Emmanuel Soffer

Ultrasonic Evaluation of Dental Implant Biomechanical Stability: An In Vitro Study

Dental implants are widely used for oral rehabilitation. However, there remain risks of failure that are difficult to anticipate. The objective of this ex vivo study is to investigate the potentiality of quantitative ultrasound (QUS) to assess the amount of bone in contact with titanium prototype cylindrical implants. Four groups of 10 rabbit femurs each are considered, corresponding to different amounts of bone in contact with the implant. The 10 MHz ultrasonic response of the implant is processed to derive a quantitative indicator I, based on the temporal variation of the signal amplitude. Analysis of variance (ANOVA) (p < 10(-5)) tests revealed a statistical distribution of I significantly correlated with the amount of bone in contact with the cylinders. An analytical model considering the propagation of lateral waves allows the understanding of the physical origin of the echoes. QUS technique may be used to investigate the amount of bone in contact with a cylinder implant.

Micro-Brillouin Scattering Measurements in Mature and Newly Formed Bone Tissue Surrounding an Implant

The evolution of implant stability in bone tissue remains difficult to assess because remodeling phenomena at the bone-implant interface are still poorly understood. The characterization of the biomechanical properties of newly formed bone tissue in the vicinity of implants at the microscopic scale is of importance in order to better understand the osseointegration process. The objective of this study is to investigate the potentiality of micro-Brillouin scattering techniques to differentiate mature and newly formed bone elastic properties following a multimodality approach using histological analysis. Coin-shaped Ti-6Al-4V implants were placed in vivo at a distance of 200 μm from rabbit tibia leveled cortical bone surface, leading to an initially empty cavity of 200 μm×4.4 mm. After 7 weeks of implantation, the bone samples were removed, fixed, dehydrated, embedded in methyl methacrylate, and sliced into 190 μm thick sections. Ultrasonic velocity measurements were performed using a micro-Brillouin scattering device within regions of interest (ROIs) of 10 μm diameter. The ROIs were located in newly formed bone tissue (within the 200 μm gap) and in mature bone tissue (in the cortical layer of the bone sample). The same section was then stained for histological analysis of the mineral content of the bone sample. The mean values of the ultrasonic velocities were equal to 4.97×10(-3) m/s in newly formed bone tissue and 5.31×10(-3) m/s in mature bone. Analysis of variance (p=2.42×10(-4)) tests revealed significant differences between the two groups of measurements. The standard deviation of the velocities was significantly higher in newly formed bone than in mature bone. Histological observations allow to confirm the accurate locations of the velocity measurements and showed a lower degree of mineralization in newly formed bone than in the mature cortical bone. The higher ultrasonic velocity measured in newly formed bone tissue compared with mature bone might be explained by the higher mineral content in mature bone, which was confirmed by histology. The heterogeneity of biomechanical properties of newly formed bone at the micrometer scale may explain the higher standard deviation of velocity measurements in newly formed bone compared with mature bone. The results demonstrate the feasibility of micro-Brillouin scattering technique to investigate the elastic properties of newly formed bone tissue.

Numerical simulation of ultrasonic wave propagation for the evaluation of dental implant biomechanical stability

Osseointegration of dental implants remains poorly understood. The objective of this numerical study is to understand the propagation phenomena of ultrasonic waves in prototypes cylindrically shaped implants and to investigate the sensitivity of their ultrasonic response to the surrounding bone biomechanical properties. The 10 MHz ultrasonic response of the implant was calculated using a finite difference numerical simulation tool and was compared to rf signals taken from a recent experimental study by Mathieu et al. [Ultrasound Med. Biol. 37, 262-270 (2011a)]. Reflection and mode conversion phenomena were analyzed to understand the origin of the different echoes and the importance of lateral wave propagation was evidenced. The sensitivity of the ultrasonic response of the implant to changes of (i) amount of bone in contact with the implant, (ii) cortical bone thickness, and (iii) surrounding bone material properties, was compared to the reproducibility of the measurements. The results show that, either a change of 1 mm of bone in contact with the implant, or 1.1 mm of cortical thickness or 12% of trabecular bone mass density should be detectable. This study paves the way for the investigation of the use of quantitative ultrasound techniques for the evaluation of bone-implant interface properties and implant stability.

Ultrasonic evaluation of dental implant osseointegration

Dental implants are widely used for oral rehabilitation. However, there remain risks of failure which are difficult to anticipate and depend on the implant osseointegration. The objective of this in vivo study is to determine the variation of the echographic ultrasonic response of a dental implant to bone healing around the implant interface. Twenty one dental implants were inserted in the femur of seven New Zealand white rabbits. Two animals were sacrificed after a healing duration of two weeks, three animals after six weeks and six animals after eleven weeks. The 10 MHz ultrasonic response of the implant was measured just after the implantation using a dedicated device positioned at the emerging surface of each dental implant. The measurements were realized again before the sacrifice with the same device. An indicator I˜ was derived based on the amplitude of the rf signal obtained for each configuration. The bone-Implant Contact (BIC) ratio was determined by histological analyses. The average value of the relative variation of the indicator I˜ obtained after initial surgery and after the corresponding healing period varies between 7% and 40%. A Kruskal-Wallis test (p<0.01) revealed a significant decrease of the value of the indicator I˜ as function of healing time. The indicator I˜ was significantly correlated (R(2)=0.45) with the BIC ratio. The results show that the ultrasonic response of a dental implant varies significantly as a function of healing time, which paves the way for the development of a new quantitative ultrasound (QUS) method in oral implantology.

Influence of healing time on the ultrasonic response of the bone-implant interface

The aim of the present study is to investigate the effect of bone healing on the ultrasonic response of coin-shaped titanium implants inserted in rabbit tibiae. The ultrasound response of the interface was measured in vitro at 15 MHz after 7 and 13 weeks of healing time. The average value of the ratio r between the amplitudes of the echo of the bone-implant interface and of the water-implant interface was determined. The bone-implant contact (BIC) was measured by histomorphometry and the degree of mineralisation of bone was estimated qualitatively by histologic staining. The significant decrease of the ultrasonic quantitative indicator r (p = 2.10⁻⁴) vs. healing time (from r = 0.53 to r = 0.49) is explained by (1) the increase of the BIC (from 27% to 69%) and (2) the increase of mineralization of newly formed bone tissue, both phenomena inducing a decrease of the gap of acoustical impedance.

Mode III cleavage of a coin-shaped titanium implant in bone: Effect of friction and crack propagation

Endosseous cementless implants are widely used in orthopaedic, maxillofacial and oral surgery. However, failures are still observed and remain difficult to anticipate as remodelling phenomena at the bone-implant interface are poorly understood. The assessment of the biomechanical strength of the bone-implant interface may improve the understanding of the osseointegration process. An experimental approach based on a mode III cleavage mechanical device aims at understanding the behaviour of a planar bone-implant interface submitted to torsional loading. To do so, coin-shaped titanium implants were inserted on the tibiae of a New Zealand white rabbit for seven weeks. After the sacrifice, mode III cleavage experiments were performed on bone samples. An analytical model was developed to understand the debonding process of the bone-implant interface. The model allowed to assess the values of different parameters related to bone tissue at the vicinity of the implant with the additional assumption that bone adhesion occurs over around 70% of the implant surface, which is confirmed by microscopy images. The approach allows to estimate different quantities related to the bone-implant interface such as: torsional stiffness (around 20.5 N m rad(-1)), shear modulus (around 240 MPa), maximal torsional loading (around 0.056 N.m), mode III fracture energy (around 77.5 N m(-1)) and stress intensity factor (0.27 MPa m(1/2)). This study paves the way for the use of mode III cleavage testing for the investigation of torsional loading strength of the bone-implant interface, which might help for the development and optimization of implant biomaterial, surface treatment and medical treatment investigations.

Variation of biomechanical properties of newly formed bone tissue determined by nanoindentation as a function of healing time

nanoindentation as a function of healing time R. Vayron, E. Barthel, V. Mathieu, E. Soffer, F. Anagnostou and G. Haiat* Modélisation et Simulation Multi Echelle, CNRS, Université Paris-Est, UMR CNRS 8208, 61, Avenue du Général de Gaulle, 94010 Créteil Cedex, France; Laboratoire CNRS/Saint Gobain UMR 125, Surface du Verre et Interfaces, 39, Quai Lucien Lefranc, 93303 Aubervilliers Cedex, France; Laboratoire de Recherches Orthopédiques, CNRS, Université Paris 7, UMR CNRS 7052, 10, Avenue de Verdun, 75010 Paris, France

Bone Formation with Deproteinized Bovine Bone Mineral or Biphasic Calcium Phosphate in the Presence of Autologous Platelet Lysate: Comparative Investigation in Rabbit

Bone substitutes alone or supplemented with platelet-derived concentrates are widely used to promote bone regeneration but their potency remains controversial. The aim of this study was, therefore, to compare the regenerative potential of preparations containing autologous platelet lysate (APL) and particles of either deproteinized bovine bone mineral (DBBM) or biphasic calcium phosphate (BCP), two bone substitutes with different resorption patterns. Rabbit APL was prepared by freeze-thawing a platelet suspension. Critical-size defects in rabbit femoral condyle were filled with DBBM or DBBM+APL and BCP or BCP+APL. Rabbits were sacrificed after six weeks and newly formed bone and residual implanted material were evaluated using nondemineralized histology and histomorphometry. New bone was observed around particles of all fillers tested. In the defects filled with BCP, the newly formed bone area was greater (70%; P < 0.001) while the residual material area was lower (60%; P < 0.001) than that observed in those filled with DBBM. New bone and residual material area of defects filled with either APL+DBBM or APL+BCP were similar to those observed in those filled with the material alone. In summary, osteoconductivity and resorption of BCP were greater than those of DBBM, while APL associated with either DBBM or BCP did not have an additional benefit.

Assessment of the biomechanical properties of newly formed bone tissue using micro-Brillouin scattering

The assessment of implant stability in bone tissue remains difficult because remodelling phenomena in the vicinity of the implant are still poorly understood. The present multimodality study investigates the potentiality of micro-Brillouin scattering technique to differentiate mature and newly formed bone microscopic elastic properties following an approach coupled with histological analysis. Coin-shaped Ti-6Al-4V implants were placed in vivo in rabbit tibia. After seven weeks of implantation, bone samples were removed, embedded in methyl methacrylate and sliced into 190 µm thick sections. A micro-Brillouin scattering technique was used to measure ultrasonic velocities in 10 µm diameter regions located in mature and newly formed bone. The same section was then stained for histological analysis of the mineral content of the bone sample. The mean values of the ultrasonic velocities were equal to 4.98 10−3 m/s in newly formed bone tissue and 5.20 10−3 m/s in mature bone. ANOVA (p=0.029) tests revealed significant differences between the two groups of measurements. Histological observations showed a lower degree of mineralization in newly formed bone than in mature cortical bone. The higher ultrasonic velocity measured in newly formed bone tissue compared to mature bone might be explained by the higher mineral content in mature bone, which was confirmed by histology. The results demonstrate the feasibility of micro-Brillouin scattering measurements to investigate the elastic properties of newly formed bone tissue.

Ultrasonic set up for the assessment of the stability of a cylinder inserted in a solid

The study aims at proposing a new experimental ultrasonic methodology for the estimation of the stability of a cylinder inserted in a solid. Such a technology may have various fields of application: aeronautics, car industry, mechanics or also surgery. The present prototype is dedicated to the study of the stability of dental implants. Cylindrical titanium implants were inserted in four groups of rabbit femurs, each group corresponding to a controlled level of stability of the cylinders. The 10 MHz ultrasonic response of the cylinder is processed to derive quantitative indicators based on the temporal variation of the signal amplitude. Analysis of variance (ANOVA) (p < 10-5) tests revealed statistical distributions of indicators significantly correlated with the stability of the cylinders. A numerical finite-difference time-domain model was considered in order to understand the origin of the different echoes and the importance of lateral wave propagation was evidenced. The numerical model also enabled to ...