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The histological evaluation of osseointegration of surface enhanced microimplants immediately loaded in conjunction with sinuslifting in humans

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Abstract
Objective: The aim was to investigate histomorphometrically whether or not implant surface nanotopography improves the bone response under immediate loading simultaneous to sinus grafting. Materials and methods: Dual acid-etched titanium microimplants with/without crystalline surface deposition of calcium phosphate particles were placed in bilateral sinuslift areas grafted with a mixture of iliac crest bone and BioOss. Surface topography of microimplants was characterized using interferometry. Loaded microimplants (MsL) were immobilized in a provisional bridge supported by four normal size implants. Some patients had unloaded microimplants as controls (MsU). Biopsies were trephined after 2 or 4 months and histomorphometric analysis of bone area (BA) and bone-to-implant contact (BC) was performed. Nonparametric methods for dependent data were used to compare effect of surface modification, and healing time (2 vs. 4 months). Results: A total of 53 biopsies were available from 13 patients. A total of 4/28 and 1/11 MsL failed after resp. 2 and 4 months vs. 0/6 and 1/5 MsU. Many loaded biopsies were damaged at the apical portion and showed no bone adhesion MsL decreased in BA from coronal to apical from 2 to 4 months; Coronal > Middle (P = 0.047), Coronal > Apical (P < 0.001) and Middle > Apical (P < 0.001). This gradual decrease was not observed for BC; Coronal < Middle and Middle > Apical (P < 0.001). Only the middle part showed significant bone contact after 2 months. For MsL there was no statistically significant difference between surface or time indicating that improvement of osseointegration over time due to maturation of the graft was poor. The MsU did not show any difference between Osseotite and Nanotite for BIC and BA (P > 0.05) but doubled both their BA and BIC (P < 0.05) between 2 and 4 months. Conclusions: Osseointegration in sinus-grafted bone mixed with BioOss was poor irrespective of healing time or nanotopographical surface modification. The apex of MsL showed minimal bone contact suggesting that the graft does not add to the loading capacity. Surface enhancement was not beneficial despite the enlarged surface area. Overloading, most critical coronally of an implant, increases risks for implant failure and jeopardizes bone healing especially under immediate loading conditions with high load.
Keywords
histomorphometry, immediate loading, sinus floor elevation, sinuslifting, titanium implantion, surface modification, RETAINED MANDIBULAR OVERDENTURES, TIOBLAST DENTAL IMPLANTS, SINUS FLOOR AUGMENTATION, HUMAN POSTERIOR MAXILLA, UP CLINICAL REPORT, FOLLOW-UP, HISTOMORPHOMETRIC EVALUATION, RADIOGRAPHIC EVALUATION, TITANIUM MICROIMPLANTS, EDENTULOUS PATIENTS

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MLA
Browaeys, Hilde, et al. “The Histological Evaluation of Osseointegration of Surface Enhanced Microimplants Immediately Loaded in Conjunction with Sinuslifting in Humans.” CLINICAL ORAL IMPLANTS RESEARCH, vol. 24, no. 1, 2013, pp. 36–44, doi:10.1111/j.1600-0501.2011.02398.x.
APA
Browaeys, H., Vandeweghe, S., Johansson, C. B., Jimbo, R., Deschepper, E., & De Bruyn, H. (2013). The histological evaluation of osseointegration of surface enhanced microimplants immediately loaded in conjunction with sinuslifting in humans. CLINICAL ORAL IMPLANTS RESEARCH, 24(1), 36–44. https://doi.org/10.1111/j.1600-0501.2011.02398.x
Chicago author-date
Browaeys, Hilde, Stefan Vandeweghe, Carina B Johansson, Ryo Jimbo, Ellen Deschepper, and Hugo De Bruyn. 2013. “The Histological Evaluation of Osseointegration of Surface Enhanced Microimplants Immediately Loaded in Conjunction with Sinuslifting in Humans.” CLINICAL ORAL IMPLANTS RESEARCH 24 (1): 36–44. https://doi.org/10.1111/j.1600-0501.2011.02398.x.
Chicago author-date (all authors)
Browaeys, Hilde, Stefan Vandeweghe, Carina B Johansson, Ryo Jimbo, Ellen Deschepper, and Hugo De Bruyn. 2013. “The Histological Evaluation of Osseointegration of Surface Enhanced Microimplants Immediately Loaded in Conjunction with Sinuslifting in Humans.” CLINICAL ORAL IMPLANTS RESEARCH 24 (1): 36–44. doi:10.1111/j.1600-0501.2011.02398.x.
Vancouver
1.
Browaeys H, Vandeweghe S, Johansson CB, Jimbo R, Deschepper E, De Bruyn H. The histological evaluation of osseointegration of surface enhanced microimplants immediately loaded in conjunction with sinuslifting in humans. CLINICAL ORAL IMPLANTS RESEARCH. 2013;24(1):36–44.
IEEE
[1]
H. Browaeys, S. Vandeweghe, C. B. Johansson, R. Jimbo, E. Deschepper, and H. De Bruyn, “The histological evaluation of osseointegration of surface enhanced microimplants immediately loaded in conjunction with sinuslifting in humans,” CLINICAL ORAL IMPLANTS RESEARCH, vol. 24, no. 1, pp. 36–44, 2013.
@article{1974620,
  abstract     = {{Objective: The aim was to investigate histomorphometrically whether or not implant surface nanotopography improves the bone response under immediate loading simultaneous to sinus grafting.
Materials and methods: Dual acid-etched titanium microimplants with/without crystalline surface deposition of calcium phosphate particles were placed in bilateral sinuslift areas grafted with a mixture of iliac crest bone and BioOss. Surface topography of microimplants was characterized using interferometry. Loaded microimplants (MsL) were immobilized in a provisional bridge supported by four normal size implants. Some patients had unloaded microimplants as controls (MsU). Biopsies were trephined after 2 or 4 months and histomorphometric analysis of bone area (BA) and bone-to-implant contact (BC) was performed. Nonparametric methods for dependent data were used to compare effect of surface modification, and healing time (2 vs. 4 months). 
Results: A total of 53 biopsies were available from 13 patients. A total of 4/28 and 1/11 MsL failed after resp. 2 and 4 months vs. 0/6 and 1/5 MsU. Many loaded biopsies were damaged at the apical portion and showed no bone adhesion MsL decreased in BA from coronal to apical from 2 to 4 months; Coronal > Middle (P = 0.047), Coronal > Apical (P < 0.001) and Middle > Apical (P < 0.001). This gradual decrease was not observed for BC; Coronal < Middle and Middle > Apical (P < 0.001). Only the middle part showed significant bone contact after 2 months. For MsL there was no statistically significant difference between surface or time indicating that improvement of osseointegration over time due to maturation of the graft was poor. The MsU did not show any difference between Osseotite and Nanotite for BIC and BA (P > 0.05) but doubled both their BA and BIC (P < 0.05) between 2 and 4 months.
Conclusions: Osseointegration in sinus-grafted bone mixed with BioOss was poor irrespective of healing time or nanotopographical surface modification. The apex of MsL showed minimal bone contact suggesting that the graft does not add to the loading capacity. Surface enhancement was not beneficial despite the enlarged surface area. Overloading, most critical coronally of an implant, increases risks for implant failure and jeopardizes bone healing especially under immediate loading conditions with high load.}},
  author       = {{Browaeys, Hilde and Vandeweghe, Stefan and Johansson, Carina B and Jimbo, Ryo and Deschepper, Ellen and De Bruyn, Hugo}},
  issn         = {{0905-7161}},
  journal      = {{CLINICAL ORAL IMPLANTS RESEARCH}},
  keywords     = {{histomorphometry,immediate loading,sinus floor elevation,sinuslifting,titanium implantion,surface modification,RETAINED MANDIBULAR OVERDENTURES,TIOBLAST DENTAL IMPLANTS,SINUS FLOOR AUGMENTATION,HUMAN POSTERIOR MAXILLA,UP CLINICAL REPORT,FOLLOW-UP,HISTOMORPHOMETRIC EVALUATION,RADIOGRAPHIC EVALUATION,TITANIUM MICROIMPLANTS,EDENTULOUS PATIENTS}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{36--44}},
  title        = {{The histological evaluation of osseointegration of surface enhanced microimplants immediately loaded in conjunction with sinuslifting in humans}},
  url          = {{http://doi.org/10.1111/j.1600-0501.2011.02398.x}},
  volume       = {{24}},
  year         = {{2013}},
}

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