Dataset Information

Design and ex vivo characterization of narrow implants with custom piezo-activated osteotomy for patients with substantial bone loss.

ABSTRACT:

Objective

Bone augmentation delays implant placement and increases risks due to additional surgeries. Implant systems compatible with reduced alveolar bone volume are required. To design, manufacture, and test a non-cylindrical dental implant system using piezotomes and custom-designed matching titanium mini-implants to address the needs of patients with missing teeth and narrow jawbone.

Materials and methods

Tapered mini-implants with a rectangular cross-section (4.6 mm ×?2.1?mm) were machined with dimensions that could accommodate narrow alveolar ridges. The performance of the implants were tested in both static and fatigue cycle 30° compression tests. Tapered, rectangular cutting tools that matched the overall trapezoidal morphology of the implant were also designed. These novel tools were engineered to be compatible with commercially available piezoelectric osteotomes. Tools were optimized using finite element analysis and were manufactured accordingly and were used by a periodontal surgery team in a pork rib bone model to monitor utility of the device and ease of use.

Results

The rectangular design of the implant allows for a full occlusal load due to the larger implant flexural rigidity compared to a similar diameter mini-implant with a standard cylindrical design. During 30° compression fatigue tests, the implant tested at 340 N did not fail after 5M cycles as shown in Kaplan-Meier survival curves. Finite element analysis allowed for functional optimization of the roughing and finishing tools. In the pork rib model, these tools successfully cut trapezoidal holes that matched the dimensions of the implant.

Conclusions

The implant system here demonstrates the feasibility of a mini-implant system that has superior flexural rigidity and potentially circumvents the need for patient bone augmentation.

SUBMITTER: Wirz H

PROVIDER: S-EPMC7301390 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

Design and ex vivo characterization of narrow implants with custom piezo-activated osteotomy for patients with substantial bone loss.

Wirz Holger H Teufelhart Stefan S McBeth Christine C Gyurko Robert R Dibart Serge S Sauer-Budge Alexis A

Clinical and experimental dental research 20191231 3

<h4>Objective</h4>Bone augmentation delays implant placement and increases risks due to additional surgeries. Implant systems compatible with reduced alveolar bone volume are required. To design, manufacture, and test a non-cylindrical dental implant system using piezotomes and custom-designed matching titanium mini-implants to address the needs of patients with missing teeth and narrow jawbone.<h4>Materials and methods</h4>Tapered mini-implants with a rectangular cross-section (4.6 mm × 2.1 mm) ...[more]

PMID: 32558317

Similar Datasets

Project description:BackgroundTreating critically sized defects (CSDs) of bone remains a significant challenge in foot and ankle surgery. Custom 3D-printed implants are being offered to a small but growing subset of patients as a salvage procedure in lieu of traditional alternates such as structural allografts after the patient has failed prior procedures. The long-term outcomes of 3D-printed implants are still unknown and understudied because of the limited number of cases and short follow-up durations. The purpose of this study was to evaluate the outcomes of patients who received custom 3D-printed implants to treat CSDs of the foot and ankle in an attempt to aid surgeons in selecting appropriate surgical candidates.MethodsThis was a retrospective study to assess surgical outcomes of patients who underwent implantation of a custom 3D-printed implant made with medical-grade titanium alloy powder (Ti-6Al-4V) to treat CSDs of the foot and ankle between June 1, 2014, and September 30, 2019. All patients had failed previous nonoperative or operative management before proceeding with treatment with a custom 3D-printed implant. Univariate and multivariate odds ratios (ORs) of a secondary surgery and implant removal were calculated for perioperative variables.ResultsThere were 39 cases of patients who received a custom 3D-printed implant with at least 1 year of follow-up. The mean follow-up time was 27.0 (12-74) months. Thirteen of 39 cases (33.3%) required a secondary surgery and 10 of 39 (25.6%) required removal of the implant because of septic nonunion (6/10) or aseptic nonunion (4/10). The mean time to secondary surgery was 10 months (1-22). Multivariate logistic regression revealed that patients with neuropathy were more likely to require a secondary surgery with an OR of 5.76 (P = .03).ConclusionThis study demonstrated that 74% of patients who received a custom 3D-printed implant for CSDs did not require as subsequent surgery (minimum of 1-year follow-up). Neuropathy was significantly associated with the need for a secondary surgery. This is the largest series to date demonstrating the efficacy of 3D-printed custom titanium implants. As the number of cases using patient-specific 3D-printed titanium implant increases, larger cohorts of patients should be studied to identify other high-risk groups and possible interventions to improve surgical outcomes.Level of evidenceLevel IV, case series.

Dataset Information

Design and ex vivo characterization of narrow implants with custom piezo-activated osteotomy for patients with substantial bone loss.

Objective

Materials and methods

Results

Conclusions

Publications

Design and ex vivo characterization of narrow implants with custom piezo-activated osteotomy for patients with substantial bone loss.

Similar Datasets

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