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The Failure Envelope Concept Applied To The Bone-Dental Implant System.

ABSTRACT: Dental implants interact with the jawbone through their common interface. While the implant is an inert structure, the jawbone is a living one that reacts to mechanical stimuli. Setting aside mechanical failure considerations of the implant, the bone is the main component to be addressed. With most failure criteria being expressed in terms of stress or strain values, their fulfillment can mean structural flow or fracture. However, in addition to those effects, the bony structure is likely to react biologically to the applied loads by dissolution or remodeling, so that additional (strain-based) criteria must be taken into account. While the literature abounds in studies of particular loading configurations, e.g. angle and value of the applied load to the implant, a general study of the admissible implant loads is still missing. This paper introduces the concept of failure envelopes for the dental implant-jawbone system, thereby defining admissible combinations of vertical and lateral loads for various failure criteria of the jawbone. Those envelopes are compared in terms of conservatism, thereby providing a systematic comparison of the various failure criteria and their determination of the admissible loads.

SUBMITTER: Korabi R

PROVIDER: S-EPMC5435678 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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The Failure Envelope Concept Applied To The Bone-Dental Implant System.

Korabi R R Shemtov-Yona K K Dorogoy A A Rittel D D

Scientific reports 20170517 1

Dental implants interact with the jawbone through their common interface. While the implant is an inert structure, the jawbone is a living one that reacts to mechanical stimuli. Setting aside mechanical failure considerations of the implant, the bone is the main component to be addressed. With most failure criteria being expressed in terms of stress or strain values, their fulfillment can mean structural flow or fracture. However, in addition to those effects, the bony structure is likely to rea ...[more]

PMID: 28515495

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Project description:IntroductionSandblasting is one of the oldest implant surface modifications to enhance osseointegration. Regarding its superiority over machined surface controversies still exist. Our objective was to compare implant failures (IF) and marginal bone level (MBL) changes between sandblasted and machined dental implants by a meta-analysis utilizing the available data. The PROSPERO registration number of the meta-analysis is CRD42018084190.MethodsThe systematic search was performed in Cochrane, Embase and Pubmed. Inclusion criteria included participants with neither systemic diseases, nor excessive alcohol consumption, nor heavy smoking. We calculated pooled Risk Ratio (RRs) with confidence intervals of 95% (CIs) for dichotomous outcomes (implant failure) and weighted mean difference (WMD) CIs of 95% for continuous outcomes (marginal bone level change). We applied the random effect model with DerSimonian-Laird estimation. I2 and chi2 tests were used to quantify statistical heterogeneity and gain probability-values, respectively.ResultsLiterature search revealed 130 records without duplicates. Out of these, seven studies met the inclusion criteria and all were included in data synthesis, involving 362 sand-blasted and 360 machined implants. The results indicate that there is an 80% (RR = 0.2 95% CI:0.06-0.67; I2 = 0.0% p = 0.986) lower among sandblasted compared to machined implants after one year of use and 74% (RR = 0.26 95% CI:0.09-0.74; I2 = 0.0% p = 0.968) five years of use, respectively. In contrast, there is no significant difference in MBL (WMD:-0.10mm, 95% CI:-0.20, 0.01; p>0.05; I2 = 0.0%, p = 0.560 and WMD:-0.01mm, 95% CI:-0.12, 0.09; p>0.05; I2 = 26.2%, p = 0.258) between the two implant surfaces after one and five years of use.ConclusionsThis meta-analysis reveals that sandblasting is superior over machined surface in implant failure but not in marginal bone level in healthy subjects. It also points out the need for further randomized clinical trials with large sample size for objective determination of the clinical benefits of certain implant surface modifications.

Project description:During the maintenance of bone marrow-derived mesenchymal stem cells (BMMSCs), suspended cells are discarded normally. We noted the osteogenic potential of these cells to be like that of anchorage-dependent BMMSCs. Therefore, we characterized suspended BMMSCs from rabbit bone marrow by bioengineering and applied the suspended BMMSCs to double-canaled dental implants inserted into rabbits. After primary isolation of BMMSCs, we collected the suspended cells during primary culture on the third day. The cells were transferred and maintained on an extracellular-matrix-coated culture plate. The cells were characterized and compared with BMMSCs by colony-forming-unit fibroblast (CFU-f) and cell proliferation assay, fluorescence-activated cell sorter (FACS), in vitro multipotency, and reverse transcription polymerase chain reaction (RT-PCR). We also analyzed the osteogenic potential of cells mixed with hydroxyapatite/tricalcium phosphate (HA/TCP) and transplanted into immunocompromised mice. We compared the viability and proliferation of the suspended BMMSCs and BMMSCs on the titanium implant surface and observed cell morphology. Then, the cells mixed with HA/TCP were applied to the double-canaled implants during installation into rabbit tibia. Four weeks later, we analyzed bone formation inside the canal by histomorphometry. The suspended cells showed higher CFU-f on the extracellular matrix (ECM)-coated culture plate and similar results of proliferation capacity compared with BMMSCs. The cells also showed osteogenic, adipogenic, and chondrogenic ability. The suspended cells showed levels of attachment survival and proliferation on the surfaces of titanium implant discs to be higher than or similar to those of BMMSCs. The suspended cells as well as BMMSCs showed stronger bone formation ability in both upper and lower canals of the implants compared with controls on double-canaled implants inserted into rabbit tibia. In this study, we showed that suspended cells after primary BMMSC isolation have bone regeneration capacity like that of BMMSCs, not only in vitro but also in vivo. ECM was valuable for propagation of MSCs for cell-based bone regeneration. Therefore, the suspended cells could also be useful tools for bone regeneration after implant surgery.

Project description:BackgroundDental implant failure is a critical condition that can seriously compromise therapeutic efficacy. Insufficient bone volume, unfavorable bone quality, periodontal bone loss, and systemic conditions, including osteopenia/osteoporosis and diabetes mellitus, have been associated with implant failure. Early indicators of potential implant failure could help mitigate the risk of severe complications. This study aimed to develop an effective implant outcome prediction model using dental periapical and panoramic films.MethodsA total of 248 patients (89 with failed implants and 159 with successful implants) were examined. A total of 529 periapical images and 551 panoramic images were collected from the patients for a deep learning-based model. Based on radiographic peri-implant alveolar bone pattern, implant outcome was divided into three categories: implant failure with marginal bone loss, implant failure without marginal bone loss, and implant success. We extracted features using a deep convolutional neural network (CNN) and built a hybrid model to combine periapical and panoramic images. A comparison among three categories of receiver operating characteristic (ROC) curves was performed. The diagnostic accuracy, precision, recall and F1-score of the dataset were assessed.ResultsOur model achieved an AUC (area under the ROC curve) of 0.972 for failure with marginal bone loss, 0.947 for failure without marginal bone loss and 0.975 for success. In all conditions, for periapical images alone, the diagnostic accuracy was 78.6%; the precision was 0.84, recall was 0.73, and F1-score was 0.75. For panoramic images alone, the diagnostic accuracy was 78.7%; the precision was 0.87, recall was 0.63, and F1-score was 0.66. Both periapical and panoramic images were used in our novel method, and the prediction accuracy was 87%. The precision was 0.85, recall was 0.88, and F1-score was 0.85.ConclusionsThe deep learning model used features from periapical and panoramic images to effectively predict the occurrence of implant failure and might facilitate early clinical intervention for potential dental implant failures.

Dataset Information

The Failure Envelope Concept Applied To The Bone-Dental Implant System.

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The Failure Envelope Concept Applied To The Bone-Dental Implant System.

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