| 1. |
- Halldin, Anders, et al.
(author)
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The effect of static strain
- 2012
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In: AstraTech World Congress, May 9-12, 2012, Göteborg, Sweden.
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Conference paper (other academic/artistic)
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| 2. |
- Sul, Young-Taeg, 1960, et al.
(author)
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Characteristics of the surface oxides on turned and electrochemically oxidized pure titanium implants up to dielectric breakdown: the oxide thickness, micropore configurations, surface roughness, crystal structure and chemical composition.
- 2002
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In: Biomaterials. - 0142-9612 .- 1878-5905. ; 23:2, s. 491-501
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Journal article (peer-reviewed)abstract
- Titanium implants have been used widely and successfully for various types of bone-anchored reconstructions. It is believed that properties of oxide films covering titanium implant surfaces are of crucial importance for a successful osseointegration, in particular at compromized bone sites. The aim of the present study is to investigate the surface properties of anodic oxides formed on commercially pure (c.p.) titanium screw implants as well as to study 'native' oxides on turned c.p. titanium implants. Anodic oxides were prepared by galvanostatic mode in CH3COOH up to the high forming voltage of dielectric breakdown and spark formation. The oxide thicknesses, measured with Auger electron spectroscopy (AES), were in the range of about 200-1000 nm. Barrier and porous structures dominated the surface morphology of the anodic film. Quantitative morphometric analyses of the micropore structures were performed using an image analysis system on scanning electron microscopy (SEM) negatives. The pore sizes were
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| 3. |
- Sul, Young-Taeg, 1960, et al.
(author)
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Optimum surface properties of oxidized implants for reinforcement of osseointegration: surface chemistry, oxide thickness, porosity, roughness, and crystal structure
- 2005
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In: International Journal of Oral & Maxillofacial Implants. - Chicago, Ill. : Quintessence Pub. Co.. - 0882-2786 .- 1942-4434. ; 20:3, s. 349-59
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Journal article (peer-reviewed)abstract
- PURPOSE: To investigate detailed surface characterization of oxidized implants in a newly invented electrolyte system and to determine optimal surface oxide properties to enhance the bone response in rabbits. MATERIALS AND METHODS: A total of 100 screw-type titanium implants were prepared and divided into 1 control group (machine-turned implants) and 4 test groups (magnesium ion-incorporated oxidized implants). Forty implants were used for surface analyses. A total of 60 implants, 12 implants from each group, were placed in the tibiae of 10 New Zealand white rabbits and measured with a removal torque test after a healing period of 6 weeks. RESULTS: For the test groups, the oxide thicknesses ranged from about 1,000 to 5,800 nm; for the control group, mean oxide thickness was about 17 nm. The surface morphology showed porous structures for test groups and nonporous barrier film for the control group. Pore diameter ranged from < or = 0.5 microm to < or = 3.0 microm. In regard to surface roughness, arithmetic average height deviation (Sa) values varied from 0.68 to 0.98 microm for test implants and 0.55 microm for control implants; developed surface ratio (Sdr) values ranged from 10.6% to 46% for the test groups and were about 10.6% for the control group. A mixture of anatase and rutile-type crystals were observed in the test groups; amorphous-type crystals were observed in the control group. After a healing period of 6 weeks, removal torque measurements in all 4 test groups demonstrated significantly greater implant integration as compared to machine-turned control implants (P < or = .033). DISCUSSION: Determinant oxide properties of oxidized implants are discussed in association with bone responses. Of all surface properties, RTVs were linearly increased as relative atomic concentrations of magnesium ion increase. CONCLUSIONS: Surface properties of the oxidized implants in the present study, especially surface chemistry, influenced bone responses. The surface chemistry of the optimal oxidized implant should be composed of approximately 9% magnesium at relative atomic concentration in titanium oxide matrix and have an oxide thickness of approximately 1,000 to 5,000 nm, a porosity of about 24%, and a surface roughness of about 0.8 microm in Sa and 27% to 46% in Sdr; its oxide crystal structure should be a mixture of anatase- and rutile-phase crystals.
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| 4. |
- Sul, Young-Taeg, 1960, et al.
(author)
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Oxidized implants and their influence on the bone response.
- 2001
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In: Journal of Materials Science: Materials in Medicine. - 0957-4530. ; 12:10-12, s. 1025-31
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Journal article (peer-reviewed)abstract
- Surface oxide properties are regarded to be of great importance in establishing successful osseointegration of titanium implants. Despite a large number of theoretical questions on the precise role of oxide properties of titanium implants, current knowledge obtained from in vivo studies is lacking. The present study is designed to address two aspects. The first is to verify whether oxide properties of titanium implants indeed influence the in vivo bone tissue responses. The second, is to investigate what oxide properties underline such bone tissue responses. For these purposes, screw-shaped/turned implants have been prepared by electrochemical oxidation methods, resulting in a wide range of oxide properties in terms of: (i) oxide thickness ranging from 200 to 1000 nm, (ii) the surface morphology of barrier and porous oxide film structures, (iii) micro pore configuration - pore sizes<8 microm by length, about 1.27 microm2 to 2.1 microm2 by area and porosity of about 12.7-24.4%, (iv) the crystal structures of amorphous, anatase and mixtures of anatase and rutile type, (v) the chemical compositions of TiO2 and finally, (vi) surface roughness of 0.96-1.03 microm (Sa). These implant oxide properties were divided into test implant samples of Group II, III, IV and V. Control samples (Group I) were turned commercially pure titanium implants. Quantitative bone tissue responses were evaluated biomechanically by resonance frequency analysis (RFA) and removal torque (RT) test. Quantitative histomorphometric analyses and qualitative enzyme histochemical detection of alkaline (ALP) and acidic phosphatase (ACP) activities were investigated on cut and ground sections after six weeks of implant insertion in rabbit tibia. In essence, from the biomechanical and quantitative histomorphometric measurements we concluded that oxide properties of titanium implants, i.e. the oxide thickness, the microporous structure, and the crystallinity significantly influence the bone tissue response. At this stage, however, it is not clear whether oxide properties influence the bone tissue response separately or synergistically. Copyright 2001 Kluwer Academic Publishers
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| 5. |
- Sul, Young-Taeg, 1960, et al.
(author)
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Resonance frequency and removal torque analysis of implants with turned and anodized surface oxides.
- 2002
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In: Clin Oral Implants Res. - 0905-7161. ; 13:3, s. 252-9
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Journal article (peer-reviewed)abstract
- The present experimental study was designed to address two issues. The first was to investigate whether oxide properties of titanium implants influenced bone tissue responses after an in vivo implantation time of six weeks. If such a result was found, the second aim was to investigate which oxide properties are involved in such bone tissue responses. Screw-shaped implants with a wide range of oxide properties were prepared by electrochemical oxidation methods, where the oxide thickness varied in the range of 200 nm to 1000 nm. The surface morphology was prepared in two substantially different ways, i.e. barrier and porous oxide film structures. The micropore structure revealed pore sizes of 8 microm in diameter, with a range in opening area from 1.27 microm 2 to 2.1 microm 2. Porosity ranged from 12.7% to 24.4%. The crystal structures of the titanium oxide were amorphous, anatase and a mixture of anatase and rutile type. The chemical compositions consisted mainly of TiO2. Surface roughness ranged from 0.96 microm to 1.03 microm (Sa). Each group of test samples showed its own, defined status with respect to these various parameters. The oxide properties of turned commercially pure titanium implants were used in the control group, which was characterized by an oxide thickness of 17.4 +/- 6.2 nm, amorphous type in crystallinity, TiO2 in chemical composition, and a surface roughness of 0.83 microm (Sa). Bone tissue responses were evaluated by resonance frequency measurements and removal torque tests that were undertaken six weeks after implant insertion in rabbit tibia. Implants that had an oxide thickness of approximately 600, 800 and 1000 nm demonstrated significantly stronger bone responses in the evaluation of removal torque values than did implants that had an oxide thickness of approximately 17 and 200 nm (P < 0.05). However, there were no difference between implants with oxide thicknesses of 17 and 200 nm (P = 0.99). It was concluded that oxide properties of titanium implants, which include oxide thickness, micropore configurations and crystal structures, greatly influence the bone tissue response in the evaluation of removal torque values. However, it is not fully understood whether these oxide properties influence the bone tissue response separately or synergistically.
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| 6. |
- Wennerberg, Ann, 1955, et al.
(author)
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Titanium release from implants prepared with different surface roughness
- 2004
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In: Clin Oral Implants Res. ; 15:5, s. 505-12
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Journal article (peer-reviewed)abstract
- OBJECTIVES: There may be a risk of greater ion release for surface-enlarged implants than conventionally turned components. The major aim of the present paper was to investigate whether a correlation exists between ion release and a surface roughness relevant for today's commercial implants. Other aims were to compare ion release after two insertion times and concentration in bone tissue as a function of distance from the implant surface. MATERIAL AND METHODS: Lactic acid aqueous solution (pH=2.3) and phosphate-buffered saline were used for the in vitro investigation. For the in vivo investigation, synchrotron radiation X-ray fluorescence (SRXRF) spectroscopy and secondary ion mass spectroscopy (SIMS) were performed 12 weeks and 1 year after implantation in rabbit tibiae. RESULTS: The average height deviation (S(a)) was 0.7, 1.27, 1.43 and 2.21 microm, respectively, for the four surfaces investigated. No difference in ion release was found in vitro. In vivo, SRXRF demonstrated slightly higher values for the roughest surface up to a distance of 400 microm from the implant surface; thereafter no difference was found. SIMS demonstrated no difference in ion release for the roughest and smoothest surfaces, but slightly more titanium in bone tissue after 1 year than after 12 weeks. Titanium rapidly decreased with distance from the implant surface. CONCLUSION: At a level relevant for commercial oral implants, no correlation was found between increasing roughness and ion release, neither in vitro nor in vivo.
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| 7. |
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| 8. |
- Albrektsson, Tomas, 1945, et al.
(author)
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An Imbalance of the Immune System Instead of a Disease Behind Marginal Bone Loss Around Oral Implants: Position Paper
- 2020
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In: The International journal of oral & maxillofacial implants. - : Quintessence Publishing. - 1942-4434 .- 0882-2786. ; 35:3, s. 495-502
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Journal article (peer-reviewed)abstract
- PURPOSE: The purpose of this paper is to present evidence that supports the notion that the primary reason behind marginal bone loss and implant failure is immune-based and that bacterial actions in the great majority of problematic cases are of a secondary nature. MATERIALS AND METHODS: The paper is written as a narrative review. RESULTS: Evidence is presented that commercially pure titanium is not biologically inert, but instead activates the innate immune system of the body. For its function, the clinical implant is dependent on an immune/inflammatory defense against bacteria. Biologic models such as ligature studies have incorrectly assumed that the primary response causing marginal bone loss is due to bacterial action. In reality, bacterial actions are secondary to an imbalance of the innate immune system caused by the combination of titanium implants and ligatures, ie, nonself. This immunologic imbalance may lead to marginal bone resorption even in the absence of bacteria. CONCLUSION: Marginal bone loss and imminent oral implant failure cannot be properly analyzed without a clear understanding of immunologically caused tissue responses.
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| 9. |
- Albrektsson, Tomas, 1945, et al.
(author)
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healing response
- 2008
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In: osseointegration. - : Quintessence Publishing Co, Inc. - 9780867154795 ; , s. 47-50, s. 51-57
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Book chapter (other academic/artistic)
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| 10. |
- Albrektsson, Tomas, 1945, et al.
(author)
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On inflammation-immunological balance theory—A critical apprehension of disease concepts around implants: Mucositis and marginal bone loss may represent normal conditions and not necessarily a state of disease
- 2019
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In: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 21:1, s. 183-189
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Journal article (peer-reviewed)abstract
- Background: Oral implants have displayed clinical survival results at the 95%-99% level for over 10 years of follow up. Nevertheless, some clinical researchers see implant disease as a most common phenomenon. Oral implants are regarded to display disease in the form of mucositis or peri-implantitis. One purpose of the present article is to investigate whether a state of disease is necessarily occurring when implants display soft tissue inflammation or partially lose their bony attachment. Another purpose of this article is to analyze the mode of defense for implants that are placed in a bacteria rich environment and to analyze when an obtained steady state between tissue and the foreign materials is disturbed. Materials and Methods: The present article is authored as a narrative review contribution. Results: Evidence is presented that further documents the fact that implants are but foreign bodies that elicit a foreign body response when placed in bone tissue. The foreign body response is characterized by a bony demarcation of implants in combination with a chronic inflammation in soft tissues. Oral implants survive in the bacteria-rich environments where they are placed due to a dual defense system in form of chronic inflammation coupled to immunological cellular actions. Clear evidence is presented that questions the automatic diagnostics of an oral implant disease based on the finding of so called mucositis that in many instances represents but a normal tissue response to foreign body implants instead of disease. Furthermore, neither is marginal bone loss around implants necessarily indicative of a disease; the challenge to the implant represented by bone resorption may be successfully counteracted by local defense mechanisms and a new tissue-implant steady state may evolve. Similar reactions including chronic inflammation occur in the interface of orthopedic implants that display similarly good long-term results as do oral implants, if mainly evaluated based on revision surgery in orthopedic cases. The most common mode of failure of orthopedic implants is aseptic loosening which has been found coupled to a reactivation of the inflammatory- immune system. Conclusions: Implants survive in the body due to balanced defense reactions in form of chronic inflammation and activation of the innate immune system. Ten year results of oral and hip /knee implants are hence in the 90+ percentage region. Clinical problems may occur with bone resorption that in most cases is successfully counterbalanced by the defense/healing systems. However, in certain instances implant failure will ensue characterized by bacterial attacks and/or by reactivation of the immune system that now will act to remove the foreign bodies from the tissues.
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