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Title: Studies of the quality of the intraosseous dental implant bed and of thermal effects in implant pathology
Author: Wong, Kevan
Awarding Body: University of London
Current Institution: University College London (University of London)
Date of Award: 1999
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Dental implants give problems if there is deficient or poor quality host bone, particularly in the maxillary sinus region, and operations to augment the bone volume into which an implant is to be placed may be undertaken as a preliminary step in which particulate irradiated mineralised cancellous allograft can be employed. It was hypothesised, and demonstrated, that practical information might be obtained through analysis of trephine bone cores removed in creating the implant bed. Therefore, such cores were embedded and examined, mainly using quantitative backscattered electron imaging to study the quantity and the quality of bone. New bone formed as woven or lamellar bone on the allograft, which retained many of its original topographical and morphological characteristics. The bone volume fraction was found to be significantly greater within 5 mm of the original sinus floor. Biopsy core specimens from native sites in both maxilla and mandible were treated similarly. The highest mineralisation densities were found in the mandible, and the lowest in the posterior maxilla beneath the sinus floor. The results led to a proposal for a future bone quality scale to include mineralisation density, volume fraction and connectivity. Another aspect of success concerns vascularity of the implant/graft bed. To this end, the possible clinical use of Laser Doppler Flowmetry to confirm positive blood flow in grafts, sinus membrane, and oral tissues was assessed and proven. Heat conduction via dental implants may impair bone healing and survival: here, a theoretical study was undertaken, and this predicted food/drink heat to be an element in implant pathology. In addition, the possible influence of temperature on osteoclastic function in vitro was examined using a volumetric resorption pit assay: measured volumes and depths of resorption lacunae were increased at 41° and 43° C compared with the standard 37C temperature used in previous studies.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Tooth loss; Dentures; Maxillary sinus