1 / 46

one day implants

one day implants. โดย นทพ.พีระยุทธ อัสโม 4309050. Osteointegration . Integrate between living bone and surface of an implants It is for directly structure and function Not to have over loading force or shearing force Waiting in mand 3 months and 6 months max. Fibrous tissue formation.

ailis
Télécharger la présentation

one day implants

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. one day implants โดย นทพ.พีระยุทธ อัสโม 4309050

  2. Osteointegration • Integrate between living bone and surface of an implants • It is for directly structure and function • Not to have over loading force or shearing force • Waiting in mand 3 months and 6 months max. • Fibrous tissue formation

  3. Paper 1 • Immediate Loading of Titanium Plasma-Sprayed Screw-Shaped implants in man: A clinical and histological report of two cases • A.Piattelli, M. Paolantonio, M. Corigliano, and A. Scarano • Journal of periodontal 1997;68:591-597

  4. Material and method • Ten patients----4 males , 6 females • Age from 48 to 72 (mean 59) • Restoration in edentulous posterior max. and mand. Arches • Three implants were inserted in each of these patients, for a total of 30. • 10 ---- immediately load • 20 ---- were allowed to heal in a submerged location

  5. Material and method • Same day ---- a fixed transitional acrylic prosthetics was put on the implant • Immediated implants were inserted in max. or mand. Premolar region • And submerged were locate posteriorly to it.

  6. Material and method

  7. Material and method

  8. Material and method • Started in November 1994,and checked at 3-month intervals to evaluation… • 1. Peri-implant tissues • 2. mobility • 3. periapical radiographs • Result in first 3 months • …no mobility, healthy condition at periapical tissue, no inflammation

  9. Material and method • It was necessary to retrieve 2 of the loaded implant • 1. max.---8 months , fracture of abutment , (case 1) • 2. mand.---9 months , psychological reason , (case 2)

  10. Material and method

  11. Histology method • Implants and surrounding tissues were washed in saline solution and immedately fixed in 4 % para-formaldehyde and 0.1 % glutaradehyde in 0.15 M cacodylate buffer at 4 oC and pH 7.4 • The specimens…dehydrate with alc. And embeded in a glyclmethacrylate resin • After polymerized specimens…section it in longitudinal axis about 100 um,30 um

  12. Histology method • The slides were stained with acid fuchsin and toluidine blue • Normal transmitted light microsope • Von Kossa staining…done to visualized the calcified structures and their relationship with titanium • Von Kossa… double staining 1. Von Kossa 2. basic fuchsin

  13. Von Kossa • After polishing, the slides were immersed in AgNO3 for 30 min. and exposed to sunlight • The slides were then washed under tap water,dried,and immersed in basic fuchsin for 5 min. ,and then washed and mouthed.

  14. Histology method • Morphometry of percentage of bone contact was done by an optical system connected to an computer • The qualitative analysis of the peri-implant bone was done according to the parameter set in Table.1

  15. Results • Case 1 max. implant • Mature,compat,cortial bone was present around the implant • No resorption,bone necrosis • The morphometrial analysis showed…the percentage of bone-implant contact was 72%(+/- 5) • The qualitve analysis was ++++(mature compat bone is present)

  16. Results • Case 1 histological • Highly mineralized present at peri-implant • Basic fusin positive • At the higher magnification no gaps were visible in the surface

  17. Results

  18. Results • Case 2 • Mature, compact bone with small osteocytic lacunae was present in peri-implant location (fig.13) • No gaps were present at the bone-implant interface

  19. Results • Case 2 • no inflamatory cells at interface • Histomorphometrical analysis showed…the percentage of bone-implant contact was 61% (+/- 4) • The qualitve analysis was ++++(mature compat bone is present)

  20. Discussion • Immediate loading implants can be success if primary stability is good with no mobility of implants • Good primary stability come from a precise fit of the implant or a friction related to implants design • Most of the case of immediately loading…were located in mandible

  21. Paper 2 • Ultrastructural characterization of the implant/bone interface of immediately loaded dental implants • U. meyer,U.Joos,J.Mythili,T.Stamn ,department of cranio-maxillofacial surgery,university of munster,Germany • Biomaterials 25(2004) 1959-1967 • www.elsevier.com/locate/biomaterials

  22. Introduction • Clinic and examination demonstrate that osseointegration can be achieved when healing under load is allowed • Szmukler-Moncler et al. show the relative the timing of loading and effect of micromotion on the bone-implant interface • Micromotion…during the healing process lead to a disruption of the bone-cell-implant contact and lead to deformation of osteoblast that fixed at surface in a strain-related manner

  23. Introduction • The physiological bone loading(500-3000 microstrains)lead to mature bone formation but higher strains make a immature bone formation and fibroblastic cell • The aims of this study … to investigate the features of osteoblast behavior and matrix mineralization during the early bone/biomaterial interaction that depend on implant loading • We have 2 different immediate loading implants on newly titanium implants design

  24. Material and method • Newly developed….. • Conical screw-shaped implants • A length… 10 mm. • A diameter… 4.1 mm. • Made from pure Titanium • Thread design… the curvature is well calculated to exhibit a homogenous and physiological strain distribution(1500-3000 microstrains) with in normal under mastigation and loading conditions

  25. Experimental animals • 6 male minipigs • Minipigs were selected to adequate alveolar ridge size and hight for implant placement • The pigs were sedated with IM injection of… 1. ketamine 10 mg/kg 2. atropine 0.06 mg/kg 3. stresnil 0.03 mg/kg • extraction on mand. Second premolar bilaterally

  26. Experimental animals

  27. Experimental animals • Two groups • 2 immediately loaded with in occlusal contact and 2 implants placed in a non-occlusal region

  28. Surgical procedure • The implants inserted by manual tapping of the screw-shaped implants until the bodies were fully embedded in bone • Single crowns were prepared at the day of surgery • Dissected a block specimens on days 1,3,14 of implants loading and embedded it in Tehnovit and subsequent undecalcified histological section • The other block…with implants use SEM to investigation and immunostaining • Section without implants…TEM and diffracton analysis

  29. Transmission electron microscopy • Tissue samples were fixed in 100mM phosphate buffer containing 2.5% glutaraldehyde (pH 7.4) • Specimens were dehydrated in a graded series of alcohol and embedded in Araldite resin • Ultrathin sections were stained for 1 h with 2% uranyl acetate followed by incubation in Reynold’s lead citrat. • Sections were examined under a Philips CM10 electron microscope. • Electron diffraction analysis was carried out on ultrathin sections with a Philips CM10 TEM. Three positions from each implant were usedto investigate the mineral formation.

  30. Transmission electron microscopy

  31. Transmission electron microscopy x20 x40

  32. Scanning electron microscopy • glutaraldehyde fixed specimens were critical-point dried • Additionally, samples were fixed in liquid nitrogen-cooled propane and cryodriedat 80C. • Samples were sputter-coated with gold for histological analysis (immunogold labeling for the localization of fibronectin,fibronectin receptor, and osteonectin on the surface) • Specimens were examined under a field emission scanning electron microscope (LEO 1530 VP,Oberkochem, Germany).

  33. Scanning electron microscopy

  34. Scanning electron microscopy

  35. Scanning electron microscopy

  36. Scanning electron microscopy

  37. Immunolabeling • Cells were incubated with primary antibodies,anti-fibronectin, anti-.bronectin receptor, and antiosteonectin(Takara Chemicals, Japan), at a dilution of 1:200. • This was followed by secondary 20 nm gold conjugated antibody incubation (British Bio-Cell International). • After washing a silver enhancement was done for the gold particles using a Silver Enhancement kit(British Bio-Cell International). • The samples were then dehydrated, critical point dried, carbon coated and viewed also through the LEO 1530 VP scanning electron microscope. • Samples without first antibodies were used as controls.

  38. Results

  39. Results

  40. Results

  41. Results

  42. Discussion • A long term success require rigid fixation between implants and host bone site • Axial symmetry is possible • Screw-shaped implants effective for achieving secure implant fixation • fibronectin,fibronectin receptor, and osteonectin on the surface

  43. reference 1. www.pubmed.com 2. www.google.com 3. Piattelli A, Paoloantonio M, CoriglianoM Scarano A. Immediate loading of titanium plasma-sprayed screw-shaped implants in man: a clinical andhistologica l report of 2 cases. J Periodontol 1997;68:591–7.

  44. Special Thanks ผู้ช่วยศาสตราจารย์ ดร. สุมิตรา พงษ์ศิริ

  45. THANK YOU for your attention

More Related