Francis K. Mante

Evaluating Parameters of Osseointegrated Dental Implants Using Finite Element AnalysisA Two-Dimensional Comparative Study Examining the Effects of Implant Diameter, Implant Shape, and Load Direction

Finite element analysis (FEA) has been proven to be a precise and applicable method for evaluating dental implant systems. By means of FEA, a parasaggital model was digitized from a computed tomography (CT)-generated patient data set, and various single-tooth, osseointegrated, two-dimensional dental implant models were simulated. The specific aims of the study were to: (1) examine the effect of implant diameter variation (3.8 mm-6.5 mm) of both a press-fit, stepped cylindrical implant type and a press-fit, straight cylindrical implant type as osseointegrated in the posterior mandible; (2) compare the stress-dissipating characteristics of the stepped implant versus the straight implant design; and (3) analyze the significance of bite force direction (vertical, horizontal, and oblique 45 degrees) on both implant types. The results of the FEA suggested that (1) using the widest diameter implant is not necessarily the best choice when considering stress distribution to surrounding bone, but within certain morphological limits, for both implant types, an optimum dental implant exists for decreasing the stress magnitudes at the bone-implant interface; (2) stress is more evenly dissipated throughout the stepped cylindrical implant when compared to the straight implant type; and (3) it is important in FEA of dental implants to consider not only axial forces (vertical loading) and horizontal forces (moment-causing loads), but also to consider a combined load (oblique bite force), since these are more realistic bite directions and for a given force will cause the highest localized stress in cortical bone. The theoretical analysis performed implies that clinically, whenever possible, an optimum, not necessarily larger, dental implant should be used based on the specific morphological limitations of the mandible and that a stepped cylindrical design for press-fit situations is most desirable from the standpoint of stress distribution to surrounding bone.

The role of surface functional groups in calcium phosphate nucleation on titanium foil: a self-assembled monolayer technique

Surface functional groups play important roles in nucleating calcium phosphate deposition on surgical titanium implants. In this study, various functional groups were introduced onto the surface of commercially pure titanium foils using a self-assembled monolayer (SAM) technique. An organic silane, 7-oct-1-enyltrichlorosilane (OETS) was used and -OH, -PO4H2, -COOH groups were derived from its unsaturated double bond. Ti foils were first oxidized in concentrated H2SO4/H2O2. ESCA and contact angle measurements were used to characterize the SAM surfaces and confirm the presence of various functional groups. A fast calcium phosphate deposition experiment was carried out by mixing Ca2+- and (PO4)(3-)-containing solutions in the presence of the surface-modified Ti samples at pH 7.4 at room temperature in order to verify the nucleating abilities of these functional groups. SEM, Raman spectroscopy, XRD and ATR-FTIR results showed that poorly crystallized hydroxyapatite (HA) can be deposited on the SAM surfaces with -PO4H2 and -COOH functional groups, but not onto the SAM with -CH=CH2 and -OH. -PO4H2 exhibited a stronger nucleating ability than that of -COOH. The oxidized Ti sample also showed some calcium phosphate deposition but to a lesser extent as compared to SAM surfaces with -PO4H2 and -COOH. The pre-deposited HA can rapidly induce biomimetic apatite layer formation after immersion in 1.5 SBF for 18 h regardless of the amount of pre-deposited HA. The results suggested that the pre-deposition of HA onto these functionalized SAM surfaces might be an effective and fast way to prepare biomimetic apatite coatings on surgical implants.

Effect of saliva on shear bond strength of an orthodontic adhesive used with moisture-insensitive and self-etching primers

The purpose of this study was to investigate the effect of saliva contamination on the shear bond strength of an orthodontic adhesive used with Transbond Moisture-Insensitive Primer (MIP, 3M Unitek, Monrovia, Calif) and Transbond Plus Self-Etching Primer (SEP, 3M Unitek). Hydrophobic Transbond XT primer (XT, 3M Unitek) was used as a control. A total of 162 extracted premolars were collected and divided equally into 9 groups of 18 teeth each, and brackets were bonded with Transbond XT adhesive (3M Unitek) under different experimental conditions: (1) control: etch/dry/XT, (2) etch/dry/MIP, (3) etch/dry/MIP/wet (saliva)/MIP, (4) etch/wet/MIP, (5) etch/wet/MIP/wet/MIP, (6) dry/SEP, (7) dry/SEP/wet/SEP, (8) wet/SEP, and (9) wet/SEP/wet/SEP. Shear bond strength of each sample was examined with a testing machine. The results showed that the control group had the highest mean shear bond strength (group 1, 21.3 +/- 6.8 MPa), followed by the MIP group in a dry field (group 2, 20.7 +/- 5.0 MPa). No significant difference was found between groups 1 and 2. Groups 3 through 9 had similar mean strengths, ranging from 12.7 to 15.0 MPa (P >.05), which were significantly lower than in groups 1 and 2 (P <.05). There was no significant difference in bond-failure site among the 9 groups. It was concluded that (1) Transbond XT adhesive with Transbond XT primer and MIP in a dry field yields similar bond strengths, which are greater than all other groups, (2) saliva contamination significantly lowers the bond strength of Transbond MIP, (3) saliva has no effect on the bond strength of Transbond SEP, (4) Transbond XT adhesive with Transbond MIP and SEP might have clinically acceptable bond strengths in either dry or wet fields.

Nanoindentation studies of titanium single crystals.

Titanium single crystal planes of different atomic density have been reported to show different oxidation characteristics. The differences in oxide characteristics have further been demonstrated to lead to differences in osteoblast attachment. Investigations of the preferred crystallographic planes of titanium for osteoblast attachment can be used to optimize the surfaces of single crystal and polycrystalline titanium implants for anchoring various prostheses. Nanoindentation techniques were used to determine mechanical properties of two crystallographic planes of titanium of different atomic density. Modulus of elasticity of 128 +/- 10 GPa was obtained for polycrystalline titanium and 123 +/- 5 and 124 +/- 6 GPa for the basal plane and pyramidal planes, respectively. The variation of modulus with crystal orientation was not greater than the statistical variation in the data. Surface hardness values were 2.1 +/- 0.1 GPa for the polycrystalline sample and 1.6 +/- 0.1 and 1.9 +/- 0.1 GPa, respectively, for the basal and pyramidal planes. Curves of hardness as a function of depth (0-2000 nm) obtained from electrochemically polished surfaces showed a sharp increase at shallow depths and may reflect changes caused by oxidation of the titanium surfaces.

Enamel preparation for orthodontic bonding: A comparison between the use of a sandblaster and current techniques*

Four methods of enamel preparation before orthodontic bonding that are currently in use or proposed for use were investigated. The study consisted of two parts. Part one evaluated the roughness of the prepared enamel surfaces by using optical profilometry and scanning electron microscopy (SEM). Part two compared the debonding force for the prepared enamel surfaces by using a mechanical testing machine. The teeth were divided into four groups as follows: In group A, the surfaces were only sandblasted. In group B, the surfaces were sandblasted and acid etched. In group C, the surfaces were buffed with an 1172 fluted bur and acid etched. In group D, the surfaces were pumiced and acid etched. There was no statistical difference in surface roughness among the four groups at p < 0.05, nor was there any statistical difference in bond strength among the three groups that were acid etched. However, there was a significant difference in bond strength between these groups and the group that received only sandblasting (no acid etching). Thus, in this preliminary study, sandblasting does not appear to damage the enamel surface and can therefore be used as a substitute for polishing with pumice. It should be followed by acid etching to produce enamel surfaces with comparable bond strengths.

Shear bond strength of a resin-reinforced glass ionomer cement: An in vitro comparative study

Shear bond strength of Concise (a composite resin adhesive) and Fuji Ortho LC (a light-cured resin-reinforced glass ionomer cement) bonded to extracted teeth was tested under different bonding conditions: (1) Concise/etched/dry (2) Fuji/etched/dry (3) Fuji/etched/wet (4) Fuji/unetched/dry (5) Fuji/unetched/wet. Concise/etched/dry and Fuji/etched/dry groups showed comparable mean shear bond strength (10.5 and 8.2 MPa, respectively); the other three groups had considerably lower values. The difference between Fuji/etched/dry and Fuji/etched/wet was not statistically significant. The site of bond failure was between bracket and adhesive in all etched groups and between adhesive and enamel in the unetched groups. We conclude that (1) enamel surface etching is required for Fuji Ortho LC to achieve optimum bond strength, (2) moisture does not affect bond strength of Fuji Ortho LC significantly.

Softening patterns of post-cure heat-treated dental composites

The softening of post-cure, heat-treated dental composites in various solutions was evaluated by Knoop hardness measurements. The samples were heated at 120 degrees C for 7 min immediately after curing and immersed in various solutions, water, ethanol, heptane and 0.1 N NaOH. Significant increases in hardness were observed for heated samples when compared to unheated samples. The various solutions softened both heated and unheated composites but heated samples were softened to a lesser degree. Plots of hardness of heated and unheated samples were nearly parallel, indicating that mechanisms such as penetration of the resin matrix, degradation of the silane coupling agent and fillers may be involved in the softening of both heated and unheated composites. Post-cure heat treatment improved the resistance to softening of dental composites.

Comparative osteogenesis of maxilla and iliac crest human bone marrow stromal cells attached to oxidized titanium: a pilot study.

OBJECTIVES Severe alveolar bone loss affects dental implant placement. Bone augmentation by grafting iliac crest bone rich in osteoprogenitor cells such as bone marrow stromal cells (BMSCs) requires a second surgical procedure in non-orofacial bone. Skeletal site-specific osteogenesis indicates maxilla and mandible BMSCs are highly proliferative and exhibit osteogenic properties superior to iliac crest BMSCs. Alveolar bone can be easily obtained during routine dental surgery, but it is unclear if titanium-attached alveolar BMSCs will retain their superior osteogenic properties. This study evaluated and compared in vitro osteogenic properties of titanium-attached maxilla and iliac crest BMSCs in same individuals. MATERIAL AND METHODS Primary culture of maxilla and iliac crest BMSCs from four normal healthy volunteers was expanded in culture. In 24-well plates, first passage BMSCs were seeded directly (1 x 10(4) cells/well) on oxidized titanium disks (1.27 cm diameter and 2 mm thickness) or tissue culture plate. Each cell type was assessed for affinity for titanium, post-attachment survival and osteogenic differentiation based on alkaline phosphatase and osteopontin expressions. RESULTS There was no difference in the affinity of maxilla and iliac crest BMSCs to titanium. However, titanium-attached maxilla BMSCs were apparently more osteogenically responsive than iliac crest cells based on calcium accumulation and gene expression of alkaline phosphatase and osteopontin. But these differences were not statistically significant in this small patient sample. CONCLUSION Maxilla and iliac crest BMSCs have similar attachment affinity for titanium. This pilot study indicates that titanium-attached maxilla BMSCs are more osteogenically responsive and may be a viable and more readily available donor graft material in implant dentistry.

Shear bond strengths of two resin-modified glass ionomer cements to porcelain

Shear bond strength of a composite resin adhesive (Concise) and two resin-modified glass ionomer cements (Fuji Ortho LC and Geristore) bonded to porcelain surface was tested. Orthodontic brackets were bonded to 120 porcelain disks (Finesse) etched with 9% HF. Samples were divided into six groups: (1) Concise, (2) Concise/silane, (3) Geristore, (4) Geristore/silane, (5) Fuji, (6) Fuji/silane. No statistical difference in mean shear bond strength was found between silanated Concise (15.8 MPa), Geristore (19.4 MPa), and Fuji (18.5 MPa) groups, which were significantly higher than nonsilanated groups. Porcelain fracture was observed in all silanated groups and nonsilanated Geristore group. We conclude that (1) silane increases bond strength to porcelain significantly for composite resin and resin-modified glass ionomer cement, (2) Concise, Geristore, and Fuji Ortho LC provide comparable shear bond strength to porcelain.

Oxidation of Titanium, RGD Peptide Attachment, and Matrix Mineralization of Rat Bone Marrow Stromal Cells

The aim of this study was to compare the efficacy of attachment of arginine-glycine-aspartic acid (RGD) peptide to titanium surfaces oxidized by different methods. Titanium surfaces were treated as follows: (1) treatment A: passivation in nitric acid, (2) treatment B: heated in air at 400 degrees C for 1 hour, (3) treatment C: immersed in 8.8 M H2O2/0.1 M HCl at 80 degrees C for 30 minutes, and (4) treatment D: treated as in treatment C and then heated at 400 degrees C for 1 hour. RGD was attached to titanium samples treated as in treatments A through D. The quantity of attached RGD was determined by an enzyme-linked immunoabsorbent assay. Mineralization of a rat bone marrow stromal cell (RMSC) culture on the titanium surfaces after 21 days was determined y atomic absorption spectroscopy. The treatments were ranked according to quantity of RGD attached as C, A, B, and D. Twenty-one days after RMSC culture, the degree of mineralization was significantly higher for treatment C than for treatments A, B, and D and for controls. The efficacy of RGD attachment varies with the oxidation treatment given to titanium. Oxidation in H2O2/0.1 M HCl at 80 degrees C provided the best overall surface for RGD attachment as well as calcified matrix formation of RMSCs.