Physicochemical and biological properties of dental materials and formulations with silica nanoparticles: A narrative review

OBJECTIVE

Silica nanoparticles (SNPs) have been extensively studied and used in different dental applications to promote improved physicochemical properties, high substance loading efficiency, in addition to sustained delivery of substances for therapeutic or preventive purposes. Therefore, this study aimed to review the SNPs applications in nanomaterials and nanoformulations in dentistry, discussing their effect on physicochemical properties, biocompatibility and ability to nanocarry bioactive substances.

DATA RESOURCES

Literature searches were conducted on PubMed, Web of Science, and Scopus databases to identify studies examining the physicochemical and biological properties of dental materials and formulations containing SNPs. Data extraction was performed by one reviewer and verified by another STUDY SELECTION: A total of 50 were reviewed. In vitro studies reveal that SNPs improved the general properties of dental materials and formulations, such as microhardness, fracture toughness, flexural strength, elastic modulus and surface roughness, in addition to acting as efficient nanocarriers of substances, such as antimicrobial, osteogenic and remineralizing substances, and showed biocompatibility CONCLUSIONS: SNPs are biocompatible, improve properties of dental materials and serve as effective carriers for bioactive substances CLINICAL SIGNIFICANCE: Overall, SNPs are a promising drug delivery system that can improve dental materials biological and physicochemical and aesthetic properties, increasing their longevity and clinical performance. However, more studies are needed to elucidate SNPs short- and long-term effects in the oral cavity, mainly on in vivo and clinical studies, to prove their effectiveness and safety.

Emerging factors affecting peri-implant bone metabolism

Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.

Advanced inorganic nanocomposite for decontaminating titanium dental implants

Oral hygiene and regular maintenance are crucial for preserving good peri-implant health. However, available prophylaxis products and toothpastes, which are optimized for cleaning teeth, tend to contaminate and abrade implant surfaces due to their organic components and silica microparticles, respectively. This study aims to develop an organic-free implant-paste based on two-dimensional nanocrystalline magnesium phosphate gel and hydrated silica nanoparticles (20-30% w/w) for cleaning oral biofilm on titanium dental implants. The surface chemistry, morphology, and bacterial load of contaminated Ti disks before and after decontamination using prophylaxis brushing with toothpaste and implant-paste were characterized by X-ray photoelectron spectroscopy (XPS), scanning electron microscopy, and fluorescence spectroscopy. Both commercial toothpastes and implant-paste remove bacteria, however, only implant-paste protects Ti metal from abrasion and removes organic contaminants. XPS showed a significant decrease of carbon contamination from 73% ± 2 to 20% ± 2 after mechanical brushing with implant-paste compared to 41% ± 11 when brushing with commercial toothpastes (p < 0.05). Fluorescence microscopy revealed that bacteria load on biofilm contaminated Ti (44 × 10³  ± 27 × 10³ /µm² ) was significantly reduced with the implant-paste to 2 × 10³  ± 1 × 10² /µm² and with a commercial toothpaste to 2.9 × 10³  ± 7·10² /µm² . This decay is relatively higher than the removal achieved using rotary prophylaxis brush alone (5 × 10³  ± 1 × 10³ /µm² , p < 0.05). Accordingly, this novel implant-paste shows a great promise as an efficient decontamination approach. © 2018 Wiley Periodicals, Inc. J. Biomed. Mater. Res. Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 761-772, 2019.

Corrosive effects of fluoride on titanium under artificial biofilm

PURPOSE

This study aimed to investigate the effect of sodium fluoride (NaF) on titanium corrosion using a biofilm model, taking environmental pH into account.

METHODS

Streptococcus mutans cells were used as the artificial biofilm, and pH at the bacteria-titanium interface was monitored after the addition of 1% glucose with NaF (0, 225 or 900ppmF) at 37°C for 90min. In an immersion test, the titanium samples were immersed in the NaF solution (0, 225 or 900ppm F; pH 4.2 or 6.5) for 30 or 90min. Before and after pH monitoring or immersion test, the electrochemical properties of the titanium surface were measured using a potentiostat. The amount of titanium eluted into the biofilm or the immersion solution was measured using inductively coupled plasma mass spectrometry. The color difference (ΔE*ab) and gloss of the titanium surface were determined using a spectrophotometer.

RESULTS

After incubation with biofilm, pH was maintained at around 6.5 in the presence of NaF. There was no significant change in titanium surface and elution, regardless of the concentration of NaF. After immersion in 900ppm NaF solution at pH 4.2, corrosive electrochemical change was induced on the surface, titanium elution and ΔE*ab were increased, and gloss was decreased.

CONCLUSIONS

NaF induces titanium corrosion in acidic environment in vitro, while NaF does not induce titanium corrosion under the biofilm because fluoride inhibits bacterial acid production. Neutral pH fluoridated agents may still be used to protect the remaining teeth, even when titanium-based prostheses are worn.

Attachment and proliferation of human osteoblast-like cells (MG-63) on laser-ablated titanium implant material

Demand is increasing for shortening the long (3-6 months) osseointegration period to rehabilitate patients' damaged chewing apparatus in as short a time as possible. For dental implants, as for biomaterials in general, the bio- and osseointegration processes can be controlled at molecular and cellular levels by modification of the implant surface. One of the most promising of such surface modifications is laser ablation, as demonstrated by our previous results [46]. Commercially pure (CP4) sand-blasted, acid-etched titanium disks (Denti® System Ltd., Hungary) were irradiated with a KrF excimer laser (248 nm, fluence 0.4 J/cm(2), FWHM 18 ns, 2000 pulses), or with a Nd:YAG laser (532 nm, 1.3 J/cm(2), 10 ns, 200 pulses) then examined by SEM, AFM, and XPS. In vitro attachment (24 h) and proliferation (72 h) of MG-63 osteoblast cells were investigated via dimethylthiazol-diphenyl tetrazolium bromide (MTT), alamarBlue (AB) assays alkaline phosphatase quantification (ALP) and SEM. SEM and AFM revealed significant changes in morphology and roughness. XPS confirmed the presence of TiO2 on each sample; after Nd:YAG treatment a reduced state of Ti (Ti(3+)) was also observed. MTT, AB and ALP measurements detected an increase in the number of cells between the 24- and 72 hour observations; however, laser treatment did not affect cell attachment and proliferation significantly.

Effect of caries preventive products on the growth of bacterial biofilm on titanium surface

Fluorides may affect the oxide layer on titanium surface. Caries preventive mouthwashes or gels contain fluorides and are applied at low pH. The aim of the present work was to study whether various concentrations of fluoride at acidic pH cause changes in the surface structure on the polished region of Ti implants, and alter the adherence and colonization of bacteria. Commercially pure Ti grade 4 discs with a polished surface were treated with a mouthwash containing 0.025% fluoride, a gel containing 1.25% fluoride or a 1% aqueous solution of NaF (pH 4.5). The change of surface roughness of the samples and the colonization of Porphyromonas gingivalis strains were studied by scanning electron microscopy after 5 days of anaerobic incubation. The quantity of the bacterial protein was determined by protein assay analysis. Agents with high fluoride concentration at acidic pH increased the roughness of the Ti surface. A slight increase in the amount of bacteria was found on the surfaces treated with 1% NaF and gel in comparison with the control surface. This study suggested that a high fluoride concentration at acidic pH may hinder the development of a healthy transgingival epithelial junction on Ti implants, due to bacterial colonization.

Titanium surface topography after brushing with fluoride and fluoride-free toothpaste simulating 10 years of use

OBJECTIVES

To conduct a controlled study contrasting titanium surface topography after procedures that simulated 10 years of brushing using toothpastes with or without fluoride.

METHODS

Commercially pure titanium (cp Ti) and Ti-6Al-4V disks (6 mm Ø×4 mm) were mirror-polished and treated according to 6 groups (n=6) as a function of immersion (I) or brushing (B) using deionised water (W), fluoride-free toothpaste (T) and fluoride toothpaste (FT). Surface topography was evaluated at baseline (pretreatment) and post-treatment, using atomic force microscope in order to obtain three-dimensional images and mean roughness. Specimens submitted to immersion were submerged in the vehicles without brushing. For brushed specimens, procedures were conducted using a linear brushing machine with a soft-bristled toothbrush. Immersion and brushing were performed for 244 h. IFT and BFT samples were analysed under scanning electron microscope with Energy-Dispersive X-ray Spectroscopy (EDS). Pre and post-treatment values were compared using the paired Student T-test (α=.05). Intergroup comparisons were conducted using one-way ANOVA with Tukey post-test (α=.05).

RESULTS

cp Ti mean roughness (in nanometers) comparing pre and post-treatment were: IW, 2.29±0.55/2.33±0.17; IT, 2.24±0.46/2.02±0.38; IFT, 2.22±0.53/1.95±0.36; BW, 2.22±0.42/3.76±0.45; BT, 2.27±0.55/16.05±3.25; BFT, 2.27±0.51/22.39±5.07. Mean roughness (in nanometers) measured in Ti-6Al-4V disks (pre/post-treatment) were: IW, 1.79±0.25/2.01±0.25; IT, 1.61±0.13/1.74±0.19; IFT, 1.92±0.39/2.29±0.51; BW, 2.00±0.71/2.05±0.43; BT, 2.37±0.86/11.17±2.29; BFT, 1.83±0.50/15.73±1.78. No significant differences were seen after immersions (p>.05). Brushing increased the roughness of cp Ti and of Ti-6Al-4V (p<.01); cp Ti had topographic changes after BW, BT and BFT treatments whilst Ti-6Al-4V was significantly different only after BT and BTF. EDS has not detected fluoride or sodium ions on metal surfaces.

CONCLUSIONS

Exposure to toothpastes (immersion) does not affect titanium per se; their use during brushing affects titanium topography and roughness. The associated effects of toothpaste abrasives and fluorides seem to increase roughness on titanium brushed surfaces.

Controlled electro-implementation of fluoride in titanium implant surfaces enhances cortical bone formation and mineralization

Previous studies have shown that bone-to-implant attachment of titanium implants to cortical bone is improved when the surface is modified with hydrofluoric acid. The aim of this study was to investigate if biological factors are involved in the improved retention of these implants. Fluoride was implemented in implant surfaces by cathodic reduction with increasing concentrations of HF in the electrolyte. The modified implants were placed in the cortical bone in the tibias of New Zealand white rabbits. After 4 weeks of healing, wound fluid collected from the implant site showed lower lactate dehydrogenase activity and less bleeding in fluoride-modified implants compared to control. A significant increase in gene expression levels of osteocalcin and tartrate-resistant acid phosphatase (TRAP) was found in the cortical bone attached to Ti implants modified with 0.001 and 0.01 vol.% HF, while Ti implants modified with 0.1% HF showed only induced TRAP mRNA levels. These results were supported by the performed micro-CT analyses. The volumetric bone mineral density of the cortical bone hosting Ti implants modified with 0.001% and 0.01% HF was higher both in the newly woven bone (<100 microm from the interface) and in the older Haversian bone (>100 microm). In conclusion, the modulation of these biological factors by surface modification of titanium implants with low concentrations of HF using cathodic reduction may explain their improved osseointegration properties.

Corrosion behaviour of titanium after short-term exposure to an acidic environment containing fluoride ions

The negative effect of fluoride ions on titanium has been known in dentistry for a long time. The presented work was aimed at the interaction between titanium and model saliva following a short-term exposure of a specimen to a model medical preparation rich in fluoride ions. The experimental work was carried out using titanium grade 2 in a physiological solution (pH non-adjusted, 5.8, 4.2; 5000 ppm F-) and in model saliva. Electrochemical measurement techniques were supplemented with XPS analysis. The presence of fluoride ions resulted in partial degradation of the passive layer even in a slightly acidic environment. The decrease of pH to the value of 4.2 and the presence of 5000 ppm F- caused titanium activation followed by a slow repassivation in model saliva. Formation of low soluble compound rich in fluorine explains experimental data. Short medical treatment can result in relatively long period of increased titanium corrosion.