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Section 5. Medical science
Habilov Nigman Lukmanovich, Head of department, PhD, professor Mun Tatyana Olegovna, Usmonov Farkhod Komilzhonovich, PhD-students, Department of hospital prosthodontics, Tashkent State Dental Institute, Tashkent, Uzbekistan E-mail: [email protected]
Densitometry study of degree of osteointegration of the dental implant "Implant.uz" in experimental conditions
Abstract: In this scientific work degree of osteointegration at border bone — tooth implant by a densitometry method in terms of 1, 3, 6 months was studied. The received results showed a positive tendency of dynamic increase in density of a neo-formed bone on border implant — bone during various periods of research.
Keywords: dental implant, osteointegration, densitometry, quantitative analysis, experimental animals, jaw bones.
Nowadays use of dental implantation, as most progressive method of elimination of defects of tooth alignments by fixed tooth prosthetics is especially actual. Its role in restoration of quality of life of patients is great [1].
Increasing the number of dental implants in edentulous patients is accompanied by the need for careful evaluation of the tissues around the implants [2; 3]. Quality and quantity of the bone are two important and effective factors on stabilising the level connection of the implant and bone [4]. In fact, enough bone volume and density are the key factors to successful implant treatment.
A new design of a dental implant "IMPLANT.UZ" was developed in Uzbekistan and the patent (The patent for useful model No. FAP 00819, Uzbekistan) was taken out [5].
For studying of impact of the general and local reaction of an organism to the entered implant, studying of processes of osteo-integration, experimental animal experiments were made. Full os-teointegration of intra bone implants is a fundamental condition of long-term success of prosthetics with a support on dental implants.
The reliable, quantitative assessment of extent of osteointegration of intra bone implants has crucial importance for a choice of a design of dental prosthesis, tactics of functional loading of implants, forecasting of efficiency of prosthodontic treatment.
It is known that the quantitative analysis of the radiological image promotes improvement of quality and an objective diagnostics. The carried-out researches with application of quantitative characteristics surpass in the informational content traditional radiological research not only at a stage of primary diagnostics.
The principle of a comparative assessment has to be the leader in definition of results and adequacy of the carried-out treatment at different stages of dynamic supervision, in particular at diseases studying of processes of an osteintegration [6].
In clinical practice some opportunities of a quantitative assessment of extent of osteointegration and stability of implants are known [7]: clinical (percussion, manual control of stability of an implant); periotestometry; the torque-test by means of a torque-controlled key; it is frequency or the magnetic and resonant analysis; densitometric assessment of density of a bone tissue.
The last, densitometry — the diagnostic testing uniting in itself various methods of obtaining the image and its quantitative analysis which main objective is determination of mineral density of a bone tissue of object [8].
Densitometric research of X-rays of dental implants in various terms of supervision allows to expand diagnostic opportunities of radiological research at osteointegration process study.
Purpose. To study density of a neoformed bone tissue on border implant — bone by scientific justification of a method of a densitometric assessment of optical density of a bone tissue on x-ray pictures.
Materials. The pilot study is conducted on 12 dogs of both sexes at the age of 2-3 years weight 25-30 kg. The studied dental implants were implanted into jaw bones of experimental animals.
Methods of research. Radiovisiography, densitometric and statistical methods of research.
Radiovisiography was conducted with help of device Wireless Portable X-ray Prox of DigiMed (South Korea) in period: before implantation, during operation, in 1, 3 and 6 months after operation.
The analysis of X-ray images in this work was carried out on the personal computer by means of the public program "Image J" (Wayne Rasband. National Institute of Health, USA. http://rsb.info. nih.gov/ij). On X-ray images measured density of a neoformed bone tissue on border implant — bone.
For an assessment of density of a neoformed bone measured a difference between average value of brightness of pixels in the field of border implant — bone and the next (healthy) site of a bone.
Results are displayed in the form of the histogram with average values. As brightness depends not only on object density, but also on settings of the device to avoid influence of settings for an indicator, x-ray pictures were received under the certain dose of radiation identical on the entire period of research, also calculated relative indicators.
Results ofthe obtained data were statistically processed with use ofthe Microsoft Office Excel 2007 program. Calculated an arithmetic average (M), an error of an arithmetic average (m) and a confidential interval (CI) for 95 % reliability level (a < 0.05). Distinctions of averages considered reliable if confidential intervals weren't blocked.
Results of study. Dynamic control of a condition of regeneration of a bone tissue in the field of an implant, in various terms of supervision (1, 3, 6 months) showed that the obvious, accurately revealed distinctions are observed at the end of 3 months. Stabilization of process is registered at the end of the 6th month.
We consider this tendency on one case. On a place of the absent first premolar on the top jaw dental implantation was carried out on the right.
As a result of radiological researches it is established that at the time of carrying out surgery accurate contours of an alveolar bone are noted. A bone tissue round an operational bed without pathological changes. The good shape of radiological signs of the next tooth is noted.
Scientific justification of development of domestic attachments and their clinic-biomechanical assessment.
The periodontal crack of the next tooth in norm testifying to lack of inflammatory process in a bone tissue.
Later 1 month after operation blurring of contours on border an implant — a bone is noted. Again formed fabric, is visually uniform, and only in separate sites the trabecularity of a structure of a neoformed bone tissue is defined.
The top of an alveolar bone hasn't restored yet, has not accurate contours. The horizontal decrease of a bone tissue is in the field observed. In communication with what height of an alveolar bone is reduced.
At this case for the 3rd month after operation, filling of a gleam with a neoformed bone tissue with trabecular drawing on border implant — bone is observed. The top of an alveolar bone isn't restored yet, but already gets more equal contour. The neoformed bone tissue has mainly close-meshed trabecular structure.
For the 6th month of research, on a place of surgery it is noted neoformed bone by fabric with trabecular drawing.
The top of an alveolar bone isn't restored yet, but already gets more equal contour. The neoformed bone tissue on all length of an implant found trabecular structure, completely identical with a surrounding bone tissue. The horizontal decrease of an alveolar bone visually hasn't observed.
On other 11 dogs similar research during which direct dependence of increase in density of a bone round a dental implant from the terms which passed from the moment of operation was observed was conducted. Strengthening of osteoreparative processes is reflected in
an operational field on average a gain of x-ray density of a bone and smaller degree of a decrease of a bone tissue of an alveolar shoot.
Positive dynamics of processes of an osteointegration is reached by 6th month, the regeneration which is noted density on border an implant — the confidant's bone to an initial indicator. It is coordinated with the data of Robustova T. G. (2005) who reports about existence of a small trabecular bone in 2-3 months after the performed operation. Though density of a neoformed bone during this period is less than control value, according to Kulakov A. A. (2004) in 6 months it comes nearer to that own bone.
Thus, by results of radiological research and densitometry it is possible to claim about positive dynamics of processes of osteointegration with use of a domestic dental implant.
The radiological data obtained by us testify to existence of a bone tissue in the field of surgery for the third month of research.
Conclusions
The conducted research showed a positive tendency of dynamic increase in density of a neoformed bone on border implant — bone during various periods of research. For definition of dynamics of process of regeneration of a bone tissue we recommend to conduct radiovisiography research with the computer analysis of x-ray images.
For an objective assessment of degree of a increase of a bone tissue and density of a neogenic bone in a hole we recommend to use the ImageJ program (Wayne Rasband. National Institute of Health, USA. http://rsb.info.nih.gov/ij).
References:
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Salimov Odilkhon, Associate professor, PhD, Tashkent state dental institute, Uzbekistan, Department of faculty orthopedic stomatology E-mail: [email protected]
Scientific justification of development of domestic attachments and their clinic-biomechanical assessment of effectiveness at a denture with use of implants
Abstract: Motivation to use of implantation artificial limbs are high esthetic and adaptation opportunities of such designs. However, treatment with use of implants has the increased risk of complications. Fixing of an orthopedic design to implants is the reason of one of widespread complications. Along with it, high cost of import production limits possibility of their broad application. Localization of development and production of latch fastenings from domestic materials will allow improving rendering the dentistry help to the population.
Keywords: attachment, dental implant, prostheses, clinical complications.
