4 - Zimmer Dental

Presented at the Academy of Osseointegration Annual Meeting, 2013
Valutazione dell‘assemblato Implantare Dentale 3
Background
Results
in Materiale Trabecular Metal in un modello canino di perimplantite.
Four dogs were euthanized at 24 and 38 weeks after implantation. Histological sections (one
section per dog) were obtained at necropsy at 24 & 38 weeks post implant placement (Figure 2)
and were stained with Sanderson’s rapid bone stain to assess percent bone-implant-contact
(%BIC), amount of bone formed and histopathological parameters (acute and chronic
All implants survived, control implants sh
Osseointegration (or bone ongrowth)
was described by
Suneel Battula,
PhD, Jin fibrosis,
Whan Lee,
PhD, Savvas
Papanicolaou,
Botissue
Wen, PhD,
Michael
Collins,
MS, MBA
inflammation,
evidence
of bacterial
infectionMS,
andHai
soft
in contact
with
the implant).
and test implants showed osseoincorp
Brånemark et al, as the process of living bone forming structural
%BIC was measured along Zimmer
the entire
length
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the implant
and total amount of bone formed
Dental
Inc.,
CA
histologically. All the implants in the PI gro
and functional connection with a load carrying titanium implant.1
Evaluation
of
Trabecular
Metal
Material
Implant
a
Canine
Periimplantitis
Model
was compared
due Dental
to the differences
in theAssembly
geometries of thein
implants.
Effects of
implant type
loss
of supporting tissue with progression
Osseoincorporation is the combination of bone ingrowth and bone
Presentato
al Meeting and
Annuale
dell’Accademia
di and
Osteintegrazione,
parameters
probing depth were 2013
statistically
on the histomorphometric
histopathological
the implants survived (Figure 2). PD of sha
Suneel
Battula,
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withPhD, Jin Whan Lee, PhD, Savvas Papanicolaou, MS, Hai Bo Wen, PhD, Michael Collins, MS, MBA
analyzed.
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implants was lower and statistically d
Trabecular MetalTM material Evaluation
(TM), 2,3 a cancellous-like
of Trabecular Metal
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Dental
Assembly
in
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Canine
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Model
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DentalImplant
Inc., Carlsbad,
CA
Quattro cani
sono stati sacrificati
alle settimane
24 e 38
post-impianto. Lein
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interconnected
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Suneel
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Jin
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Lee,
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PhD,
PhD,
Savvas
Savvas
Papanicolaou,
Papanicolaou,
MS,
MS,
Hai
Hai
Bo
Bo
Wen,
Wen,
PhD,
PhD,
Michael
Collins,
Collins,
MS,
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MBA
MBA
istologiche
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sezione
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alle
was significantly different from that at 30
Risultati
Premessa
studies conducted
using a TM implant in a healed site canine
Presented
atWhan
theLee,
Academy
of Osseointegration
Annual
Meeting,
2013
Suneel
Suneel
Battula,
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Jin
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Lee,PhD,
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Savvas
MS,
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mane
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e 38 post-impianto
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rapidaMichael
week
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Carlsbad, CA
CA
di euthanized
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la percentuale
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were
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and 38 weeks
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Carlsbad,CA
CA
early healing stages and level of osseointegration and stability section per dog) were obtained atZimmer
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impianti di controllo
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Results
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2.
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at
the
Academy
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Meeting,
2013
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Presented
at
the
Osseointegration
Annual
Meeting,
2013
Presented
at
the
Academy
of
Osseointegration
Annual
Meeting,
2013
sections
of
38
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sia dal punto di vista clinico che istologico.
gli impianti
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amount
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bone formed
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1
Four
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24 and
and
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38
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weeks
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after l’intera
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rali e funzionali
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All implants survived, control implants showed osseointegration
Four
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24
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è stata
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obtained
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at
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24
&
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(Figure
2)
2)
Four
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24
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Four
Fourdogs
dogs
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atat24
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and
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38weeks
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a èdental
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an
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Background
Background
Results
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as the process
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total
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2)
(b)ma
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2).
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at24
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2)
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the
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in
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group
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2,3 implant.1
and
functional
connection
with
a
load
carrying
titanium
Background
Background
Results
Results
between
the
for
Ti portions
experimentally
induced
canine
periimplantitis
model
by
comparing
con un impianto dentale con il Materiale Trabecular Metal (TM), una struttura ostemetria
degli
impianti.
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effettiinrapid
del
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sui
parametri
istomorfometrici,
was and
compared
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(%BIC),
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and
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gruppo
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e
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3). More
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statistically
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evidence
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ongrowthOsseointegration
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the
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entire
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length
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the
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implant
and
and
total
total
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of
bone
bone
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of
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and
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tissue
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the
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piego
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evidence
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in
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with
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the
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implant).
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was
measured
along
the
entire
length
of
the
implant
and
total
amount
of
bone
formed
porous
regions
along
the length of the imp
tissue response,
histomorphometry
and
risk
of
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histologically.
histologically.
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the
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implants
in
inosseoincorporation
the
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exhibited
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etetal,
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histologically.
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asthe
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alle
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e 24
eraPIsignificativamente
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the
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implant
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%BIC
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and
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%BIC
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was
was
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the
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and
and
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was
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in
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2:
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aeis
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2).
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2).
2).
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Trabecular
MetalTM
material
(TM),
2,3
aa cancellous-like
cancellous-like
settimane
model
demonstrated
active
bone
formation
inside
the
pores
at with
successo clinico
di impianti
filettati
convenzionali.
Lo
scopo
studio
era
di
valu- analyzed.
analyzed.
analyzed.
35.6%
& that
32.7%
for di
sham
& (plaPI groups
group
group
for
for both
both
24
24lower
&
&
38
38mean
week
week
groups.
groups.
The
Thedifferent
PD
PD at
at 18
18
and
and
24
24
weeks
weeks
of
implants
was
lower
and
statistically
different
from
that
ofofiPI
PI
structure
with interconnected
interconnected
porosity.
porosity.
Prior
Prior
osteoconductive
osteoconductive
structure
Trabecular
MetalTM
material
(TM),
2,3
cancellous-like
group
for
both
24
&
38
week
groups.
The
PD
at
18
and
24
weeks
of
of
implants
implants
was
lower
and
and statistically
statistically
different
from
that
of
PIwere
(a)
(b)
(c) (a) Controllo(d)
62,9%;
69,6%
ewas
71,3%;
46,9%
e 56,2%,
68,9%
efrom
64,8%
per
gruppi
controllo
Trabecular
Trabecular
MetalTM
MetalTM
material
(TM),
(TM), 2,3
2,3 aaand
a cancellous-like
cancellous-like
with
interconnected
porosity.
Prior
osteoconductive
structure
periimplantitis.
The
bone-implant-contact
(BIC)
values
Materials
and
early healing
stages
and
levelmaterial
of with
osseointegration
stability
placebo
tare le prestazioni
di studies
impianti
dentali
assemblati
con
una guaina
porosa
incanine
TM
in un
was
was
significantly
significantly
different
different
from
from
that
that
at
at
30
30
&
&
38
38
weeks
weeks
in
in
the
the
38
38
group
for
both
24
&
38
week
groups.
The
PD
at
18
and
24
weeks
Figure
2.
Histological
studies
conducted
conducted
using
using
a
a
TM
TM
implant
implant
in
in
a
a
healed
healed
site
site
canine
structure
with
interconnected
porosity.
Prior
osteoconductive
group
group
for
for
both
both
24
24
&
&
38
38
week
week
groups.
groups.
The
The
PD
PD
at
at
18
18
and
and
24
24
weeks
weeks
was
significantly
different
from
that
at
30
&
38
weeks
in
the
38
structure
structure
with
with
interconnected
interconnected
porosity.
porosity.
Prior
Prior
osteoconductive
osteoconductive
studies
conducted
using
a
TM
implant
in
a
healed
site
canine
respectively.
Histopathological
(Fig
52.7%
&test
62.9%,
69.6%
& 71.3%,
46.9%
&24
56.2%,
& 64.8% I valori BICanalysis
comparable to clinically successful conventional threaded
cebo
e PI) study
estudy
(placebo
e PI)
alle
settimane
e 38,68.9%
rispettivamente.
non
(b) Controllo
PI38 weeks
week
week
group
group
which
which
indicated
indicated
the
the
progression
progression
of
of
was
significantly
different
from
that
at
30
&
38
weeks
ininthe
the
38
modello canino di perimplantite
indottausing
sperimentalmente
mediante
il
confronto
model
model
demonstrated
demonstrated
active
active
bone
bone
formation
formation
inside
inside
the
the
pores
pores
at
at con
sections of
studies
conducted
using
TM
implant
in
healed
site
canine
was
was
significantly
significantly
different
different
from
that
thatat
at30
30&
&&
38
38
weeks
weeks
in
the24
38
38& 38
week
study
group
which
the
progression
of
model
demonstrated
active
bone
formation
the
pores
at
studies
conducted
conducted
using
TM
TM
implant
implant
in
inperformance
aaainside
healed
healed
site
site
canine
Methods
formostrato
control
(sham
&differenza
PI)from
andindicated
test
(sham
PI)
groups
at
implant.2studies
The
aim
of the study
wasaaato
evaluate
the
ofcanine
to
mild
incidence
of
acute
and
chronic
in
hanno
alcuna
statisticamente
significativa
tra
i
gruppi
rispetto
alle
periimplantitis.
periimplantitis.
The
The
mean
mean
bone-implant-contact
bone-implant-contact
(BIC)
(BIC)
values
values were
were
week
study
group
which
indicated
the
progression
of
early
early
healing
healing
stages
stages active
and
and
level
level
of
of
osseointegration
osseointegration
and
and
stability
(c) Test
placebo
model
demonstrated
active
bone
formation
inside
the
pores
atat
week
week
study
group
group
which
which
indicated
indicated
the
the
progression
progression
of
of
periimplantitis.
The
mean
bone-implant-contact
(BIC)
values
were
group
(a) Control Sham
model
demonstrated
demonstrated
active
bone
bone
formation
formation
inside
inside
the
the
pores
at
early
healing
stages
and
level
of
osseointegration
and
stability
impianti in titanio
(Ti)model
filettati
convenzionali
rispetto
alla
risposta
tissutale,
istability
parametri
weeksstudy
respectively.
BIC
values
showed
no
statistical
difference
a dental
implant
assembled
with
porous
TM sleeve
in pores
an
(a)
(b)
Figure
Figure
2.
2.
Histological
Histological
Figure
2.
Histological
52.7%
52.7%
&
&
62.9%,
62.9%,
69.6%
69.6%
&
&
71.3%,
71.3%,
46.9%
46.9%
&
&
56.2%,
56.2%,
68.9%
68.9%
&
&
64.8%
64.8%
periimplantitis.
The
mean
bone-implant-contact
(BIC)
values
were
porzioni
filettate
in
titanio
impianti
3).
Negli
test, è stata rilevata
comparable
comparable
to
clinically
clinically
successful
successful
conventional
conventional
threaded
threaded
reveal
any
evidence
early
healing
stages
and
level
ofof osseointegration
osseointegration
and
stability
periimplantitis.
periimplantitis.
The
The
mean
mean
bone-implant-contact
bone-implant-contact
(BIC)
(BIC)
values
values
were
were
52.7%
& 62.9%,
69.6%
& degli
71.3%,
46.9%
&(Figura
56.2%,
68.9%
& impianti
64.8%
(b)
Control
PI
(c) Test
early
early healing
healing
stages
stages
and
and level
level
of
osseointegration
and
and
stability
stability
comparable
to
clinically
successful
conventional
threaded
Test
(TM and
andto
control
(Ti6Al4V)
dental
implants
(d) Test
PI 2.of
istomorfometrici
eTi6Al4V)
il rischio
di infezione.
between
the
groups
for
threaded
Ti portions
of
the
implants
(Figure of bacterial infect
experimentally
induced
canine
model
by
sections
sections
of
38
38 weeks
weeks
Figure
Histological
Figure
Figure2.
2.
Histological
Histological
sections
of
38
weeks
for
for
control
control
(sham
(sham
&
& PI)
PI)
and
test
test
(sham
(sham
&
&56.2%,
PI)
PI) groups
groups
at
at
24
&
& 38
38
52.7%
&&62.9%,
62.9%,
69.6%
&and
71.3%,
46.9%
&compresa
56.2%,
68.9%
&24
64.8%
implant.2
implant.2
The
The to
aim
aim
of
of
the
theperiimplantitis
study
study
was
was to
to evaluate
evaluate
the
thecomparing
performance
performance
of
of
comparable
to
clinically
successful
conventional
threaded
52.7%
52.7%
&
62.9%,
69.6%
69.6%
&
&
71.3%,
71.3%,
46.9%
46.9%&
&
56.2%,
68.9%
68.9%
&
&
64.8%
64.8%
for
control
(sham
&
PI)
and
test
(sham
&
PI)
groups
at
24
&
38
comparable
comparable
to clinically
clinically
successful
successful
conventional
conventional
threaded
threaded
implant.2
The
aim
of
the
study
was
to
evaluate
the
performance
of
una
maggiore
quantità
di
osso
nell’area
fra
le
regioni
filettate
e porose
lun-of the gr
Sham
(d)
Test
PI
tissues
or
inside
TM
in any
3).control
More
bone was
found
in
area
encompassing
the
threaded
andpores
group
group
(a)
(a)of
Control
Control
Sham
Sham
with conventional
titanium
(Ti)
threaded
implant
with
respect
(4.1mm x13mm,
n=32)
were
bilaterally
placed
inthe
mandibular
sections
of
38
weeks
sections
sections
of
38
38weeks
weeks
group
(a)
Control
Sham
weeks
weeks
respectively.
respectively.
BIC
BIC
values
values
showed
showed
no
no
statistical
statistical
difference
difference
for
(sham
&&PI)
PI)
and
test
(sham
&&
PI)
groups
atat
24
&&38
38
a
aimplant.2
dental
dentalThe
implant
implant
assembled
assembled
with
with
porous
porous
TM
TM
sleeve
sleeve toin
in of
an
an
*
The
aim
of
the
study
was
to
evaluate
the
performance
of
for
for
control
control
(sham
(sham
&
PI)and
and
test
test
(sham
(sham
&
PI)
PI)
groups
groupsat
24
24
&
38 regione porosa, gli
weeks
respectively.
BIC
values
showed
no
statistical
difference
implant.2
The
aim
aimof
of
the
thestudy
studywas
was
to
toevaluate
evaluate
theperformance
performance
of
aimplant.2
dental
implant
assembled
with
porous
TM
sleeve
in
an
go
la
lunghezza
dell’impianto,
sia
nei
gruppi
placebo
che
PI.
Nella
(b)
(b)
Control
Control
PI
PI
(c)
(c)
Test
Test
porous
regions
along
the
length
of
the
implant,
for
test
implants
in
group
(a)
Control
Sham
tissue
response,
histomorphometry
andperiimplantitis
risk ofporous
infection.
group
group
(a)
(a)Control
Control
Sham
(b)
Control
PI *(c) Sham
Test
* respectively.
indicated
mild
to minimal fibrosis and mo
between
between
the
the groups
groups for
for
threaded
threaded
Ti
portions
portions
of
ofstatistical
the
the
implants
implants
(Figure
(Figure
weeks
respectively.
BIC
values
showed
no
statistical
difference
experimentally
induced
induced
canine
canine
periimplantitis
model
model
by
by comparing
comparing
aexperimentally
dental
implant
assembled
with
TM
sleeve
an
premolar and
molar
sockets
of
eight
hound
dogs
(4 inintest
weeks
weeks
respectively.
BIC
BIC
values
valuesTi
showed
showed
no
no
statistical
difference
difference
between
the
groups
for
threaded
Ti
portions
of
the
implants
(Figure
a
aextraction
dental
dental implant
implant
assembled
assembled
with
with porous
porous
TM
TM
sleeve
sleeve
in an
an
experimentally
induced
canine
periimplantitis
model
by
comparing
Sham
Sham
(d)
(d) Test
Test
PI
PI
(b)
Control
PI
(c)
Test
both
the
sham
and
PI
groups.
In
the porous
region,
test
implants
impianti
test
hanno
dimostrato
una
crescita
interna
ossea
media
dithe
28,4%
e 36,33%
(b)
(b)
Control
Control
PI
PI
(c)
(c)
Test
Test
Sham
(d)
Test
PI
3).
3).
More
More
bone
bone
was
was
found
found
in
in
area
area
encompassing
encompassing
the
the
threaded
threaded
and
and
between
the
groups
for
threaded
Ti
portions
of
the
implants
(Figure
with
with
conventional
conventional
titanium
titanium
(Ti)
(Ti)
threaded
threaded
implant
implant
with
with
respect
respect
to
to
experimentally
induced
canine
periimplantitis
model
by
comparing
between
between
the
the
groups
groups
for
for
threaded
threaded
Ti
Ti
portions
portions
of
of
the
the
implants
implants
(Figure
(Figure
3).
More
bone
was
found
in
area
encompassing
the
threaded
and
experimentally
experimentally
induced
induced
canine
canine
periimplantitis
periimplantitis
model
model
by
bycomparing
comparing
with
conventional
titanium
(Ti)
threaded assignment.
implant
with
respect
to
tissue
contact
withand
implant
for both
and 4 control Materiali
implants
per
dog)
by
random
The
e
metodi
Sham
(d)
Test
PI
demonstrated
a
mean
bone
ingrowth
of
28.4%
&
36.33%
Sham
Sham
(d)
(d)
Test
Test
PI
PI
porous
porous
regions
regions
along
along
the
the
length
length
of
of
the
the
implant,
implant,
for
for
test
test
implants
implants
in
in
3).
More
bone
was
found
in
area
encompassing
the
threaded
and
*was
tissue
tissue
response,
response, histomorphometry
histomorphometry
and
and risk
risk
of
of infection.
infection.
e di3).
35,6%
ebone
32,7%
i gruppi
placebo
e PI alle
settimane
24
with
conventional
titanium
(Ti)
threaded
implant
with
respect
toto
3).
More
More
bone
wasper
found
found
ininarea
area
encompassing
the
the
threaded
threaded
and
and
porous
regions
along
the
length
ofencompassing
the implant,
for
test
implants
in e 38, rispettivamente.
with
withconventional
conventional
titanium
titanium(Ti)
(Ti)threaded
threaded
implant
implant
with
withrespect
respectto
tissue
response,
histomorphometry
and
risk
of
infection.
implants.
& 32.7%
for
sham
&
PI
groups
at
24
and
38 in
35.6%
extraction sockets tissue
wereresponse,
filled
with
bone
graft
material
(Puros®
both
both
the
the
sham
sham
and
and
PI
PI
groups.
groups.
In
Inof
the
the
porous
porous
region,
region,
test
test
implants
implants
porous
regions
along
the
length
ofof
the
implant,
for
test
implants
a)
b)
c)
d)
(a)
(b)
(c)
(d)
tissue
response,
histomorphometry
and
risk
ofofinfection.
infection.
Materials
and
porous
porous
regions
regions
along
along
the
the
length
length
the
the
implant,
implant,
for
fortest
test
implants
implants
in
both
the
sham
and
PI
groups.
In
the
porous
region,
test
implants
tissue
response,
histomorphometry
histomorphometry
and
andrisk
risk
of
infection.
L’analisi
istopatologica
(Figura
4)
ha
mostrato
un’incidenza
diinweeks
infiammazione
acuta e
respectively.
Histopathological
analysis
(Figure
showed
minimal
demonstrated
demonstrated
mean
mean
bone
bone ingrowth
ingrowth
of
of 28.4%
28.4%
&
&4)test
36.33%
36.33%
and
and
both
the
sham
and
PI
groups.
InInthe
the
porous
region,
test
implants
demonstrated
aa
mean
bone
ingrowth
of
28.4%
&
36.33%
and
both
both
the
thesham
shama
and
and
PI
PIgroups.
groups.
In
theporous
porous
region,
region,
test
implants
implants
Cancellous Particulate). 12 weeks
post
implantation,
periimplantitis
cronica
da
minima
a
lieve,
ma
non
ha
rilevato
alcuna
evidenza
di
infezione
batterica
Methods
&
32.7%
for
sham
&ingrowth
PI
PI groups
groups
at
at
24
24 &
and
and
38
38 weeks
weeks
35.6%
35.6%
& incidence
32.7%
for ofsham
to mild
acute
and
chronic
inflammation
but
did not
demonstrated
mean
bone
ingrowth
ofof 28.4%
28.4%
&
36.33%
and
Gli impianti dentali (4,1 mm 3 13 mm,
n=32) testand
(TM e Ti6Al4V) e di controllo
demonstrated
demonstrated
aaa mean
mean
bone
bone&
ingrowth
of
28.4%
& 36.33%
36.33%
and
and
(a)
(a)
(b)
(b)
(c)
(c)
(d)
(d)
sham
&
PI
groups
at
24
and
38
weeks
35.6%
&
32.7%
for
Materials
Materials
and
(a)
(b) nell’ambito
was inducedTest
by (TM
placement
of ligatures
in periimplantitis
(PI)
group
dei
tessuti
perimplantari
o (Figure
all’interno
dei 38
pori
TM in nessuno dei gruppi.
respectively.
respectively.
Histopathological
Histopathological
analysis
analysis
(Figure
4)
4)
showed
showed
minimal
minimal
&
32.7%
for
sham
&
PI
groups
at
24
and
38
weeks
35.6%
reveal
any
evidence
of
bacterial
infection
within
peri-implant
&
&
32.7%
32.7%
for
for
sham
sham
&
&
PI
PI
groups
groups
at
at
24
24
and
and
38
weeks
weeks
35.6%
35.6%
respectively.
Histopathological
analysis
(Figure
4)
showed
minimal
(a)
(b)
(c)
(d)
and
Ti6Al4V)
and
control
(Ti6Al4V)
dental
implants
(a)
(b)
(c)
(d)
(Ti6Al4V) sono stati inseriti bilateralmente
in siti post-estrattivi
Materials
Materials
and
and premolari e molari di
Methods
Methods
to
to
mild
mildhaincidence
incidence
of
of
acute
acute
and
chronic
chronic
inflammation
inflammation
but
butanalysis
did
did
not
not
respectively.
Histopathological
analysis
(Figure
4)
showed
minimal
(4 8 dogs)
while
the
shamn=32)
group
(4
dogs)
received
regular
oral I siti
anche
rilevato
laand
presenza
di
fibrosi
da
minima
a lieve
tissues
or
inside
TM
pores
in
any of(Figure
the
groups.
The
alsoe un contatto da
respectively.
respectively.
Histopathological
Histopathological
analysis
analysis
(Figure
4)
4)showed
showed
minimal
minimal
to
mild
incidence
of
acute
and
chronic
inflammation
but
did
not
(4.1mm
were
bilaterally
placed
in mandibular
4.0
*
100
(a)
(a)
(b)
(b) L’analisi
cani (4 impianti
testx13mm,
e 4 di controllo
perMethods
ogni
cane)
con
assegnazione
casuale.
Methods
Conclusion
reveal
reveal
any
any
evidence
evidence
of
of
bacterial
bacterial
infection
infection
within
within
peri-implant
peri-implant
to
mild
incidence
of
acute
and
chronic
inflammation
but
did
not
*
Test
Test
(TM
(TM
and
and
Ti6Al4V)
Ti6Al4V)
and
and
control
control
(Ti6Al4V)
(Ti6Al4V)
dental
dental
implants
implants
to
to
mild
mild
incidence
incidence
of
of
acute
acute
and
and
chronic
chronic
inflammation
inflammation
but
but
did
did
not
not soft
reveal
any
evidence
of
bacterial
infection
within
peri-implant
*
indicated
mild
to
minimal
fibrosis
and
moderate
to
minimal
Test
(TMinand
Ti6Al4V)
and control
(Ti6Al4V)
dental
implants
premolar
and molar
extraction
sockets
of eight
hound
dogs
(4 test
minimo
a
lieve
del
tessuto
molle
con
l’impianto,
sia
per
i
controlli
che per
gli impianti
prophylaxis.
The
dogs
the
PI
group
did
not
receive
oral
(a)
(a)
(b)
estrattivi sono stati riempiti
con
materiale
da and
innesto
osseo
(Particolato
diimplants
Osso
Spontissues
tissues
or
or
inside
inside
TM
TM
pores
pores
in
in
any
any of
of the
the
groups.
groups.
The
The analysis
analysis
also
alsodental
Controllo(b)
placebo
reveal
any
evidence
of
bacterial
infection
within
peri-implant
Controllo placebo
(4.1mm
(4.1mm
x13mm,
x13mm,
n=32)
n=32)
were
were
bilaterally
bilaterally
placed
placed
in
in
mandibular
mandibular
reveal
reveal
any
any
evidence
evidence
of
of
bacterial
bacterial
infection
infection
within
within
peri-implant
peri-implant
tissues
or
inside
TM
pores
in
any
of
the
groups.
The
analysis
also
Test
(TM
and
Ti6Al4V)
and
control
(Ti6Al4V)
dental
implants
tissue
contact
with
the
implant
for
both
control
and
test
Test
Test
(TM
(TM
and
and
Ti6Al4V)
Ti6Al4V)
and
control
control
(Ti6Al4V)
(Ti6Al4V)
dental
dental
implants
(4.1mm
x13mm,
n=32)
were
bilaterally
placed
in
mandibular
*
*
3.0
and
4
control
implants
per
dog)
by
random
assignment.
The
75
*
dentali
test.
p
>0.05
***
Test placebo
*
prophylaxis.
were
placed
in sockets
the
cervical
region
of (4
the
Test placebo
***
indicated
indicated
mild
to
toTM
minimal
minimal
fibrosis
and
and
moderate
to
to analysis
minimal
minimal
soft
soft
tissues
or
inside
TM
pores
in
any
ofof
the
groups.
The
analysis
also
premolar
premolar
and
and
molar
molar
extraction
extraction
sockets
of
of eight
eight
hound
hound
dogs
(4
test
test
gioso Puros®extraction
).The
A 12ligatures
settimane
dall’impianto
èwere
stata
indotta
la
perimplantite
mediante
tissues
tissues
or
ormild
inside
inside
TM
pores
poresfibrosis
in
inany
anyof
the
themoderate
groups.
groups.The
The
analysisalso
also
indicated
mild
to
minimal
fibrosis
and
moderate
to
minimal
soft
(4.1mm
x13mm,
n=32)
were
bilaterally
placed
in
mandibular
implants.
(4.1mm
(4.1mm
x13mm,
n=32)
n=32)
were
bilaterally
bilaterally
placed
placed
in
indogs
mandibular
mandibular
premolar
and
molar
extraction
sockets
of
eight
hound
dogs
(4
test
socketsx13mm,
were
filled
with
bone
graft
material
(Puros®
** *
<0.05
* pimplant
The
histopathological
and histomorphome
Controllo PI
Controllo PI
**
tissue
tissue
contact
contact
with
with
the
the
implant
for
for
both
both
control
control
and
and
test
test
dental
dental
*
indicated
mild
to
minimal
fibrosis
and
moderate
to
minimal
soft
*
and
and
4
4
control
control
implants
implants
per
per
dog)
dog)
by
by
random
random
assignment.
assignment.
The
The
*
*
indicated
indicated
mild
mild
to
to
minimal
minimal
fibrosis
fibrosis
and
and
moderate
moderate
to
to
minimal
minimal
soft
soft
tissue
contact
with
the
implant
for
both
control
and
test
dental
premolar
and
molar
extraction
sockets
of
eight
hound
dogs
(4
test
implants
and
were
held
in
place
by
a
healing
collar.
Probing
depth
premolar
premolar
and
and
molar
molar
extraction
extraction
sockets
sockets
of
of
eight
eight
hound
hound
dogs
dogs
(4
(4
test
test
andParticulate).
4 control
implants
dog)
by random
il posizionamento
di legature
nel gruppo
dellaper
perimplantite
(PI) periimplantitis
(4 assignment.
cani) mentreThe
il grup2.0
Test PI
***
50
Cancellous
12 weeks
post
implantation,
Test PI
implants.
implants.
tissue
contact
with
the
implant
for
both
control
and
test
dental
canine
study
suggest
that the TM dent
extraction
extraction
sockets
sockets
were
were per
filled
filled
with
withby
bone
bone
graft
graft assignment.
material
material
(Puros®
(Puros®
tissue
tissue
contactwith
withthe
theimplant
implantfor
forboth
bothcontrol
controland
andtest
testdental
dental
implants.
and
control
implants
per
dog)
by
assignment.
The
and
444 the
control
control
implants
implants
per dog)
dog)
by
random
random
assignment.
The
The
extraction
sockets
were
filled
with
bone
graft
(Puros®
Figure 3. Comparing histomorphometric parameters
measured
for contact
different
induced
by
placement
of
ligatures
inorale.
periimplantitis
(PI)
group
(PD)
was measured
for
24
week
group
at
18
&
24
weeks
po placebo
(4was
cani)
haand
ricevuto
la
normale
profilassi
Irandom
cani
delmaterial
gruppo
PIand
non
han** *
implants.
Cancellous
Cancellous
Particulate).
Particulate).
12
12
weeks
weeks
post
post
implantation,
implantation,
periimplantitis
periimplantitis
implants.
implants.
extraction
sockets
were
filled
with
bone
graft
material
(Puros®
extraction
extraction
sockets
sockets
were
were
filled
with
with
bone
bone
graft
graftregular
material
material
(Puros®
(Puros®
Cancellous
Particulate).
12filled
weeks
post
implantation,
periimplantitis
similarly to the conventional thread
25
Conclusioni
dogs)
while
the
sham
group
(4
dogs)
received
oral
ricevuto
la(4profilassi
orale.
LeParticulate).
legature
sono
state
posizionate
nella periimplantitis
regione
cervicale
implant systems 1.0
(a) %BIC (b) total amount of bone formed.
fornothe
38 week
group
at
18,
24,
30
&12
38
weeks.
was
was
induced
induced
by
by placement
placement
of
of
ligatures
ligatures
in
in
periimplantitis
periimplantitis
(PI)
(PI) group
group
Cancellous
Particulate).
12
weeks
post
implantation,
periimplantitis
Conclusion
Cancellous
Cancellous
Particulate).
12
weeks
weeks
post
postimplantation,
implantation,
periimplantitis
was
induced
by
placement
of
ligatures
in
periimplantitis
(PI)
group
prophylaxis.
The
dogs
in
the
PI
group
did
not
receive
oral
experimentally induced periimplantitis env
(4
(4
dogs)
dogs)
while
while
the
the
sham
sham
group
group
(4
(4 dogs)
dogs)
received
received La
regular
regular
oral
oral di
degli impianti ed erano
tenute
in
posizione
da un
collare
diin
guarigione.
profondità
was
induced
by
placement
of
ligatures
inin
periimplantitis
(PI)
group
was
was
induced
induced
by
byplacement
placement
of
ofligatures
ligatures
periimplantitis
periimplantitis
(PI)
(PI)group
group
(4
dogs)
while
the
sham
group
(4
dogs)
received
regular
oral
0
0.0
Conclusion
Conclusion
p >0.05
prophylaxis.
The ligatures
were
placed
inPI
the
cervical
region
of
the oral
2438
2438
prophylaxis.
prophylaxis.
The
The
dogs
dogs
in
in
the
the
PI
group
group
did
did
not
not
receive
receive
oral
(4
dogs)
while
the
sham
group
(4
dogs)
received
regular
exhibit
bacterial
infection.
I
risultati
istopatologici
e
istomorfometrici
di questo
canino
suggeriscono
(4
(4
dogs)
dogs)
while
while
the
the
sham
sham
group
group
(4
(4
dogs)
dogs)
received
received
regular
regular
oral
oral
prophylaxis.
The
dogs
in
the
PI
group
did
not
receive
* p <0.05
The histopathological and histomorphometric
findingsstudio
from
this
sondaggio (PD)
è stata
misurata
perinil place
gruppo
dia 24
settimane
alle
settimane
18 e 24,
Post-impianto (settimane)
Post-impianto (settimane)
implants
and
were held
by
healing
collar.
Probing
depthof
Conclusion
Conclusion
p .0.05
p .0.05
p
>0.05
prophylaxis.
prophylaxis.
The
ligatures
ligatures
were
were
placed
placed
in
in the
thedid
cervical
cervical
region
of oral
the
the
The
dogs
in
the
PI
group
did
not
receive
oral
pp>0.05
>0.05
prophylaxis.
prophylaxis.The
The
The
dogs
dogs in
in
the
the
PI
PI group
group
did not
notregion
receive
receive
oral
The
ligatures
were
placed
in
the
cervical
region
of
the
canine study suggest that the TM dental implants performed
1
1
3
1
3
1
11
3
33
2
2
2
22
4
e per il gruppo
di 38
alle
settimane
18,group
24,
30healing
e18
38.& collar.
(PD)
wassettimane
measured
theheld
24 week
24
weeks
anddepth
implants
implants
and
andfor
were
were
held
in
in place
place
by
by aaat
healing
collar.
Probing
Probing
depth
prophylaxis.
The
ligatures
were
placed
ininthe
the
cervical
region
of
the
prophylaxis.
prophylaxis.
Theligatures
ligatures
wereplaced
placed
in
thecervical
cervical
region
regionof
ofthe
the
implants
andThe
were
held in were
place
by a healing
collar.
Probing
depth
for the 38implants
week
group
at
18,held
24,
30
&
weeks.
(PD)
(PD)
was
was
measured
measured
for
for in
the
the
24
2438
week
week
group
at
atcollar.
18
18 &
& 24
24
weeks
weeks
and
and
implants
and
were
held
in
place
by
healing
collar.
Probing
depth
(PD)
was
measured
for
the
24
week
group
at
18
&
24
weeks
and
implants
and
and
were
were
held
inplace
place
by
by
aaagroup
healing
healing
collar.
Probing
Probing
depth
depth
for
for
the
the
38
38 measured
week
week
group
group
at
atthe
18,
18,
24,
24,
30
30 &
&group
38
38
weeks.
weeks.
(PD)
was
measured
for
the
24
week
group
atat18
18
&&24
24
weeks
and
(PD)
(PD)
was
was
measured
for
for
the24
24week
week
group
at
18&
24weeks
weeksand
and
for
the
38
week
group
at
18,
24,
30
&
38
weeks.
for
the
38
week
group
atat18,
18,
24,
30
&&38
38
weeks.
for
forthe
the38
38week
weekgroup
groupat
18,24,
24,30
30&
38weeks.
weeks.
Crescita (mm2)
Percentuale (%)
2
(a)
<0.05
<0.05
Figure 3. Comparing histomorphometric parameters measured for different *** ppp<0.05
pp >0.05
p>0.05
>0.05
Figura 3: Figure
Raffronto
dei
parametri
istomorfometrici
misurati
per formed.
i diversi
sistemi
implant
systems
(a) %BIC
(b) totalparameters
amount
of bone
histomorphometric
parameters
measured
measured
for
for different
different
Figure
3.
3. Comparing
Comparing
histomorphometric
parameters
measured
for
different
Figure
3.
Comparing
histomorphometric
­implantari
(a) BIC%
(b) systems
quantità
totale
di(b)
osso
formato.
implant
implant
systems
systems
(a)
(a)
%BIC
%BIC
(b)
(b)
total
total
amount
amount of
of
ofmeasured
bone
bone formed.
formed.
formed.
histomorphometric
parameters
measured
for
different
Figure
3.
Comparing
histomorphometric
histomorphometric
parameters
parameters
measured
for
fordifferent
different
Figure
Figure
3.
3.Comparing
Comparing
implant
(a)
%BIC
total
amount
bone
(a)
(a)
(a)
(a)
(a)
(a)
3.00
or or
or
or
orTest
Controllo
Figure 1: Implant placement in a canine
model.
Control
Test
Figure 1:Figure
Implant
placement
in a canine
model.model.
Figure
1:
1: Implant
Implant placement
placement
in
in
a
canine
model.
Control
TestTest
Figure
1:
Implant
placement
in
aa canine
canine
model.
Control
Control
Test
Figure
1:
Implant
placement
ininaaacanine
canine
model.
Figure
Figure1:
1:Implant
Implantplacement
placementin
caninemodel.
model.
Control
Control
Test
Test
Figura 1: Inserimento degli impianti in un modello canino.
© 2013
Zimmer
Dental,
All rights
ZD1093,
Rev.
04/13
© ©2013
2013
Zimmer
Dental,
AllInc.
rights
reserved.
ZD1093,
Rev.
04/13
©
© riservati.
2013
2013Inc.
Zimmer
Zimmer
Dental,
Dental,
Inc.
All
Allreserved.
rights
rights reserved.
reserved.
ZD1093,
ZD1093,
Rev.
Rev.
04/13
04/13
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ZD1093IT, Rev.
04/13. Inc.
©
2013
Zimmer
Dental,
Inc.
All
rights
reserved.
ZD1093,
Rev.
04/13
©©2013
2013
Zimmer
Dental,
Inc.
All
rights
reserved.
ZD1093,
Rev.
04/13
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2013Zimmer
ZimmerDental,
Dental,Inc.
Inc.All
Allrights
rightsreserved.
reserved.ZD1093,
ZD1093,Rev.
Rev.04/13
04/13
p<0.05
<0.05
** *pp <0.05
implant
systems
(a)
%BIC
(b)
total
amount
ofofbone
bone
formed.
implant
implantsystems
systems(a)
(a)%BIC
%BIC(b)
(b)total
totalamount
amountof
boneformed.
formed.
4.00
oro
44
(b)
(b)
(b)
(b)
(b)
4.00
3.00
Controllo placebo
Test placebo
Controllo PI
Test PI
2.00
Scala di valutazione
Measurement
Scale
0. Nessuna
evidenza
Measurement
Measurement
0.
Measurement
1.00
1.
0.00
(b)
2.
3.
Tessuto molle Infezione
a contatto con batterica
l’impianto
Infiamma­
Infiamma­
zione acuta zione cronica
Fibrosi
4.
Scale
1. MinimaScale
0.0. Scale
No
0.
2. Lieve
evidence
Measurement
No
No
Measurement
Measurement
Measurement
Minimal
3. Moderata
Scale
No
evidence
evidence
Scale
Scale
Scale
Mild
0.
evidence
Minimal
0. 0.
0. Minimal
4. Grave
Moderate
Minimal
1. 1.
Mild
Mild
No
Mild
SevereNo
Moderate
Moderate
No
No
evidence
3.
Moderate
4. 4.
Severe
Severe
evidence
evidence
evidence
Minimal
4.1.
Severe
1.
1.
1. Minimal
Minimal
Minimal
2.
Mild
2.
2.
2. MildMild
Mild
3.
Moderate
3.
3.
3. Moderate
Moderate
Moderate
4.
Severe
4.
4.
4. Severe
Severe
Severe
1.
2. 2.
2.
3. 3.
2.00
1.00
Measurement
Scale
0.
1.
2.
3.
4.
0.00
Controllo placebo
Test placebo
Controllo PI
Test PI
No
evidence
Minimal
Mild
Moderate
Severe
Scala di valutazione
Measurement
0. Nessuna evidenza
Scale
Measurement
Measurement
0.
Measurement
1. Minima
Scale
Scale
0.0. Scale
No
2. Lieve0.
evidence
Measurement
No
No
3. Moderata
Measurement
Measurement
Measurement
Minimal
Scale
No
evidence
evidence
Scale
Scale
Scale
Mild
4. Grave0.0. 0.0. evidence
Minimal
Minimal
1.
1. 1.
Tessuto molle Infezione
a contatto con batterica
l’impianto
Infiamma­
Infiamma­
zione acuta zione cronica
Fibrosi
2.
3.
1.
2. 2.
2.
4.
3. 3.
Moderate
Minimal
Mild
Mild
No
Mild
Severe
Moderate
Moderate
No
No
No
evidence
Moderate
Severe
Severe
evidence
evidence
evidence
Minimal
Severe
Minimal
Minimal
Minimal
Mild
MildMild
Mild
Moderate
Moderate
Moderate
Moderate
Severe
Severe
Severe
Severe
4
4
4
cheThe
le prestazioni
degli and
impianti
dentali TM sono
statefrom
simili
(b)
The
histopathological
histopathological
and
histomorphometric
histomorphometric
findings
findings
from
this
thisa quelle degli impianti
The
histopathological
and
histomorphometric
findings
from
this
similarly
tosuggest
theinand
conventional
threaded
implants
in an
canine
canine
study
studyfilettati
suggest
that
thathistomorphometric
the
the TM
TMdidental
dental
implants
implants
performed
performed
The
histopathological
and
histomorphometric
findings
from
this
convenzionali
condizioni
perimplantite
indotta
sperimentalmente
e non
The
The
histopathological
histopathological
and
histomorphometric
findings
findings
from
from this
this
canine
study
suggest
that
the
TM
dental
implants
performed
experimentally
induced
periimplantitis
environment
and
did
similarly
similarly
to
to
the
the
conventional
conventional
threaded
threaded
implants
implants
in
in
an
an
canine
study
suggest
that
the
TM
dental
implants
performed
canine
canine
study
study
suggest
suggest
that
that the
the TM
TM
dental
dental implants
implants
performed
performed
similarly
to segni
the
conventional
threaded
implants
in an not
hanno
mostrato
di infezione
batterica.
55
Bibliografia
­implantari a (a) 24 settimane
(b) 38
settimane
implant
systems
atat(a)
(a)
24
weeks
(b)
38
weeks
implant
implant
systems
systems
at
(a)24
24weeks
weeks(b)
(b)38
38weeks
weeks
4.1.
1.
2.
2.
3.
3.
4.
4.
1.
1.
2.
2.
3.
3.
4.
4.
References
Brånemark PI, Hansson BO, Adell R, Breine
Öhman
A.. Scand J Plast Reconstr Surg. 1977
References
References
1 Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O,2.ÖhmanKim
A. Scand
J Plast
ReconstrS,
Surg.Larsen
1977;111 (Suppl
D,
Huja
P, 16):1-132.
et. Al. Conferenc
References
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BO, Adell R, Breine U, Lindström
J, Hallén
O,
2 Kim D, Huja S, Larsen P, et. Al. Conference Proceeding of European Association for Osseointegration. Glasgow, UK, 2010
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Brånemark
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BO,Reconstr
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Adell R,
R, Breine
Breine1977;111
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U, Lindström
Lindström
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J, Hallén
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Osseointegration.
Glasgow, UK
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Öhman
A..
J
Plast
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3 Bobyn JD, Stackpool G, Hacking SA et. al. J Bone Joint Surg Br. 1999; 81(5):907-914.
Öhman
Öhman
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1977;111
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16):1-132.
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PI,
Hansson
BO,
Adell
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Kim D,
S,JJJ Plast
Larsen
P,Adell
et. Surg.
Al.
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Proceeding
of
European
Brånemark
Brånemark
PI,
PI,Hansson
Hansson
BO,
BO,
Adell
R,
R,Breine
Breine
U,Lindström
Lindström
J,
J,Hallén
Hallén
O,
O,
3. U,
Bobyn
JD,
Stackpool
G,
Hacking
SA et. al. J
Nota: Trabecular
Metal™
èScand
unS,
marchio
registrato
di Zimmer,
Inc. 1977;111
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Kim
D,
D, A..
Huja
Huja
S,
Larsen
P,
et.
et.
Al.
Al. Surg.
Conference
Conference
Proceeding
Proceeding
of
of European
European
Öhman
A..
Plast
Reconstr
Surg.
(Suppl
16):1-132.
Kim
D,
Huja
S,
Larsen
P,
et.
Al.
Conference
Proceeding
of
European
Association
forLarsen
Glasgow,
UK,
201016):1-132.
Öhman
Öhman
A..Scand
Scand
JJOsseointegration.
JPlast
PlastP,
Reconstr
Reconstr
Surg.
1977;111
1977;111
(Suppl
(Suppl
16):1-132.
81(5):907-914.
Association
Association
for
for
Osseointegration.
Osseointegration.
Glasgow,
Glasgow,
UK,
UK,
2010
2010
Kim
D,
Huja
S,
Larsen
P,
et.
Al.
Conference
Proceeding
ofofEuropean
European
Association
forS,
Osseointegration.
Glasgow,
UK,al.Proceeding
2010
Kim
Kim
D,
D,Huja
Huja
S,
Larsen
LarsenP,
P,et.
et.Al.
Al.
Conference
Conference
Proceeding
of
European
Bobyn
JD,
Stackpool
G,
Hacking
SA et.
J Bone Joint
Surg
Br. 1999;
1.
1.1.
1.
5
55
1. 1.2.
1.
References
2. 2.
2.
3.
1.
Measurement
Scale
0.
2.2.
2.
1.
No
evidence
Minimal
Mild
Moderate
Severe
Bobyn
Bobyn
JD,
JD, Stackpool
Stackpool
G,
G, Hacking
HackingGlasgow,
SA
SA
et.
et. al.
al.UK,
JJUK,
J Bone
Bone
Joint
Joint Surg
Surg Br.
Br. 1999;
1999;
Association
for
Osseointegration.
Glasgow,
UK,
2010
Bobyn
JD,
Stackpool
G,
Hacking
SA
et.
al.
Bone
Joint
Surg
Br.
1999;
Association
Association
for
forOsseointegration.
Osseointegration.
Glasgow,
2010
2010
81(5):907-914.
81(5):907-914.
81(5):907-914.
Bobyn
JD,
Stackpool
G,
Hacking
SA
et.
al.
Bone
Joint
Surg
Br.
1999;
81(5):907-914.
Bobyn
BobynJD,
JD,Stackpool
StackpoolG,
G,Hacking
HackingSA
SAet.
et.al.
al.JJNote:
JBone
BoneJoint
Joint
Surg
Surg
Br.
Br.
1999;
Trabecular 1999;
Metal™
81(5):907-914.
81(5):907-914.
81(5):907-914.
Note:
Trabecular
Metal™
istrademark
a trademark
of Zimmer,
Inc.
Note:
Note:
Trabecular
Trabecular
Metal™
Metal™
is
is
a
a
trademark
of
of
Zimmer,
Zimmer,
Inc.
Inc.
Note: Trabecular Metal™ is a trademark of Zimmer, Inc.
Note:
Trabecular
Metal™
isisaaatrademark
trademark
ofofZimmer,
Zimmer,
Inc.
Note:
Note:Trabecular
TrabecularMetal™
Metal™is
trademarkof
Zimmer,Inc.
Inc.
3.3.
3.
3. 3.
3.
Figure 4.
Comparingparameters
histopathological
parameters
measured for different
Figure
4. Comparing
histopathological
for
different
Figure
Figure
4.
4. Comparing
Comparing
histopathological
histopathological
parameters
parametersmeasured
measured
measured for
for different
different
Figure
4.
Comparing
histopathological
parameters
measured
for
different
Figura 4: Raffronto
dei
parametri
istopatologici
misurati
per
i
diversi
sistemi
implant
systems
at
(a)
24
weeks
(b)
38
weeks
implant
systems
atat
(a)(a)
2424
(b)
weeks
implant
implant
systems
systems
at
(a)
24weeks
weeks
weeks
(b)
(b)38
38
38
weeks
weeks for
Figure
4.4.Comparing
Comparing
histopathological
parameters
measured
for
different
Figure
Figure4.
Comparing
histopathological
histopathological
parameters
parameters
measured
measured
fordifferent
different
implant
systems
at
(a)
24
weeks
(b)
38
weeks
3.
4. 4.
5
exhibit bacterial
infection.
experimentally
experimentally
induced
induced
periimplantitis
periimplantitis
environment
environment
and
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threaded
implants
inin not
an
similarly
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and
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infection.
experimentally
induced
periimplantitis
environment
and
did
not
exhibit
bacterial
infection.
experimentally
experimentally
induced periimplantitis
periimplantitis environment
environment and
and did
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not
exhibit
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exhibit
exhibitbacterial
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infection.
2.
3.
4.
is a trademark of Zimme