Tigran can now offer a technical writing service for writing articles, compiling case reports and putting together PowerPoint presentations.
Read more about the services, provided in cooperation with Avenues Europe.
Please contact Francoise Bonnefond with your technical writing requirements.
The first dental application with Tigran™ PTG was performed in 1995, when porous titanium granules were successfully used to enhance bone regeneration in a ridge splitting case of a severely resorbed maxillary dento-alveolar ridge. The reconstruction allowed a cross arch bridge installation (1).
Large cystic cavities have successfully been reconstructed after enucleation, where the cavities in the bone were filled with titanium granules. All patients recovered quickly with very good results (2).
Sinus floor augmentation with Tigran™ PTG (placed in the maxillary sinus floor) was performed first time in 2003 with excellent clinical and radiological result (3).
In a clinical pilot study, the one-stage procedures were reliable, while the two-stage procedures (performed in those cases where primary implant stability was impossible to achieve) were more unpredictable. No autologous bone was applied and therefore surgery times were shorter and the patients had less discomfort (4).
A six-months animal experimental study on sinus lift demonstrated an excellent three-dimensional stability over time of the titanium granules (5). Actually not surprising, because the granules – in contrast to bone grafts, substitutes derived from bone tissue and synthetic calcium phosphate-based materials – are non-resorbable and thus maintain their volume during the healing period.
Improved bone regeneration was seen in two clinical studies of patients with peri-implantitis treated with Tigran™ PTG (6, 7)
– suggesting an osteoconductive effect of the titanium granules.
In two clinical pilot studies of peri-implantitis, where debridement with Tigran’s rotating titanium brush and either antimicrobial photodynamic therapy (8a, 8b) or decontamination with hydrogen peroxide (9) were performed, and where titanium granules were used as a non-resorbable, osteoconductive bone substitute, had encouraging results.
In a case report, a biopsy taken 12 months after treatment of a human peri-implant osseous defect with titanium granules, showed well-integrated granules. The bone was growing through the porosities of the granules and the implant was re-osseo-integrated (10).
In a clinical case study with 38 patients the contour of deformed alveolar processes were successfully restored by onlay augmentation with Tigran™ PTG White. The granules were dimensionally stable and no visible changes of the processes occurred during the observation period of 28 months (11). Actually, an expected result, since Tigran's irregularly formed, non-resorbable granules interlock when packed together, and thus form a stable unit.
In a randomized animal experiment of degree II furcation defects, Tigran™ PTG appeared (in contrast to Bio-Oss) to integrate well into the alveolar bone (12).
A clinical pilot study indicated that titanium granules can be safely used as bone graft substitute in degree II furcation defects; significant improvements were found in three of six clinical parameters (13).
Improved guided bone regeneration (GBR) was demonstrated in three series of animal experiments, where bone defects (14, 15) or extraction sockets (16) were treated with Tigran™ PTG – all these studies indicate an osteoconductive effect of the titanium granules.
Drilling through Tigran™ PTG incorporated into the bone has been investigated in an animal experiment, where dental extraction sockets were either treated with titanium granules or left untreated. No harmful elevation in temperature or technical complications were noted. There were no differences between the temperature measurements while drilling to place implants in the extraction sockets after a 11 week healing period, and – most important – all the measurements were below 40°C, i.e. safely below the threshold temperature for heat injury (17).
In an animal experimental study of extraction sockets, the grey PTG performed well as a bone graft substitute and was easy and bone-like to drill in, whereas the ceramic nature of PTG White requires selection of proper drilling procedures and implant installation techniques (18).
Tigran™ PTG have been demonstrated experimentally to have superior microstructural properties, ductility and cell proliferation rate compared to both Straumann BoneCeramic and Geistlich Bio-Oss (19).
Debridement with Tigran's rotating titanium brushes (both the old Brush No 1 and the new PeriBrush™) have experimentally been found to be more gentle to the implant surface than other mechanical methods (20). Especially PeriBrush™ makes it easier to reach implant threads and narrow cavities, which results in a more efficient surface cleaning and also shortens the treatment time compared to traditional manual treatment.
At present, Tigran Technologies is sponsoring two multicenter studies on sinus lift and one multicenter study on peri-implantitis.
1. Holmberg L, Forsgren L, Kristerson L. Porous titanium granules for implant stability and bone regeneration – a case followed for 12 years. Ups J Med Sci 2008;113(2):217–20.
2. Magistri A, Botticelli L, Romitelli AM, De Luca P, Evangelisti N, Guadagno I. Trattamento delle grandi cavità cistiche con biomateriali [Treatment of large cystic cavities with biomaterial]. ChirOrale 2006;2(2):16–9. [English translation by Tigran]
3. Bystedt H. Natix used as osteoconductive material for sinus floor augmentation. Three years follow-up. Case report. Swed Dent J 2007;31(4):193.
4. Bystedt H, Rasmusson L. Porous titanium granules used as osteoconductive material for sinus floor augmentation: a clinical pilot study. Clin Implant Dent Relat Res 2009;11(2):101–5.
5. Lambert F, Lecloux G, Léonard A, Sourice S, Layrolle P, Rompen E. Bone regeneration using porous titanium particles versus bovine hydroxyapatite: a sinus lift study in rabbits. Clin Implant Dent Relat Res (Epub 2011 ahead of print).
6. Wohlfahrt JC, Aass AM, Rønold HJ, Karlsson S, Ellingsen JE, Saxegaard E, Lyngstadaas SP. Porous titanium granules in the surgical treatment of peri-implant osseous defects – a randomized clinical trial. Int J Oral Maxillofac Implants (accepted for publication).
7. Frei B, Steveling H, Mertens C. Porous titanium granules for bone regeneration in peri-implantitis-related defects. Clin Oral Impl Res 2010;21(10):1146.
8a. Bergmann F. Ein neues Konzept bei Periimplantitis. Vorgehen mittels aPDT und knochenregenerativ augmentativen Maßnahmen. Implantologie Journal 2010;14(6):36–9. (References)
8b. Bergmann F. A new treatment concept for peri-implantitis. Photodynamic therapy and regenerative bone augmentation. European Journal for Dental Implantologists 2010;6(4):66–9.
9. Gholami GA, Amid R, Aghaloo M. Management of peri-implant bone loss occurred during osseointegration phase with porous titanium granules. Clin Oral Impl Res 2011;22(9):1021.
10. Wohlfahrt JC, Aass AM, Rønold HJ, Lyngstadaas SP. Micro CT and human histological analysis of a peri-implant osseous defect grafted with porous titanium granules: a case report. Int J Oral Maxillofac Implants 2011;26(1):e9–e14. Scientific summary by Tigran.
11. Steveling H, Mertens C. Konturverbesserung des Alveolarfortsatzes durch Titangranulat [Titanium granules for contour enhancement of the alveolar process]. Zahnarzt & Praxis 2011;14(Sonderausgabe Implantologie):6–9. [English translation by Tigran]
12. Wohlfahrt JC, Aass AM, Rønold HJ, Heijl L, Haugen HJ, Lyngstadaas SP. Microcomputed tomographic and histologic analysis of animal experimental degree II furcation defects treated with porous titanium granules or deproteinized bovine bone. J Periodontol 2012;83(2):211–21.
13. Wohlfahrt JC, Lyngstadaas SP, Heijl L, Aass AM. Porous titanium granules in the treatment of mandibular class II furcation defects: A consecutive case series. J Periodontol 2012;83(1):61–9.
14. Wohlfahrt JC, Monjo M, Rønold HJ, Aass AM, Ellingsen JE, Lyngstadaas SP. Porous titanium granules promote bone healing and growth in rabbit tibia peri-implant osseous defects. Clin Oral Implants Res 2010;21(2):165–73. Scientific summary by Tigran.
15. Gholami GA, Tehranchi M, Kadkhodazadeh M, Moghadam AA, Ghanavati F, Ardakani MRT, Aghaloo M, Mashhadiabbas F. Histologic and histomorphometric evaluation of bone substitutes in experimental defects. Research Journal of Biological Sciences 2010;5(7):465–9.
16. Bashara H, Wohlfahrt J, Polyzois I, Lyngstadaas S, Renvert S, Claffey N. The effect of permanent grafting materials on the preservation of the buccal bone plate after tooth extraction. An experimental study in the dog. Clin Oral Implants Res (Epub 2011 ahead of print). Scientific summary by Tigran.
17. Wohlfahrt C, Lundberg E, Bjursten LM. Drilling and placing of implants in bone grafted with porous titanium granules does not cause overheating or technical complication. Presented at the Third Annual Meeting of the Scandinavian Society for Biomaterials, April 14–16, 2010, Hafjell, Norway.
18. Verket A, Lyngstadaas SP, Rønold HJ, Wohlfahrt JC. Implants inserted in extraction sockets grafted with porous titanium granules. Presented at the 89th General Session of the International Association of Dental Research, March 16–19, 2011, San Diego, California.
19. Sabetrasekh R, Tiainen H, Lyngstadaas SP, Reseland J, Haugen H. A novel ultra-porous titanium dioxide ceramic with excellent biocompatibility. J Biomater Appl 2011;25(6):559–80.
20. Duddeck DU, Karapetian VE, Faber FJ, Rothamel D, Zöller JE. Effects of rotating titanium debridement brushes on the surface structure of dental implants. Presented at the 20th Annual Scientific Meeting of the European Association for Osseointegration, October 13–15, 2011, Athens, Greece. Scientific summary by Tigran.