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Oates WA, Anastasiou AD. A novel microfluidic tool for the evaluation of local drug delivery systems in simulated in vivo conditions. LAB ON A CHIP 2024; 24:3840-3849. [PMID: 39045628 DOI: 10.1039/d4lc00181h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
A 3D-printed microfluidic tool for assessing local drug delivery systems (LDD) in simulated in vivo conditions was developed and evaluated. The device was designed considering the oral environment and dental applications, and it was fabricated with a high-precision resin 3D printer. Chitosan scaffolds loaded with different concentrations of doxycycline were used for evaluating our device. The concentration of the released drug was measured through in-line UV-VIS spectroscopy, and to verify the repeatability and accuracy of our measurements, comparisons with standard HPLC results were made (5% deviation). Cumulative drug release profiles in steady-state conditions were obtained and compared to the Weibull model. The behaviour of the LDD system in a dynamic environment was also evaluated during experiments where step changes in pH were introduced. It was demonstrated that under infection-like conditions, there is an immediate response from the polymer and a clear increase in the concentration of the released drug. Continuous flow and recirculation experiments were also conducted, revealing significant differences in the drug release profiles. Specifically, in the case of continuous flow, the quantity of the released drug is much higher due to the higher driving force for diffusion (concentration gradient). Overall, the proposed microfluidic tool proved to be ideal for evaluating LDD systems, as the in vivo microenvironment can be replicated in a better way than with currently used standard systems.
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Affiliation(s)
- William A Oates
- Lab of Complex Fluids and Microfluidics, Department of Chemical Engineering, University of Manchester, Manchester, M1 9PL, UK.
| | - Antonios D Anastasiou
- Lab of Complex Fluids and Microfluidics, Department of Chemical Engineering, University of Manchester, Manchester, M1 9PL, UK.
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2
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Carvalho FS, Tarabal VS, Livio DF, Cruz LF, Monteiro APF, Parreira AG, Guimarães PPG, Scheuerman K, Chagas RCR, da Silva JA, Gonçalves DB, Granjeiro JM, Sinisterra RD, Segura MEC, Granjeiro PA. Production and characterization of the lipopeptide with anti-adhesion for oral biofilm on the surface of titanium for dental implants. Arch Microbiol 2024; 206:354. [PMID: 39017726 DOI: 10.1007/s00203-024-04078-1] [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: 04/24/2024] [Accepted: 07/02/2024] [Indexed: 07/18/2024]
Abstract
Titanium implants are subject to bacterial adhesion and peri-implantitis induction, and biosurfactants bring a new alternative to the fight against infections. This work aimed to produce and characterize the biosurfactant from Bacillus subtilis ATCC 19,659, its anti-adhesion and antimicrobial activity, and cell viability. Anti-adhesion studies were carried out against Streptococcus sanguinis, Staphylococcus aureus, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Proteus mirabilis as the minimum inhibitory concentration and the minimum bactericidal concentration. Cell viability was measured against osteoblast and fibroblast cells. The biosurfactant was classified as lipopeptide, with critical micelle concentration at 40 µg mL- 1, and made the titanium surface less hydrophobic. The anti-adhesion effect was observed for Staphylococcus aureus and Streptococcus sanguinis with 54% growth inhibition and presented a minimum inhibitory concentration of 15.7 µg mL- 1 for Streptococcus sanguinis and Aggregatibacter actinomycetemcomitans. The lipopeptide had no cytotoxic effect and demonstrated high potential application against bacterial biofilms.
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Affiliation(s)
- Fernanda Souza Carvalho
- Biotechnological Processes and Macromolecules Purification Laboratory, Campus Centro Oeste, Federal University of São João del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Vinícius Souza Tarabal
- Biotechnological Processes and Macromolecules Purification Laboratory, Campus Centro Oeste, Federal University of São João del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Diego Fernandes Livio
- Biotechnological Processes and Macromolecules Purification Laboratory, Campus Centro Oeste, Federal University of São João del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Luísa F Cruz
- Biotechnological Processes and Macromolecules Purification Laboratory, Campus Centro Oeste, Federal University of São João del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Ana P F Monteiro
- Chemistry Department, Federal University of Minas Gerais, Presidente Antônio Carlos Ave., 6627, Belo Horizonte, MG, 31270901, Brazil
| | - Adriano Guimarães Parreira
- Microbiology Laboratory, State University of Minas Gerais, Paraná Ave., 3001, Divinópolis, MG, 35501-179, Brazil
| | - Pedro P G Guimarães
- Department of Physiology and Biophysics, Federal University of Minas Gerais, Presidente Antônio Carlos Ave., 6627, Belo Horizonte, MG, 31270901, Brazil
| | - Karina Scheuerman
- Restorative Dentistry Department, Faculty of Dentistry, Federal University of Minas Gerais, Presidente Antônio Carlos Ave., 6627, Belo Horizonte, MG, 31270901, Brazil
| | - Rafael Cesar Russo Chagas
- Laboratory of Bioactive and Catalytic Compounds, Federal University of São João Del-Rei, Campus Centro Oeste, Sebastião Gonçalves Coelho St., 400, Divinópolis, MG, 35501-296, Brazil
| | - José Antônio da Silva
- Biotechnological Processes and Macromolecules Purification Laboratory, Campus Centro Oeste, Federal University of São João del-Rei, Divinópolis, MG, 35501-296, Brazil
| | - Daniel Bonoto Gonçalves
- Department of Biosystems Engineering, Federal University of São João del-Rei, Campus Dom Bosco, Padre João Pimentel St., 80, São João del Rei, MG, 36301-158, Brazil
| | - José Mauro Granjeiro
- Bioengineering Laboratory, National Institute of Metrology, Quality and Technology, Nossa Senhora das Graças Ave., 50, Duque de Caxias, RJ, 25250020, Brazil
- Dental Clinical Research, Dentistry School, Fluminense Federal University, Mario Santos Braga St., 28, Niterói, RJ, 24020140, Brazil
| | - Ruben Dario Sinisterra
- Chemistry Department, Federal University of Minas Gerais, Presidente Antônio Carlos Ave., 6627, Belo Horizonte, MG, 31270901, Brazil
| | - Maria E C Segura
- Restorative Dentistry Department, Faculty of Dentistry, Federal University of Minas Gerais, Presidente Antônio Carlos Ave., 6627, Belo Horizonte, MG, 31270901, Brazil
| | - Paulo Afonso Granjeiro
- Biotechnological Processes and Macromolecules Purification Laboratory, Campus Centro Oeste, Federal University of São João del-Rei, Divinópolis, MG, 35501-296, Brazil.
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3
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Ramseier CA. Diagnostic measures for monitoring and follow-up in periodontology and implant dentistry. Periodontol 2000 2024. [PMID: 38951873 DOI: 10.1111/prd.12588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/31/2024] [Accepted: 06/10/2024] [Indexed: 07/03/2024]
Abstract
This review discusses the role of diagnostic measures in the lifelong management of periodontal disease and peri-implant complications. After active treatment, these conditions require regular monitoring of the supporting structures of teeth and dental implants to assess bone and soft tissue health over time. Several clinical measures have been developed for the routine assessment of periodontal and peri-implant tissues, including periodontal and peri-implant probing, bleeding on probing, intraoral radiography, biomarker analysis, and microbiological testing. This review highlights the evolution of diagnostic practices, integrating traditional methods with emerging technologies such as resonance frequency analysis and ultrasound imaging to provide a holistic view of peri-implant health assessment. In addition to objective measurements, patient risk factors are considered. The goals of periodontal and peri-implant maintenance are to control disease activity and stabilize tissues through supportive care, which includes diagnostic measures at follow-up visits. This enables clinicians to monitor treatment outcomes, assess health status, and detect recurrence or progression early through routine evaluation, allowing additional interventions, including adjustment of supportive therapy intervals, to further improve and maintain periodontal and peri-implant stability over time.
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Affiliation(s)
- Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Park G, Matsuura T, Komatsu K, Ogawa T. Optimizing implant osseointegration, soft tissue responses, and bacterial inhibition: A comprehensive narrative review on the multifaceted approach of the UV photofunctionalization of titanium. J Prosthodont Res 2024:JPR_D_24_00086. [PMID: 38853001 DOI: 10.2186/jpr.jpr_d_24_00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Titanium implants have revolutionized restorative and reconstructive therapy, yet achieving optimal osseointegration and ensuring long-term implant success remain persistent challenges. In this review, we explore a cutting-edge approach to enhancing implant properties: ultraviolet (UV) photofunctionalization. By harnessing UV energy, photofunctionalization rejuvenates aging implants, leveraging and often surpassing the intrinsic potential of titanium materials. The primary aim of this narrative review is to offer an updated perspective on the advancements made in the field, providing a comprehensive overview of recent findings and exploring the relationship between UV-induced physicochemical alterations and cellular responses. There is now compelling evidence of significant transformations in titanium surface chemistry induced by photofunctionalization, transitioning from hydrocarbon-rich to carbon pellicle-free surfaces, generating superhydrophilic surfaces, and modulating the electrostatic properties. These changes are closely associated with improved cellular attachment, spreading, proliferation, differentiation, and, ultimately, osseointegration. Additionally, we discuss clinical studies demonstrating the efficacy of UV photofunctionalization in accelerating and enhancing the osseointegration of dental implants. Furthermore, we delve into recent advancements, including the development of one-minute vacuum UV (VUV) photofunctionalization, which addresses the limitations of conventional UV methods as well as the newly discovered functions of photofunctionalization in modulating soft tissue and bacterial interfaces. By elucidating the intricate relationship between surface science and biology, this body of research lays the groundwork for innovative strategies aimed at enhancing the clinical performance of titanium implants, marking a new era in implantology.
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Affiliation(s)
- Gunwoo Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
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Pujarern P, Klaophimai A, Amornsettachai P, Panyayong W, Chuenjitkuntaworn B, Rokaya D, Suphangul S. Efficacy of Biofilm Removal on the Dental Implant Surface by Sodium Bicarbonate and Erythritol Powder Airflow System. Eur J Dent 2024. [PMID: 38555648 DOI: 10.1055/s-0044-1779424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Peri-implantitis is a common complication in implant therapy and it is one of the main contributing factors to implant failure. This can be prevented by regular maintenance with mechanical debridement. One of the recent mechanical debridement methods is air abrasion therapy using different abrasive powders. This study aimed to evaluate the two common abrasive powders of different sizes (sodium bicarbonate and erythritol) for their biofilm cleaning efficacy on dental implant surfaces. MATERIALS AND METHODS In an in vitro setting, a total of 33 implants were divided into three groups: Group 1 (n =11) = no treatment; group 2 (n = 11) = air abrasion therapy treated group using a sodium bicarbonate powder (AIRFLOW Powder Classic Comfort, EMS Electro Medical Systems, Nyon, Switzerland); and group 3 (n = 11) = air abrasion therapy treated group using an erythritol powder (AIRFLOW Powder Plus, EMS Electro Medical Systems, Nyon, Switzerland). The implants in each group were subjected to biofilm formation, and group 2 and group 3 were treated with air abrasion therapy of two different powders having different sizes with the same settings. The particle sizes were sodium bicarbonate (40 µm) and erythritol (14µm). The surface characteristics of the dental implants in three groups were studied from a digital camera and under the scanning electron microscope at different magnifications. The comparison of biofilm-removal efficacy between the three groups was performed by using a one-way analysis of variance with post-hoc Dunnett's T3 test. A p-value less than 0.05 was chosen to indicate statistical significance. RESULTS There were no statistical differences (p > 0.05) between the two powder-treated groups for the biofilm cleaning efficacy. However, both groups showed significantly better biofilm-cleaning efficacy than the control group (p < 0.05). CONCLUSION This suggests that both powders are effective in removing biofilm from the implant surface under ideal conditions. However, there was no clear distinction between the cleaning potential of the two powders, as both performed in a similar manner.
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Affiliation(s)
- Patr Pujarern
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Arthit Klaophimai
- Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Parinya Amornsettachai
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Woraphong Panyayong
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Dinesh Rokaya
- Department of Prosthodontics, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
| | - Suphachai Suphangul
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Hussain B, Haugen HJ, Aass AM, Sanz M, Antonoglou GN, Bouchard P, Bozic D, Eickholz P, Jepsen K, Jepsen S, Karaca EO, Kuru BE, Nemcovsky CE, Papapanou PN, Pilloni A, Renvert S, Roccuzzo M, Sanz-Esporrin J, Spahr A, Stavropoulos A, Verket A, Vražić D, Lyngstadaas SP. Peri-Implant Health and the Knowing-Doing Gap—A Digital Survey on Procedures and Therapies. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.726607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Peri-implant tissue maintenance and treatment is becoming a serious challenge in implantology. With increasing numbers of implants being placed, more cases of peri-implant mucositis and peri-implantitis is seen. A digital survey on peri-implant disease management was issued to experts in periodontology and implantology to identify the tools and procedures most commonly used today to treat peri-implant diseases and successfully manage peri-implant health. The primary aim was to assess whether there is consensus in the choice of treatment to manage peri-implant diseases and to prevent their recurrence once treated. The secondary aim was to obtain insight into future protocols and /or devices, and the research and development needed.Materials and Methods: Participants in this digital survey were professionals specialising in periodontology, oral surgery, and implant dentistry. The questionnaire included both a series of closed- and open-ended questions. A total of 16 countries participated. The survey was sent by e-mail to 70 individuals, 66 received the survey and 37 of receivers responded, two of the participants were excluded due to insufficient filling of the survey. In the end 35 respondents completed the survey.Results: Respondents agree that the efficacy of mechanical and chemical decontamination of implant surfaces needs to be improved and better documented. It is a common opinion that the current remedies, mostly adapted from periodontal practises, do not provide effective and reliable clinical outcomes when treating peri-implant ailments. There is a general agreement amongst experts that regularly scheduled (3–6-month intervals) maintenance treatments are essential for maintaining peri-implant health in patients experiencing implant complications. Respondents are also concerned about unnecessary use of systemic antibiotics for managing peri-implant health.Conclusion: Regardless of agreements in parts, there was no observed consensus on the most effective treatment options for treating peri-implantitis. The experts all agree it is an urgent need for well-designed, long-term follow-up randomised and controlled clinical trials comparing interventions to provide an evidence-based strategy for peri-implant health management.
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2021; 126:276-359. [PMID: 34489050 DOI: 10.1016/j.prosdent.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Frederick Eichmiller
- Vice President and Science Officer, Delta Dental of Wisconsin, Stevens Point, Wis
| | | | - Jean-Pierre Albouy
- Assistant Professor of Prosthodontics, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md; Private practice, Baltimore, Md
| | - Matthias Troeltzsch
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University of Munich, Munich, Germany; Private practice, Ansbach, Germany
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Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment. Eur J Dent 2020; 14:672-682. [PMID: 32882741 PMCID: PMC7536094 DOI: 10.1055/s-0040-1715779] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Despite the success rates of dental implants, peri-implantitis presents as the most common complication in implant dentistry. This review discusses various factors associated with peri-implantitis and various available treatments, highlighting their advantages and disadvantages. Relevant articles on peri-implantitis published in English were reviewed from August 2010 to April 2020 in MEDLINE/PubMed, Scopus, and ScienceDirect. The identified risk indicators of peri-implant diseases are plaque, smoking, history of periodontitis, surface roughness, residual cement, emergence angle >30 degrees, radiation therapy, keratinized tissue width, and function time of the implant, sex, and diabetes. Peri-implantitis treatments can be divided into nonsurgical (mechanical, antiseptic, and antibiotics), surface decontamination (chemical and laser), and surgical (air powder abrasive, resective, and regenerative). However, mechanical debridement alone may fail to eliminate the causative bacteria, and this treatment should be combined with other treatments (antiseptics and surgical treatment). Surface decontamination using chemical agents may be used as an adjuvant treatment; however, the definitive clinical benefit is yet not proven. Laser treatment may result in a short-term decrease in periodontal pocket depth, while air powder abrasive is effective in cleaning a previously contaminated implant surface. Surgical elimination of a pocket, bone recontouring and plaque control are also effective for treating peri-implantitis. The current evidence indicates that regenerative approaches to treat peri-implant defects are unpredictable.
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Affiliation(s)
- Dinesh Rokaya
- International College of Dentistry, Walailak University, Bangkok, Thailand.,Research Unit of Herbal Medicine, Biomaterials and Materials for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Viritpon Srimaneepong
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Wichaya Wisitrasameewon
- Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Manoj Humagain
- Department of Periodontics, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Pasutha Thunyakitpisal
- Research Unit of Herbal Medicine, Biomaterials and Materials for Dental Treatment, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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A Fluorescent Zn(II)-Coordination Polymer: Selective Detection of Nitrofurantoin and Prevention of Peri-Implantitis after Ultrafine-Grained Titanium Implant by Reducing Inflammatory Cytokines Release. J Fluoresc 2020; 30:1035-1042. [PMID: 32607733 DOI: 10.1007/s10895-020-02575-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/23/2020] [Indexed: 10/24/2022]
Abstract
In the current research, a novel coordination polymer (CP) containing Zn(II) ions as nodes with the chemical formula of [Zn(IPT)2]n (1) has been produced via reaction of Zn(NO3)2·6H2O with 5-(3-(1H-imidazol-1-yl)phenyl)-1H-tetrazolate (HIPT), a heterotopic imidazole-tetrazole-bifunctional ligand. The as-prepared complex 1 has been charactered via single crystal X-ray diffraction, elemental analysis, powder X-ray diffraction (PXRD), thermogravimetric analysis (TGA) and fourier transform infrared spectroscopy (FT-IR). Because of its outstanding luminescent performances and stability, the synthesized complex 1 is a kind of excellent material of luminescent sensor of nitrofurantoin (NFT) in the water. The value of Ksv for the complex 1 to NFT is about 1.4 × 104 M-1. For the treatment of the peri-implantitis with complex 1, the ELISA test was carried out to determine the levels of the inflammatory cytokines released into the gingival crevicular fluid. The results showed that the levels of the inflammatory cytokines could be significantly reduced by complex 1 treatment. In addition to this, the real time RT-PCR was also conducted, and the data suggested the signaling pathway of TLR-4-NF-κB activation was inhibited by complex 1.
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