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Effects of early functional loading on maintenance of free autogenous bone graft and implant osseointegration: an experimental study in dogs.

Journal article
Authors Paulo E P Faria
A L Carvalho
Erica M de Torres
Lars Rasmusson
Luiz A Salata
Published in Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
Volume 68
Issue 4
Pages 825-32
ISSN 1531-5053
Publication year 2010
Published at Institute of Clinical Sciences, Department of Biomaterials
Pages 825-32
Language en
Keywords Alveolar Ridge Augmentation, methods, Analysis of Variance, Animals, Bone Density, Bone Screws, Bone Transplantation, Dental Abutments, Dental Implantation, Endosseous, Dental Prosthesis Retention, Dental Prosthesis, Implant-Supported, Dental Stress Analysis, Dogs, Male, Osseointegration, Probability, Statistics, Nonparametric, Time Factors, Tomography, X-Ray Computed, Vibration
Subject categories Biomaterials


PURPOSE: The aim of the present study was to investigate the healing, integration, and maintenance of autogenous onlay bone grafts and implant osseointegration either loaded in the early or the delayed stages. MATERIALS AND METHODS: A total of 5 male dogs received bilateral blocks of onlay bone grafts harvested from the contralateral alveolar ridge of the mandible. On one side, the bone block was secured by 3 dental implants (3.5 mm x 13.0 mm, Osseospeed; AstraTech AB, Mölndal, Sweden). Two implants at the extremities of the graft were loaded 2 days after installation by abutment connection and prosthesis (simultaneous implant placement group); the implant in the middle remained unloaded and served as the control. On the other side, the block was fixed with 2 fixation screws inserted in the extremities of the graft. Four weeks later, the fixation screws were replaced with 3 dental implants. The loading procedure (delayed implant placement group) was performed 2 days later, as described for the simultaneous implant placement sites. The animals were sacrificed 12 weeks after the grafting procedure. Implant stability was measured through resonance frequency analysis. The bone volume and density were assessed on computed tomography. The bone to implant contact and bone area in a region of interest were evaluated on histologic slides. RESULTS: The implant stability quotient showed statistical significance in favor of the delayed loaded grafts (P = .001). The bone-to-implant contact (P = .008) and bone area in a region of interest (P = 0.005) were significantly greater in the delayed group. Nevertheless, no difference was found in terms of graft volume and density between the early loaded and delayed-loaded approaches. CONCLUSIONS: The protocol in which the implant and bone graft were given delayed loading allows for effective quality of implant osseointegration and stabilization, with healing and remodeling occurring in areas near the implant resulting in denser bone architecture.

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