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Santos AFP, da Silva RC, Hadad H, de Jesus LK, Pereira-Silva M, Nímia HH, Oliveira SHP, Guastaldi AC, Queiroz TP, Poli PP, Barbosa DDB, da Silva Fabris AL, Garcia Júnior IR, Gruber R, Souza FÁ. Early Peri-Implant Bone Healing on Laser-Modified Surfaces with and without Hydroxyapatite Coating: An In Vivo Study. BIOLOGY 2024; 13:533. [PMID: 39056725 PMCID: PMC11274123 DOI: 10.3390/biology13070533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/09/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
(1) Objective: The aim of this study was to assess the biological behavior of bone tissue on a machined surface (MS) and modifications made by a laser beam (LS) and by a laser beam incorporated with hydroxyapatite (HA) using a biomimetic method without thermic treatment (LHS). (2) Methods: Scanning electron microscopy coupled with energy-dispersive X-ray spectrometry (SEM/EDX) was performed before and after installation in the rabbit tibiae. A total of 20 Albinus rabbits randomly received 30 implants of 3.75 × 10 mm in the right and left tibias, with two implants on each surface in each tibia. In the animals belonging to the 4-week euthanasia period group, intramuscular application of the fluorochromes calcein and alizarin was performed. In implants placed mesially in the tibiofemoral joint, biomechanical analysis was performed by means of a removal torque (N/cm). The tibias with the implants located distally to the joint were submitted for analysis by confocal laser microscopy (mineral apposition rate) and for histometric analysis by bone contact implant (%BIC) and newly formed bone area (%NBA). (3) Results: The SEM showed differences between the surfaces. The biomechanical analysis revealed significant differences in removal torque values between the MSs and LHSs over a 2-week period. Over a 4-week period, both the LSs and LHSs demonstrated removal torque values statistically higher than the MSs. BIC of the LHS implants were statistically superior to MS at the 2-week period and LHS and LS surfaces were statistically superior to MS at the 4-week period. Statistical analysis of the NBA of the implants showed difference between the LHS and MS in the period of 2 weeks. (4) Conclusions: The modifications of the LSs and LHSs provided important physicochemical modifications that favored the deposition of bone tissue on the surface of the implants.
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Affiliation(s)
- Ana Flávia Piquera Santos
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (H.H.); (L.K.d.J.); (M.P.-S.); (I.R.G.J.)
| | - Rodrigo Capalbo da Silva
- Department of Dental Materials and Prosthetics, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.C.d.S.); or (H.H.N.); (D.d.B.B.)
| | - Henrique Hadad
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (H.H.); (L.K.d.J.); (M.P.-S.); (I.R.G.J.)
| | - Laís Kawamata de Jesus
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (H.H.); (L.K.d.J.); (M.P.-S.); (I.R.G.J.)
| | - Maísa Pereira-Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (H.H.); (L.K.d.J.); (M.P.-S.); (I.R.G.J.)
| | - Heloisa Helena Nímia
- Department of Dental Materials and Prosthetics, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.C.d.S.); or (H.H.N.); (D.d.B.B.)
- Health Sciences Institute, Pontificiae University Catholic of Minas Gerais—PUC-Minas, Poços de Caldas 37714-620, MG, Brazil
| | - Sandra Helena Penha Oliveira
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16018-805, SP, Brazil;
| | - Antônio Carlos Guastaldi
- Department of Analytical, Physical-Chemistry and Inorganic Chemistry, Institute of Chemistry, São Paulo State University (UNESP), Araraquara 14800-900, SP, Brazil;
| | - Thallita Pereira Queiroz
- Department of Health Science, University of Araraquara-UNIARA, Araraquara 14801-340, SP, Brazil;
| | - Pier Paolo Poli
- Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCSS Cà Granda Maggiore Policlinico Hospital, University of Milan, 20122 Milan, Italy;
| | - Debora de Barros Barbosa
- Department of Dental Materials and Prosthetics, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (R.C.d.S.); or (H.H.N.); (D.d.B.B.)
| | - André Luis da Silva Fabris
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (H.H.); (L.K.d.J.); (M.P.-S.); (I.R.G.J.)
| | - Idelmo Rangel Garcia Júnior
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (H.H.); (L.K.d.J.); (M.P.-S.); (I.R.G.J.)
| | - Reinhard Gruber
- Department of Oral Biology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Francisley Ávila Souza
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil; (H.H.); (L.K.d.J.); (M.P.-S.); (I.R.G.J.)
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Mamani-Valeriano HL, Silva NP, Nímia HH, Pereira-Silva M, Oliveira MEDFS, Rodrigues LGDS, Tavares PMH, Hadad H, de Jesus LK, Santos AFP, Barbosa DDB, Poli PP, Maiorana C, de Carvalho PSP, Okamoto R, Souza FÁ. Bone Incorporation of a Poly (L-Lactide-Co-D, L-Lactide) Internal Fixation Device in a Rat's Tibia: Microtomographic, Confocal LASER, and Histomorphometric Analysis. BIOLOGY 2024; 13:471. [PMID: 39056666 PMCID: PMC11273520 DOI: 10.3390/biology13070471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024]
Abstract
This study evaluated the bone incorporation process of a screw-shaped internal fixation device made of poly (L-lactide-co-D, L-lactide) (PLDLLA). Thirty-two male Wistar rats received 32 fixation devices (2 mm × 6 mm) randomly assigned to either the right or left tibia and one implant in each animal. After 7, 14, 28, and 42 days, the rats were euthanized and the specimens were subjected to microtomographic computed tomography (microCT) and histomorphometric analyses to evaluate bone interface contact (BIC%) and new bone formation (NBF%) in cortical and cancellous bone areas. The animals euthanized on days 28 and 42 were treated with calcein and alizarin red, and confocal LASER microscopy was performed to determine the mineral apposition rate (MAR). Micro-CT revealed a higher percentage of bone volume (p < 0.006), trabecular separation (p < 0.001), and BIC in the cortical (p < 0.001) and cancellous (p = 0.003) areas at 28 and 42 days than at 7 and 14 days. The cortical NBF at 42 days was greater than that at 7 and 14 days (p = 0.022). No statistically significant differences were observed in cancellous NBF or MAR at 28 and 42 days. Based on these results, it can be seen that the PLDLLA internal fixation device is biocompatible and allows new bone formation around the screw thread.
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Affiliation(s)
- Harrisson Lucho Mamani-Valeriano
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Nelson Padilha Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Heloisa Helena Nímia
- Department of Dental Materials and Prothesis, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.H.N.); (D.d.B.B.)
| | - Maísa Pereira-Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Maria Eduarda de Freitas Santana Oliveira
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Letícia Gabriella de Souza Rodrigues
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Paulo Matheus Honda Tavares
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Henrique Hadad
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Laís Kawamata de Jesus
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Ana Flávia Piquera Santos
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
| | - Débora de Barros Barbosa
- Department of Dental Materials and Prothesis, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.H.N.); (D.d.B.B.)
| | - Pier Paolo Poli
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Carlo Maiorana
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (P.P.P.); (C.M.)
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
| | - Paulo Sergio Perri de Carvalho
- Implant Dentistry Postgraduate Program, São Leopoldo Mandic School of Dentistry and Research Center, Campinas 13045-755, SP, Brazil;
| | - Roberta Okamoto
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-253, SP, Brazil;
| | - Francisley Ávila Souza
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16010-380, SP, Brazil; (H.L.M.-V.); (M.P.-S.); (M.E.d.F.S.O.); (L.G.d.S.R.); (P.M.H.T.); (H.H.); (L.K.d.J.); (A.F.P.S.)
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Teixeira JFL, de Souza JAC, Magalhães FAC, de Oliveira GJPL, de Santis JB, de Souza Costa CA, de Souza PPC. Laser-Modified Ti Surface Improves Paracrine Osteogenesis by Modulating the Expression of DKK1 in Osteoblasts. J Funct Biomater 2023; 14:jfb14040224. [PMID: 37103314 PMCID: PMC10145280 DOI: 10.3390/jfb14040224] [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: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
Titanium surface modifications are widely used to modulate cellular behavior by recognition of topographical cues. However, how those modifications affect the expression of mediators that will influence neighboring cells is still elusive. This study aimed to evaluate the effects of conditioned media from osteoblasts cultured on laser-modified titanium surfaces on the differentiation of bone marrow cells in a paracrine manner and to analyze the expression of Wnt pathway inhibitors. Mice calvarial osteoblasts were seeded on polished (P) and Yb:YAG laser-irradiated (L) Ti surfaces. Osteoblast culture media were collected and filtered on alternate days to stimulate mice BMCs. Resazurin assay was performed every other day for 20 days to check BMC viability and proliferation. After 7 and 14 days of BMCs maintained with osteoblasts P and L-conditioned media, alkaline phosphatase activity, Alizarin Red staining, and RT-qPCR were performed. ELISA of conditioned media was conducted to investigate the expression of Wnt inhibitors Dickkopf-1 (DKK1) and Sclerostin (SOST). BMCs showed increased mineralized nodule formation and alkaline phosphatase activity. The L-conditioned media enhanced the BMC mRNA expression of bone-related markers Bglap, Alpl, and Sp7. L-conditioned media decreased the expression of DKK1 compared with P-conditioned media. The contact of osteoblasts with Yb:YAG laser-modified Ti surfaces induces the regulation of the expression of mediators that affect the osteoblastic differentiation of neighboring cells. DKK1 is among these regulated mediators.
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Affiliation(s)
- Jorge Felipe Lima Teixeira
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | | | | | | | - José Bernardo de Santis
- Department of Basic and Oral Biology, Bone Research Lab, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | - Pedro Paulo Chaves de Souza
- Innovation in Biomaterials Laboratory (iBioM), School of Dentistry, Federal University of Goiás, Goiânia 74605-020, Brazil
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Guastaldi FPS, Queiroz TP, Marques DO, Santos ABS, Molon RS, Margonar R, Guastaldi AC. Comparative Evaluation of Implants with Different Surface Treatments Placed in Human Edentulous Mandibles: A 1-Year Prospective Study. J Maxillofac Oral Surg 2022; 21:815-823. [PMID: 36274893 PMCID: PMC9474755 DOI: 10.1007/s12663-021-01600-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022] Open
Abstract
The aims of this study were to analyze prospectively and comparatively the peri-implant bone crest levels, bone density, stability and success rate of implants with different surface treatments in human edentulous mandibles. Twenty edentulous patients were selected. Four different implants were placed between the mental foramen. Four groups were evaluated: (1) laser-modified surface (LASER), (2) surface modified by laser with deposition of apatites (LASER + HA), (3) surface modified by double acid etching (ACID, Implacil De Bortoli) and (4) surface modified by sandblasting and acid etching (SLActive®, Straumann). Clinical, radiographic, resonance frequency and tomographic analyses were used. After 4 months, mandibular fixed implant prostheses were installed. Clinical and radiographic analyses were performed at times T0 (immediately after implant placement), T1 (15 days), T2 (30 days), T3 (60 days), T4 (90 days), T5 (120 days), T6 (180 days) and T7 (360 days), post-implant placement. The resonance frequency analysis (RFA) was measured at T0, T4, T6 and T7. The tomographic analysis was performed at T0, T4 and T7. In the radiographic bone density analysis, a statistical difference was found between the SLActive® and LASER + HA groups at T4 (p < 0.05). Statistical differences were observed in RFA at T4 (90 days), between the SLActive® and LASER groups (p < 0.05) and between the SLActive® and LASER + HA groups (p < 0.05). At T6 and T7, statistical differences were found between the SLActive® group and all other implant surfaces (p < 0.01). The experimental surfaces analyzed showed encouraging positive outcomes compared to those of the SLActive® surface. Long-term follow-up should be performed to confirm these results.
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Affiliation(s)
- Fernando P. S. Guastaldi
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Araraquara, SP Brazil
- Skeletal Biology Research Center, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Thier Research Building, 50 Blossom St, Boston, MA 513A USA
| | - Thallita P. Queiroz
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Daniela O. Marques
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Anne B. S. Santos
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Rafael S. Molon
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Araraquara, SP Brazil
| | - Rogerio Margonar
- Department of Health Sciences, University Center of Araraquara (UNIARA), Araraquara, SP Brazil
| | - Antonio C. Guastaldi
- Department of Physical Chemistry, Institute of Chemistry, São Paulo State University (Unesp), Araraquara, SP Brazil
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An Evaluation of the Effects of Photobiomodulation Therapy on the Peri-Implant Bone Healing of Implants with Different Surfaces: An In Vivo Study. MATERIALS 2022; 15:ma15134371. [PMID: 35806496 PMCID: PMC9267620 DOI: 10.3390/ma15134371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/21/2022]
Abstract
(1) Background: This study evaluates the effects of photobiomodulation (PBM) therapy on the peri-implant bone healing of implants with a machined surface (MS) and treated surface (TS). (2) Methods: Topographic characterization of the surfaces (scanning electron microscopy [SEM]- energy dispersive X-ray spectroscopy [EDX]) was performed before and after implant removal. Twenty rabbits were randomly divided into four groups: MS and TS groups (without PBM therapy) and LMS and LTS groups (with PBM therapy). After implant placement, the stability coefficient (ISQ) was measured. In the periods of 21 and 42 days, the ISQ was measured again, followed by biomechanical analysis. (3) Results: The surfaces of the TS implants showed topographic differences compared with MS implants. The ISQ values of the LMS were statistically significant when compared with those of the MS at 42 days (p < 0.001). The removal torque values of the LMS were statistically significant when compared with those of the MS at 21 days (p = 0.023) and 42 days (p = 0.023). For SEM, in general, the LMS, TS and LTS presented high bone tissue coverage when compared to MS. (4) Conclusions: The PBM therapy modulated the osseointegration process and was evidenced mainly on the machined surface.
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Bahraminasab M, Arab S, Safari M, Talebi A, Kavakebian F, Doostmohammadi N. In vivo performance of Al 2O 3-Ti bone implants in the rat femur. J Orthop Surg Res 2021; 16:79. [PMID: 33482866 PMCID: PMC7821505 DOI: 10.1186/s13018-021-02226-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Alumina-titanium (Al2O3-Ti) biocomposites have been recently developed with improved mechanical properties for use in heavily loaded orthopedic sites. Their biological performance, however, has not been investigated yet. Methods The aim of the present study was to evaluate the in vivo biological interaction of Al2O3-Ti. Spark plasma sintering (SPS) was used to fabricate Al2O3-Ti composites with 25 vol.%, 50 vol.%, and 75 vol.% Ti content. Pure alumina and titanium were also fabricated by the same procedure for comparison. The fabricated composite disks were cut into small bars and implanted into medullary canals of rat femurs. The histological analysis and scanning electron microscopy (SEM) observation were carried out to determine the bone formation ability of these materials and to evaluate the bone-implant interfaces. Results The histological observation showed the formation of osteoblast, osteocytes with lacuna, bone with lamellar structures, and blood vessels indicating that the healing and remodeling of the bone, and vasculature reconstruction occurred after 4 and 8 weeks of implantation. However, superior bone formation and maturation were obtained after 8 weeks. SEM images also showed stronger interfaces at week 8. There were differences between the composites in percentages of bone area (TB%) and the number of osteocytes. The 50Ti composite showed higher TB% at week 4, while 25Ti and 75Ti represented higher TB% at week 8. All the composites showed a higher number of osteocytes compared to 100Ti, particularly 75Ti. Conclusions The fabricated composites have the potential to be used in load-bearing orthopedic applications.
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Affiliation(s)
- Marjan Bahraminasab
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran. .,Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran.
| | - Samaneh Arab
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran.,Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Manouchehr Safari
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Athar Talebi
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Kavakebian
- Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Nesa Doostmohammadi
- Faculty of Metallurgical and Materials Engineering, Semnan University, Semnan, Iran
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Brogini S, Sartori M, Giavaresi G, Cremascoli P, Alemani F, Bellini D, Martini L, Maglio M, Pagani S, Fini M. Osseointegration of additive manufacturing Ti-6Al-4V and Co-Cr-Mo alloys, with and without surface functionalization with hydroxyapatite and type I collagen. J Mech Behav Biomed Mater 2020; 115:104262. [PMID: 33321396 DOI: 10.1016/j.jmbbm.2020.104262] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/24/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022]
Abstract
The introduction of additive manufacturing (AM) technologies has profoundly revolutionized the implant manufacturing industry, with a particularly significant impact on the field of orthopedics. Electron Beam Melting (EBM) and Direct Metal Laser Sintering (DMLS) represents AM fabrication techniques with a pivotal role in the realization of complex and innovative structure starting from virtual 3D model data. In this study, Ti-6Al-4V and Co-Cr-Mo materials, developed by EBM (Ti-POR) and DMLS (Co-POR) techniques, respectively, with hydroxyapatite (Ti-POR + HA; Co-POR + HA) and type I collagen (Ti-POR-COLL; Co-POR-COLL) coatings, were implanted into lateral femoral condyles of rabbits. Osseointegration process was investigated by histological, histomorphometrical and microhardness evaluations at 4 and 12 weeks after implantation. Both Ti-6Al-4V and Co-Cr-Mo implants, with or without HA and COLL coatings, demonstrated good biocompatibility. As expected, HA coating hastened bone-to-implant contact (BIC) process, while collagen did not significantly improved the osseointegration process in comparison to controls. Regarding newly trabecular bone formation (B.Ar/T.Ar), Co-POR presented the highest values, significantly different from those of Co-POR-COLL. Over time, an increase of BIC parameter and a decrease of B.Ar/T.Ar were detected. Higher mineral apposition rate was observed for Ti-POR and Co-POR in comparison to Ti-POR-COLL and Co-POR-COLL, respectively, at 12 weeks. The same behavior was found for bone formation rate between Co-POR and Co-POR-COLL at 12 weeks. In conclusion, the AM materials guarantee a good osseointegration and provide a suitable environment for bone regeneration with the peculiarity of allowing personalized and patient-specific needs customization to further improve the long-term clinical outcomes.
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Affiliation(s)
- Silvia Brogini
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Maria Sartori
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy.
| | - Gianluca Giavaresi
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | | | | | | | - Lucia Martini
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Melania Maglio
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Stefania Pagani
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Milena Fini
- IRCCS Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
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Zhang H, Liu K, Lu M, Liu L, Yan Y, Chu Z, Ge Y, Wang T, Qiu J, Bu S, Tang C. Micro/nanostructured calcium phytate coating on titanium fabricated by chemical conversion deposition for biomedical application. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 118:111402. [PMID: 33255005 DOI: 10.1016/j.msec.2020.111402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/26/2020] [Accepted: 08/11/2020] [Indexed: 01/01/2023]
Abstract
A bioactive micro/nanostructured calcium phytate coating was successfully prepared on titanium surfaces by chemical conversion deposition, mainly through hydrothermal treatment of a mixed solution of phytic acid and saturated calcium hydroxide solution. Ultraviolet radiation was carried out to improve the adhesion of the coating to the titanium substrate. Pure titanium with a sandblasted/acid-etched surface was used as the control group. The topography and chemical composition of the modified surfaces were characterized by scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), energy-dispersive X-ray spectroscopy (EDX), and static water contact angle measurement. A pull-off test was performed to measure the coating-to-substrate adhesion strength. Bovine serum albumin was used as a model to study the protein adsorption effect. Cells were cultured on titanium surfaces for 7 days in osteogenic differentiation medium, then the osteoblast compatibility in vitro were explored by alkaline phosphatase and alizarin red staining. After 1, 2, 4 and 8 wks of immediate implantation of titanium implants into the mandibles of New Zealand white rabbits, biological effects in vivo were researched by microcomputed tomography analysis and histological evaluation. The results indicated that the roughness and hydrophilicity of the modified surfaces with micro/nanostructure remarkably increased compared to those of the control group. The pull-off test showed the average adhesion strength at the coating-substrate interface to be higher than 13.56 ± 1.71 MPa. In addition, approximately 4.41 mg/L calcium ion was released from the calcium phytate micro/nano coatings to the local environment after 48 h of immersion. More importantly, the micro/nanostructure titanium substrates significantly promoted cellular differentiation in vitro and in vivo. After 8 wks, the bone implant contact ratio (BIC, %) of the modified implants was higher than that of the control group, at 94.09 ± 0.55% and 86.18 ± 1.99% (p < 0.05). Overall, this study provided new insights into the factors promoting early osseointegration of titanium alloys, which had great potential not only for dental implants but also for various other biomaterial applications.
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Affiliation(s)
- Hao Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Kun Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China; Department of Implantology, Hefei Stomatological Hospital, Hefei Clinical School of Stomatology, Anhui Medical University, Hefei 230001, China
| | - Mengmeng Lu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Lin Liu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yanzhe Yan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Zhuangzhuang Chu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Yuran Ge
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China
| | - Tao Wang
- College of Materials Science and Technology, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Jing Qiu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Shoushan Bu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Chunbo Tang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing 210029, China; Department of Dental Implantology, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China.
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9
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González-Henríquez CM, Veliz-Silva DF, Sarabia-Vallejos MA, Del Campo-García A, Rodríguez-Hernández J. Micrometric Wrinkled Patterns Spontaneously Formed on Hydrogel Thin Films via Argon Plasma Exposure. Molecules 2019; 24:E751. [PMID: 30791473 PMCID: PMC6412580 DOI: 10.3390/molecules24040751] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 02/02/2019] [Accepted: 02/13/2019] [Indexed: 11/16/2022] Open
Abstract
The generation of microstructured patterns on the surface of a specific polymeric material could radically improve their performance in a particular application. Most of the interactions with the environment occur at the material interface; therefore, increasing the exposed active surface considerably improves their range of application. In this article, a simple and reliable protocol to form spontaneous wrinkled patterns using a hydrogel layer is reported. For this purpose, we took advantage of the doctor blade technique in order to generate homogenous films over solid substrates with controlled thickness and large coverage. The hydrogel wrinkle formation involves a prepolymerization step which produces oligomers leading to a solution with increased viscosity, enough for doctor blade deposition. Subsequently, the material was exposed to vacuum and plasma to trigger wrinkled pattern formation. Finally, a UV-polymerization treatment was applied to fix the undulations on top. Interestingly, the experimental parameters allowed us to finely tune the wrinkle characteristics (period, amplitude, and orientation). For this study, two main aspects were explored. The first one is related to the role of the substrate functionalization on the wrinkle formation. The second study correlates the deswelling time and its relationship with the dimensions and distribution of the wrinkle pattern. In the first batch, four different 3-(trimethoxysilyl)propyl methacrylate (TSM) concentrations were used to functionalize the substrate in order to enhance the adhesion between hydrogel film and the substrate. The wrinkles formed were characterized in terms of wrinkle amplitude, wavelength, pattern roughness, and surface Young modulus, by using AFM in imaging and force spectroscopy modes. Moreover, the chemical composition of the hydrogel film cross-section and the effect of the plasma treatment were analyzed with confocal Raman spectroscopy. These results demonstrated that an oxidized layer was formed on top of the hydrogel films due to the exposure to an argon plasma.
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Affiliation(s)
- Carmen M González-Henríquez
- Facultad de Ciencias Naturales, Matemáticas y del Medio Ambiente, Departamento de Química, Universidad Tecnológica Metropolitana, Las Palmeras 3360, Santiago 7800003, Chile.
- Programa Institucional de Fomento a la Investigación, Desarrollo e Innovación, Universidad Tecnológica Metropolitana, Ignacio Valdivieso 2409, Santiago 8940577, Chile.
| | - Diego F Veliz-Silva
- Facultad de Ciencias Naturales, Matemáticas y del Medio Ambiente, Departamento de Química, Universidad Tecnológica Metropolitana, Las Palmeras 3360, Santiago 7800003, Chile.
| | - Mauricio A Sarabia-Vallejos
- Escuela de Ingeniería, Departamento de Ingeniería Estructural y Geotecnia, Pontificia Universidad Católica de Chile, Avenida Vicuña Mackenna 4860, Santiago 7820436, Chile.
- Escuela de Ingeniería, Instituto de Ingeniería Biológica y Médica, Pontificia Universidad Católica de Chile, Avenida Vicuña Mackenna 4860, Santiago 7820436, Chile.
| | - Adolfo Del Campo-García
- Ceramics for Smart Systems Group, Departamento de Electrocerámicos, Instituto de Cerámica y Vidrio- Consejo Superior de Investigaciones Científicas (ICV-CSIC), Kelsen 5, Madrid 28049, Spain.
| | - Juan Rodríguez-Hernández
- Polymer Functionalization Group. Instituto de Ciencia y Tecnología de Polímeros-Consejo Superior de Investigaciones Científicas (ICTP-CSIC), Departamento de Química Macromolecular Aplicada, Juan de la Cierva 3, Madrid 28006, Spain.
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10
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Voltrova B, Hybasek V, Blahnova V, Sepitka J, Lukasova V, Vocetkova K, Sovkova V, Matejka R, Fojt J, Joska L, Daniel M, Filova E. Different diameters of titanium dioxide nanotubes modulate Saos-2 osteoblast-like cell adhesion and osteogenic differentiation and nanomechanical properties of the surface. RSC Adv 2019; 9:11341-11355. [PMID: 35520235 PMCID: PMC9062999 DOI: 10.1039/c9ra00761j] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/28/2019] [Indexed: 01/09/2023] Open
Abstract
Nanostructured cpTi surfaces affected Saos-2 cell adhesion, proliferation, and osteogenic differentiation as well as the nanomechanical properties of the surface.
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11
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Ren L, Pan S, Li H, Li Y, He L, Zhang S, Che J, Niu Y. Effects of aspirin-loaded graphene oxide coating of a titanium surface on proliferation and osteogenic differentiation of MC3T3-E1 cells. Sci Rep 2018; 8:15143. [PMID: 30310118 PMCID: PMC6181949 DOI: 10.1038/s41598-018-33353-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 09/27/2018] [Indexed: 12/20/2022] Open
Abstract
Graphene oxide (GO) has attracted considerable attention for biomedical applications such as drug delivery because of its two-dimensional structure, which provides a large surface area on both sides of the nanosheet. Here, a new method for titanium (Ti) surface modification involving a GO coating and aspirin (A) loading (A/Ti-GO) was developed, and the bioactive effects on mouse osteoblastic MC3T3-E1 cells were preliminarily studied. The X-ray photoelectron spectrometry indicated new C-O-N, C-Si-O-C, and C-N=C bond formation upon GO coating. Remarkably, the torsion test results showed stable bonding between the GO coating and Ti under a torsional shear force found in clinical settings, in that, there was no tearing or falling off of GO coating from the sample surface. More importantly, through π-π stacking interactions, the release of aspirin loaded on the surface of Ti-GO could sustain for 3 days. Furthermore, the A/Ti-GO surface displayed a significantly higher proliferation rate and differentiation of MC3T3-E1 cells into osteoblasts, which was confirmed by a water-soluble tetrazolium salt-8 (WST-8) assay and alkaline phosphatase activity test. Consequently, Ti surface modification involving GO coating and aspirin loading might be a useful contribution to improve the success rate of Ti implants in patients, especially in bone conditions.
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Affiliation(s)
- Liping Ren
- Department of Prosthodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Shuang Pan
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China.,Oral Biomedical Research institute of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Haiqing Li
- Department of Stomatology, Hospital of Heilongjiang Province, No. 82 Zhongshan Street, Xiangfang District, Harbin, 150036, China
| | - Yanping Li
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Lina He
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Shuang Zhang
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Jingyi Che
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China
| | - Yumei Niu
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China. .,Oral Biomedical Research institute of Harbin Medical University, No. 143 Yiman Street, Nangang District, Harbin, 150001, China.
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12
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Evaluation of bone turnover after bisphosphonate withdrawal and its influence on implant osseointegration: an in vivo study in rats. Clin Oral Investig 2018; 23:1733-1744. [DOI: 10.1007/s00784-018-2612-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/23/2018] [Indexed: 12/29/2022]
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13
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Tavakoli J, Khosroshahi ME. Surface morphology characterization of laser-induced titanium implants: lesson to enhance osseointegration process. Biomed Eng Lett 2018; 8:249-257. [PMID: 30603208 DOI: 10.1007/s13534-018-0063-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/05/2018] [Accepted: 03/18/2018] [Indexed: 12/27/2022] Open
Abstract
The surface properties of implant are responsible to provide mechanical stability by creating an intimate bond between the bone and implant; hence, play a major role on osseointegration process. The current study was aimed to measure surface characteristics of titanium modified by a pulsed Nd:YAG laser. The results of this study revealed an optimum density of laser energy (140 Jcm-2), at which improvement of osteointegration process was seen. Significant differences were found between arithmetical mean height (Ra), root mean square deviation (Rq) and texture orientation, all were lower for 140 Jcm-2 samples compared to untreated one. Also it was identified that the surface segments were more uniformly distributed with a more Gaussian distribution for treated samples at 140 Jcm-2. The distribution of texture orientation at high laser density (250 and 300 Jcm-2) were approximately similar to untreated sample. The skewness index that indicates how peaks and valleys are distributed throughout the surface showed a positive value for laser treated samples, compared to untreated one. The surface characterization revealed that Kurtosis index, which tells us how high or flat the surface profile is, for treated sample at 140 Jcm-2 was marginally close to 3 indicating flat peaks and valleys in the surface profile.
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Affiliation(s)
- Javad Tavakoli
- 1Biomechanics and Implants Research Group, The Medical Device Research Institute, College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, SA 5001 Australia
| | - Mohammad E Khosroshahi
- 2Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON M5S 3G8 Canada
- MIS-Electronics, Nanobiophotonics and Biomedical Research Lab, Richmond Hill, ON L4B 1B4 Canada
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14
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Henningsen A, Smeets R, Hartjen P, Heinrich O, Heuberger R, Heiland M, Precht C, Cacaci C. Photofunctionalization and non-thermal plasma activation of titanium surfaces. Clin Oral Investig 2017; 22:1045-1054. [PMID: 28730456 DOI: 10.1007/s00784-017-2186-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to compare UV light and non-thermal plasma (NTP) treatment regarding the improvement of physical material characteristics and cell reaction on titanium surfaces in vitro after short-term functionalization. MATERIALS AND METHODS Moderately rough (Ra 1.8-2.0 μm) sandblasted and acid-etched titanium disks were treated by UV light (0.05 mW/cm2 at λ = 360 nm and 2 mW/cm2 at λ = 250 nm) or by NTP (24 W, -0.5 mbar) of argon or oxygen for 12 min each. Surface structure was investigated by scanning electron microscopy, confocal microscopy and X-ray photoelectron spectroscopy (XPS). Hydrophilicity was assessed by dynamic contact angle measurement. Cell attachment, viability, cell proliferation and cytotoxicity were assessed in vitro using murine osteoblast-like cells. RESULTS UV irradiation or NTP treatment of titanium surfaces did not alter the surface structure. XPS analysis revealed a significantly increased oxidation of the surface and a decrease of carbon after the use of either method. NTP and UV light led to a significant better cell attachment of murine osteoblasts; significantly more osteoblasts grew on the treated surfaces at each time point (p < 0.001). CONCLUSIONS UV light as well as NTP modified the surface of titanium and significantly improved the conditions for murine osteoblast cells in vitro. However, results indicate a slight advantage for NTP of argon and oxygen in a short time interval of surface functionalization compared to UV. CLINICAL RELEVANCE UV light and NTP are able to improve surface conditions of dental implants made of titanium.
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Affiliation(s)
- Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
- Department of Oral and Maxillofacial Surgery, German Armed Forces Hospital, Lesserstrasse 180, 22049, Hamburg, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Philip Hartjen
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Oliver Heinrich
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Roman Heuberger
- RMS Foundation, Bischmattstraße 12, 2544, Bettlach, Switzerland
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité University Hospital, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Clarissa Precht
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Claudio Cacaci
- Implant Competence Centrum, Weinstr. 4, 80333, Munich, Germany
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15
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de Molon RS, Sakakura CE, Faeda RS, Sartori R, Palhares D, Margonar R, Marcantonio E. Effect of the long-term administration of Cyclosporine A on bone healing around osseointegrated titanium implants: A histomorphometric study in the rabbit tibia. Microsc Res Tech 2017; 80:1000-1008. [DOI: 10.1002/jemt.22894] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/12/2017] [Accepted: 05/06/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Rafael Scaf de Molon
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara; Sao Paulo State University - UNESP; Araraquara SP Brazil
- Department of Rheumatology; Rheumatology Research and Advanced Therapeutics, Radboud University Nijmegen Medical Centre; 6500 HB Nijmegen The Netherlands
| | - Celso Eduardo Sakakura
- Department of Periodontology; Barretos Dental School, Education Foundation of Barretos - FEB; Barretos SP Brazil
| | - Rafael Silveira Faeda
- Department of Health Sciences; Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School; SP Brazil
| | - Rafael Sartori
- Department of Dentistry; Ponta Grossa State University; Ponta Grossa Paraná Brazil
| | - Daniel Palhares
- Department of Periodontology; Barretos Dental School, Education Foundation of Barretos - FEB; Barretos SP Brazil
| | - Rogerio Margonar
- Department of Health Sciences; Implantology Post Graduation Course, University Center of Araraquara - UNIARA Dental School; SP Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara; Sao Paulo State University - UNESP; Araraquara SP Brazil
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