title: Peri-implant bone organization under immediate loading state. Circularly polarized light analyses: a minipig study.
abstract: BACKGROUND
  Immediate loading of dental implants is currently one of the most examined topics in implant dentistry. Using screw implants with a microstructured surface and bone-quality-adapted insertion procedures, osseointegration is achieved when implants are initially stable and when splinted with the superstructure. Despite reported success, there is a shortage of information relating to remodeling and peri-implant bone formation with immediately loaded implants.
  
  
  METHODS
  Four to six immediately loaded and unloaded dental implants with a microstructured surface were placed in the mandible and the maxilla in seven minipigs. A total of 85 implants were placed. After a 4-month healing period, all implants were retrieved. Histomorphometry was performed using a light microscope in transmitted polarized light connected to a high-resolution video camera interfaced to a monitor and personal computer. This optical system was associated with a digitizing pad and a histomorphometry software package with image capturing capabilities.
  
  
  RESULTS
  Implants showed osseointegration if the average insertion torque of the implants within one bridge was >35 Ncm. If the primary stability of the bridge was <35 Ncm, all implants in the quadrant were lost after 4 months. The multivariate discriminant analysis showed the highest correlation for implant stability by bridge insertion torque (BIT), localization (mandible or maxilla), and implant insertion torque (IIT) as success parameters. The loaded implants displayed collagen fibers, which were oriented in a more transverse way. In addition, a higher quantity of secondary osteons was present. In comparison, the unloaded implants had collagen fibers with a more parallel orientation, and a higher quantity of marrow spaces was present.
  
  
  CONCLUSIONS
  When observed after 4 months, immediately loaded implants showed a higher degree of bone formation and remodeling in comparison to unloaded implants. Immediately loaded implants also demonstrated a prevalence of transversely oriented collagen fibers in the peri-implant bone. In this animal model, an average insertion torque of the implants within one bridge>35 Ncm was associated with the most successful implants.
authors.affiliation: Department of Craniomaxillofacial and Plastic Surgery, University of Cologne, Cologne, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Neugebauer
authors.forename: Tonino
authors.initials: T
authors.lastname: Traini
authors.forename: Ulf
authors.initials: U
authors.lastname: Thams
authors.forename: Adriano
authors.initials: A
authors.lastname: Piattelli
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Zöller
mesh_terms: D000818:Animals; D001853:Bone Marrow / Q000473:pathology / Q000503:physiopathology; D016723:Bone Remodeling / Q000502:physiology; D002942:Circular Dichroism; D003094:Collagen; D000044:Dental Abutments; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D006253:Haversian System / Q000473:pathology / Q000503:physiopathology; D007091:Image Processing, Computer-Assisted; D008334:Mandible / Q000473:pathology* / Q000503:physiopathology; D008437:Maxilla / Q000473:pathology* / Q000503:physiopathology; D008859:Microscopy, Polarization; D023421:Models, Animal; D016348:Osseointegration / Q000502:physiology*; D010012:Osteogenesis / Q000502:physiology; D013552:Swine; D013556:Swine, Miniature; D019415:Torque; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D015921:Dental Implants; D003094:Collagen