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De Nardo L, Raffaini G, Ebramzadeh E, Ganazzoli F. Titanium Oxide Modeling and Design for Innovative Biomedical Surfaces: A Concise Review. Int J Artif Organs 2018. [DOI: 10.1177/039139881203500902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Luigi De Nardo
- Politecnico di Milano, Department of Chemistry, Materials, and Chemical Engineering “G. Natta”, Milan - Italy
| | - Giuseppina Raffaini
- Politecnico di Milano, Department of Chemistry, Materials, and Chemical Engineering “G. Natta”, Milan - Italy
| | - Edward Ebramzadeh
- UCLA / Orthopaedic, Hospital Department of Orthopaedic Surgery, David Geffen School of Medicine, JVL Orthopaedic Research Center, Los Angeles, CA - USA
| | - Fabio Ganazzoli
- Politecnico di Milano, Department of Chemistry, Materials, and Chemical Engineering “G. Natta”, Milan - Italy
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Constantino JA, Delgado-Rastrollo M, Pacha-Olivenza MA, González-Martín ML, Quiles M, Pérez-Giraldo C, Bruque JM, Gallardo-Moreno AM. In vivo bactericidal efficacy of the Ti6Al4V surface after ultraviolet C treatment. J Orthop Traumatol 2016; 18:59-67. [PMID: 27137674 PMCID: PMC5310995 DOI: 10.1007/s10195-016-0407-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 04/08/2016] [Indexed: 11/30/2022] Open
Abstract
Background Biomaterial-associated infections are one of the most important complications in orthopedic surgery. The main goal of this study was to demonstrate the in vivo bactericidal effect of ultraviolet (UV) irradiation on Ti6Al4V surfaces. Materials and methods An experimental model of device-related infections was developed by direct inoculation of Staphylococcus aureus into the canal of both femurs of 34 rats. A UV-irradiated Ti6Al4V pin was press-fit into the canal by retrograde insertion in one femur and the control pin was inserted into the contralateral femur. To assess the efficacy of UV radiation, the mean colony counts after inoculation in the experimental subjects and the control group were compared at different times of sacrifice and at different inoculum doses. Results At 72 h, the mean colony counts after inoculation in experimental femurs were significantly lower than those of the control group, with a reduction percentage of 76 % (p = 0.041). A similar difference between control and experimental pins was observed at 24 h using an inoculum dose <104 colony-forming units (CFU), for which the reduction percentage was 70.48 % (p = 0.017). Conclusion The irradiated surface of Ti6Al4V is able to reduce early bacterial colonization of Ti6AlV pins located in the medullar channel and in the surrounding femur. The reductions depend on the initial inoculums used to cause infection in the animals and the greatest effects are detected for inoculums <104 CFU. Level of evidence Not applicable.
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Affiliation(s)
- Juan A Constantino
- Orthopaedic and Traumatic Service, Complejo Hospitalario Universitario de Badajoz, Avenida Tellez Lafuente s/n, 06010, Badajoz, Spain.
| | - María Delgado-Rastrollo
- Department of Biomedical Sciences, Microbiology Area, Faculty of Medicine, University of Extremadura, Avda de Elvas s/n, 06006, Badajoz, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - Miguel A Pacha-Olivenza
- Department of Applied Physics, Faculty of Science, University of Extremadura, Avda de Elvas s/n, 06006, Badajoz, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - M Luisa González-Martín
- Department of Applied Physics, Faculty of Science, University of Extremadura, Avda de Elvas s/n, 06006, Badajoz, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - Manuel Quiles
- Orthopaedic and Traumatic Service, Complejo Hospitalario Universitario de Badajoz, Avenida Tellez Lafuente s/n, 06010, Badajoz, Spain
| | - C Pérez-Giraldo
- Department of Biomedical Sciences, Microbiology Area, Faculty of Medicine, University of Extremadura, Avda de Elvas s/n, 06006, Badajoz, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - José M Bruque
- Department of Applied Physics, Faculty of Science, University of Extremadura, Avda de Elvas s/n, 06006, Badajoz, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
| | - Amparo M Gallardo-Moreno
- Department of Applied Physics, Faculty of Science, University of Extremadura, Avda de Elvas s/n, 06006, Badajoz, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Badajoz, Spain
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Titanium Oxide Antibacterial Surfaces in Biomedical Devices. Int J Artif Organs 2011; 34:929-46. [DOI: 10.5301/ijao.5000050] [Citation(s) in RCA: 184] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2011] [Indexed: 02/07/2023]
Abstract
Titanium oxide is a heterogeneous catalyst whose efficient photoinduced activity, related to some of its allotropic forms, paved the way for its widespread technological use. Here, we offer a comparative analysis of the use of titanium oxide as coating for materials in biomedical devices. First, we introduce the photoinduced catalytic mechanisms of TiO2 and their action on biological environment and bacteria. Second, we overview the main physical and chemical technologies for structuring suitable TiO2 coatings on biomedical devices. We then present the approaches for in vitro characterization of these surfaces. Finally, we discuss the main aspects of TiO2 photoactivated antimicrobial activity on medical devices and limitations for these types of applications.
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Ferraris S, Spriano S, Pan G, Venturello A, Bianchi CL, Chiesa R, Faga MG, Maina G, Vernè E. Surface modification of Ti-6Al-4V alloy for biomineralization and specific biological response: Part I, inorganic modification. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2011; 22:533-545. [PMID: 21287240 DOI: 10.1007/s10856-011-4246-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 01/18/2011] [Indexed: 05/30/2023]
Abstract
Titanium and its alloys represent the gold standard for orthopaedic and dental prosthetic devices, because of their good mechanical properties and biocompatibility. Recent research has been focused on surface treatments designed to promote their rapid osteointegration also in case of poor bone quality. A new surface treatment has been investigated in this research work, in order to improve tissue integration of titanium based implants. The surface treatment is able to induce a bioactive behaviour, without the introduction of a coating, and preserving mechanical properties of Ti6Al4V substrates (fatigue resistance). The application of the proposed technique results in a complex surface topography, characterized by the combination of a micro-roughness and a nanotexture, which can be coupled with the conventional macro-roughness induced by blasting. Modified metallic surfaces are rich in hydroxyls groups: this feature is extremely important for inorganic bioactivity (in vitro and in vivo apatite precipitation) and also for further functionalization procedures (grafting of biomolecules). Modified Ti6Al4V induced hydroxyapatite precipitation after 15 days soaking in simulated body fluid (SBF). The process was optimised in order to not induce cracks or damages on the surface. The surface oxide layer presents high scratch resistance.
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Affiliation(s)
- S Ferraris
- DISMIC Department, Politecnico di Torino, C.so Duca degli Abruzzi, 24, 10129, Turin, Italy.
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Bornstein MM, Wittneben JG, Brägger U, Buser D. Early loading at 21 days of non-submerged titanium implants with a chemically modified sandblasted and acid-etched surface: 3-year results of a prospective study in the posterior mandible. J Periodontol 2010; 81:809-18. [PMID: 20450357 DOI: 10.1902/jop.2010.090727] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study evaluates 3-year success rates of titanium screw-type implants with a chemically modified sandblasted and acid-etched surface (mod SLA), which were functionally loaded after 3 weeks of healing. METHODS A total of 56 implants, inserted in the posterior mandibles of 39 partially edentulous patients, underwent undisturbed healing for 3 weeks. At day 21, the implants were fully loaded with provisional crowns. Definitive metal ceramic restorations were fabricated after 6 months of healing. Clinical measurements regarding soft tissue parameters and radiographs were obtained at different time points up to 36 months after implant placement. The soft tissue and radiographic parameters for the mod SLA implants after 3 years in function were compared to a historic control group of implants with an SLA surface using an early loading protocol after 6 weeks. RESULTS None of the implants failed to integrate. However, two implants were considered "spinners" at day 21 and were left unloaded for an extended period. Therefore, 96.4% of the inserted implants were loaded according to the protocol tested. All 56 implants, including the "spinners," showed favorable clinical and radiographic findings at the 3-year follow-up examination. All 56 implants were considered successfully integrated, resulting in a 3-year survival and success rate of 100%. Dental implants with a mod SLA surface demonstrated statistically significant differences for probing depths and clinical attachment level values compared to the historic control group, with the mod SLA surface implants having overall lower probing depths and clinical attachment level scores. CONCLUSION This prospective study using an early loading protocol demonstrates that titanium implants with the mod SLA surface can achieve and maintain successful tissue integration over a period of 3 years.
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Affiliation(s)
- Michael M Bornstein
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
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Schlegel P, Hayes JS, Frauchiger VM, Gasser B, Wieling R, Textor M, Richards RG. An in vivo evaluation of the biocompatibility of anodic plasma chemical (APC) treatment of titanium with calcium phosphate. J Biomed Mater Res B Appl Biomater 2008; 90:26-34. [PMID: 18985774 DOI: 10.1002/jbm.b.31249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P Schlegel
- AO Research Institute, AO Foundation, Davos, Switzerland
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Anitua E, Orive G, Aguirre JJ, Ardanza B, Andía I. 5-year clinical experience with BTI dental implants: risk factors for implant failure. J Clin Periodontol 2008; 35:724-32. [PMID: 18616758 DOI: 10.1111/j.1600-051x.2008.01248.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aims of this study were to identify with appropriate statistical tests the risk factors associated with implant failure and to evaluate the long-term survival of dental implants using implant loss as an outcome variable and performing an implant-, surgery- and patient-based analysis of failures. MATERIAL AND METHODS A retrospective cohort study design was used. One thousand sixty patients received 5787 BTI implants during the years of 2001-2005 in Vitoria, Spain. The potential influence of demographic items, clinical items, surgery-dependent items and prosthetic variables on implant survival was studied. Implant survival was analysed using a life-table analysis. Cox proportional hazards regression was used to identify risk factors related to implant failure. RESULTS Smoking habits, implant position, implant staging (two-stage implants) and the implementation of special techniques were statistically correlated with lower implant survival rates. Two risk factors associated with implant failure were detected in this study: implant staging (two-stage implants) and the use of special techniques. Additionally, the overall survival rates of BTI implants were 99.2%, 96.4% and 96% for the implant-, surgery- and patient-based analysis, respectively. Totally, 28 out from 5787 implants (0.48%) were lost during the observation period. Most of the patients with implant failure (69.6%) presented chronic or aggressive periodontitis. CONCLUSIONS Implant staging and the use of special techniques are risk factors for implant failure.
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Giavaresi G, Fini M, Chiesa R, Giordano C, Sandrini E, Bianchi AE, Ceribelli P, Giardino R. A novel multiphase anodic spark deposition coating for the improvement of orthopedic implant osseointegration: an experimental study in cortical bone of sheep. J Biomed Mater Res A 2008; 85:1022-31. [PMID: 17926330 DOI: 10.1002/jbm.a.31566] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The effect of a new three-step anodic spark deposition process, labeled TiSpark, including two consecutive treatments performed first in a P solution and second in Ca solution, followed by an additional alkali etching step, was investigated for the improvement of osseointegration of commercial grade 2 titanium, machined (Ti) or Al(2)O(3) sandblasted (Ti-SA), cylindrical implants (12 mm in length and 4 mm in diameter) in cortical bone of 12 adult sheep. Histomorphometric and microhardness measurements were carried out at each experimental time (4, 8, and 12 weeks) to quantify the bone-to-implant contact around the implants as well as the newly bone hardness and bone maturation index. TiSpark treated surfaces were covered by a thick layer of crystalline anatase TiO(2) and by a further Ca/P layer. Bone tissue extends and grows on the surface of the TiSpark treated implants without any fibrous tissue, enhancing the short-term osseointegration properties of implant. Bone mineralization rate was also influenced by the chemical composition of implants and sandblasted materials presented the lowest bone maturation rate at the interface. Data suggests that the TiSpark treatment produces a modification of the Ti surface, which presents good bioactivity and may be suitable for achieving a stable implant osseointegration.
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Affiliation(s)
- Gianluca Giavaresi
- Laboratory of Experimental Surgery, Rizzoli Orthopaedic Institute, Bologna Italy.
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Anitua E, Orive G, Aguirre JJ, Andía I. Five-year clinical evaluation of short dental implants placed in posterior areas: a retrospective study. J Periodontol 2008; 79:42-8. [PMID: 18166091 DOI: 10.1902/jop.2008.070142] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND The aims of this study were to evaluate the long-term survival rates of short dental implants in posterior areas and to analyze the influence of different factors on implant survival. METHODS A retrospective cohort study design was used. A total of 293 subjects received 532 short implants between 2001 and 2004. All implants were placed by two experienced surgeons, and rehabilitations were done by three prosthodontists. Each implant failure was analyzed carefully. The potential influence of demographic factors, clinical factors, surgery-dependent factors, and prosthetic variables on implant survival was studied. Implant survival was analyzed using a life-table analysis (Wilcoxon [Gehan] test). RESULTS The overall survival rates of short implants were 99.2% and 98.7% for the implant- and subject-based analyses, respectively. The mean follow-up period was 31 +/- 12.3 months. Two of 532 implants were lost during the observation period. None of the variables studied were statistically associated with implant failure. CONCLUSION Treatment with short implants can be considered safe and predictable if used under strict clinical protocols.
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Bornstein MM, Valderrama P, Jones AA, Wilson TG, Seibl R, Cochran DL. Bone apposition around two different sandblasted and acid-etched titanium implant surfaces: a histomorphometric study in canine mandibles. Clin Oral Implants Res 2008; 19:233-41. [PMID: 18177427 DOI: 10.1111/j.1600-0501.2007.01473.x] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to evaluate bone apposition to a modified sandblasted and acid-etched (SLA) implant surface (modSLA) in the canine mandible as compared with the standard SLA surface. MATERIAL AND METHODS In this experimental study, all mandibular premolars and first molars were extracted bilaterally in five foxhounds. After a healing period of 6 months, each side of the mandible received six randomly assigned dental implants alternating between the standard SLA and modSLA surface. The dogs were sacrificed at 2 weeks (n=2) or 4 weeks (n=3) after implant placement. Histologic and histomorphometric analyses were then performed for each implant. RESULTS The microscopic healing patterns at weeks 2 and 4 for the two implant types with the standard SLA and modSLA surfaces showed similar qualitative findings. New bone tissue had already established direct contact with implant surfaces after 2 weeks of healing. The mean percentage of newly formed bone in contact with the implant (BIC) was significantly greater for modSLA (28.2+/-7.9%) than for SLA (22.2+/-7.3%) (P<0.05). This difference was no longer evident after 4 weeks. An increase in BIC for both implant surface types occurred from weeks 2 to 4. This increase was statistically significant when compared with SLA at 2 weeks (P<0.05), but not when compared with modSLA at 2 weeks. CONCLUSION The data from the present study demonstrate significantly more bone apposition for the modSLA surface than the standard SLA surface after 2 weeks of healing. This increased bone apposition may allow a further reduction of the healing period following implant placement for patients undergoing early loading procedures.
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Affiliation(s)
- Michael M Bornstein
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Ferguson SJ, Broggini N, Wieland M, de Wild M, Rupp F, Geis-Gerstorfer J, Cochran DL, Buser D. Biomechanical evaluation of the interfacial strength of a chemically modified sandblasted and acid-etched titanium surface. J Biomed Mater Res A 2006; 78:291-7. [PMID: 16637025 DOI: 10.1002/jbm.a.30678] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The functional capacity of osseointegrated dental implants to bear load is largely dependent on the quality of the interface between the bone and implant. Sandblasted and acid-etched (SLA) surfaces have been previously shown to enhance bone apposition. In this study, the SLA has been compared with a chemically modified SLA (modSLA) surface. The increased wettability of the modSLA surface in a protein solution was verified by dynamic contact angle analysis. Using a well-established animal model with a split-mouth experimental design, implant removal torque testing was performed to determine the biomechanical properties of the bone-implant interface. All implants had an identical cylindrical shape with a standard thread configuration. Removal torque testing was performed after 2, 4, and 8 weeks of bone healing (n = 9 animals per healing period, three implants per surface type per animal) to evaluate the interfacial shear strength of each surface type. Results showed that the modSLA surface was more effective in enhancing the interfacial shear strength of implants in comparison with the conventional SLA surface during early stages of bone healing. Removal torque values of the modSLA-surfaced implants were 8-21% higher than those of the SLA implants (p = 0.003). The mean removal torque values for the modSLA implants were 1.485 N m at 2 weeks, 1.709 N m at 4 weeks, and 1.345 N m at 8 weeks; and correspondingly, 1.231 N m, 1.585 N m, and 1.143 N m for the SLA implants. The bone-implant interfacial stiffness calculated from the torque-rotation curve was on average 9-14% higher for the modSLA implants when compared with the SLA implants (p = 0.038). It can be concluded that the modSLA surface achieves a better bone anchorage during early stages of bone healing than the SLA surface; chemical modification of the standard SLA surface likely enhances bone apposition and this has a beneficial effect on the interfacial shear strength.
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Affiliation(s)
- S J Ferguson
- MEM Research Center for Orthopaedic Surgery, Institute for Surgical Technology and Biomechanics, University of Berne, Berne, Switzerland.
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Ellingsen JE, Thomsen P, Lyngstadaas SP. Advances in dental implant materials and tissue regeneration. Periodontol 2000 2006; 41:136-56. [PMID: 16686931 DOI: 10.1111/j.1600-0757.2006.00175.x] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Jan Eirik Ellingsen
- Oral Research Laboratory and Department of Prosthetic Dentistry, Institute of Clinical Dentistry, Dental Faculty, University of Oslo, Oslo, Norway
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