Effect of Surgical Instrumentation Variables on the Osseointegration of Narrow- and Wide-Diameter Short Implants

Lukasz Witek; Marcelo Parra; Nick Tovar; Adham Alifarag; Christopher D Lopez; Andrea Torroni; Estevam A Bonfante; Paulo G Coelho

doi:10.1016/j.joms.2020.09.041

Effect of Surgical Instrumentation Variables on the Osseointegration of Narrow- and Wide-Diameter Short Implants

J Oral Maxillofac Surg. 2021 Feb;79(2):346-355. doi: 10.1016/j.joms.2020.09.041. Epub 2020 Oct 8.

Authors

Lukasz Witek¹, Marcelo Parra², Nick Tovar³, Adham Alifarag⁴, Christopher D Lopez⁵, Andrea Torroni⁶, Estevam A Bonfante⁷, Paulo G Coelho⁸

Affiliations

¹ Assistant Professor, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY and Assistant Professor, Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY. Electronic address: lukasz.witek@nyu.edu.
² Graduate Student, PhD Program in Morphological Sciences, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; and Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.
³ Research Fellow, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY; and OMFS Resident, Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, NY.
⁴ Research Fellow, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; and Surgical Resident Fellow, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
⁵ Plastic Surgery Resident, Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD.
⁶ Associate Professor, Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY.
⁷ Assistant Professor, Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
⁸ Professor, Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Professor, Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA; and Professor, Department of Mechanical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY.

PMID: 33137302
DOI: 10.1016/j.joms.2020.09.041

Abstract

Purpose: The aim of the present study was to systematically analyze how a multifactorial surgical instrumentation approach affects osseointegration on both narrow-diameter and wide-diameter short implants.

Materials and methods: Twelve skeletally mature female sheep were used in the study along with 144 plateau-root-form healing chamber titanium (Ti-6Al-4V) implants (Bicon LLC, Boston, MA), evenly distributed between narrow (3.5 mm) and wide (6.0 mm) diameters. The presence or the absence of irrigation, different drilling speeds, and 2 time points quantifying bone-implant contact (BIC) and bone area fraction occupancy (BAFO) to evaluate the osteogenic parameters around the implants.

Results: There were no signs of inflammation, infection, or failure of the implants observed at either healing period. The narrow 3.5-mm implant, at 6 weeks, yielded significant differences in terms of BIC at a drilling speed of 50 rotations per minute (RPM), with higher values of the samples using irrigation (30.6 ± 6.1%) compared with those without (19.7 ± 6.1%). No statistical differences were detected for 500 and 1,000 RPM with or without irrigation. The wide 6-mm diameter implant showed differences with respect to drilling speed, 500 and 1,000 RPM, with higher values associated with samples subjected to irrigation. BAFO results, for both diameters, only detected statistical differences between the 2 times (3 vs 6 weeks); no statistical differences were detected when evaluating as a function of time, drilling speed, and irrigation.

Conclusions: Surgical instrumentation variables (ie, drilling speed [RPM] and irrigation) yielded to be more of an effect for BIC at longer healing time (6 weeks) for the wider implants. Furthermore, deploying narrow or wide plateau-root-form implants, where conditions allow, has shown to be a safe alternative, considering the high BIC and BAFO values observed, independent of irrigation.

MeSH terms

Animals
Boston
Dental Implantation, Endosseous
Dental Implants*
Osseointegration*
Sheep
Surface Properties
Titanium

Substances

Dental Implants
Titanium