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      Implant stability and bone remodeling up to 84 days of implantation with an initial static strain. An in vivo and theoretical investigation

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          Abstract

          Objectives

          When implants are inserted, the initial implant stability is dependent on the mechanical stability. To increase the initial stability, it was hypothesized that bone condensation implants will enhance the mechanical stability initially and that the moderately rough surface will further contribute to the secondary stability by enhanced osseointegration. It was further hypothesized that as the healing progresses the difference in removal torque will diminish. In addition, a 3D model was developed to simulate the interfacial shear strength. This was converted to a theoretical removal torque that was compared to the removal torque obtained in vivo.

          Material and methods

          Condensation implants, inducing bone strains of 0.015, were installed into the left tibia of 24 rabbits. Non‐condensation implants were installed into the right tibia. All implants had a moderately rough surface. The implants had an implantation time of 7, 28, or 84 days before the removal torque was measured. The interfacial shear strength at different healing time was estimated by the means of finite element method.

          Results

          At 7 days of healing, the condensation implant had an increased removal torque compared to the non‐bone‐condensation implant. At 28 and 84 days of healing, there was no difference in removal torque. The simulated interfacial shear strength ratios of bone condensation implants at different implantation time were in line with the in vivo data.

          Conclusions

          Moderately rough implants that initially induce bone strain during installation have increased stability during the early healing period. In addition, the finite element method may be used to evaluate differences in interlocking capacity.

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          Most cited references14

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          Effects of titanium surface topography on bone integration: a systematic review.

          To analyse possible effects of titanium surface topography on bone integration. Our analyses were centred on a PubMed search that identified 1184 publications of assumed relevance; of those, 1064 had to be disregarded because they did not accurately present in vivo data on bone response to surface topography. The remaining 120 papers were read and analysed, after removal of an additional 20 papers that mainly dealt with CaP-coated and Zr implants; 100 papers remained and formed the basis for this paper. The bone response to differently configurated surfaces was mainly evaluated by histomorphometry (bone-to-implant contact), removal torque and pushout/pullout tests. A huge number of the experimental investigations have demonstrated that the bone response was influenced by the implant surface topography; smooth (S(a) 1-2 microm) surfaces showed stronger bone responses than rough (S(a)>2 microm) in some studies. One limitation was that it was difficult to compare many studies because of the varying quality of surface evaluations; a surface termed 'rough' in one study was not uncommonly referred to as 'smooth' in another; many investigators falsely assumed that surface preparation per se identified the roughness of the implant; and many other studies used only qualitative techniques such as SEM. Furthermore, filtering techniques differed or only height parameters (S(a), R(a)) were reported. * Surface topography influences bone response at the micrometre level. * Some indications exist that surface topography influences bone response at the nanometre level. * The majority of published papers present an inadequate surface characterization. * Measurement and evaluation techniques need to be standardized. * Not only height descriptive parameters but also spatial and hybrid ones should be used.
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            Oral implant surfaces: Part 1--review focusing on topographic and chemical properties of different surfaces and in vivo responses to them.

            This article reviews the topographic and chemical properties of different oral implant surfaces and in vivo responses to them. The article considers detailed mechanical, topographic, and physical characteristics of implant surfaces. Anchorage mechanisms such as biomechanical and biochemical bonding are examined. Osteoattraction and doped surfaces are discussed. Surface quality of an oral implant may be subdivided into mechanical, topographic, and physicochemical properties. Topographic properties are evaluated at the micrometer level of resolution. Moderately rough surfaces (Sa between 1.0 and 2.0 microm) show stronger bone responses than smoother or rougher surfaces. The majority of currently marketed implants are moderately rough. Oral implants permit bone ingrowth into minor surface irregularities-biomechanical bonding or osseointegration. Additional biochemical bonding seems possible with certain surfaces. Osteoattraction is a commercial term without precise biologic correspondence. Surfaces doped with biochemical agents such as bone growth factors have been developed. Moderately roughened surfaces seem to have some clinical advantages over smoother or rougher surfaces, but the differences are small and often not statistically significant. Bioactive implants may offer some promise.
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              Osseointegration: hierarchical designing encompassing the macrometer, micrometer, and nanometer length scales.

              Osseointegration has been a proven concept in implant dentistry and orthopedics for decades. Substantial efforts for engineering implants for reduced treatment time frames have focused on micrometer and most recently on nanometer length scale alterations with negligible attention devoted to the effect of both macrometer design alterations and surgical instrumentation on osseointegration. This manuscript revisits osseointegration addressing the individual and combined role of alterations on the macrometer, micrometer, and nanometer length scales on the basis of cell culture, preclinical in vivo studies, and clinical evidence.
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                Author and article information

                Contributors
                anders.halldin@mah.se
                Journal
                Clin Oral Implants Res
                Clin Oral Implants Res
                10.1111/(ISSN)1600-0501
                CLR
                Clinical Oral Implants Research
                John Wiley and Sons Inc. (Hoboken )
                0905-7161
                1600-0501
                14 January 2016
                October 2016
                : 27
                : 10 ( doiID: 10.1111/clr.2016.27.issue-10 )
                : 1310-1316
                Affiliations
                [ 1 ] Department of Prosthodontics, Faculty of OdontologyMalmö University MalmöSweden
                [ 2 ]DENTSPLY Implants MölndalSweden
                [ 3 ] Department of Applied MechanicsChalmers University of Technology GöteborgSweden
                Author notes
                [*] [* ] Corresponding author:

                Anders Halldin

                Department of Prosthodontics, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden

                Tel.: +46 40 665 70 00

                Fax: +46 40 92 53 59

                e‐mail: anders.halldin@ 123456mah.se

                Article
                CLR12748
                10.1111/clr.12748
                5066632
                26762885
                2995d4df-0ec3-4f35-8e5b-c68fa21d5a0d
                © 2016 The Authors. Clinical Oral Implants Research Published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 07 November 2015
                Page count
                Figures: 4, Tables: 3, Pages: 7, Words: 5394
                Funding
                Funded by: Swedish Research Council
                Award ID: 621‐2010‐4760
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                clr12748
                October 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.9.5 mode:remove_FC converted:17.10.2016

                bone condensation,implant stability,in vivo,remodeling,static strain

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