The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone
Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thr...
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MDPI AG
2025-06-01
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| author | Nicholas J. Iglesias Vasudev Vivekanand Nayak Arthur Castellano Lukasz Witek Bruno Martins de Souza Edmara T. P. Bergamo Ricky Almada Blaire V. Slavin Estevam A. Bonfante Paulo G. Coelho |
| author_facet | Nicholas J. Iglesias Vasudev Vivekanand Nayak Arthur Castellano Lukasz Witek Bruno Martins de Souza Edmara T. P. Bergamo Ricky Almada Blaire V. Slavin Estevam A. Bonfante Paulo G. Coelho |
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| description | Achieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread’s crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone–implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS’s cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, <i>p</i> = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (<i>p</i> = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density. |
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| spelling | doaj-art-0bd9c6eadc8e43afbd7686775e5214822025-08-20T02:24:31ZengMDPI AGBiomimetics2313-76732025-06-0110639510.3390/biomimetics10060395The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV BoneNicholas J. Iglesias0Vasudev Vivekanand Nayak1Arthur Castellano2Lukasz Witek3Bruno Martins de Souza4Edmara T. P. Bergamo5Ricky Almada6Blaire V. Slavin7Estevam A. Bonfante8Paulo G. Coelho9DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USAMackenzie Evangelical School of Medicine Paraná, Curitiba 80730-000, PR, BrazilBiomaterials and Regenerative Biology Division, NYU College of Dentistry, New York, NY 10010, USABiomaterials and Regenerative Biology Division, NYU College of Dentistry, New York, NY 10010, USADepartment of Prosthodontics, NYU College of Dentistry, New York, NY 10010, USADepartment of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USAUniversity of Miami Miller School of Medicine, Miami, FL 33136, USADepartment of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru 17012-901, SP, BrazilDepartment of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USAAchieving the appropriate primary stability for immediate or early loading in areas with low-density bone, such as the posterior maxilla, is challenging. A three-dimensional (3D) stabilization implant design featuring a tapered body with continuous cutting flutes along the length of the external thread form, with a combination of curved and linear geometric surfaces on the thread’s crest, has the capacity to enhance early biomechanical and osseointegration outcomes compared to implants with traditional buttressed thread profiles. Commercially available implants with a buttress thread design (TP), and an experimental implant that incorporated the 3D stabilization trimmed-thread design (TP 3DS) were used in this study. Six osteotomies were surgically created in the ilium of adult sheep (N = 14). Osteotomy sites were randomized to receive either the TP or TP 3DS implant to reduce site bias. Subjects were allowed to heal for either 3 or 12 weeks (N = 7 sheep/time point), after which samples were collected en bloc (including the implants and surrounding bone) and implants were either subjected to bench-top biomechanical testing (e.g., lateral loading), histological/histomorphometric analysis, or nanoindentation testing. Both implant designs yielded high insertion torque (ITV ≥ 30 N⋅cm) and implant stability quotient (ISQ ≥ 70) values, indicative of high primary stability. Qualitative histomorphological analysis revealed that the TP 3DS group exhibited a continuous bone–implant interface along the threaded region, in contrast to the TP group at the early, 3-week, healing time point. Furthermore, TP 3DS’s cutting flutes along the entire length of the implant permitted the distribution of autologous bone chips within the healing chambers. Histological evaluation at 12 weeks revealed an increase in woven bone containing a greater presence of lacunae within the healing chambers in both groups, consistent with an intramembranous-like healing pattern and absence of bone dieback. The TP 3DS macrogeometry yielded a ~66% increase in average lateral load during pushout testing at baseline (T = 0 weeks, <i>p</i> = 0.036) and significantly higher bone-to-implant contact (BIC) values at 3 weeks post-implantation (<i>p</i> = 0.006), relative to the traditional TP implant. In a low-density (Type IV) bone model, the TP 3DS implant demonstrated improved performance compared to the conventional TP, as evidenced by an increase in baseline lateral loading capacity and increased BIC during the early stages of osseointegration. These findings indicate that the modified implant configuration of the TP 3DS facilitates more favorable biomechanical integration and may promote more rapid and stable bone anchorage under compromised bone quality conditions. Therefore, such improvements could have important clinical implications for the success and longevity of dental implants placed in regions with low bone density.https://www.mdpi.com/2313-7673/10/6/395insertion torque valueimplant stability quotientosseointegrationprimary stabilitynanoindentationlateral loading |
| spellingShingle | Nicholas J. Iglesias Vasudev Vivekanand Nayak Arthur Castellano Lukasz Witek Bruno Martins de Souza Edmara T. P. Bergamo Ricky Almada Blaire V. Slavin Estevam A. Bonfante Paulo G. Coelho The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone Biomimetics insertion torque value implant stability quotient osseointegration primary stability nanoindentation lateral loading |
| title | The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone |
| title_full | The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone |
| title_fullStr | The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone |
| title_full_unstemmed | The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone |
| title_short | The Effect of Three-Dimensional Stabilization Thread Design on Biomechanical Fixation and Osseointegration in Type IV Bone |
| title_sort | effect of three dimensional stabilization thread design on biomechanical fixation and osseointegration in type iv bone |
| topic | insertion torque value implant stability quotient osseointegration primary stability nanoindentation lateral loading |
| url | https://www.mdpi.com/2313-7673/10/6/395 |
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