J Korean Acad Prosthodont.  2012 Jul;50(3):149-155. 10.4047/jkap.2012.50.3.149.

The influence of intentional mobilization of implant fixtures before osseointegration

• Cho JH
• Jo KH
• Cho SA
• Lee KB
• Lee CH

• KMID: 2000202
• DOI: http://doi.org/10.4047/jkap.2012.50.3.149

Abstract

PURPOSE
The purpose of this study was to investigate the influence of mobilization on bone-implant interface prior to osseointegration of fixtures.
MATERIALS AND METHODS
The experimental implants (3.75 mm in diameter, 4.0 mm in length) were made of commercially pure (Grade IV) titanium, and were treated with RBM (MegaGen(R): Ca-P). The 80 implants (two in each tibia) were inserted into the monocortical tibias of 20 rabbits which each weighed more than 3.5 kg (Female, New Zealand White). According to the removal torque interval, the groups were divided into 10 groups, Group I (6 wks), Group II (4 days + 6 wks), Group III (4 days + 1 wk + 6 wks), Group IV (1 wk + 6 wks), Group V (1 wk + 1 wk + 6 wks), Group VI (2 wks + 6 wks), Group VII (2 wks+ 1 wk + 6 wk), Group VIII (3 wks + 6 wks), Group IX (3 wks + 1 wk + 6 wks) and Group X (10 wks). The control groups were Group I and X, the removal torque was measured at 6 wks and 10 wks with a digital torque gauge (Mark-10, USA). In the experimental groups, the removal torque was given once or twice before the final removal torque and the value was measured each time. After which, the implants were put back where they had been except the control groups. All the experimental groups were given a final healing time (6 wks) before the final removal torque test, in which values were compared with the control groups and the 1st and/or 2nd removal torque values in each experimental group.
RESULTS
In the final removal torque tests, the removal torque value of Group X (10 wks) was higher than that of Group I (6 wks) in the control groups but not statistically different. There were no significant differences between the experimental groups and control groups (P>.05). In the first removal torque comparison, the experimental groups (4 days or 1 wk) values were significantly lower than the other experimental groups (2 wks or 3 wks). In the comparison of each experimental group according to healing time, the final removal torque value was significantly higher than the 1st torque test value.
CONCLUSION
Once or twice mobilization of fixture prior to osseointegration did not deter the final bone to implant osseointegration, if sufficient healing time was given.

Keyword

Osseointegration; Reintegration; Removal torque test

MeSH Terms

Implants, Experimental
New Zealand
Osseointegration
Rabbits
Tibia
Titanium
Torque
Titanium

Figure

• 

  Fig. 1 Schematic diagram of experimental implant.

• 

  Fig. 2 Digital torque gauge (Ncm).

• 

  Fig. 3 A photograph of the removal torque test holding the sample. The driver is connected to the implant and the jaws of the digital torque gauge (Mark-10, USA).

Reference

1. Brånemark PI, Breine U, Asell R, Hanson BO, Lindström J, Ohlsson A. Intraosseous anchorage of dental prosthesis I. Experimental studies. Scand J Plast Reconstr Surg. 1969. 3:81–100.

2. Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, Ohman A. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl. 1977. 16:1–132.

3. Szmukler-Moncler S, Salama H, Reingewirtz Y, Dubruille JH. Timing of loading and effect of micromotion on bone-dental implant interface: review of experimental literature. J Biomed Mater Res. 1998. 43:192–203.

4. Randow K, Ericsson I, Nilner K, Petersson A, Glantz PO. Immediate functional loading of Brånemark dental implants. An 18-month clinical follow-up study. Clin Oral Implants Res. 1999. 10:8–15.

5. Lefkove MD, Beals RP. Immediate loading of cylinder implants with overdentures in the mandibular symphysis: the titanium plasma-sprayed screw technique. J Oral Implantol. 1990. 16:265–271.

6. Misch CE. Implant design considerations for the posterior regions of the mouth. Implant Dent. 1999. 8:376–386.

7. Coelho PG, Granjeiro JM, Romanos GE, Suzuki M, Silva NR, Cardaropoli G, Thompson VP, Lemons JE. Basic research methods and current trends of dental implant surfaces. J Biomed Mater Res B Appl Biomater. 2009. 88:579–596.

8. Albrektsson T, Wennerberg A. Oral implant surface: Part I--review focusing on topographic and chemical properties of different surfaces and in vivo responses to them. Int J Prosthodont. 2004. 17:536–543.

9. Coelho PG, Lemons JE. Physico/chemical characterization and in vivo evaluation of nanothickness bioceramic depositions on alumina-blasted/acid-etched Ti-6Al-4V implant surfaces. J Biomed Mater Res A. 2009. 90:351–361.

10. Roberts WE, Turley PK, Brezniak N, Fielder PJ. Implants: Bone physiology and metabolism. CDA J. 1987. 15:54–61.

11. Szmukler-Moncler S, Reingewirtz Y, Weber HP. Davidovitch Z, Norton LA, editors. Bone response to early loading: the effect of surface state. Biological Mechanisms of Tooth Movement & Craniofacial Adaptation. 1996. Boston: Harvard Society for the Advancement of Orthodontics;611–616.

12. Ivanoff CJ, Sennerby L, Lekholm U. Reintegration of mobilized titanium implants. An experimental study in rabbit tibia. Int J Oral Maxillofac Surg. 1997. 26:310–315.

13. Jang JH, Cho JH, Lee CH. Study of re-osseointegration of implant fixture after mechanical unscrewing. J Korean Acad Prosthodont. 2010. 48:209–214.

14. Hwang YJ, Cho JH, Lee CH. Investigation of osseointegration according to the healing time after having iatrogenic mobility of implant fixture. J Korean Acad Prosthodont. 2010. 48:308–314.

15. Ye SH. An investigation of reosseointegration according to time course after intentional mobilization of implant fixture. 2009. Graduate School, Kyungpook National University;MS Thesis.

16. Albrektsson T, Hansson HA, Kasemo B, et al. The interface zone of inorganic implants in vivo; titanium implants in bone. Ann Biomed Eng. 1983. 11:1.

17. De Bruyn H, Kisch J, Collaert B, Lindén U, Nilner K, Dvärsäter L. Fixed mandibular restorations on three early-loaded regular platform Brånemark implants. Clin Implant Dent Relat Res. 2001. 3:176–184.

18. Chiapasco M, Abati S, Romeo E, Vogel G. Implant-retained mandibular overdentures with Brånemark System MKII implants: a prospective comparative study between delayed and immediate loading. Int J Oral Maxillofac Implants. 2001. 16:537–546.

19. Ganeles J, Rosenberg MM, Holt RL, Reichman LH. Immediate loading of implants with fixed restorations in the completely edentulous mandible: report of 27 patients from a private practice. Int J Oral Maxillofac Implants. 2001. 16:418–426.

20. Brånemark PI, Engstrand P, Ohrnell LO, Gröndahl K, Nilsson P, Hagberg K, Darle C, Lekholm U. Brånemark Novum: a new treatment concept for rehabilitation of the edentulous mandible. Preliminary results from a prospective clinical follow-up study. Clin Implant Dent Relat Res. 1999. 1:2–16.

21. Ericsson I, Randow K, Nilner K, Peterson A. Early functional loading of Brånemark dental implants: 5-year clinical follow-up study. Clin Implant Dent Relat Res. 2000. 2:70–77.

22. Colomina LE. Immediate loading of implant-fixed mandibular prostheses: a prospective 18-month follow-up clinical study-preliminary report. Implant Dent. 2001. 10:23–29.

23. Sennerby L, Thomsen P, Ericson LE. Early tissue response to titanium implants inserted in rabbit cortical bone. Part II light microscopic observations. J Mater Sci Mater Med. 1993. 4:240–250.

24. Sennerby L, Thomsen P, Ericson LE. A morphometric and biomechanic comparison of titanium implants inserted in rabbit cortical and cancellous bone. Int J Oral Maxillofac Implants. 1992. 7:62–71.

25. Sennerby L, Gottlow J. Clinical outcomes of immediate/early loading of dental implants. A literature review of recent controlled prospective clinical studies. Aust Dent J. 2008. 53:S82–S88.

26. Castellon P, Blatz MB, Block MS, Finger IM, Rogers B. Immediate loading of dental implants in the edentulous mandible. J Am Dent Assoc. 2004. 135:1543–1549. quiz 1621-2.

27. Oleinick AJ. Osseointegration versus fibro-osseointegration: review of endosseous dental implant systems. Gen Dent. 1993. 41:406–408.

28. Brunski JB. Avoid pitfalls of overloading and micromotion of intraosseous implants. Dent Implantol Update. 1993. 4:77–81.