Novel nanocomposite coating for dental implant applications in vitro and in vivo evaluation

Nanotechnology in tissue engineering: expanding possibilities with nanoparticles

Tissue engineering is a multidisciplinary field that merges engineering, material science, and medical biology in order to develop biological alternatives for repairing, replacing, maintaining, or boosting the functionality of tissues and organs. The ultimate goal of tissue engineering is to create biological alternatives for repairing, replacing, maintaining, or enhancing the functionality of tissues and organs. However, the current landscape of tissue engineering techniques presents several challenges, including a lack of suitable biomaterials, inadequate cell proliferation, limited methodologies for replicating desired physiological structures, and the unstable and insufficient production of growth factors, which are essential for facilitating cell communication and the appropriate cellular responses. Despite these challenges, there has been significant progress made in tissue engineering techniques in recent years. Nanoparticles hold a major role within the realm of nanotechnology due to their unique qualities that change with size. These particles, which provide potential solutions to the issues that are met in tissue engineering, have helped propel nanotechnology to its current state of prominence. Despite substantial breakthroughs in the utilization of nanoparticles over the past two decades, the full range of their potential in addressing the difficulties within tissue engineering remains largely untapped. This is due to the fact that these advancements have occurred in relatively isolated pockets. In the realm of tissue engineering, the purpose of this research is to conduct an in-depth investigation of the several ways in which various types of nanoparticles might be put to use. In addition to this, it sheds light on the challenges that need to be conquered in order to unlock the maximum potential of nanotechnology in this area.

Highly Adhesive Antimicrobial Coatings for External Fixation Devices

Pin site infections arise from the use of percutaneous pinning techniques (as seen in skeletal traction, percutaneous fracture pinning, and external fixation for fracture stabilization or complex deformity reconstruction). These sites are niduses for infection because the skin barrier is disrupted, allowing for bacteria to enter a previously privileged area. After external fixation, the rate of pin site infections can reach up to 100%. Following pin site infection, the pin may loosen, causing increased pain (increasing narcotic usage) and decreasing the fixation of the fracture or deformity correction construct. More serious complications include osteomyelitis and deep tissue infections. Due to the morbidity and costs associated with its sequelae, strategies to reduce pin site infections are vital. Current strategies for preventing implant-associated infections include coatings with antibiotics, antimicrobial polymers and peptides, silver, and other antiseptics like chlorhexidine and silver-sulfadiazine. Problems facing the development of antimicrobial coatings on orthopedic implants and, specifically, on pins known as Kirschner wires (or K-wires) include poor adhesion of the drug-eluting layer, which is easily removed by shear forces during the implantation. Development of highly adhesive drug-eluting coatings could therefore lead to improved antimicrobial efficacy of these devices and ultimately reduce the burden of pin site infections. In response to this need, we developed two types of gel coatings: synthetic poly-glycidyl methacrylate-based and natural-chitosan-based. Upon drying, these gel coatings showed strong adhesion to pins and remained undamaged after the application of strong shear forces. We also demonstrated that antibiotics can be incorporated into these gels, and a K-wire with such a coating retained antimicrobial efficacy after drilling into and removal from a bone. Such a coating could be invaluable for K-wires and other orthopedic implants that experience strong shear forces during their implantation.

Nanotechnology for Dentistry: Prospects and Applications

In the XXI century, application of nanostructures in oral medicine has become common. In oral medicine, using nanostructures for the treatment of dental caries constitutes a great challenge. There are extensive studies on the implementation of nanomaterials to dental composites in order to improve their properties, e.g., their adhesive strength. Moreover, nanostructures are helpful in dental implant applications as well as in maxillofacial surgery for accelerated healing, promoting osseointegration, and others. Dental personal care products are an important part of oral medicine where nanomaterials are increasingly used, e.g., toothpaste for hypersensitivity. Nowadays, nanoparticles such as macrocycles are used in different formulations for early cancer diagnosis in the oral area. Cancer of the oral cavity-human squamous carcinoma-is the sixth leading cause of death. Detection in the early stage offers the best chance at total cure. Along with diagnosis, macrocycles are used for photodynamic mechanism-based treatments, which possess many advantages, such as protecting healthy tissues and producing good cosmetic results. Application of nanostructures in medicine carries potential risks, like long-term influence of toxicity on body, which need to be studied further. The introduction and development of nanotechnologies and nanomaterials are no longer part of a hypothetical future, but an increasingly important element of today's medicine.

The Use of Lactide Polymers in Bone Tissue Regeneration in Dentistry-A Systematic Review

(1) Background: Different compositions of biodegradable materials are being investigated to successfully replace non-resorbable ones in bone tissue regeneration in dental surgery. The systematic review tried to address the question, "Can biodegradable polymers act as a replacement for conventional materials in dental surgery procedures?" (2) Methods: An electronic search of the PubMed and Scopus databases was conducted in October 2022. The following keywords were used: (lactide polymers) and (hydroxyapatite or fluorapatite) and (dentistry) and (regeneration). Initially, 59 studies were found. Forty-one studies met the inclusion criteria and were included in the review. (3) Results: These usually improved the properties and induced osteogenesis, tissue mineralisation and bone regeneration by inducing osteoblast proliferation. Five studies showed higher induction of osteogenesis in the case of biomaterials, UV-HAp/PLLA, ALBO-OS, bioresorbable raw particulate hydroxyapatite/poly-L-lactide and PLGA/Hap, compared to conventional materials such as titanium. Four studies confirmed improvement in tissue mineralisation with the usage of biomaterials: hydroxyapatite/polylactic acid (HA/PLA) loaded with dog's dental pulp stem cells (DPSCs), Coll/HAp/PLCL, PDLLA/VACNT-O:nHAp, incorporation of hydroxyapatite and simvastatin. Three studies showed an acceleration in proliferation of osteoblasts for the use of biomaterials with additional factors such as collagen and UV light. (4) Conclusions: Lactide polymers present higher osteointegration and cell proliferation rate than the materials compared. They are superior to non-biodegradable materials in terms of the biocompability, bone remodelling and healing time tests. Moreover, because there is no need of reoperation, as the material automatically degrades, the chance of scars and skin sclerosis is lower. However, more studies involving greater numbers of biomaterial types and mixes need to be performed in order to find a perfect biodegradable material.

Evaluation of 'surgery-friendly' bone scaffold characteristics: 3D printed ductile BG/PCL scaffold with high inorganic content to repair critical bone defects

The repair of irregular and complex critical bone defects remains a challenge in clinical practice. The application of 3D-printed bioceramics particle/polymer composite scaffolds in bone tissue engineering has been widely studied. At present, the inorganic particle content of the composite scaffolds is generally low, resulting in poor osteogenic activity. However, scaffold with high inorganic content are highly brittle, difficult to operate during surgery, and cannot be in close contact with surrounding bones. Therefore, it is of great significance to design a 'surgery-friendly' scaffold with high bioceramic content and good ductility. In this study, we used the solvent method to add high concentration (wt% 70%) bioglass (BG) into polycaprolactone (PCL), and polyethylene glycol was used as plasticizer to prepare 70% BG/PCL composite scaffolds with high ductility using 3D printing technology.In vitroexperiments showed that the scaffold had good mechanical properties: easy extension, easy folding and strong compressive resistance. It also showed good performance in biocompatibility and osteogenic activity. It was further observed that compared with pure BG or PCL implantation, the scaffold with higher BG content could have more new bone tissue appeared after 12 weeks. All these results indicate that 3D-printed 70% BG/PCL scaffolds have great potential for personalized repair of bone defects.

Nanostructured Coatings: Review on Processing Techniques, Corrosion Behaviour and Tribological Performance

Corrosion and tribology are surface phenomena. Modifying surfaces of materials without resorting to altering their bulk properties is an effective route to alleviate corrosion, friction and wear, encountered in engineering applications. With the advancements in the field of nanotechnology, surface protective coatings with nanomaterials can be readily developed to explore their functionality in mitigating chemical/physical damage of surfaces. Surface protection enhances performance and operating lifetimes of industrial machinery components. This review presents insights on various types of recently developed nanostructured coatings, their synthesis routes, corrosion behaviour and tribological performance. It provides the state-of-the-art information on the development of nanostructured coatings, namely, ceramic coatings, metallic coatings and nanocomposite coatings with metal and polymer matrices. Biomimetic approaches in making nanostructured coatings and challenges encountered in the development of nanostructured coatings are highlighted.

Customized Therapeutic Surface Coatings for Dental Implants

Dental implants are frequently used to support fixed or removable dental prostheses to replace missing teeth. The clinical success of titanium dental implants is owed to the exceptional biocompatibility and osseointegration with the bone. Therefore, the enhanced therapeutic effectiveness of dental implants had always been preferred. Several concepts for implant coating and local drug delivery had been developed during the last decades. A drug is generally released by diffusion-controlled, solvent-controlled, and chemical controlled methods. Although a range of surface modifications and coatings (antimicrobial, bioactive, therapeutic drugs) have been explored for dental implants, it is still a long way from designing sophisticated therapeutic implant surfaces to achieve the specific needs of dental patients. The present article reviews various interdisciplinary aspects of surface coatings on dental implants from the perspectives of biomaterials, coatings, drug release, and related therapeutic effects. Additionally, the various types of implant coatings, localized drug release from coatings, and how released agents influence the bone–implant surface interface characteristics are discussed. This paper also highlights several strategies for local drug delivery and their limitations in dental implant coatings as some of these concepts are yet to be applied in clinical settings due to the specific requirements of individual patients.

The Effects of Fibrin-icariin Nanoparticle Loaded in Poly (lactic-co-glycolic) Acid Scaffold as a Localized Delivery System on Chondrogenesis of Human Adipose-derived Stem Cells

Background:

Nowadays, cartilage tissue engineering is the best candidate for regeneration of cartilage defects. This study evaluates the effect of fibrin/icariin (ICA) nanoparticles (F/I NPs) on chondrogenesis of stem cells.

Materials and Methods:

F/I NPs were characterized by Dynamic Light Scattering DLS. Poly (lactic-co-glycolic) acid (PLGA)-F/I NP scaffold was fabricated and assessed by scanning electron microscope. Human adipose-derived stem cells (hADSCs) were seeded on scaffold and induced for chondrogenesis. After 14 days, cell viability and gene expression were analyzed by the 3-(4, 5- dimethylthiazol-2yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. MTT assay and real-time polymerase chain reaction (RT-PCR).

Results:

The size and surface charge of F/I NP were about 28–30 nm and − 17, respectively. The average of pore size of PLGA and PLGA–fibrin/ICA was 230 and 340 μm, respectively. Cell viability of differentiated cells in P/F group was higher than others significantly (P ≤ 0.05). Furthermore, quantitative RT-PCR analysis demonstrated that ICA upregulated cartilaginous-specific gene expression. Furthermore, the results of the expression of type I collagen revealed that ICA downregulated this gene significantly (P < 0.01).

Conclusions:

The results indicated that F/I NP could be a potential factor for chondrogenesis of stem cells and downregulation of fibrocartilage marker.

Stimulatory Effects of Boron Containing Bioactive Glass on Osteogenesis and Angiogenesis of Polycaprolactone: In Vitro Study

Polycaprolactone (PCL) has attracted great attention for bone regeneration attributed to its cost-efficiency, high toughness, and good processability. However, the relatively low elastic modulus, hydrophobic nature, and insufficient bioactivity of pure PCL limited its wider application for bone regeneration. In the present study, the effects of the addition of boron containing bioactive glass (B-BG) materials on the mechanical properties and biological performance of PCL polymer were investigated with different B-BG contents (0, 10, 20, 30, and 40 wt.%), in order to evaluate the potential applications of B-BG/PCL composites for bone regeneration. The results showed that the B-BG/PCL composites possess better tensile strength, human neutral pH value, and fast degradation as compared to pure PCL polymers. Moreover, the incorporation of B-BG could enhance proliferation, osteogenic differentiation, and angiogenic factor expression for rat bone marrow stromal cells (rBMSCs) as compared to pure PCL polymers. Importantly, the B-BG also promoted the angiogenic differentiation for human umbilical vein endothelial cells (HUVECs). These enhanced effects had a concentration dependence of B-BG content, while 30 wt.% B-BG/PCL composites achieved the greatest stimulatory effect. Therefore the 30 wt.% B-BG/PCL composites have potential applications in bone reconstruction fields.

Preparation and in vitro evaluation of polycaprolactone/PEG/bioactive glass nanopowders nanocomposite membranes for GTR/GBR applications

In the present study, nanocomposite membranes are investigated using poly-ε-caprolactone (PCL), polyethylene glycol (PEG) and bioactive glass nanopowders (BGs) synthesized via solvent casting method with different reinforcement rates of BGs consisting of 3, 5 and 7 wt% for regenerating the periodontal tissue in vitro. These prepared membranes were evaluated by a vast range of essential tests; including Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), Transmition-electron microscopy (TEM), tensile testing before and after soaking in PBS solution, degradation and contact angle assessments as well as cell culture assays. In spite of the fact that the percentage of Cu incorporated into BGs was trivial, this negligible amount exerted major cytotoxic impact upon cells during in vitro cell tests. According to the results, the blended-membrane contained 7 wt% copper-free BGs indicated optimum characteristics including satisfactory mechanical and biodegradation features, more wettable surface, higher proliferation rates of adipose-derived stem cells (ADSCs), superior ALP activity and brilliant bone mineralization capacity which was confirmed by Alizarin red assay. As a consequence, it can be used as a desirable candidate for guided tissue/bone regeneration (GTR/GBR) to accelerate bone tissue healing.

Nanomaterials in dentistry: a cornerstone or a black box?

Aim: The studies on tooth structure provided basis for nanotechnology-based dental treatment approaches known as nanodentistry which aims at detection and treatment of oral pathologies, such as dental caries and periodontal diseases, insufficiently being treated by conventional materials or drugs. This review aims at defining the role of nanodentistry in the medical area, its potential and hazards. Materials & methods: To validate these issues, current literature on nanomaterials for dental applications was critically reviewed. Results: Nanomaterials for teeth restoration, bone regeneration and oral implantology exhibit better mechanical properties and provide more efficient esthetic outcome. However, still little is known about influence of long-term function of such biomaterials in the living organism. Conclusion: As application of nanomaterials in industry and medical-related sciences is still expanding, more information is needed on how such nano-dental materials may interfere with oral cavity, GI tract and general health.

Development of a novel resin-based dental material with dual biocidal modes and sustained release of Ag+ ions based on photocurable core-shell AgBr/cationic polymer nanocomposites

Research on the incorporation of cutting-edge nano-antibacterial agent for designing dental materials with potent and long-lasting antibacterial property is demanding and provoking work. In this study, a novel resin-based dental material containing photocurable core-shell AgBr/cationic polymer nanocomposite (AgBr/BHPVP) was designed and developed. The shell of polymerizable cationic polymer not only provided non-releasing antibacterial capability for dental resins, but also had the potential to polymerize with other methacrylate monomers and prevented nanoparticles from aggregating in the resin matrix. As a result, incorporation of AgBr/BHPVP nanocomposites did not adversely affect the flexural strength and modulus but greatly increased the Vicker's hardness of resin disks. By continuing to release Ag⁺ ions without the impact of anaerobic environment, resins containing AgBr/BHPVP nanoparticles are particularly suitable to combat anaerobic cariogenic bacteria. By reason of the combined bactericidal effect of the contact-killing cationic polymers and the releasing-killing Ag⁺ ions, AgBr/BHPVP-containing resin disks had potent bactericidal activity against S. mutans. The long-lasting antibacterial activity was also achieved through the sustained release of Ag⁺ ions due to the core-shell structure of the nanocomposites. The results of macrophage cytotoxicity showed that the cell viability of dental resins loading less than 1.0 wt% AgBr/BHPVP was close to that of neat resins. The AgBr/BHPVP-containing dental resin with dual bactericidal capability and long term antimicrobial effect is a promising material aimed at preventing second caries and prolonging the longevity of resin composite restorations.

Evaluation of bone loss in antibacterial coated dental implants: An experimental study in dogs

The aim of this study was to evaluate the in vivo effect of antibacterial modified dental implants in the first stages of peri-implantitis. Thirty dental implants were inserted in the mandibular premolar sites of 5 beagle dogs. Sites were randomly assigned to Ti (untreated implants, 10units), Ti_Ag (silver electrodeposition treatment, 10units), and Ti_TSP (silanization treatment, 10units). Coated implants were characterized by scanning electron microscopy, interferometry and X-ray photoelectron spectroscopy. Two months after implant insertion, experimental peri-implantitis was initiated by ligature placement. Ligatures were removed 2months later, and plaque formation was allowed for 2 additional months. Clinical and radiographic analyses were performed during the study. Implant-tissue samples were prepared for micro computed tomography, backscattered scanning electron microscopy, histomorphometric and histological analyses and ion release measurements. X-ray, SEM and histology images showed that vertical bone resorption in treated implants was lower than in the control group (P<0.05). This effect is likely due to the capacity of the treatments to reduce bacteria colonization on the implant surface. Histological analysis suggested an increase of peri-implant bone formation on silanized implants. However, the short post-ligature period was not enough to detect differences in clinical parameters among implant groups. Within the limits of this study, antibacterial surface treatments have a positive effect against bone resorption induced by peri-implantitis.

The in Vitro and in Vivo Degradation of Cross-Linked Poly(trimethylene carbonate)-Based Networks

The degradation of the poly(trimethylene carbonate) (PTMC) and poly(trimethylene carbonate-co-ε-caprolactone) (P(TMC-co-CL)) networks cross-linked by 0.01 and 0.02 mol % 2,2'-bis(trimethylene carbonate-5-yl)-butylether (BTB) was carried out in the conditions of hydrolysis and enzymes in vitro and subcutaneous implantation in vivo. The results showed that the cross-linked PTMC networks exhibited much faster degradation in enzymatic conditions in vitro and in vivo versus in a hydrolysis case due to the catalyst effect of enzymes; the weight loss and physical properties of the degraded networks were dependent on the BTB amount. The morphology observation in lipase and in vivo illustrated that enzymes played an important role in the surface erosion of cross-linked PTMC. The hydrolytic degradation rate of the cross-linked P(TMC-co-CL) networks increased with increasing ε-caprolactone (CL) content in composition due to the preferential cleavage of ester bonds. Cross-linking is an effective strategy to lower the degradation rate and enhance the form-stability of PTMC-based materials.

Effects of coating with different ceromers on the impact strength, transverse strength and elastic modulus of polymethyl methacrylate

The aim of this study was to evaluate the mechanical properties of polymethyl methacrylate (PMMA) after coating with different ceromers. For transverse strength and modulus of elasticity tests, specimens of 65×10×2.5 mm dimensions were prepared (5 groups, n=10). For impact strength test, specimens of 60×7.5×4 mm dimensions were prepared (5 groups, n=10). Test group specimens were coated with one of four different types of ceromers, and specimens in the control group were not coated. After specimens were tested for transverse and impact strengths, the data were analyzed with Kruskal-Wallis and Conover post hoc tests (p<0.05). GLYMOTEOS-TiO2 and A174-TEOS significantly increased the transverse strength of PMMA. All ceromers caused a statistically significant increase in the elastic modulus of PMMA. While GLYMO-TEOS-ZrO2 significantly decreased the impact strength, the other ceromers did not cause any statistically significant difference in impact strength. Coating with ceromers substantially improved the mechanical properties of PMMA.

Tissue engineering for bone regeneration and osseointegration in the oral cavity

OBJECTIVE

The focus of this review is to summarize recent advances on regenerative technologies (scaffolding matrices, cell/gene therapy and biologic drug delivery) to promote reconstruction of tooth and dental implant-associated bone defects.

METHODS

An overview of scaffolds developed for application in bone regeneration is presented with an emphasis on identifying the primary criteria required for optimized scaffold design for the purpose of regenerating physiologically functional osseous tissues. Growth factors and other biologics with clinical potential for osteogenesis are examined, with a comprehensive assessment of pre-clinical and clinical studies. Potential novel improvements to current matrix-based delivery platforms for increased control of growth factor spatiotemporal release kinetics are highlighting including recent advancements in stem cell and gene therapy.

RESULTS

An analysis of existing scaffold materials, their strategic design for tissue regeneration, and use of growth factors for improved bone formation in oral regenerative therapies results in the identification of current limitations and required improvements to continue moving the field of bone tissue engineering forward into the clinical arena.

SIGNIFICANCE

Development of optimized scaffolding matrices for the predictable regeneration of structurally and physiologically functional osseous tissues is still an elusive goal. The introduction of growth factor biologics and cells has the potential to improve the biomimetic properties and regenerative potential of scaffold-based delivery platforms for next-generation patient-specific treatments with greater clinical outcome predictability.

A comparative study of zirconium and titanium implants in rat: osseointegration and bone material quality

Permanent metal implants are widely used in human medical treatments and orthopedics, for example as hip joint replacements. They are commonly made of titanium alloys and beyond the optimization of this established material, it is also essential to explore alternative implant materials in view of improved osseointegration. The aim of our study was to characterize the implant performance of zirconium in comparison to titanium implants. Zirconium implants have been characterized in a previous study concerning material properties and surface characteristics in vitro, such as oxide layer thickness and surface roughness. In the present study, we compare bone material quality around zirconium and titanium implants in terms of osseointegration and therefore characterized bone material properties in a rat model using a multi-method approach. We used light and electron microscopy, micro Raman spectroscopy, micro X-ray fluorescence and X-ray scattering techniques to investigate the osseointegration in terms of compositional and structural properties of the newly formed bone. Regarding the mineralization level, the mineral composition, and the alignment and order of the mineral particles, our results show that the maturity of the newly formed bone after 8 weeks of implantation is already very high. In conclusion, the bone material quality obtained for zirconium implants is at least as good as for titanium. It seems that the zirconium implants can be a good candidate for using as permanent metal prosthesis for orthopedic treatments.

Dental applications of nanostructured bioactive glass and its composites

To improve treatments of bone or dental trauma and diseases such as osteoporosis, cancer, and infections, scientists who perform basic research are collaborating with clinicians to design and test new biomaterials for the regeneration of lost or injured tissue. Developed some 40 years ago, bioactive glass (BG) has recently become one of the most promising biomaterials, a consequence of discoveries that its unusual properties elicit specific biological responses inside the body. Among these important properties are the capability of BG to form strong interfaces with both hard and soft tissues, and its release of ions upon dissolution. Recent developments in nanotechnology have introduced opportunities for materials sciences to advance dental and bone therapies. For example, the applications for BG expand as it becomes possible to finely control structures and physicochemical properties of materials at the molecular level. Here, we review how the properties of these materials have been enhanced by the advent of nanotechnology, and how these developments are producing promising results in hard-tissue regeneration and development of innovative BG-based drug delivery systems.