Influence of pH on the tribocorrosion behavior of CpTi in the oral environment: synergistic interactions of wear and corrosion

Anticorrosion and Antimicrobial Tannic Acid-Functionalized Ti-Metallic Glass Ribbons for Dental Abutment

In this study, a recently reported Ti-based metallic glass (MG), without any toxic element, but with a significant amount of metalloid (Si-Ge-B, 18 atom %) and minor soft element (Sn, 2 atom %), was produced in ribbon form using conventional single-roller melt-spinning. The produced Ti60Zr20Si8Ge7B3Sn2 ribbons were investigated by differential scanning calorimetry and X-ray diffraction to confirm their amorphous structure, and their corrosion properties were further investigated by open-circuit potential and cyclic polarization tests. The ribbon's surface was functionalized by tannic acid, a natural plant-based polyphenol, to enhance its performance in terms of corrosion prevention and antimicrobial efficacy. These properties can potentially be exploited in the premucosal parts of dental implants (abutments). The Folin and Ciocalteu test was used for the quantification of tannic acid (TA) grafted on the ribbon surface and of its redox activity. Fluorescent microscopy and ζ-potential measurements were used to confirm the presence of TA on the surfaces of the ribbons. The cytocompatibility evaluation (indirect and direct) of TA-functionalized Ti60Zr20Si8Ge7B3Sn2 MG ribbons toward primary human gingival fibroblast demonstrated that no significant differences in cell viability were detected between the functionalized and as-produced (control) MG ribbons. Finally, the antibacterial investigation of TA-functionalized samples against Staphylococcus aureus demonstrated the specimens' antimicrobial properties, shown by scanning electron microscopy images after 24 h, presenting a few single colonies remaining on their surfaces. The thickness of bacterial aggregations (biofilm-like) that were formed on the surface of the as-produced samples reduced from 3.5 to 1.5 μm.

A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis

This mapping review highlights the need for a new paradigm in the understanding of peri-implantitis pathogenesis. The biofilm-mediated inflammation and bone dysregulation (BIND) hypothesis is proposed, focusing on the relationship between biofilm, inflammation, and bone biology. The close interactions between immune and bone cells are discussed, with multiple stable states likely existing between clinically observable definitions of peri-implant health and peri-implantitis. The framework presented aims to explain the transition from health to disease as a staged and incremental process, where multiple factors contribute to distinct steps towards a tipping point where disease is manifested clinically. These steps might be reached in different ways in different patients and may constitute highly individualised paths. Notably, factors affecting the underlying biology are identified in the pathogenesis of peri-implantitis, highlighting that disruptions to the host-microbe homeostasis at the implant-mucosa interface may not be the sole factor. An improved understanding of disease pathogenesis will allow for intervention on multiple levels and a personalised treatment approach. Further research areas are identified, such as the use of novel biomarkers to detect changes in macrophage polarisation and activation status, and bone turnover.

Metallic Dental Implants Wear Mechanisms, Materials, and Manufacturing Processes: A Literature Review

OBJECTIVES

From the treatment of damaged teeth to replacing missing teeth, dental biomaterials cover the scientific interest of many fields. Dental biomaterials are one of the implants whose effective life depends vastly on their material and manufacturing techniques. The purpose of this review is to summarize the important aspects for metallic dental implants from biomedical, mechanical and materials science perspectives. The review article will focus on five major aspects as mentioned below. Tooth anatomy: Maximizing the implant performance depends on proper understanding of human tooth anatomy and the failure behavior of the implants. Major parts from tooth anatomy including saliva characteristics are explored in this section. Wear mechanisms: The prominent wear mechanisms having a high impact on dental wear are abrasive, adhesive, fatigue and corrosion wear. To imitate the physiological working condition of dental implants, reports on the broad range of mastication force and various composition of artificial saliva have been included in this section, which can affect the tribo-corrosion behavior of dental implants. Dental implants classifications: The review paper includes a dedicated discussion on major dental implants types and their details for better understanding their applicability and characteristics. Implant materials: As of today, the most established dental implant materials are SS316L, cobalt chrome alloy and titanium. Detailed discussion on their material properties, microstructures, phase transformations and chemical compositions have been discussed here. Manufacturing techniques: In terms of different production methods, the lost wax casting method as traditional manufacturing is considered. Selective Laser Melting (SLM) and Directed Energy Deposition (DED) as additive manufacturing techniques (AM) have been discussed. For AM, the relationships between process-property-performance details have been explored briefly. The effectiveness of different manufacturing techniques was compared based on porosity distribution, mechanical and biomechanical properties.

SUMMARY

Despite having substantial research available on dental implants, there is a lack of systematic reviews to present a holistic viewpoint combining state-of-the-art from biomedical, mechanical, materials science and manufacturing perspectives. This review article attempts to combine a wide variety of analyzing approaches from those interdisciplinary fields to deliver deeper insights to researchers both in academia and industry to develop next-generation dental implants.

Bio-Tribocorrosion of Titanium Dental Implants and Its Toxicological Implications: A Scoping Review

Bio-tribocorrosion is a phenomenon that combines the essentials of tribology (friction, wear, and lubrication) and corrosion with microbiological processes. Lately, it has gained attention in implant dentistry because dental implants are exposed to wear, friction, and biofilm formation in the corrosive oral environment. They may degrade upon exposure to various microbial, biochemical, and electrochemical factors in the oral cavity. The mechanical movement of the implant components produces friction and wear that facilitates the release of metal ions, promoting adverse oro-systemic reactions. This review describes the bio-tribocorrosion of the titanium (Ti) dental implants in the oral cavity and its toxicological implications. The original research related to the bio-tribo or tribocorrosion of the dental implants was searched in electronic databases like Medline (Pubmed), Embase, Scopus, and Web of Science. About 34 studies included in the review showed that factors like the type of Ti, oral biofilm, acidic pH, fluorides, and micromovements during mastication promote bio-tribocorrosion of the Ti dental implants. Among the various grades of Ti, grade V, i.e., Ti6Al4V alloy, is most susceptible to tribocorrosion. Oral pathogens like Streptococcus mutans and Porphyromonas gingivalis produce acids and lipopolysaccharides (LPS) that cause pitting corrosion and degrade the TiO₂. The low pH and high fluoride concentration in saliva hinder passive film formation and promote metal corrosion. The released metal ions promote inflammatory reactions and bone destruction in the surrounding tissues resulting in peri-implantitis, allergies, and hyper-sensitivity reactions. However, further validation of the role of bio-tribocorrosion on the durability of the Ti dental implants and Ti toxicity is warranted through clinical trials.

(Bio)Tribocorrosion in Dental Implants: Principles and Techniques of Investigation

Tribocorrosion is a current and very discussed theme in tribology and medicine for its impact on industrial applications. Currently, the phenomena are mainly oriented to the biological environment and, in particular, to medical devices such as hip prostheses, dental implants, knee joints, etc. The term tribocorrosion underlines the simultaneous action of wear and corrosion in a tribocouple. It has a non-negligible effect on the total loss of contact materials and the potential failure of the bio-couplings. This overview aims to focus firstly on the basic principles of prosthesis tribocorrosion and subsequently to describe the techniques and the analytical models developed to quantify this phenomenon, reporting the most relevant results achieved in the last 20 years, proposed in chronological order, in order to discuss and to depict the future research developments and tendencies. Despite considerable research efforts, from this investigation come many issues worthy of further investigation, such as how to prevent or minimize tribocorrosion in biological tribopairs, the development of a consolidated protocol for tribological experiments in corrosive environments joined with new biomaterials and composites, the possibility to achieve more and more accurate theoretical models, and how to be able to ensure the success of new implant designs by supporting research and development for the management of implant complications. The above issues certainly constitute a scientific challenge for the next years in the fields of tribology and medicine.

Electrical Potentiometry with Intraoral Applications

Dental implants currently in use are mainly made of titanium or titanium alloys. As these metallic elements are immersed in an electrolytic medium, galvanic currents are produced between them or with other metals present in the mouth. These bimetallic currents have three potentially harmful effects on the patient: micro-discharges, corrosion, and finally, the dispersion of metal ions or their oxides, all of which have been extensively demonstrated in vitro. In this original work, a system for measuring the potentials generated in vivo is developed. Specifically, it is an electrogalvanic measurements system coupled with a periodontal probe that allows measurement of the potentials in the peri-implant sulcus. This device was tested and verified in vitro to guarantee its applicability in vivo. As a conclusion, this system is able to detect galvanic currents in vitro and it can be considered capable of being employed in vivo, so to assess the effects they may cause on dental implants.

Prediction of tribocorrosion processes in titanium-based dental implants using acoustic emission technique: Initial outcome

The use of dental implants is growing rapidly for the last few decades and Ti-based dental implants are a commonly used prosthetic structure in dentistry. Recently, the combined effect of corrosion and wear, called tribocorrosion, is considered as a major driving process in the early failure of dental implants. However, no previous study has reported the prediction of tribocorrosion processes in advance. Therefore, this study is a novel investigation on how the acoustic emission (AE) technique can predict tribocorrosion processes in commercially-pure titanium (cpTi) and titanium-zirconium (TiZr) alloys. In this study, tribocorrosion tests were performed under potentiostatic conditions and AE detection system associated with it captures AE data. Current evolution and friction coefficient data obtained from the potentiostatic evaluations were compared with AE absolute energy showcased the same data interpretation of tribocorrosion characteristics. Other AE data such as duration, count, and amplitude, matched more closely with other potentiostatic corrosion evaluations and delivered more promising results in the detection of tribocorrosion. Hence, AE can be consider as a tool for predicting tribocorrosion in dental implants. Experimental results also reveal Ti5Zr as one of the most appropriate dental implant materials while exposing Ti10Zr's lower effectiveness to withstand in the simulated oral environment.

The unfavorable role of titanium particles released from dental implants

Titanium is considered to be a metal material with the best biological safety. Studies have proved that the titanium implanted in the bone continuously releases titanium particles (Ti particles), significantly increasing the total titanium content in human body. Generally, Ti particles are released slowly without causing a systemic immune response. However, the continuous increased local concentration may result in damage to the intraepithelial homeostasis, aggravation of inflammatory reaction in the surrounding tissues, bone resorption and implant detachment. They also migrate with blood flow and aggregate in the distal organ. The release of Ti particles is affected by the score of the implant surface structure, microenvironment wear and corrosion, medical operation wear, and so on, but the specific mechanism is not clear. Thus, it difficult to prevent the release completely. This paper reviews the causes of the Ti particles formation, the damage to the surrounding tissue, and its mechanism, in particular, methods for reducing the release and toxicity of the Ti particles.

Effect of albumin, urea, lysozyme and mucin on the triboactivity of Ti6Al4V/zirconia pair used in dental implants

The titanium implant/zirconia abutment interface can suffer failure upon mechanical and biological issues, ultimately leading to the loss of the artificial tooth. The study of the effect of the organic compounds present in saliva on the tribological behavior of these systems is of utmost importance to understand the failure mechanisms and better mimic the in vivo conditions. The aim of the present work is to evaluate the effect of the addition of albumin, urea, lysozyme and mucin to artificial saliva, on the triboactivity of Ti6Al4V/zirconia pair commonly used in dental implants and then, compare the results with those obtained with human saliva. The solutions' viscosity was measured and the adsorption of the different biomolecules to both Ti6Al4V and zirconia was accessed. Tribological tests were performed using Ti6Al4V balls sliding on zirconia plates inside of a corrosion cell. Friction and wear coefficients were determined, and the open circuit potential (OCP) was monitored during the tests. Also, the wear mechanisms were identified. The presence of mucin in the artificial lubricant led to the lowest wear coefficients. The main wear mechanism was abrasion, independently of the used lubricant. Adhesive wear was observed for the systems without mucin. Tribocorrosion activity and wear coefficient were lower in the presence of mucin. None of the studied artificial lubricants mimicked the effect of human saliva (HS) on the tribological behavior of the studied pair since this lubricant led to the lowest friction coefficient and highest corrosion activity.

Titanium Wear of Dental Implants from Placement, under Loading and Maintenance Protocols

The objective of this review was to analyze the process of wear of implants leading to the shedding of titanium particles into the peri-implant hard and soft tissues. Titanium is considered highly biocompatible with low corrosion and toxicity, but recent studies indicate that this understanding may be misleading as the properties of the material change drastically when titanium nanoparticles (NPs) are shed from implant surfaces. These NPs are immunogenic and are associated with a macrophage-mediated inflammatory response by the host. The literature discussed in this review indicates that titanium NPs may be shed from implant surfaces at the time of implant placement, under loading conditions, and during implant maintenance procedures. We also discuss the significance of the micro-gap at the implant-abutment interface and the effect of size of the titanium particles on their toxicology. These findings are significant as the titanium particles can have adverse effects on local soft and hard tissues surrounding implants, implant health and prognosis, and even the health of systemic tissues and organs.

Effectiveness and surface changes of different decontamination protocols at smooth and minimally rough titanium surfaces

BACKGROUND

The objective of this study is to evaluate titanium decontamination after different protocols while assessing changes in surface roughness, chemical composition, and wettability.

METHODS

Ninety-six smooth (S) and 96 minimally rough (R) titanium microimplants were used. Pristine microimplants were reserved for negative control (S-nC/R-nC, n = 9), while the remaining microimplants were incubated in Escherichia coli culture. Non-decontaminated microimplants were used as positive control (S-pC/R-pC, n = 3). The other microimplants were divided into seven different decontamination protocols (12 S/R per group): 24% EDTA, 2% chlorhexidine (CHL), gauze soaked in 2% chlorhexidine (GCHL), gauze soaked in ultrapure water (GMQ), scaling (SC), titanium brush (TiB), and implantoplasty (IP). Contaminated areas were assessed by scanning electron microscope images, chemical composition by energy dispersive X-ray spectroscopy, wettability by meniscus technique, and roughness by an optical profiler.

RESULTS

Higher residual bacteria were observed in R-pC compared with S-pC (P <0.0001). When comparing S and R with their respective pC groups, the best results were obtained with GCHL, SC, TiB, and IP, with no difference between these protocols (P >0.05). Changes in surface roughness were observed after all treatments, with S/R-IP presenting the smoother and a less hydrophilic surface (P <0.05). Apart from IP protocol, all the other groups presented a more hydrophilic surface in R than in S microimplants (P <0.003). All decontamination protocols resulted in a lower percentage of superficial Ti when compared with S/R-nC (P <0.002).

CONCLUSIONS

All decontamination protocols resulted in changes in roughness, wettability, and chemical composition, but GCHL, SC, TiB, an IP presented the best decontamination outcomes.

A Comprehensive Review on the Corrosion Pathways of Titanium Dental Implants and Their Biological Adverse Effects

The main aim of this work was to perform a comprehensive review of findings reported by previous studies on the corrosion of titanium dental implants and consequent clinical detrimental effects to the patients. Most studies were performed by in vitro electrochemical tests and complemented with microscopic techniques to evaluate the corrosion behavior of the protective passive oxide film layer, namely TiO2. Results revealed that bacterial accumulation, dietary, inflammation, infection, and therapeutic solutions decrease the pH of the oral environment leading to the corrosion of titanium. Some therapeutic products used as mouthwash negatively affect the corrosion behavior of the titanium oxide film and promote changes on the implant surface. In addition, toothpaste and bleaching agents, can amplify the chemical reactivity of titanium since fluor ions interacting with the titanium oxide film. Furthermore, the number of in vivo studies is limited although corrosion signs have been found in retrieved implants. Histological evaluation revealed titanium macro- and micro-scale particles on the peri-implant tissues. As a consequence, progressive damage of the dental implants and the evolution of inflammatory reactions depend on the size, chemical composition, and concentration of submicron- and nanoparticles in the surrounding tissues and internalized by the cells. In fact, the damage of the implant surfaces results in the loss of material that compromises the implant surfaces, implant-abutment connections, and the interaction with soft tissues. The corrosion can be an initial trigger point for the development of biological or mechanical failures in dental implants.

A Literature Review Study on Atomic Ions Dissolution of Titanium and Its Alloys in Implant Dentistry

This review of literature paper was done in order to conduct a review of the literature and an assessment of the effects of titanium implant corrosion on peri-implant health and success in the oral environment. This paper evaluates and critically reviews the findings of the multiple in-depth in vivo and in vitro studies that are related to corrosion aspects of the titanium and its alloys. A literature survey was conducted by electronic search in Medline and studies that were published between 1940 and August 2018 were selected. The search terms used were types of corrosion, corrosion of titanium implants, titanium corrosion, metal ion release from the titanium implants, fretting and pitting corrosion, implant corrosion, peri implantitis, and corrosion. Both in vivo and in vitro studies were also included in the review. The search and selection resulted in 64 articles. These articles were divided on the basis of their context to different kinds of corrosion related to titanium dental implants. It is evident that metal ions are released from titanium and titanium alloy dental implants as a result of corrosion. Corrosion of implants is multifactorial, including electrical, chemical, and mechanical factors, which have an effect on the peri-implant tissues and microbiota. The literature surveyed showed that corrosion related to titanium and its alloys has an effect on the health of peri-implant soft and hard tissue and the long term survival of metal dental implants. It can be concluded that presence of the long-term corrosion reaction along with continuous corrosion leads to the release of ions into the peri-implant tissue but also to a disintegration of the implant that contribute to material fatigue and even fracture of the abutments and implant body or both. This combined impact of the corrosion, bacterial activity, chemical reactions, and functional stresses are to be looked at as important factors of implant failure. The findings can be used to explore the possible strategies of research to investigate the biological impact of implant materials.

The role of bacterial biofilm and mechanical forces in modulating dental implant failures

Currently many assume that bacteria are the primary etiological factor associated with failure of titanium dental implants. However, emerging data indicates a possible role for mechanical forces in implant failure. This study is based on the hypothesis that the synergistic effect of mechanical forces and bacterial biofilm can lead to surface damage resulting in in vivo release of metallic particles. The primary aim of the study was to develop a dynamic fatigue test method for dental implants immersed in wet environments such as; (i) 0.01 M phosphate buffer saline (PBS); (ii) lactic acid (pH = 5); (iii) bacterial polyculture. Four dental implants each were subjected to fatigue loading from 45 N to 450 N at 4 Hz for 2 million cycles while immersed in (i) PBS (negative control); (ii) bacterial culture (test); and (iii) lactic acid (positive control). Post-testing, optical microscopy, x-ray photoelectron spectroscopy, and electrochemical corrosion tests were performed to evaluate the surface morphology, chemistry, and potential, respectively, of titanium implants. Post-testing, surface discoloration was evident in all three groups. However, the surface damage was further established in XPS analyses of test specimens, which showed that the interplay of bacterial biofilm and mechanical forces resulted in thinning of the TiO₂. Lower corrosion potential (Ecorr) of the test specimens compared to positive and negative controls also illustrated damage to the oxide layer. However, other electrochemical parameters such as linear polarization resistance (LPR) and corrosion rate (CR) were comparable among the groups indicating the corrosion resistance post-testing. The synergistic effect of cyclic occlusal loading and bacteria biofilm could negatively affect the surface of titanium dental implants.

Nanoparticles having amphiphilic silane containing Chlorin e6 with strong anti-biofilm activity against periodontitis-related pathogens

OBJECTIVES

The objectives of this study were to: (1) develop the multifunctional nanoparticles containing Chlorin e6 (Ce6), Coumarin 6 (C6) and Fe₃O₄ nanoparticles (NPs); and (2) investigate the inhibitory effects of the nanoparticles via antibacterial photodynamic therapy (aPDT) against three species of periodontitis-related pathogens for the first time.

MATERIALS AND METHODS

Ce6 and C6 were co-loaded into the Fe₃O₄-silane core-shell structure to form multifunctional nanoparticles (denoted "Fe₃O₄-silane@Ce6/C6 MNPs"). The physical and chemical properties of nanoparticles were characterized. Biofilm properties of Streptococcus sanguinis, Porphyromonas gingivalis and Fusobacterium nucleatum were tested. Colony-forming units (CFU), live/dead assay, and metabolic activity of biofilms were determined to evaluate the aPDT function mediated by the Fe₃O₄-silane@Ce6/C6 MNPs. Fluorescence imaging and the targeted antibacterial effects were also investigated.

RESULTS

Fe₃O₄-silane@Ce6/C6 MNPs showed superparamagnetic properties, chemical stability and water-solubility, with no cytotoxicity. Fe₃O₄ NPs did not compromise the emission peaks of C6 and Ce6. The Fe₃O₄-silane@Ce6/C6-mediated aPDT had much greater reduction in biofilms than the control groups (p < 0.05). Biofilm CFU was reduced by about 4-5 orders of magnitude via Fe₃O₄-silane@Ce6/C6-mediated aPDT. The co-loading of Ce6 and C6 enabled the real-time aPDT monitoring by ratio emissions with the same wavelength. Fe₃O₄ with magnetic field enabled the targeting of infection sites by killing bacteria via magnetic field.

CONCLUSION

The multifunctional nanoparticles exerted strong anti-biofilm activity against periodontitis-related pathogens, with excellent biocompatibility, real-time monitoring, and magnetically-targeting capacities. The multifunctional nanoparticles have great potential in antibacterial applications to inhibit the occurrence and progression of periodontitis.

Potential Causes of Titanium Particle and Ion Release in Implant Dentistry: A Systematic Review

Implant surface characteristics, as well as physical and mechanical properties, are responsible for the positive interaction between the dental implant, the bone and the surrounding soft tissues. Unfortunately, the dental implant surface does not remain unaltered and changes over time during the life of the implant. If changes occur at the implant surface, mucositis and peri-implantitis processes could be initiated; implant osseointegration might be disrupted and bone resorption phenomena (osteolysis) may lead to implant loss. This systematic review compiled the information related to the potential sources of titanium particle and ions in implant dentistry. Research questions were structured in the Population, Intervention, Comparison, Outcome (PICO) framework. PICO questionnaires were developed and an exhaustive search was performed for all the relevant studies published between 1980 and 2018 involving titanium particles and ions related to implant dentistry procedures. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for the selection and inclusion of the manuscripts in this review. Titanium particle and ions are released during the implant bed preparation, during the implant insertion and during the implant decontamination. In addition, the implant surfaces and restorations are exposed to the saliva, bacteria and chemicals that can potentially dissolve the titanium oxide layer and, therefore, corrosion cycles can be initiated. Mechanical factors, the micro-gap and fluorides can also influence the proportion of metal particles and ions released from implants and restorations.

Wear and Corrosion Interactions at the Titanium/Zirconia Interface: Dental Implant Application

PURPOSE

Dental implants have been shown to have predictable success, but esthetic complications often arise. To reduce tissue shadowing from titanium, zirconia abutments may be used; however, the literature suggests that the use of zirconia leads to greater destruction of the implant interface that may result in biological complications such as titanium tattoos and heavy metal toxicity. Previous studies have examined the mechanical aspects of this implant/abutment relationship, but they have not accounted for the corrosive degradation that also takes place in the dynamic environment of the oral cavity. This study investigated the combined effect of both wear and corrosion on the materials at the implant and abutment interface.

MATERIALS AND METHODS

Using a simulated oral tribocorrosive environment, titanium (Ti) and zirconia (Zr) abutment materials were slid against titanium and Roxolid implant alloys. The four couplings (Ti/Ti, Ti/Rox, Zr/Ti, Zr/Rox) were selected for the tribocorrosion tests (N = 3). The testing was conducted for 25K cycles, and the coefficient of friction (CoF) and voltage evolution were recorded simultaneously. Following the tribocorrosion assays, the wear volume loss was calculated, and surface characterization was performed. Statistical analysis was completed using a one-way ANOVA followed by post-hoc Bonferroni comparisons.

RESULTS

Zr/Ti groups had the highest CoF (1.1647), and Ti/Ti had the lowest (0.5033). The Zr/Ti coupling generated significantly more mechanical damage than the Ti/Ti group (p = 0.021). From the corrosion aspect, the Ti/Ti groups had the highest voltage drop (0.802 V), indicating greater corrosion susceptibility. In comparison, the Zr/Roxolid group had the lowest voltage drop (0.628 V) and significantly less electrochemical degradation (p = 0.019). Overall, the Ti/Ti group had the largest wear volume loss (15.1 × 10⁷ μm³ ), while the Zr/Ti group had the least volume loss (2.26 × 10⁷ μm³ ). Both zirconia couplings had significantly less wear volume than the titanium couplings (p < 0.001).

CONCLUSIONS

This study highlights the synergistic interaction between wear and corrosion, which occurs when masticatory forces combine with the salivary environment of the oral cavity. Overall, the zirconia groups outperformed the titanium groups. In fact, the titanium groups generated 5 to 6 times more wear to the implant alloys as compared with the zirconia counterparts. The best performing group was Zr/Ti, and the worst performing group was Ti/Ti.

Biofunctional Sr- and Si-loaded titania nanotube coating of Ti surfaces by anodization-hydrothermal process

BACKGROUND

Two frequent problems associated with titanium (Ti) surfaces of bone/dental implants are their corrosion and lack of native tissue integration.

METHODS

Here, we present an anodization-hydrothermal method for coating Ti surfaces with a layer of silicon (Si)- and strontium (Sr)-loaded titania nanotubes (TNs). The Ti surfaces coated with such a layer (Si-Sr-TNs) were characterized with different techniques.

RESULTS

The results indicate that the Si4+ and Sr2+ ions were evenly incorporated into the TNs and that the Si-Sr-TN layer provides good protection against corrosive media like simulated body fluid. The excellent cytocompatibility of the coating was confirmed in vitro by the significant growth and differentiation of MC3T3-E1 osteoblastic cells.

CONCLUSION

Being easily and economically fabricated, the Si-Sr-TN surfaces may find their niche in clinical applications, thanks to their excellent biological activity and corrosion resistance.

Dicationic Imidazolium-Based Ionic Liquid Coatings on Zirconia Surfaces: Physico-Chemical and Biological Characterization

In the present work, dicationic imidazolium-based ionic liquids (ILs) were investigated as multi-functional coatings on a zirconia (ZrO₂) surface to prevent biofilm formation and enhance the wear performance of zirconia while maintaining the material’s compatibility with host cells. ILs containing phenylalanine and methionine were synthesized and deposited on zirconia. Intermolecular interactions driving IL deposition on zirconia were studied using X-ray photoelectron spectroscopy (XPS). Anti-biofilm activity and cell compatibility were evaluated in vitro after one and seven days, and wear performance was tested using a pin-on-disk apparatus. ILs were observed to form strong hydrogen bonds with zirconia. IL containing phenylalanine formed a stable film on the surface after one and seven days in phosphate-buffered saline (PBS) and artificial saliva and showed excellent anti-biofilm properties against Streptococcussalivarius and Streptococcussanguinis. Compatibility with gingival fibroblasts and pre-osteoblasts was maintained, and conditions for growth and differentiation were preserved. A significantly lower coefficient of friction and wear volume loss were observed for IL-coated surfaces as compared to non-coated substrates. Overall, zirconia is an emerging alternative to titanium in dental implants systems, and this study provides additional evidence of the materials’ behavior and IL coatings as a potential surface treatment technology for improvement of its properties.

Release of titanium after insertion of dental implants with different surface characteristics - an ex vivo animal study

In the present study, amount of titanium (Ti) released into the surrounding bone during placement of implants with different surface structure was investigated. Quantification of Ti released during insertion from three different implants was performed in this ex vivo study. Jaw bone from pigs was used as model for installation of the implants and Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES) was used for analysis of the released Ti. Implant surface were examined with scanning electron microscopy (SEM), before and after the placement into the bone. Ti was abraded to the surrounding bone upon insertion of a dental implant and the surface roughness of the implant increased the amount of Ti found. Diameter and total area of the implant were of less importance for the Ti released to the bone. No visible damages to the implant surfaces could be identified in SEM after placement.

Fretting Corrosion Behavior of Experimental Ti-20Cr Compared to Titanium

Experimental cast titanium alloys containing 20 mass% chromium (Ti-20Cr) show preferable mechanical properties and a good corrosion resistance. This study evaluated the fretting corrosion behavior of Ti-20Cr. Ti-20Cr (n = 4) and commercially pure titanium (CP-Ti, n = 6) disk specimens were used. The fretting corrosion test was performed by electrochemical corrosion at 0.3 V in 0.9% saline solution and mechanical damage using 10 scratching cycles with three different scratching speeds (10–40 mm/s) at 10 N. After testing, the activation peak, repassivation time and surface morphology of each specimen were analyzed. The differences between the results were tested by parametric tests (α = 0.05). The average activation peaks were significantly higher in CP-Ti than in Ti-20Cr (p < 0.01), except at 20 mm/s. In the series of scratching speeds, faster scratching speeds showed higher activation peaks. The maximum activation peaks were also higher in CP-Ti. Slight differences in the repassivation time were observed between the materials at every scratching speed; faster scratching speeds showed shorter repassivation times in both materials (p < 0.05). CP-Ti showed severe damage and significantly higher wear depth than Ti-20Cr (p < 0.05). In conclusion, adding chromium to titanium reduced surface damage and improved the fretting corrosion resistance.

Metal in Total Hip Arthroplasty: Wear Particles, Biology, and Diagnosis

Total hip arthroplasty (THA) has been performed for nearly 50 years. Between 2006 and 2012, more than 600,000 metal-on-metal THA procedures were performed in the United States. This article reviews the production of metal wear debris in a metal-on-metal articulation and the interaction of cobalt and chromium ions that ultimately led to a dramatic decline in the use of metal-on-metal THA articulations. Additionally, the article reviews mechanisms of metal wear, the biologic reaction to cobalt and chromium ions, the clinical presentation of failing metal-on-metal articulations, and current diagnostic strategies. Further, the article discusses the use of inflammatory markers, metal ion levels, radiographs, metal artifact reduction sequence magnetic resonance imaging, and ultrasound for failed metal-on-metal THA procedures. When adopting new technologies, orthopedic surgeons must weigh the potential increased benefits against the possibility of new mechanisms of failure. Metal-on-metal bearings are a prime example of the give and take between innovation and clinical results, especially in the setting of an already successful procedure such as THA. [Orthopedics. 2016; 39(6):371-379.].

The effect of fretting associated periodic cathodic potential shifts on the electrochemistry and in vitro biocompatibility of commercially pure titanium

This study explored how periodic cathodic polarization of commercially pure titanium (cpTi) alters its electrochemical properties and biocompatibility. MC3T3-E1 preosteoblast cells were cultured directly on cpTi samples and maintained at open circuit potential (OCP) for 24 h followed by an additional 24-h sequence of periodic cathodic polarization to -1000 or -750 mV (vs. Ag/AgCl) for 1 s followed by a 5-s recovery at OCP. Control experiments were performed where the samples were maintained at OCP throughout the entire test. Subsequent electrochemical impedance spectroscopy revealed both of the periodic cathodic polarization conditions significantly reduced the polarization resistance (R_p ), while only the -1000 mV condition significantly increased the capacitance (C) as compared to the controls. Scanning electron micrographs showed that the cells were fragmented and balled up on the samples periodically shifted to -1000 mV as compared to the cells that were well spread on the controls and samples periodically shifted to -750 mV. Additionally, live/dead fluorescence microscopy revealed that periodic polarizations to -1000 mV reduced cell viability to around 12% as compared to the greater than 95% cell viability observed on the controls and samples periodically polarized to -750 mV. This work showed that periodic cathodic potential shifts can notably alter the electrochemical behavior of cpTi and the viability and morphology of cells seeded directly onto its surface. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1591-1601, 2016.

Biomimetic coatings enhance tribocorrosion behavior and cell responses of commercially pure titanium surfaces

Biofunctionalized surfaces for implants are currently receiving much attention in the health care sector. Our aims were (1) to create bioactive Ti-coatings doped with Ca, P, Si, and Ag produced by microarc oxidation (MAO) to improve the surface properties of biomedical implants, (2) to investigate the TiO2 layer stability under wear and corrosion, and (3) to evaluate human mesenchymal stem cells (hMSCs) responses cultured on the modified surfaces. Tribocorrosion and cell experiments were performed following the MAO treatment. Samples were divided as a function of different Ca/P concentrations and treatment duration. Higher Ca concentration produced larger porous and harder coatings compared to the untreated group (p < 0.001), due to the presence of rutile structure. Free potentials experiments showed lower drops (-0.6 V) and higher coating lifetime during sliding for higher Ca concentration, whereas lower concentrations presented similar drops (-0.8 V) compared to an untreated group wherein the drop occurred immediately after the sliding started. MAO-treated surfaces improved the matrix formation and osteogenic gene expression levels of hMSCs. Higher Ca/P ratios and the addition of Ag nanoparticles into the oxide layer presented better surface properties, tribocorrosive behavior, and cell responses. MAO is a promising technique to enhance the biological, chemical, and mechanical properties of dental implant surfaces.

The applicability of PEEK-based abutment screws

The high-performance polymer PEEK (poly-ether-ether-ketone) is more and more being used in the field of dentistry, mainly for removable and fixed prostheses. In cases of screw-retained implant-supported reconstructions of PEEK, an abutment screw made of PEEK might be advantageous over a conventional metal screw due to its similar elasticity. Also in case of abutment screw fracture, a screw of PEEK could be removed more easily. M1.6-abutment screws of four different PEEK compounds were subjected to tensile tests to set their maximum tensile strengths in relation to an equivalent stress of 186MPa, which is aused by a tightening torque of 15Ncm. Two screw types were manufactured via injection molding and contained 15% short carbon fibers (sCF-15) and 40% (sCF-40), respectively. Two screw types were manufactured via milling and contained 20% TiO2 powder (TiO2-20) and >50% parallel orientated, continuous carbon fibers (cCF-50). A conventional abutments screw of Ti6Al4V (Ti; CAMLOG(®) abutment screw, CAMLOG, Wimsheim, Germany) served as control. The maximum tensile strength was 76.08±5.50MPa for TiO2-20, 152.67±15.83MPa for sCF-15, 157.29±20.11MPa for sCF-40 and 191.69±36.33MPa for cCF-50. The maximum tensile strength of the Ti-screws amounted 1196.29±21.4MPa. The results of the TiO2-20 and the Ti screws were significantly different from the results of the other samples, respectively. For the manufacturing of PEEK abutment screws, PEEK reinforced by >50% continuous carbon fibers would be the material of choice.

The biological response to orthopaedic implants for joint replacement: Part I: Metals

Joint replacement is a commonly performed, highly successful orthopaedic procedure, for which surgeons have a large choice of different materials and implant designs. The materials used for joint replacement must be both biologically acceptable to minimize adverse local tissue reactions, and robust enough to support weight bearing during common activities of daily living. Modern joint replacements are made from metals and their alloys, polymers, ceramics, and composites. This review focuses on the biological response to the different biomaterials used for joint replacement. In general, modern materials for joint replacement are well tolerated by the body as long as they are in bulk (rather than in particulate or ionic) form, are mechanically stable and noninfected. If the latter conditions are not met, the prosthesis will be associated with an acute/chronic inflammatory reaction, peri-prosthetic osteolysis, loosening and failure. This article (Part 1 of 2) is dedicated to the use of metallic devices in orthopaedic surgery including the associated biological response to metallic byproducts is a review of the basic science literature regarding this topic. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2162-2173, 2017.

In Vitro Evaluation of the Effects of Multiple Oral Factors on Dental Implants Surfaces

Presence of metal ions and debris resulting from corrosion processes of dental implants in vivo can elicit adverse tissue reactions, possibly leading to peri-implant bone loss and eventually implant failure. This study hypothesized that the synergistic effects of bacterial biofilm and micromotion can cause corrosion of dental implants and release of metal ions in vivo. The goal is to simulate the oral environment where an implant will be exposed to a combination of acidic electrochemical environment and mechanical forces. Four conditions were developed to understand the individual and synergistic effects of mechanical forces and bacterial biofilm on the surface of dental implants; In condition 1, it was found that torsional forces during surgical insertion did not generate wear particle debris or metal ions. In condition 2, fatigue tests were performed in a wet environment to evaluate the effect of cyclic occlusal forces. The mechanical forces applied on the implants were able to cause implant fracture as well as surface corrosion features such as discoloration, delamination, and fatigue cracks. Immersion testing (condition 3) showed that bacteria (Streptococcus mutans) were able to create an acidic condition that triggered surface damage such as discoloration, rusting, and pitting. A novel testing setup was developed to understand the conjoint effects of micromotion and bacterial biofilm (condition 4). Surface damage initiated by acidic condition due to bacteria (condition 3), can be accelerated in tandem with mechanical forces through fretting-crevice corrosion. Permanent damage to surface layers can affect osseointegration and deposition of metal ions in the surrounding tissues can trigger inflammation.

Influence of sulfide concentration on the corrosion behavior of titanium in a simulated oral environment

This study assessed the corrosion behavior of titanium in response to sulfide by determining the effects of sulfide concentration and pH over immersion period. Corrosion was evaluated through changes in color, glossiness, surface characterization, and titanium release. Sulfide solutions were prepared in 3 different concentrations with Na2S, each in pH unadjusted (sulfide-alkaline) and pH adjusted to 7.5 (sulfide-neutral). Titanium discoloration increased and glossiness decreased as sulfide concentration and immersion period increased in sulfide-alkaline solutions. Coral-like complexes were observed on the surface of these specimens, which became more pronounced as concentration increased. Small amounts of titanium release were detected in sulfide-alkaline solutions; however, this was not affected by immersion periods. Corrosion was indicated through considerable surface oxidation suggesting the formation of a thick oxide layer. No significant changes in color and glossiness, or titanium release were indicated for titanium specimens immersed in sulfide-neutral solutions indicating that pH had a significant effect on corrosion. Our findings suggest that a thick oxide layer on the titanium surface was formed in sulfide-alkaline solutions due to excessive oxidation.

Spectroscopic and microscopic investigation of the effects of bacteria on dental implant surfaces

The surface morphology and chemical composition of commercially pure titanium dental implants and healing abutments exposed in vitro or in vivo to oral bacteria were studied.

Improvement of tribological and anti-corrosive performance of titanium surfaces coated with dicationic imidazolium-based ionic liquids

In this work, dicationic imidazolium-based ionic liquids (ILs) with amino acid anionic moieties were employed as coatings for commercially pure titanium (Ti) surfaces.

Tribocorrosion behaviors of 304SS: effect of solution pH

The tribocorrosion behaviors of 304SS in chloride-containing solutions are pH dependent, which can affect both the corroding and wear behaviors, and eventually determine the total material degradation.

Attachment of Porphyromonas gingivalis to corroded commercially pure titanium and titanium-aluminum-vanadium alloy

BACKGROUND

Titanium dental material can become corroded because of electrochemical interaction in the oral environment. The corrosion process may result in surface modification. It was hypothesized that a titanium surface modified by corrosion may enhance the attachment of periodontal pathogens. This study evaluates the effects of corroded titanium surfaces on the attachment of Porphyromonas gingivalis.

METHODS

Commercially pure titanium (cp-Ti) and titanium-aluminum-vanadium alloy (Ti-6Al-4V) disks were used. Disks were anodically polarized in a standard three-electrode setting in a simulated oral environment with artificial saliva at pH levels of 3.0, 6.5, or 9.0. Non-corroded disks were used as controls. Surface roughness was measured before and after corrosion. Disks were inoculated with P. gingivalis and incubated anaerobically at 37°C. After 6 hours, the disks with attached P. gingivalis were stained with crystal violet, and attachment was expressed based on dye absorption at optical density of 550 nm. All assays were performed independently three times in triplicate. Data were analyzed by two-way analysis of variance, the Tukey honestly significant difference test, t test, and Pearson's correlation test (α = 0.05).

RESULTS

Both cp-Ti and Ti-6Al-4V alloy-corroded disks promoted significantly more bacterial attachment (11.02% and 41.78%, respectively; P <0.0001) than did the non-corroded controls. Significantly more (11.8%) P. gingivalis attached to the cp-Ti disks than to the Ti-6Al-4V alloy disks (P <0.05). No significant difference in P. gingivalis attachment was noted among the corroded groups for both cp-Ti and Ti-6Al-4V alloy (P >0.05). There was no significant correlation between surface roughness and P. gingivalis attachment.

CONCLUSION

A higher degree of corrosion on the titanium surface may promote increased bacterial attachment by oral pathogens.

Titanium Corrosion Mechanisms in the Oral Environment: A Retrieval Study

Corrosion of titanium dental implants has been associated with implant failure and is considered one of the triggering factors for peri-implantitis. This corrosion is concerning, because a large amount of metal ions and debris are generated in this process, the accumulation of which may lead to adverse tissue reactions in vivo. The goal of this study is to investigate the mechanisms for implant degradation by evaluating the surface of five titanium dental implants retrieved due to peri-implantitis. The results demonstrated that all the implants were subjected to very acidic environments, which, in combination with normal implant loading, led to cases of severe implant discoloration, pitting attack, cracking and fretting-crevice corrosion. The results suggest that acidic environments induced by bacterial biofilms and/or inflammatory processes may trigger oxidation of the surface of titanium dental implants. The corrosive process can lead to permanent breakdown of the oxide film, which, besides releasing metal ions and debris in vivo, may also hinder re-integration of the implant surface with surrounding bone.