kajiwara etal 1015

7212019 Kajiwara Etal 1015

httpslidepdfcomreaderfullkajiwara-etal-1015 15

Soft Tissue Biological Response to

Zirconia and Metal Implant AbutmentsCompared With Natural ToothMicrocirculation Monitoring as

a Novel Bioindicator

Norihiro Kajiwara DDS Chihiro Masaki DDS PhDdagger Taro Mukaibo DDS PhDDagger Yusuke Kondo DDS PhDsect

Tetsuji Nakamoto DDS PhDk and Ryuji Hosokawa DDS PhDpara

Due to the recent development of computer-assisted designing computer-assisted manufactur-

ing ceramic materials such as glassceramics poly-crystalline alumina andzirconia-based ceramics have begun tobe used as dental materials1 In particu-lar zirconia is widely applied clinicallyas a substriate for conventional metalsand it is used in crowns and copings for natural teeth and in the framework of 1047297xed partial dentures2 Given its excel-lent strength and resistance to fracturezirconia has begun to be used widely indentistry3ndash5 furthermore in dentalimplant treatment as the price of zirco-nia is more stable than that of noblemetals it is used in abutments andimplant-supported all-ceramic zirconia

frameworks6 Moreover because zirco-nia offers suf 1047297cient strength andesthetic properties without the risk of releasing metal ions it is an implant 1047297xture material expected to replaceconventional titanium implants for pa-tients with metal allergies7 Reportsindicate signi1047297cantly reduced bone lossaround zirconia implants comparedwith titanium implants8 and that zirco-

nia accumulates less bacterial plaque

than titanium910 suggest the high bio-compatibility of the material Given itsexcellent mechanical properties andbiocompatibility zirconia has gainedwide acceptance as a dental material11

High-strength ceramics such as alu-mina and zirconia have also been devel-oped as implant abutment materials1213

The advantages of ceramic abutmentsinclude less mucosal discoloration com-

pared with metal abutments

14

less

Graduate Student Department of Oral Reconstruction andRehabilitation Graduate School Kyushu Dental UniversityFukuoka Japandagger Assistant Professor Department of Oral Reconstruction andRehabilitation Kyushu Dental University Fukuoka Japan

Dagger Assistant Professor Department of Oral Reconstruction andRehabilitation Kyushu Dental University Fukuoka JapansectAssistant Professor Department of Oral Reconstruction andRehabilitation Kyushu Dental University Fukuoka Japank Associate Professor Department of Oral Reconstruction andRehabilitation Kyushu Dental University Fukuoka JapanparaProfessor Department of Oral Reconstruction andRehabilitation Kyushu Dental University Fukuoka Japan

Reprint requests and correspondence to Chihiro

Masaki DDS PhD Department of Oral Reconstruction and Rehabilitation Kyushu Dental University 2-6-1 Manazuru Kokurakita Kitakyushu Fukuoka 803-

8580 Japan Phone +81-93-285-3100 Fax +81-93- 592-3230 E-mail masakikyu-dentacjp

ISSN 1056-61631502401-037Implant Dentistry

Volume 24 Number 1Copyright copy 2014 by Lippincott Williams amp Wilkins

DOI 101097ID0000000000000167

Introduction Zirconia is often

used for implant abutments for es-

thetics The aim of this clinical study

was to compare the effects of zirco-

nia and metal abutments on periim-

plant soft tissue

Materials and Methods Ten

maxillary anterior implant patients

5 with metal abutments and 5 with

zirconia abutments were enrolled in

this trial The soft tissue around the

implant abutments was evaluated by

2-dimensional laser speckle imaging

and thermography The blood 1047298 ow in

soft tissue around natural teeth was

also measured to correct for differ-

ences among the subjects

Results Signi 1047297cantly greater

blood 1047298 ow was detected in the

zirconia abutment group (9564 6

517) relative to the metal abut-

ment group (8225 6 892) in free

gingiva (P frac14 00317) Reduced

blood 1047298 ow (by almost 18) was de-

tected in the tissue surrounding

metal abutments compared with

the tissue surrounding natural teeth

The surface temperature showed no

signi 1047297cant difference for all meas-

urements

Conclusions These results sug-

gest that blood 1047298 ow in tissue sur-

rounding zirconia abutments is

similar to that in soft tissue around

natural teeth Moreover zirconia

abutments could be advantageous

for the maintenance of immune func-

tion by improving blood circulation

(Implant Dent 20152437 ndash 41)

Key Words blood 1047298 ow laser speckle imaging thermograph zirconia abutment

IMPLANT DENTISTRY VOLUME 24 NUMBER 1 2015 37



bacterial adhesion compared with tita-nium abutments and in animal studiesmore favorable soft tissue integrationcompared with titanium abutments15

Although high-strength ceramics suchas alumina and zirconia generally have

high fracture resistance zirconia in par-ticular has suf 1047297cient fracture resistancefor use as an abutment material Zirconia abutments supporting anterior and pre-molar single crowns have shown highsurvival rates in some studies16ndash18 anda high 5-year survival rate was reportedin a randomized-controlled clinical trialof zirconia and titanium abutments inposterior regions19

For the long-term stability of favor-able outcomes following implant treat-ment thehealth of thesoft tissuearound

implants must be maintained (ie plaquecontrol and blood 1047298ow preservation areindispensable) In bone-level implantsbecause implant abutments come intocontact with the soft tissue around theimplants selection of the implant abut-ment material is considered very impor-tant for the health of periimplant soft tissue However the effects of theimplant abutment material on the peri-implant mucosa particularly on itsblood 1047298ow have not been clari1047297ed Inthis study therefore we selected zirco-

nia which is used widely as an implant abutment material because of its excel-lent esthetic properties and biocompat-ibility and compared the effects of zirconia and metal abutments on peri-implant soft tissue by evaluating themicrocirculatory dynamics and surfacetemperature

MATERIALS AND METHODS

Subjects

This study was performed with the

approval of the Ethics Committee of Kyushu Dental College (FukuokaJapan nos 10 ‒ 25) Subjects were cho-sen from those who had undergoneimplant placement in the anterior max-illa at Kyushu Dental College Hospital(Fukuoka Japan) and showed a favor-able prognosis no signs of surroundingbone resorption on a follow-up dentalx-ray and no signs of soft tissue in1047298am-mation The patients received a detailedexplanation of the study and then

signed a consent form Those who had

Fig 1 Examples of acquired images A Oral photograph (11 is a natural tooth 12 is animplant-supported prosthesis) B Blood 1047298ow image The color scale shows the blood 1047298owfrom 0 (dark blue) to 64 mL $minminus1$100 gminus1 tissue (red) C Thermograph The color scaleshows the surface temperature from 32 (dark blue) to 375degC (red) D Regions of interestBfree gingivaC free gingiva (implant)O attached gingiva attached gingiva (implant)h

alveolar mucosa and n alveolar mucosa (implant)

Fig 2 Blood 1047298ow and surface temperature around implants versus natural teeth Blood 1047298owfrom LSI (left panels) and surface temperature from thermograph (right panels) in free gingiva( A and D ) attached gingiva (B and E ) and alveolar mucosa (C and F ) was compared betweenimplants and natural teeth P 005 with paired t test Signi1047297cantly greater blood 1047298ow wasdetected in natural teeth relative to implants in free gingiva and attached gingiva (free gingivaP frac14 00055 attached gingiva P frac14 00052) The surface temperature was signi1047297cantly higherin the implant in free gingiva (P frac14 00079)

38 SOFT TISSUE BIOLOGICAL RESPONSE TO ZIRCONIA AND METAL IMPLANT ABUTMENTS K AJIWARA ET AL



a systemic disease such as diabetes or blood-blood vessel disease wereexcluded A total of 10 subjects wereincluded in the study (mean age 51years range 21ndash78 years 5 men and5 women)

Blood Flow and Surface

Temperature Imaging

Blood 1047298ow was monitored witha 2-dimensional blood 1047298ow analysismachine using infrared laser speckleimaging (LSI 780 nm) (OZ-1 Omega-wave Tokyo Japan) its effective mea-suring depth was within 1 mm of thesurfaceACCDcamerawassetataright angle to the buccal surface at a 25-cm distance and 10 images were obtainedfrom each subject Subjects were asked

to wear goggles (YL331 YamamotoKogaku Co Ltd HigashiosakaJapan) to avoid possible eye discom-fort The surface temperature was thenmonitored by thermography (ThermoGEAR NEC Avio Tokyo Japan) at a 10-cm distance to obtain 43 cm highand 57 cm wide images Additionallya spot thermometer (Thermo-Hunter PT-7LD Optics Co Ltd Otsu Japan)was used to verify the temperaturefrom the thermograph Subjects wereasked to remain quiet on a dental chair

for at least 10 minutes before eachmeasurement Blood 1047298ow imaging andtemperature measurements were thenperformed

Data Analysis

Ten-pixel regions of interest (ROIs) were set on the buccal freegingiva attached gingiva interdentalpapilla implant-dental papilla andalveolar mucosa for blood 1047298ow imag-ing as shown in Figure 1

Temperature data were also ob-

tained from the thermograph in refer-ence to the ROI on blood 1047298ow imagesFor the comparison of blood 1047298owbetween zirconia and metal abutmentsour values were corrected by the valueon the gingiva surrounding adjacent natural teeth A paired t test was usedto compare the subjectsrsquo natural teethand implants The Mann-Whitney test was used for comparisons betweenabutments In all cases P 005 wasconsidered to indicate a signi1047297cant

difference

RESULTS

Laser Speckle Imaging

Implants versus natural teeth (Figure 2)Signi1047297cantly greater blood 1047298ow wasdetected in natural teeth (25808 65370 mL$minminus1$100 gminus1 tissue) thanin implants (22628 6 5182mL$minminus1$100gminus1 tissue) in the free gin-

giva (P frac14 00055) and attached gingiva

(tooth 25362 6 4685 implant 226826 6084 mL$minminus1$100 gminus1 tissue P frac1400052) however there was no signif-icant difference in the alveolar mucosa (tooth 25703 6 8985 implant253626 4685 mL$minminus1$100gminus1 tis-sue P frac14 019)

Zirconia versus metal abutments(Figure 3) As a result of correction in

the value of natural teeth the blood1047298

ow

Fig 3 Blood 1047298ow and the surface temperature around zirconia abutments (ZA) versus metalabutments (MA) Relative blood 1047298ow from LSI (left panels) and surface temperature from ther-mograph (right panels) in free gingiva ( A and D ) attached gingiva (B and E ) and alveolar mucosa(C and F ) was compared between zirconia and metal abutments Relative blood 1047298ow values werecorrected by the value on the gingiva surrounding adjacent natural teeth P 005 with Mann-Whitney test Signi1047297cantly greater blood 1047298ow was detected with a zirconia abutment (9564 6517) relative to a metal abutment (8225 6 893) in free gingiva (P frac14 00317)




wassigni1047297cantly higherin zirconia abut-ments (9564 6 517) than in metalabutments (8225 6 893) in the freegingiva (P frac14 00317) however therewas no signi1047297cant difference in theattached gingiva (zirconia 8870 6

1151 metal 88016

1022) or alve-olar mucosa (zirconia 8492 6 959metal 10834 6 2659)

Temperature Measurement

Using Thermography

Implants versus natural teeth Thesurface temperature was signi1047297cantlyhigher in implants (33976 134 tooth3361degC 6 145degC) than in naturalteeth (3361degC 6 145degC) in the freegingiva (P frac14 00079) however there

was no signi1047297

cant difference in theattached gingiva (implant 3363 6142 tooth 3358degC 6 122degC) or alveolar mucosa (implant 3427 6136 tooth 3416degC 6 134degC)

Zirconia versus metal abutments Thesurface temperatures were not signi1047297-cantly different among the free gingiva (zirconia 34466172 metal 3348degC6068degC) attached gingiva (zirconia3421 6 189 metal 3305degC 6

035degC) and alveolar mucosa (zirconia35026 142 metal 3551degC6 085degC)

DISCUSSION

Recently blood 1047298ow has attractedattention as a method of assessing oralsoft tissue and noncontrast and noninva-sive laser Doppler 1047298owmetry (LDF) wasdeveloped to evaluate blood 1047298ow inmarginal tissue2021The use ofan infraredlaser to irradiate red blood cells in micro-vessels causes re1047298ection and scatteringand the Doppler shift causes a frequencychange between the incidence and re1047298ec-

tion that is proportionate to the blood1047298ow In dentistry much research hasbeenconducted using this method includinganalyses of the relationship between peri-odontaldisease andgingivalblood1047298ow22

changes in gingival blood 1047298ow after peri-odontal surgery2324 and the relationshipbetween smoking and blood 1047298ow2526

However although LDF is advan-tageous for the real-time measurement of local microcirculatory dynamics asit is a technique for point measurement

with a narrow measuring range of

1 mm 2 comparing the blood 1047298owdynamics among different regions isdif 1047297cult and the technique has not beenapplied clinically To solve this prob-lem LSI was recently developed2728

These measurement methods are basi-

cally the same but in LSI a laser isapplied to the object of measurementand granular changes called specklesare rapidly scanned with a CCD camera and measured as an index of the blood1047298ow dynamics By LSI noncontactnoninvasive measurement is possibleand the blood 1047298ow dynamics are ex-tracted as 2-dimensional images andcaptured as visual information permit-ting blood 1047298ow measurement over a wide area as well as conventionalpoint measurement Also as multiple

ROIs can be displayed on the sameimage quantitative analyses (eg com-parison of the blood 1047298ow dynamicsamong sites at the same time point) havebecome possible Given these advan-tages LSI has been clinically appliedto cerebrovascular surgery29ndash31 skin dis-eases29ndash31andblood recoveryfromburninjury32

Moreover we found that 2-dimensional temperature measurement by thermography could be used toclarify the assessment of and diagnos-

tic criteria for soft tissues Thermogra-phy provides 2-dimensional images of temperature distribution similar toLSI and is used in many 1047297elds for a variety of purposes

Using these methods we evaluateddifferences in the blood 1047298ow and sur-face temperature between tissuesaround implants and natural teeth Wealso evaluated the effects of the abut-ment material on periimplant soft tissue We found that the blood 1047298owwas signi1047297cantly lower in periimplant

soft tissue than in soft tissue aroundnatural teeth in free and attached gin-giva These results are in agreement with those we reported previously33 Inaddition when comparisons were madeamong abutment types the blood 1047298owwas 4 lower in the zirconia groupand 18 lower in the metal groupthan in the free gingiva around naturalteeth indicating that a richer blood1047298owcan be secured in periimplant soft tissuearound zirconia than around metal abut-

ments(Pfrac1400317) Because the pocket

depth of the periimplant mucosa was2 mm in all patients and no bleedingwas noted on probing the effect of localin1047298ammation could be excluded

In contrast the proportion of leuko-cytes in the epithelium has been reported

to be lower around zirconia than titanium abutments or other cast-to-abutments34

suggesting the superiority of the mucosalseal of zirconia Also in vitro and in vivodata indicate that bacterial colonizationon the abutment surface differs by abut-ment type that the amount of plaqueattachment is signi1047297cantlysmaller on zir-conia than on titanium and that zirconia may be involved in the formation of theperiimplant mucosa These characteris-tics of zirconia may have affected theblood 1047298ow in this study The results of

this study suggest that zirconia abut-ments promote microcirculatory dynam-ics in periimplant mucosa that are closer to those around natural teeth Moreoversecuring a rich blood 1047298ow in soft tissuesaround implants is considered to beadvantageous for the maintenance of immune function

It is important to consider not only the resistance and esthetic prop-erties of abutment materials but alsotheir effects on soft tissues for long-term preservation of the health of

periimplant soft tissues However asvarious factors are involved in a com-plex manner in the selection of abut-ments for implant treatment it isnecessary to select an appropriateabutment design and material basedon the state of plaque control estheticeffect and prosthetic design in eachpatient

CONCLUSIONS

Blood 1047298ow in soft tissue around

zirconia abutments is similar to that around natural teeth and signi1047297cantlygreater blood 1047298ow was maintainedaround zirconia abutments comparedwith metal abutments Moreover zirco-nia abutmentscould be advantageous for the maintenance of immune function byimproving blood circulation

DISCLOSURE

The authors claim to have no1047297

nancial interest either directly or




indirectly in the products or informa-tion listed in the article

REFERENCES

1 Miyazaki T Nakamura T Matsumura Het al Current status of zirconia restoration

J Prosthodont Res 201357236ndash2612 Beuer F Schweiger J Eichberger M

et al High-strength CADCAM-fabricatedveneering material sintered to zirconiacopingsd A new fabrication mode for all-ceramic restorations Dent Mater 200925121ndash128

3 Gargari M Gloria F Cappello A et alStrength of zirconia 1047297xed partial denturesReview of the literature Oral Implantol (Rome) 2010315ndash24

4 Tinschert J Zwez D Marx R et alStructural reliability of alumina- feldspar-leucite- mica- and zirconia-based ceramic

J Dent 200028529ndash5355 Takaba M Tanaka S Ishiura Y

et al Implant-supported 1047297xed dentalprostheses with CADCAM-fabricatedporcelain crown and zirconia-based frame-work J Prosthodont 201322402ndash407

6 Pelaacuteez J Cogolludo PG Serrano Bet al A prospective evaluation of zirconiaposterior 1047297xed dental prostheses Three-year clinical results J Prosthet Dent2012107373ndash379

7 Andreiotelli M Wenz HJ Kohal RJet al Are ceramic implants a viable alter-native to titanium implants A systematic

literature review Clin Oral Implants Res20092032ndash47

8 Andersson B Schaumlrer P Simion Met al Ceramic implant abutments used forshort-span 1047297xed partial dentures A pro-spective 2-year multicenter study Int JProsthodont 199912318ndash324

9 Rimondini L Cerroni L Carrassi Aet al Bacterial colonization of zirconiaceramic surfaces An in vitro and in vivostudy Int J Oral Maxillofac Implants200217793ndash798

10 Scarano A Piattelli M Caputi Set al Bacterial adhesion on commercially

pure titanium and zirconium oxide disks An in vivo human study J Periodontol200475292ndash296

11 Piconi C Maccauro G Zirconia asa ceramic biomaterial Biomaterials 1999201ndash25

12 Denry I Kelly JR State of the art of zirconia for dental applications Dent Mater 200824299ndash307

13 Kim SS Yeo IS Lee SJ et al Clin-ical use of alumina-toughened zirconiaabutments for implant-supported restora-tion Prospective cohort study of survival

analysis Clin Oral Implants Res 201324517ndash52214 Jung RE Pjetursson BE Glauser

R et al A systematic review of the 5-yearsurvival and complication rates of implant-supported single crowns Clin Oral Im-

plants Res 200819119ndash13015 Abrahamsson I Berglundh T

Glantz PO et al The mucosal attachmentat different abutments An experimentalstudy in dogs J Clin Periodontol 199825721ndash727

16 Lops D Bressan E Chiapasco Met al Zirconia and titanium implant abut-ments for single-tooth implant prostheses

after 5 years of function in posterior re-gions Int J Oral Maxillofac Implants201328281ndash287

17 Glauser R Sailer I Wohlwend Aet al Experimental zirconia abutments forimplant-supported single-tooth restorationsin esthetically demanding regions 4-Year re-sults of a prospective clinical study Int JProsthodont 200417285ndash290

18 Ekfeldt A Fuumlrst B Carlsson GEZirconia abutments for single-toothimplant restorations A retrospective andclinical follow-up study Clin Oral ImplantsRes 2011221308ndash1314

19 Zembic A Boumlsch A Jung RE et alFive-year results of a randomized controlledclinical trial comparing zirconia and titaniumabutments supporting single-implant crownsin canine and posterior regions Clin Oral Im-

plants Res 201324384ndash39020 Nilsson GE Tenland T Oberg PA

Evaluation of a laser Doppler 1047298owmeter formeasurement of tissue blood 1047298ow IEEE Trans Biomed Eng 198027597ndash604

21 Nilsson GE Signal processor forlaser Doppler tissue 1047298owmeters Med Biol Eng Comput 198422343ndash348

22 Gleissner C Kempski O Peylo Set al Local gingival blood 1047298ow at healthy

and in1047298amed sites measured by laserDoppler 1047298owmetry J Periodontol 2006771762ndash1771

23 Donos N Drsquo Aiuto F Retzepi Met al Evaluation of gingival blood 1047298owby the use of laser doppler 1047298owmetry

following periodontal surgery A pilot study J Periodontal Res 200540129ndash137

24 Retzepi M Tonetti M Donos NComparison of gingival blood 1047298ow duringhealing of simpli1047297ed papilla preservationand modi1047297ed widman 1047298ap surgery A clin-ical trial using laser doppler 1047298owmetry

J Clin Periodontol 200734903ndash

91125 Ketabi M Hirsch RS The effectsof local anesthetic containing adrenalineon gingival blood 1047298ow in smokers andnon-smokers J Clin Periodontol 199724888ndash892

26 Mavropoulos A Brodin P RoumlsingCK et al Gingival blood 1047298ow in perio-dontitis patients before and after peri-odontal surgery assessed in smokersand non-smokers J Periodontol 2007781774ndash1782

27 Forrester KR Stewart C Tulip Jet al Comparison of laser speckle andlaser doppler perfusion imaging Measure-

ment in human skin and rabbit articulartissue Med Biol Eng Comput 200240687ndash697

28 Forrester KR Tulip J Leonard Cet al A laser speckle imaging technique formeasuring tissue perfusion IEEE TransBiomed Eng 2004512074ndash2084

29 Ayata C Dunn AK Gursoy-OZdemir Y et al Laser speckle 1047298owmetryfor the study of cerebrovascular physiol-ogy in nor- mal and ischemic mouse cor-tex J Cereb Blood Flow Metab 200424744ndash755

30 Dunn AK Bolay H Moskowitz MAet al Dynamic imaging of cerebral blood1047298ow using laser speckle J Cereb Blood Flow Metab 200121195ndash201

31 Zakharov P Vo lker AC Wyss MTet al Dynamic laser speckle imaging of cerebral blood 1047298ow Opt Express 20091713904ndash13917

32 Stewart CJ Frank R Forrester KRet al A comparison of two laser-basedmethods for determination of burn scar per-fusion Laser Doppler versus laser speckleimaging Burns 200531744ndash752

33 Nakamoto T Kanao M Kondo Yet al Two-dimensional real-time blood 1047298owand temperature of soft tissue around

maxillary anterior implants Implant Dent201221522ndash527

34 Welander M Abrahamsson IBerglundh T The mucosal barrier atimplant abutments of different materialsClin Oral Implants Res 200819635ndash641




bacterial adhesion compared with tita-nium abutments and in animal studiesmore favorable soft tissue integrationcompared with titanium abutments15

Although high-strength ceramics suchas alumina and zirconia generally have

high fracture resistance zirconia in par-ticular has suf 1047297cient fracture resistancefor use as an abutment material Zirconia abutments supporting anterior and pre-molar single crowns have shown highsurvival rates in some studies16ndash18 anda high 5-year survival rate was reportedin a randomized-controlled clinical trialof zirconia and titanium abutments inposterior regions19

For the long-term stability of favor-able outcomes following implant treat-ment thehealth of thesoft tissuearound

implants must be maintained (ie plaquecontrol and blood 1047298ow preservation areindispensable) In bone-level implantsbecause implant abutments come intocontact with the soft tissue around theimplants selection of the implant abut-ment material is considered very impor-tant for the health of periimplant soft tissue However the effects of theimplant abutment material on the peri-implant mucosa particularly on itsblood 1047298ow have not been clari1047297ed Inthis study therefore we selected zirco-

nia which is used widely as an implant abutment material because of its excel-lent esthetic properties and biocompat-ibility and compared the effects of zirconia and metal abutments on peri-implant soft tissue by evaluating themicrocirculatory dynamics and surfacetemperature

MATERIALS AND METHODS

Subjects

This study was performed with the

approval of the Ethics Committee of Kyushu Dental College (FukuokaJapan nos 10 ‒ 25) Subjects were cho-sen from those who had undergoneimplant placement in the anterior max-illa at Kyushu Dental College Hospital(Fukuoka Japan) and showed a favor-able prognosis no signs of surroundingbone resorption on a follow-up dentalx-ray and no signs of soft tissue in1047298am-mation The patients received a detailedexplanation of the study and then

signed a consent form Those who had

Fig 1 Examples of acquired images A Oral photograph (11 is a natural tooth 12 is animplant-supported prosthesis) B Blood 1047298ow image The color scale shows the blood 1047298owfrom 0 (dark blue) to 64 mL $minminus1$100 gminus1 tissue (red) C Thermograph The color scaleshows the surface temperature from 32 (dark blue) to 375degC (red) D Regions of interestBfree gingivaC free gingiva (implant)O attached gingiva attached gingiva (implant)h

alveolar mucosa and n alveolar mucosa (implant)

Fig 2 Blood 1047298ow and surface temperature around implants versus natural teeth Blood 1047298owfrom LSI (left panels) and surface temperature from thermograph (right panels) in free gingiva( A and D ) attached gingiva (B and E ) and alveolar mucosa (C and F ) was compared betweenimplants and natural teeth P 005 with paired t test Signi1047297cantly greater blood 1047298ow wasdetected in natural teeth relative to implants in free gingiva and attached gingiva (free gingivaP frac14 00055 attached gingiva P frac14 00052) The surface temperature was signi1047297cantly higherin the implant in free gingiva (P frac14 00079)






Temperature Imaging




Data Analysis




difference

RESULTS







ow






1151 metal 88016



Using Thermography


was no signi1047297




DISCUSSION






















CONCLUSIONS



DISCLOSURE







REFERENCES





















































Temperature Imaging




Data Analysis




difference

RESULTS







ow






1151 metal 88016



Using Thermography


was no signi1047297




DISCUSSION






















CONCLUSIONS



DISCLOSURE







REFERENCES




















































1151 metal 88016



Using Thermography


was no signi1047297




DISCUSSION






















CONCLUSIONS



DISCLOSURE







REFERENCES




















































REFERENCES

















































kajiwara etal 1015

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