Background. Biological barriers are commonly used to treat alveolar bone defects and guide tissue regeneration. Understanding the biological and mechanical properties of the available membranes is crucial for selecting the one that is optimal for enhancing clinical outcomes.Purpose. To evaluate the mechanical behavior of three different collagen membranes to increasing tensile force in dry and wet conditions.Materials and Methods. Three commercially collagen membranes were selected for analysis: Bio-Gide® (Geistlich Biomaterials, Baden-Baden, Germany), Remaix™ (RX; Matricel GmbH, Herzogenrath, Germany), and Ossix Plus® (Datum Dental Biotech, Lod, Israel). Increasing tensile forces were applied on 10 dry and wet membranes of standard size via a loading machine. Force and extension values were acquired up to maximum load before failure, and maximum stress, maximum extension, and amount of energy needed for membrane tearing were analyzed. Membranes’ densities were also calculated.Results. The Remaix membrane exhibited the highest values of maximum load tensile strength, maximum extension, and maximum energy required for membrane tearing, followed by Bio-Gide. Ossix Plus had the lowest scores in all these parameters. Dry membranes had the highest scores for all parameters except extension. Membrane density was directly and significantly correlated with all tested parameters.Conclusions. The study was undertaken to provide clinicians with data upon which to base the selection of collagen membranes in order to achieve optimal clinical results. It emerged that the mechanical properties of dry and wet collagen membranes were significantly different from one another. Among the 3 tested membranes, Remaix exhibited higher performance results in all the mechanical tests. Collagen membrane density seems to have a significant influence upon mechanical resistance. These findings may also guide manufacturers in improving the quality of their product.

Primary implant stability can be evaluated at the time of placement by measuring the insertion torque (IT). However, another method to monitor implant stability over time is resonance frequency analysis (RFA). Our aim was to examine the effect of bone type, implant design, and implant length on implant primary stability as measured by IT and two RFA devices (Osstell and Penguin) in an in vitro model. Ninety-six implants were inserted by a surgical motor in an artificial bone material, resembling soft and dense bone. Two different implant designs—conical connection (CC) and internal hex (IH), with lengths of 13 and 8 mm, were compared. The results indicate that the primary stability as measured by RFA and IT is significantly increased by the quality of bone (dense bone), and implant length and design, where the influence of dense bone is similar to that of CC design. Both the Osstell and Penguin devices recorded higher primary implant stability for long implants in dense bone, favoring the CC over the IH implant design. The CC implant design may compensate for the low stability expected in soft bone, and dense bone may compensate for short implant length if required by the anatomical bone conditions.

Our aim was to analyze the correlation between the IT evaluated by a surgical motor and the primary implant stability (ISQ) measured by two RFA devices, Osstell and Penguin, in an in vitro model. This study examines the effect of bone type (soft or dense), implant length (13 mm or 8 mm), and implant design (CC: conical connection; IH: internal hexagon), on this correlation. Ninety-six implants were inserted using a surgical motor (IT) into two types of synthetic foam blocks. Initial measurements for both the peak IT and ISQ were recorded at the point when implant insertion was stopped by the surgical motor, and the final measurements were recorded when the implant was completely inserted into the synthetic blocks using only the RFA devices. Our null hypothesis was that there is a good correlation between the devices, independent of the implant length, design, or bone type. We found a positive, significant correlation between the IT, and the Osstell and Penguin devices. Implant length and bone type did not affect this correlation. The correlation between the devices in the CC design was maintained; however, in the IH design it was maintained only between the RFA devices. We concluded that there is a high positive correlation between the IT and ISQ from a mechanical perspective, which was not affected by bone type or implant length but was affected by the implant design.

Objectives: To evaluate the effectiveness of a Mg‐based membrane as a barrier for guided bone regeneration in rabbits calvaria.Materials and Methods: Nine rabbits had four critical size defects created in each calvarium, randomly filled with a blood clot or bovine xenograft. One side was covered with the Mg‐based membrane, and the control was left without membrane. After 8 weeks, histomorphometric analysis was performed to compare new bone formation with the pristine bone.Results: Mg‐supported membrane for guided bone regeneration (GBR) is safe and promotes bone formation in critical size defects (CSD) in a rabbit calvaria. Gas accumulation was observed in a third of the specimens due to membrane degradation. Histomorphometric analysis revealed greater bone formation in the defects grafted with the Mg membrane (4.85 ± 1.73 mm²) compared to the blood clot (2.14 ± 2.22 mm²). Treating lesions with filler or the magnesium membrane resulted in significantly higher bone formation in all three examined regions (25%–62%). New bone formation was observed beyond the original bone envelope.Conclusion: Mg‐based membrane supports guided bone regeneration (GBR), and when used in combination with a bone graft, enhances the performance despite the gas accumulation associated with membrane degradation.Clinical Relevance: Limited data exist on the use of Mg‐based membranes in GBR and its effect on bone formation.

Introduction: This in vitro study investigates the impact of blood, saliva, and chlorhexidine contamination on the reverse torque values (RTVs) of healing abutments in two types of implant‐abutment connections: internal hex and conical.Methods: A total of 88 Ti6Al4V titanium alloy dental implants were tested, comprising two types of connections: internal hex (n = 44, MIS Seven) and conical (n = 44, MIS C1). Each group was further divided into four subgroups (n = 11) based on the type of contamination medium used. Healing abutments were tightened onto the implant fixtures using a torque of 25 Ncm with the designated medium, followed by retightening after a 10‐min interval. After a two‐week incubation period, reverse torque values (RTVs) were recorded using a digital torque gauge. To assess differences between the implant systems within the same medium, as well as differences between the medium types within the same implant system, the Welch two‐sample t‐test was employed. Additionally, linear regression analysis was conducted to evaluate the interaction between medium types and the implant systems.Results: For MIS Seven implants, RTVs were consistently lower than the initial 25 Ncm torque across all contamination groups. In contrast, for MIS C1 implants, RTVs exceeded 25 Ncm in the saliva and blood contamination groups; however, the presence of chlorhexidine reduced the RTVs. A comparative analysis revealed that the C1 conical connection required significantly higher RTVs than the Seven internal hex system (coefficient = 3.318). No significant differences were observed between implant systems in the control and chlorhexidine groups. However, the C1 system required higher RTVs than the Seven system in the presence of saliva (p = 0.0006) and blood (p = 0.00009). Furthermore, the interaction analysis indicated that in the presence of saliva and blood contamination, C1 implants required significantly higher RTVs, with mean differences of 7.18 and 4.9 (Ncm), respectively, compared to the Seven implants.Conclusions: Conical implant‐abutment connections generally require higher RTVs for abutment disconnection compared to internal hex connections. Both implant connection and the type of contaminant significantly affect RTVs. Chlorhexidine has been shown to reduce reverse torque for both types of connections. In contrast, contamination with saliva and blood tends to increase reverse torque, particularly for conical connections.

Malpositioned and broken implants are usually fully osseointegrated; hence, their removal, especially from the lower arch, can be very challenging. Implant removal techniques include reverse torque and trephination. Trephination is an invasive technique that can jeopardize vital structures, cause mandibular fatigue fractures, or lead to osteomyelitis. In this study, we aimed to assess the relationship between trephination depth and implant stability by recording implant stability quotient (ISQ) readings at varying trephination depths in vitro. Materials and methods: Forty-eight implants were inserted into dense synthetic polyurethane foam blocks as artificial bone. Primary implant stability was measured with a Penguin resonance frequency analysis (RFA) device. Implants of two designs with a diameter of 3.75 mm and a length of 13 or 8 mm were inserted. Twenty-four internal hexagon (IH) (Seven^®) and twenty-four conical connection (CC) implants (C1^®; MIS^® Implants, Ltd., Misgav, Israel) were used. The primary implant stability was measured with the RFA device. Trephination was performed, and implant stability was recorded at depths of 0, 3, and 6 mm for the 8 mm implants and 0, 3, 6, 8, 10, and 11.5 mm for the 13 mm implants. Results: Linear regression revealed a significant relation between the trephination depth and the ISQ (F (1, 213) = 1113.192, p < 0.001, adjusted r2 = 0.839). The trephination depth significantly predicted the ISQ (β = −5.337, p < 0.001), and the ISQ decreased by −5.33 as the trephination depth increased by 1 mm. Conclusion: Implant stability reduction as measured using an RFA device during trephination may be a valuable guide to achieving safe reverse torque for implant removal. Further studies are needed to evaluate these data in clinical settings.