Avaliação da osseointegração e da resistência mecânica de um novo desenho de implante dentário
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Data
2023-03-08
Autores
Augusto Neto, Renato Torres
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
As reabilitações de áreas desdentadas com implantes ósseointegráveis, em regiões de baixa quantidade e qualidade óssea, são desafios que estimulam as pesquisas para o desenvolvimento de modificações nos implantes dentários a fim de melhorar seu desempenho nestas condições. Algumas das principais modificações são alterações na macro e microgeometria. O objetivo deste trabalho foi avaliar, em modelo animal, o reparo ósseo periimplantar de uma nova geometria de implante, de ápice oco e perfurações na superfície (SWE), em relação a um implante convencional (controle). Para tanto, foram utilizados 30 coelhos da espécie Oryctolagus cunilicus (New Zealand), divididos em dois grupos de acordo com o tipo de implante utilizado, sendo os tempos de avaliação 15, 30 e 60 dias. Foram realizadas as análises de frequência de ressonância, contra torque, uCT, histologia e histomorfometria. Os resultados foram formatados em 3 artigos científicos. O primeiro artigo é relacionado à estabilidade primária, o segundo a ósseointegração e estabilidade secundária, e, o terceiro à qualidade e quantidade do reparo ósseo periimplantar. Não houve diferenças estatisticamente significativas na avaliação do ISQ, porém foi encontrada diferença no teste de torque reverso, no qual os grupos de 15 dias apresentaram diferenças estatisticamente inferiores (controle 26,06 ± 7,31; teste 24,88 ± 4,80), em relação aos grupos de 30 (controle 44,3 ± 7,42; teste 53,2 ± 10,12) e 60 dias (controle 44,28 ± 12,93; teste 49,2±7,97). As comparações microtomográficas foram realizadas nos grupos controle e SWE, como também entre Roscas x Câmara de reparo no implante SWE; houve diferença estatística no período de 15 dias para as análises BV (controle 3181347±228760; teste 4123507±158372) e BV/TV (controle 29,93±2,108; teste 38,95±1,528); quando comparamos Roscas x Câmara, tivemos diferença estatísticas em todas as análises (P>0,05; IC 95%). A avaliação histológica mostrou processo de reparo normal entre os dois grupos na porção coronal, enquanto na parte apical houve um retardo na parte interna da câmara. Nas análises de BIC e BAFO as comparações foram realizadas nos grupos controle e SWE, como também entre Roscas x Câmara de reparo no implante SWE. Houve diferença estatística entre os grupos apenas na porção medular, sendo para BIC: 15 dias (controle 25,88±10,45; teste 51,56±8,712); 30 dias (controle 30,02±4,594; teste 35,17±1,926); 60 dias (controle 25,67±5,254; teste 31,26±2,507), e, para BAFO: 30 dias (controle 16,59±3,595; teste 22,01±3,218). Assim, é possível afirmar que o implante SWE passa pelo mesmo processo de osseointegração que o implante controle, e a câmara apical auxilia na osseointegração na região medular.
Rehabilitation of edentulous areas with osseointegrated implants in regions of low bone quantity and quality can be challenging. In order to improve their performance in these conditions, researches for the development of modifications in dental implants are needed. Some of the main modifications are changes in macro and microgeometry. Using animal model, the objective of this study was to evaluate the periimplant bone repair of a new implant geometry, with a hollow apex and surface perforations (SWE) when compared to conventional implant (control group). For this purpose, 30 rabbits of the species Oryctolagus cunilicus (New Zealand) were used divided into two groups according to the type of implant used, considering the evaluation times being 15, 30 and 60 days. Analyzes of resonance frequency, countertorque, uCT, histology and histomorphometry were performed. The results were formatted in 3 scientific articles. The first article is related to primary stability. The second article is about osseointegration and secondary stability. The third aims on quality and quantity of periimplant bone repair. There were no statistically significant differences in the ISQ assessment, but difference was found in the reverse torque test, in which the 15-day groups showed statistically lower differences (control 26.06 ± 7.31; test 24.88 ± 4.80) , in relation to the groups of 30 (control 44.3 ± 7.42; test 53.2 ± 10.12) and 60 days (control 44.28 ± 12.93; test 49.2 ± 7.97). Microtomographic comparisons were performed in the control and SWE groups, as well as between Threads x Repair chamber in the SWE implant; there was a statistical difference in the 15-day period for the BV (control 3181347±228760; test 4123507±158372) and BV/TV (control 29.93±2.108; test 38.95±1.528) analyses. When comparing Threads x Chamber, we had statistical differences in all analyzes (P>0.05; 95%CI). The histological evaluation showed a normal repair process between the two groups in the coronal portion, while in the apical part there was a delay in the inner part of the chamber. In the bone to implant contact (BIC) and bone area fraction occupancy (BAFO) analyses, comparisons were made in the control and SWE groups, as well as between Threads x Repair chamber in the SWE implant. There was statistical difference between the groups only in the medullary portion, for BIC: 15 days (control 25.88±10.45; test 51.56±8.712); 30 days (control 30.02±4.594; test 35.17±1.926); 60 days (control 25.67±5.254; test 31.26±2.507), and for BAFO: 30 days (control 16.59±3.595; test 22.01±3.218). Thus, it is possible to state that the SWE implant undergoes the same osseointegration process as the control implant, and the apical chamber assists in osseointegration in the medullary region.
Rehabilitation of edentulous areas with osseointegrated implants in regions of low bone quantity and quality can be challenging. In order to improve their performance in these conditions, researches for the development of modifications in dental implants are needed. Some of the main modifications are changes in macro and microgeometry. Using animal model, the objective of this study was to evaluate the periimplant bone repair of a new implant geometry, with a hollow apex and surface perforations (SWE) when compared to conventional implant (control group). For this purpose, 30 rabbits of the species Oryctolagus cunilicus (New Zealand) were used divided into two groups according to the type of implant used, considering the evaluation times being 15, 30 and 60 days. Analyzes of resonance frequency, countertorque, uCT, histology and histomorphometry were performed. The results were formatted in 3 scientific articles. The first article is related to primary stability. The second article is about osseointegration and secondary stability. The third aims on quality and quantity of periimplant bone repair. There were no statistically significant differences in the ISQ assessment, but difference was found in the reverse torque test, in which the 15-day groups showed statistically lower differences (control 26.06 ± 7.31; test 24.88 ± 4.80) , in relation to the groups of 30 (control 44.3 ± 7.42; test 53.2 ± 10.12) and 60 days (control 44.28 ± 12.93; test 49.2 ± 7.97). Microtomographic comparisons were performed in the control and SWE groups, as well as between Threads x Repair chamber in the SWE implant; there was a statistical difference in the 15-day period for the BV (control 3181347±228760; test 4123507±158372) and BV/TV (control 29.93±2.108; test 38.95±1.528) analyses. When comparing Threads x Chamber, we had statistical differences in all analyzes (P>0.05; 95%CI). The histological evaluation showed a normal repair process between the two groups in the coronal portion, while in the apical part there was a delay in the inner part of the chamber. In the bone to implant contact (BIC) and bone area fraction occupancy (BAFO) analyses, comparisons were made in the control and SWE groups, as well as between Threads x Repair chamber in the SWE implant. There was statistical difference between the groups only in the medullary portion, for BIC: 15 days (control 25.88±10.45; test 51.56±8.712); 30 days (control 30.02±4.594; test 35.17±1.926); 60 days (control 25.67±5.254; test 31.26±2.507), and for BAFO: 30 days (control 16.59±3.595; test 22.01±3.218). Thus, it is possible to state that the SWE implant undergoes the same osseointegration process as the control implant, and the apical chamber assists in osseointegration in the medullary region.
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Palavras-chave
Implantes dentários, Osseointegração, Interface osso-implante, Estresse mecânico, Fraturas de estresse , Dental implants, Osseointegration, Bone-implant interface, Mechanical, stress, Fractures, stress