN dosages applied in the present study. Further altering the ALN dosage combined with robust mechanical stimuli needs to be considered in osteoporosis research and eventually therapy.

Changes in bone macro- and microstructure in diabetic obese mice revealed by high resolution microfocus X-ray computed tomography.

High resolution microfocus X-ray computed tomography (HR-microCT) was employed to characterize the structural alterations of the cortical and trabecular bone in a mouse model of obesity-driven type 2 diabetes (T2DM). C57Bl/6J mice were randomly assigned for 14 weeks to either a control diet-fed (CTRL) or a high fat diet (HFD)-fed group developing obesity, hyperglycaemia and insulin resistance. The HFD group showed an increased trabecular thickness and a decreased trabecular number compared to CTRL animals. Midshaft tibia intracortical porosity was assessed at two spatial image resolutions. At 2 µm scale, no change was observed in the intracortical structure. At 1 µm scale, a decrease in the cortical vascular porosity of the HFD bone was evidenced. The study of a group of 8 week old animals corresponding to animals at the start of the diet challenge revealed that the decreased vascular porosity was T2DM-dependant and not related to the ageing process. Our results offer an unprecedented ultra-characterization of the T2DM compromised skeletal micro-architecture and highlight an unrevealed T2DM-related decrease in the cortical vascular porosity, potentially affecting the bone health and fragility. Additionally, it provides some insights into the technical challenge facing the assessment of the rodent bone structure using HR-microCT imaging.

Mechanical competence of ovariectomy-induced compromised bone after single or combined treatment with high-frequency loading and bisphosphonates.

Osteoporosis leads to increased bone fragility, thus effective approaches enhancing bone strength are needed. Hence, this study investigated the effect of single or combined application of high-frequency (HF) loading through whole body vibration (WBV) and alendronate (ALN) on the mechanical competence of ovariectomy-induced osteoporotic bone. Thirty-four female Wistar rats were ovariectomized (OVX) or sham-operated (shOVX) and divided into five groups: shOVX, OVX-shWBV, OVX-WBV, ALN-shWBV and ALN-WBV. (Sham)WBV loading was applied for 10 min/day (130 to 150 Hz at 0.3g) for 14 days and ALN at 2 mg/kg/dose was administered 3x/week. Finite element analysis based on micro-CT was employed to assess bone biomechanical properties, relative to bone micro-structural parameters. HF loading application to OVX resulted in an enlarged cortex, but it was not able to improve the biomechanical properties. ALN prevented trabecular bone deterioration and increased bone stiffness and bone strength of OVX bone. Finally, the combination of ALN with HF resulted in an increased cortical thickness in OVX rats when compared to single treatments. Compared to HF loading, ALN treatment is preferred for improving the compromised mechanical competence of OVX bone. In addition, the association of ALN with HF loading results in an additive effect on the cortical thickness.

Single and combined effect of high-frequency loading and bisphosphonate treatment on the bone micro-architecture of ovariectomized rats.

UNLABELLED: Mechanical loading at high frequency affects bone. Whether this also applies to osteoporotic bone, combined or not with bisphosphonate therapy, was investigated in this animal study through imaging. An anabolic effect of high-frequency loading on osteoporotic bone, however non-synergistic with bisphosphonates, was found, thereby revealing its potential for treatment of osteoporosis. INTRODUCTION: In an effort to elucidate the effect of high-frequency (HF) loading on bone and to optimize its potential for treatment osteoporosis, this study aimed to investigate the effect of HF loading via whole body vibration (WBV), alone or in association with bisphosphonate treatment (alendronate--ALN), on the micro-architecture of ovariectomy (OVX)-induced compromised bone. METHODS: Eighty-four female Wistar rats were ovariectomized (OVX) or sham-operated (shOVX). OVX animals were treated either with ALN (3 days/week at a dose of 2 mg/kg) or with saline solution. Each group (shOVX, OVX, ALN) was further divided into subgroups relative to the loading status (sham-WBV versus WBV) and the duration of experimental period (4 days versus 14 days). (Sham)WBV loading was applied for 10 min/day using 10 consecutive steps of HF loading (130, 135, 140, 145, 150, 130, 135, 140, 145, 150 Hz). Tibial bone structural responses to WBV and/or ALN treatment were analyzed using ex vivo micro-computed tomography. RESULTS: The animal's hormonal status displayed a major impact on the trabecular and cortical bone structural parameters. Furthermore, mechanical treatment with HF WBV increased the cortical thickness and reduced the medullar area in OVX rats. However, OVX trabecular bone was not affected by HF stimuli. Finally, ALN prevented OVX-associated bone loss, but the association of ALN with WBV did not lead to a synergistic bone response in OVX bone. CONCLUSIONS: HF WBV mechanical stimulation displayed an anabolic effect on osteoporotic cortical bone, confirming its therapeutic properties for enhancing compromised bone. Additionally, its association with bisphosphonates' administration did not produce any additive effect on the bone micro-architecture in the present study.

High-frequency loading positively impacts titanium implant osseointegration in impaired bone.

UNLABELLED: High-frequency loading via whole body vibration promotes bone formation and increases bone strength. Whether this translates to positive titanium implant osseointegration in osteoporotic bone was explored in this animal study. An anabolic effect of not only bisphosphonate treatment but also high-frequency loading on implant osseointegration in osteoporotic bone was observed. INTRODUCTION: The present study investigated the impact of high-frequency (HF) loading, applied via whole body vibration (WBV), on titanium implant osseointegration in healthy versus ovariectomy-induced compromised versus pharmacologically treated compromised bone. METHODS: A custom-made Ti implant was inserted into the metaphyseal tibia of 59 rats and left to heal for either 4 or 14 days. Rats were divided into six groups according to their hormonal and mechanical status. WBV, consisting of 10 consecutive frequency steps at an acceleration of 0.3 g, was applied daily for either 4 or 14 days. Tissue samples were processed for quantitative histology at the tibial cortical and medullar level. Data were analyzed by three-way ANOVA and by post hoc pairwise comparisons. RESULTS: The bone healing response at the interface and surrounding titanium implants was negatively influenced by osteoporotic bone conditions, mainly at the trabecular bone level. Furthermore, the administration of bisphosphonates for preventing the ovariectomy-induced impaired peri-implant response was successful. Finally, the effect of HF WBV loading on the peri-implant bone healing was dependent on the bone condition and was anabolic solely in untreated osteoporotic trabecular bone when applied for an extended period of time. CONCLUSIONS: The bone healing response to implant installation is compromised in osteoporotic bone conditions, in particular at the trabecular bone compartment. Meanwhile, not only pharmacological treatment but also mechanical loading via HF WBV can exert a positive effect on implant osseointegration in this specific bone micro-environment. The peri-implant cortical bone, however, seems to be less sensitive to HF WBV loading influences.

Micro-CT analysis of the rodent jaw bone micro-architecture: A systematic review.

INTRODUCTION: Knowledge about macro- and micro-structural characteristics may improve in vivo estimation of the quality and quantity of regenerated bone tissue. For this reason, micro-CT imaging has been applied to evaluate alveolar bone remodelling, alterations of periodontal ligament thickness and cortical and trabecular bone changes in rodent jaw bones. In this paper, we provide a systematic review on the available micro-CT literature on jaw bone micro-architecture. METHODOLOGY: A detailed search through the PubMed database was performed. Articles published up to December 2013 and related to maxilla, mandible and condyle with quantitatively analysed bone micro-architectural parameters were considered eligible for inclusion. Two reviewers assessed the search results according to inclusion criteria designed to identify animal studies quantifying the bone micro-architecture of the jaw rodent bones in physiological or drug-induced disease status, or in response to interventions such as mechanical loading, hormonal treatment and other metabolic alterations. Finally, the reporting quality of the included publications was evaluated using the tailored ARRIVE guidelines outlined by Vignoletti and Abrahamsson (2012). RESULTS: Database search, additional manual searching and assessment of the inclusion and exclusion criteria retrieved 127 potentially relevant articles. Eventually, 14 maxilla, 20 mandible and 12 condyle articles with focus on bone healing were retained, and were analysed together with 3 methodological papers. Each study was described systematically in terms of subject, experimental intervention, follow-up period, selected region of interest used in the micro-CT analysis, parameters quantified, micro-CT scanner device and software. The evidence level evaluated by the ARRIVE guidelines showed high mean scores (between 18 and 25; range: 0-25), indicating that most of the selected studies are well-reported. The major obstacles identified were related to sample size calculation, absence of adverse event descriptions, randomization or blinding procedures. CONCLUSIONS: The evaluated studies are highly heterogeneous in terms of research topic and the different regions of interest. These results illustrate the need for a standardized methodology in micro-CT analysis. While the analysed studies do well according to the ARRIVE guidelines, the micro-CT procedure is often insufficiently described. Therefore we recommend to extend the ARRIVE guidelines for micro-CT studies.

The effect of loading on peri-implant bone: a critical review of the literature.

In the 90s, there was a general belief that mechanical overloading was one of the main reasons for late implant failure. This triggered research to assess the role of mechanical loading on the establishment and the maintenance of oral implant osseointegration. Animal experimental studies indeed suggested the potential detrimental effect of excessive mechanical load on peri-implant bone, although randomised or controlled clinical trials of treatment interventions of oral implants designed to study overload are lacking. The lack of quantification of so-called overload at the implant level in the intra-oral setting is one of the main shortcomings in the literature. The level of evidence of the studies on bone response to implant loading is weak and does not indicate that overload can lead to peri-implant bone loss, except in case of inflammation. Clinical and animal experimental studies on early and immediate implant loading, however, provide information on the impact of mechanical loading on the process of osseointegration. It is obvious that micromotion between the implant and host tissues compromises osseointegration. However, in case of an efficient force transfer between implant and surrounding tissues, mechanical loading might even stimulate peri-implant bone formation and therefore osseointegration.

Cephalometric assessment of craniofacial dysmorphologies in relation with Msx2 mutations in mouse.

OBJECTIVES: To determine the role of Msx2 in craniofacial morphology and growth, we used a mouse model and performed a quantitative morphological characterization of the Msx2 (-/-) and the Msx2 (+/-) phenotype using a 2D cephalometric analysis applied on micrographs. MATERIALS AND METHODS: Forty-four three-and-a-half-month-old female CD1 mice were divided into the following three groups: Msx2 (+/+) (n = 16), Msx2 (+/-) (n = 16), and Msx2 (-/-) (n = 12). Profile radiographs were scanned. Modified cephalometric analysis was performed to compare the three groups. RESULTS: Compared with the wild-type mice, the Msx2 (-/-) mutant mice presented an overall craniofacial size decrease and modifications of the shape of the different parts of the craniofacial skeleton, namely the neurocranium, the viscerocranium, the mandible, and the teeth. In particular, dysmorphologies were seen in the cochlear apparatus and the teeth (taurodontism, reduced incisor curvature). Finally contrary to previous published results, we were able to record a specific phenotype of the Msx2 (+/-) mice with this methodology. This Msx2 (+/-) mouse phenotype was not intermediate between the Msx2 (-/-) and the wild-type animals. CONCLUSION: Msx2 plays an important role in craniofacial morphogenesis and growth because almost all craniofacial structures were affected in the Msx2(-/-) mice including both intramembranous and endochondral bones, the cochlear apparatus, and the teeth. In addition, Msx2 haploinsufficiency involves a specific phenotype with subtle craniofacial structures modifications compared with human mutations.

Ultrastructural characterization of the implant interface response to loading.

Dynamic loading can affect the bone surrounding implants. For ultrastructural exploration of the peri-implant tissue response to dynamic loading, titanium implants were installed in rat tibiae, in which one implant was loaded while the contralateral served as the unloaded control. The loaded implants received stimulation either within 24 hrs after implantation (immediate loading) or after a 28-day healing period (delayed loading) for 4, 7, 14, 21, or 28 days. The samples were processed for histology and gene expression quantification. Compared with the unloaded control, bone-to-implant contact increased significantly by immediate loading for 28 days (p < .05), but not in case of delayed loading. No effect of loading was observed on the bone formation in the implant thread areas, on the blood vessel area, and on endosteal callus formation. Loading during healing (immediate) for 7 days induced, relative to the unloaded control, a 2.3-fold increase of Runx2 in peri-implant cortical bone (p < .01) without a change in the RANKL/Opg ratio. Loading after healing (delayed) for 7 days up-regulated Runx2 (4.3-fold, p < .01) as well as Opg (22.3-fold, p < .05) compared with the unloaded control, resulting in a significantly decreased RANKL/Opg ratio. These results indicate a stimulating effect of dynamic loading on implant osseointegration when applied during the healing phase. In addition, gene expression analyses revealed molecular adaptations favoring bone formation and, at the same time, affecting bone remodeling.

Overnight storage of removable dentures in alkaline peroxide-based tablets affects biofilm mass and composition.

BACKGROUND: Clinical guidelines for denture care are available, but evidence for optimal nocturnal storage is scarce. The aim of the study was to compare the role of the overnight storage state on plaque growth and composition on acrylic removable dentures. METHODS: In a parallel-group randomized controlled trial of 51 institutionalized participants, 3 denture overnight preservation methods were considered: (i) in water, (ii) dry or (iii) in water with added alkaline peroxide-based cleansing tablet. Biofilm samples were taken on day 7 (developing biofilm - dBF) and day 14 (maturing biofilm - mBF) from a mechanically uncleaned, standardized region, situated distally to the second lower premolars. Total and individual levels of selected perio-pathogenic and commensal species (n=20), and of Candida albicans were calculated by PCR. Differences between storage conditions (water/dry/tablet) and between the samples (dBF/mBF) were assessed by means of unpaired and paired t-tests respectively, with α=5%. RESULTS: Overnight denture storage with cleansing tablet significantly decreased the total bacterial level of dBF and mBF up to 13.8%. Fn, Ec, Cs, Sc, Ao and Vp counts were particularly affected by tablet care. Significant lower amounts of Candida albicans for tablet storage compared to water preservation were recorded in dBF and mBF (-69.3 ± 3.8% and -75.9 ± 3.2% respectively). The mass and pathogenicity of dBF and mBF was equal, irrespective of the overnight storage intervention. CONCLUSIONS: The use of cleansing tablets for acrylic removable denture overnight storage reduces denture biofilm mass and pathogenicity compared to dry and water preservation, and may contribute to the overall systemic health. CLINICAL SIGNIFICANCE: Evidence-based clinical guidelines for overnight storage of removable acrylic dentures are lacking. The findings of this study indicate that alkaline peroxide-based cleansing tablets decrease bacterial and Candida levels in denture biofilms in case of poor oral hygiene. This provides evidence for a clinical guideline to minimize microbial load of dentures, thereby reducing associated systemic health risks.

Silencing synaptic communication between random interneurons during Drosophila larval locomotion.

Genetic manipulation of individual neurons provides a powerful approach toward understanding their contribution to stereotypic behaviors. We describe and evaluate a method for identifying candidate interneurons and associated neuropile compartments that mediate Drosophila larval locomotion. We created Drosophila larvae that express green fluorescent protein (GFP) and a shibire(ts1) (shi(ts1)) transgene (a temperature-sensitive neuronal silencer) in small numbers of randomly selected cholinergic neurons. These larvae were screened for aberrant behavior at an elevated temperature (31-32°C). Among larvae with abnormal locomotion or sensory-motor responses, some had very small numbers of GFP-labeled temperature-sensitive interneurons. Labeled ascending interneurons projecting from the abdominal ganglia to specific brain neuropile compartments emerged as candidates for mediation of larval locomotion. Random targeting of small sets of neurons for functional evaluation, together with anatomical mapping of their processes, provides a tool for identifying the regions of the central nervous system that are required for normal locomotion. We discuss the limitations and advantages of this approach to discovery of interneurons that regulate motor behavior.

Strategies for improving the efficacy of bioengineered bone constructs: a perspective.

Bioengineered bone scaffolds are intended for use in large bone defects. Successful bone constructs should stimulate and support both the onset and the continuance of bone ingrowth. In an attempt to improve their performance and to compete with the one of autologous bone grafts, a growing symbiosis at the biological and material level is required. Recent advances have been made to further exploit the osteogenic potential of MSCs in scaffold development. Current research encompasses new strategies for reducing cell death after implantation and the manufacturing of tailored, instructive scaffolds.

Numerical simulation of bone regeneration in a bone chamber.

While mathematical models are able to capture essential aspects of biological processes like fracture healing and distraction osteogenesis, their predictive capacity in peri-implant osteogenesis remains uninvestigated. We tested the hypothesis that a mechano-regulatory model has the potential to predict bone regeneration around implants. In an in vivo bone chamber set-up allowing for controlled implant loading (up to 90 microm axial displacement), bone tissue formation was simulated and compared qualitatively and quantitatively with histology. Furthermore, the model was applied to simulate excessive loading conditions. Corresponding to literature data, implant displacement magnitudes larger than 90 microm predicted the formation of fibrous tissue encapsulation of the implant. In contradiction to findings in orthopedic implant osseointegration, implant displacement frequencies higher than 1 Hz did not favor the formation of peri-implant bone in the chamber. Additional bone chamber experiments are needed to test these numerical predictions.

Conceptual and physical object qualities contribute differently to motor affordances.

Priming studies have demonstrated that an object's intrinsic and extrinsic qualities (size, orientation) influence subsequent motor behavior thus suggesting that these object qualities 'afford' actions that are congruent with the prime. We present four experiments that aim to evaluate the relative effect of conceptual and physical object qualities on action priming. In Experiment 1 equally graspable known and unknown tools are presented as primes. In Experiment 2 the primes depict high versus low graspable unfamiliar tools, and in Experiments 3 and 4 we present simple graspable shapes versus high graspable unfamiliar or familiar tools respectively. In all experiments the (unrelated) task consists of a timed motor response to the direction of a centrally placed arrow that is superimposed on the prime. Whereas tool familiarity reveals no significant difference on reaction time (Exp 1), responses to high graspable unfamiliar tools (Exp 2) and simple graspable shapes (Exps 3 and 4) are significantly faster. We conclude that motor affordances are most readily determined by object qualities that depend on the object's physical appearance provided by visual information. Conceptual information about the stimuli, such as semantic category or stored knowledge about its function and associated movements, does not appear to produce detectable effects of action priming in this paradigm.

The influence of micro-motion on the tissue differentiation around immediately loaded cylindrical turned titanium implants.

OBJECTIVE: The aim of this study was to evaluate the effect of various degrees of implant displacement on the tissue differentiation around immediately loaded cylindrical turned titanium implants. DESIGN: The experiments were conducted in repeated sampling bone chambers placed in the tibia of 10 rabbits. Tissues could grow into the bone chambers via perforations. Due to its double structure, tissues inside the chamber could be harvested leaving the chamber intact. This allowed several experiments within the same animal. The chambers contained a cylindrical turned titanium implant that was loaded in a well-controlled manner. In each of the 10 chambers, four experiments were conducted with the following test conditions: immediate implant loading by inducing 0 (control), 30, 60 and 90 microm implant displacement, 800 cycles per day at a frequency of 1 Hz, twice a week during a period of 6 weeks. Histological and histomorphometrical analyses were performed on methylmethacrylate histological sections. An ANOVA was conducted on the dataset. RESULTS: The total tissue volume was significantly lowest in the unloaded control condition. The bone volume fraction on the other hand, was significantly larger in the unloaded and 90 microm implant displacement, compared to the 30 microm implant displacement. Bone density increased with increasing micro-motion with significantly higher values for the 60 microm- and 90 microm-test conditions compared to the unloaded situation. The chance to have bone-to-implant contact decreased in case of micro-motion at the tissues-implant interface. CONCLUSION: The magnitude of implant displacement had a statistically significant effect on the tissue differentiation around immediately loaded cylindrical turned titanium implants. Implant micro-motion had a detrimental effect on the bone-to-implant contact in an immediate loading regimen.