{"id":3698,"date":"2015-10-25T09:34:59","date_gmt":"2015-10-25T09:34:59","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=3698"},"modified":"2020-04-25T09:20:46","modified_gmt":"2020-04-25T09:20:46","slug":"nano-hdroxyapatite-particulate-graft-in-immediate-implant-placement-a-review-of-10-cases","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol8octoberspledition\/nano-hdroxyapatite-particulate-graft-in-immediate-implant-placement-a-review-of-10-cases\/","title":{"rendered":"Nano Hdroxyapatite Particulate Graft in Immediate Implant Placement – A Review Of 10 Cases"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

The basis for modern dental implants is a biologic process called\u00a0osseointegration\u00a0where materials, such as\u00a0titanium, form an intimate bond to bone. Titanium is widely used as material for permanent implants in dental applications. Nanosized hydroxyapatite (HA) is the main component of mineral bone .The biomineralized HA layer acts as a bonding layer to the bone and integration at the atomic\/molecular scale can develop. For this reason HA is proposed as a suitable coating material to provide stronger early fixation of uncemented prosthesis. Although hydroxyapatite coatings on implants showed long-term survival [2],<\/sup> there are concerns about their reliability under loads. Hydroxyapatite\u00a0 nano particles possesses exceptional biocompatibility and bioactivity properties with respect to bone cells and tissues, probably due to its similarity with the hard tissues of the body The HA naturally occurring in bone is a multi-substituted calcium phosphate, including traces of CO32- , F-, Mg2+, Sr2+, Si4+, Zn2+, Li+ etc [3, 4].<\/sup> These ionic substitutions are considered to play an important role for the formation and properties of bone. The basic building block of bone tissue is mineralized collagen fibrils approximately 100 nm in diameter ,These fibrils are made of collagen fibers 300 nm long and 1 \u2013 1.5 nm thick. Within these fibrils are the hydroxyapatite crystals. They \u00a0usually form as thin flat plates parallel to the long axis of surrounding collagen fibers[5]<\/sup><\/p>\n

Case Report<\/strong><\/p>\n

This case report gives study of \u00a0implants which was\u00a0 placed immediately following\u00a0 an extraction\u00a0 , with placement of hydroxyapatite\u00a0 nanoparticles (HANANO<\/sup> ). The use of this \u00a0hydroxyapatite\u00a0 nanoparticles in this immediate implants provides more strength and stability to the implants , thus improvising the\u00a0 bone formation . The mechanism of osseointegration with faster and stronger bone formation, for better stability during the healing process, thus allowing more rapid loading of the implant 6,,7<\/sup>This study was done with\u00a0 10 patients \u00a0whose age group varied from 24- 53 yrs , The patient fulfilled the following required criteria before undergoing treatment ,a through detailed history was taken for any systemic disorders and routine blood investigations were done .Patient had fractured\u00a0 teeth in relation to 11 and 21(FIG 1). The\u00a0 patient was informed about the procedure and placement of hydroxyapatite nanoparticles ( synthetic bone particles)\u00a0 in detail and informed consent was taken. Pre operative OPG and IOPA (FIG 2) as taken and bone level\u00a0 sinus \u00a0was noted\u00a0\u00a0 .The teeth was extracted with\u00a0 care in preserving the buccal bones (FIG 3) , the implant was placed in the prepared\u00a0 socket(FIG 4) and \u00a0hydroxyapatite \u00a0nano \u00a0particles are placed surrounding the implant (FIG 5) and packed gently \u00a0and suturing was done.\u00a0 Immediate post operative radiograph of the implant reveals bone like mass surrounding the implant (FIG 6) ,<\/p>\n\n\n\n
\"figure<\/td>\nFigure 1: Pre Operative- Fractured Incisors<\/strong><\/p>\n

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\"figure<\/td>\nFigure 2: Pre Operativ Iopa<\/strong><\/p>\n

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\"figure<\/td>\nFigure 3: Atraumatic Extraction<\/strong><\/p>\n

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\"figure<\/td>\nFigure 4: Placement of Implants<\/strong><\/p>\n

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\"figure<\/td>\nFigure 5: Placement of Hydroxyapatite Nano Particles<\/strong><\/p>\n

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\"figure<\/td>\nFigure 6: Immediate Post Operative Iopa<\/strong><\/p>\n

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\"figure<\/td>\nFigure 7: Fifth Month Post Operative Opg<\/strong><\/p>\n

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These\u00a0 hydroxyapatite crystals get resorbed by four weeks\u00a0 thus inducing the osteoblast \u00a0effect surrounding the\u00a0 implant .These HA particles are three times more stronger than cortical bone hence gives good stability to implants and\u00a0 immediate \u00a0post operative \u00a0radiograph taken( FIG 6) ,following\u00a0 fifth month review was done ( FIG 7) and OPG reveals a definitive bone formation around the implant thus providing more stability and less\u00a0 chances of \u00a0failures of the implant\u00a0 less bone loss as noted comparatively to implants\u00a0 without hydroxyapatite nano\u00a0 particles.<\/p>\n

Discussion<\/strong><\/p>\n

This study shows that immediate implants with hydroxyapatite nano particles\u00a0 which is used to bridge the small gap between the implant a submerged surgical technique provides a clinically and radiographically\u00a0 good result\u00a0 of\u00a0 stability and bone formation . The quality of implant surface influences wound healing at implantation site and subsequently\u00a0 affects osseointegration[6]<\/sup>. Hydroxyapatite nano particles increases the surface area of the implant , thus increasing the implant bone surface contact area and thereby implant stability. Synthetic hydroxyapatite is commercially available. Muller-Mai et al tested nanoapatite and nanoapatite\/organic implants in vivo. From their results, it was seen that both materials were suitable for bone replacement and for drug release such as antibiotics, growth factors or other substances. In addition, the organic component can be used to control physical properties in the bone implantation [7]<\/sup>The production is usually based on aqueous precipitation or conversion from other calcium rich material. While these methods are common for supplying the material in a bulk form, coating hydroxyapatite onto other material is 20 also common[8]<\/sup>. The aim\u00a0 of this study was to\u00a0 observe the bone formation and stability of implants with the hydroxyapatite nano particles which proved to have better results than immediate implants without any bone grafts . \u00a0Since hydroxyapatite is found in bone tissue and teeth, not only is it non-toxic but it would not be targeted by the immune system as foreign body. Therefore the local tissue inflammation and eventual scarring caused by an immunological response would not be an issue if hydroxyapatite were used.<\/p>\n

Conclusion<\/strong><\/p>\n

Review of these cases were with one year\u00a0 done and IOPA and OPG \u00a0revealed good density\u00a0 of bone formation Thus in this study we conclude that use of hydroxyapatite\u00a0 nanoparticles in\u00a0 the placement of the immediate implants provides good result in stability , less complication \u00a0and perform comparatively well than without bone graft .<\/p>\n

Reference<\/strong><\/p>\n

    \n
  1. Ellingsen J. A study on the mechanism of protein adsorption to TiO2. Biomaterials\u00a01991;12:593-596<\/li>\n
  2. Kido H, Saha S. Effect of HA coating on the long-term survival of dental implant: a\u00a0review of the literature. J Long Term Eff Med Implants 1996;6(2):119-133.<\/li>\n
  3. Dorozhkin SV, Epple M. Biological and medical significance of calcium phosphates.\u00a0Angew Chem Int Ed Engl 2002;41(17):3130-3146.<\/li>\n
  4. Vallet-Reg\u00ed M. Ceramics for medical applications. J Chem Soc, Dalton Trans 2001:97-108<\/li>\n
  5. Fratzl, Peter; Weinkamer, Richard (2007) Nature\u2019s Heirarchichal Materials, Progress in\u00a0Materials Science, in press, corrected proof, doi:10.1016\/j.pmatsci.2007.06.001.<\/li>\n
  6. Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: a systematic review. Clin Oral Implants Res 2009;20:172-184<\/li>\n
  7. Beutner R, Michael J, Schwenzer B, Scharnweber D. Biological nano-functionalization of titanium-based biomaterial surfaces: a flexible toolbox. J R Soc Interface 2010;7:S93-S105.<\/li>\n
  8. Albrektsson T, Lekholm U. Osseo-integration: Current state of art. Dent Clin north Am 1989;(4):537-54<\/li>\n
  9. Muller-Mai CM, Stupp SI, Voigt C, Gross KA. Nanoapatite and organoapatite implants in bone: Histology and ultrastructure of the interface. J Biomed Mater Res 1995; 29: 9-18<\/li>\n
  10. Ratner, Hoffman, Schoen, and Lemons (2004), Biomaterials Science, Second Edition: An Introduction to Materials in Medicine (Boston: American Press, 2004)<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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