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Väisänen A, Hoikkala N, Härkönen V, Moritz N, Vallittu PK. Biomechanical considerations of semi-anatomic glass fiber-reinforced (GFRC) composite implant for mandibular segmental defects: A technical note. J Mech Behav Biomed Mater 2024; 156:106604. [PMID: 38810543 DOI: 10.1016/j.jmbbm.2024.106604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the selected biomechanical properties of semi-anatomic implant plate made of biostable glass fiber-reinforced composite (GFRC) for mandibular reconstruction. Two versions of GFRC plates were tested in vitro loading conditions of a mandible segmental defect model, for determining the level of mechanical stress at the location of fixation screws, and in the body of the plate. METHODS GFRC of bidirectional S3-glass fiber weaves with dimethacrylate resin matrix were used to fabricate semi-anatomic reconstruction plates of two GFRC laminate thicknesses. Lateral surface of the plate followed the contour of the resected part of the bone, and the medial surface was concave allowing for placement of a microvascular bone flap in the next stages of the research. Plates were fixed with screws to a plastic model of the mandible with a large segmental defect in the premolar-molar region. The mandible-plate system was loaded from incisal and molar locations with loads of 10, 50, and 100 N and stress (microstrain, με) at the location of fixation screws and the body of the plate was measured by strain gauges. In total the test set-up had four areas for measuring the stress of the plate. RESULTS No signs of fractures or buckling failures of the plates were found during loading. Strain values at the region of the fixation screws were higher with thick plate, whereas thin plates demonstrated higher strain at the body of the plate. Vertical displacement of the mandible-plate system was proportional to the loading force and was higher with incisal than molar loading locations but no difference was found between thin and thick plates. CONCLUSION GFRC plates withstood the loading conditions up to 100 N even when loaded incisally. Thick plates concentrated the stress to the ramus mandibulae region of the fixation screws whereas the thin plates showed stress concentration in the angulus mandibulae region of the fixation and the plate itself. In general, thin plates caused a lower magnitude of stress to the fixation screw areas than thick plates, suggesting absorption of the loading energy to the body of the plate.
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Affiliation(s)
- Antti Väisänen
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, Finland.
| | - Niko Hoikkala
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, Finland
| | - Ville Härkönen
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, Finland
| | - Niko Moritz
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, Finland
| | - Pekka K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, Finland; Wellbeing Services, County of South-West Finland, Turku, Finland
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Domingo MG, Kurtz M, Maglione G, Martin M, Brites F, Tasat DR, Olmedo DG. Chronic exposure to TiO 2 micro- and nano particles: A biochemical and histopathological experimental study. J Biomed Mater Res B Appl Biomater 2024; 112:e35443. [PMID: 38968028 DOI: 10.1002/jbm.b.35443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 04/08/2024] [Accepted: 06/09/2024] [Indexed: 07/07/2024]
Abstract
The aim of this work was to analyze the effects of long-term exposure to titanium dioxide (TiO2) micro- (MPs) and nanoparticles (NPs) (six and 12 months) on the biochemical and histopathological response of target organs using a murine model. Male Wistar rats were intraperitoneally injected with a suspension of TiO2 NPs (5 nm; TiO2-NP5 group) or MPs (45 μm; TiO2-NP5 group); the control group was injected with saline solution. Six and 12 months post-injection, titanium (Ti) concentration in plasma and target organs was determined spectrometrically (ICP-MS). Blood smears and organ tissue samples were evaluated by light microscopy. Liver and kidney function was evaluated using serum biochemical parameters. Oxidative metabolism was assessed 6 months post-injection (determination of superoxide anion by nitroblue tetrazolium (NBT) test, superoxide dismutase (SOD) and catalase (CAT), lipid peroxidation, and paraoxonase 1). Titanium (Ti) concentration in target organs and plasma was significantly higher in the TiO2-exposed groups than in the control group. Histological evaluation showed the presence of titanium-based particles in the target organs, which displayed no structural alterations, and in blood monocytes. Oxidative metabolism analysis showed that TiO2 NPs were more reactive over time than MPs (p < .05) and mobilization of antioxidant enzymes and membrane damage varied among the studied organs. Clearance of TiO2 micro and nanoparticles differed among the target organs, and lung clearance was more rapid than clearance from the lungs and kidneys (p < .05). Conversely, Ti concentration in plasma increased with time (p < .05). In conclusion, neither serum biochemical parameters nor oxidative metabolism markers appear to be useful as biomarkers of tissue damage in response to TiO2 micro- and nanoparticle deposits at chronic time points.
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Affiliation(s)
- Mariela Gisele Domingo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina
- Becario de Investigación de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Melisa Kurtz
- CONICET, Buenos Aires, Argentina
- Instituto de Tecnologías Emergentes y Ciencias Aplicadas (ITECA), Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín-CONICET, Buenos Aires, Argentina
| | - Guillermo Maglione
- Instituto de Tecnologías Emergentes y Ciencias Aplicadas (ITECA), Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín-CONICET, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Histología y Embriología, Buenos Aires, Argentina
| | | | - Fernando Brites
- CONICET, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Lipoproteínas, Buenos Aires, Argentina
| | - Deborah Ruth Tasat
- Instituto de Tecnologías Emergentes y Ciencias Aplicadas (ITECA), Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín-CONICET, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Histología y Embriología, Buenos Aires, Argentina
| | - Daniel Gustavo Olmedo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina
- CONICET, Buenos Aires, Argentina
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3
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Kandaswamy E, Harsha M, Joshi VM. Titanium corrosion products from dental implants and their effect on cells and cytokine release: A review. J Trace Elem Med Biol 2024; 84:127464. [PMID: 38703537 DOI: 10.1016/j.jtemb.2024.127464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Titanium is considered to be an inert material owing to the ability of the material to form a passive titanium oxide layer. However, once the titanium oxide layer is lost, it can lead to exposure of the underlying titanium substructure and can undergo corrosion. SUMMARY The article explores the role of titanium ions and particles from dental implants on cells, cytokine release, and on the systemic redistribution of these particles as well as theories proposed to elucidate the effects of these particles on peri-implant inflammation based on evidence from in-vitro, human, and animal studies. Titanium particles and ions have a pro-inflammatory and cytotoxic effect on cells and promote the release of pro-inflammatory mediators like cytokines. Three theories to explain etiopathogenesis have been proposed, one based on microbial dysbiosis, the second based on titanium particles and ions and the third based on a synergistic effect between microbiome and titanium particles on the host. CONCLUSION There is clear evidence from in-vitro and limited human and animal studies that titanium particles released from dental implants have a detrimental effect on cells directly and through the release of pro-inflammatory cytokines. Future clinical and translational studies are required to clarify the role of titanium particles and ions in peri-implant inflammation and the etiopathogenesis of peri-implantitis.
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Affiliation(s)
- Eswar Kandaswamy
- Department of Periodontics, LSUHSC, School of Dentistry, 100 Florida Avenue, New Orleans, LA 70119, USA
| | - M Harsha
- Department of Oral Pathology & Microbiology, Yogita Dental College & Hospital, Naringi Riverside, At Post Tal Dist. SH104, Khed, Maharashtra 415709, India
| | - Vinayak M Joshi
- Department of Periodontics, LSUHSC, School of Dentistry, 100 Florida Avenue, New Orleans, LA 70119, USA.
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Yin D, Zhan S, Liu Y, Yan L, Shi B, Wang X, Zhang S. Experimental models for peri-implant diseases: a narrative review. Clin Oral Investig 2024; 28:378. [PMID: 38884808 DOI: 10.1007/s00784-024-05755-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES Peri-implant diseases, being the most common implant-related complications, significantly impact the normal functioning and longevity of implants. Experimental models play a crucial role in discovering potential therapeutic approaches and elucidating the mechanisms of disease progression in peri-implant diseases. This narrative review comprehensively examines animal models and common modeling methods employed in peri-implant disease research and innovatively summarizes the in vitro models of peri-implant diseases. MATERIALS AND METHODS Articles published between 2015 and 2023 were retrieved from PubMed/Medline, Web of Science, and Embase. All studies focusing on experimental models of peri-implant diseases were included and carefully evaluated. RESULTS Various experimental models of peri-implantitis have different applications and advantages. The dog model is currently the most widely utilized animal model in peri-implant disease research, while rodent models have unique advantages in gene knockout and systemic disease induction. In vitro models of peri-implant diseases are also continuously evolving to meet different experimental purposes. CONCLUSIONS The utilization of experimental models helps simplify experiments, save time and resources, and promote advances in peri-implant disease research. Animal models have been proven valuable in the early stages of drug development, while technological advancements have brought about more predictive and relevant in vitro models. CLINICAL RELEVANCE This review provides clear and comprehensive model selection strategies for researchers in the field of peri-implant diseases, thereby enhancing understanding of disease pathogenesis and providing possibilities for developing new treatment strategies.
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Affiliation(s)
- Derong Yin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030032, Shanxi, China
| | - Suying Zhan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yanbo Liu
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030032, Shanxi, China
| | - Lichao Yan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Binmian Shi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiayi Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Shiwen Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
- Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
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Ng E, Tay JRH, Mattheos N, Bostanci N, Belibasakis GN, Seneviratne CJ. A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis. Cells 2024; 13:315. [PMID: 38391928 PMCID: PMC10886485 DOI: 10.3390/cells13040315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
This mapping review highlights the need for a new paradigm in the understanding of peri-implantitis pathogenesis. The biofilm-mediated inflammation and bone dysregulation (BIND) hypothesis is proposed, focusing on the relationship between biofilm, inflammation, and bone biology. The close interactions between immune and bone cells are discussed, with multiple stable states likely existing between clinically observable definitions of peri-implant health and peri-implantitis. The framework presented aims to explain the transition from health to disease as a staged and incremental process, where multiple factors contribute to distinct steps towards a tipping point where disease is manifested clinically. These steps might be reached in different ways in different patients and may constitute highly individualised paths. Notably, factors affecting the underlying biology are identified in the pathogenesis of peri-implantitis, highlighting that disruptions to the host-microbe homeostasis at the implant-mucosa interface may not be the sole factor. An improved understanding of disease pathogenesis will allow for intervention on multiple levels and a personalised treatment approach. Further research areas are identified, such as the use of novel biomarkers to detect changes in macrophage polarisation and activation status, and bone turnover.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand;
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia
- School of Dentistry, Center for Oral-Facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, QLD 4072, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore
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Insua A, Galindo-Moreno P, Miron RJ, Wang HL, Monje A. Emerging factors affecting peri-implant bone metabolism. Periodontol 2000 2024; 94:27-78. [PMID: 37904311 DOI: 10.1111/prd.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/05/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023]
Abstract
Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.
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Affiliation(s)
- Angel Insua
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pablo Galindo-Moreno
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Wang D, Yue Y, Liu H, Zhang T, Haney EF, Hancock REW, Yu J, Shen Y. Antibiofilm peptides enhance the corrosion resistance of titanium in the presence of Streptococcus mutans. Front Bioeng Biotechnol 2024; 11:1339912. [PMID: 38274010 PMCID: PMC10809395 DOI: 10.3389/fbioe.2023.1339912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Titanium alloys have gained popularity in implant dentistry for the restoration of missing teeth and related hard tissues because of their biocompatibility and enhanced strength. However, titanium corrosion and infection caused by microbial biofilms remains a significant clinical challenge leading to implant failure. This study aimed to evaluate the effectiveness of antibiofilm peptides 1018 and DJK-5 on the corrosion resistance of titanium in the presence of Streptococcus mutans. Commercially pure titanium disks were prepared and used to form biofilms. The disks were randomly assigned to different treatment groups (exposed to S. mutans supplied with sucrose) including a positive control with untreated biofilms, peptides 1018 or DJK-5 at concentrations of 5 μg/mL or 10 μg/mL, and a negative control with no S. mutans. Dynamic biofilm growth and pH variation of all disks were measured after one or two treatment periods of 48 h. After incubation, the dead bacterial proportion, surface morphology, and electrochemical behaviors of the disks were determined. The results showed that peptides 1018 and DJK-5 exhibited significantly higher dead bacterial proportions than the positive control group in a concentration dependent manner (p < 0.01), as well as far less defects in microstructure. DJK-5 at 10 μg/mL killed 84.82% of biofilms and inhibited biofilm growth, preventing acidification due to S. mutans and maintaining a neutral pH. Potential polarization and electrochemical impedance spectroscopy data revealed that both peptides significantly reduced the corrosion and passive currents on titanium compared to titanium surfaces with untreated biofilms, and increased the resistance of the passive film (p < 0.05), with 10 μg/mL of DJK-5 achieving the greatest effect. These findings demonstrated that antibiofilm peptides are effective in promoting corrosion resistance of titanium against S. mutans, suggesting a promising strategy to enhance the stability of dental implants by endowing them with antibiofilm and anticorrosion properties.
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Affiliation(s)
- Dan Wang
- Department of Stomatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Yingying Yue
- Liaoning Institute of Science and Technology, Benxi, China
| | - He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Tian Zhang
- School of Medicine, Vanderbilt University, Nashville, TN, United States
| | - Evan F. Haney
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Robert E. W. Hancock
- Centre for Microbial Diseases and Immunity Research, Department of Microbiology and Immunology, University of British Columbia, Vancouver, BC, Canada
| | - Jian Yu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Chen L, Tong Z, Luo H, Qu Y, Gu X, Si M. Titanium particles in peri-implantitis: distribution, pathogenesis and prospects. Int J Oral Sci 2023; 15:49. [PMID: 37996420 PMCID: PMC10667540 DOI: 10.1038/s41368-023-00256-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Peri-implantitis is one of the most important biological complications in the field of oral implantology. Identifying the causative factors of peri-implant inflammation and osteolysis is crucial for the disease's prevention and treatment. The underlying risk factors and detailed pathogenesis of peri-implantitis remain to be elucidated. Titanium-based implants as the most widely used implant inevitably release titanium particles into the surrounding tissue. Notably, the concentration of titanium particles increases significantly at peri-implantitis sites, suggesting titanium particles as a potential risk factor for the condition. Previous studies have indicated that titanium particles can induce peripheral osteolysis and foster the development of aseptic osteoarthritis in orthopedic joint replacement. However, it remains unconfirmed whether this phenomenon also triggers inflammation and bone resorption in peri-implant tissues. This review summarizes the distribution of titanium particles around the implant, the potential roles in peri-implantitis and the prevalent prevention strategies, which expects to provide new directions for the study of the pathogenesis and treatment of peri-implantitis.
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Affiliation(s)
- Long Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zian Tong
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Hongke Luo
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yuan Qu
- Zhejiang University-University of Edinburgh Institute, International Campus, Zhejiang University, Haining, China
| | - Xinhua Gu
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Misi Si
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
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Dua R, Sharufa O, Terry J, Dunn W, Khurana I, Vadivel J, Zhang Y, Donahue HJ. Surface modification of Polyether-ether-ketone for enhanced cell response: a chemical etching approach. Front Bioeng Biotechnol 2023; 11:1202499. [PMID: 37744253 PMCID: PMC10517429 DOI: 10.3389/fbioe.2023.1202499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 08/28/2023] [Indexed: 09/26/2023] Open
Abstract
Polyether-ether-ketone (PEEK) is increasingly becoming popular in medicine because of its excellent mechanical strength, dimensional stability, and chemical resistance properties. However, PEEK being bioinert, has weak bone osseointegration properties, limiting its clinical applications. In this study, a porous PEEK structure was developed using a chemical etching method with 98 wt% sulfuric acids and three post-treatments were performed to improve bone cell adhesion and proliferation. Four groups of PEEK samples were prepared for the study: Control (untreated; Group 1); Etched with sulfuric acid and washed with distilled water (Group 2); Etched with sulfuric acid and washed with acetone and distilled water (Group 3); and Etched with sulfuric acid and washed with 4 wt% sodium hydroxide and distilled water (Group 4). Surface characterization of the different groups was evaluated for surface topology, porosity, roughness, and wettability using various techniques, including scanning electron microscopy, profilometer, and goniometer. Further chemical characterization was done using Energy-dispersive X-ray spectroscopy to analyze the elements on the surface of each group. Bone cell studies were conducted using cell toxicity and alkaline phosphatase activity (ALP) assays. The SEM analysis of the different groups revealed porous structures in the treatment groups, while the control group showed a flat topology. There was no statistically significant difference between the pore size within the treated groups. This was further confirmed by the roughness values measured with the profilometer. We found a statistically significant increase in the roughness from 7.22 × 10-3 μm for the control group to the roughness range of 0.1 µm for the treated groups (Groups 2-4). EDX analysis revealed the presence of a 0.1% weight concentration of sodium on the surface of Group 4, while sulfur weight percentage concentration was 1.1%, 0.1%, and 1.4% in groups 2, 3, and 4, respectively, indicating different surface chemistry on the surface due to different post-treatments. Cell toxicity decreased, and ALP activity increased in groups 3 and 4 over 7 days compared with the control group. It is demonstrated that the surface modification of PEEK using a chemical etching method with post-processing with either acetone or sodium hydroxide provides a nano-porous structure with improved properties, leading to enhanced osteoblastic cell differentiation and osteogenic potential.
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Affiliation(s)
- Rupak Dua
- American Dental Association Science and Research Institute (ADASRI), Gaithersburg, MD, United States
- Department of Chemical Engineering, Hampton University, Hampton, VA, United States
| | - Onessa Sharufa
- Department of Chemical Engineering, Hampton University, Hampton, VA, United States
| | - Joi Terry
- Department of Biology, Hampton University, Hampton, VA, United States
| | - William Dunn
- The New Horizons Governor’s School for Science and Technology, Hampton, VA, United States
| | - Indu Khurana
- Department of Economics and Business, Hampden-Sydney College, Hampden-Sydney, VA, United States
| | - Jagasivamani Vadivel
- Department of Chemical Engineering, Hampton University, Hampton, VA, United States
| | - Yue Zhang
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, United States
| | - Henry J. Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, United States
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Sahoo N, Carvalho O, Özcan M, Silva F, Souza JCM, Lasagni AF, Henriques B. Ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced adhesion to resin-matrix cements used in dentistry: An integrative review. J Mech Behav Biomed Mater 2023; 143:105943. [PMID: 37276650 DOI: 10.1016/j.jmbbm.2023.105943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 06/07/2023]
Abstract
Surface modification of yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) using lasers for adhesion enhancement with resin-matrix cement has been increasingly explored. However, Y-TZP is chemically inert and non-reactive, demanding surface modification using alternative approaches to enhance its bond strength to resin-matrix cements. The main aim of this study was to conduct an integrative review on the influence of ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced bonding to resin-matrix cements. An electronic search was performed on web of science, SCOPUS, Pubmed/Medline, Google Scholar and EMBASE using a combination of the following search items: zirconia, 3Y-TZP, surface modification, laser surface treatment, AND laser, ultrashortpulse laser, bonding, adhesion, and resin cement. Articles published in the English language, up to January 2022, were included regarding the influence of surface patterning on bond strength of Y-TZP to resin-matrix cements. Out of the 12 studies selected for the present review 10 studies assessed femtosecond lasers while 2 studies assessed picosecond lasers. Ultrashort pulsed laser surface patterning successfully produced different surface morphological aspects without damaging the bulk properties of zirconia. Contrarily, defects such as micro-cracks occurs after surface modification using traditional methods such as grit-blasting or long-pulsed laser patterning. Ultrashort pulsed laser surface patterning increase bond strength of zirconia to resin-matrix cements and therefore such alternative physical method should be considered in dentistry. Also, surface defects were avoided using ultrashort pulsed laser surface patterning, which become the major advantage when compared with traditional physical methods or long pulse laser patterning.
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Affiliation(s)
- Narayan Sahoo
- Centre Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, 4800-058, Portugal; LABBELS Associate Laboratory, University of Minho, Guimarães, 4710-057, Braga, Portugal
| | - Oscar Carvalho
- Centre Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, 4800-058, Portugal; LABBELS Associate Laboratory, University of Minho, Guimarães, 4710-057, Braga, Portugal
| | - Mutlu Özcan
- Division of Dental Materials, Center for Dental Medicine, Clinic of Reconstructive Dentistry, University of Zurich, Zurich, 8032, Switzerland
| | - Filipe Silva
- Centre Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, 4800-058, Portugal; LABBELS Associate Laboratory, University of Minho, Guimarães, 4710-057, Braga, Portugal
| | - Júlio C M Souza
- Centre Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, 4800-058, Portugal; LABBELS Associate Laboratory, University of Minho, Guimarães, 4710-057, Braga, Portugal; Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, Gandra, PRD, 4585-116, Portugal
| | - Andrés-Fabian Lasagni
- Institute for Manufacturing Technology, Technische Universität Dresden, 01062, Dresden, Germany
| | - Bruno Henriques
- Centre Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, 4800-058, Portugal; LABBELS Associate Laboratory, University of Minho, Guimarães, 4710-057, Braga, Portugal; Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, Florianópolis, SC, 88040-900, Brazil.
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11
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Domingo MG, Nalli GA, Tasat DR, Olmedo DG. Exfoliated oral mucosa cells as bioindicators of short- and long-term systemic titanium contamination. J Trace Elem Med Biol 2023; 76:127114. [PMID: 36516572 DOI: 10.1016/j.jtemb.2022.127114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 11/03/2022] [Accepted: 11/30/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Humans are exposed to exogenous sources of titanium-containing particles that can enter the body mainly by inhalation, ingestion, or dermal absorption. Given the widespread use of biomaterials in medicine, the surface of a titanium (Ti) biomedical device is a potential endogenous source of Ti ions and/or Ti-containing particles, such as TiO2 micro-(MPs) and nano-particles (NPs), resulting from biotribocorrosion processes. Ti ions or Ti-containing particles may deposit in epithelial cells of the oral mucosa, and the latter may therefore serve as bioindicators of short and long-term systemic Ti contamination. The aim of the present study was to histologically and quantitatively evaluate the presence of Ti traces in cells exfoliated from the oral mucosa as possible bioindicators of systemic contamination with this metal at short and long-term experimental time points METHODS: Thirty Wistar rats were intraperitoneally injected with a suspension of titanium dioxide (TiO2) (0.16 g/100 g body weight of TiO2 in 5 ml of NaCl 0.9%) using 5 nm NPs (Group: TiO2-NP5; n = 10), 45 µm MPs (Group: TiO2-MP45; n = 10), or vehicle alone (Control group; n = 10). At one and six months post-injection, right-cheek mucosa cells were obtained by exfoliative cytology using a cytobrush; they were spray fixed and stained using Safranin or the Papanicolaou technique. The smears were cytologically evaluated (light microscopy) to determine the presence of particulate material, which was also analyzed microchemically (SEM-EDS). Left-cheek mucosa cells were similarly obtained and re-suspended in 5 ml of PBS (pH: 7.2-7.4); the samples corresponding to each group were pooled together and analyzed spectrometrically (ICP-MS) to determine Ti concentration in each of the studied groups. Blood samples were obtained for histological determination of the presence of particulate material on Safranin-stained blood smears and determination of plasma concentration of Ti by ICP-MS RESULTS: Different size and shape metal-like particles were observed inside and outside epithelial cells in TiO2-NP5 and TiO2-MP45 cytological smears at both one and six months post-injection. EDS analysis showed the presence of Ti in the particles. ICP-MS revealed higher Ti concentrations in both TiO2 injected groups compared to the control group. In addition, Ti concentration did not vary with time or particle size. Monocytes containing particles were observed in blood smears of TiO2-exposed animals one- and six-months post-injection. Plasma levels of Ti were significantly higher in TiO2-NP5- and TiO2-MP45- exposed animals than in controls (p < 0.05), and Ti concentration was significantly higher at one month than at six months in both TiO2-exposed groups (p < 0.05). CONCLUSIONS Cells exfoliated from the oral mucosa could be used as bioindicators of short- and long-term systemic contamination with Ti. Exfoliative cytology could be used as a simple, non-invasive, and inexpensive diagnostic method for monitoring biotribocorrosion of Ti implants and patient clinical follow-up.
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Affiliation(s)
- Mariela Gisele Domingo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina, M. T. de Alvear 2142, 2° A, C1122AAH Buenos Aires, Argentina; Becario de Investigación de la Universidad de Buenos Aires, Buenos Aires, Argentina.
| | - Gabriela Alejandra Nalli
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Estomatología, Buenos Aires, Argentina, M. T. de Alvear 2142, 2° A, C1122AAH Buenos Aires, Argentina.
| | - Deborah Ruth Tasat
- Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín, San Martín, Buenos Aires, UNSAM Campus Miguelete, 25 de Mayo y Francia, San Martín, B1650HMN Buenos Aires, Argentina; CONICET - Universidad Nacional de San Martín, Instituto de Tecnologías Emergentes y Ciencias Aplicadas (ITECA), San Martín, Buenos Aires, UNSAM Campus Miguelete, 25 de Mayo y Francia, San Martín, B1650HMN Buenos Aires, Argentina; Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Histología y Embriología, Buenos Aires, Argentina, M. T. de Alvear 2142, 2° A, C1122AAH Buenos Aires, Argentina.
| | - Daniel Gustavo Olmedo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina, M. T. de Alvear 2142, 2° A, C1122AAH Buenos Aires, Argentina; CONICET, Buenos Aires, Argentina, Godoy Cruz 2290, C1425FQB Buenos Aires, Argentina.
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12
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Santos AA, Teixeira JVU, Pintão CAF, Correa DRN, Grandini CR, Lisboa-Filho PN. Ti-15Zr and Ti-15Zr-5Mo Biomaterials Alloys: An Analysis of Corrosion and Tribocorrosion Behavior in Phosphate-Buffered Saline Solution. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1826. [PMID: 36902942 PMCID: PMC10004271 DOI: 10.3390/ma16051826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/15/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
It is crucial for clinical needs to develop novel titanium alloys feasible for long-term use as orthopedic and dental prostheses to prevent adverse implications and further expensive procedures. The primary purpose of this research was to investigate the corrosion and tribocorrosion behavior in the phosphate buffered saline (PBS) of two recently developed titanium alloys, Ti-15Zr and Ti-15Zr-5Mo (wt.%) and compare them with the commercially pure titanium grade 4 (CP-Ti G4). Density, XRF, XRD, OM, SEM, and Vickers microhardness analyses were conducted to give details about the phase composition and the mechanical properties. Additionally, electrochemical impedance spectroscopy was used to supplement the corrosion studies, while confocal microscopy and SEM imaging of the wear track were used to evaluate the tribocorrosion mechanisms. As a result, the Ti-15Zr (α + α' phase) and Ti-15Zr-5Mo (α″ + β phase) samples exhibited advantageous properties compared to CP-Ti G4 in the electrochemical and tribocorrosion tests. Moreover, a better recovery capacity of the passive oxide layer was observed in the studied alloys. These results open new horizons for biomedical applications of Ti-Zr-Mo alloys, such as dental and orthopedical prostheses.
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Affiliation(s)
- Adriana Alencar Santos
- Materials Science and Technology Program, Department of Physics, School of Sciences, UNESP—São Paulo State University, Bauru 17033-360, SP, Brazil
| | - Jean Valdir Uchôa Teixeira
- Materials Science and Technology Program, Department of Physics, School of Sciences, UNESP—São Paulo State University, Bauru 17033-360, SP, Brazil
| | - Carlos Alberto Fonzar Pintão
- Physical and Rheological Characterization Laboratory, Department of Physics, School of Sciences, UNESP—São Paulo State University, Bauru 17033-360, SP, Brazil
| | - Diego Rafael Nespeque Correa
- Laboratory of Anelasticity and Biomaterials, Department of Physics, School of Sciences, UNESP—São Paulo State University, Bauru 17033-360, SP, Brazil
| | - Carlos Roberto Grandini
- Laboratory of Anelasticity and Biomaterials, Department of Physics, School of Sciences, UNESP—São Paulo State University, Bauru 17033-360, SP, Brazil
| | - Paulo Noronha Lisboa-Filho
- Laboratory of Nanotechnology and Advanced Materials Department of Physics, School of Sciences, UNESP—São Paulo State University, Bauru 17033-360, SP, Brazil
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13
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Fischer KR, Büchel J, Gubler A, Liu CC, Sahrmann P, Schmidlin PR. Nonsurgical cleaning potential of deep-threaded implants and titanium particle release: A novel in vitro tissue model. Clin Oral Implants Res 2023; 34:416-425. [PMID: 36757141 DOI: 10.1111/clr.14045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES To measure the efficiency of three cleaning modalities on two implant designs with similar diameters but different thread depths as well as the presence of titanium particles. METHODS Sixty dyed implants (30 × 4.8 apically tapered (ATAP) and 30 × 5.0 fully tapered (FTAP)) were fixed in plastic models. The horizontal bone defects were surrounded with porcine soft tissue. Three instrumentation modalities were used to clean for 150 s: Curette (CUR), ultrasonic scaler (US), and air powder waterjet device (APWJ) with erythritol powder. Afterward, implants were photographed and scanning electron microscopic (SEM) images were taken. Titanium in the soft tissues was quantified in dissolved samples and histologically confirmed. RESULTS For ATAP and FTAP implants, the percentage of the cleaned surface was 26.4 ± 3.0 and 17.1 ± 2.4% for CUR, 33.7 ± 3.8% and 28.1 ± 2.3% for US, and 45.5 ± 4.1% and 24.7 ± 3.8% for APWJ, respectively. SEM images showed significant implant surface changes, especially after instrumentation with CUR and US, whereas APWJ had little to no effect. Most titanium residues were found after cleaning ATAP implants with CUR (152.0 ± 75.5), followed by US (89.5 ± 73.8) and APWJ (0.3 ± 0.8). For the FTAP implants, respective values accounted for 129.5 ± 58.6 μg and 67.0 ± 14.4 μg for CUR and US, respectively. No titanium residues were detected on ATAP with APWJ. CONCLUSION Based on in vitro data, erythritol-powered APWJ still appears to be the most efficient and gentle cleaning method. All three instruments, however, were found to have unprocessed areas depending on different implant designs, hence, clinical relevance for non-surgical approaches remains challenging and warrants further improvement.
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Affiliation(s)
- Kai R Fischer
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jasmin Büchel
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Andrea Gubler
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic for Periodontology, Endodontology and Cariology, University Center of Dental Medicine, University of Basel, Basel, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zurich, Switzerland
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14
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Root canal disinfection and maintenance of the remnant tooth tissues by using grape seed and cranberry extracts. Odontology 2022:10.1007/s10266-022-00766-w. [DOI: 10.1007/s10266-022-00766-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/08/2022] [Indexed: 12/14/2022]
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15
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Shirazi S, Ravindran S, Cooper LF. Topography-mediated immunomodulation in osseointegration; Ally or Enemy. Biomaterials 2022; 291:121903. [PMID: 36410109 PMCID: PMC10148651 DOI: 10.1016/j.biomaterials.2022.121903] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.
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Affiliation(s)
- Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | - Sriram Ravindran
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.
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16
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Hasan J, Bright R, Hayles A, Palms D, Zilm P, Barker D, Vasilev K. Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants. ACS Biomater Sci Eng 2022; 8:4697-4737. [PMID: 36240391 DOI: 10.1021/acsbiomaterials.2c00540] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.
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Affiliation(s)
- Jafar Hasan
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia
| | - Richard Bright
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Andrew Hayles
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Dennis Palms
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Peter Zilm
- Adelaide Dental School, University of Adelaide, Adelaide, 5005, South Australia, Australia
| | - Dan Barker
- ANISOP Holdings, Pty. Ltd., 101 Collins St, Melbourne VIC, 3000 Australia
| | - Krasimir Vasilev
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
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17
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Evaluation of the inflammatory and osteogenic response induced by titanium particles released during implantoplasty of dental implants. Sci Rep 2022; 12:15790. [PMID: 36138061 PMCID: PMC9500064 DOI: 10.1038/s41598-022-20100-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
Implantoplasty is a mechanical decontamination technique that consists of removing the threads and polishing and smoothing the dental implant surface. During implantoplasty there is a large release of titanium metal particles that might provoke a proinflammatory response and reduce the viability of osteogenic cells. We analyze the inflammatory and osteogenic response induced by Ti6Al4V particles released during implantoplasty and by as-received commercially pure Ti particles. Macrophages stimulated with metal particles obtained by implantoplasty and with as-received Ti particles showed an increased proinflammatory expression of TNF-α and a decreased expression of TGF-β and CD206. Regarding cytokine release, there was an increase in IL-1β, while IL-10 decreased. The osteogenic response of Ti6Al4V extracts showed a significant decrease in Runx2 and OC expression compared to the controls and commercially pure Ti extracts. There were no relevant changes in ALP activity. Thus, implantoplasty releases metal particles that seems to induce a pro-inflammatory response and reduce the expression of osteogenic markers.
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18
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In Vitro Molecular Study of Titanium-Niobium Alloy Biocompatibility. Biomedicines 2022; 10:biomedicines10081898. [PMID: 36009444 PMCID: PMC9405746 DOI: 10.3390/biomedicines10081898] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/19/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Titanium dental implants have common clinical applications due to their biocompatibility, biophysical and biochemical characteristics. Although current titanium is thought to be safe and beneficial for patients, there are several indications that it may release toxic metal ions or metal nanoparticles from its alloys into the surrounding environment, which could lead to clinically relevant complications including toxic reactions as well as immune dysfunctions. Hence, an adequate selection and testing of medical biomaterial with outstanding properties are warranted. This study was designed to explore the biocompatibility of smooth titanium-niobium alloy (S_TiNb) versus smooth titanium commercially pure (S_TiCp)—a reference in implantology. All experiments were performed in vitro using human osteoblast-like SaOs-2 and monocyte THP-1 cell lines as models. Cell adhesion and growth morphology were determined by scanning electron microscopy, while cell viability was evaluated using WST-1 assay. Because niobate anions or niobium nanoparticles can be released from implants during biomaterial-cell interaction, potential immunotoxicity of potassium niobate (KNbO3) salt was evaluated by examining both metabolic activity and transcriptomic profiling of treated THP-1 monocytes. The main findings of this study are that S_TiCp and S_TiNb discs do not show an impact on the proliferation and viability of SaOs-2 cells compared to polystyrene surfaces, whereas a significant decrease in THP-1 cells’ viability and metabolic activity was observed in the presence of S_TiNb discs compared to the control group. However, no significant changes were found neither at the metabolic activity nor at the transcriptomic level of THP-1 monocytes exposed to KNbO3 salt, suggesting that niobium has no effect on the immune system. Overall, these data imply a possible toxicity of S_TiNb discs toward THP-1 cells, which may not be directly related to niobium but perhaps to the manufacturing process of titanium-niobium alloy. Thus, this limitation must be overcome to make titanium alloy an excellent material for medical applications.
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Polymer–Metal Composite Healthcare Materials: From Nano to Device Scale. JOURNAL OF COMPOSITES SCIENCE 2022. [DOI: 10.3390/jcs6080218] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Metals have been investigated as biomaterials for a wide range of medical applications. At nanoscale, some metals, such as gold nanoparticles, exhibit plasmonics, which have motivated researchers’ focus on biosensor development. At the device level, some metals, such as titanium, exhibit good physical properties, which could allow them to act as biomedical implants for physical support. Despite these attractive features, the non-specific delivery of metallic nanoparticles and poor tissue–device compatibility have greatly limited their performance. This review aims to illustrate the interplay between polymers and metals, and to highlight the pivotal role of polymer–metal composite/nanocomposite healthcare materials in different biomedical applications. Here, we revisit the recent plasmonic engineered platforms for biomolecules detection in cell-free samples and highlight updated nanocomposite design for (1) intracellular RNA detection, (2) photothermal therapy, and (3) nanomedicine for neurodegenerative diseases, as selected significant live cell–interactive biomedical applications. At the device scale, the rational design of polymer–metallic medical devices is of importance for dental and cardiovascular implantation to overcome the poor physical load transfer between tissues and devices, as well as implant compatibility under a dynamic fluidic environment, respectively. Finally, we conclude the treatment of these innovative polymer–metal biomedical composite designs and provide a future perspective on the aforementioned research areas.
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Tchinda A, Chézeau L, Pierson G, Kouitat-Njiwa R, Rihn BH, Bravetti P. Biocompatibility of ZrO2 vs. Y-TZP Alloys: Influence of Their Composition and Surface Topography. MATERIALS 2022; 15:ma15134655. [PMID: 35806779 PMCID: PMC9267226 DOI: 10.3390/ma15134655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/21/2022] [Accepted: 06/29/2022] [Indexed: 12/04/2022]
Abstract
The osseointegration of implants is defined as the direct anatomical and functional connection between neoformed living bone and the surface of a supporting implant. The biological compatibility of implants depends on various parameters, such as the nature of the material, chemical composition, surface topography, chemistry and loading, surface treatment, and physical and mechanical properties. In this context, the objective of this study is to evaluate the biocompatibility of rough (Ra = 1 µm) and smooth (Ra = 0 µm) surface conditions of yttria–zirconia (Y-TZP) discs compared to pure zirconia (ZrO2) discs by combining a classical toxicological test, morphological observations by SEM, and a transcriptomic analysis on an in vitro model of human Saos-2 bone cells. Similar cell proliferation rates were observed between ZrO2 and Y-TZP discs and control cells, regardless of the surface topography, at up to 96 h of exposure. Dense cell matting was similarly observed on the surfaces of both materials. Interestingly, only 110 transcripts were differentially expressed across the human transcriptome, consistent with the excellent biocompatibility of Y-TZP reported in the literature. These deregulated transcripts are mainly involved in two pathways, the first being related to “mineral uptake” and the second being the “immune response”. These observations suggest that Y-TZP is an interesting candidate for application in implantology.
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21
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Fidalgo-Pereira R, Carpio D, Torres O, Carvalho O, Silva F, Henriques B, Özcan M, Souza JCM. The influence of inorganic fillers on the light transmission through resin-matrix composites during the light-curing procedure: an integrative review. Clin Oral Investig 2022; 26:5575-5594. [PMID: 35767045 DOI: 10.1007/s00784-022-04589-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 06/19/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of this study was to perform an integrative review on the effect the inorganic fillers on the light transmission through the resin-matrix composites during the light-curing procedure. METHOD A bibliographic review was performed on PubMed using the following search terms: "fillers" OR "particle" AND "light curing" OR "polymerization" AND "light transmission" OR "light absorption" OR "light irradiance" OR "light attenuation" OR "light diffusion" AND "resin composite." The search involved articles published in English language in the last 10 years. RESULTS Selected studies reported a decrease in biaxial strength and hardness in traditional resin-matrix composites in function of the depth of polymerization. However, there were no significant differences in biaxial strength and hardness recorded along the polymerization depth of Bulk-Fill™ composites. Strength and hardness were enhanced by increasing the size and content of inorganic fillers although some studies revealed a progressive decrease in the degree of conversion on increasing silica particle size. The translucency of glass-ceramic spherical fillers promoted light diffusion mainly in critical situations such as in the case of deep proximal regions of resin-matrix composites. CONCLUSIONS The amount of light transmitted through the resin-matrix composites is influenced by the size, content, microstructure, and shape of the inorganic filler particles. The decrease of the degree of conversion affects negatively the physical and mechanical properties of the resin-matrix composites. CLINICAL RELEVANCE The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization. As a consequence, the clinical performance of resin-matrix composites can be compromised leading to variable physical properties and degradation. The polymerization mode of resin-matrix composites can be improved according to the type of inorganic fillers in their chemical composition.
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Affiliation(s)
- Rita Fidalgo-Pereira
- University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra, PRD, Portugal
| | - Daniela Carpio
- University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra, PRD, Portugal
| | - Orlanda Torres
- University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra, PRD, Portugal
| | - Oscar Carvalho
- Center for Microelectromechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
- Associate Laboratory (LABBELS), University of Minho, 4710-057, Guimarães, Braga, Portugal
| | - Filipe Silva
- Center for Microelectromechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
- Associate Laboratory (LABBELS), University of Minho, 4710-057, Guimarães, Braga, Portugal
| | - Bruno Henriques
- Center for Microelectromechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
- Associate Laboratory (LABBELS), University of Minho, 4710-057, Guimarães, Braga, Portugal
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Mutlu Özcan
- Dental Materials Unit, Center of Dental Medicine, Clinic of Reconstructive Dentistry, University of Zurich, 8032, Zurich, Switzerland
| | - Júlio C M Souza
- University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra, PRD, Portugal.
- Center for Microelectromechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal.
- Associate Laboratory (LABBELS), University of Minho, 4710-057, Guimarães, Braga, Portugal.
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Ti Ions Induce IL-1β Release by Activation of the NLRP3 Inflammasome in a Human Macrophage Cell Line. Inflammation 2022; 45:2027-2037. [PMID: 35726039 PMCID: PMC9499900 DOI: 10.1007/s10753-022-01672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to investigate whether titanium (Ti)-induced release of interleukin (IL)-1β acts through the assembly of the NACHT, LRR, and PYD domain-containing protein 3 (NLRP3) inflammasome. In addition, we examined whether particulate Ti or TiO2 activates the same intracellular pathways with the assembly of the NLRP3 inflammasome as Ti ions. Ti ions are known to induce IL-1β maturation and release by the formation of metal-protein aggregates. Wild-type THP-1 (wt.) cells and NLRP3- and ASC- (apoptosis-associated speck-like protein containing caspase recruitment domain (CARD)) knockdown cells were used in the experimental analyses. Macro- and nanoparticles (NPs) of both Ti and TiO2 were used as test agents. IL-1β release as a biomarker for inflammasome activation and cell viability was also analyzed. Periodate-oxidized adenosine triphosphate (oATP) was used to attenuate downstream signaling in NLRP3 inflammasome activation. Cellular uptake of Ti was examined using transmission electron microscopy. Cells exposed to the Ti-ion solution showed a dose-dependent increase in the release of IL-1β; conversely, exposure to particulate Ti did not result in increased IL-1β release. Cell viability was not affected by particulate Ti. Knockdown cells exposed to Ti showed a statistically significant reduction in the release of IL-1β compared with wt. cells (p < 0.001). Cellular uptake was detected in all Ti mixtures, and aggregates with various structures were observed. Ti ion-induced release of bioactive IL-1β in THP-1 cells involves the assembly of the NLRP3 inflammasome.
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Schick F, Lechner J, Notter F. Linking Dentistry and Chronic Inflammatory Autoimmune Diseases – Can Oral and Jawbone Stressors Affect Systemic Symptoms of Atopic Dermatitis? A Case Report. Int Med Case Rep J 2022; 15:323-338. [PMID: 35782227 PMCID: PMC9242433 DOI: 10.2147/imcrj.s367434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/09/2022] [Indexed: 11/23/2022] Open
Abstract
Background This case report demonstrates the value of ultrasound measurements, and immunological and toxicological diagnostics in addition to current x-ray imaging procedures to diagnose hidden oral and maxillofacial infections. Using a clear scheme shows the procedure of the authors’ steps. The positive impact on the patient’s dermatological clinical picture is shown. Functional regeneration using metal-free ceramic implants and autologous bone augmentation is demonstrated. After a healing period, a postoperative control took place. Question Are chronic inflammatory and chronic toxic stressors from the oral region affecting the patient’s state of health and dermatological symptoms? Patients and Methods A 52 year old female suffering from neurodermatitis, who had been therapy-resistant for several years, was rehabilitated by oral surgery and prosthetics. Radiological examinations with orthopantomogram (OPG) and three-dimensional imaging (DVT/CBCT) were inconclusive for possible jawbone inflammatory sites. Immunological, toxicological diagnostics and trans-alveolar bone densitometry with ultrasound (TAU), were able to show immunological and toxicological stressors and areas of reduced bone density. Bone densitometry with ultrasound raised the suspicion of silent inflammations in the jawbone with potentially increased cytokine levels. Results For the patient incompatible materials, teeth with increased toxin exposure and surrounding softened, fatty, ischaemic bone was removed. Histologies and cytokine profiles were obtained. The resulting defects were functionally regenerated using ceramic implants and autologous augmentation. The cytokine profiles showed significantly elevated RANTES/CCL5, confirming the need for surgical intervention. The patient’s atopic dermatitis improved significantly in this case. Summary Individualized immunological and toxicological diagnostics and trans-alveolar bone density bone densitometry with ultrasound (TAU) identified immunological and toxicological stressors as well as reduced bone density with increased cytokine levels. A therapy-resistant neurodermatitis improved significantly after treatment. Conclusion This case report illustrates the need for patient-specific and individualized examinations that link dentistry more closely with other medical conditions in order to clarify possible interactions.
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Affiliation(s)
- Fabian Schick
- Clinic for Integrative Dentistry, Munich, Germany
- Correspondence: Fabian Schick, Clinic for Integrative Dentistry, Gruenwalder Str. 10A, Munich, 81547, Germany, Tel +49 89 697 00 55, Email
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24
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Li L, Sun W, Yu J, Lei W, Zeng H, Shi B. Effects of titanium dioxide microparticles and nanoparticles on cytoskeletal organization, cell adhesion, migration, and proliferation in human gingival fibroblasts in the presence of lipopolysaccharide. J Periodontal Res 2022; 57:644-659. [PMID: 35438207 DOI: 10.1111/jre.12993] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/02/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Titanium wear particles may participate in the etiology of peri-implantitis. However, the influence of titanium wear particles on biological behavior of human gingival fibroblasts (HGFs) in the presence of LPS is still not clear. The present study demonstrated the effects of titanium dioxide micro- and nanoparticles (TiO2 MPs and NPs) on HGF cell viability, cytoskeletal organization, adhesion, migration, and proliferation in vitro, and LPS was used to mimic the in vivo condition. METHODS Primary HGFs were treated with TiO2 MPs (primary particle size <5 μm, 0.1 mg/ml) and NPs (primary particle size <100 nm, 0.1 mg/ml) with or without 1 μg/ml LPS. The effects of TiO2 MPs and NPs on HGFs cell viability was measured by CCK-8 assay. The proliferation of HGF was detected by Ki67 nuclear staining. The confocal laser scanning microscope (CLSM) was used to detect the internalization of TiO2 MPs and NPs in HGFs as well as the arrangement of F-actin, vinculin, and vimentin organization. Wound healing assay and transwell assay were performed to measure the migration of HGFs induced by TiO2 MPs and NPs. Cell adhesion was measured using fibronectin-coated plates. The relative mRNA and protein expression of adhesion relative protein such as focal adhesion kinase (FAK), fibronectin (FN), and type I collagen (COL1) were measured using quantitative RT-PCR and western blot analysis. One-way analysis of variance (ANOVA) and Student's t-test were used to analyze the statistical significance, and p < .05 was considered statistically significant. RESULTS TiO2 NPs significantly inhibited HGF cell viability, proliferation, and migration compared with TiO2 MPs group and control group. Compared with control group (2.64 ± 0.09), the mean absorbance of the cells in 1 mg/ml TiO2 MPs group and 0.25 mg/ml TiO2 NPs group were significantly decreased to 1.93 ± 0.33 (p < .05) and 2.22 ± 0.18 (p < .01), respectively. The cytoskeleton disruption was found in TiO2 NPs group. The mRNA and protein expression were significantly downregulated by TiO2 NPs. Furthermore, both TiO2 NPs and MPs induced more adverse effects on HGFs in the presence of LPS. CONCLUSION Our results indicate that TiO2 NPs but not TiO2 MPs significantly disrupt the cytoskeletal organization and inhibited cell adhesion, migration, and proliferation of HGFs. However, in the presence of LPS, TiO2 MPs, and TiO2 NPs enhance these negative effects in HGFs. Titanium wear particles are probably involved in the initiation and progression of peri-implant diseases.
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Affiliation(s)
- Lei Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jian Yu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wenlong Lei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hao Zeng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
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25
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Oral Microbiota in Patients with Peri-Implant Disease: A Narrative Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073250] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Peri-implant infections are the most common complications related to the placement of dental implants. There are many microbial similarities between peri-implantitis and periodontitis but due to current laboratory techniques there are just as many differences. This review was performed to assess changes in the oral microbiota at sites with peri-implant disease, according to the state of the art. The peri-implant microbiota presents a lower microbial quality than the periodontal microbiota, becoming increasingly complex as it progresses from peri-implant mucositis to peri-implantitis. The microbial difference detected between the peri-implant and periodontal microbiota is primarily related to whole bacterial populations, rather than specific bacterial taxa. The use of probiotics could support the reduction of peri-implant pockets, in association with mechanical debridement, due to their mechanism of action of competitive inhibition for adhesion sites. The peri-implant microbiota represents a qualitatively inferior but quantitatively superior bacterial ecosystem for some bacterial genera compared to the periodontal microbiota, showing that a progression from healthy state to peri-implantitis causes changes in microbiota composition in the absence of specific disease-causing bacteria. Transcriptomics could provide useful information for the prevention, diagnosis, and therapy of peri-implant pathology through knowledge of bacterial virulence factors.
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26
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SEM-EDX Analysis of Metal Particles Deposition from Surgical Burs after Implant Guided Surgery Procedures. COATINGS 2022. [DOI: 10.3390/coatings12020240] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The preparation of the implant site in guided surgery procedure takes place without irrigation, which could lead to increased friction of the drills with the formation and release of debris or metal particles. The presence of metal particles in the peri-implant tissue could represent a trigger for macrophage activity, bone resorption processes, and consequent implant loss. According to the guided surgical protocol, the study aimed to evaluate the presence of metal particles deposited during implant site preparation. Twenty-five adult porcine ribs from the same adult individual were chosen due to their trabecular bone structure, similar to facial bones. The samples were all 8 cm (length) × 3 cm (depth) × 2 cm (width) and were further subdivided to obtain 50 elements of 4 cm × 3 cm × 2 cm. Plexiglass was used to create structures such as surgical guides so that their function could be mimicked, and the guided implant site preparation sequence could be performed with them. The drill kit used in this study is a guided surgery drill kit characterized by high wear resistance, high yield strength, and good corrosion resistance. This same kit was used 50 times in this way to prepare 50 different implant sites and evaluated at different edges and number of preparation (T0-neutral edge, T1-1 full preparation, T2-10, T3-20, T4-30, T5-40, and T6-50) by SEM-EDX to assess the presence of any metal deposition. The presence of metal residues in the implant site increased according to the cycles of use of the drills. We have observed that in the first three groups, there is no presence of metals. This is evident in groups T3 and T4. Finally, the presence of metal residues becomes significant in the study’s last two groups of samples. The study highlighted how the lack of irrigation in the work site leads the deposition of metal particles and in addition to a reduction in the efficiency of the drills, resulting in less precise cutting, altering the shape of the prepared site, and, lastly, reducing the primary stability of the implants.
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27
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Romanos GE, Fischer GA, Rahman ZT, Delgado-Ruiz R. Spectrometric Analysis of the Wear from Metallic and Ceramic Dental Implants following Insertion: An In Vitro Study. MATERIALS 2022; 15:ma15031200. [PMID: 35161144 PMCID: PMC8838065 DOI: 10.3390/ma15031200] [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: 12/12/2021] [Revised: 01/13/2022] [Accepted: 02/02/2022] [Indexed: 12/10/2022]
Abstract
Titanium wear is a growing area of interest within dental implantology. This study aimed to investigate titanium and zirconium wear from dental implants at the time of insertion using X-ray-fluorescence spectrometry (XRF) and an in vitro protocol utilizing artificial bovine bone plates. Five groups were analyzed using XRF-spectrometry: groups 1–4 (titanium implants) and group 5 (zirconia implants). The implants were inserted into two bone blocks held together by a vice. The blocks were separated, and the insertion sites were analyzed for titanium (Ti) and zirconium (Zr). Statistical descriptive analyses of Ti and Zr concentrations in the coronal, middle and apical bone interface were performed. A comparative analysis confirmed differences between the implant’s surface stability and Ti accumulation within the insertion sites of the bone block. There was a direct relationship between implant length and the quantity of titanium found on the bone block. The data generally indicates greater quantities of titanium in the coronal thirds of the implants, and less in the apical thirds. The titanium and zirconium found in the bone samples where the group 5 implants were inserted was not of statistical significance when compared to control osteotomies. The results of this study confirm wear from metallic, but not ceramic, dental implants at the time of insertion.
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Affiliation(s)
- Georgios E. Romanos
- Laboratory for Periodontal-Implant-Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (G.A.F.); (Z.T.R.)
- Correspondence: ; Tel.: +1-(631)-632-8755; Fax: +1-(631)-632-8670
| | - Gerard A. Fischer
- Laboratory for Periodontal-Implant-Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (G.A.F.); (Z.T.R.)
| | - Zaid T. Rahman
- Laboratory for Periodontal-Implant-Phototherapy (LA-PIP), Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA; (G.A.F.); (Z.T.R.)
| | - Rafael Delgado-Ruiz
- Department of Prosthodontics and Digital Technology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA;
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Cunha W, Carvalho O, Henriques B, Silva FS, Özcan M, Souza JCM. Surface modification of zirconia dental implants by laser texturing. Lasers Med Sci 2022; 37:77-93. [PMID: 35022871 DOI: 10.1007/s10103-021-03475-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022]
Abstract
The aim of this work was to perform an integrative literature review on the influence of laser irradiation on zirconia implants to enhance surface topographic aspects and the biological response for osseointegration. An electronic search was carried out on the PubMed database using the following search terms: "zirconia" AND "laser" AND "surface modification" OR "surface treatment" AND "dental implants" OR "bone" OR "osteoblast" OR "osseointegration." Of the identified articles, 12 studies were selected in this review. Results reported that the laser irradiation was capable of promoting changes on the zirconia surfaces regarding topographic aspects, roughness, and wettability. An increase in roughness was recorded at micro- and nano-scale and it resulted in an enhanced wettability and biological response. Also, adhesion, spreading, proliferation, and differentiation of osteogenic cells were also enhanced after laser irradiation mainly by using a femtosecond laser at 10nJ and 80 MHz. After 3 months of osseointegration, in vivo studies in dogs revealed a similar average percentage of bone-to-implant contact (BIC) on zirconia surfaces (around 47.9 ± 16%) when compared to standard titanium surfaces (61.73 ±16.27%), denoting that there is no significant difference between such different materials. The laser approach revealed several parameters that can be used for zirconia surface modification such as irradiation intensity, time, and frequency. Laser irradiation parameters can be optimized and well-controlled to reach desirable surface morphologic aspects and biological response concerning the osseointegration process.
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Affiliation(s)
- Welson Cunha
- School of Dentistry, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal
| | - Oscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
| | - Bruno Henriques
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal.,Ceramic and Composite Materials Research Group (CERMAT), Dept. of Mechanical Engineering (EMC), Federal University of Santa Catarina (UFSC), Florianópolis, 88040-900, Brazil
| | - Filipe S Silva
- Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, 8032, Switzerland
| | - Júlio C M Souza
- School of Dentistry, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal. .,Center for MicroElectroMechanical Systems (CMEMS-UMINHO), University of Minho, Campus Azurém, 4800-058, Guimarães, Portugal.
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Fabris D, Fredel MC, Souza JCM, Silva FS, Henriques B. Biomechanical behavior of functionally graded S53P4 bioglass-zirconia dental implants: Experimental and finite element analyses. J Mech Behav Biomed Mater 2021; 120:104565. [PMID: 34087536 DOI: 10.1016/j.jmbbm.2021.104565] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this work was to evaluate the biomechanical behavior of one-piece zirconia implants with a functionally graded bioglass (BG) layer as compared to monolithic zirconia and BG-coated implants, using the finite element method (FEM). METHODS Zirconia disks were infiltrated with bioglass S53P4 and then morphologically inspected by scanning electron microscopy (SEM) followed by mechanical analyses on micro-indentation tests for further biomechanical validation using the finite element method (FEM). On modeling, zirconia dental implants anchored into mandibular bone were simulated on occlusal loading as recorded under mastication. Three types of implants were simulated: i) free of BG coating, ii) with 100 μm or 150 μm thick conventional BG coatings; and iii) with graded BG coatings involving 3 different chemical composition distributions. The stress state at both implant and bone were evaluated using the FEM. The mechanically-induced bone remodelling was analyzed through the bone strain results. RESULTS Infiltration of BG into a zirconia structure resulted in a ∼100 μm thick layer with an exponential-like gradation of chemical composition and properties. Regarding the FEM calculations, the BG coating induced up to 30% decrease on stress in the implant body when compared to the monolithic zirconia implant. The gradient of chemical composition also improved the stresses' distribution. The stresses distribution towards the BG-coatings were significantly high and could lead to failure. Stresses on the bone were recorded down to its strength threshold, with insignificant influence of the coating layer. The bone strain values on all models indicates further bone remodelling although BG-coated and BG-graded zirconia implants showed the highest strain magnitude that may enhance the mechanical stimulation for bone maintenance. SIGNIFICANCE Graded BG-zirconia dental implants showed enhanced overall biomechanical behaviour as compared to the BG-coated or monolithic zirconia dental implants. Also, such biomechanical improvements noticed for the BG-graded system should be considered in combination with the well-known osseointegration benefits of bioactive glasses.
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Affiliation(s)
- Douglas Fabris
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil
| | - Márcio C Fredel
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil
| | - Júlio C M Souza
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal; CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Filipe S Silva
- CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Bruno Henriques
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil; Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra PRD, Portugal; School of Dentistry (DODT), Postgraduate Program in Dentistry (PPGO), Federal University of Santa Catarina, Campus Trindade, 88040-900, Florianópolis, SC, Brazil.
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30
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Chen W, Zhu WQ, Qiu J. Impact of exogenous metal ions on peri-implant bone metabolism: a review. RSC Adv 2021; 11:13152-13163. [PMID: 35423842 PMCID: PMC8697588 DOI: 10.1039/d0ra09395e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/25/2021] [Indexed: 11/21/2022] Open
Abstract
The development of effective methods to promote the osseointegration of dental implants by surface modification is an area of intense research in dental materials science. Exogenous metal ions present in the implant and surface modifications are closely related to the bone metabolism around the implant. In the complex oral microenvironment, the release of metal ions caused by continuous corrosion of dental implants has an unfavorable impact on the surrounding tissue, and then affects osseointegration, leading to bad results such as loosening and falling off in the late stage of the implant. Besides, these ions can even be distributed in distant tissues and organs. Currently, surface modification techniques are being developed that involve different processing technologies including the introduction of exogenous metal ions with different properties onto the surface of implants to improve performance. However, most metal elements have some level of biological toxicity and can only be used within a safe concentration range to exert the optimum biological effects on recipients. In this paper, we review the adverse effects of metal ions on osseointegration and highlight the emerging applications for metal elements in improving the performance of dental implants.
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Affiliation(s)
- Wei Chen
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University Nanjing 210029 PR China +86 25 69593085
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University Nanjing 210029 PR China
| | - Wen-Qing Zhu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University Nanjing 210029 PR China +86 25 69593085
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University Nanjing 210029 PR China
| | - Jing Qiu
- Department of Oral Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University Nanjing 210029 PR China +86 25 69593085
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University Nanjing 210029 PR China
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