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PubMed2005

Titanium mesh fracture in mandibular reconstruction.

Mandibular reconstruction is important for providing good functional and cosmetic results after the resection of a mandibulary segment. Reconstruction plates and titanium meshes are usually used to reconstruct the bony defects in mandible. Although their complications are well known there is not a report on the fractures of a titanium mesh after mandible reconstruction in the literature. We reported a case of a broken titanium mesh after mandible reconstruction.

Bone Plates↗
PubMed1988

The in-vitro effect of a titanium implant on oral microflora: comparison with other metallic compounds.

Dental implant research has been mostly concerned with the biocompatibility of materials for implantation. In this study the effects of titanium dioxide and other metallic salts on seven bacterial species commonly found in dental plaque, two which are uncommon, and a yeast, were determined by agar incorporation and diffusion techniques, and compared with the effects of a titanium implant abutment. Neither the titanium dioxide nor the implant abutment demonstrated any inhibitory activity, although other compounds such as cobalt used in dental alloys had some effects.

Bacteria↗
PubMed2002

Tissue reactions evoked by porous and plane surfaces made out of silicon and titanium.

Square-shaped silicon or titanium implants with plane or porous surfaces surrounded by a rim of silicone were implanted in the rat abdominal wall for evaluation of the tissue response after one, six, or 12 weeks. Cell damage was identified as increased membrane permeability using fluorescence microscopy by injection of propidium iodide prior to the killing of the rats. Capsule thickness and immunohistochemical quantification of macrophages were used as a further measure of the foreign-body reaction. There were no significant differences in capsular cell densities for macrophages, total cells (macrophages, fibroblasts, and other cells), or necrotic cells at the different time points for the four surfaces studied. However, significant differences in the kinetics of the response were found between plane surfaces compared with porous ones. Both types of plane surfaces developed a significant increase in capsule thickness over time in contrast to the porous implants. Porous silicon displayed a significant decrease in total cells in the reactive capsule over time. Furthermore, porous silicon and titanium surfaces displayed a significant decrease in total cell numbers at the implant interface between six and 12 weeks. The present study demonstrated that implanted silicon elicited soft-tissue reactions comparable to that of titanium.

Abdominal Muscles↗
PubMed2004

Effects of a metal etchant and two primers on resin bonding durability to titanium.

The purpose of this study was to investigate the efficacy of an etchant in titanium bonding. The aqueous etchant consisted of 0, 5, or 10 wt% ammonium hydrogen fluoride (AHF) in combination with 0, 0.03, 0.3, or 3 wt% cupric chloride (CC). The two primers used were a phosphate-methacrylate primer and a thiophosphate-methacrylate primer, and two self-curing resins (Super-Bond C&B and MT) were employed as luting agents. Disk specimens were cast with a commercially pure titanium. The surface was air-abraded with 50 microm alumina, etched for 10 s, rinsed with water, and then air-dried. The primer was applied to the bonding area (5 mm in diameter), and an acrylic rod was bonded to the specimen with the luting agent. Shear bond strengths were evaluated after 24 h of water storage and following 10,000 thermocycles (4 degrees C and 60 degrees C). The post-thermocycling bond strength was significantly increased with each of the two primers compared with the unprimed controls. The etchant containing 5 wt% AHF and 0.3 wt% CC further increased their durability, and microscopic observation revealed that innumerable submicron crystals were created on the etched specimen. The present results suggest that the chemical etching improved the resin bonding durability to titanium in combination with the primer used.

Ammonium Compounds↗
PubMed2005

A prospective evaluation of the Essen titanium stapes prosthesis.

OBJECTIVES: This is the first clinical trial to evaluate the suitability of a new titanium stapes prosthesis, which we developed jointly with the Kurz Company (Dusslingen). DESIGN: In a prospective clinical study, patients with otosclerosis underwent stapes surgery using our new titanium stapes prosthesis during a period of 14 months. One year after surgery pre- and postoperative audiograms were performed and all patients participated in a structured interview. SETTING: Tertiary otorhinolaryngological university department PARTICIPANTS: Of 49 patients with otosclerosis, entering the study, two patients were excluded, because they were not located any more. MAIN OUTCOME MEASURES AND RESULTS: All patients experienced a hearing improvement of 21 dB on average except one patient. Sixty percentage of patients achieved a reduction of the air-bone gap to less than 10 dB and 31% of patients having their air-bone gap closed to within 20 dB--averaged across 0.5, 1.0, 2.0 and 4 kHz. The hearing level improved significantly in the air and in the bone conduction thresholds. CONCLUSIONS: This paper presents our first '1 year postimplantation' results of our titanium stapes prosthesis. We consider the development of this implant to be beneficial. The results confirm significant improvement in hearing status and tinnitus levels.

Adult↗
PubMed1994

A study in vitro of threaded titanium pins used for retrograde obturation of root canals.

The microleakage of four retrograde filling materials was compared in vitro. Fifty-three single rooted teeth were instrumentated and root filled with resin chloroform and gutta-percha. The gutta-percha cones were left extruding from the access opening. All teeth were apicected and retrograde fillings placed. The materials used were a non gamma 2 amalgam (Amalcap), a glass ionomer cement (ChemFil II), threaded titanium pins cemented with a glass ionomer cement (ChemFil II) and identical titanium pins cemented with a silicone material (Adheseal). After removal of the gutta-percha with tweezers, a radioactive isotope solution was placed in the teeth. Extraradicular samples were taken at 3, 7, 28, 77 and 104 days. All retrograde fillings showed some microleakage. The group with titanium pins cemented with silicone showed the least leakage: significantly less than the teeth with glass ionomer cement (P < 0.01) and with amalgam (P < 0.01). No significant differences were found between other groups.

Dental Amalgam↗
PubMed1995

Torsional and stiffness properties of nickel-titanium K files.

The purpose of this study was to compare stiffness and resistance to fracture of four brands of nickel titanium K files. Instruments of sizes 15 to 40 were tested according to ANSI/ADA Specification No. 28. Resistance to fracture was determined by twisting and measuring the maximum torque and angular deflection at failure. Stiffness was determined by measuring the moment required to bend the instrument 45 degrees. The permanent deformation angle remaining between the tip and the flutes of the instruments after bending ceased was also recorded. Nickel titanium K files satisfied and far exceeded specification standards for stiffness. They also satisfied and exceeded the standards for angular deflection at failure. They met or exceeded the maximum torque at failure standards in all sizes except for the size 40 of the Maillefer Niti, and the size 30 of the MacSpadden Niti. Nickel titanium K files presented a null permanent deformation angle. Clinical studies are required to evaluate the influence of low bending moment on other properties such as breakage and canal transportation.

American Dental Association↗
PubMed2006

Fracture of ProFile nickel-titanium rotary instruments: a laboratory simulation assessment.

AIM: To determine the incidence of ProFile nickel-titanium rotary instrument fracture in an endodontic laboratory simulation. METHODOLOGY: Three hundred and sixty dental students used 2880 ProFile nickel-titanium rotary instruments to prepare 1440 simulated root canals in 720 plastic teeth, and another 2880 ProFile nickel-titanium rotary instruments to prepare 1440 natural root canals in 720 extracted teeth. A standardized crown-down rotary instrumentation technique was used, which included measures to prevent fracture. Rotary instrument fracture was monitored during and after completion of the laboratory simulation exercises to determine the incidence of fracture. When fracture occurred, data were collected concerning the size of the instrument, the length of the instrument fragment, the location of the fragment in the canal and the curvature of the canal in which the instrument fractured. RESULTS: The incidence of instrument fracture was 0.41% in plastic simulated canals and 0.31% in natural root canals. The overall incidence of instrument fracture was 0.36%. Of the instruments that fractured 67% were size 25, 0.04 taper; and 81% of the fragments were located in the apical third of the canal. The mean, median and mode of the fragment lengths were all 3 mm. CONCLUSIONS: The low overall incidence of fracture in this study suggests that ProFile rotary instruments are safe for use by dental students in laboratory simulations and that if preventive measures are taken the incidence of instrument fracture can be minimized.

Dental Alloys↗
PubMed2006

Nickel-titanium rotary instrument fracture: a clinical practice assessment.

AIM: To prospectively determine the incidence of nickel-titanium rotary instrument fracture in an endodontic clinical practice setting. METHODOLOGY: Eleven second year endodontic residents, using four nickel-titanium rotary instrument systems (ProFile, ProTaper, GTRotary and K3Endo) according to the recommendations of the manufacturers, instrumented 3181 canals in 1403 teeth of 1235 patients, in a dental school post-graduate endodontic clinic, in 1 year. The incidence of instrument fracture was determined based on the number of instruments used. When fracture occurred, data were collected concerning the type, size, taper and prior use of the fractured instruments, the length and location of the fragment within the root canal and the curvature of the canal. RESULTS: The overall incidence of instrument fracture was 0.39%. The incidence of fracture for ProFile, ProTaper, GTRotary and K3Endo files was 0.28%, 0.41%, 0.39% and 0.52%, respectively. There was no statistically significant difference between instrument systems. The percentage of teeth in which instruments fractured was 1.9% (0.28% for anterior teeth, 1.56% for pre-molars and 2.74% for molars). A total of 26 instruments fractured, of which 23 had tapers of 0.06 or greater. Most of the fragments were located in the apical third of the root canal, and both the median and mode amongst the fragment lengths were 2 mm. CONCLUSIONS: The low incidence of nickel-titanium rotary instrument fracture supports the continued use of these instruments in root canal treatment.

Chi-Square Distribution↗
PubMed1996

Retention force changes in implant-supported titanium telescope crowns over long-term use in vitro.

Titanium is used to fabricate spherical and bar attachments for overdentures on osseointegrated implants. This in vitro study investigated the long-term effects of commercially pure titanium on the retention force of telescope crowns with conical interface. Combinations of various materials for the inner and outer crowns were tested. Telescope crowns of pure titanium showed retention force characteristics comparable to telescope crowns fabricated conventionally in a precious alloy.

Chromium Alloys↗
PubMed2006

Nd:YAG laser penetration into cast titanium and gold alloy with different surface preparations.

This study investigated the effect of surface preparation on the Nd:YAG laser penetration into cast titanium and gold alloy. Cast blocks of each metal were given four different surface preparations: (i) coloured with black marker; (ii) air-abraded with 50 microm Al2O3; (iii) ground with SiC points and (iv) polished with 1 microm Al2O3 (mirror-polished). Two blocks with each of the surface preparations were abutted and laser-welded at their interface using the voltages of 210-260 V in increments of 10 V. After the welded blocks were mechanically separated, the laser penetration was measured using computer graphics. Regardless of the surface preparation, an increase in voltage increased the laser penetration for both metals. The laser penetration into titanium prepared with black marker and air-abrasion was significantly deeper than into the titanium ground with SiC points and mirror-polished. Although there were no statistical differences in penetration among the surface preparations for the gold alloy, the penetration in the mirror-polished specimens was shallower than any of the other preparation methods at higher voltages of 240-260 V. The results obtained in this study suggested that broken metal frameworks with finished surfaces should be painted with black marker or air-abraded before laser welding.

Air↗
PubMed2006

Biological responses of anodized titanium implants under different current voltages.

The oxide layer of a titanium surface is very stable, and seems to result in excellent biocompatibility and successful osseointegration. The purpose of this study was to investigate the effects of high anodic oxidation voltages on the surface characteristics of titanium implants and the biologic response of rabbit tibiae. Bone tissue responses were evaluated by removal torque tests and histomorphometric analysis. Screw-shaped implants with microthreads were made of commercially pure titanium (Grade II). We prepared anodized implants under 300 V (group I), 400 V (group II), 500 V (group III) and 550 V (group IV). The surface characteristics of specimens were inspected according to three categories: surface morphology, surface roughness and oxide layer thickness. The screw-shaped implants were installed in rabbit tibiae. The removal torque values were measured and histomorphometric analysis was done after 1- and 3-month healing periods. Data indicate that as anodic oxidation voltage increased above 300 V, oxide layer thickness increased rapidly and pore size also increased. The roughness values of the implants increased with voltage up to 500 V, but decreased at 550 V. In the removal torque test, group III showed higher values than groups I and II at a statistically significant level (P < 0.05) after a 1-month healing period. In histomorphometric analysis, groups III and IV, after a 3-month healing period, showed greater bone to implant contact ratios for the total implant surface than did group I (P < 0.05).

Animals↗
PubMed2001

Discoloration of a titanium alloy removable partial denture: a clinical report.

With recent advances in dental technology, titanium is currently used for fabrication of crowns, fixed partial dentures, implant frameworks, and removable partial denture frameworks. The use of titanium-aluminum-vanadium (Ti-6Al-4V) alloy assumes that it imparts similar anti-corrosion characteristics to the commercially pure titanium. This clinical report describes a patient who experienced discoloration of a Ti-6Al-4V alloy removable partial denture.

Alloys↗
PubMed2004

Vertical alveolar ridge augmentation by means of a titanium mesh and autogenous bone grafts.

The aim of this study is to evaluate a surgical protocol for vertical ridge augmentation in the maxilla and mandible using autogenous onlay bone graft associated with a titanium mesh. A group of 18 partially edentulous patients, presenting the need for vertical bone augmentation of at least 4 mm, were treated before implant placement. During the first surgery, an autogenous bone graft was harvested from either the mandibular ramus or the mental symphysis and secured by means of titanium screws. Particulate bone was added and a titanium micro-mesh was used to stabilize and protect the graft. After a mean interval of 4.6 months, meshes and screws were removed and 37 endosseous implants were successfully placed. The desired bone gain was reached in all patients. Mean vertical bone augmentation obtained was 4.8 mm (range 4-7 mm). No major complications were recorded at recipient or donor sites. Abutment connection was carried out 2-3 months after implant placement. No implant was lost. Clinical parameters and probing depth, after prosthetic reconstruction, demonstrated the presence of a healthy peri-implant mucosa. The preliminary results suggest that, by using the presented technique, patients can be successfully rehabilitated by means of implant-supported prosthesis 6-7 months after the first surgery, even in case of severely atrophied maxilla.

Adult↗
PubMed2005

New formation of periodontal tissues around titanium implants in a novel dentin chamber model.

Direct bone-to-implant contact, defined as "osseointegration", is considered most optimal for long-term stability and survival of dental implants. However, the possibility of the formation of a tooth-like attachment apparatus around implants has also been demonstrated. The purpose of this study was to explore the formation of periodontal tissues around titanium implants using a novel and unique experimental model. After resection of the crowns of the maxillary canine teeth in nine mongrel dogs, the roots were hollowed to a depth of 5 mm leaving a thin dentinal wall. Slits were prepared in the cavity wall to create passages from the chamber to the periodontal ligament area. A custom-made, titanium implant was placed into the center of each chamber. Machined, titanium plasma sprayed (TPS) and sand blasted with large grit and acid attacked (SLA) surfaces were used. A collagen barrier was placed over the submerged chamber. Following 4 months of healing, jaw sections were processed for histology. Newly formed periodontal ligament, alveolar bone, and root cementum filled the space between the implant and the wall of the chamber. Ingrown bone was neither in contact with dentin nor with the implant. Thus, an interposed soft connective tissue layer was present. Healing by fibrous encapsulation was observed around most implants. However, cellular cementum was deposited on one TPS and one SLA implant and on the dentinal walls of the chamber. This study shows a remarkable capacity for new periodontal tissue formation at a site where no such tissues ever existed. Maintenance of original periodontal tissue domains most likely prevented osseointegration of the implants. The cementum layer deposited on two implants was likely formed through cementoconductivity rather than by differentiation of periodontal ligament cells upon contact with the implant surface.

Animals↗
PubMed2005

Bone-implant contact at calcium phosphate-coated and porous titanium oxide (TiUnite)-modified oral implants.

BACKGROUND: Calcium phosphate (CP)-coated implants are usually referred to as having osteoconductive properties, whereas titanium implants with a native oxide layer are considered less osteoconductive. Often smooth titanium oxides (TOs) are compared to relatively rough CP structures. The objective of this study was to evaluate osteoconduction by comparing bone-implant contact at a relatively smooth, highly crystalline CP coating with a structured, porous TO (TiUnite)-modified surface. MATERIAL AND METHODS: Ten adult Hound Labrador mongrel dogs were used. Four titanium implants (Nobel Biocare) with CP-coated (2) or TO-modified (2) surfaces were installed 12 weeks following mandibular premolar and molar teeth extraction. The implants were alternated within and between jaw quadrants in consecutive animals. Mucosal flaps were advanced and sutured leaving the implants in a submerged position. The animals were injected with fluorescent bone labels at 3 and 4 weeks postsurgery, and pre-euthanasia to monitor progress of bone formation. The animals were euthanized at 8 weeks postsurgery and block biopsies were prepared for histologic and histometric analysis. RESULTS: There were no remarkable differences in bone formation and apparent bone-implant contact comparing the TO-modified and CP-coated surfaces. However, the measured average bone-implant contact was 71% and 57% (P=0.027) for TO-modified and CP-coated implants, respectively. CONCLUSIONS: We conclude that the TO surface exhibits osteoconductive properties exceeding that of the CP surface. One or several of the chemical and physical properties of the TO surface may result in the remarkable bone formation along its surface. This study indicated that crystallinity and/or chemistry may be important.

Animals↗
PubMed2005

Effect of three distinct treatments of titanium surface on osteoblast attachment, proliferation, and differentiation.

Cell-titanium interactions are crucial to the clinical success of bone and dental implants. The physico-chemical characteristics of the substrates surface influence osteoblast proliferation, differentiation, and activity as well. The osteoblast behavior was analyzed on three different titanium surfaces: ground with an abrasive 600 grit SiC paper, blasted with alumina particles (65 microm diameter) and alumina blasted followed by a double chemical etch (4% HF+4% HF/8% H2O2). Scanning electron microscopy (SEM) and profilometry showed distinct microtopographies. Ground samples showed parallel-groove orientation. The Al2O3-blasted surface presented the roughest microtopography with aluminum-rich particles incrusted in the titanium surface. Osteoblasts cells from femora of Balb/c mice were seeded onto the substrates tested. Cell morphology and initial attachment were evaluated by SEM. Osteoblasts adhered to and spread on all samples tested. However, on rough surfaces, osteoblasts did not spread completely and acquired a polygonal morphology. Besides, the cell proliferation rate was diminished at the beginning of incubation on rough surfaces. Our results suggest a delay, rather than an impairment, in osteoblast viability and alkaline phosphatase activity when cells are cultured on rough surfaces, inducing a distinct osteoblast phenotype, rather than blocking its activity. At least in the culture conditions used in this work, alumina particles did not affect osteoblast behavior.

Aluminum Oxide↗
PubMed2005

Effect of immobilized bone morphogenic protein 2 coating of titanium implants on peri-implant bone formation.

The aim of the present study was to test the hypothesis that immobilization of bone morphogenic protein (BMP2) on the surface of titanium implants can enhance peri-implant bone formation. Ten adult female foxhounds received experimental titanium screw implants in the mandible 3 months after removal of all premolar teeth. Three types of implant surfaces were evaluated in each animal: (i) implants with machined titanium surface, (ii) implants coated with collagen I, (iii) implants coated with collagen I, chondroitin sulphate (CS) and BMP2. Peri-implant bone regeneration was assessed using histomorphometry after 1 and 3 months in five dogs each by measuring bone-implant contact (BIC) and the volume density of the newly formed peri-implant bone (BVD). After 1 month, there was no significant enhancement in BIC values but volume density of the newly formed peri-implant bone was significantly higher in the two groups of coated implants. No significant difference was found between collagen and BMP2 coating. After 3 months, BIC was significantly higher in both collagen and BMP2-coated implants compared with implants with machined surfaces. Peri-implant BVD was also significantly increased in coated implants in comparison with machined surfaces. It was concluded that collagen coating of dental screw implants can enhance BIC and peri-implant bone formation. Addition of BMP2 does not increase peri-implant bone formation in the present application.

Animals↗