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IN VITRO STUDY OF FRACTAL ANALYSIS OF OSTEOTOMIES PERFORMED WITH DIFFERENT DESIGN IMPLANT DRILLS IN LOW DENSITY BONE BLOCKS

Year 2023, Volume: 6 Issue: 2, 160 - 165, 26.06.2023
https://doi.org/10.26650/JARHS2023-1207763

Abstract

Objective: Alternative osteotomy techniques were introduced instead of the traditional drilling procedures of dental implant placement. One of these techniques is bone densification through a special design of drills. To study the effect of densification burs on low bone quality in comparison with conventional drilling procedures, the trabecular bone changes will be determined quantitively using fractal analysis (FA).
Material and Methods: A control group (PKD) with the standard osteotomy burs and a test group (PV) with the osseodensification burs were used. In each group, 10 dental implants (4.2x10mm) were placed. A three dimensional (3D) image was obtained from the blocks on a Micro Computed Tomography (micro-CT) device. Fractal analysis was performed, and the results were analyzed by nonparametric tests (p<0.05).
Results: According to the results, the FA value of apical and lateral areas from the PV group (1.292, 1.251 respectively) were significantly higher than the control group (p<0.01). When apical and lateral FA values of the PV group were compared, the apical values were found to be significantly higher than the lateral ones (p<0.01).
Conclusion: In terms of fractal analysis, the bone densification effect of the burs in the PV group around the implants, compared to the PKD group, apical and lateral values, were found to be higher and have been found to provide better trabecular compression. FA may be useful for preoperative and non-invasive assessment of bone quality at implant sites.

Project Number

Grant/Award Number: 36994

References

  • Boustany CM, Reed H, Cunningham G, Richards M, Kanawati A. Effect of a modified stepped osteotomy on the primary stability of dental implants in low-density bone: a cadaver study. Int J Oral Maxillofac Implants 2015;30(1):48-55. google scholar
  • El-Kholey KE, Elkomy A. does the drilling technique for implant site preparation enhance implant success in low-density bone? a systematic review. Implant Dent 2019;28(5):500-9. google scholar
  • Huwais S, Meyer EG. A novel osseous densification approach in implant osteotomy preparation to increase biomechanical primary stability, bone mineral density, and bone-to-implant contact. Int J Oral Maxillofac Implants 2017;32(1):27-36. google scholar
  • Lahens B, Neiva R, Tovar N, Alifarag AM, Jimbo R, Bonfante EA, et al. Biomechanical and histologic basis of osseodensification drilling for endosteal implant placement in low density bone. An experimental study in sheep. J Mech Behav Biomed Mater 2016;63:56-65. google scholar
  • Trisi P, Berardini M, Falco A, Podaliri Vulpiani M. New Osseodensification Implant Site Preparation Method to increase bone density in low-density bone: In Vivo Evaluation in Sheep. Implant Dent 2016;25(1):24-31. google scholar
  • Trisi P, Perfetti G, Baldoni E, Berardi D, Colagiovanni M, Scogna G. Implant micromotion is related to peak insertion torque and bone density. Clin Oral Implants Res 2009;20(5):467-71. google scholar
  • Ostman PO, Hellman M, Wendelhag I, Sennerby L. Resonance frequency analysis measurements of implants at placement surgery. Int J Prosthodont 2006;19(1):77-84. google scholar
  • Skalak R, Zhao Y. Interaction of force-fitting and surface roughness of implants. Clin Implant Dent Relat Res 2000;2(4):219-24. google scholar
  • Shalabi MM, Wolke JG, de Ruijter AJ, Jansen JA. A mechanical evaluation of implants placed with different surgical techniques into the trabecular bone of goats. J Oral Implantol 2007;33(2):51-8. google scholar
  • Groen WM, Diloksumpan P, van Weeren PR, Levato R, Malda J. From intricate to integrated: Biofabrication of articulating joints. J Orthop Res 2017;35(10):2089-97. google scholar
  • Taşsöker M, Özcan S, Güleç M. Tıpta ve diş hekimliğinde fraktal analiz. EÜ DişHek Fak Derg 2019;40(1):17-31. google scholar
  • Updike SX, Nowzari H. Fractal analysis of dental radiographs to detect periodontitis-induced trabecular changes. J Periodontal Res 2008;43(6):658-64. google scholar
  • Southard TE, Southard KA, Jakobsen JR, Hillis SL, Najim CA. Fractal dimension in radiographic analysis of alveolar process bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82(5):569-76. google scholar
  • Bollen AM, Taguchi A, Hujoel PP, Hollender LG. Fractal dimension on dental radiographs. Dentomaxillofac Radiol 2001;30(5):270-5. google scholar
  • Sânchez I, Uzcâtegui G. Fractals in dentistry. J Dent 2011;39(4):273-92. google scholar
  • Hua Y, Nackaerts O, Duyck J, Maes F, Jacobs R. Bone quality assessment based on cone beam computed tomography imaging. Clin Oral Implants Res 2009;20(8):767-71. google scholar
  • Ghavami-Lahiji M, Davalloo RT, Tajziehchi G, Shams P. Micro-computed tomography in preventive and restorative dental research: A review. Imaging Sci Dent 2021;51(4):341-50. google scholar
  • Guggenbuhl P, Bodic F, Hamel L, Basle MF, Chappard D. Texture analysis of X-ray radiographs of iliac bone is correlated with bone micro-CT. Osteoporos Int 2006;17(3):447-54. google scholar
  • Veltri M, Ferrari M, Balleri P. Correlation of radiographic fractal analysis with implant insertion torque in a rabbit trabecular bone model. Int J Oral Maxillofac Implants 2011;26(1):108-14. google scholar
  • Hetaimish BM. Sawbones laboratory in orthopedic surgical training. Saudi Med J 2016;37(4):348-53. google scholar
  • 21. Tosoni GM, Lurie AG, Cowan AE, Burleson JA. Pixel intensity and fractal analyses: detecting osteoporosis in perimenopausal and postmenopausal women by using digital panoramic images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(2):235-41. google scholar
  • Shrout MK, Farley BA, Patt SM, Potter BJ, Hildebolt CF, Pilgram TK, et al. The effect of region of interest variations on morphologic operations data and gray-level values extracted from digitized dental radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88(5):636-9. google scholar
  • Lee DH, Ku Y, Rhyu IC, Hong JU, Lee CW, Heo MS, et al. A clinical study of alveolar bone quality using the fractal dimension and the implant stability quotient. J Periodontal Implant Sci 2010;40(1):19-24. google scholar
  • Kavitha MS, An SY, An CH, Huh KH, Yi WJ, Heo MS, et al. Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119(3):346-56. google scholar
  • Baksi BG, Fidler A. Fractal analysis of periapical bone from lossy compressed radiographs: a comparison of two lossy compression methods. J Digit Imaging 2011;24(6):993-8. google scholar
  • 2 Sansare K, Singh D, Karjodkar F. Changes in the fractal dimension on pre- and post-implant panoramic radiographs. Oral Radiology 2011;28(1):15-23. google scholar
  • Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clin Oral Investig 2015;19(2):519-24. google scholar
  • Gonzâlez-Martm O, Lee EA, Veltri M. CBCT fractal dimension changes at the apex of immediate implants placed using undersized drilling. Clin Oral Implants Res 2012;23(8):954-7. google scholar
  • Delgado-Ruiz R, Mahdian M, Benezha I, Romanos G. Counterclockwise drilling with different tapered drills condenses the implant bed-an optical coherence tomography in vitro study. Medicina (Kaunas) 2021;57(9):940. google scholar
  • Delgado-Ruiz R, Gold J, Somohano Marquez T, Romanos G. Under-drilling versus hybrid osseodensification technique: differences in implant primary stability and bone density of the implant bed walls. Materials (Basel) 2020;13(2):390. google scholar
  • Link TM, Majumdar S. Current diagnostic techniques in the evaluation of bone architecture. Curr Osteoporos Rep 2004;2(2):47-52. google scholar
  • van der Linden JC, Weinans H. Effects of microarchitecture on bone strength. Curr Osteoporos Rep 2007;5(2):56-61. google scholar
  • Reznikov N, Bilton M, Lari L, Stevens MM, Kröger R. Fractal-like hierarchical organization of bone begins at the nanoscale. Science 2018;360(6388):eaao2189. doi: 10.1126/science.aao2189. google scholar
  • Corpas LS, Jacobs R, QuirynenM HY, Naert I, Duyck J. Periimplant bone tissue assessment by comparing the outcome of intraoral radiograph and cone beam computed tomography analyses to the histological standard. Clin Oral Implants Res 2011;22(5):492-9. google scholar
  • Devlin H, Horner K, Ledgerton D. A comparison of maxillary and mandibular bone mineral densities. J Prosthet Dent 1998;79(3):323-7. google scholar

DÜŞÜK YOĞUNLUKLU KEMİK BLOKLARINDA FARKLI TASARIMA SAHİP İMPLANT FREZLERİ İLE GERÇEKLEŞTİRİLEN OSTEOTOMİLERİN FRAKTAL ANALİZLERİNİN VİTRO İNCELENMESİ

Year 2023, Volume: 6 Issue: 2, 160 - 165, 26.06.2023
https://doi.org/10.26650/JARHS2023-1207763

Abstract

Amaç: Dental implant cerrahisinde; osteotomi bölgelerindeki kemik partiküllerini dışarı çıkarma prensibi ile çalışan geleneksel yaklaşımlara ek olarak; partikülleri osteotomi alanında tutarak yoğunlaştırılmasını sağlayan frezleme teknikleri geliştirilmiştir. Bu çalışma ile, düşük kemik yoğunluğuna sahip yapay bloklar kullanılarak; iki farklı frez tasarımı ile oluşturulan osteotomilerde; trabeküler kemik değişikliklerinin kantitatif olarak belirlenmesinde fraktal analizin (FA) etkinliği araştırılmıştır.
Gereç ve Yöntem: Standart osteotomi frezleri ile bir kontrol grubu (PKD) osseodensifikasyon frezleri ile bir test grubu (PV) oluşturulmuştur. Osteotomiler 2x2x2cm ebatlarındaki yapay kemik bloklarında gerçekleştirilmiştir ve her gruba 10 adet dental implant (4,2x10mm) yerleştirilmiştir. Blokların, Mikro Bilgisayarlı Tomografi (mikro-BT) cihazında elde edilen kesitlerinin mezial ve lateral bölgelerinden ölçümler gerçekleştirilmiş, kutu sayma algoritması ile ImageJ programı kullanılarak FA yapılmıştır. Veriler varyans analizi ile değerlendirilmiştir (p<0,05).
Bulgular: Elde edilen bulgulara göre PV grubunda apikal ve lateral alanlarda FA değerleri (sırasıyla 1,292, 1,251), PKD grubuna göre (1,258, 1,233)istatistiksel olarak anlamlı bulunmuştur (p<0,01). PV grubunun apikal ve lateral FA değerleri karşılaştırıldığında ise apikal değerler laterale göre anlamlı derecede yüksek bulunmuştur (p<0,01).
Sonuçlar: Fraktal analiz değerleri açısından; osseodensifikasyon frezlerininimplant etrafındaki kemik yoğunlaştırma etkisi, geleneksel grubuna göre, hem apikalde hem de lateralde yüksek bulunmuş ve daha etkin trabeküler sıkıştırma sağladığı tespit edilmiştir. FA; implant bölgelerindeki kemik kalitesinin, preoprative ve noninvaziv değerlendirilmesinde, faydalı bir yöntem olarak düşünülmektedir.

Project Number

Grant/Award Number: 36994

References

  • Boustany CM, Reed H, Cunningham G, Richards M, Kanawati A. Effect of a modified stepped osteotomy on the primary stability of dental implants in low-density bone: a cadaver study. Int J Oral Maxillofac Implants 2015;30(1):48-55. google scholar
  • El-Kholey KE, Elkomy A. does the drilling technique for implant site preparation enhance implant success in low-density bone? a systematic review. Implant Dent 2019;28(5):500-9. google scholar
  • Huwais S, Meyer EG. A novel osseous densification approach in implant osteotomy preparation to increase biomechanical primary stability, bone mineral density, and bone-to-implant contact. Int J Oral Maxillofac Implants 2017;32(1):27-36. google scholar
  • Lahens B, Neiva R, Tovar N, Alifarag AM, Jimbo R, Bonfante EA, et al. Biomechanical and histologic basis of osseodensification drilling for endosteal implant placement in low density bone. An experimental study in sheep. J Mech Behav Biomed Mater 2016;63:56-65. google scholar
  • Trisi P, Berardini M, Falco A, Podaliri Vulpiani M. New Osseodensification Implant Site Preparation Method to increase bone density in low-density bone: In Vivo Evaluation in Sheep. Implant Dent 2016;25(1):24-31. google scholar
  • Trisi P, Perfetti G, Baldoni E, Berardi D, Colagiovanni M, Scogna G. Implant micromotion is related to peak insertion torque and bone density. Clin Oral Implants Res 2009;20(5):467-71. google scholar
  • Ostman PO, Hellman M, Wendelhag I, Sennerby L. Resonance frequency analysis measurements of implants at placement surgery. Int J Prosthodont 2006;19(1):77-84. google scholar
  • Skalak R, Zhao Y. Interaction of force-fitting and surface roughness of implants. Clin Implant Dent Relat Res 2000;2(4):219-24. google scholar
  • Shalabi MM, Wolke JG, de Ruijter AJ, Jansen JA. A mechanical evaluation of implants placed with different surgical techniques into the trabecular bone of goats. J Oral Implantol 2007;33(2):51-8. google scholar
  • Groen WM, Diloksumpan P, van Weeren PR, Levato R, Malda J. From intricate to integrated: Biofabrication of articulating joints. J Orthop Res 2017;35(10):2089-97. google scholar
  • Taşsöker M, Özcan S, Güleç M. Tıpta ve diş hekimliğinde fraktal analiz. EÜ DişHek Fak Derg 2019;40(1):17-31. google scholar
  • Updike SX, Nowzari H. Fractal analysis of dental radiographs to detect periodontitis-induced trabecular changes. J Periodontal Res 2008;43(6):658-64. google scholar
  • Southard TE, Southard KA, Jakobsen JR, Hillis SL, Najim CA. Fractal dimension in radiographic analysis of alveolar process bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82(5):569-76. google scholar
  • Bollen AM, Taguchi A, Hujoel PP, Hollender LG. Fractal dimension on dental radiographs. Dentomaxillofac Radiol 2001;30(5):270-5. google scholar
  • Sânchez I, Uzcâtegui G. Fractals in dentistry. J Dent 2011;39(4):273-92. google scholar
  • Hua Y, Nackaerts O, Duyck J, Maes F, Jacobs R. Bone quality assessment based on cone beam computed tomography imaging. Clin Oral Implants Res 2009;20(8):767-71. google scholar
  • Ghavami-Lahiji M, Davalloo RT, Tajziehchi G, Shams P. Micro-computed tomography in preventive and restorative dental research: A review. Imaging Sci Dent 2021;51(4):341-50. google scholar
  • Guggenbuhl P, Bodic F, Hamel L, Basle MF, Chappard D. Texture analysis of X-ray radiographs of iliac bone is correlated with bone micro-CT. Osteoporos Int 2006;17(3):447-54. google scholar
  • Veltri M, Ferrari M, Balleri P. Correlation of radiographic fractal analysis with implant insertion torque in a rabbit trabecular bone model. Int J Oral Maxillofac Implants 2011;26(1):108-14. google scholar
  • Hetaimish BM. Sawbones laboratory in orthopedic surgical training. Saudi Med J 2016;37(4):348-53. google scholar
  • 21. Tosoni GM, Lurie AG, Cowan AE, Burleson JA. Pixel intensity and fractal analyses: detecting osteoporosis in perimenopausal and postmenopausal women by using digital panoramic images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102(2):235-41. google scholar
  • Shrout MK, Farley BA, Patt SM, Potter BJ, Hildebolt CF, Pilgram TK, et al. The effect of region of interest variations on morphologic operations data and gray-level values extracted from digitized dental radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88(5):636-9. google scholar
  • Lee DH, Ku Y, Rhyu IC, Hong JU, Lee CW, Heo MS, et al. A clinical study of alveolar bone quality using the fractal dimension and the implant stability quotient. J Periodontal Implant Sci 2010;40(1):19-24. google scholar
  • Kavitha MS, An SY, An CH, Huh KH, Yi WJ, Heo MS, et al. Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119(3):346-56. google scholar
  • Baksi BG, Fidler A. Fractal analysis of periapical bone from lossy compressed radiographs: a comparison of two lossy compression methods. J Digit Imaging 2011;24(6):993-8. google scholar
  • 2 Sansare K, Singh D, Karjodkar F. Changes in the fractal dimension on pre- and post-implant panoramic radiographs. Oral Radiology 2011;28(1):15-23. google scholar
  • Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clin Oral Investig 2015;19(2):519-24. google scholar
  • Gonzâlez-Martm O, Lee EA, Veltri M. CBCT fractal dimension changes at the apex of immediate implants placed using undersized drilling. Clin Oral Implants Res 2012;23(8):954-7. google scholar
  • Delgado-Ruiz R, Mahdian M, Benezha I, Romanos G. Counterclockwise drilling with different tapered drills condenses the implant bed-an optical coherence tomography in vitro study. Medicina (Kaunas) 2021;57(9):940. google scholar
  • Delgado-Ruiz R, Gold J, Somohano Marquez T, Romanos G. Under-drilling versus hybrid osseodensification technique: differences in implant primary stability and bone density of the implant bed walls. Materials (Basel) 2020;13(2):390. google scholar
  • Link TM, Majumdar S. Current diagnostic techniques in the evaluation of bone architecture. Curr Osteoporos Rep 2004;2(2):47-52. google scholar
  • van der Linden JC, Weinans H. Effects of microarchitecture on bone strength. Curr Osteoporos Rep 2007;5(2):56-61. google scholar
  • Reznikov N, Bilton M, Lari L, Stevens MM, Kröger R. Fractal-like hierarchical organization of bone begins at the nanoscale. Science 2018;360(6388):eaao2189. doi: 10.1126/science.aao2189. google scholar
  • Corpas LS, Jacobs R, QuirynenM HY, Naert I, Duyck J. Periimplant bone tissue assessment by comparing the outcome of intraoral radiograph and cone beam computed tomography analyses to the histological standard. Clin Oral Implants Res 2011;22(5):492-9. google scholar
  • Devlin H, Horner K, Ledgerton D. A comparison of maxillary and mandibular bone mineral densities. J Prosthet Dent 1998;79(3):323-7. google scholar
There are 35 citations in total.

Details

Primary Language English
Subjects Dentistry
Journal Section Research Articles
Authors

Ayşegül Öztürk 0000-0002-7991-4731

Volkan Arısan 0000-0002-0881-7483

Project Number Grant/Award Number: 36994
Publication Date June 26, 2023
Submission Date November 21, 2022
Published in Issue Year 2023 Volume: 6 Issue: 2

Cite

MLA Öztürk, Ayşegül and Volkan Arısan. “IN VITRO STUDY OF FRACTAL ANALYSIS OF OSTEOTOMIES PERFORMED WITH DIFFERENT DESIGN IMPLANT DRILLS IN LOW DENSITY BONE BLOCKS”. Sağlık Bilimlerinde İleri Araştırmalar Dergisi, vol. 6, no. 2, 2023, pp. 160-5, doi:10.26650/JARHS2023-1207763.