Bernd Stadlinger
Research interests
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InterestsMaxillofacial Surgery, Implant Dentistry
Publications
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3.55Impact points
Systematic review of animal models for the study of implant integration, assessing the influence of material, surface and design.
Journal of clinical periodontology. 02/2012; 39 Suppl 12:28-36.
The aim of this systematic review was to assess the scientific literature in terms of pre-clinical studies evaluating the influence of material, surface and design on the integration of an implant by hard and soft tissues. The included publications were analysed with regard to the frequency of repor... [more] The aim of this systematic review was to assess the scientific literature in terms of pre-clinical studies evaluating the influence of material, surface and design on the integration of an implant by hard and soft tissues. The included publications were analysed with regard to the frequency of reporting of criteria being derived from the ARRIVE guidelines. This served to trace elements within animal studies, where the quality of reporting needs to improve. The literature search was performed in Ovid Medline and included English literature from January 1990 to July 2011. A list of 24 criteria derived from the ARRIVE guidelines for animal research was adjusted to implant studies on osseointegration in pristine bone and was applied to all included study manuscripts. Each criteria was graded by "0" (not reported) or "1" (reported) and the frequency of reporting for each criteria was recorded. A total of 271 studies were included into this review. Generally the quality of reporting increased with time. Low frequencies of reporting were achieved for criteria like "randomisation of animals", "reasons for the animal model" and "relevance to humans". The frequency of reporting showed high percentages for most criteria. However, the quality of reporting in pre-clinical studies needs to improve in areas like the reporting of statistical information, study setup and the possible translation of the results to humans.
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5.38Impact points
Comparison of bone-implant contact and bone-implant volume between 2D-histological sections and 3D-SRµCT slices.
European cells & materials. 01/2012; 23:237-48.
Histological imaging is still considered the gold standard for analysing bone formation around metallic implants. Generally, a limited number of histological sections per sample are used for the approximation of mean values of peri-implant bone formation. In this study we compared statistically the ... [more] Histological imaging is still considered the gold standard for analysing bone formation around metallic implants. Generally, a limited number of histological sections per sample are used for the approximation of mean values of peri-implant bone formation. In this study we compared statistically the results of bone-implant contact (BIC) and bone-implant volume (BIV) obtained by histological sections, with those obtained by X-ray absorption images from synchrotron radiation micro-computed tomography (SRµCT) using osseointegrated screw-shaped implants from a mini-pig study. Comparing the BIC results of 3-4 histological sections per implant sample with the appropriate 3-4 SRµCT slices showed a non-significant difference of 1.9 % (p = 0.703). The contact area assessed by the whole 3D information from the SRµCT measurement in comparison to the histomorphometric results showed a non-significant difference in BIC of 4.9 % (p = 0.171). The amount of the bone-implant volume in the histological sections and the appropriate SRµCT slices showed a non-significant difference by only 1.4 % (p = 0.736) and also remains non-significant with 2.6 % (p = 0.323) using the volumetric SRµCT information. We conclude that for a clinical evaluation of implant osseointegration with histological imaging at least 3-4 sections per sample are sufficient to represent the BIC or BIV for a sample. Due to the fact that in this study we have found a significant intra-sample variation in BIC of up to ± 35 % the selection of only one or two histological sections per sample may strongly influence the determined BIC.
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1.33Impact points
Three-dimensional fixation of fractures of the mandibular condyle with a resorbable three-dimensional osteosynthesis mesh.
The British journal of oral & maxillofacial surgery. 12/2011;
We describe the use of a resorbable mesh fixed by ultrasound-activated pins, and report the satisfactory outcome in the first 5 patients treated.
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2.19Impact points
Biological functionalization of dental implants with collagen and glycosaminoglycans-A comparative study.
Journal of biomedical materials research. Part B, Applied biomaterials. 11/2011;
Biological implant surface coatings are an emerging technology to increase bone formation. Such an approach is of special interest in anatomical regions like the maxilla. In the present study, we hypothesized that the coating of titanium implants with components of the organic extracellular matrix i... [more] Biological implant surface coatings are an emerging technology to increase bone formation. Such an approach is of special interest in anatomical regions like the maxilla. In the present study, we hypothesized that the coating of titanium implants with components of the organic extracellular matrix increases bone formation and implant stability compared to an uncoated reference. The implants were coated using collagen-I with either two different concentrations of chondroitin sulfate (CS) or two differentially sulfated hyaluronans. Implant coatings were characterized biochemically and with atomic force microscopy. Histomorphometry was used to assess bone-implant contact (BIC) and bone-volume density (BVD) after 4 and 8 weeks of submerged healing in the maxilla of 20 minipigs. Further, implant stability was measured by resonance frequency analysis (RFA). Implants containing the lower CS concentration had significantly more BIC, compared to the uncoated reference at both times of interest. No significant increase was measured from week 4 to 8. Differences in BVD and RFA were statistically not significant. A higher concentration of CS and the application of sulfated hyaluronans showed no comparable increase in BIC. This study demonstrates a positive effect of a specific collagen-glycosaminoglycan combination on early bone formation in vivo. © 2011 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2011.
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2.92Impact points
Osseointegration - communication of cells.
Clinical oral implants research. 11/2011;
BACKGROUND: The article provides the scientific documentation for the 3D animated film - "Osseointegration - Communication of cells". AIM: The aim of this article and of the film is to visualise the molecular and cellular events during the healing of an osseous wound after installation of ... [more] BACKGROUND: The article provides the scientific documentation for the 3D animated film - "Osseointegration - Communication of cells". AIM: The aim of this article and of the film is to visualise the molecular and cellular events during the healing of an osseous wound after installation of a dental implant with special emphasis on the process of osseointegration. MATERIAL AND RESULTS: In this review article for didactic reasons the concept of the four phases of a healing soft tissue wound was transferred to a bone wound after insertion of a dental implant: haemostasis, inflammatory phase, proliferative phase and remodelling phase. Wound healing throughout these phases is the result of a coordinated action of different cell types which communicate with each other by their interaction using signalling molecules like cytokines, extracellular matrix proteins and small molecules. A regular sequence of cell types controlled by adequate concentrations of signalling molecules results in undisturbed healing. Disturbed healing is associated with a continuation of the early inflammatory phase and the development of a toxic wound environment. The latter is characterized by high counts of polymorphnuclear cells, high concentrations of toxic radicals and proteolytic enzymes and low concentrations of growth factors and extracellular matrix molecules. Clinically the development of a toxic wound environment should be avoided, e.g. by antibacterial measures. DISCUSSION AND CONCLUSION: Experiencing implant osseointegration as a biological process may provide the clinician new targets to improve the therapy with dental implants.
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1.33Impact points
Ultrasound-aided resorbable osteosynthesis of fractures of the mandibular condylar base: an experimental study in sheep.
The British journal of oral & maxillofacial surgery. 11/2011;
We evaluated the osteosynthesis of condylar fractures using resorbable mini plates and ultrasound-aided insertion of pins clinically and histologically. Stability was greater than that with resorbable screws because of the fusion of pin and plate. Long term evaluation showed complete resorption of t... [more] We evaluated the osteosynthesis of condylar fractures using resorbable mini plates and ultrasound-aided insertion of pins clinically and histologically. Stability was greater than that with resorbable screws because of the fusion of pin and plate. Long term evaluation showed complete resorption of the polymeric osteosynthesis material.
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1.33Impact points
Stability of fixation of diacapitular fractures of the mandibular condylar process by ultrasound-aided resorbable pins (SonicWeld Rx® System) in pigs.
The British journal of oral & maxillofacial surgery. 06/2011; 49(4):297-301.
To assess the stability of osteosynthesis in diacapitular condylar fractures we compared fixation using ultrasound-aided resorbable pins with poly-(D,L)-lactide (SonicWeld® Rx, KLS Martin, Tuttlingen, Germany) with that of titanium screws in 20 pig mandibles, 10 in each group. Isolated diacapitular ... [more] To assess the stability of osteosynthesis in diacapitular condylar fractures we compared fixation using ultrasound-aided resorbable pins with poly-(D,L)-lactide (SonicWeld® Rx, KLS Martin, Tuttlingen, Germany) with that of titanium screws in 20 pig mandibles, 10 in each group. Isolated diacapitular fractures were created using a surgical chisel. Ten fractures were each repositioned and fixed by two pins (17 and 11 mm long, 2.1mm in diameter), and 10 fractures were fixed by two titanium screws of equal length, 2.0mm in diameter. Shear tests were done immediately after treatment to measure the maximum force to disrupt the fixation. Fixation with pins resisted mean shear forces of 310N until the pins fractured, whereas fixation with titanium screws failed at 918N when the screws pulled out of the bone. Long-term stability and resorption of pins will have to be analysed in an in vivo study.
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1.33Impact points
Biomechanical evaluation of a titanium implant surface conditioned by a hydroxide ion solution.
The British journal of oral & maxillofacial surgery. 12/2010; 50(1):74-9.
Two groups of titanium dental implants, identical in geometry but different in the treatment of their surfaces, were tested in an in vivo minipig model of the mandible. The surfaces that were tested were, first, sandblasted and acid-etched; and secondly, sandblasted, acid-etched, and conditioned. Th... [more] Two groups of titanium dental implants, identical in geometry but different in the treatment of their surfaces, were tested in an in vivo minipig model of the mandible. The surfaces that were tested were, first, sandblasted and acid-etched; and secondly, sandblasted, acid-etched, and conditioned. The removal torque was assessed at 2, 4, and 8 weeks after implantation (n=6 animals in each healing period). The interfacial stiffness was also evaluated. All dental implants were well-integrated at the time of death. Removal torque values increased significantly over the course of 8 weeks. Removal torque and interfacial stiffness were increased for conditioned surfaces after 2 weeks, but there were no significant differences between the two surfaces. The sandblasted and acid-etched implants are the standard, and conditioning of the surface showed a tendency to increase early peri-implant formation of bone.
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1.44Impact points
Comparison of zirconia and titanium implants after a short healing period. A pilot study in minipigs.
International journal of oral and maxillofacial surgery. 02/2010; 39(6):585-92.
The aim of this animal study was to investigate and compare the osseointegration of zirconia and titanium dental implants. 14 one-piece zirconia implants and 7 titanium implants were inserted into the mandibles of 7 minipigs. The zirconia implants were alternately placed submerged and non-submerged.... [more] The aim of this animal study was to investigate and compare the osseointegration of zirconia and titanium dental implants. 14 one-piece zirconia implants and 7 titanium implants were inserted into the mandibles of 7 minipigs. The zirconia implants were alternately placed submerged and non-submerged. To enable submerged healing, the supraosseous part was removed, using a diamond saw. The titanium implants were all placed submerged. After a healing period of 4 weeks, a histological analysis of the soft and hard tissue and a histomorphometric analysis of the bone-implant contact (BIC) and relative peri-implant bone-volume density (rBVD; relation to bone-volume density of the host bone) was performed. Two zirconia implants were found to be loose. All other implants were available for evaluation. For submerged zirconia and titanium implants, the implant surface showed an intimate connection to the neighbouring bone, with both types achieving a BIC of 53%. For the non-submerged zirconia implants, some crestal epithelial downgrowth could be detected, with a resultant BIC of 48%. Highest rBVD values were found for submerged zirconia (80%), followed by titanium (74%) and non-submerged zirconia (63%). The results suggest that unloaded zirconia and titanium implants osseointegrate comparably, within the healing period studied.
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1.33Impact points
Comparative evaluation of ten different condylar base fracture osteosynthesis techniques.
The British journal of oral & maxillofacial surgery. 10/2009;
The aim of this study on the mandibles of minipigs was to compare the biomechanical stability of different methods of osteosynthesis that are used in the operative treatment of fractures of the base of the condyle. Ten different systems of osteosynthesis were used to fix 164 fractures, which were te... [more] The aim of this study on the mandibles of minipigs was to compare the biomechanical stability of different methods of osteosynthesis that are used in the operative treatment of fractures of the base of the condyle. Ten different systems of osteosynthesis were used to fix 164 fractures, which were tested by a two-point bending test after repositioning and fixing. This stress test was applied in four directions: lateral to medial, anterior to distal, distal to anterior, and medial to lateral. The Eckelt lag screw, one or two 2.0mm miniplates, one miniplate with bar (KLS Martin), minicompression plates (Medicon), zygoma compression plates (Medartis), condylus fracture plates (Medartis), square 4-hole plates (KLS Martin), and either one or two resorbable 4-hole miniplates (Resorb-X, Martin) were used for osteosynthesis. A total of 164 tests were done using a universal test machine that measured forces until the osteosynthesis failed. Advantages in mechanical load capacity were also measured for the Eckelt lag screw when force was applied from medial to lateral. Fixation with one resorbable miniplate was not functionally stable. Irrespective of the direction of force applied, two miniplates were the most stable technique. There were pronounced differences depending on the direction of force applied. The results suggest that treatment with a single resorbable miniplate is not functionally stable.
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3.55Impact points
Surface-conditioned dental implants: an animal study on bone formation.
Journal of clinical periodontology. 10/2009;
Stadlinger B, Lode AT, Eckelt U, Range U, Schlottig F, Hefti T, Mai R. Surface-conditioned dental implants: an animal study on bone formation. J Clin Periodontol 2009. doi: 10.1111/j.1600-051X.2009.01466.x. Abstract Aim: The aim of this study was to determine whether bone formation around surface-co... [more] Stadlinger B, Lode AT, Eckelt U, Range U, Schlottig F, Hefti T, Mai R. Surface-conditioned dental implants: an animal study on bone formation. J Clin Periodontol 2009. doi: 10.1111/j.1600-051X.2009.01466.x. Abstract Aim: The aim of this study was to determine whether bone formation around surface-conditioned implants is enhanced compared with non-surface-conditioned sandblasted acid-etched titanium implants. Materials and Methods: One hundred and forty-four implants were placed in the mandible of 18 minipigs. Before placement, implants were either surface conditioned in a solution containing hydroxide ions (conSF) or assigned to controls. Animals were euthanized after 2, 4 and 8 weeks of submerged healing, the 8-week group receiving polyfluorochrome labelling at week 2, 4, 6 and 8. One jaw quadrant per animal was selected for histological and histomorphometrical evaluation of mineralized bone-implant contact (mBIC), osteoid-implant contact (OIC) and bone volume (BV) analysis. Results: Polyfluorochrome labelling showed no general differences in bone dynamics. mBIC showed the most pronounced differences after 2 weeks, reaching 65.5% for conSF compared with 48.1% for controls, p=0.270. Differences levelled out after 4 weeks (67.4% control, 65.7% conSF) and 8 weeks (64.0% control, 70.2% conSF). OIC levels were initially comparable, showing a slower decline for conSF after 4 weeks. BV was higher for conSF at all times. No significant differences could be found. Conclusion: A tendency towards increased mBIC was shown for surface-conditioned implants after short-term healing.
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1.50Impact points
Bone block fixation by ultrasound activated resorbable pin osteosynthesis: a biomechanical in vitro analysis of stability.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 10/2009;
OBJECTIVES: The aim of this study was to determine the compound strength of the fixation between 2 blocks of synthetic bone using ultrasound activated resorbable pins (regarding drill hole diameter) and compare them to fixation with titanium miniscrews. Resorbable pins were up to 17 mm long. STUDY D... [more] OBJECTIVES: The aim of this study was to determine the compound strength of the fixation between 2 blocks of synthetic bone using ultrasound activated resorbable pins (regarding drill hole diameter) and compare them to fixation with titanium miniscrews. Resorbable pins were up to 17 mm long. STUDY DESIGN: Two synthetic bone blocks (Sawbone) were fixed by either a resorbable pin or miniscrew osteosynthesis. Maximum tensile forces were determined mechanically. Pin lengths of 7 mm, 11 mm, and 17 mm were analyzed in relation to different drill hole diameters. RESULTS: The ideal drill hole configuration was a combination of diameters of 2.1/1.6 mm (in a lag screw configuration). Mean maximum tensile force was 80 N for 7 mm pins (105 N/11 mm, 69 N/17 mm). In comparison, tensile forces of titanium screws were 20 N (7 mm), 97 N (11 mm), and 135 N (17 mm). CONCLUSIONS: Osteosynthesis by resorbable pins reached equal compound strength levels compared with titanium miniscrews. This in vitro study was the basis for a clinical trial of ultrasound-guided resorbable pin osteosynthesis.
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3.55Impact points
Increased bone formation around coated implants.
Journal of clinical periodontology. 07/2009;
Aim: We hypothesized that coating threaded, sandblasted acid-etched titanium implants with collagen and chondroitin sulphate (CS) increases bone formation and implant stability, compared with uncoated controls. Materials and Methods: Three different implant surface conditions were applied: (1) sandb... [more] Aim: We hypothesized that coating threaded, sandblasted acid-etched titanium implants with collagen and chondroitin sulphate (CS) increases bone formation and implant stability, compared with uncoated controls. Materials and Methods: Three different implant surface conditions were applied: (1) sandblasted acid-etched (control), (2) collagen/chondroitin sulphate (low-dose - CS1), (3) collagen/chondroitin sulphate (high-dose - CS2). Sixty 9.5 mm experimental implants were placed in the mandible of 20 minipigs. Bone-implant contact (BIC) and relative peri-implant bone-volume density (rBVD - relation to bone-volume density of the host bone) were assessed after 1 and 2 months of submerged healing. Implant stability was measured by resonance frequency analysis (RFA). Results: After 1 month, coated implants had significantly more BIC compared with controls (CS1: 68%, p<0.0001, CS2: 63%, p=0.009, control: 52%). The rBVD was lower for all surface conditions, compared with the hostbone. After 2 months, BIC increased for all surfaces. No significant differences were measured (CS1: 71%, p=0.016, CS2: 68%, p=0.67, control: 63%). The rBVD was increased for coated implants. RFA values were 71-77 at implantation, 67-73 after 1 month and 74-75 after 2 months. Differences in rBVD and RFA were not statistically significant. Conclusions: Data analysis suggests that collagen/CS has a positive influence on bone formation after 1 month of endosseous healing.
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0.53Impact points
O-phospho-l-serine: a modulator of bone healing in calcium-phosphate cements.
Biomedizinische Technik. Biomedical engineering. 10/2008;
Abstract Bone substitution materials are seen as an alternative to autogenous bone transplants in the reconstruction of human bone structures. The aim of the present animal study was to evaluate the clinical handling and the conditions of bone healing after the application of a phosphoserine and col... [more] Abstract Bone substitution materials are seen as an alternative to autogenous bone transplants in the reconstruction of human bone structures. The aim of the present animal study was to evaluate the clinical handling and the conditions of bone healing after the application of a phosphoserine and collagen-I-modified calcium-phosphate cement (Biozement D). The application of phosphoserine is supposed to influence the texture of the extracellular matrix. Standardised bone defects were created in the lower jaw of 10 adult minipigs. These defects were reconstructed with a pasty calcium-phosphate cement mixture. After a healing time of 4 months, the animals were sacrificed. The mandibles of all animals were resected and non-decalcified histological sections of the areas of interest were prepared. The experiment was evaluated by means of qualitative histology and histomorphometry. The hydroxyapatite cement entirely hardened intraoperatively. Modelling and handling of the cement was facile and the margin fit to the host bone was excellent. Histology showed that resorption started in the periphery and proceeded exceptionally fast. The bony substitution, especially in phosphoserine-endowed cements, was very promising. After a healing period of 4 months, phosphoserine cements showed a bone regeneration of nearly two-thirds of the defect sizes. In the applied animal experiment, the newly developed hydroxyapatite collagen-I cement is well suited for bone substitution due to its easy handling, its excellent integration and good resorption characteristics. The addition of phosphoserine is very promising in terms of influencing resorption features and bone regeneration.
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2.19Impact points
Suitability of differently designed matrix-based implant surface coatings: An animal study on bone formation.
Journal of biomedical materials research. Part B, Applied biomaterials. 06/2008;
Introduction: The aim of the present study was to assay how bone formation around dental implants is influenced by differently composed collagen matrices and RGD peptide as implant surface coatings compared to a sandblasted titanium surface. Material and Methods: Five different implant surface coati... [more] Introduction: The aim of the present study was to assay how bone formation around dental implants is influenced by differently composed collagen matrices and RGD peptide as implant surface coatings compared to a sandblasted titanium surface. Material and Methods: Five different implant surface coatings were designed: titanium (sandblasted), collagen type I, collagen type I&III, RGD-peptide, and mineralized collagen. Sixty experimental implants of a square-shaped design were inserted into the mandibles of 12 minipigs, 3 months following extraction of the premolar teeth. During the 6-month study period, sequential polyfluorochrome labeling was performed. After sacrifice, bone implant contact (BIC) was evaluated using histologic and histomorphometric methods. Results: New bone formation was observed against all implant surfaces. Polyfluorochrome labeling showed that bone growth started from the host bone in the majority of samples. The highest BIC was measured for collagen I and collagen I/III coated implants; however, significant differences between the coatings could not be found. Conclusion: Osseointegration was achieved for all implant surfaces. Although a statistically significant increase in BIC could not be demonstrated for the experimental coatings after the 6 months study period, there was also no discernible detrimental effect of the coatings in comparison to the uncoated titanium surfaces. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008.
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1.96Impact points
Effect of biological implant surface coatings on bone formation, applying collagen, proteoglycans, glycosaminoglycans and growth factors.
Journal of materials science. Materials in medicine. 04/2008; 19(3):1043-9.
OBJECTIVES: The aim of the present study was to evaluate six different implant surface coatings with respect to bone formation. Being major structural components of the extracellular matrix, collagen, the non-collagenous components decorin/chondroitin sulphate (CS) and the growth factors TGF-beta1/B... [more] OBJECTIVES: The aim of the present study was to evaluate six different implant surface coatings with respect to bone formation. Being major structural components of the extracellular matrix, collagen, the non-collagenous components decorin/chondroitin sulphate (CS) and the growth factors TGF-beta1/BMP-4 served in different combinations as coatings of experimental titanium implants. MATERIALS AND METHODS: Eight miniature pigs received each six implants in the mandible. The implant design showed two circular recesses along the length axis. Three, four, five and six weeks after implant placement, the animals were sacrificed in groups of two. Bone-implant contact (BIC) was evaluated along the outer implant surface and within the recesses. Bone volume was determined by synchrotron radiation micro computed tomography (SRmicroCT) for one implant of each surface state, 6 weeks after placement. RESULTS: At each week of observation, collagen/CS or collagen/CS/BMP-4 coated implants showed the highest BIC of all surface states. This was statistically significant at week five (p=0.030, p=0.040) and six (p=0.025, p=0.005). SRmicroCT measurements determined the highest bone volume for a collagen/CS coated implant. CONCLUSION: The results indicate that collagen/CS and collagen/CS/BMP-4 lead to a higher degree of bone formation compared to other ECM components.
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1.50Impact points
Histologic study of incorporation and resorption of a bone cement-collagen composite: an in vivo study in the minipig.
Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 04/2008; 105(3):e9-14.
OBJECTIVE: Calcium phosphates are clinically established as bone defect fillers. They have the capability of osseoconduction and are characterized by a slow resorption process. The present study evaluated the suitability of a newly developed calcium phosphate cement modified with collagen type I. ST... [more] OBJECTIVE: Calcium phosphates are clinically established as bone defect fillers. They have the capability of osseoconduction and are characterized by a slow resorption process. The present study evaluated the suitability of a newly developed calcium phosphate cement modified with collagen type I. STUDY DESIGN: The modified cement paste was inserted in differently designed defects of 10 minipigs. Further, an alveolar ridge augmentation was performed, applying the cement paste. The cement hardened in situ during the operation, forming a hydroxyapatite collagen composite. Animals were sacrificed after 1, 3, 6, 12, and 18 months. The tissue integration and resorption process was then evaluated using nondecalcified microsections. All animals were evaluated for histology. RESULTS: The implanted material showed osseoconductive characteristics. Resorption started from the edge of the defect zone, and bone substitution followed rapidly. Twelve months after placement of the cement, complete remodeling was observed. CONCLUSION: It can be concluded that the applied hydroxyapatite-collagen cement composite shows good resorption and bone integration.
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1.44Impact points
Evaluation of osseointegration of dental implants coated with collagen, chondroitin sulphate and BMP-4: an animal study.
International journal of oral and maxillofacial surgery. 01/2008; 37(1):54-9.
Various studies have shown type I collagen (coll) to increase bone-implant contact (BIC) compared to uncoated implants. The aim of this animal study was to test whether the integration of chondroitin sulphate (CS) and the growth factor rhBMP-4 into a collagenous coating could further increase the me... [more] Various studies have shown type I collagen (coll) to increase bone-implant contact (BIC) compared to uncoated implants. The aim of this animal study was to test whether the integration of chondroitin sulphate (CS) and the growth factor rhBMP-4 into a collagenous coating could further increase the measured BIC compared to collagen coated implants alone. The experimental implants had two recesses along the length axis. 120 implants with the surface modifications: coll, coll/CS, coll/CS/rhBMP-4 were inserted into the mandible of 20 minipigs. Six months after implantation, BIC was measured histomorphometrically on the surface and within the recesses. Due to the specific animal model and strict criteria in placement, 39.2 % of the implants were considered as failure and not included in the analysis. Of the successfully gained 73 implants, the highest percentage of BIC was obtained for coll/CS (40%), followed by coll (30%) and coll/CS/rhBMP-4 (27%), P=0.013. BIC within the recesses was highest for coll/CS (51%), followed by coll (43%) and coll/CS/rhBMP-4 (34%), P=0.025. The result suggests that the inclusion of CS slightly increases the BIC compared to collagen coated implants. The further inclusion of a low amount rhBMP-4 had a detrimental effect on bone formation compared to coll/CS, P<0.05.
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2.19Impact points
Influence of extracellular matrix coatings on implant stability and osseointegration: an animal study.
Journal of biomedical materials research. Part B, Applied biomaterials. 11/2007; 83(1):222-31.
Aim of the present study was to test the hypothesis that the application of components of the extracellular matrix such as glycosaminoglycans used as implant surface coatings in combination with collagen, with and without growth factor, can lead to enhanced ossification and thus improve implant stab... [more] Aim of the present study was to test the hypothesis that the application of components of the extracellular matrix such as glycosaminoglycans used as implant surface coatings in combination with collagen, with and without growth factor, can lead to enhanced ossification and thus improve implant stability compared with collagen coatings alone. Twenty miniature pigs received 120 experimental titanium implants in the mandible. Three types of surface coatings were created: (1) collagen type I (coll), (2) collagen type I/chondroitin sulphate (coll/CS), (3) collagen type I/chondroitin sulphate/BMP-4 (coll/CS/BMP). Periimplant bone formation was assessed within a defined recess along the length axis of the implant. Bone-implant contact (BIC) and bone volume density (BVD) were determined, using both histomorphometry and synchrotron radiation micro computed tomography (SRmicroCT). To measure implant stability, resonance frequency analysis was applied after implantation and 1, 3, 7, and 22 weeks after placement. BIC was highest for coll/CS coated implants, followed by coll, p = 0.082. Histomorphometric BVD did not significantly change for any coating. SRmicroCT analysis showed an increased BVD for collagen coated implants, compared with the other two surface coatings. Implant stability showed a decrease for all coatings up to the third week. At 22 weeks, all coatings showed an increase in stability without reaching their initial level. Highest stability was reached for coll coated implants, p = 0.051. It was concluded that collagen and coll/CS implant coatings have advantageous characteristics for peri-implant bone formation, compared with the further integration of BMP-4.
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1.33Impact points
An experimental in vivo analysis of the resorption to ultrasound activated pins (Sonic weld) and standard biodegradable screws (ResorbX) in sheep.
The British journal of oral & maxillofacial surgery. 10/2007; 45(6):447-50.
We compared the healing and reaction in the mandibles of 11 sheep of a conventional bioresorbable screw osteosynthesis with the newly developed ultrasound-activated pin osteosynthesis. The thermal stress caused by insertion of the ultrasound-aided pins leads to no cellular reaction around the pin. T... [more] We compared the healing and reaction in the mandibles of 11 sheep of a conventional bioresorbable screw osteosynthesis with the newly developed ultrasound-activated pin osteosynthesis. The thermal stress caused by insertion of the ultrasound-aided pins leads to no cellular reaction around the pin. There is neither clinical nor histological evidence of any initial inflammation that could have been induced by the insertion. Adequate attachment of fibrous tissue to the pin head and the absence of any inflammation are important preconditions for the introduction of this new method of osteosynthesis into clinical practice. Further advantageous characteristics are easy intraoperative handling and a reduction in operating time, because cutting the thread is not required. There must be sufficient interlinkage of the polymer and the trabecular structures to ensure stability.
Following (3)
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Dieter Scharnweber
Technische Universität Dresden -
Richard Loukota
Leeds Teaching Hospital -
Susanne Bierbaum
Technische Universität Dresden
Topics (4)
