Variation of the ultrasonic response of a dental implant embedded in tricalcium silicate-based cement under cyclic loading Romain Vayron a , Patrick Karasinski b , Vincent Mathieu a , Adrien Michel a , Domitille Loriot a , Gilles Richard c , Gregory Lambert c , Guillaume Haiat a,n a CNRS, Laboratoire Mode ´lisation et Simulation MultiEchelle, MSME UMR CNRS 8208, 61 Avenue du Ge´ne´ral de Gaulle, 94010 Cre ´teil, Cedex, France b Universite´ Paris-Est, Laboratoire Images Signaux et Syst  emes Intelligents, LISSI, EA-3956, France c Septodont, 58 rue du Pont de Cre ´teil, 94107 Saint-Maur-des-fosse ´s Cedex, France article info Article history: Accepted 1 January 2013 Keywords: Tricalcium silicate-based cement Mechanical fatigue Quantitative ultrasound Sinus lift surgery Dental implant abstract The use of tricalcium silicate-based cement (TSBC) as bone substitute material for implant stabilization is promising. However, its mechanical behavior under fatigue loading in presence of a dental implant was not reported so far because of the difficulty of measuring TSBC properties around a dental implant in a nondestructive manner. The aim of this study is to investigate the evolution of the 10 MHz ultrasonic response of a dental implant embedded in TSBC versus fatigue time. Seven implants were embedded in TSBC following the same experimental protocol used in clinical situations. One implant was left without any mechanical solicitation after its insertion in TSBC. The ultrasonic response of all implants was measured during 24 h using a dedicated device deriving from previous studies. An indicator I based on the temporal variation of the signal amplitude was derived and its variation as a function of fatigue time was determined. The results show no significant variation of I as a function of time without mechanical solicitation, while the indicator significantly increases (p o10 5 , F ¼199.1) at an average rate of 2.2 h 1 as a function of fatigue time. The increase of the indicator may be due to the degradation of the Biodentine–implant interface, which induces an increase of the impedance gap at the implant surface. The results are promising because they show the potentiality of ultrasonic methods to (i) investigate the material properties around a dental implant and (ii) optimize the conception of bone substitute materials in the context of dental implant surgery. & 2013 Elsevier Ltd. All rights reserved. 1. Introduction The use of bone substitute biomaterials in the context of dental implant surgery has become a common technique used for edentulous patients with poor bone quality. Different bioma- terials have been used as bone substitute material such as autogenous (Khoury et al., 2007; Rickert et al., 2012), allogeneic (Waasdorp and Reynolds, 2010) and xenogeneic (Simion and Fontana, 2004; Taschieri et al., 2010) bone grafts as well as different synthetic biomaterials (Davies et al., 2010). Autogeneous bone graft has good clinical performances but constitutes a relatively invasive surgical procedure. Allogeneic bone graft can be considered as a good alternative because of the greater amount of material available and the possibility of using local anesthesia only. However, allograft requires a longer period for bone regeneration and the risk of rejection and infection may be higher (Jones, 2008). Therefore, xenogeneic bone graft has been employed using biomaterials such as coral or animal bone tissue, which are easier to handle (Simion and Fontana, 2004; Eppley and Dadvand, 2006). Another option lies in using synthetic biomaterials which may be easier to produce (Shigeishi et al., 2012) and injectable (Gauthier et al., 1999). Different biomaterials of synthetic origin have been developed such as calcium phos- phate ceramic (Morimoto et al., 2012) and bioglass (Kenny and Buggy, 2003; Trindade-Suedam et al., 2010). Among the different calcium phosphate ceramics, b-tricalcium phosphate (Podaropoulos et al., 2009), hydroxyapatite material (Kenny and Buggy, 2003; Shigeishi et al., 2012) and a mix of both (Yamada et al., 1997) have been used as bone substitute materials in the context of dental implantology (Miyamoto et al., 2012). When bone graft, calcium phosphate ceramic and bioglass are used, relatively important healing time (four to nine months) is needed to allow bone remodeling and to secure implant insertion (Brook and Hatton, 1998; Larsson et al., 2012), while modern dental implant treatments aim at a rapid strong and long-lasting attachment between implant and bone for optimal performances. Interestingly, tricalcium silicate-based cements (TSBCs) (such as Biodentine (G. Koubi et al., 2012; S. Koubi et al., 2012)), which are used in the clinic in the context of restorative and endodontic procedures for dentinal tissue replacement (O’Brien, 2008), could be used as bone substitutes in the context of dental implantology Contents lists available at SciVerse ScienceDirect journal homepage: www.elsevier.com/locate/jbiomech www.JBiomech.com Journal of Biomechanics 0021-9290/$ - see front matter & 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jbiomech.2013.01.003 n Correspondence to: Guillaume HA € lAT, Laboratoire Mode ´ lisation Simulation Multi-E ´ chelle, UMR CNRS 8208, 61 avenue du ge ´ne ´ ral de Gaulle, 94010 Cre ´ teil, France. Tel.: þ33 1 4517 1441; fax: þ33 1 4517 1433. E-mail address: guillaume.haiat@univ-paris-est.fr (G. Haiat). Journal of Biomechanics 46 (2013) 1162–1168