Daniele Botticelli | Osaka Dental University (original) (raw)

Papers by Daniele Botticelli

Oral and maxillofacial surgery, Jan 29, 2024

Oral and maxillofacial surgery, Mar 2, 2024

Research Square (Research Square), Nov 22, 2023

Background: Healing of critical-size defects is a well-known problem that has been challenged in ... more Background: Healing of critical-size defects is a well-known problem that has been challenged in several studies. The aim of the experiment was to evaluate bone formation and osseointegration of implants installed in critical defects of the mandibular body simultaneously grafted with Bio-Oss® or Cerabone®. Material and methods: Defects, 10 mm wide and 3 mm deep, were prepared at both lateral aspects of the mandible in 12 rabbits. One implant was installed in the center of the defect, and bovine xenografts produced either at low (Bio-Oss®; Low-T) or high (Cerabone®; High-T) temperatures were used to ll the defects. A collagen membrane was placed to cover the sites. Healing was evaluated 10 weeks after surgery. Results: In both groups, most sites showed optimal healing with closure of the coronal entrance of the defects. However, residual defects occupied by soft tissues and biomaterial particles were observed, even though generally limited to some regions of the defect. Osseointegration of the implant surface in the region of the defect was poor in both groups. Conclusions: Circumferential marginal critical-size defects around implants lled with bovine xenografts presented regions with a complete healing in both groups. However, the healing was not complete at all regions in most defects; therefore, a complete optimal healing of critical-size marginal defects cannot be predicted.

Journal of Stomatology, Oral and Maxillofacial Surgery, Sep 1, 2022

PURPOSE Assess the role of tenting screws in the remodeling processes of autogenous bone blocks u... more PURPOSE Assess the role of tenting screws in the remodeling processes of autogenous bone blocks used for mandibular lateral augmentation in rabbits. METHODS Eighteen rabbits, approximately 3.5-4.0 kg of weight and 4-5 months of age, were included in this study. The lateral side of the angle of the mandible was augmented bilaterally with block autografts. Animals were euthanized after 7, 20 and 60 days of healing, respectively. Biopsies were taken for each period and specimens underwent microtomographic scanning. The total volume (TV, mm3), bone volume (BV: residual graft plus new bone, mm3), periimplant bone volume (PIBV), bone implant contact (BIC) along the screw and linear bone gain at five vertical points symmetrically dispersed from the fixation screw in the midline were measured. ANOVA and the t test were performed. RESULTS The total volume (TV) of autografts decreased between 7 and 60 days from 258.13±15.3 mm3 to 107.2±17.5 mm3 (p < 0.05). Contraction rates of 58.5% were observed. BV was 52.8±7.7 mm3, 27.2±11.1 mm3, and 33.1±2.8 mm3 after 7, 20, and 60 days of healing, respectively. PIBV and BIC remained unchanged along time demonstrating no contraction around the screw. Total linear bone gain demonstrated a total of 18 % linear contraction after 60 days. Point 1, demonstrated no changes along time representing no resorption along time. Points 2 and 4 demonstrate a minimum linear contraction (10-15%) with borderline significance. Resembling the total results, contraction starts after 20 days. Points 3 and 5 demonstrate a statistically significant contraction (p<0.05) of 35-40% starting at 20 days. CONCLUSION Tenting screws may reduce bone resorption symmetrically in a model of lateral block augmentation.

Clinical Oral Implants Research, Oct 1, 2018

Background : If one or more dental elements are missing, the use of dental implants is considered... more Background : If one or more dental elements are missing, the use of dental implants is considered a consolidated method to guarantee a correct oral rehabilitation. The absence of ideal anatomic conditions might result in insufficient bone volume. In these circumstances, bone augmentation surgical techniques or use of short implants are often required. Aim/Hypothesis : To evaluate prospectively the clinical and radiographic outcomes after 10 years of early loading of 6 mm implants with a moderately rough surface supporting single crowns in the posterior regions. Material and Methods : 40 short (6 mm long) implants were installed in 35 consecutive patients. Early loading, after 6 weeks of healing, were performed with cemented single porcelain fuse to metal crowns. Implant survival rate, marginal bone loss, clinical crown implant ratio and periodontal parameters (FMPS, full mouth plaque score FMBS, full mouth bleeding score PD, peri-implant probing depth) were analysed at various time intervals until 10 years after loading. Results : Two out of 40 implants were lost before loading, one implant was lost due to perimplantitis after 7 years. One patient with two implants dropped out, and survival rate at long term follow up was 92.1%(n = 38). A mean marginal bone loss after 10 years of function was 0.8 ± 0.7 mm. Between 5 and 10 years the bone loss was 0.2 ± 0.4 mm. The mean bone level after 10 years was located at 2.8 mm from the shoulder (at the level of the interface between the smooth implant neck and the coronal margin of rough surface). The clinical crown implant ratio increased with time from 1.6 at the delivery of the prosthesis to 2.0 after 10 years of loading with no increase between 5 and 10 years. No technical complications were registered during the 10-year follow-up period. Patients registered mean FMPS 8% and FMBS 16% and periimplant probing depth ≤ 4 mm. Conclusions and Clinical Implications : 6 mm implants with a moderately rough surface supporting single crowns in the distal region maintained full function for at least 10 year with low marginal bone loss.

Clinical Oral Implants Research, Oct 1, 2018

Background : The use of xenogenous bone blocks (XBB) as an alternative to autogenous bone blocks ... more Background : The use of xenogenous bone blocks (XBB) as an alternative to autogenous bone blocks (ABB) has considerably increased in oral implantology. Nevertheless, there is little information on the histological findings of these grafts to date. Aim/Hypothesis : To compare histomorphometrically the graft remodeling process of ABB and XBB used for mandibular onlay grafting. Material and Methods : Nine adult male New Zealand white rabbits (3.5-4 kg) were used in this split mouth randomized study. The control side of the mandible was subjected to onlay iliac crest grafting (ABB) and test side received xenogenous (XBB) bone graft (Heket Biomaterials, Vicenza, Italy), with 10 mm diameter × 3 mm height dimension. Both sides were covered with a collagen membrane (Heket Biomaterials, Vicenza, Italy). At 07, 20 and 60 days post-operatively, 03 animals were sacrificed in order to obtain bone biopsies. Paraffin sections were stained in Hematoxylin-Eosin and Masson´s Trichrome for histomorphometric assessment. The percentage of residual graft and new bone was evaluated through a counting point procedure in which a lattice of about 0.4 × 0.6 mm, with squares of 50 μm in dimensions, was superposed over the slides at a magnification of ×200. ANOVA and the t test were performed for statistical analysis. Results : New bone formation could not be observed at 07 days for both ABB and XBB groups. At 20 and 60 days, o statistical differences were found between intra-group (time) and inter-group (grafts). Residual xenograft was significantly resorbed between 07 and 20 days. At 60 days, inter-group analysis showed more residual autograft in comparison to residual xenograft. Conclusions and Clinical Implications : These data indicate that ABB and XBB showed similar amount of new bone formation over time. The percentage of residual iliac graft and xenograft tended to decrease for both groups, with more remaining bone at 60 days for ABB.

PubMed, Jun 10, 2022

Objective: To compare the sequential healing of maxillary sinuses grafted with two different xeno... more Objective: To compare the sequential healing of maxillary sinuses grafted with two different xenogeneic bone substitutes processed at either a low (300°C) or high (1200°C) temperature. Methods: A sinus augmentation procedure was performed bilaterally in 20 rabbits and two different xenogeneic bone grafts were randomly used to fill the elevated spaces. Healing was studied after 2 and 10 weeks, in 10 rabbits during each period. Results: After 2 weeks of healing, very small amounts of new bone were observed in both groups, and were mainly confined to close to the sinus bone walls and osteotomy edges. After 10 weeks of healing, new bone was found in all regions, with higher percentages in those close to the bone walls and to the osteotomy. In this period of healing, the proportion of new bone in the 300°C group was 20.0% ± 4.3%, and in the 1200°C group it was 17.2% ± 4.3% (P = 0.162). In the 1200°C group, translucent, dark fog-like shadows in regions of the grafts were hiding portions of new bone (interpenetrating bone network). Conclusion: Both biomaterials provided conditions that allowed bone growth within the elevated space, confirming that both biomaterials are suitable to be used as a graft for sinus floor augmentation.

European Journal of Oral Implantology, 2014

To compare the clinical outcome of 6-mm and 10-mm long implants in partially edentulous posterior... more To compare the clinical outcome of 6-mm and 10-mm long implants in partially edentulous posterior areas. Twenty-four patients, with a partially edentulous area in the jaws with a height and width allowing the positioning of 2 to 3 adjacent 10 × 4.1 mm implants without any augmentation procedure, were randomly allocated according to a parallel group design to receive 6-mm long or 10-mm long implants. A total of 54 implants were placed (26 × 6 mm and 28 × 10 mm implants). Patients were restored 8 weeks after surgery and were followed for 5 years. Outcome measures were prosthesis and implant survival, as well as marginal bone level changes and complications. After 5 years, 18 patients were available. One 6 mm implant failed during the healing period and its related prosthesis could not be placed. No implants were lost after loading. The 6 mm group registered 5 complications (1 mucositis, 3 prosthesis decementations and 1 chipping), while only 3 were registered in the 10 mm group (2 decementations and 1 chipping). The difference in complications between the two groups was not statistically significant (P = 0.39). Marginal bone loss at 5 years was 0.43 and 0.24 mm with the 6 mm and 10 mm groups, respectively (not statistically significant; difference between the two groups 0.19 mm; SD 0.23 mm; 95% CI -0.34;0.73; t test P = 0.42). Implant and prosthetic survival and success rates were similar between prostheses supported by 6-mm or 10-mm long implants.

Oral and Maxillofacial Surgery, Dec 9, 2019

The aim of the present experiment was to compare the data on new bone formation measured histolog... more The aim of the present experiment was to compare the data on new bone formation measured histologically and microtomographically in maxillary sinuses augmented with a xenograft with higher density and higher mineral content compared with the natural bone. The hypothesis was that histomorphometric and micro-computed tomography (microCT) analyses do not yield similar outcomes when a xenograft with higher density and mineral content compared with the natural bone is used. Methods In 18 rabbits, the maxillary sinus was augmented bilaterally using deproteinized bovine bone mineral (DBBM) xenograft granules of either 0.125-1 mm or 1-2 mm of dimensions. The rabbits were euthanized after 2, 4, and 8 weeks of healing. Comparisons were performed between microCT and histological analyses. Results After 2 weeks of healing, higher contents of bone were found at the histological compared with the microCT analyses in both sinuses, especially in the middle regions of the grafted sinus. Between 2 and 8 weeks of healing, new bone increased of about 21% at the histological analyses while, at the microCT, increased only about 4%. In the same period, the xenograft proportion decreased from 51.6 ± 4.9 to 45.3 ± 3.3% at the histological analyses while, at the microCT, the xenograft appeared to increase in percentages. Conclusion Histological and microCT analyses yielded different outcomes when a xenograft with higher density and higher mineral content compared with the natural bone was used.

Clinical and experimental dental research, Nov 23, 2018

The objective of this study was to evaluate possible differences in the assessment of bone format... more The objective of this study was to evaluate possible differences in the assessment of bone formation between histological and micro-computed tomography (CT) analyses in maxillary sinuses augmented with a xenograft with similar density and mineral content of bone. A collagen membrane was placed subjacent the elevated sinus mucosa at the test sites of 18 rabbits, and the elevated spaces were filled with xenograft. The antrostomy was covered with collagen membranes, bilaterally. Six rabbits per group were sacrificed after 2, 4, and 8 weeks of healing. Biopsies were retrieved and scanned in a high-resolution micro-CT at two different gray thresholds. Histological assessments were subsequently performed. At the histological analyses, bone increased over time, from 7.5 ± 2.4% to 27.0 ± 5.3%, between 2 and 8 weeks of healing. The highest content of bone was found close to the sinus bone walls, whereas the middle regions contained lower amounts. At the micro-CT analyses, discrepancies were found in bone content percentages compared with the histological analyses, especially after 2 weeks of healing and within the middle regions of the sinus, in which new bone was 15-22% at the micro-CT analyses and only 1.6% at the histological evaluation. The outcomes of a micro-CT analysis performed in an early phase of healing may be altered when a resorbable bone substitute with similar density and mineral content of bone is applied.

Clinical Oral Implants Research, Jun 7, 2018

Objective: To test if repositioning the bony plate secured with a cyanoacrylate over the antrosto... more Objective: To test if repositioning the bony plate secured with a cyanoacrylate over the antrostomy in maxillary sinus augmentation was superior to covering the antrostomy with a collagen membrane in terms of the bone augmentation area and the bone density. Material and Methods: After the exposure of the nasal bone in eighteen rabbits, a rectangular access window was prepared with a sonic instrument, and the bony plate was removed. A bilateral sinus mucosa elevation was performed, and the space was filled with a resorbable xenograft. On the test side, the bone plate was repositioned over the antrostomy and fixed with a cyanoacrylate. On the control side, a collagen membrane was placed over the opening. Per group, six animals were sacrificed after 2, 4, and 8 weeks of healing, respectively. Histological ground sections were prepared. Results: The augmented area after elevation decreased between 2 and 8 weeks from 9.4 ± 1.8 to 4.8 ± 2.8 mm 2 at the test and from 9.5 ± 2.6 and 5.1 ± 1.6 mm 2 at the control sites. Small amounts of new bone were seen after 2 weeks in both groups (~1.6%-2.5%) forming from the bony sinus walls. New bone density increased over time in both groups reaching ~ 10%-11% and ~ 23%-25% after 4 and 8 weeks, respectively. No statistically significant differences were found. Small residual defects were present both at the test sites in the margin of the bone plate, and at the control sites in the center of the antrostomy. Conclusions: The bone healing in the elevated sinus space was similar irrespective of the coverage of the antrostomy. After 8 weeks, the bone plate repositioned on the antrostomy was incorporated while at the control sites the healing was still incomplete. Residual defects were still present in both groups.

Clinical Oral Implants Research, Dec 1, 2018

Objectives: To evaluate prospectively the clinical and radiographic outcomes after ten years of s... more Objectives: To evaluate prospectively the clinical and radiographic outcomes after ten years of short (6 mm) implants with a moderately rough surface supporting single crowns in the posterior region. Material and Methods: Forty 6 mm modified sandblasted large-grit acid-etched (mod-SLA), soft tissue level implants were installed in the distal segments of 35 consecutive patients. After 6 weeks of healing, abutments were tightened, and single porcelain fusedto-metal crowns were cemented. Implant survival, marginal bone loss and clinical crown/implant ratio were evaluated at various time intervals up to 10 years after loading. Results: Two out of the 40 implants were lost before loading, one implant was lost after 7 years because of peri-implantitis. One patient with two implants died and was excluded from analysis. Two patients did not come at the 10-year follow-up and were considered as drop out (2 implants). The survival rate was 91.7% (n=36). Thirty-three implants were available for marginal bone loss evaluation. A mean marginal bone loss after 10 years of function was 0.8±0.7mm. Between 5 and 10 years the loss was 0.2±0.4 mm. No technical complications were registered during the 10-year period. The clinical crown/implant ratio increased with time from 1.6 at the delivery of the prosthesis to 2.0 after 10 years of loading with no increase between 5 and 10 years. Conclusion: Short (6mm) implants with a moderately rough surface supporting single crowns in the posterior region and loaded after 6-7 weeks maintained full function for at least 10 years with low marginal bone resorption.

Journal of Clinical Periodontology, May 1, 2005

Background: Marginal hard tissue defects present at implants with a rough surface can heal with a... more Background: Marginal hard tissue defects present at implants with a rough surface can heal with a high degree of bone fill and osseointegration. The healing of similar defects adjacent to implants with a smooth surface appears to be less predictable.Objective: The aim was to compare bone healing at implants with turned or rough surface topographies placed in self‐contained defects using either a submerged or non‐submerged installation technique.Material and Methods: Six dogs were used. Three months after tooth extraction four experimental sites were prepared for implant installation in both sides of the mandible. The marginal 5 mm of the canal prepared for the implant was widened. Thus, following implant placement a circumferential gap occurred between the bone tissue and the implant surface that was between 1 and 1.25 mm wide. In each side of the mandible two implants with a turned surface and two implants with a rough surface were installed. The implants in the right side were fully submerged, while a non‐submerged technique was applied in the left side. The animals were sacrificed 4 months later, block biopsies of each implant site were dissected and ground as well as paraffin sections were prepared.Results: The marginal defects around rough surface implants exhibited after 4 months of healing substantial bone fill and a high degree of osseointegration following either the submerged or the non‐submerged installation technique. Healing at turned implants was characterized by incomplete bone fill and the presence of a connective tissue zone between the implant and the newly formed bone. The distance between the implant margin (M) and the most coronal level of bone‐to‐implant contact (B) at implants with a rough surface was 0.84±0.37 mm at submerged and 0.90±0.39 mm at non‐submerged sites. The distance M–B at implants with a turned surface was 3.39±0.52 mm at submerged and 3.23±0.68 mm at non‐submerged sites. The differences between the rough and turned implants regarding the length of distance M–B were statistically significant (paired t‐test).Conclusion: Osseointegration at implants placed in sites with marginal defects is influenced by the surface characteristics of the implant.

REDVET. Revista Electrónica de Veterinaria, 2017

Applied sciences, Mar 18, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Clinical Oral Implants Research, Jun 1, 2004

The present experiment was performed to determine the influence of Bio-Oss on hard tissue formati... more The present experiment was performed to determine the influence of Bio-Oss on hard tissue formation at sites that, following implant installation, presented a 1-1.25 mm wide marginal defect. Four Labrador dogs were used. The premolars and first molars on both sides of the mandible were extracted. After 3 months, mucoperiosteal flaps were elevated and three experimental sites were prepared for implant installation in each side of the mandible. A step drill was used to widen the marginal 5 mm of the canal. Thus, following the placement of the implant (3.3 x 10 mm, SLA surface, Straumann AG, Waldenburg, Switzerland) a circumferential gap, about 1-1.25 wide and 5 mm deep, remained lateral to the titanium rod. The test sites in the left side of the mandible were first filled with a deproteinized cancellous bone mineral (Bio-Oss). The defect sites in the right side of the mandible (control sites) were left for spontaneous healing. A resorbable barrier membrane (Bio-Gide) was placed to cover the implant and the bone tissue in two sites of each quadrant, while the third site was left without membrane placement. The flaps were repositioned to cover all defect sites and were sutured. After 4 months of healing, block biopsies of each implant site were dissected and processed for ground sectioning. It was demonstrated that at 4 months, all types of defects were filled with newly formed bone and that the biomaterial placed in the marginal defect in conjunction with implant installation during healing became incorporated in the newly formed bone tissue. A high degree of contact was established between the Bio-Oss particles and the newly formed bone. Bio-Oss became integrated with the newly formed bone. In the model used, Bio-Oss did not enhance the process of bone formation and defect closure.

European Journal of Dental Education, Feb 1, 2014

IntroductionTraining for dental practitioners in implant dentistry ranges from 1‐ or 2‐day short ... more IntroductionTraining for dental practitioners in implant dentistry ranges from 1‐ or 2‐day short Continuing Professional Development (CPD) courses to certificate/diploma programmes run by universities. In general, the teaching of implant dentistry in Europe lacks structure and standardisation. This paper aims to: (i) identify the current trends in CPD in implant dentistry in Europe; (ii) identify potential and limitations with regards to the design and implementation of CPD activities in implant dentistry; (iii) provide recommendations on the future structure and development of CPD activities in implant dentistry.MethodsA search of the literature was undertaken in PubMed for manuscripts published in English after 2000 reporting on CPD in dentistry and in implant dentistry in particular. In addition, an electronic survey was conducted, investigating the attitudes towards CPD among a wide group of stakeholders in implant dentistry education.ConclusionsThere is a wide diversity of educational pathways towards achieving competences in implant dentistry through CPD. At present, there is a need for improving the CPD structures in implant dentistry, strengthening the quality assurance and encouraging standardisation and transparency of the learning outcomes. Development of a structured CPD system with clearly defined educational objectives mapped against specific levels of competence is recommended.

Oral Surgery, Apr 17, 2012

Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant ... more Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants.

International Journal of Periodontics & Restorative Dentistry, 2019

This assignment applies to all translations of the Work as well as to preliminary display/posting... more This assignment applies to all translations of the Work as well as to preliminary display/posting of the abstract of the accepted article in electronic form before publication. If any changes in authorship (order, deletions, or additions) occur after the manuscript is submitted, agreement by all authors for such changes must be on file with the Publisher. An author's name may be removed only at his/her written request. (Note: Material prepared by employees of the US government in the course of their official duties cannot be copyrighted.

European Journal of Dental Education, Feb 1, 2014

IntroductionPrevious surveys have shown that newly graduated dentists, in most European countries... more IntroductionPrevious surveys have shown that newly graduated dentists, in most European countries, do not obtain adequate theoretical knowledge and, especially, clinical skills in implant dentistry (ID) through their undergraduate education and must therefore acquire knowledge and develop competencies through further postgraduate study. Moreover, clinicians, in general, need to continue to maintain the currency of their competence by undertaking ongoing continuing professional development (CPD). This seems particularly important in ID as techniques, and materials develop rapidly due to advances in biomedical technology. Despite recent developments, CPD in ID remains poorly organised with little standardisation or harmonisation across Europe. The objective of this survey was to explore the current status and trends within CPD education in ID in Europe.Materials and methodsStakeholders and opinion leaders associated with ID education were invited by email to fill an online questionnaire (closing date: 30th April 2013). Two hundred and forty‐seven questionnaires were distributed, and two separate reminders were sent to participants in 38 European countries. The survey contained 14 multiple‐choice questions, and the data were collected using SurveyMonkey© software, exported in SPSS (Inc, Chicago, IL, USA) format and analysed using descriptive statistics.ResultsTwo hundred respondents working in 24 countries replied to the survey (response rate of 81% of invitees and 63% of countries surveyed). The results demonstrated a wide divergence in the content and structure of CPD in ID in Europe.ConclusionsDentists need CPD to develop their skills and to maintain their competence in ID. There is an urgent need for structured and accredited CPD, which should be readily available to all dentists practising ID. It should have pre‐determined learning objectives, delivered by accredited CPD providers and educators, and have assessable outcome measures to ensure the best possible impact on clinical practice and patient safety.

Oral and maxillofacial surgery, Jan 29, 2024

Oral and maxillofacial surgery, Mar 2, 2024

Research Square (Research Square), Nov 22, 2023

Background: Healing of critical-size defects is a well-known problem that has been challenged in ... more Background: Healing of critical-size defects is a well-known problem that has been challenged in several studies. The aim of the experiment was to evaluate bone formation and osseointegration of implants installed in critical defects of the mandibular body simultaneously grafted with Bio-Oss® or Cerabone®. Material and methods: Defects, 10 mm wide and 3 mm deep, were prepared at both lateral aspects of the mandible in 12 rabbits. One implant was installed in the center of the defect, and bovine xenografts produced either at low (Bio-Oss®; Low-T) or high (Cerabone®; High-T) temperatures were used to ll the defects. A collagen membrane was placed to cover the sites. Healing was evaluated 10 weeks after surgery. Results: In both groups, most sites showed optimal healing with closure of the coronal entrance of the defects. However, residual defects occupied by soft tissues and biomaterial particles were observed, even though generally limited to some regions of the defect. Osseointegration of the implant surface in the region of the defect was poor in both groups. Conclusions: Circumferential marginal critical-size defects around implants lled with bovine xenografts presented regions with a complete healing in both groups. However, the healing was not complete at all regions in most defects; therefore, a complete optimal healing of critical-size marginal defects cannot be predicted.

Journal of Stomatology, Oral and Maxillofacial Surgery, Sep 1, 2022

PURPOSE Assess the role of tenting screws in the remodeling processes of autogenous bone blocks u... more PURPOSE Assess the role of tenting screws in the remodeling processes of autogenous bone blocks used for mandibular lateral augmentation in rabbits. METHODS Eighteen rabbits, approximately 3.5-4.0 kg of weight and 4-5 months of age, were included in this study. The lateral side of the angle of the mandible was augmented bilaterally with block autografts. Animals were euthanized after 7, 20 and 60 days of healing, respectively. Biopsies were taken for each period and specimens underwent microtomographic scanning. The total volume (TV, mm3), bone volume (BV: residual graft plus new bone, mm3), periimplant bone volume (PIBV), bone implant contact (BIC) along the screw and linear bone gain at five vertical points symmetrically dispersed from the fixation screw in the midline were measured. ANOVA and the t test were performed. RESULTS The total volume (TV) of autografts decreased between 7 and 60 days from 258.13±15.3 mm3 to 107.2±17.5 mm3 (p < 0.05). Contraction rates of 58.5% were observed. BV was 52.8±7.7 mm3, 27.2±11.1 mm3, and 33.1±2.8 mm3 after 7, 20, and 60 days of healing, respectively. PIBV and BIC remained unchanged along time demonstrating no contraction around the screw. Total linear bone gain demonstrated a total of 18 % linear contraction after 60 days. Point 1, demonstrated no changes along time representing no resorption along time. Points 2 and 4 demonstrate a minimum linear contraction (10-15%) with borderline significance. Resembling the total results, contraction starts after 20 days. Points 3 and 5 demonstrate a statistically significant contraction (p<0.05) of 35-40% starting at 20 days. CONCLUSION Tenting screws may reduce bone resorption symmetrically in a model of lateral block augmentation.

Clinical Oral Implants Research, Oct 1, 2018

Background : If one or more dental elements are missing, the use of dental implants is considered... more Background : If one or more dental elements are missing, the use of dental implants is considered a consolidated method to guarantee a correct oral rehabilitation. The absence of ideal anatomic conditions might result in insufficient bone volume. In these circumstances, bone augmentation surgical techniques or use of short implants are often required. Aim/Hypothesis : To evaluate prospectively the clinical and radiographic outcomes after 10 years of early loading of 6 mm implants with a moderately rough surface supporting single crowns in the posterior regions. Material and Methods : 40 short (6 mm long) implants were installed in 35 consecutive patients. Early loading, after 6 weeks of healing, were performed with cemented single porcelain fuse to metal crowns. Implant survival rate, marginal bone loss, clinical crown implant ratio and periodontal parameters (FMPS, full mouth plaque score FMBS, full mouth bleeding score PD, peri-implant probing depth) were analysed at various time intervals until 10 years after loading. Results : Two out of 40 implants were lost before loading, one implant was lost due to perimplantitis after 7 years. One patient with two implants dropped out, and survival rate at long term follow up was 92.1%(n = 38). A mean marginal bone loss after 10 years of function was 0.8 ± 0.7 mm. Between 5 and 10 years the bone loss was 0.2 ± 0.4 mm. The mean bone level after 10 years was located at 2.8 mm from the shoulder (at the level of the interface between the smooth implant neck and the coronal margin of rough surface). The clinical crown implant ratio increased with time from 1.6 at the delivery of the prosthesis to 2.0 after 10 years of loading with no increase between 5 and 10 years. No technical complications were registered during the 10-year follow-up period. Patients registered mean FMPS 8% and FMBS 16% and periimplant probing depth ≤ 4 mm. Conclusions and Clinical Implications : 6 mm implants with a moderately rough surface supporting single crowns in the distal region maintained full function for at least 10 year with low marginal bone loss.

Clinical Oral Implants Research, Oct 1, 2018

Background : The use of xenogenous bone blocks (XBB) as an alternative to autogenous bone blocks ... more Background : The use of xenogenous bone blocks (XBB) as an alternative to autogenous bone blocks (ABB) has considerably increased in oral implantology. Nevertheless, there is little information on the histological findings of these grafts to date. Aim/Hypothesis : To compare histomorphometrically the graft remodeling process of ABB and XBB used for mandibular onlay grafting. Material and Methods : Nine adult male New Zealand white rabbits (3.5-4 kg) were used in this split mouth randomized study. The control side of the mandible was subjected to onlay iliac crest grafting (ABB) and test side received xenogenous (XBB) bone graft (Heket Biomaterials, Vicenza, Italy), with 10 mm diameter × 3 mm height dimension. Both sides were covered with a collagen membrane (Heket Biomaterials, Vicenza, Italy). At 07, 20 and 60 days post-operatively, 03 animals were sacrificed in order to obtain bone biopsies. Paraffin sections were stained in Hematoxylin-Eosin and Masson´s Trichrome for histomorphometric assessment. The percentage of residual graft and new bone was evaluated through a counting point procedure in which a lattice of about 0.4 × 0.6 mm, with squares of 50 μm in dimensions, was superposed over the slides at a magnification of ×200. ANOVA and the t test were performed for statistical analysis. Results : New bone formation could not be observed at 07 days for both ABB and XBB groups. At 20 and 60 days, o statistical differences were found between intra-group (time) and inter-group (grafts). Residual xenograft was significantly resorbed between 07 and 20 days. At 60 days, inter-group analysis showed more residual autograft in comparison to residual xenograft. Conclusions and Clinical Implications : These data indicate that ABB and XBB showed similar amount of new bone formation over time. The percentage of residual iliac graft and xenograft tended to decrease for both groups, with more remaining bone at 60 days for ABB.

PubMed, Jun 10, 2022

Objective: To compare the sequential healing of maxillary sinuses grafted with two different xeno... more Objective: To compare the sequential healing of maxillary sinuses grafted with two different xenogeneic bone substitutes processed at either a low (300°C) or high (1200°C) temperature. Methods: A sinus augmentation procedure was performed bilaterally in 20 rabbits and two different xenogeneic bone grafts were randomly used to fill the elevated spaces. Healing was studied after 2 and 10 weeks, in 10 rabbits during each period. Results: After 2 weeks of healing, very small amounts of new bone were observed in both groups, and were mainly confined to close to the sinus bone walls and osteotomy edges. After 10 weeks of healing, new bone was found in all regions, with higher percentages in those close to the bone walls and to the osteotomy. In this period of healing, the proportion of new bone in the 300°C group was 20.0% ± 4.3%, and in the 1200°C group it was 17.2% ± 4.3% (P = 0.162). In the 1200°C group, translucent, dark fog-like shadows in regions of the grafts were hiding portions of new bone (interpenetrating bone network). Conclusion: Both biomaterials provided conditions that allowed bone growth within the elevated space, confirming that both biomaterials are suitable to be used as a graft for sinus floor augmentation.

European Journal of Oral Implantology, 2014

To compare the clinical outcome of 6-mm and 10-mm long implants in partially edentulous posterior... more To compare the clinical outcome of 6-mm and 10-mm long implants in partially edentulous posterior areas. Twenty-four patients, with a partially edentulous area in the jaws with a height and width allowing the positioning of 2 to 3 adjacent 10 × 4.1 mm implants without any augmentation procedure, were randomly allocated according to a parallel group design to receive 6-mm long or 10-mm long implants. A total of 54 implants were placed (26 × 6 mm and 28 × 10 mm implants). Patients were restored 8 weeks after surgery and were followed for 5 years. Outcome measures were prosthesis and implant survival, as well as marginal bone level changes and complications. After 5 years, 18 patients were available. One 6 mm implant failed during the healing period and its related prosthesis could not be placed. No implants were lost after loading. The 6 mm group registered 5 complications (1 mucositis, 3 prosthesis decementations and 1 chipping), while only 3 were registered in the 10 mm group (2 decementations and 1 chipping). The difference in complications between the two groups was not statistically significant (P = 0.39). Marginal bone loss at 5 years was 0.43 and 0.24 mm with the 6 mm and 10 mm groups, respectively (not statistically significant; difference between the two groups 0.19 mm; SD 0.23 mm; 95% CI -0.34;0.73; t test P = 0.42). Implant and prosthetic survival and success rates were similar between prostheses supported by 6-mm or 10-mm long implants.

Oral and Maxillofacial Surgery, Dec 9, 2019

The aim of the present experiment was to compare the data on new bone formation measured histolog... more The aim of the present experiment was to compare the data on new bone formation measured histologically and microtomographically in maxillary sinuses augmented with a xenograft with higher density and higher mineral content compared with the natural bone. The hypothesis was that histomorphometric and micro-computed tomography (microCT) analyses do not yield similar outcomes when a xenograft with higher density and mineral content compared with the natural bone is used. Methods In 18 rabbits, the maxillary sinus was augmented bilaterally using deproteinized bovine bone mineral (DBBM) xenograft granules of either 0.125-1 mm or 1-2 mm of dimensions. The rabbits were euthanized after 2, 4, and 8 weeks of healing. Comparisons were performed between microCT and histological analyses. Results After 2 weeks of healing, higher contents of bone were found at the histological compared with the microCT analyses in both sinuses, especially in the middle regions of the grafted sinus. Between 2 and 8 weeks of healing, new bone increased of about 21% at the histological analyses while, at the microCT, increased only about 4%. In the same period, the xenograft proportion decreased from 51.6 ± 4.9 to 45.3 ± 3.3% at the histological analyses while, at the microCT, the xenograft appeared to increase in percentages. Conclusion Histological and microCT analyses yielded different outcomes when a xenograft with higher density and higher mineral content compared with the natural bone was used.

Clinical and experimental dental research, Nov 23, 2018

The objective of this study was to evaluate possible differences in the assessment of bone format... more The objective of this study was to evaluate possible differences in the assessment of bone formation between histological and micro-computed tomography (CT) analyses in maxillary sinuses augmented with a xenograft with similar density and mineral content of bone. A collagen membrane was placed subjacent the elevated sinus mucosa at the test sites of 18 rabbits, and the elevated spaces were filled with xenograft. The antrostomy was covered with collagen membranes, bilaterally. Six rabbits per group were sacrificed after 2, 4, and 8 weeks of healing. Biopsies were retrieved and scanned in a high-resolution micro-CT at two different gray thresholds. Histological assessments were subsequently performed. At the histological analyses, bone increased over time, from 7.5 ± 2.4% to 27.0 ± 5.3%, between 2 and 8 weeks of healing. The highest content of bone was found close to the sinus bone walls, whereas the middle regions contained lower amounts. At the micro-CT analyses, discrepancies were found in bone content percentages compared with the histological analyses, especially after 2 weeks of healing and within the middle regions of the sinus, in which new bone was 15-22% at the micro-CT analyses and only 1.6% at the histological evaluation. The outcomes of a micro-CT analysis performed in an early phase of healing may be altered when a resorbable bone substitute with similar density and mineral content of bone is applied.

Clinical Oral Implants Research, Jun 7, 2018

Objective: To test if repositioning the bony plate secured with a cyanoacrylate over the antrosto... more Objective: To test if repositioning the bony plate secured with a cyanoacrylate over the antrostomy in maxillary sinus augmentation was superior to covering the antrostomy with a collagen membrane in terms of the bone augmentation area and the bone density. Material and Methods: After the exposure of the nasal bone in eighteen rabbits, a rectangular access window was prepared with a sonic instrument, and the bony plate was removed. A bilateral sinus mucosa elevation was performed, and the space was filled with a resorbable xenograft. On the test side, the bone plate was repositioned over the antrostomy and fixed with a cyanoacrylate. On the control side, a collagen membrane was placed over the opening. Per group, six animals were sacrificed after 2, 4, and 8 weeks of healing, respectively. Histological ground sections were prepared. Results: The augmented area after elevation decreased between 2 and 8 weeks from 9.4 ± 1.8 to 4.8 ± 2.8 mm 2 at the test and from 9.5 ± 2.6 and 5.1 ± 1.6 mm 2 at the control sites. Small amounts of new bone were seen after 2 weeks in both groups (~1.6%-2.5%) forming from the bony sinus walls. New bone density increased over time in both groups reaching ~ 10%-11% and ~ 23%-25% after 4 and 8 weeks, respectively. No statistically significant differences were found. Small residual defects were present both at the test sites in the margin of the bone plate, and at the control sites in the center of the antrostomy. Conclusions: The bone healing in the elevated sinus space was similar irrespective of the coverage of the antrostomy. After 8 weeks, the bone plate repositioned on the antrostomy was incorporated while at the control sites the healing was still incomplete. Residual defects were still present in both groups.

Clinical Oral Implants Research, Dec 1, 2018

Objectives: To evaluate prospectively the clinical and radiographic outcomes after ten years of s... more Objectives: To evaluate prospectively the clinical and radiographic outcomes after ten years of short (6 mm) implants with a moderately rough surface supporting single crowns in the posterior region. Material and Methods: Forty 6 mm modified sandblasted large-grit acid-etched (mod-SLA), soft tissue level implants were installed in the distal segments of 35 consecutive patients. After 6 weeks of healing, abutments were tightened, and single porcelain fusedto-metal crowns were cemented. Implant survival, marginal bone loss and clinical crown/implant ratio were evaluated at various time intervals up to 10 years after loading. Results: Two out of the 40 implants were lost before loading, one implant was lost after 7 years because of peri-implantitis. One patient with two implants died and was excluded from analysis. Two patients did not come at the 10-year follow-up and were considered as drop out (2 implants). The survival rate was 91.7% (n=36). Thirty-three implants were available for marginal bone loss evaluation. A mean marginal bone loss after 10 years of function was 0.8±0.7mm. Between 5 and 10 years the loss was 0.2±0.4 mm. No technical complications were registered during the 10-year period. The clinical crown/implant ratio increased with time from 1.6 at the delivery of the prosthesis to 2.0 after 10 years of loading with no increase between 5 and 10 years. Conclusion: Short (6mm) implants with a moderately rough surface supporting single crowns in the posterior region and loaded after 6-7 weeks maintained full function for at least 10 years with low marginal bone resorption.

Journal of Clinical Periodontology, May 1, 2005

Background: Marginal hard tissue defects present at implants with a rough surface can heal with a... more Background: Marginal hard tissue defects present at implants with a rough surface can heal with a high degree of bone fill and osseointegration. The healing of similar defects adjacent to implants with a smooth surface appears to be less predictable.Objective: The aim was to compare bone healing at implants with turned or rough surface topographies placed in self‐contained defects using either a submerged or non‐submerged installation technique.Material and Methods: Six dogs were used. Three months after tooth extraction four experimental sites were prepared for implant installation in both sides of the mandible. The marginal 5 mm of the canal prepared for the implant was widened. Thus, following implant placement a circumferential gap occurred between the bone tissue and the implant surface that was between 1 and 1.25 mm wide. In each side of the mandible two implants with a turned surface and two implants with a rough surface were installed. The implants in the right side were fully submerged, while a non‐submerged technique was applied in the left side. The animals were sacrificed 4 months later, block biopsies of each implant site were dissected and ground as well as paraffin sections were prepared.Results: The marginal defects around rough surface implants exhibited after 4 months of healing substantial bone fill and a high degree of osseointegration following either the submerged or the non‐submerged installation technique. Healing at turned implants was characterized by incomplete bone fill and the presence of a connective tissue zone between the implant and the newly formed bone. The distance between the implant margin (M) and the most coronal level of bone‐to‐implant contact (B) at implants with a rough surface was 0.84±0.37 mm at submerged and 0.90±0.39 mm at non‐submerged sites. The distance M–B at implants with a turned surface was 3.39±0.52 mm at submerged and 3.23±0.68 mm at non‐submerged sites. The differences between the rough and turned implants regarding the length of distance M–B were statistically significant (paired t‐test).Conclusion: Osseointegration at implants placed in sites with marginal defects is influenced by the surface characteristics of the implant.

REDVET. Revista Electrónica de Veterinaria, 2017

Applied sciences, Mar 18, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Clinical Oral Implants Research, Jun 1, 2004

The present experiment was performed to determine the influence of Bio-Oss on hard tissue formati... more The present experiment was performed to determine the influence of Bio-Oss on hard tissue formation at sites that, following implant installation, presented a 1-1.25 mm wide marginal defect. Four Labrador dogs were used. The premolars and first molars on both sides of the mandible were extracted. After 3 months, mucoperiosteal flaps were elevated and three experimental sites were prepared for implant installation in each side of the mandible. A step drill was used to widen the marginal 5 mm of the canal. Thus, following the placement of the implant (3.3 x 10 mm, SLA surface, Straumann AG, Waldenburg, Switzerland) a circumferential gap, about 1-1.25 wide and 5 mm deep, remained lateral to the titanium rod. The test sites in the left side of the mandible were first filled with a deproteinized cancellous bone mineral (Bio-Oss). The defect sites in the right side of the mandible (control sites) were left for spontaneous healing. A resorbable barrier membrane (Bio-Gide) was placed to cover the implant and the bone tissue in two sites of each quadrant, while the third site was left without membrane placement. The flaps were repositioned to cover all defect sites and were sutured. After 4 months of healing, block biopsies of each implant site were dissected and processed for ground sectioning. It was demonstrated that at 4 months, all types of defects were filled with newly formed bone and that the biomaterial placed in the marginal defect in conjunction with implant installation during healing became incorporated in the newly formed bone tissue. A high degree of contact was established between the Bio-Oss particles and the newly formed bone. Bio-Oss became integrated with the newly formed bone. In the model used, Bio-Oss did not enhance the process of bone formation and defect closure.

European Journal of Dental Education, Feb 1, 2014

IntroductionTraining for dental practitioners in implant dentistry ranges from 1‐ or 2‐day short ... more IntroductionTraining for dental practitioners in implant dentistry ranges from 1‐ or 2‐day short Continuing Professional Development (CPD) courses to certificate/diploma programmes run by universities. In general, the teaching of implant dentistry in Europe lacks structure and standardisation. This paper aims to: (i) identify the current trends in CPD in implant dentistry in Europe; (ii) identify potential and limitations with regards to the design and implementation of CPD activities in implant dentistry; (iii) provide recommendations on the future structure and development of CPD activities in implant dentistry.MethodsA search of the literature was undertaken in PubMed for manuscripts published in English after 2000 reporting on CPD in dentistry and in implant dentistry in particular. In addition, an electronic survey was conducted, investigating the attitudes towards CPD among a wide group of stakeholders in implant dentistry education.ConclusionsThere is a wide diversity of educational pathways towards achieving competences in implant dentistry through CPD. At present, there is a need for improving the CPD structures in implant dentistry, strengthening the quality assurance and encouraging standardisation and transparency of the learning outcomes. Development of a structured CPD system with clearly defined educational objectives mapped against specific levels of competence is recommended.

Oral Surgery, Apr 17, 2012

Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant ... more Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants.

International Journal of Periodontics & Restorative Dentistry, 2019

This assignment applies to all translations of the Work as well as to preliminary display/posting... more This assignment applies to all translations of the Work as well as to preliminary display/posting of the abstract of the accepted article in electronic form before publication. If any changes in authorship (order, deletions, or additions) occur after the manuscript is submitted, agreement by all authors for such changes must be on file with the Publisher. An author's name may be removed only at his/her written request. (Note: Material prepared by employees of the US government in the course of their official duties cannot be copyrighted.

European Journal of Dental Education, Feb 1, 2014

IntroductionPrevious surveys have shown that newly graduated dentists, in most European countries... more IntroductionPrevious surveys have shown that newly graduated dentists, in most European countries, do not obtain adequate theoretical knowledge and, especially, clinical skills in implant dentistry (ID) through their undergraduate education and must therefore acquire knowledge and develop competencies through further postgraduate study. Moreover, clinicians, in general, need to continue to maintain the currency of their competence by undertaking ongoing continuing professional development (CPD). This seems particularly important in ID as techniques, and materials develop rapidly due to advances in biomedical technology. Despite recent developments, CPD in ID remains poorly organised with little standardisation or harmonisation across Europe. The objective of this survey was to explore the current status and trends within CPD education in ID in Europe.Materials and methodsStakeholders and opinion leaders associated with ID education were invited by email to fill an online questionnaire (closing date: 30th April 2013). Two hundred and forty‐seven questionnaires were distributed, and two separate reminders were sent to participants in 38 European countries. The survey contained 14 multiple‐choice questions, and the data were collected using SurveyMonkey© software, exported in SPSS (Inc, Chicago, IL, USA) format and analysed using descriptive statistics.ResultsTwo hundred respondents working in 24 countries replied to the survey (response rate of 81% of invitees and 63% of countries surveyed). The results demonstrated a wide divergence in the content and structure of CPD in ID in Europe.ConclusionsDentists need CPD to develop their skills and to maintain their competence in ID. There is an urgent need for structured and accredited CPD, which should be readily available to all dentists practising ID. It should have pre‐determined learning objectives, delivered by accredited CPD providers and educators, and have assessable outcome measures to ensure the best possible impact on clinical practice and patient safety.