Journal of Dental Implants
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Table of Contents
CASE REPORT
Year : 2018  |  Volume : 8  |  Issue : 1  |  Page : 31-33

A novel implant designed to improve mechanical bone adaptation


Private Clinic for Periodontics Implantology and Restorative Dentistry, Jerusalem, Israel

Date of Web Publication25-Jul-2018

Correspondence Address:
Dr. Amos Ben-Yehouda
Private Clinic for Periodontics Implantology and Restorative Dentistry, R&D in Gravity Implants co, Ramban 33, Jerusalem
Israel
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdi.jdi_9_18

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   Abstract 

Research shows an exaggerated bone loss adjacent to installed implants during the healing period. This phenomenon may continue later along the years in a slower rate. Sometimes, there is even an acceleration of the phenomenon during the years. The presented implant was designed to restore short-term bone loss caused during the healing phase and to slow and even prevent long-term bone loss. The result is achieved by emitting at the bone, mainly, compressive stress vectors that are essential for improved mechanical bone adaptation, including organization of bone into load-bearing type and modeling of the bone by enlarging its volume. This case report shows how a nonfunctional bone architecture turns into a load-bearing type and how initial bone loss may be restored after implant loading.

Keywords: Bone modelling, dental implant bone loss, mechanical bone adaptation


How to cite this article:
Ben-Yehouda A. A novel implant designed to improve mechanical bone adaptation. J Dent Implant 2018;8:31-3

How to cite this URL:
Ben-Yehouda A. A novel implant designed to improve mechanical bone adaptation. J Dent Implant [serial online] 2018 [cited 2019 Jun 26];8:31-3. Available from: http://www.jdionline.org/text.asp?2018/8/1/31/237590


   Introduction Top


Clinical follow-up states the impression of bone loss along dental implants during the years. This situation is supported lately by retrospective long-term studies. Bone loss was found among 64% of the patients [1],[2] treated by implants (up to 10 years of follow-up). More than that, it seems [1],[2] that the older the implant, the grater is the rate of bone absorption. The extent of moderate-to-severe bone loss was found to reach 40.1% after 9 years of [3] loading. Initial bone loss during the healing phase which is significant was not considered usually in these studies; however, other researches show an exaggerated loss of marginal bone support adjacent to inserted implants during the healing period. It was found to be between 1.03 and 1.28 mm after 3 months of [4],[5] healing. More information exists concerning bone level after 1 year of loading. It [6],[7] was found to be between 1.6 mm [8] and 1.5 mm. Whereas, compressive stress in the bone implant interface maintains ideally mechanical bone adaptation, shear stress violate implant integration and hamper [9] bone remodeling. These shear stresses are more prominent in the cervical area of the implants and so make it prone to bone degradation.

Orthopedic research supports the hypothesis that muscle forces are not enough [10] for bone remodeling and that the effect of gravity forces is superior. The unique effect of gravitation impact loads is the fact that they are repeated compressive loads with one principal direction and are happened to last for a very short time. These compressive impact loads enable an efficient curving of the bone with minimal damage at the point of power application. The result of this activity is enlargement of bone volume, thickening of cortical bone, and [11],[12],[13] arrangement of bone trabecula into load-bearing architecture as a normal physiologic protective action. These insights are implemented in the presented implant by increasing compressive stress at the bone implant interface and curving peripheral bone at the same time during occlusal loads.


   Case Report Top


A 40-year-old female patient asked for rehabilitation of missing tooth #30 [Figure 1]. Epsilon implant 4.7 mm width and 10 mm length (Gravity Implants Co. Israel) was installed [Figure 2]. The unique macro-geometry of this implant enables bone compression along the implant beginning at the most coronary area [Figure 3]. Three months later, at the stage of implant loading, it can be seen that there was loss of 2 mm of bone [Figure 4]. Two years of loading reveal rearrangement of bone trabecula and reconstruction of most of the bone that was lost during the stage of implant installation [Figure 5]. Three years of loading follow-up proves complete restoration of lost bone [Figure 6].
Figure 1: Preoperative image of site #30

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Figure 2: Graphical illustration of Epsilon implant

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Figure 3: Immediate postinstallation site #30

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Figure 4: Loading phase. Bone loss can be seen

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Figure 5: Two years' postloading of implant #30

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Figure 6: Three years' follow-up

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   Discussion Top


Bone loss around dental implants is a common phenomenon that necessitates professional help, consumes money, and causes discomfort for patients. Sometimes, the result is extraction of the implants and installation of new implants.

The present implant was designed in attempt to overcome bone loss around dental implants. In this case report, a follow-up of 3 years shows a complete restoration of lost bone.

Implant macro-geometry that is intended to transmit compressive stresses to nearby bone during occlusal impact loads may encourage load-bearing architecture of the bone and even reconstruction of initial bone loss that during the healing phase.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Fransson C, Tomasi C, Pikner SS, Gröndahl K, Wennström JL, Leyland AH, et al. Severity and pattern of peri-implantitis-associated bone loss. J Clin Periodontol 2010;37:442-8.  Back to cited text no. 1
    
2.
Fransson C, Wennström J, Tomasi C, Berglundh T. Extent of peri-implantitis-associated bone loss. J Clin Periodontol 2009;36:357-63.  Back to cited text no. 2
    
3.
Derks J, Schaller D, Håkansson J, Wennström JL, Tomasi C, Berglundh T, et al. Effectiveness of implant therapy analyzed in a Swedish population: Prevalence of peri-implantitis. J Dent Res 2016;95:43-9.  Back to cited text no. 3
    
4.
Tadi DP, Pinisetti S, Gujjalapudi M, Kakaraparthi S, Kolasani B, Vadapalli SH, et al. Evaluation of initial stability and crestal bone loss in immediate implant placement: An in vivo study. J Int Soc Prev Community Dent 2014;4:139-44.  Back to cited text no. 4
    
5.
Pal US, Dhiman NK, Singh G, Singh RK, Mohammad S, Malkunje LR, et al. Evaluation of implants placed immediately or delayed into extraction sites. Natl J Maxillofac Surg 2011;2:54-62.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416.  Back to cited text no. 6
    
7.
Jung YC, Han CH, Lee KW. A 1-year radiographic evaluation of marginal bone around dental implants. Int J Oral Maxillofac Implants 1996;11:811-8.  Back to cited text no. 7
    
8.
Cox JF, Zarb GA. The longitudinal clinical efficacy of osseointegrated dental implants: A 3-year report. Int J Oral Maxillofac Implants 1987;2:91-100.  Back to cited text no. 8
    
9.
Lai H, Zhang F, Zhang B, Yang C, Xue M. Influence of percentage of osseointegration on stress distribution around dental implants. Chin J Dent Res 1998;1:7-11.  Back to cited text no. 9
    
10.
Kohrt WM, Barry DW, Schwartz RS. Muscle forces or gravity: What predominates mechanical loading on bone? Med Sci Sports Exerc 2009;41:2050-5.  Back to cited text no. 10
    
11.
Vinter I, Krmpotić-Nemanić J, Ivanković D, Jalsovec D. The influence of the dentition on the shape of the mandible. Coll Antropol 1997;21:555-60.  Back to cited text no. 11
    
12.
Schwartz-Dabney CL, Dechow PC. Edentulation alters material properties of cortical bone in the human mandible. J Dent Res 2002;81:613-7.  Back to cited text no. 12
    
13.
Merrot O, Vacher C, Merrot S, Godlewski G, Frigard B, Goudot P, et al. Changes in the edentate mandible in the elderly. Surg Radiol Anat 2005;27:265-70.  Back to cited text no. 13
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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