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D'Agostino A, Misiti G, Scalia AC, Pavarini M, Fiorati A, Cochis A, Rimondini L, Borrini VF, Manfredi M, Andena L, De Nardo L, Chiesa R. Gallium-doped zirconia coatings modulate microbiological outcomes in dental implant surfaces. J Biomed Mater Res A 2024. [PMID: 38884299 DOI: 10.1002/jbm.a.37727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/22/2024] [Accepted: 04/14/2024] [Indexed: 06/18/2024]
Abstract
Despite the significant recent advances in manufacturing materials supporting advanced dental therapies, peri-implantitis still represents a severe complication in dental implantology. Herein, a sol-gel process is proposed to easily deposit antibacterial zirconia coatings onto bulk zirconia, material, which is becoming very popular for the manufacturing of abutments. The coatings' physicochemical properties were analyzed through x-ray diffraction and scanning electron microscopy-energy-dispersive x-ray spectroscopy investigations, while their stability and wettability were assessed by microscratch testing and static contact angle measurements. Uniform gallium-doped tetragonal zirconia coatings were obtained, featuring optimal mechanical stability and a hydrophilic behavior. The biological investigations pointed out that gallium-doped zirconia coatings: (i) displayed full cytocompatibility toward human gingival fibroblasts; (ii) exhibited significant antimicrobial activity against the Aggregatibacter actinomycetemcomitans pathogen; (iii) were able to preserve the commensal Streptococcus salivarius. Furthermore, the proteomic analyses revealed that the presence of Ga did not impair the normal oral microbiota. Still, interestingly, it decreased by 17% the presence of Fusobacterium nucleatum, a gram-negative, strictly anaerobic bacteria that is naturally present in the gastrointestinal tract. Therefore, this work can provide a valuable starting point for the development of coatings aimed at easily improving zirconia dental implants' performance.
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Affiliation(s)
- Agnese D'Agostino
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Giulia Misiti
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | | | - Matteo Pavarini
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Andrea Fiorati
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Andrea Cochis
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Piedmont, Italy
| | - Lia Rimondini
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Piedmont, Italy
| | | | - Marcello Manfredi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Piedmont, Italy
| | - Luca Andena
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Luigi De Nardo
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Roberto Chiesa
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
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Riivari S, Areid N, Närvä E, Willberg J, Närhi T. Saliva exposure reduces gingival keratinocyte growth on TiO 2-coated titanium. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2024; 35:25. [PMID: 38635066 PMCID: PMC11026266 DOI: 10.1007/s10856-024-06792-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/19/2024] [Indexed: 04/19/2024]
Abstract
Bioactive, nanoporous TiO2-coating has been shown to enhance cell attachment on titanium implant surface. The aim of this study was to evaluate, whether the saliva proteins affect the epithelial cell adhesion on TiO2-coated and non-coated titanium. Grade V titanium discs were polished. Half of the discs were provided with TiO2-coating produced in sol with polycondensation method. Half of the TiO2-coated and non-coated discs were treated with pasteurized saliva for 30 min. After saliva treatment, the total protein amounts on surfaces were measured. Next, the hydrophilicity of discs were measured with water contact angle measurements. Further, the gingival keratinocyte adhesion strength was measured after 2 and 6 h of cultivation using serial trypsinization. In addition, cell growth and proliferation were measured after 1, 3, and 7 days of cell culture. Finally, cell morphology, spreading and adhesion protein signals were detected with high resolution confocal microscopy. As a result, in sol coated TiO2-surface had significantly higher hydrophilicity when compared to non-coated titanium, meanwhile both non-coated and TiO2-coated surfaces with saliva treatment had a significant increase in hydrophilicity. Importantly, the amounts of adhered saliva proteins were equal between TiO2-coated and non-coated surfaces. Adhesion strength against enzymatic detachment was weakest on non-coated titanium after saliva exposure. Cell proliferation and cell spreading were highest on TiO2-coated titanium, but saliva exposure significantly decreased cell proliferation and spreading on TiO2-coated surface. To conclude, even though saliva exposure makes titanium surfaces more hydrophilic, it seems to neutralize the bioactive TiO2-coating and decrease cell attachment to TiO2-coated surface.
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Affiliation(s)
- Sini Riivari
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, FI-20520, Turku, Finland.
| | - Nagat Areid
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, FI-20520, Turku, Finland
| | - Elisa Närvä
- Institute of Biomedicine and Cancer Research Laboratory FICAN West, University of Turku, FI-20520, Turku, Finland
| | - Jaana Willberg
- Department of Oral Pathology and Oral Radiology, University of Turku, FI-20520, Turku, Finland
- Turku University Hospital and University of Turku, FI-20520, Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku, FI-20520, Turku, Finland
- Wellbeing Services County of South-West Finland and University of Turku, FI-20520, Turku, Finland
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Shayya G, Benedetti C, Chagot L, Stachowicz ML, Chassande O, Catros S. Revolutionizing Dental Implant Research: A Systematic Review on Three-Dimensional In Vitro Models. Tissue Eng Part C Methods 2024. [PMID: 38587434 DOI: 10.1089/ten.tec.2023.0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024] Open
Abstract
Dental implants have been clinically used for almost five decades with high success rates. In vitro research models used in implant dentistry are limited to two-dimensional experiments, which are reproducible and well adapted to evaluate a single parameter but do not reproduce the complexity of clinical settings. On the contrary, the in vivo research models using animals offer similar histological and anatomical features to humans, and tissue healing can be close to a clinical situation, but those models are usually accompanied with ethical concerns, and their outcomes could not be extrapolated to humans because of interspecies variabilities. This makes the development of novel in vitro models that recapitulate physiological events occurring during dental implant placement of particular interest for current research in dentistry. Also, such models could be challenged by setting a pathological environment (peri-implantitis) to better understand the disease and eventually serve as a platform to evaluate novel treatment modalities. The aim of this systematic literature review was to cover all the in vitro three-dimensional (3D) complex models available for research in implant dentistry. To accomplish this, a comprehensive search of the literature present on Scopus and PubMed databases was done using specific keywords, as well as inclusion/exclusion criteria. Out of 1334 articles found, we have finally included 27 articles in this review with publication dates between 2001 and 2022. In those articles, the 3D models were designed to study tissue-implant interface behavior in bone or gingival tissue. The articles focused on simulating implant integration, evaluating the effect of different conditions on implant integration, or developing an infection model for the implant integration process. The methods used involved implant material and cells organized in a specific 3D structure. The 3D models developed were able to simulate the process of dental implant osseo- and soft tissue integration and lead to results comparable with conventional in vitro and in vivo models. A relatively limited number of articles were obtained, which indicates that this is an emerging field, highly dependent on progresses made in biotechnologies and tissue engineering, and that further investigation is needed to enhance these 3D in vitro models.
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Affiliation(s)
- Ghannaa Shayya
- Inserm BioTis, Laboratory for the Bioengineering of Tissues, University of Bordeaux, Bordeaux, France
| | - Clémentine Benedetti
- Inserm BioTis, Laboratory for the Bioengineering of Tissues, University of Bordeaux, Bordeaux, France
| | - Lise Chagot
- Inserm BioTis, Laboratory for the Bioengineering of Tissues, University of Bordeaux, Bordeaux, France
| | - Marie-Laure Stachowicz
- Inserm BioTis, Laboratory for the Bioengineering of Tissues, University of Bordeaux, Bordeaux, France
| | - Olivier Chassande
- Inserm BioTis, Laboratory for the Bioengineering of Tissues, University of Bordeaux, Bordeaux, France
| | - Sylvain Catros
- Inserm BioTis, Laboratory for the Bioengineering of Tissues, University of Bordeaux, Bordeaux, France
- Department of Oral Surgery, University Hospital of Bordeaux, Bordeaux, France
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Areid N, Riivari S, Abushahba F, Shahramian K, Närhi T. Influence of Surface Characteristics of TiO 2 Coatings on the Response of Gingival Cells: A Systematic Review of In Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2533. [PMID: 36984413 PMCID: PMC10056999 DOI: 10.3390/ma16062533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 06/18/2023]
Abstract
The soft tissue-implant interface requires the formation of epithelium and connective tissue seal to hinder microbial infiltration and prevent epithelial down growth. Nanoporous titanium dioxide (TiO2) surface coatings have shown good potential for promoting soft tissue attachment to implant surfaces. However, the impact of their surface properties on the biological response of gingival cells needs further investigation. This systematic review aimed to investigate the cellular behavior of gingival cells on TiO2-implant abutment coatings based on in vitro studies. The review was performed to answer the question: "How does the surface characteristic of TiO2 coatings influence the gingival cell response in in vitro studies?". A search in MEDLINE/PubMed and the web of science databases from 1990 to 2022 was performed using keywords. A quality assessment of the studies selected was performed using the SciRAP method. A total of 11 publications were selected from the 289 studies that fulfilled the inclusion criteria. The mean reporting and methodologic quality SciRAP scores were 82.7 ± 6.4/100 and 87 ± 4.2/100, respectively. Within the limitations of this in vitro systematic review, it can be concluded that the TiO2 coatings with smooth nano-structured surface topography and good wettability improve gingival cell response compared to non-coated surfaces.
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Affiliation(s)
- Nagat Areid
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
| | - Sini Riivari
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
| | - Khalil Shahramian
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
- Turku Clinical Biomaterials Center (TCBC), University of Turku, FI-20014 Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
- Turku Clinical Biomaterials Center (TCBC), University of Turku, FI-20014 Turku, Finland
- Oral Health Care, Wellbeing services county of Southwest Finland, P.O. Box 52, FIN-20521 Turku, Finland
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Fischer NG, Aparicio C. Junctional epithelium and hemidesmosomes: Tape and rivets for solving the "percutaneous device dilemma" in dental and other permanent implants. Bioact Mater 2022; 18:178-198. [PMID: 35387164 PMCID: PMC8961425 DOI: 10.1016/j.bioactmat.2022.03.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/14/2022] [Accepted: 03/12/2022] [Indexed: 02/06/2023] Open
Abstract
The percutaneous device dilemma describes etiological factors, centered around the disrupted epithelial tissue surrounding non-remodelable devices, that contribute to rampant percutaneous device infection. Natural percutaneous organs, in particular their extracellular matrix mediating the "device"/epithelium interface, serve as exquisite examples to inspire longer lasting long-term percutaneous device design. For example, the tooth's imperviousness to infection is mediated by the epithelium directly surrounding it, the junctional epithelium (JE). The hallmark feature of JE is formation of hemidesmosomes, cell/matrix adhesive structures that attach surrounding oral gingiva to the tooth's enamel through a basement membrane. Here, the authors survey the multifaceted functions of the JE, emphasizing the role of the matrix, with a particular focus on hemidesmosomes and their five main components. The authors highlight the known (and unknown) effects dental implant - as a model percutaneous device - placement has on JE regeneration and synthesize this information for application to other percutaneous devices. The authors conclude with a summary of bioengineering strategies aimed at solving the percutaneous device dilemma and invigorating greater collaboration between clinicians, bioengineers, and matrix biologists.
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Affiliation(s)
- Nicholas G. Fischer
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, MN, 55455, USA
| | - Conrado Aparicio
- MDRCBB-Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 16-212 Moos Tower, 515 Delaware St. SE, Minneapolis, MN, 55455, USA
- Division of Basic Research, Faculty of Odontology, UIC Barcelona – Universitat Internacional de Catalunya, C/. Josep Trueta s/n, 08195, Sant Cugat del Valles, Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), C/. Baldiri Reixac 10-12, 08028, Barcelona, Spain
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Establishment of Biomimetic Soft Tissue Integration with the Surface of Zirconia Fused with Platelet-Activating Peptide. MATERIALS 2022; 15:ma15134597. [PMID: 35806723 PMCID: PMC9267760 DOI: 10.3390/ma15134597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/10/2022] [Accepted: 06/27/2022] [Indexed: 01/25/2023]
Abstract
Soft tissue sealing around zirconia (ZrO2) abutment is critical for the long-term stability of dental implants. The goal of the study is to develop a strong basal lamina (BL)-mediated epithelial attachment to ZrO2 via a novel physicochemical immobilization method. An electrophoretic fusion (EPF) method was applied to fuse a phosphonic acid (PA) linker to ZrO2 discs. Bindings of the PA linker and the following protease activated receptor 4 (PAR4) were verified by Fourier-transform infrared spectroscopy (FITR). Then, ZrO2 discs were doped in platelet-rich plasma (PRP). Platelet-derived growth factor (PDGF) was measured to assess platelet activation. PRP-doped discs were subsequently co-cultured with human gingival epithelial cells (OBA9) to evaluate establishment of basal lamina-mediated epithelial attachment. The EPF method achieved robust immobilization of the PA linker and PAR4 onto the ZrO2 surface. The resultant PAR4-coupled ZrO2 successfully induced platelet aggregation and activation. Furthermore, a BL-mediated epithelial attachment was established. The results are significant for clinical application to minimize the risk of developing peri-implant diseases.
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7
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The Effect of Ultraviolet Treatment on TiO2 Nanotubes: A Study of Surface Characteristics, Bacterial Adhesion, and Gingival Fibroblast Response. METALS 2022. [DOI: 10.3390/met12010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Titanium dioxide (TiO2) nanotubes are emerging as a provocative target for oral implant research. The aim of this study was to evaluate the effect of UV on the wettability behavior, bacterial colonization, and fibroblast proliferation rate of TiO2 nanotube surfaces prepared using different anodization voltages and aimed for use as implant abutment materials. Four different experimental materials were prepared: (1) TiO2 nanotube 10 V; (2) TiO2 nanotube 15 V; (3) TiO2 nanotube 20 V; and (4) commercial pure titanium as a control group. TiO2 nanotube arrays were prepared in an aqueous electrolyte solution of hydrofluoric acid (HF, 0.5 vol.%). Different anodization voltages were used to modify the morphology of the TiO2 nanotubes. Equilibrium contact angles were measured using the sessile drop method with a contact angle meter. The investigated surfaces (n = 3) were incubated at 37 °C in a suspension of Streptococcus mutans (S. mutans) for 30 min for bacterial adhesion and 3 days for biofilm formation. Human gingival fibroblasts were plated and cultured on the experimental substrates for up to 7 days and the cell proliferation rate was assessed using the AlamarBlue assayTM (BioSource International, Camarillo, CA, USA). The data were analyzed using one-way ANOVA followed by Tukey’s post-hoc test. Water contact angle measurements on the TiO2 after UV treatment showed an overall hydrophilic behavior regardless of the anodization voltage. The ranking of the UV-treated surfaces of experimental groups from lowest to highest for bacterial adhesion was: TiO2 nanotube 20 V < Ti and TiO2 nanotube 15 V < TiO2 nanotube 10 V (p < 0.05), and for bacterial biofilm formation was: TiO2 nanotube 20 V-TiO2 nanotube 10 V < Ti-TiO2 nanotube 15 V (p < 0.05). Fibroblast cell proliferation was lower on TiO2 nanotube surfaces throughout the incubation period and UV light treatment showed no enhancement in cellular response. UV treatment enhances the wettability behavior of TiO2 nanotube surfaces and could result in lower bacterial adhesion and biofilm formation.
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Han CY, Wang DZ, Bai JF, Zhao LL, Song WZ. Peri-implant keratinized gingiva augmentation using xenogeneic collagen matrix and platelet-rich fibrin: A case report. World J Clin Cases 2021; 9:10738-10745. [PMID: 35005010 PMCID: PMC8686158 DOI: 10.12998/wjcc.v9.i34.10738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/14/2021] [Accepted: 10/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Keratinized gingival insufficiency is a disease attributed to long-term tooth loss, can severely jeopardizes the long-term health of implants. A simple and effective augmentation surgery method should be urgently developed.
CASE SUMMARY A healthy female patient, 45-year-old, requested implant restoration of the her left mandibular first molar and second molar. Before considering a stage II, as suggested from the probing depth measurements, the widths of the mesial, medial, and distal buccal keratinized gingiva of second molar (tooth #37) were measured and found to be 0.5 mm, 0.5 mm, and 0 mm, respectively. This suggested that the gingiva was insufficient to resist damage from bacterial and mechanical stimulation. Accordingly, modified apically repositioned flap (ARF) surgery combined with xenogeneic collagen matrix (XCM) and platelet-rich fibrin (PRF) was employed to increase the width of gingival tissue. After 1 mo of healing, the widths of mesial, medial, and distal buccal keratinized gingiva reached 4 mm, 4 mm, and 3 mm, respectively, and the thickness of the augmented mucosa was 4.5 mm. Subsequently, through the second-stage operation, the patient obtained an ideal soft tissue shape around the implant.
CONCLUSION For cases with keratinized gingiva widths around implants less than 2mm,the soft tissue width and thickness could be increased by modified ARF surgery combined with XCM and PRF. Moreover, this surgery significantly alleviated patients’ pain and ameliorated oral functional comfort.
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Affiliation(s)
- Chun-Yu Han
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - De-Zhou Wang
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - Jian-Fei Bai
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - Lan-Lan Zhao
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
| | - Wen-Zhi Song
- Department of Stomatology, China-Japan Union Hospital, Jilin University, Changchun 130031, Jilin Province, China
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Areid N, Willberg J, Kangasniemi I, Närhi TO. Organotypic in vitro block culture model to investigate tissue-implant interface. An experimental study on pig mandible. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:136. [PMID: 34709465 PMCID: PMC8553714 DOI: 10.1007/s10856-021-06608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 10/05/2021] [Indexed: 06/13/2023]
Abstract
In vitro studies of implant-tissue attachment are primarily based on two-dimensional cell culture models, which fail to replicate the three-dimensional native human oral mucosal tissue completely. Thus, the present study aimed to describe a novel tissue culture model using pig mandibular block including alveolar bone and gingival soft tissues to evaluate the tissue attachment to titanium implant provided with hydrothermally induced TiO2 coating. Tissue attachment on TiO2 coated and non-coated implants were compared. Ti-6Al-4V alloy posts were used to function as implants that were inserted in five pig mandibles. Implants were delivered with two different surface treatments, non-coated (NC) titanium and hydrothermal induced TiO2 coated surfaces (HT). The tissue-implant specimens were cultured at an air/liquid interface for 7 and 14 days. The tissue-implant interface was analyzed by histological and immunohistochemical stainings. The microscopic evaluation suggests that pig tissue explants established soft and hard tissue attachment to both implant surfaces. The epithelial cells appeared to attach to the coated implant. The epithelium adjacent to the implant abutment starts to change its phenotype during the early days of the healing process. New bone formation was seen within small pieces of bone in close contact with the coated implant. In conclusion, this in vitro model maintains the viability of pig tissue and allows histologically and immunohistochemically evaluate the tissue-implant interface. HT-induced TiO2 coating seems to have a favorable tissue response. Moreover, this organotypic tissue culture model is applicable for further studies with quantitative parameters to evaluate adhesion molecules present at the implant-tissue interface.
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Affiliation(s)
- Nagat Areid
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland.
| | - Jaana Willberg
- Department of Oral Pathology and Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Department of Pathology, Turku University Central Hospital, Turku, Finland
- Welfare Division, Oral Health Care, Turku, Finland
| | - Ilkka Kangasniemi
- Turku Clinical Biomaterials Centre (TCBC), University of Turku, Turku, Finland
| | - Timo O Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku, Finland
- Welfare Division, Oral Health Care, Turku, Finland
- Turku Clinical Biomaterials Centre (TCBC), University of Turku, Turku, Finland
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Gasik M, Lambert F, Bacevic M. Biomechanical Properties of Bone and Mucosa for Design and Application of Dental Implants. MATERIALS 2021; 14:ma14112845. [PMID: 34073388 PMCID: PMC8199480 DOI: 10.3390/ma14112845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 12/20/2022]
Abstract
Dental implants’ success comprises their proper stability and adherence to different oral tissues (integration). The implant is exposed to different mechanical stresses from swallowing, mastication and parafunctions for a normal tooth, leading to the simultaneous mechanical movement and deformation of the whole structure. The knowledge of the mechanical properties of the bone and gingival tissues in normal and pathological conditions is very important for the successful conception of dental implants and for clinical practice to access and prevent potential failures and complications originating from incorrect mechanical factors’ combinations. The challenge is that many reported biomechanical properties of these tissues are substantially scattered. This study carries out a critical analysis of known data on mechanical properties of bone and oral soft tissues, suggests more convenient computation methods incorporating invariant parameters and non-linearity with tissues anisotropy, and applies a consistent use of these properties for in silico design and the application of dental implants. Results show the advantages of this approach in analysis and visualization of stress and strain components with potential translation to dental implantology.
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Affiliation(s)
- Michael Gasik
- School of Chemical Engineering, Aalto University Foundation, 02150 Espoo, Finland
- Correspondence:
| | - France Lambert
- Dental Biomaterials Research Unit, University of Liege, 4000 Liège, Belgium; (F.L.); (M.B.)
| | - Miljana Bacevic
- Dental Biomaterials Research Unit, University of Liege, 4000 Liège, Belgium; (F.L.); (M.B.)
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11
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Kunrath MF, Gupta S, Lorusso F, Scarano A, Noumbissi S. Oral Tissue Interactions and Cellular Response to Zirconia Implant-Prosthetic Components: A Critical Review. MATERIALS 2021; 14:ma14112825. [PMID: 34070589 PMCID: PMC8198172 DOI: 10.3390/ma14112825] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 12/20/2022]
Abstract
Background: Dental components manufactured with zirconia (ZrO2) represent a significant percentage of the implant prosthetic market in dentistry. However, during the last few years, we have observed robust clinical and pre-clinical scientific investigations on zirconia both as a prosthetic and an implantable material. At the same time, we have witnessed consistent technical and manufacturing updates with regards to the applications of zirconia which appear to gradually clarify points which until recently were not well understood. Methods: This critical review evaluated the “state of the art” in relation to applications of this biomaterial in dental components and its interactions with oral tissues. Results: The physico-chemical and structural properties as well as the current surface treatment methodologies for ZrO2 were explored. A critical investigation of the cellular response to this biomaterial was completed and the clinical implications discussed. Finally, surface treatments of ZrO2 demonstrate that excellent osseointegration is possible and provide encouraging prospects for rapid bone adhesion. Furthermore, sophisticated surface treatment techniques and technologies are providing impressive oral soft tissue cell responses thus leading to superior biological seal. Conclusions: Dental devices manufactured from ZrO2 are structurally and chemically stable with biocompatibility levels allowing for safe and long-term function in the oral environment.
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Affiliation(s)
- Marcel F. Kunrath
- Dentistry Department, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), P.O. Box 6681, Porto Alegre 90619-900, RS, Brazil;
- Materials and Nanoscience Laboratory, Pontifical Catholic University of Rio Grande do Sul (PUCRS), P.O. Box 6681, Porto Alegre 90619-900, RS, Brazil
| | - Saurabh Gupta
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Master Dental Science, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
| | - Antonio Scarano
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
- Correspondence: ; Tel.: +08713554084
| | - Sammy Noumbissi
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
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12
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Li L, Yao L, Wang H, Shen X, Lou W, Huang C, Wu G. Magnetron sputtering of strontium nanolayer on zirconia implant to enhance osteogenesis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 127:112191. [PMID: 34225847 DOI: 10.1016/j.msec.2021.112191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/21/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
The zirconia implants have a wide range of clinical applications, however, the biological inertness and lack of osteoinductive properties limit these applications. Strontium possesses superior biocompatibility and excellent osteogenic properties. To take advantage of these, the strontium titanate-coated zirconia implants were prepared in this study by sandblasting, acid etching, and magnetron sputtering, followed by the analysis of the biological behavior. Briefly, the zirconia sheets were polished and subjected to sandblasting and acid etching. Subsequently, a nano‑strontium titanate coating was developed on the sheets by magnetron sputtering. The specimens were characterized by scanning electron microscopy (SEM), water contact angle measurement (WCA) and EDS mapping, which confirmed the physical alternation and successful deposition of the strontium titanate coating. The in vitro experiments indicated that the majority of the filopodia and actin fibers of the MC3T3-E1 cells on SA-ZrO2/Sr possessed an optimal osteogenic property to promote the osteogenic differentiation. Moreover, the RT-PCR results revealed that SA-ZrO2/Sr significantly up-regulated the gene expression of Runx2, COL-1, ALP, OPG, OPN and OCN. Further, the in vivo evaluation confirmed that the SA-ZrO2/Sr implants promoted the bone-implant osseointegration to the greatest extent as compared to SA-ZrO2 and ZrO2 implant. Overall, the SA-ZrO2/Sr system was confirmed to be a promising implant, thus, providing new pathways for an effective implant design.
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Affiliation(s)
- Li Li
- Department of Dentistry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China; Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam (VU), Amsterdam Movement Science (AMS), Amsterdam, the Netherlands
| | - Litao Yao
- Department of Dentistry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China; Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam (VU), Amsterdam Movement Science (AMS), Amsterdam, the Netherlands.
| | - Haiyan Wang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xufei Shen
- Deqing campus, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Weiwei Lou
- Department of stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chengyi Huang
- Department of Dentistry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310058, Zhejiang, China.
| | - Gang Wu
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam (VU), Amsterdam Movement Science (AMS), Amsterdam, the Netherlands; Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam (UvA) and Vrije Universiteit Amsterdam (VU), Amsterdam, the Netherlands
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13
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Dantas T, Madeira S, Gasik M, Vaz P, Silva F. Customized Root-Analogue Implants: A Review on Outcomes from Clinical Trials and Case Reports. MATERIALS 2021; 14:ma14092296. [PMID: 33946678 PMCID: PMC8124429 DOI: 10.3390/ma14092296] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 01/14/2023]
Abstract
(1) It is estimated that 10% of the world’s population will need a dental implant in their lifetime. Despite all the advances in the comprehension of dental implant designs, materials and techniques, traditional implants still have many limitations. Customized root-analogue implants are, therefore, gaining increased interest in dental rehabilitation and are expected to not only preserve more hard and soft tissues but also avoid a second surgery and improve patient overall satisfaction. In this sense, the aim of this review was to collect and analyse the clinical trials and case reports on customized root-analogue implants available in the literature; (2) This review was carried out according to the PRISMA Statement. An electronic database search was performed using five databases: PubMed, Google Scholar, Medline, Science Direct, and Scopus. The following keywords were used for gathering data: custom-made, dental implants, root-analogue, anatomical, customized and tooth-like; (3) 15 articles meeting the inclusion criteria—articles reporting clinical trials, case reports or animal studies and articles with root-analogue implants and articles with totally customized implant geometries—were selected for the qualitative synthesis. The design and manufacturing techniques, implant material and surface treatments were assessed and discussed; (4) The performance of some root-analogue implants with specific features (i.e., macro-retentions) was successful, with no signs of infection, periodontitis nor bleeding during the follow-up periods.
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Affiliation(s)
- Telma Dantas
- CMEMS (Center for Micro Electro Mechanical Systems), University of Minho, 4800-058 Guimarães, Portugal; (S.M.); (F.S.)
- MIT Portugal Program—School of Engineering, University of Minho, 4800-058 Guimarães, Portugal
- Correspondence:
| | - Sara Madeira
- CMEMS (Center for Micro Electro Mechanical Systems), University of Minho, 4800-058 Guimarães, Portugal; (S.M.); (F.S.)
| | - Michael Gasik
- School of Chemical Engineering, Aalto University Foundation, 02150 Espoo, Finland;
| | - Paula Vaz
- Fixed Prosthodontics, Genetics—Faculty of Dental Medicine, University of Porto, 4200-135 Porto, Portugal;
| | - Filipe Silva
- CMEMS (Center for Micro Electro Mechanical Systems), University of Minho, 4800-058 Guimarães, Portugal; (S.M.); (F.S.)
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14
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Enhancement of Gingival Tissue Adherence of Zirconia Implant Posts: In Vitro Study. MATERIALS 2021; 14:ma14020455. [PMID: 33477782 PMCID: PMC7832313 DOI: 10.3390/ma14020455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/01/2021] [Accepted: 01/17/2021] [Indexed: 11/17/2022]
Abstract
Prevention of bacterial inflammation around dental implants (peri-implantitis) is one of the keys to success of the implantation and can be achieved by securing the gingival tissue-abutment interface preventing penetration of bacteria. Modern dental practice has adopted zirconia abutments in place of titanium, but the adhesion of gingival tissue to zirconia is inferior to titanium. The aim of this study was to assess and improve the adhesion of mucosal tissues to zirconia posts using sol-gel derived TiO2 coating following dynamic mechanical testing. The posts were cultivated with porcine bone-gingival tissue specimens in vitro for 7 and 14 days and then subjected to dynamic mechanical analysis simulating physiological loading at 1 Hz up to 50 μm amplitude. In parallel in silico analysis of stresses and strains have been made simulating "the worst case" when the fixture fails in osseointegration while the abutment still holds. Results show treatment of zirconia can lead to double interface stiffness (static shear stiffness values from 5-10 to 17-23 kPa and dynamic from 20-50 to 60-125 kPa), invariant viscostiffness (from 5-35 to 45-90 kPa·sα) and material memory values (increased from 0.06-0.10 to 0.17-0.25), which is beneficial in preventing bacterial contamination in dental implants. This suggests TiO2-coated zirconia abutments may have a significant clinical benefit for prevention of the bacterial contamination.
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