Corrosion behavior of novel Ti-24Nb-4Zr-7.9Sn alloy for dental implant applications in vitro

Synergistic Amelioration of Osseointegration and Osteoimmunomodulation with a Microarc Oxidation-Treated Three-Dimensionally Printed Ti-24Nb-4Zr-8Sn Scaffold via Surface Activity and Low Elastic Modulus

Biomaterial scaffolds, including bone substitutes, have evolved from being primarily a biologically passive structural element to one in which material properties such as surface topography and chemistry actively direct bone regeneration by influencing stem cells and the immune microenvironment. Ti-6Al-4V(Ti6Al4V) implants, with a significantly higher elastic modulus than human bone, may lead to stress shielding, necessitating improved stability at the bone-titanium alloy implant interface. Ti-24Nb-4Zr-8Sn (Ti2448), a low elastic modulus β-type titanium alloy devoid of potentially toxic elements, was utilized in this study. We employed 3D printing technology to fabricate a porous scaffold structure to further decrease the structural stiffness of the implant to approximate that of cancellous bone. Microarc oxidation (MAO) surface modification technology is then employed to create a microporous structure and a hydrophilic oxide ceramic layer on the surface and interior of the scaffold. In vitro studies demonstrated that MAO treatment enhances the proliferation, adhesion, and osteogenesis capabilities on the scaffold surface. The chemical composition of the MAO-Ti2448 oxide layer is found to enhance the transcription and expression of osteogenic genes in bone mesenchymal stem cells (BMSCs), potentially related to the enrichment of Nb2O5 and SnO2 in the oxide layer. The MAO-Ti2448 scaffold, with its synergistic surface activity and low stiffness, significantly activates the anti-inflammatory macrophage phenotype, creating an immune microenvironment that promotes the osteogenic differentiation of BMSCs. In vivo experiments in a rabbit model demonstrated a significant improvement in the quantity and quality of the newly formed bone trabeculae within the scaffold under the contact osteogenesis pattern with a matched elastic modulus. These trabeculae exhibit robust connections to the external structure of the scaffold, accelerating the formation of an interlocking structure between the bone and implant and providing higher implantation stability. These findings suggest that the MAO-Ti2448 scaffold has significant potential as a bone defect repair material by regulating osteoimmunomodulation and osteogenesis to enhance osseointegration. This study demonstrates an optional strategy that combines the mechanism of reducing the elastic modulus with surface modification treatment, thereby extending the application scope of β-type titanium alloy.

Assessment of Titanium Level in Submucosal Plaque Around Healthy Implants and Implants with Peri-implantitis: A Clinical Study

Background

The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants.

Methodology

Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry.

Results

The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 μg and in Group II was 0.91 ± 0.04 μg. A highly significant difference between both groups was found (P < 0.05).

Conclusion

There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.

Corrosion Behavior of Titanium in Simulated Body Solutions with the Addition of Biomolecules

Titanium is one of the most used biomaterials for different applications. The aim of this study is to investigate the influence of adenine, thymine, and l-histidine as important biomolecules in the human body on the corrosion behavior of titanium in simulated body solutions. Open circuit measurements, potentiodynamic measurements, electrochemical impedance spectroscopy measurements, and quantum chemical calculations were employed during the investigation. All electrochemical methods used revealed that the investigated biomolecules provide better corrosion resistance to titanium in artificial body solutions. The increase in corrosion resistance is a result of the formation of a stable protective film on the metal surface. Also, quantum chemical calculations are in compliance with electrochemical test results and indicate that adenine, thymine, and l-histidine may act as corrosion inhibitors in the investigated solutions.

Comparison of the osteoblastic activity of low elastic modulus Ti-24Nb-4Zr-8Sn alloy and pure titanium modified by physical and chemical methods

Ti-24Nb-4Zr-8Sn (Ti2448) alloy is a novel low elastic modulus β-titanium alloy without toxic elements. It also has the advantage of high strength, so it has potential application prospects for implantation. To develop its osteogenic effects, it can be modified by electrochemical, and physical processes. The main research aim of this study was to explore the bioactivity of Ti2448 alloy modified by sandblasted, large-grit, acid-etched (SLA), micro-arc oxidation (MAO) and anodic oxidation (AO), and to determine which of the three surface modifications is the best way for developing the osteogenesis of bone marrow mesenchymal stem cells (BMMSCs). In vitro studies, the cytoskeleton, focal adhesion and proliferation of BMMSCs showed that both pure titanium and Ti2448 alloy have good biocompatibility. The osteogenic differentiation of BMMSCs with the Ti2448 alloy were examined by detecting alkaline phosphatase (ALP), mineralization nodules and osteogenic proteins and were better than that with pure titanium. These results showed that the Ti2448 alloy treated by SLA has a better effect on osteogenesis than pure titanium, and AO is the best way of three surface treatments to improve osteogenesis in this study.

Corrosion resistance of coupled sandblasted, large-grit, acid-etched (SLA) and anodized Ti implant surfaces in synthetic saliva

Purpose

The purpose of this study was to investigate the corrosion resistance of galvanically coupled SLA and anodized implant surfaces with a Co‐Cr alloy.

Materials and Methods

Three groups were included in this study. The first (SLA) was composed of SLA implants (Institut Straumann, Basel, Switzerland), the second (ANO) of NobelReplace® (Nobel Biocare, Göteborg, Sweden), and the third (MIX) of both implant systems combined. All groups were assembled with a single Co‐Cr superstructure. Electrochemical testing included open‐circuit potential, electrochemical impedance spectroscopy, cyclic potentiodynamic polarization, and chronoamperometric current‐time measurements. The quantitative results (EOCP, ECORR, ICORR, EPROT, RP, and ICA) were statistically analyzed by one‐way ANOVA and Tukey's post‐hoc multiple comparison test (α = 0.05)

Results

All the aforementioned parameters showed statistically significant differences apart from ECORR and EPROT. The evaluation of qualitative and quantitative results showed that although SLA had higher corrosion resistance compared with ANO, it had less resistance to pitting corrosion. This means that SLA showed increased resistance to uniform corrosion but less resistance if pitting corrosion was initiated. In all cases, MIX showed intermediate behavior.

Conclusion

The corrosion resistance of implant‐retained superstructures is dependent on the electrochemical properties of the implants involved, and thus different degrees of intraoral corrosion resistance among different implant systems are anticipated.

Favorable modulation of osteoblast cellular activity on Zr-modified Co-Cr-Mo alloy: The significant impact of zirconium on cell-substrate interactions

Cobalt-chromium-molybdenum alloys exhibit good mechanical properties (yield strength: ~530 MPa, ultimate tensile strength: ~1114 MPa, elongation-to-failure: ~47.3%, and modulus: ~227 GPa) and corrosion resistance. In recent years, from the perspective of osseointegration, they are considered to be lower in rank in comparison to the widely used titanium alloys. We elucidate here the significant and favorable modulation of cellular activity of Zr-modified Co-Cr-Mo alloys. The average grain size of Co-Cr-Mo alloy samples with and without Zr was 104 ± 27 and ~53 ± 11 μm, respectively. The determining role of small addition of Zr (0.04 wt. %) to the Co-Cr-Mo alloys in favorable modulation of cellular activity was accomplished by combining cellular biology and materials science and engineering. Experiments on the influence of Zr addition to Co-Cr-Mo alloys clearly demonstrated that the cell adhesion, spread and cell-substrate interactions were enhanced in the presence of Zr. The spread/growth rate of cells was ~120% on the Co-Cr-Mo alloy and 190% per day on the Co-Cr-Mo-Zr alloy. While the % area covered by the cells increased from ~5.1 to ~33.6% on Co-Cr-Mo alloy and ~19.2 to ~47.8% on Co-Cr-Mo-Zr alloy after 2 and 24 hr of incubation. Similarly, the cell density increased from ~1354 to ~3424 cells/cm² on Co-Cr-Mo alloy and ~3583 to ~7804 cells/cm² on Co-Cr-Mo-Zr alloy after 2 and 24 hr of incubation. Additionally, stronger vinculin focal adhesion contact and signals associated with actin stress fibers together with extracellular matrix protein, fibronectin, were noted.

A unique hybrid-structured surface produced by rapid electrochemical anodization enhances bio-corrosion resistance and bone cell responses of β-type Ti-24Nb-4Zr-8Sn alloy

Ti-24Nb-4Zr-8Sn (Ti2448), a new β-type Ti alloy, consists of nontoxic elements and exhibits a low uniaxial tensile elastic modulus of approximately 45 GPa for biomedical implant applications. Nevertheless, the bio-corrosion resistance and biocompatibility of Ti2448 alloys must be improved for long-term clinical use. In this study, a rapid electrochemical anodization treatment was used on Ti2448 alloys to enhance the bio-corrosion resistance and bone cell responses by altering the surface characteristics. The proposed anodization process produces a unique hybrid oxide layer (thickness 50-120 nm) comprising a mesoporous outer section and a dense inner section. Experiment results show that the dense inner section enhances the bio-corrosion resistance. Moreover, the mesoporous surface topography, which is on a similar scale as various biological species, improves the wettability, protein adsorption, focal adhesion complex formation and bone cell differentiation. Outside-in signals can be triggered through the interaction of integrins with the mesoporous topography to form the focal adhesion complex and to further induce osteogenic differentiation pathway. These results demonstrate that the proposed electrochemical anodization process for Ti2448 alloys with a low uniaxial tensile elastic modulus has the potential for biomedical implant applications.

Increased Levels of Dissolved Titanium Are Associated With Peri-Implantitis - A Cross-Sectional Study

BACKGROUND

Peri-implantitis represents a disruption of the biocompatible interface between the titanium dioxide layer of the implant surface and the peri-implant tissues. Increasing preclinical data suggest that peri-implantitis microbiota not only triggers an inflammatory immune response but also causes electrochemical alterations of the titanium surfaces, i.e., corrosion, that aggravate this inflammatory response. Thus, it was hypothesized that there is an association between dissolution of titanium from dental implants, which suggests corrosion, and peri-implantitis in humans. The objective of this study is to compare levels of dissolved titanium in submucosal plaque collected from healthy implants and implants with peri-implantitis.

METHODS

Submucosal plaque from 20 implants with peri-implantitis and 20 healthy implants was collected with sterile curets from 30 participants. Levels of titanium were quantified using inductively coupled plasma mass spectrometry and normalized for mass of bacterial DNA per sample to exclude confounding by varying amounts of plaque per site. Statistical analysis was performed using generalized estimated equations to adjust for clustering of implants per participant.

RESULTS

Implants with peri-implantitis harbored significantly higher mean levels of titanium (0.85 ± 2.47) versus healthy implants (0.07 ± 0.19) after adjusting for amount of plaque collected per site (P = 0.033).

CONCLUSIONS

Greater levels of dissolved titanium were detected in submucosal plaque around implants with peri-implantitis compared with healthy implants, indicating an association between titanium dissolution and peri-implantitis. Factors triggering titanium dissolution, as well as the role of titanium corrosion in the peri-implant inflammatory process, warrant further investigation.

Mini-implants for Orthodontic Anchorage: Surface Analysis after Redrilling and Sterilization - An in vitro Study

OBJECTIVE

This study aimed to investigate, in vitro, possible alterations on mini-implants surface after retrieval and if the cleaning process and sterilization can predispose damages.

MATERIALS AND METHODS

Two commercial mini-implants were tested for deformations after drilling and removing in artificial bone four times. Samples were analyzed by scanning electron microscopy, and surface alterations verified through thread and pitches deformation. To alterations caused by insertion/removal and the cleaning process and sterilization were verified in different procedures: Insertions and sterilization, only insertions, and only sterilization. Photomicrographs were analyzed in order to compare the surface characteristics. Head deformation was verified qualitatively. For a quantitative analysis, distances between threads were measured across the active part of the mini-implants.

RESULTS

No deformation was observed in both groups. The cleaning and sterilization processes did not provoke alteration in both groups. Nevertheless, the presence of synthetic bone was noted in some samples. The mean distances between implant threads were similar after all steps in all regions in both groups.

CONCLUSION

The results suggest that the tested mini-implants can be retrieved without damage of its surface after four cycles of insertion, removal, and sterilization.

KEYWORDS

Orthodontic mini-implant, Redrilling, Sterilization.

CLINICAL SIGNIFICANCE

Mini-implants can be retrieved without damage to its surface after four cycles of insertion, removal, and sterilization in the same patient without representing a biological concern.

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.