In vitro effects of zirconia and alumina particles on human blood monocyte-derived macrophages: X-ray microanalysis and flow cytometric studies

Effect of Titanium and Zirconium Oxide Microparticles on Pro-Inflammatory Response in Human Macrophages under Induced Sterile Inflammation: An In Vitro Study

The wear-debris particles released by shearing forces during dental implant insertion may contribute to inflammatory reactions or osteolysis associated with peri-implantitis by stimulating inflammasome-activation. The study aim was to examine cytotoxic and pro-inflammatory effects of titanium (TiO₂) and zirconia (ZrO₂) particles in macrophages regarding their nature/particle concentration over time under sterile lipopolysaccharide (LPS) inflammation. Macrophages were exposed to TiO₂ and ZrO₂ particles (≤5 µm) in cell culture. Dental glass was used as inert control and LPS (1 μg/mL) was used to promote sterile inflammation. Cytotoxicity was determined using MTT assays and cytokine expression of TNF-α, IL-1β and IL-6 was evaluated by qRT-PCR. Data were analyzed using Student's t-test and ANOVA (p ≤ 0.05). Cytotoxicity was significantly increased when exposed to higher concentrations of glass, TiO₂ and ZrO₂ (≥10⁷ particles/mL) compared to controls (p ≤ 0.05). Macrophages challenged with TiO₂ particles expressed up to ≈3.5-fold higher upregulation than ZrO₂ from 12 to 48 h. However, when exposed to LPS, TiO₂ and ZrO₂ particle-induced pro-inflammatory gene expression was further enhanced (p ≤ 0.05). Our data suggest that ZrO₂ particles produce less toxicity/inflammatory cytokine production than TiO₂. The present study shows that the biological reactivity of TiO₂ and ZrO₂ depends on the type and concentration of particles in a time-dependent manner.

Biomechanical and Histological Analysis of Titanium (Machined and Treated Surface) Versus Zirconia Implant Materials: An In Vivo Animal Study

OBJECTIVES

The aim of this study was to perform an in vivo histological comparative evaluation of bone formation around titanium (machined and treated surface) and zirconia implants. For the present study were used 50 commercially pure titanium implants grade IV, being that 25 implants with a machined surface (TiM group), 25 implants with a treated surface (TiT group) and, 25 implants were manufactured in pure zirconia (Zr group). The implants (n = 20 per group) were installed in the tibia of 10 rabbits. The implants distribution was randomized (n = 3 implants per tibia). Five implants of each group were analyzed by scanning electron microscopy and an optical laser profilometer for surface roughness characterization. Six weeks after the implantation, 10 implants for each group were removed in counter-torque for analysis of maximum torque value. The remaining samples were processed, included in historesin and cut to obtain non-decalcified slides for histomorphological analyses and histomorphometric measurement of the percentage of bone-implant contact (BIC%). Comparisons were made between the groups using a 5% level of significance (p < 0.05) to assess statistical differences. The results of removal torque values (mean ± standard deviation) showed for the TiM group 15.9 ± 4.18 N cm, for TiT group 27.9 ± 5.15 N cm and for Zr group 11.5 ± 2.92 N cm, with significant statistical difference between the groups (p < 0.0001). However, the BIC% presented similar values for all groups (35.4 ± 4.54 for TiM group, 37.8 ± 4.84 for TiT group and 34.0 ± 6.82 for Zr group), with no statistical differences (p = 0.2171). Within the limitations of the present study, the findings suggest that the quality of the new bone tissue formed around the titanium implants present a superior density (maturation) in comparison to the zirconia implants.

Zirconia in biomedical applications

INTRODUCTION

The use of zirconia in medicine and dentistry has rapidly expanded over the past decade, driven by its advantageous physical, biological, esthetic, and corrosion properties. Zirconia orthopedic hip replacements have shown superior wear-resistance over other systems; however, risk of catastrophic fracture remains a concern. In dentistry, zirconia has been widely adopted for endosseous implants, implant abutments, and all-ceramic crowns. Because of an increasing demand for esthetically pleasing dental restorations, zirconia-based ceramic restorations have become one of the dominant restorative choices. Areas covered: This review provides an updated overview of the applications of zirconia in medicine and dentistry with a focus on dental applications. The MEDLINE electronic database (via PubMed) was searched, and relevant original and review articles from 2010 to 2016 were included. Expert commentary: Recent data suggest that zirconia performs favorably in both orthopedic and dental applications, but quality long-term clinical data remain scarce. Concerns about the effects of wear, crystalline degradation, crack propagation, and catastrophic fracture are still debated. The future of zirconia in biomedical applications will depend on the generation of these data to resolve concerns.

Zirconia: Established facts and perspectives for a biomaterial in dental implantology

Currently, zirconia is widely used in biomedical area as a material for prosthetic devices because of its good mechanical and chemical properties. Largely employed in clinical area for total hip replacement, zirconia ceramics (ZrO(2)) are becoming a prevalent biomaterial in dentistry and dental implantology. Although titanium is used in dental implantology currently, there is a trend to develop new ceramic-based implants as an alternative to monolithic titanium. This article reviews the evolution and development of zirconia through data published between 1963 and January 2008 in English language. Articles were identified via a MEDLINE search using the following keywords: zirconia, zirconia/biocompatibility, zirconia/osseointegration, zirconia/periointegration, zirconia/review, and zirconia/bacterial adhesion or colonization. This review of the literature aims at highlighting and discussing zirconia properties in biological systems for their future use in dental implantology. In conclusion, zirconia with its interesting microstructural properties has been confirmed to be a material of choice for the "new generation" of implants, thanks to its biocompatibility, osseoconductivity, tendency to reduce plaque accumulation, and interaction with soft tissues, which leads to periointegration. However, scientific studies are promptly needed to fulfill gaps like long-term clinical evaluations of "all zirconia implants," currently leading to propose an alternative use of "hybrid systems" (i.e., titanium screw with zirconia collar) and also bacterial colonization of zirconia. Moreover, there is a permanent need for consistent information about topography and chemistry of zirconia allowing easier cross-product comparisons of clinical devices.

Electron probe X-ray microanalysis for the study of cell physiology

Of the analytical electron microscopy techniques available, electron probe X-ray microanalysis has been most widely used for the study of biological specimens. This technique is able to identify, localize, and quantify elements both at the whole cell and at the intracellular level. The use SEM or TEM to analyze individual whole cells gives a simple and rapid method to study changes in ion transport after stimulation, whereas the analysis of thin sections of cryoprepared cell sections, although technically more difficult, allows details about ionic content in intracellular compartments, such as mitochondria, ER, and lysosomes, to be obtained. In this chapter the principles underlying X-ray emission are briefly outlined, step-by-step methods for specimen preparation of whole cells and cell sections for microanalysis are given, as are the methods used for deriving quantitative information from spectra. Areas where problems might occur have been highlighted. The different areas in which X-ray microanalysis is being used in the study of cell physiology are briefly reviewed.

Actin plays a crucial role in the phagocytosis and biological response to respirable quartz particles in macrophages

The uptake of respirable quartz particles by alveolar macrophages (AM) is believed to cause an inflammatory response, which is discussed as a crucial step in quartz pathogenicity. However, little is known about the mechanism and the relevance of particle uptake. Therefore, the aim of this study was to analyze the role of the actin cytoskeleton in quartz particle uptake, reactive oxygen species generation (ROS) and tumour necrosis factor alpha (TNF-alpha) release. Primary rat alveolar and interstitial macrophages (IM) as well as a rat alveolar macrophage cell line (NR8383) were treated with quartz particles at various concentrations and time intervals. Particle uptake was studied using flow cytometry and light/fluorescence microscopy to analyze particle uptake and cytoskeleton recruitment. Intra- as well as extracellular ROS generation was analyzed by flow cytometry and electron spin resonance (ESR). Flow cytometric investigations demonstrated a dose- and time-dependent particle uptake. Primary AM showed a similar uptake indicating that the cell line provides a good model to investigate the mechanisms of particle uptake while primary IM had a lower uptake rate. Inhibition of actin polymerization using cytochalasin-D caused a significant reduction of particle uptake in NR8383 cells. The quartz induced dose-dependent increase of ROS generation and TNF-alpha release was also blocked by inhibition of actin polymerization. Our results demonstrate an active involvement of the cytoskeleton in uptake of quartz particles and suggest a role of the actin framework and/or the particle uptake in DQ12-induced ROS generation and cytokine release.

In vitro effects on macrophages induced by noncytotoxic doses of silica particles possibly relevant to ambient exposure

The RAW 246.7 macrophage cell line was exposed in vitro to aged crystalline silica particles of respirable size for 24 h at a range of doses starting from 15 microg/2 x 10(6) cells, which is a realistic exposure level of macrophages in the airways of ambiently exposed individuals. The particle sample used for the experiments was prepared to mimic some aspects of ambient crystalline silica particles: size distribution, morphology, and surface reactivity. Our purpose was to determine whether a nontoxic quartz load comparable to that of ambient exposure would be able to induce macrophage activation and impairment of the phagocytic ability, factors altering the lung's capacity to deal with increased particle loads (as occurs during high-pollution episodes) or infections and affecting the local and systemic responses through the release of biologically active compounds (cytokines, reactive oxygen species, NO, isoprostanes). Exposure of RAW 264.7 cells to aged silica particles induced macrophage activation (evidenced by the morphological features observed with scanning electron microscopy and by the release of TNF-alpha and IL-6) and impairment of phagocytosis of test particles, even at noncytotoxic doses. The reduction of the phagocytic function of the cells after silica treatment was dose-dependent, as evidenced by an increase of the population of unphagocytic cells, paralleled by a decrease of the actively phagocytizing cell population. We evaluated the oxidative stress induced by aged silica particles, quantifying the peroxidation products (8-isoprostanes) in the culture media of treated cells, and found a strong release at low doses. Isoprostanes are a complex family of compounds which have been used as in vivo markers of lipid peroxidation in human disorders, but that, as far as we know, have never been evaluated in relation to airborne particulate matter exposure. Lipid peroxides are involved in various cellular events in the inflammatory response, and isoprostanes are also supposed to exert important biological actions on airway and pulmonary vascular smooth muscles and on platelets.

Biologic and tribologic considerations of alternative bearing surfaces

Patients who are young or active or both who require total joint replacement pose a unique challenge; their high activity demands wear-resistant bearings that will perform for decades, without suffering from the adverse effects of accumulated wear products. We discuss the tribologic and biologic properties of newly introduced bearing materials for hip prostheses. The new PEs are intended to address the aseptic loosening problem by reducing the volume of submicron PE particles to a level well below that historically associated with osteolysis. However, choosing among the several variations of the cross-linked thermally-stabilized PEs is confounded by conflicting opinions regarding the optimum balance between long-term wear resistance and mechanical strength, and regarding potential effects of differences in morphologic features of the submicron-sized wear particles on their relative osteolytic potential. Metal-on-metal bearings have clinically proven wear resistance and the advantage of self-polishing, but the long-term biologic effects of metallic ions remain unknown. Ceramic-on-ceramic bearings have the advantage of high biocompatibility and usually very low wear, but fracture remains a rare but catastrophic complication. The choice of an appropriate bearing couple should be made after a thorough consideration of the relative risks and potential benefits of each of these materials.

Effects of bioactive glass particles and their ionic products on intracellular concentrations

Numerous studies have described the bioactive properties of glass particles in the SiO(2)-CaO-Na(2)O-P(2)O(5) system. This kind of material is capable of developing a direct contact with bone through dissolution and physicochemical reactions. We have investigated the influence of bioactive particles, and ionic products from the same particles, on the intracellular concentrations in monocyte cells, which are among the first cells to colonize implantation sites. The only way to access these concentrations and particularly diffusible ionic concentrations (potassium, sodium, and chlorine) is to use cryomethods coupled to electron probe microanalysis. We have paid particular attention to the potassium:sodium ratio, the most sensitive criterion of viability. We have cultured cells with bioactive glass particles and in a conditioned medium obtained from the dissolution of the glass particles in the standard medium. Our study demonstrates that cells cultured in a conditioned medium are more active than cells cultured in a standard medium, or cells exposed to bioactive particles, and particles are more toxic for cells than are ionic products.

Effect of hydroxyapatite sintering temperature on intracellular ionic concentrations of monocytes: a TEM-cryo-X-ray microanalysis study

Hydroxyapatite used as bone replacement can lead to particle release in the implantation site. These particles interact with monocytes, which are the first immune cells to colonize the implant and an inflammatory site. Thanks to cryo-X-ray microanalysis, we can observe cells in a state close to the physiological one and we have access to diffusible ions. We paid particular attention to the potassium-to-sodium ratio, which is one of the best viability criteria. We used this method to study the interaction between three hydroxyapatite particles treated at three different temperatures (not treated, treated at 600 degrees C and 1180 degrees C), and monocytes. In the culture condition, the hydroxyapatite treated at 1180 degrees C underwent the least dissolution. We demonstrate that monocytes were altered by the three hydroxyapatite particles. The hydroxyapatite particules treated at 600 degrees C were found to be more toxic.