Ryuji Hosokawa

Comparison between freestanding and tooth-connected partially stabilized zirconia implants after two years' function in monkeys: A clinical and histologic study

STATEMENT OF PROBLEM Partially stabilized zirconia implants placed by a 1-stage procedure have been previously shown to obtain initial osseointegration under clinically unloaded condition. However, it is unknown whether freestanding and tooth-connected partially stabilized zirconia implants can maintain a long-term direct bone-implant interface. PURPOSE This study examined the possibility of the long-term stability of osseointegration around partially stabilized zirconia implants with a 1-stage procedure with different loading designs. MATERIAL AND METHODS Thirty-two partially stabilized zirconia implants were placed into the mandibles of 8 monkeys. Three months after implant placement, 3 types of superstructure were provided in each animal to obtain different concepts of support as (1) single freestanding implant support, (2) connected freestanding implant support, and (3) a combination of implant and tooth support. At 12 and 24 months after loading, clinical, histologic, and histomorphometric evaluations of peri-implant tissues were performed on 28 implants. RESULTS No clear difference in clinical features was observed among the different types of support. Direct bone apposition to the implant was generally seen in all groups. Histometrically, bone contact ratio ranged between 66% and 81%, and bone area ratio varied between 49% and 78% at 24 months after loading. These values showed almost no difference among single freestanding, connected freestanding, and implant-tooth supports of partially stabilized zirconia implants. CONCLUSION In a primate model, partially stabilized zirconia implants placed with a 1-stage procedure achieve long-term stability of osseointegration with the use of single freestanding, connected freestanding, and implant-tooth supports.

Diverse mechanisms of osteoblast spreading on hydroxyapatite and titanium

Hydroxyapatite (HA) is an osteoconductive implant material. We previously demonstrated that RGD peptides regulate the spreading of HOS cells on HA but not on titanium, speculating that the osteoconductivity of HA might be attributed to this RGD domain-dependent spreading of osteoblasts. To confirm this hypothesis, the molecules which regulate the spreading of HOS cells on HA and on titanium were investigated. The 50% effective dose (ED50) of RGD peptide for the spreading on HA was five fold lower comparing to titanium. Anti-alphaV integrin antibody, vitronectin, and fibronectin inhibited the spreading on HA but not on titanium. In Western blot analysis, vitronectin and fibronectin were found in components adsorbed to HA but not to titanium. Taken together, the spreading of HOS cells on HA but not on titanium requires the interaction of alphaV integrin and its ligands. The ED50 of the RGD peptides on titanium but not on HA was remarkably reduced by neuraminidase treatment, that by itself could not inhibit the spreading on both materials. This phenomenon suggests that RGD domain and sialic acid cooperatively but not independently mediate the spreading of HOS cells on titanium. Collectively, the molecules regulating the spreading on HA are apparently different from those on titanium. The spreading of osteoblasts mediated by RGD domain of vitronectin and fibronectin might contribute to the osteoconductive ability of HA.

RGD Peptides Regulate the Specific Adhesion Scheme of Osteoblasts to Hydroxyapatite but not to Titanium

Hydroxyapatite (HA) is a bioactive dental implant material which accelerates bone formation on its surface. The mechanism of this acceleration is not clear. The elucidation of the cell adhesion might be the key to the understanding of the bioactive mechanism of HA. In this study, we analyzed the adhesion of HOS human osteoblasts onto HA and titanium to find the particular adhesion to HA. In short-term cultures in fetal bovine serum-pre-coated materials, a significantly higher number of cells adhered to HA than to titanium. In addition, serum-free conditions with phosphate-buffered saline pre-coating or bovine serum albumin pre-coating materials were tested. The results were nearly the same among all pre-coating conditions, suggesting that the quantity of cell adhesion was not affected by serum components. However, in the morphological observations by SEM, the form of adhesion was found to differ among pre-coating conditions. The osteoblasts tightly adhered and spread onto both HA and titanium with serum pre-coating, whereas the cells loosely adhered and did not spread without serum. To evaluate the Arg-Gly-Asp (RGD) sequence-specific adhesion, we used synthetic RGD peptides for a competitive inhibition test. The results showed that RGD peptides remarkably inhibited the tight adhesion and spreading of osteoblasts onto HA, whereas they did not strongly inhibit adhesion and spreading onto titanium. These results demonstrate that the regulation of cell adhesion to HA is different from that to titanium. Our study suggests that the RGD-containing serum proteins might have a major role in regulating the specific adhesion of osteoblasts to HA, and in inducing enhanced cell growth and differentiation.

Continuous Administration of Basic Fibroblast Growth Factor (FGF-2) Accelerates Bone Induction on Rat Calvaria— An Application of a New Drug Delivery System:

Some studies have shown that locally applied basic fibroblast growth factor (FGF-2) enhances bone regeneration at a fracture site, while others have not been in agreement. We developed a new continuous FGF-2 delivery system designed to accelerate cytokine-induced new bone formation. A subperiosteal pocket was surgically formed in 36 eight-week-old male Wistar rats. The rats were administered 0, 1, 10, or 100 ng of FGF-2 contained in a collagen minipellet, mixed with allogeneic demineralized bone matrix in a dome-shaped Millipore® filter and then placed into the pocket. New bone formation in the dome was evaluated at 2, 4, and 8 wks after placement. Soft x-ray radiographs disclosed an apparently larger radiopaque region in the 1-ng group at 4 wks compared with those in the other groups. Morphometrical analysis revealed that the new bone area in the 1-g group was significantly larger than that in the 0-g group (p < 0.01). In the 100-ng FGF-2 group, new bone formation seemed suppressed. We concluded that continuous slow administration of a small amount of FGF-2 accelerates bone-derived osteogenic cytokine-induced new bone formation.

Biomechanical effects of double or wide implants for single molar replacement in the posterior mandibular region

Double implants have been thought to have biomechanical advantages for single molar replacement. To evaluate the effectiveness of double implants versus a wide implant, the vertical forces and torque on each implant were calculated by three-dimensional geometric analysis. Buccal load (100N) perpendicular to cuspal inclination (20 degrees) was applied at the occlusal surface of the superstructure. The three kinds of load points (A, B, C) were 1.5, 3.5, and 5.5 mm from the mesial contact point, respectively. Three implants were compared: mesial and distal double implants (phi 3.3 mm), and a wide implant (phi 5 mm). The wide implant showed torque around the long axis (1.8-15.0 N x cm) whereas double implants had no torque. On the other hand, the vertical forces on the mesial double implant were both smaller (60%: loaded at point C) and larger (140%: loaded at point A) than the wide implant. Given the smaller surface area of the mesial double implant, this large force may generate much higher stress in the peri-implant bone. These results suggest that the biomechanical advantage of double implants for single molar replacement is questionable when the occlusal force is loaded at the occlusal surface near the contact point.

The effect of occlusal rest size and shape on yield strength

STATEMENT OF PROBLEM Occlusal rests, essential for conventional removable partial dentures, may fracture and cause failure of the prosthesis. It is unknown whether alterations in the size or shape of occlusal rests might improve their performance. PURPOSE In this in vitro study, 3-dimensional finite element analysis was used to evaluate the effects of occlusal rest size and shape on yield strength. MATERIAL AND METHODS An occlusal rest and a minor connector as part of a clasp assembly were modeled for 3-dimensional finite element analysis with 3 variations of width (2.0, 3.0, and 4.0 mm), thickness (0.7, 1.0, and 1.5 mm) and length (2.0, 3.0, and 4.0 mm). A concentrated vertical load of 100 N was applied at the most protruded point of the occlusal rest base. Maximal principal stress and yield strength were calculated. In addition, the following parameters were altered: radius of curvature at the inner connection (r), thickness of the minor connector (m), inclination of horizontal axis of occlusal rest (i), and thickness at the most protruded point (t). RESULTS Yield strength increased with increased width (183% to 242% from 2.0 to 4.0 mm) and thickness (141% to 230% from 0.7 to 1.5 mm). Alterations in length had a lesser effect on yield strength (120% to 178% from 4.0 to 2.0 mm). All other parameters except thickness at the most protruded point (t) affected yield strength. CONCLUSION The results of this in vitro study suggest basic principles for optimizing the size and shape of occlusal rests. In general, increased width and thickness are desirable, whereas overrounded or sharp line angles and excessive rest inclination should be avoided. These principles may be useful in removable partial denture design.

Proximal plate in conventional circumferential cast clasp retention

Improper guiding planes are commonly used with conventional removable partial denture cast clasps. Short guiding planes with improper proximal plates decrease retention and cause repetitive traumatic movement of abutments. This article discusses the importance of guiding planes and proximal plates for conventional tooth-supported removable partial dentures with circumferential clasp. The retention force of the clasps was analyzed geometrically. If the guiding plane is short or the prepared surface is oblique, the contact between the proximal plate and the guiding plane or oblique plane diminishes at an early stage, which results in reduction of retention. The guiding plane should be parallel to the path of insertion and must be of a certain length for adequate retention. An elongated proximal plate that is parallel to the path of insertion may compensate for retention deficiency when an adequate guiding plane cannot be prepared.

Morphogenetic behavior of periodontium on inorganic implant materials: An experimental study of canines

Periodontal ligament derived cells have the potential to regenerate all the components of the periodontium on the surface of inorganic implants, as well as on dentin. This suggests the hypothesis that the nature of the material affects the migration, proliferation, and differentiation of the progenitor cells for periodontium formation. To clarify this hypothesis, we evaluated the material-specific morphogenetic potential of periodontium-derived cells using an animal model for inducing cell migration from the functioning periodontium onto bioactive (hydroxyapatite, HA) and bioinert (titanium alloy, TA) material. Histologically, total periodontium including calcified cementum-like tissue only formed on HA and not on TA. Morphometrically, however, the length of fibrous connective tissue formed on HA was the same as on TA. This suggests that the bioactivity of the material does not affect the migration of periodontium-derived cells but strongly influences cell differentiation.

Immediate maxillary denture base extension for posterior palatal seal

A procedure for extension of the maxillary denture base for development of a posterior palatal seal is described. The technique involves provisional extension with paraffin wax and adding direct relining resin supported by a silicone putty core. This simple, quick procedure achieves immediate recovery of retention for underextended maxillary dentures without additional laboratory procedures.

Accurate procedure for transferring a cast replacement clasp arm to a removable partial denture.

This article describes a simple, quick and accurate procedure to replace a broken bar-type clasp with a new clasp arm. This procedure involves a resin matrix that transfers a new clasp arm from a working cast to a removable partial denture. This simple procedure enables quick and precise replacement of a broken clasp arm.