title: Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique: a pilot study in minipigs.
abstract: BACKGROUND
  Most dental implants are positioned using a drilling surgery technique. However, dentistry recently experienced the implementation of piezoelectric surgery. This technique was introduced to overcome some of the limitations involving rotating instruments in bone surgery. This study used biomolecular and histologic analyses to compare the osseointegration of porous implants positioned using traditional drills versus the piezoelectric bone surgery technique.
  
  
  METHODS
  Porous titanium implants were inserted into minipig tibias. Histomorphology and levels of bone morphogenetic protein (BMP)-4, transforming growth factor (TGF)-beta2, tumor necrosis factor-alpha, and interleukin-1beta and -10 were evaluated in the peri-implant osseous samples.
  
  
  RESULTS
  Histomorphological analyses demonstrated that more inflammatory cells were present in samples from drilled sites. Also, neo-osteogenesis was consistently more active in bone samples from the implant sites that were prepared using piezoelectric bone surgery. Moreover, bone around the implants treated with the piezoelectric bone surgery technique showed an earlier increase in BMP-4 and TGF-beta2 proteins as well as a reduction in proinflammatory cytokines.
  
  
  CONCLUSIONS
  Piezoelectric bone surgery appears to be more efficient in the first phases of bone healing; it induced an earlier increase in BMPs, controlled the inflammatory process better, and stimulated bone remodeling as early as 56 days post-treatment.
authors.affiliation: Department of Biomedical Sciences and Human Oncology, Section of Prosthetic Dentistry, School of Dentistry, University of Turin, Turin, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Preti
authors.forename: Germana
authors.initials: G
authors.lastname: Martinasso
authors.forename: Bruno
authors.initials: B
authors.lastname: Peirone
authors.forename: Roberto
authors.initials: R
authors.lastname: Navone
authors.forename: Carlo
authors.initials: C
authors.lastname: Manzella
authors.forename: Giuliana
authors.initials: G
authors.lastname: Muzio
authors.forename: Crescenzo
authors.initials: C
authors.lastname: Russo
authors.forename: Rosa A
authors.initials: RA
authors.lastname: Canuto
authors.forename: Gianmario
authors.initials: G
authors.lastname: Schierano
mesh_terms: D000818:Animals; D019485:Bone Morphogenetic Proteins / Q000032:analysis; D016207:Cytokines / Q000032:analysis*; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D004560:Electricity; D036341:Intercellular Signaling Peptides and Proteins / Q000032:analysis*; D016348:Osseointegration / Q000502:physiology*; D010865:Pilot Projects; D016133:Polymerase Chain Reaction / Q000379:methods; D013552:Swine; D013556:Swine, Miniature; D013977:Tibia / Q000601:surgery
chemical_list: D019485:Bone Morphogenetic Proteins; D016207:Cytokines; D015921:Dental Implants; D036341:Intercellular Signaling Peptides and Proteins