Thesis (Ph. D.)--University of Toronto, 1997. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Toronto, 1997. / Includes bibliographical references.

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Objectives: The present work was under taken to compare osseointegration of immediately and delayed restored implants in a sheep model, and to compare methods of assessing osseointegration. Methods: Twenty wide-platform implants were placed in the posterior mandibles of 10 sheep, 3 months after premolar extractions. Ten were control implants placed and restored after 3 months of submerged healing. Ten were test implants placed contralaterally and immediately restored. Animals were sacrificed after a further 3 months of healing. At each experimental stage implant stability was measured with resonance frequency analysis (RFA) and standardized radiographs were taken. Tissue blocks with the implants were embedded in acrylic resin. The specimens were analysed by three-dimensional micro tomogram (micro-CT) images. Ground sections of the tissue blocks were then prepared for light microscopy and quantitative morphometry. Morphometric parameters computed by both methods were mean percent bone-to-implant contact (BIC) and mean percent bone density (BD). Radiographic, stability and morphometric measurements were compared statistically. Results: The survival rate was 60% (controls) versus 40% (test) (p=0.28). Mean crestal bone levels after three months restoration did not differ significantly between control (5.54 � 0.92) and test groups (4.35 � 1.61) (p=0.56). All surviving implants were stable at stage three and RFA values in implant stability quotient (ISQ) did not differ significantly between the two groups (test 82.3 � 3.9 versus control 78.8 � 4.3, p=0.36). No correlation was found between crestal bone loss and RFA (Spearman�s rho =-0.27, p=0.46). Histomorphometric analysis found no statistical difference (%BIC test 65.65 � 12.7%, control 53.36 � 6.41%, p=0.18; and %BD test 54.84 � 8.45%, control 64.69 � 13.57%, p=0.11). A similar trend was observed for mean micro-CT (%BIC test 65.72 � 72, control 50.84 � 4.19, p=0.11). Histology revealed high density inflammatory infiltrates beneath the sulcular and pocket epithelium. No significant difference was found between histomorphometric (HMA) and microCT analysis (%BIC p=0.08, %BD p=0.08). A statistically significant correlation was observed between HMA and microCT for %BIC (Spearman�s rho = 0.89, p=0.02) but not %BD (Spearman�s rho = 0.51, p=0.30). Conclusions: The results suggest that the sheep mandibular model has limited potential for evaluation of implants designed for poor quality bone and for the assessment of implant loading protocols. This thesis does highlight the potential for the use of this model in peri-implantitis studies. The results suggest that morphometric variables determined by HMA and microCT analysis are comparable, however further studies are required to standardize the microCT protocol to reduce metal artifacts and enhance bone-implant contrast.

Objectives: The present work was under taken to compare osseointegration of immediately and delayed restored implants in a sheep model, and to compare methods of assessing osseointegration. Methods: Twenty wide-platform implants were placed in the posterior mandibles of 10 sheep, 3 months after premolar extractions. Ten were control implants placed and restored after 3 months of submerged healing. Ten were test implants placed contralaterally and immediately restored. Animals were sacrificed after a further 3 months of healing. At each experimental stage implant stability was measured with resonance frequency analysis (RFA) and standardized radiographs were taken. Tissue blocks with the implants were embedded in acrylic resin. The specimens were analysed by three-dimensional micro tomogram (micro-CT) images. Ground sections of the tissue blocks were then prepared for light microscopy and quantitative morphometry. Morphometric parameters computed by both methods were mean percent bone-to-implant contact (BIC) and mean percent bone density (BD). Radiographic, stability and morphometric measurements were compared statistically. Results: The survival rate was 60% (controls) versus 40% (test) (p=0.28). Mean crestal bone levels after three months restoration did not differ significantly between control (5.54 � 0.92) and test groups (4.35 � 1.61) (p=0.56). All surviving implants were stable at stage three and RFA values in implant stability quotient (ISQ) did not differ significantly between the two groups (test 82.3 � 3.9 versus control 78.8 � 4.3, p=0.36). No correlation was found between crestal bone loss and RFA (Spearman�s rho =-0.27, p=0.46). Histomorphometric analysis found no statistical difference (%BIC test 65.65 � 12.7%, control 53.36 � 6.41%, p=0.18; and %BD test 54.84 � 8.45%, control 64.69 � 13.57%, p=0.11). A similar trend was observed for mean micro-CT (%BIC test 65.72 � 72, control 50.84 � 4.19, p=0.11). Histology revealed high density inflammatory infiltrates beneath the sulcular and pocket epithelium. No significant difference was found between histomorphometric (HMA) and microCT analysis (%BIC p=0.08, %BD p=0.08). A statistically significant correlation was observed between HMA and microCT for %BIC (Spearman�s rho = 0.89, p=0.02) but not %BD (Spearman�s rho = 0.51, p=0.30). Conclusions: The results suggest that the sheep mandibular model has limited potential for evaluation of implants designed for poor quality bone and for the assessment of implant loading protocols. This thesis does highlight the potential for the use of this model in peri-implantitis studies. The results suggest that morphometric variables determined by HMA and microCT analysis are comparable, however further studies are required to standardize the microCT protocol to reduce metal artifacts and enhance bone-implant contrast.

Thesis (M. Sc.)--McGill University, 1998. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1997. / Includes bibliographical references.

Thesis (M. Sc.)--McGill University, 1998. / Includes bibliographical references.

Objectives: To compare the osseointegration of conventionally and immediately restored tapered implants in a split-mouth animal model, and to compare different methods of analysis for measuring osseointegration. Materials & Methods: Twenty tapered implants were placed in the posterior mandibles of ten sheep, three months after premolar extractions. Ten control implants were placed and were restored after three months submerged healing. Ten test implants were placed on the contralateral side at this time and immediately restored. Animals were sacrificed after a further three months healing. Resonance frequency analysis (Implant Stability Quotient, ISQ), and standardized radiographs were taken at all stages. Alveolar bone height relative to the implant shoulder was measured on digitized radiographs. Histomorphometric and micro-Computed Tomograph ([mu]CT) morphometric analysis for Bone-to-Implant Contact (BIC) and Bone Density (BD) were performed. Radiographic, stability and morphometric measurements were compared statistically. Results: Only three (30%) of conventionally restored and two (20%) immediately restored implants survived (p = 0.74). Mean crestal bone level after three months loading differed significantly (control 5.3 � 0.9 mm versus test 0.9 � 1.3 mm; p = 0.02). Control implants lost more crestal bone over three months than test implants but this was not statistically significant (3.5 � 1.0 mm versus 0.7 � 1.0 mm; p = 0.06). The test group showed a higher mean ISQ value (85.4 � 6.9) compared to the control group (72 � 14.4; p = 0.349). Both groups showed a slightly reduced stability during the loaded period. This was more marked for the test group but not statistically significant (-0.5 � 3.8 ISQ versus -4.35 � 6.6 ISQ; p = 0.8). A statistically significant negative correlation was found between the loss of crestal bone and ISQ with loading (Pearson�s coefficient of correlation r = -0.473 p = 0.026). Both groups showed a statistically significant difference in BIC for both histomorphometric analaysis (HMA); p = 0.039 and [mu]CT morphometric analysis; p = 0.013. When the two forms of morphometric analysis were compared, HMA and [mu]CT morphometric analysis differed significantly for both BIC (p = 0.05) and BD (p = 0.048). However, a statistically significant correlation was found between the two measuring techniques, for both BIC (r = 0.335 p = 0.013) and BD (r = 0.439 p = 0.01). Conclusions: The placement of wide-bodied 3i Osseotite NT[TM] tapered implants into sheep mandible resulted in high failure rate regardless of the loading protocol. The sheep mandibular model may be inappropriate as a model for evaluation of immediate loading, and to test implants which are designed for soft bone. Further investigations are needed to look into the variations in bone microstructure along with their impact on the mechanics of implant-bone union. Although a statistically significant difference was found between the two measurement techniques, a positive correlation was found between HMA and [mu]CT morphometric analysis suggesting non-invasive methods may have a potential in assessing osseointegration. Further research is required to optimize the variables in [mu]CT analysis, such as, voltage, filters, and thresholding to minimize artifacts and to maximize bone contrast when titanium implants are present.

Objectives: To compare the osseointegration of conventionally and immediately restored tapered implants in a split-mouth animal model, and to compare different methods of analysis for measuring osseointegration. Materials & Methods: Twenty tapered implants were placed in the posterior mandibles of ten sheep, three months after premolar extractions. Ten control implants were placed and were restored after three months submerged healing. Ten test implants were placed on the contralateral side at this time and immediately restored. Animals were sacrificed after a further three months healing. Resonance frequency analysis (Implant Stability Quotient, ISQ), and standardized radiographs were taken at all stages. Alveolar bone height relative to the implant shoulder was measured on digitized radiographs. Histomorphometric and micro-Computed Tomograph ([mu]CT) morphometric analysis for Bone-to-Implant Contact (BIC) and Bone Density (BD) were performed. Radiographic, stability and morphometric measurements were compared statistically. Results: Only three (30%) of conventionally restored and two (20%) immediately restored implants survived (p = 0.74). Mean crestal bone level after three months loading differed significantly (control 5.3 � 0.9 mm versus test 0.9 � 1.3 mm; p = 0.02). Control implants lost more crestal bone over three months than test implants but this was not statistically significant (3.5 � 1.0 mm versus 0.7 � 1.0 mm; p = 0.06). The test group showed a higher mean ISQ value (85.4 � 6.9) compared to the control group (72 � 14.4; p = 0.349). Both groups showed a slightly reduced stability during the loaded period. This was more marked for the test group but not statistically significant (-0.5 � 3.8 ISQ versus -4.35 � 6.6 ISQ; p = 0.8). A statistically significant negative correlation was found between the loss of crestal bone and ISQ with loading (Pearson�s coefficient of correlation r = -0.473 p = 0.026). Both groups showed a statistically significant difference in BIC for both histomorphometric analaysis (HMA); p = 0.039 and [mu]CT morphometric analysis; p = 0.013. When the two forms of morphometric analysis were compared, HMA and [mu]CT morphometric analysis differed significantly for both BIC (p = 0.05) and BD (p = 0.048). However, a statistically significant correlation was found between the two measuring techniques, for both BIC (r = 0.335 p = 0.013) and BD (r = 0.439 p = 0.01). Conclusions: The placement of wide-bodied 3i Osseotite NT[TM] tapered implants into sheep mandible resulted in high failure rate regardless of the loading protocol. The sheep mandibular model may be inappropriate as a model for evaluation of immediate loading, and to test implants which are designed for soft bone. Further investigations are needed to look into the variations in bone microstructure along with their impact on the mechanics of implant-bone union. Although a statistically significant difference was found between the two measurement techniques, a positive correlation was found between HMA and [mu]CT morphometric analysis suggesting non-invasive methods may have a potential in assessing osseointegration. Further research is required to optimize the variables in [mu]CT analysis, such as, voltage, filters, and thresholding to minimize artifacts and to maximize bone contrast when titanium implants are present.