RESUMO
More insight into the biological fundamentals of leukocyte platelet-rich fibrin (L-PRF) guided healing is necessary to recommend its application, in particular in deficient bone sites that need to support implants. This study investigated the short-term bone healing effect of L-PRF treatment in cylindrical non-critical sized bone defects with 3 mm diameter and 6 mm depth in tibiae of 18 adult male New Zealand White rabbits. After a randomization process, 96 bone defects were prepared and half of them were filled with a L-PRF membrane, while untreated defects in the opposite tibia served as control group. The rabbits were euthanized after 7, 14 or 28 days of healing. The bone healing of the cortical and medullary areas was investigated by micro-CT, while the expression of molecular markers (RUNX2, VEGFA, COL1A2 and BMP2) was assessed by qRT-PCR. Treatment with L-PRF did not affect the micro-structural bone characteristics of the repaired bone tissue, except for a decrease in the trabecular connectivity at the cortical level after 14 days of healing. At this time, RUNX2 and VEGFA mRNA levels were significantly lower in the treated defects. L-PRF membranes thus had a temporary negative influence on the bone microarchitecture (Tb.Pf) and on the RUNX2 and VEGFA expression during early bone healing. Overall, L-PRF treatment did not enhance bone regeneration in these non-critical size defects after 28 days.
Assuntos
Regeneração Óssea/efeitos dos fármacos , Leucócitos , Fibrina Rica em Plaquetas , Tíbia/lesões , Cicatrização/efeitos dos fármacos , Animais , Biomarcadores/metabolismo , Proteína Morfogenética Óssea 2/genética , Proteína Morfogenética Óssea 2/metabolismo , Colágeno Tipo I/genética , Colágeno Tipo I/metabolismo , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Coelhos , Tíbia/diagnóstico por imagem , Tíbia/efeitos dos fármacos , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo , Microtomografia por Raio-XRESUMO
PURPOSE: To evaluate the influence of platform switching on the biomechanical environment of implants in different placement and loading protocols. MATERIALS AND METHODS: A computed tomography-based finite element model of a maxillary central incisor extraction socket was constructed containing a conical 13-mm external-hex implant with a 4.3-mm-diameter shoulder. Abutment models that were 4.3 mm and 3.8 mm in diameter were then imported and aligned to the implant. The 4.3-mm abutment edge matched perfectly the edge of the implant shoulder, while the 3.8-mm abutment assumed a platform-switching configuration. Then, immediately placed, immediately loaded, and osseointegrated (ie, conventional delayed loaded) protocols were simulated. Analysis of variance was used to interpret the data for peak equivalent strain (EQV strain) in the bone, bone-to-implant relative displacement, peak von Mises stress (EQV stress) in the abutment screw, and implant-abutment gap. RESULTS: In the same clinical situation, the differences in the values of the assessed results were minor for abutments of different diameters. In addition, no statistically significant influence of the abutment diameter was seen on any of the evaluated biomechanical parameters, except for the bone-to-implant displacement, although this was observed in a rather low percentage. Nevertheless, a slightly higher EQV stress in the abutment screw was seen in all cases for the 3.8-mm-diameter abutment, although this was not statistically significant. CONCLUSION: Within the limitation of this finite element analysis, it can be concluded that a circumferential horizontal mismatch of 0.5 mm does not make an important contribution to the biomechanical environment of implants. Also, there seems to be no significant biomechanical drawback to the design rationale of reducing the abutment diameter to move the implant-abutment gap area away from the implant-bone interface.
Assuntos
Simulação por Computador , Dente Suporte , Implantes Dentários , Planejamento de Prótese Dentária , Análise do Estresse Dentário , Alvéolo Dental/cirurgia , Fenômenos Biomecânicos , Implantação Dentária Endóssea/métodos , Análise do Estresse Dentário/métodos , Análise de Elementos Finitos , Humanos , Imageamento Tridimensional , Carga Imediata em Implante Dentário , Maxila/diagnóstico por imagem , Modelos Biológicos , Osseointegração , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: The purpose of the present study was to evaluate the biomechanical environment of immediately placed implants, before and after osseointegration, by comparing three different implant-abutment connection types. MATERIALS AND METHODS: A computer tomography-based finite element model of an upper central incisor extraction socket was constructed containing implants with either external hex, internal hex, or Morse-taper connection. Frictional contact elements were used in the bone, implant, abutment, and abutment screw interfaces in the immediately placed simulations. In osseointegrated simulations, the repair of bone alveolar defect and a glued bone-to-implant interface were assumed. By analysis of variance, the influence was assessed of connection type, clinical situation, and loading magnitude on the peak equivalent strain in the bone, peak von Mises stress in the abutment screw, bone-to-implant relative displacement, and abutment gap. RESULTS: The loading magnitudes had a significant contribution, regardless of the assessed variable. However, the critical clinical situation of an immediately placed implant itself was the main factor affecting the peak equivalent strain in the bone and bone-to-implant displacement. The largest influence of the connection type in this protocol was seen on the peak equivalent stress in the abutment screw. On the other hand, a higher influence of the various connection types on bone stress/strain could be noted in osseointegrated simulations. CONCLUSIONS: The implant-abutment connection design did not significantly influence the biomechanical environment of immediately placed implants. Avoiding implant overloading and ensuring a sufficient initial intraosseous stability are the most relevant parameters for the promotion of a safe biomechanical environment in this protocol.