Publications by authors named "Ríos-Carrasco Blanca"

14 Publications

  • Page 1 of 1

Complications in the Use of Deepithelialized Free Gingival Graft vs. Connective Tissue Graft: A One-Year Randomized Clinical Trial.

Int J Environ Res Public Health 2021 04 23;18(9). Epub 2021 Apr 23.

Departamento de Ciencias Sociosanitarias, Universidad de Sevilla, 41004 Sevilla, Spain.

In the treatment of gingival recession, different surgical options have been described: free gingival grafts (FGG), connective tissue Grafts (CTG), and a more recent technique, de-epithelialized free gingival graft (DFGG). They are not procedures exempt from the appearance of complications. Most publications refer to postoperative complications, and there is limited literature regarding the development of late complications (weeks or months). Our working group carried out a study to describe the development of late complications associated with the use of DFGG in comparison with CTG, providing an incidence rate and a classification. Sixty-eight patients with mucogingival problems were selected, and divided into two groups: the Test Group, for which we used DFGG + Coronal Advancement Flap (CAF), and the Control Group (CTG + CAF). All patients were treated at the University of Seville's dental school to solve mucogingival problems for aesthetic and/or functional reasons. A classification is proposed based on its severity; Major and Minor. Major complications included reepithelialization of the graft, epithelial bands, cul-de-sac, epithelial cysts, and bone exostoses. Minor complications included the graft´s color changes and superficial revascularization. Late major complications were only associated with the use of the DFGG, and the late minor complications developed with the use of the DFGG were much higher than those associated with CTG. CTG appears to be a safer procedure than DFGG in terms of late complications.
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http://dx.doi.org/10.3390/ijerph18094504DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8123082PMC
April 2021

Sinus Floor Elevation via an Osteotome Technique without Biomaterials.

Int J Environ Res Public Health 2021 01 27;18(3). Epub 2021 Jan 27.

Department of Periodontology, School of Dentistry, Universidad de Sevilla, 41009 Sevilla, Spain.

According to classic Hirschfeld studies, the first teeth to be lost are the first and second maxillary molars. After the teeth are extracted and the alveolar process is developed, the maxillary sinus is reabsorbed and pneumatized with a decrease in bone availability in the posterior sector of the maxilla. This process often creates the need to perform regeneration techniques for the placement of implants in this area due to the low availability of bone. The most frequently used and documented technique for the elevation of the sinus maxillary floor is elevation by the side window, as proposed by Tatum. In 1994, Summers proposed a technique that allowed the elevation of the sinus floor from a crestal access using an instrument called an osteotome, as well as the placement of the implant in the same surgical act. The aimed of the study was to evaluate the survival of 32 implants placed in posterior maxilla with bone availability less than 5 mm performing a sinus lift augmentation technique with osteotome without biomaterials. The results of this study show a survival rate of 100% for 32 implants placed in situations with an initial bone availability of 2 to 5 mm without the use of graft material. The infra-drilling technique used offers an increase in the primary stability of implants that allows adequate osteointegration Implants placed were charged at 12 weeks. In all cases, spontaneous bone formation was observed, even in cases where a positive Valsalva maneuver was observed. This proposed technique reduces treatment time and the need for more invasive maxillary sinus augmentation techniques.
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http://dx.doi.org/10.3390/ijerph18031103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908564PMC
January 2021

Digital Impressions in Implant Dentistry: A Literature Review.

Int J Environ Res Public Health 2021 01 24;18(3). Epub 2021 Jan 24.

Porto Dental Institute, 4150-518 Porto, Portugal.

Introduction: Digital impressions in implant dentistry rely on many variables, and their accuracy, particularly in complete edentulous patients, is not well understood. The purpose of this literature review was to determine which factors may influence the accuracy of digital impressions in implant dentistry. Emphasized attention was given to the design of the intra-oral scan body (ISB) and scanning techniques.

Materials And Methods: A Medline, PubMed and EBSCO Host databases search, complemented by a hand search, was performed in order to select relevant reports regarding the appliance of digital impressions in implant dentistry. The search subject included but was not limited to accuracy of digital impressions in implant dentistry, digital scanning techniques, the design and material of the ISBs, and the depth and angulation of the implant. The related titles and abstracts were screened, and the remaining articles that fulfilled the inclusion criteria were selected for full-text readings.

Results: The literature search conducted for this review initially resulted in 108 articles, among which only 21 articles fulfilled the criteria for inclusion. Studies were evaluated according to five subjects: accuracy of digital impressions in implant dentistry; the design and material of the intra-oral scan bodies; scanning technique; the influence of implants depth/angulations on the digital impression and accuracy of different intra-oral scanner devices.

Conclusions: The accuracy of digital impressions in implant dentistry depends on several aspects. The depth/angulation of the implant, the experience of the operator, the intra-oral scanner used, and environmental conditions may influence the accuracy of digital impressions in implant dentistry. However, it seems that ISBs' design and material, as well as scanning technique, have a major impact on the trueness and precision of digital impressions in implant dentistry. Future research is suggested for the better understanding of this subject, focusing on the optimization of the ISB design and scanning protocols.
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http://dx.doi.org/10.3390/ijerph18031020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908474PMC
January 2021

Influence of Removing or Leaving the Prosthesis after Regenerative Surgery in Peri-Implant Defects: Retrospective Study: 32 Clinical Cases with 2 to 8 Years of Follow-Up.

Int J Environ Res Public Health 2021 01 13;18(2). Epub 2021 Jan 13.

Porto Dental Institute, 4150-518 Porto, Portugal.

Purpose: The aim of this retrospective study was to compare the influence of removing or not removing a prosthesis after regenerative surgery on peri-implant defects.

Methods: Two different groups were compared (Group 1: removing the prosthesis; Group 2: maintaining the prosthesis), analyzing radiographic bone filling (n = 32 implants) after regenerative treatment in periapical radiographs. The peri-implant defects were measured before and after regenerative treatment using Bio-Oss (Geistlich Pharma, Wohhusen, Switzerland) and a reabsorbable collagen membrane (Jason, Botis, Berlin, Germany), the healing period was two years after peri-implant regenerative surgery. Statistical analysis was performed, and a Chi square test was carried out. To determine the groups that made the difference, corrected standardized Haberman residuals were used, and previously a normality test had been applied; therefore, an ANOVA or Mann-Whitney U test was used for the crossover with the non-normal variables in Group 1 and Group 2.

Results: The results obtained suggest that a regenerative procedure with xenograft, resorbable membrane, and detoxifying the implant surface with hydrogen peroxide form a reliable technique to achieve medium-term results, obtaining an average bone gain at a radiographic level of 2.84 mm (±1.78 mm) in patients whose prosthesis was not removed after peri-implant bone regenerative therapy and 2.18 mm (±1.41 mm) in patients whose prosthesis was removed during the healing period.

Conclusions: There are no statistically significant differences in the response to treatment when removing or keeping the prosthesis after regenerative surgery in peri-implant defects.
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http://dx.doi.org/10.3390/ijerph18020645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7828701PMC
January 2021

One Abutment One Time: A Multicenter, Prospective, Controlled, Randomized Study.

Int J Environ Res Public Health 2020 12 17;17(24). Epub 2020 Dec 17.

Porto Dental Institute, 4150-518 Porto, Portugal.

: (PRIMARY) Assess the changes in bone level (6 and 12 months after implant placement) between the test (definitive abutment (DEF)) and control (healing abutment (HEA)) groups. (SECONDARY) Assess the changes in bone level (6 and 12 months after implant placement) between the 1 mm high abutment group and 2 mm abutment group. Evaluate changes in implant stability recorded with analysis of the resonance frequency (RFA) Osstell system, at 6 and 12 months after implant placement, between the control group (HEA) and test (DEF). For the DEF group, the abutment was placed at the time of the surgery and was never removed. For the HEA group, the abutment was removed three times during the manufacture of the crowns. The abutments used were 1 mm high (Subgroup A) and 2 mm high (Subgroup B). Materials and methods: A total of 147 patients were selected between 54.82 ± 11.92 years old. After implant placement, patients were randomly distributed in the DEF and HEA group. After the implant placement, a periapical radiograph was taken to assess the peri-implant bone level; the same procedure was carried out 6 and 12 months post-placement. To compare the qualitative variables between the groups (HEA/DEF), the Chi-square test was used; for quantitative (MANOVA). : After a year, the accumulated bone loss was 0.48 ± 0.71 mm for the HEA group and 0.36 ± 0.79 mm for the DEF group, without statistical significance. Differences were only found due to timing (time) between 0 and 6 months (=0.001) and 0 and 12 months (0.001), with no differences attributable to the study groups (DEF and HEA). The accumulated bone loss (1 year) was 0.45 ± 0.78 mm for the 1 mm abutment group and 0.41 ± 0.70 mm for the 2 mm abutment group ( = 0.02). No differences were observed in implant stability between groups. : The "One Abutment-One Time" concept does not reduce peri-implant bone loss compared to the connection-disconnection technique. The height of the abutment does influence bone loss: the higher the abutment, the lower the bone loss.
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http://dx.doi.org/10.3390/ijerph17249453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765846PMC
December 2020

Effects of Different Undersizing Site Preparations on Implant Stability.

Int J Environ Res Public Health 2020 12 2;17(23). Epub 2020 Dec 2.

Porto Dental Institute, 4150-518 Porto, Portugal.

As immediate loading protocols are becoming more frequent, the primary stability of implants has become an essential criterion for the osseointegration of dental implants. Based on this, the objective of this study was to understand the influence of different undersized surgical preparation sites on the insertion torque (IT) and implant stability quotient (ISQ). Four different site-preparation protocols were performed on fresh humid type III bovine bone: one control, the standard protocol recommended by the manufacturer (P1), and three variations of undersized techniques (P2, P3 and P4). The implant used was VEGA by Klockner Implant System. The sample size was n = 40 for each of the four groups. A torquemeter was used to measure the IT, and the ISQ was measured with a Penguin RFA. Both variables showed a tendency to increase as the preparation technique was reduced, although not all the values were statistically significant ( < 0.05) when comparing with the standard preparation. The preparations without a cortical drill, P2 and P4, showed better results than those with a cortical drill. Given the limitations of this study, it can be concluded that reducing the implant preparation can increase both the IT and ISQ. Removing the cortical drill is an effective method for increasing implant stability, although it should be used carefully.
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http://dx.doi.org/10.3390/ijerph17238965DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731014PMC
December 2020

Reliability of the Resonance Frequency Analysis Values in New Prototype Transepithelial Abutments: A Prospective Clinical Study.

Int J Environ Res Public Health 2020 09 16;17(18). Epub 2020 Sep 16.

Department of Social and Health Sciences, Universidad de Sevilla, 41009 Sevilla, Spain.

Resonance frequency analysis (RFA) requires abutment disconnection to monitor implant stability. To overcome this limitation, an experimental transepithelial abutment was designed to allow a SmartPeg to be screwed onto it, in order to determine the prototype abutments repeatability and reproducibility using Osstell ISQ and to assess whether implant length and diameter have an influence on the reliability of these measurements. RFA was conducted with a SmartPeg screwed directly into the implant and onto experimental abutments of different heights of 2, 3.5 and 5 mm. A total of 32 patients (116 implants) were tested. RFA measurements were taken twice for each group from mesial, distal, buccal and palatal/lingual surfaces. Mean values and SD were calculated and Intraclass Correlation Coefficients (ICC) ( < 0.05, IC 95%). The implant stability quotient (ISQ) mean values were 72.581 measured directly to implant and 72.899 (2 mm), 72.391 (3.5 mm) and 71.458 (5 mm) measured from the prototypes. ICC between measurements made directly to implant and through 2-, 3.5- and 5-mm abutments were 0.908, 0.919 and 0.939, respectively. RFA values registered through the experimental transepithelial abutments achieved a high reliability. Neither the implant length nor the diameter had any influence on the measurements' reliability.
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http://dx.doi.org/10.3390/ijerph17186733DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559410PMC
September 2020

Improvement of Periodontal Parameters with the Sole Use of Free Gingival Grafts in Orthodontic Patients: Correlation with Periodontal Indices. A 15-Month Clinical Study.

Int J Environ Res Public Health 2020 09 9;17(18). Epub 2020 Sep 9.

Private Practice Via Patini, 67039 Sulmona, Italy.

The aim of this study was to evaluate the changes in periodontal parameters solely using free gingival grafts during orthodontic treatment without any oral hygiene re-enforcement.

Methods: A total of 19 patients underwent periodontal examination before orthodontic treatment. Patients received oral hygiene instruction and professional hygiene therapy. Where needed; full periodontal treatment was completed. Only periodontally stable patients were included in the study. Periodontal indices and keratinized tissue were recorded at time 0 (T0) (delivery of orthodontic appliances), and at three months (T1) during orthodontic therapy; when surgery was performed. At T1; orthodontically treated sites with minimum keratinized tissue (≤1 mm) received a free gingival graft to enhance the band of keratinized tissue. At three months after surgery (T2), new measurements were recorded. The orthodontics-treated sites after three months (T1) were used as control. The same sites were used as a test three months after mucogingival correction (T2). Between T1 and T2; orthodontics was suspended; no professional oral hygiene was performed; and no additional oral hygiene instructions were given to the patient. No oral hygiene procedures were administered for 15 months (T3), when the final recordings were taken.

Results: The results showed that there was a worsening of gingival index (GI) and plaque index (PI) of the treated sites between T0 and T1 during initial orthodontics treatment; whereas there was an improvement of the gingival inflammation at T2 when compared with T1. At T2; there was also a statistically significant improvement in GI and PI compared with T0. A T3 improvement in periodontal parameters was sustained. A non-parametric test (Wilcoxon signed-rank test) was used for statistical analysis.

Conclusions: Augmentation of the width of keratinized gingiva; as the sole treatment; favors the improvement of GI and PI during orthodontic therapy.
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http://dx.doi.org/10.3390/ijerph17186578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560096PMC
September 2020

Influence of Implant Design and Under-Preparation of the Implant Site on Implant Primary Stability. An In Vitro Study.

Int J Environ Res Public Health 2020 06 20;17(12). Epub 2020 Jun 20.

Department of Periodontology, University of Seville, 41009 Seville, Spain.

The aim of this study was to evaluate the effects of different implant sites an under-preparation sequence associated with two different implant designs on implant primary stability measured by two parameters: insertion torque (IT) and implant stability quotient (ISQ). It used two different implants: one cylindrical as a control and another one with a tapered design. The implants were inserted in type III fresh humid bovine bone and four drilling sequences were used: one control, the one proposed by the implant company (P1), and three different undersized (P2, P3 and P4). P2 was the same as P1 without the cortical drill, P3 was without the last pilot drill and P4 was without both of them. The sample size was = 40 for each of the eight groups. Final IT was measured with a torquemeter and the ISQ was measured with Penguin resonance frequency analysis. Results showed that both ISQ and IT have a tendency to increase as the preparation technique reduces the implant site diameter when compared with the standard preparation, P1. The preparations without cortical drill, P2 and P4, showed the best results when compared with the ones with a cortical drill. Tapered implants always showed higher or the same ISQ and IT values when compared with the cylindrical implants. Giving the limitations of this study, it can be concluded that reducing implant preparation can increase IT and ISQ values. Removing the cortical drill and the use of a tapered design implant are also effective methods of increasing primary implant stability.
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http://dx.doi.org/10.3390/ijerph17124436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345708PMC
June 2020

Is It Possible to Monitor Implant Stability on a Prosthetic Abutment? An In Vitro Resonance Frequency Analysis.

Int J Environ Res Public Health 2020 06 8;17(11). Epub 2020 Jun 8.

Porto Dental Institute, Av. de Montevideu 810, 4150-518 Porto, Portugal.

In order to apply the "one-abutment-one-time" concept, we evaluated the possibility of measuring resonance frequency analysis (RFA) on the abutment. This trial aimed to compare the Implant Stability Quotient (ISQ) values obtained by the Penguin when screwing the transducer onto the implant or onto abutments with different heights and angulations. Eighty implants (VEGA, Klockner Implant System, SOADCO, Les Escaldes, Andorra) were inserted into fresh bovine ribs. The groups were composed of 20 implants, 12 mm in length, with two diameters (3.5 and 4 mm). Five different abutments for screwed retained restorations (Permanent) were placed as follows: straight with 1, 2, and 3 mm heights, and angulated at 18° with 2 and 3 mm heights. The mean value of the ISQ measured directly on the implant was 75.72 ± 4.37. The mean value of the ISQ registered over straight abutments was 79.5 ± 8.50, 76.12 ± 6.63, and 71.42 ± 6.86 for 1, 2, and 3 mm height abutments. The mean ISQ over angled abutments of 2 and 3 mm heights were 68.74 ± 4.68 and 64.51 ± 4.53 respectively. The present study demonstrates that, when the ISQ is registered over the straight abutments of 2 and 3 mm heights, the values decrease, and values are lower for angled, 3 mm height abutments.
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http://dx.doi.org/10.3390/ijerph17114073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313046PMC
June 2020

Assessment of the Simultaneous Use of Biomaterials in Transalveolar Sinus Floor Elevation: Prospective Randomized Clinical Trial in Humans.

Int J Environ Res Public Health 2020 03 14;17(6). Epub 2020 Mar 14.

Department. of Sociosanitary Sciences Facultad de Medicina, Universidad de Sevilla, Avda. Dr. Fedriani, S/N, 41009 Sevilla, Spain.

Implants inserted in the posterior maxilla frequently need additional surgery for successful bone augmentation. One of the most common procedures for this is transalveolar sinus floor elevation. There are different protocols for this procedure, and there is controversy over the simultaneous application of grafting material upon elevating. In this prospective randomized clinical study in humans, a total of 49 transalveolar sinus floor elevations were performed in 49 different patients, divided into a control group (without graft, 25 patients) and a test group (with graft, 24 patients). The analyzed variables were obtained through digital orthopantomography on day 0 (day of surgery) and 18 months after surgery. These measurements showed a tendency towards greater vertical bone gain in the test group, but this was not statistically significant. Therefore, considering that sinus elevation and implant placement without the application of grafts is a successful treatment with fewer complications, a critical assessment of the need for these biomaterials is necessary.
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http://dx.doi.org/10.3390/ijerph17061888DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143782PMC
March 2020

In vitro comparative analysis of two resonance frequency measurement devices: Osstell implant stability coefficient and Penguin resonance frequency analysis.

Clin Implant Dent Relat Res 2019 Dec 12;21(6):1124-1131. Epub 2019 Nov 12.

Department of Periodontics and Implant Dentistry, Periodontics and Implant Dentistry, Dental School University of Seville, Seville, Spain.

Adequate implant stability is an essential requirement. The introduction of the Penguin resonance frequency analysis raises some questions regarding its reliability, reproducibility, and repeatability as well as how it compares to the older Osstell device.

Purpose: To assess the newer Penguin implant stability coefficient (ISQ) device (vs the Osstell device).

Materials And Methods: A total of 120 implants were used, divided into four groups (A, B, C, and D) (according to design) and placed in fresh bovine bone. Consecutive measurements were made with both devices (Penguin/Osstell) with their respective transducers. Then, the ISQ values were measured with the Penguin device using the Osstell transducer, and vice-versa.

Results: The mean insertion torque (N/cm) values for the implants were as follows: Group A = 24.7 ± 9.4; Group B = 25.6 ± 9.7; Group C = 28.7 ± 7.9; Group D = 19.1 ± 5.5. The mean ISQ values for the entire sample were as follows: Penguin 67.7 ± 6.1 and Osstell 68.5 ± 9.6. The ISQ value measured with the Penguin device using a SmartPeg transducer was 67.0 ± 8.0, and that for the Osstell device using a MultiPeg transducer was 68.3 ± 7.5. The intraclass correlation coefficient (ICC) was calculated for the ISQ values obtained from both devices and was >0.90 for all transducers. When the ICC transducers were interchanged, the values were <0.77.

Conclusions: Both ISQ devices allow for reliable and repeatable measurement of implant stability; however, the use of each device-specific transducer is recommended.
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http://dx.doi.org/10.1111/cid.12868DOI Listing
December 2019

Influence of a Novel Surface of Bioactive Implants on Osseointegration: A Comparative and Histomorfometric Correlation and Implant Stability Study in Minipigs.

Int J Mol Sci 2019 May 9;20(9). Epub 2019 May 9.

Porto Dental Institute, 4150-518 Oporto, Portugal.

Purpose: The objective of this study was to assess the influence of a novel surface of dental implants (ContacTi) on the osseointegration process in a minipig model. The surface was compared with other existing surfaces on the market (SLA and SLActive) by employing bone implant contact analysis (BIC) and implant stability.

Method: Twelve minipigs were used with prior authorisation from an ethics committee. Three types of surfaces were tested: SLA (sand-blasted acid-etched titanium), SLActive (same but hydrophilic, performed under a nitrogen atmosphere), and ContacTi (alumina particle bombardment of titanium, bioactivated when treated thermochemically) in 4.1 mm × 8 mm implants with internal connection and a polished neck. Twelve implants of each surface type ( = 36) were placed, sacrificing 1/3 of the animals at 2 weeks of placement, 1/3 at 4 weeks and the remaining 1/3 at 8 weeks. Numerical variables were compared with Analysis of Variance, and the correlation between ISQ and BIC was established with the Spearman's rank correlation coefficient.

Results: SLActive and ContacTi surfaces showed elevated osteoconductivity at 4 weeks, maintaining a similar evolution at 8 weeks (large amount of mature lamellar tissue with high maturity and bone quality). The SLA surface showed slower maturation. The ISQ values in surgery were elevated (above 65), higher at necropsy and higher at 4 and 8 weeks in the SLA group than in the other two (SLActive and ContacTi). No significant correlation was found between ISQ and BIC for each implant surface and necropsy time.

Conclusion: The three surfaces analysed showed high RFA and BIC values, which were more favourable for the SLActive and ContacTi surfaces. No statistical correlation was found between the RFA and BIC values in any of the three surfaces analysed.
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http://dx.doi.org/10.3390/ijms20092307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539430PMC
May 2019

Influence of a Novel Surface of Bioactive Implants on Osseointegration: A Comparative and Histomorfometric Correlation and Implant Stability Study in Minipigs.

Int J Mol Sci 2019 May 9;20(9). Epub 2019 May 9.

Porto Dental Institute, 4150-518 Oporto, Portugal.

Purpose: The objective of this study was to assess the influence of a novel surface of dental implants (ContacTi) on the osseointegration process in a minipig model. The surface was compared with other existing surfaces on the market (SLA and SLActive) by employing bone implant contact analysis (BIC) and implant stability.

Method: Twelve minipigs were used with prior authorisation from an ethics committee. Three types of surfaces were tested: SLA (sand-blasted acid-etched titanium), SLActive (same but hydrophilic, performed under a nitrogen atmosphere), and ContacTi (alumina particle bombardment of titanium, bioactivated when treated thermochemically) in 4.1 mm × 8 mm implants with internal connection and a polished neck. Twelve implants of each surface type ( = 36) were placed, sacrificing 1/3 of the animals at 2 weeks of placement, 1/3 at 4 weeks and the remaining 1/3 at 8 weeks. Numerical variables were compared with Analysis of Variance, and the correlation between ISQ and BIC was established with the Spearman's rank correlation coefficient.

Results: SLActive and ContacTi surfaces showed elevated osteoconductivity at 4 weeks, maintaining a similar evolution at 8 weeks (large amount of mature lamellar tissue with high maturity and bone quality). The SLA surface showed slower maturation. The ISQ values in surgery were elevated (above 65), higher at necropsy and higher at 4 and 8 weeks in the SLA group than in the other two (SLActive and ContacTi). No significant correlation was found between ISQ and BIC for each implant surface and necropsy time.

Conclusion: The three surfaces analysed showed high RFA and BIC values, which were more favourable for the SLActive and ContacTi surfaces. No statistical correlation was found between the RFA and BIC values in any of the three surfaces analysed.
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http://dx.doi.org/10.3390/ijms20092307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539430PMC
May 2019