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Hussain B, Grytten JI, Rongen G, Sanz M, Haugen HJ. Surface Topography Has Less Influence on Peri-Implantitis than Patient Factors: A Comparative Clinical Study of Two Dental Implant Systems. ACS Biomater Sci Eng 2024; 10:4562-4574. [PMID: 38916970 DOI: 10.1021/acsbiomaterials.3c01809] [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] [Indexed: 06/27/2024]
Abstract
OBJECTIVES This study aims to assess the risk of peri-implantitis (PI) onset among different implant systems and evaluate the severity of the disease from a population of patients treated in a university clinic. Furthermore, this study intends to thoroughly examine the surface properties of the implant systems that have been identified and investigated. MATERIAL AND METHODS Data from a total of six hundred and 14 patients were extracted from the Institute of Clinical Dentistry, Dental Faculty, University of Oslo. Subject- and implant-based variables were collected, including the type of implant, date of implant installation, medical records, recall appointments up to 2022, periodontal measurements, information on diabetes, smoking status, sex, and age. The outcome of interest was the diagnosis of PI, defined as the occurrence of bleeding on probing (BoP), peri-implant probing depth (PD) ≥ 5 mm, and bone loss (BL). Data were analyzed using multivariate linear and logistic regression. Scanning electron microscopy, light laser profilometer, and X-ray photoelectron spectroscopy were utilized for surface and chemical analyses. RESULTS Among the patients evaluated, 6.8% were diagnosed with PI. A comparison was made between two different implant systems: Dentsply Sirona, OsseospeedTM and Straumann SLActive, with mean follow-up times of 3.84 years (SE: 0.15) and 3.34 years (SE: 0.15), respectively. The surfaces have different topographies and surface chemistry. However, no significant association was found between PI and implant surface/system, including no difference in the onset or severity of the disease. Nonetheless, plaque control was associated with an increased risk of developing PI, along with the gender of the patient. Furthermore, patients suffering from PI exhibited increased BL in the anterior region. CONCLUSION No differences were observed among the evaluated implant systems, although the surfaces have different topography and chemistry. Factors that affected the risk of developing PI were plaque index and male gender. The severity of BL in patients with PI was more pronounced in the anterior region. Consequently, our findings show that success in implantology is less contingent on selecting implant systems and more on a better understanding of patient-specific risk factors, as well as on implementing biomaterials that can more effectively debride dental implants.
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Affiliation(s)
- Badra Hussain
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo 0316, Norway
| | | | - Gunnar Rongen
- Institute of Community Dentistry, University of Oslo, Oslo 0316, Norway
| | - Mariano Sanz
- Section of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid 28040, Spain
- ETEP (Etiology and Therapy of Periodiontal and Peri-Implant Diseases) Research Group, Complutense University, Madrid 28040, Spain
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo 0316, Norway
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Yang KR, Hong MH. Improved Biocompatibility and Osseointegration of Nanostructured Calcium-Incorporated Titanium Implant Surface Treatment (XPEED ®). MATERIALS (BASEL, SWITZERLAND) 2024; 17:2707. [PMID: 38893971 PMCID: PMC11173531 DOI: 10.3390/ma17112707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. A microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p < 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration.
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Affiliation(s)
- Kyung Ran Yang
- Daegu Mir Dental Hospital, Jung-gu, Daegu 41934, Republic of Korea;
| | - Min-Ho Hong
- Department of Dental Laboratory Science, College of Health Sciences, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Busan 46252, Republic of Korea
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Hocková B, Slávik R, Azar B, Stebel J, Poruban D, Bonfante EA, Ewers R, Cheng YC, Stebel A. Short and Extra Short Dental Implants in Osseous Microvascular Free Flaps: A Retrospective Case Series. J Pers Med 2024; 14:384. [PMID: 38673010 PMCID: PMC11050822 DOI: 10.3390/jpm14040384] [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: 02/25/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
There is limited information regarding implant and prosthetic survival after osseous microvascular free flap (OMFF). This case series aims to describe the placement of short and extra short implants in osseous microvascular free flaps to support prostheses, and present an up to 40-month retrospective follow-up. Short and extra short dental implants were placed in six fibula free flaps (FFF) and in two microvascular deep circumflex iliac artery (DCIA) flaps. In total, 27 short and extra short dental implants have been placed into two different types of free flaps. Kaplan-Meyer (K-M) survival analyses were performed to evaluate the survival and success outcomes of implants and prostheses. Out of the eight patients reconstructed with free flap, five were rehabilitated with prostheses, one patient has a temporary prosthesis, and two patients are in the process of prosthetic rehabilitation. Twenty-seven implants were followed up for up to 40 months, and K-M analyses showed 100% implant survival probability (95% confidence interval: 100%), while the implant success probability was 91.0% (95% confidence interval: 68.6-97.7%). Short and extra short dental implants placed in OMFF presented high survival and success rates in a retrospective case series after up to 40 months.
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Affiliation(s)
- Barbora Hocková
- Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital of Banská Bystrica, 974 01 Banská Bystrica, Slovakia; (B.H.); (R.S.); (D.P.); (A.S.)
| | - Rastislav Slávik
- Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital of Banská Bystrica, 974 01 Banská Bystrica, Slovakia; (B.H.); (R.S.); (D.P.); (A.S.)
| | - Basel Azar
- Department of Prosthodontics, Faculty of Medicine and Dentistry, Palacky University, 779 00 Olomouc, Czech Republic;
- Dentaris Praha Dental Clinic, Olšanská 7, 130 00 Prague, Czech Republic
| | - Jakub Stebel
- 3S DENT Dental Clinic, Šancová Street, 831 04 Bratislava, Slovakia;
| | - Dušan Poruban
- Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital of Banská Bystrica, 974 01 Banská Bystrica, Slovakia; (B.H.); (R.S.); (D.P.); (A.S.)
| | - Estevam A. Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012, SP, Brazil
| | - Rolf Ewers
- The University Hospital for Cranio-Maxillofacial and Oral Surgery, Waehringer Guertel 18-20, 1090 Vienna, Austria;
- CMF Institute Vienna, Schumanngasse 15, 1180 Vienna, Austria
| | - Yu-Chi Cheng
- Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115, USA;
| | - Adam Stebel
- Department of Maxillofacial Surgery, F. D. Roosevelt University Hospital of Banská Bystrica, 974 01 Banská Bystrica, Slovakia; (B.H.); (R.S.); (D.P.); (A.S.)
- 3S DENT Dental Clinic, Šancová Street, 831 04 Bratislava, Slovakia;
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van den Braak MCT, Hoekstra JWM, Bronkhorst EM, Schols JGJH, Ongkosuwito EM, Meijer GJ, van den Beucken JJJP. The effect of surface roughening on the success of orthodontic mini-implants: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2024; 165:262-271.e3. [PMID: 38069923 DOI: 10.1016/j.ajodo.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 11/01/2023] [Accepted: 11/01/2023] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Orthodontic mini-implants are a widely accepted treatment modality in orthodontics; however, the failure rate is moderately high. Surface roughening is the golden standard in conventional oral implantology, and this may prove beneficial for orthodontic mini-implants as well. The objective of this systematic review is to assess the effect of surface roughening on the success rate of orthodontic mini-implants in both adolescent and adult patients undergoing orthodontic treatment. METHODS Randomized studies comparing the success of surface-roughened and smooth, machined-surface orthodontic mini-implants were included. A literature search was conducted for 6 electronic databases (Pubmed/Medline, Embase, Cochrane, CINAHL, Web of Science, and Scopus), Clinical trial registry (https://www. CLINICALTRIALS gov), and grey literature (Google Scholar). A manual search of the reference lists of included studies was performed. Two authors independently performed the screening, data extraction, risk of bias, and quality assessments. The risk of bias was assessed with the Cochrane risk-of-bias 2.0 Tool. Data were synthesized using a random effect model meta-analysis presented as a forest plot. The certainty in the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool. RESULTS A total of 4226 unique records were screened, and 6 of these were included in the quantitative analysis. Four additional articles were selected for a secondary outcome. A total of 364 orthodontic mini-implants were included in the primary outcome analysis. There was no statistically significant effect of surface roughening on the success of orthodontic mini-implants (odds ratio = 0.63 favoring roughened orthodontic mini-implants; 95% confidence interval, 0.35-1.14). The secondary outcome (ie, the overall failure rate of roughened orthodontic mini-implants) was 6% based on studies with high heterogeneity. Limitations of this study were the risk of bias, study imprecision, and possible publication bias, leading to a very low certainty in the body of evidence. CONCLUSIONS There is very low-quality evidence that there is no statistically significant effect of surface roughening on the success of orthodontic mini-implants in humans. The overall failure rate of surface-roughened orthodontic mini-implants was 6%. FUNDING No funding was received for this review. REGISTRATION This study was preregistered in the Prospective Register of Systematic Reviews (CRD42022371830).
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Affiliation(s)
- Matheus C T van den Braak
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Jan Willem M Hoekstra
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jan G J H Schols
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Edwin M Ongkosuwito
- Section of Orthodontics and Craniofacial Biology, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Gert J Meijer
- Department of Oral Maxillofacial Surgery, Radboud University Nijmegen Medical Center Nijmegen, The Netherlands
| | - Jeroen J J P van den Beucken
- Section of Regenerative Biomaterials, Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Tagliaferri N, Pisciotta A, Orlandi G, Bertani G, Di Tinco R, Bertoni L, Sena P, Lunghi A, Bianchi M, Veneri F, Bellini P, Bertacchini J, Conserva E, Consolo U, Carnevale G. Zirconia Hybrid Dental Implants Influence the Biological Properties of Neural Crest-Derived Mesenchymal Stromal Cells. NANOMATERIALS (BASEL, SWITZERLAND) 2024; 14:392. [PMID: 38470723 PMCID: PMC10934982 DOI: 10.3390/nano14050392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024]
Abstract
Dental implants are regularly employed in tooth replacement, the good clinical outcome of which is strictly correlated to the choice of an appropriate implant biomaterial. Titanium-based implants are considered the gold standard for rehabilitation of edentulous spaces. However, the insurgence of allergic reactions, cellular sensitization and low integration with dental and gingival tissues lead to poor osseointegration, affecting the implant stability in the bone and favoring infections and inflammatory processes in the peri-implant space. These failures pave the way to develop and improve new biocompatible implant materials. CERID dental implants are made of a titanium core embedded in a zirconium dioxide ceramic layer, ensuring absence of corrosion, a higher biological compatibility and a better bone deposition compared to titanium ones. We investigated hDPSCs' biological behavior, i.e., cell adhesion, proliferation, morphology and osteogenic potential, when seeded on both CERID and titanium implants, before and after cleansing with two different procedures. SEM and AFM analysis of the surfaces showed that while CERID disks were not significantly affected by the cleansing system, titanium ones exhibited well-visible modifications after brush treatment, altering cell morphology. The proliferation rate of DPSCs was increased for titanium, while it remained unaltered for CERID. Both materials hold an intrinsic potential to promote osteogenic commitment of neuro-ectomesenchymal stromal cells. Interestingly, the CERID surface mitigated the immune response by inducing an upregulation of anti-inflammatory cytokine IL-10 on activated PBMCs when a pro-inflammatory microenvironment was established. Our in vitro results pave the way to further investigations aiming to corroborate the potential of CERID implants as suitable biomaterials for dental implant applications.
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Affiliation(s)
- Nadia Tagliaferri
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Alessandra Pisciotta
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Giulia Orlandi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Giulia Bertani
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Rosanna Di Tinco
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Laura Bertoni
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Paola Sena
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Alice Lunghi
- Center for Translational Neurophysiology of Speech and Communication, Fondazione Istituto Italiano di Tecnologia, 44121 Ferrara, Italy;
- Section of Physiology, University of Ferrara, 44121 Ferrara, Italy
| | - Michele Bianchi
- Department of Life Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Federica Veneri
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Pierantonio Bellini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Jessika Bertacchini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Enrico Conserva
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Ugo Consolo
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
| | - Gianluca Carnevale
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy; (N.T.); (G.O.); (G.B.); (R.D.T.); (L.B.); (P.S.); (F.V.); (P.B.); (J.B.); (E.C.); (U.C.); (G.C.)
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Bergamo ETP, de Oliveira PGFP, Campos TMB, Bonfante EA, Tovar N, Boczar D, Nayak VV, Coelho PG, Witek L. Osseointegration of implant surfaces in metabolic syndrome and type-2 diabetes mellitus. J Biomed Mater Res B Appl Biomater 2024; 112:e35382. [PMID: 38355936 PMCID: PMC10883641 DOI: 10.1002/jbm.b.35382] [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: 06/06/2022] [Revised: 11/20/2023] [Accepted: 01/27/2024] [Indexed: 02/16/2024]
Abstract
This in vivo study evaluated the bone healing response around endosteal implants with varying surface topography/chemistry in a preclinical, large transitional model induced with metabolic syndrome (MS) and type-2 diabetes mellitus (T2DM). Fifteen Göttingen minipigs were randomly distributed into two groups: (i) control (normal diet, n = 5) and (ii) O/MS (cafeteria diet for obesity induction, n = 10). Following obesity induction, five minipigs from the obese/metabolic syndrome (O/MS) group were further allocated, randomly, into the third experimental group: (iii) T2DM (cafeteria diet + streptozotocin). Implants with different surface topography/chemistry: (i) dual acid-etched (DAE) and (ii) nano-hydroxyapatite coating over the DAE surface (NANO), were placed into the right ilium of the subjects and allowed to heal for 4 weeks. Histomorphometric evaluation of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO) within implant threads were performed using histomicrographs. Implants with NANO surface presented significantly higher %BIC (~26%) and %BAFO (~35%) relative to implants with DAE surface (%BIC = ~14% and %BAFO = ~28%, p < .025). Data as a function of systemic condition presented significantly higher %BIC (~28%) and %BAFO (~42%) in the control group compared with the metabolically compromised groups (O/MS: %BIC = 14.35% and %BAFO = 26.24%, p < .021; T2DM: %BIC = 17.91% and %BAFO = 26.12%, p < .021) with no significant difference between O/MS and T2DM (p > .05). Statistical evaluation considering both factors demonstrated significantly higher %BIC and %BAFO for the NANO surface relative to DAE implant, independent of systemic condition (p < .05). The gain increase of %BIC and %BAFO for the NANO compared with DAE was more pronounced in O/MS and T2DM subjects. Osseointegration parameters were significantly reduced in metabolically compromised subjects compared with healthy subjects. Nanostructured hydroxyapatite-coated surfaces improved osseointegration relative to DAE, regardless of systemic condition.
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Affiliation(s)
- Edmara T P Bergamo
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Paula G F P de Oliveira
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- CESUPA, Department of Periodontology, University Center of State of Para, Belem, Para, Brazil
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Department of Physics, Technological Institute of Aeronautics, São José dos Campos, São Paulo, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nick Tovar
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Oral and Maxillofacial Surgery, NYU Langone Medical Center and Bellevue, Hospital Center, New York, New York, USA
| | - Daniel Boczar
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, New York, USA
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, New York, USA
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7
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Alamoudi A. Nanoengineering and Surface Modifications of Dental Implants. Cureus 2024; 16:e51526. [PMID: 38304686 PMCID: PMC10833059 DOI: 10.7759/cureus.51526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 02/03/2024] Open
Abstract
Dental implants are one of the most important and successful advancements in modern dentistry. One aspect of dental implant design that influences the rate and degree of osseointegration is implant surface features. Nano-engineering techniques are anticipated to improve titanium dentistry implants' surface characteristics, which in turn promote peri-implant osteogenesis. In this paper, we review the recent advances in nanosurface engineering techniques for enhancing the bioactivity of dental implants.
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Fernandes CJDC, de Almeida GS, Wood PF, Gomes AM, Bezerra FJ, Vieira JCS, Padilha PM, Zambuzzi WF. Mechanosignaling-related angiocrine factors drive osteoblastic phenotype in response to zirconia. J Trace Elem Med Biol 2024; 81:127337. [PMID: 38000168 DOI: 10.1016/j.jtemb.2023.127337] [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: 06/21/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The growing use of zirconia as a ceramic material in dentistry is attributed to its biocompatibility, mechanical properties, esthetic appearance, and reduced bacterial adhesion. These favorable properties make ceramic materials a viable alternative to commonly used titanium alloys. Mimicking the physiological properties of blood flow, particularly the mechanosignaling in endothelial cells (ECs), is crucial for enhancing our understanding of their role in the response to zirconia exposure. METHODS In this study, EC cultures were subjected to shear stress while being exposed to zirconia for up to 3 days. The conditioned medium obtained from these cultures was then used to expose osteoblasts for a duration of 7 days. To investigate the effects of zirconia on osteoblasts, we examined the expression of genes associated with osteoblast differentiation, including Runx2, Osterix, bone sialoprotein, and osteocalcin genes. Additionally, we assessed the impact of mechanosignaling-related angiocrine factors on extracellular matrix (ECM) remodeling by measuring the activities of matrix metalloproteinases 2 and 9 (MMP2 and MMP9) during the acquisition of the osteogenic phenotype, which precedes mineralization. RESULTS Our data revealed that mechanosignaling-related angiocrine factors play a crucial role in promoting an osteoblastic phenotype in response to zirconia exposure. Specifically, exposed osteoblasts exhibited significantly higher expression levels of genes associated with osteoblast differentiation, such as Runx2, Osterix, bone sialoprotein, and osteocalcin genes. Furthermore, the activities of MMP2 and MMP9, which are involved in ECM remodeling, were modulated by mechanosignaling-related angiocrine factors. This modulation is likely an initial event preceding the mineralization phase. CONCLUSION Based on our findings, we propose that mechanosignaling drives the release of angiocrine factors capable of modulating the osteogenic phenotype at the biointerface with zirconia. This process creates a microenvironment that promotes wound healing and osseointegration. Moreover, these results highlight the importance of considering the mechanosignaling of endothelial cells in the modulation of bone healing and osseointegration in the context of blood vessel effects. Our data provide new insights and open avenues for further investigation into the influence of mechanosignaling on bone healing and the osseointegration of dental devices.
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Affiliation(s)
- Célio Junior da C Fernandes
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil
| | - Gerson Santos de Almeida
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil
| | - Patrícia Fretes Wood
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil
| | - Anderson M Gomes
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil
| | - Fábio J Bezerra
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil
| | - José C S Vieira
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil
| | - Pedro M Padilha
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil
| | - Willian F Zambuzzi
- Department of Chemical and Biological Sciences, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, São Paulo, CEP 18618-970, Brazil.
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9
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Bergamo ET, Witek L, Ramalho I, Lopes ACO, Vivekanand Nayak V, Bonfante EA, Tovar N, Torroni A, Coelho PG. Bone healing around implants placed in subjects with metabolically compromised systemic conditions. J Biomed Mater Res B Appl Biomater 2023; 111:1664-1671. [PMID: 37184298 PMCID: PMC10330391 DOI: 10.1002/jbm.b.35264] [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: 09/26/2022] [Revised: 02/28/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
The aim of this study was to evaluate the bone healing of tight-fit implants placed in the maxilla and mandible of subjects compromised with metabolic syndrome (MS) and type-2 Diabetes Mellitus (T2DM). Eighteen Göttingen minipigs were randomly distributed into three groups: (i) control (normal diet), (ii) MS (cafeteria diet for obesity induction), (iii) T2DM (cafeteria diet for obesity induction + Streptozotocin for T2DM induction). Maxillary and mandibular premolars and molar were extracted. After 8 weeks of healing, implants with progressive small buttress threads were placed, and allowed to integrate for 6 weeks after which the implant/bone blocks were retrieved for histological processing. Qualitative and quantitative histomorphometric analyses (percentage of bone-to-implant contact, %BIC, and bone area fraction occupancy within implant threads, %BAFO) were performed. The bone healing process around the implant occurred predominantly through interfacial remodeling with subsequent bone apposition. Data as a function of systemic condition yielded significantly higher %BIC and %BAFO values for healthy and MS relative to T2DM. Data as a function of maxilla and mandible did not yield significant differences for either %BIC and %BAFO. When considering both factors, healthy and MS subjects had %BIC and %BAFO trend towards higher values in the mandible relative to maxilla, whereas T2DM yielded higher %BIC and %BAFO in the maxilla relative to mandible. All systemic conditions presented comparable levels of %BIC and %BAFO in the maxilla; healthy and MS presented significantly higher %BIC and %BAFO relative to T2DM in the mandible. T2DM presented lower amounts of bone formation around implants relative to MS and healthy. Implants placed in the maxilla and in the mandible showed comparable amounts of bone in proximity to implants.
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Affiliation(s)
- Edmara T.P. Bergamo
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Lukasz Witek
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY USA
| | - Ilana Ramalho
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Adolfo CO Lopes
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Vasudev Vivekanand Nayak
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, Brooklyn, NY USA
| | - Estevam A Bonfante
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Nick Tovar
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Oral and Maxillofacial Surgery, NYU Langone Medical Center and Bellevue, Hospital Center, New York, NY USA
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, Grossman School of Medicine, New York University, New York, NY USA
| | - Paulo G. Coelho
- Division of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
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10
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Cui JT, Wang XY, Mu XD, Huang M, Wang YD, Luo Q, He HX. Bone marrow stromal cell-derived exosome combinate with fibrin on tantalum coating titanium implant accelerates osseointegration. Front Bioeng Biotechnol 2023; 11:1198545. [PMID: 37496851 PMCID: PMC10367419 DOI: 10.3389/fbioe.2023.1198545] [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: 04/01/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023] Open
Abstract
This study aims to present a sustainably releasing system of exosomes-fibrin combinate loaded on tantalum-coating titanium implants. We hope to investigate potential effects of the system on osseointegration between tantalum coating titanium implants and its surrounding bone tissue. Exosomes derived from rabbit bone marrow stromal cells (rBMSCs) and fibrin were deposited onto the micro-nanostructure tantalum coating surface (Ta + exo + FI) and compared to control groups, including tantalum coating (Ta), tantalum coating loaded exosomes (Ta + exo) and tantalum coating loaded fibrin (Ta + FI). The optimal concentration of loading exosomes, exosomes uptake capacity by BMSCs, and the effect of controlled-release by fibrin were assessed by laser scanning confocal microscope (LCSM) and microplate reader. The optimal concentration of exosomes was 1 μg/μL. Adhesion, proliferation, and osteogenic differentiation ability of BMSCs on different materials were assessed in vitro. Finally, osseointegrative capacity of Ta, Ta + exo, Ta + FI, Ta + exo + FI implants in rabbit tibia were respectively evaluated with histology and bone-implant contact ratio (BIC%). It was demonstrated that exosome sustained-release system with fibrin loading on the tantalum coating was successfully established. Fibrin contribute to exosomes release extension from 2d to 6d. Furthermore, Ta + exo + FI significantly promoted adhesion, proliferation, and osteogenic differentiation of BMSCs. In vivo, the implants in Ta + exo + FI group displayed the highest osseointegrative capability than those in other groups. It is concluded that this exosome delivery system on the implants may be an effective way for tantalum coating titanium implants to promote osseointegration between implant and its surrounding bone tissue.
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Affiliation(s)
- Jian-Tong Cui
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Shannxi Provincial Crops Hospital of Chinese People’s Armed Police Forces, Xian, China
| | - Xin-Yuan Wang
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Xiao-Dan Mu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Meng Huang
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ya-Di Wang
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Qiang Luo
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hui-Xia He
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
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11
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Pacheco-Vergara MJ, Benalcázar-Jalkh EB, Nayak VV, Bergamo ETP, Cronstein B, Zétola AL, Weiss FP, Grossi JRA, Deliberador TM, Coelho PG, Witek L. Employing Indirect Adenosine 2 A Receptors (A 2AR) to Enhance Osseointegration of Titanium Devices: A Pre-Clinical Study. J Funct Biomater 2023; 14:308. [PMID: 37367272 DOI: 10.3390/jfb14060308] [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: 02/24/2023] [Revised: 04/20/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
The present study aimed to evaluate the effect of dipyridamole, an indirect adenosine 2A receptors (A2AR), on the osseointegration of titanium implants in a large, translational pre-clinical model. Sixty tapered, acid-etched titanium implants, treated with four different coatings ((i) Type I Bovine Collagen (control), (ii) 10 μM dipyridamole (DIPY), (iii) 100 μM DIPY, and (iv) 1000 μM DIPY), were inserted in the vertebral bodies of 15 female sheep (weight ~65 kg). Qualitative and quantitative analysis were performed after 3, 6, and 12 weeks in vivo to assess histological features, and percentages of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO). Data was analyzed using a general linear mixed model analysis with time in vivo and coating as fixed factors. Histomorphometric analysis after 3 weeks in vivo revealed higher BIC for DIPY coated implant groups (10 μM (30.42% ± 10.62), 100 μM (36.41% ± 10.62), and 1000 μM (32.46% ± 10.62)) in comparison to the control group (17.99% ± 5.82). Further, significantly higher BAFO was observed for implants augmented with 1000 μM of DIPY (43.84% ± 9.97) compared to the control group (31.89% ± 5.46). At 6 and 12 weeks, no significant differences were observed among groups. Histological analysis evidenced similar osseointegration features and an intramembranous-type healing pattern for all groups. Qualitative observation corroborated the increased presence of woven bone formation in intimate contact with the surface of the implant and within the threads at 3 weeks with increased concentrations of DIPY. Coating the implant surface with dipyridamole yielded a favorable effect with regard to BIC and BAFO at 3 weeks in vivo. These findings suggest a positive effect of DIPY on the early stages of osseointegration.
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Affiliation(s)
- Maria Jesus Pacheco-Vergara
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Ernesto Byron Benalcázar-Jalkh
- Department of Prosthodontic and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-901, SP, Brazil
| | - Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Edmara T P Bergamo
- Department of Prosthodontic and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-901, SP, Brazil
- Division of Biomaterials, New York University College of Dentistry, 345 E 24th St., Room 902D, New York, NY 10010, USA
| | - Bruce Cronstein
- Department of Medicine, New York University Langone Medical Center, New York, NY 10016, USA
| | - André Luis Zétola
- Oral and Maxillofacial Surgeon, Chairman of Implantology, SOEPAR, Curitiba 80730-000, PR, Brazil
| | | | | | | | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Division of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Lukasz Witek
- Division of Biomaterials, New York University College of Dentistry, 345 E 24th St., Room 902D, New York, NY 10010, USA
- Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
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12
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de Carvalho Formiga M, da Silva HDP, Ghiraldini B, Siroma RS, Ardelean LC, Piattelli A, Shibli JA. Effects of Osseodensification on Primary Stability of Cylindrical and Conical Implants-An Ex Vivo Study. J Clin Med 2023; 12:jcm12113736. [PMID: 37297938 DOI: 10.3390/jcm12113736] [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: 05/03/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Primary stability is an important factor for dental implant success. In the past years, a new method for bone site preparation was introduced, named osseodensification (OD). OD produces a condensation of the trabecular portion of the bone, increasing bone-to-implant contact and primary stability. This study aims to compare the effect of OD in cylindrical and conical implants to conventional instrumentation. A total of forty implants, divided into four groups, were placed in porcine tibia: cylindrical conventional (1a), cylindrical OD (1b), conical conventional (2a) and conical OD (2b). Each implant was measured for implant stability quotient (ISQ), insertion torque (IT) and removal torque (RT). Group 2b showed the higher values for each of the evaluated parameters; groups 1b and 2b showed better results than 1a and 2a, respectively. Regarding the IT and RT, group 1b achieved higher values than group 2a, but not for ISQ. The inter-group comparison showed significant difference between groups 1a vs 2a, 1a vs 2b and 1b vs 2b for ISQ and 1a vs 1b and 1a vs 2b for RT analysis. OD resulted in improved ISQ, IT and RT of both cylindrical and conical implants.
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Affiliation(s)
- Márcio de Carvalho Formiga
- Department of Periodontology and Oral Implantology, Unisul, Palhoça, 515 Felipe Schmidt Str., Florianopolis 88101-001, SC, Brazil
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Helio Doyle Pereira da Silva
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Bruna Ghiraldini
- Dental Research Division, Paulista University, 303 Borges de Figueiredo Str., São Paulo 03110-010, SP, Brazil
| | - Rafael Shinoske Siroma
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
| | - Lavinia Cosmina Ardelean
- Department of Technology of Materials and Devices in Dental Medicine, Faculty of Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, 332 Viale Abruzzo Str., 66100 Chieti, Italy
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, 88 Praça Tereza Cristina Sq., Guarulhos 07011-010, SC, Brazil
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13
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Babadjanov F, Specht U, Lukasczyk T, Mayer B. Heat Accumulation-Induced Surface Structures at High Degrees of Laser Pulse Overlap on Ti6Al4V Surfaces by Femtosecond Laser Texturing. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2498. [PMID: 36984383 PMCID: PMC10059092 DOI: 10.3390/ma16062498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
In this work, femtosecond laser pulses at high repetition rates were used to fabricate unique microstructures on the surface of Ti6Al4V. We investigated the influence of pulse overlap and laser repetition rates on structure formation. Laser texturing with a high degree of overlap resulted in melting of the material, leading to the formation of specific microstructures that can be used as cavities for drug delivery. The reason for melt formation is attributed to local heat accumulation at high repetition rates. Such structures can be fabricated on materials with low thermal conductivity, which prevent heat dissipation into the bulk of the material. The heat accumulation effect has also been demonstrated on steel, which also has low thermal conductivity.
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Affiliation(s)
- Farkhod Babadjanov
- Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM, Wiener Str. 12, 28359 Bremen, Germany
| | - Uwe Specht
- Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM, Wiener Str. 12, 28359 Bremen, Germany
| | - Thomas Lukasczyk
- Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM, Wiener Str. 12, 28359 Bremen, Germany
| | - Bernd Mayer
- Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM, Wiener Str. 12, 28359 Bremen, Germany
- Faculty of Production Engineering, University of Bremen, 28359 Bremen, Germany
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14
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Siegler S, Taghvaei M, Zegarski R, Palmese G, Mathew R, Schayes J, Schaer T, Najafi A. A porous swelling copolymeric material for improved implant fixation to bone. J Biomed Mater Res B Appl Biomater 2023; 111:1342-1350. [PMID: 36815442 DOI: 10.1002/jbm.b.35238] [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: 08/30/2022] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Abstract
Most metallic commercial bone anchors, such as screws and suture anchors achieve their fixation to bone through shear of the bone located between the threads. They have several deficiencies, potentially leading to failure, which are particularly evident in low-density bone. These include stress-shielding resulting from mechanical properties mismatch; lack of mechanically induced remodeling and osteointegration; and when the pullout force on the anchor, during functional activities, exceeds their pullout strength, catastrophic failure occurs leaving behind large bone defects that may be hard to repair. To overcome these deficiencies, we introduced in this study a porous swelling co-polymeric material and studied its swelling and compressive mechanical characteristics as bone anchor under different configurations. Porosity was achieved by adding a non-dissolvable agent (NaCl) during the process of polymerization, which was later dissolved in water, leaving behind a porous structure with adequate porosity for osteointegration. Three different groups of cylindrical samples of the swelling co-polymer were investigated. Solid, fully porous, and partially porous with a solid core and a porous outer layer. The results of the swelling and simple compression study show that the partially porous swelling co-polymer maintains excellent mechanical properties matching those of cancellous bone, quick swelling response, and an adequate porous outer layer for mechanically induced osteointegration. These suggest that this material may present an effective alternative to conventional bone anchors particularly in low-density bone.
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Affiliation(s)
- Sorin Siegler
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Moein Taghvaei
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ryan Zegarski
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Giuseppe Palmese
- College of Engineering, Rowan University, Glassboro, New Jersey, USA
| | - Rena Mathew
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
| | - Julia Schayes
- School of Veterniary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Thomas Schaer
- School of Veterniary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ahmad Najafi
- Department of Mechanical Engineering, Drexel University, Philadelphia, Pennsylvania, USA
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15
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Zemtsova EG, Kozlova LA, Yudintceva NM, Sokolova DN, Arbenin AY, Ponomareva AN, Korusenko PM, Kraeva LA, Rogacheva EV, Smirnov VM. Creation of a Composite Bioactive Coating with Antibacterial Effect Promising for Bone Implantation. Molecules 2023; 28:molecules28031416. [PMID: 36771083 PMCID: PMC9919298 DOI: 10.3390/molecules28031416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
When creating titanium-containing bone implants, the bioactive coatings that promote their rapid engraftment are important. The engraftment rate of titanium implants with bone tissue depends significantly on the modification of the implant surface. It is achieved by changing either the relief or the chemical composition of the surface layer, as well as a combination of these two factors. In this work, we studied the creation of composite coatings with a two-level (the micro- and nanolevel) hierarchy of the surface relief, which have bioactive and bactericidal properties, which are promising for bone implantation. Using the developed non-lithographic template electrochemical synthesis, a composite coating on titanium with a controlled surface structure was created based on an island-type TiO2 film, silver and hydroxyapatite (HAp). This TiO2/Ag/HAp composite coating has a developed surface relief at the micro- and nanolevels and has a significant cytological response and the ability to accelerate osteosynthesis, and also has an antibacterial effect. Thus, the developed biomaterial is suitable for production of dental and orthopedic implants with improved biomedical properties.
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Affiliation(s)
- Elena G. Zemtsova
- Institute of Chemistry, St. Petersburg State University, 7/9 Universitetskaya nab, 199034 Saint Petersburg, Russia
- Correspondence: ; Tel.: +7-812-428-4033
| | - Lada A. Kozlova
- Institute of Chemistry, St. Petersburg State University, 7/9 Universitetskaya nab, 199034 Saint Petersburg, Russia
| | - Natalia M. Yudintceva
- Institute of Cytology, Russian Academy of Sciences (RAS), Tikhoretsky pr 4, 194064 Saint Petersburg, Russia
| | - Daria N. Sokolova
- Institute of Chemistry, St. Petersburg State University, 7/9 Universitetskaya nab, 199034 Saint Petersburg, Russia
| | - Andrey Yu. Arbenin
- Institute of Chemistry, St. Petersburg State University, 7/9 Universitetskaya nab, 199034 Saint Petersburg, Russia
| | - Alexandra N. Ponomareva
- Institute of Chemistry, St. Petersburg State University, 7/9 Universitetskaya nab, 199034 Saint Petersburg, Russia
| | - Petr M. Korusenko
- Institute of Chemistry, St. Petersburg State University, 7/9 Universitetskaya nab, 199034 Saint Petersburg, Russia
| | - Ludmila A. Kraeva
- Pasteur Institute of Epidemiology and Microbiology, 14 Mira Street, 197101 Saint Petersburg, Russia
| | - Elizaveta V. Rogacheva
- Pasteur Institute of Epidemiology and Microbiology, 14 Mira Street, 197101 Saint Petersburg, Russia
| | - Vladimir M. Smirnov
- Institute of Chemistry, St. Petersburg State University, 7/9 Universitetskaya nab, 199034 Saint Petersburg, Russia
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16
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Tang C, Deng J, Xu R, Li J, Yin C, Yang Y, Zhou Y, Deng F. Micro/nano-modified titanium surfaces accelerate osseointegration via Rab7-dependent mitophagy. Biomater Sci 2023; 11:666-677. [PMID: 36511190 DOI: 10.1039/d2bm01528e] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
To achieve rapid and successful osseointegration of titanium (Ti) implants, the underlying mechanisms of surface modification-mediated bone metabolism need to be clarified. Given that the microenvironment surrounding Ti implants may be altered after implant insertion, mitophagy as a key control system for cellular homeostasis is most likely to regulate osseointegration. Recent findings suggest that PTEN-induced putative kinase 1 (Pink1)/Parkin-mediated mitophagy plays a key role in bone metabolism. Since the micro/nano-modified surfaces of Ti implants have been widely appreciated for osseointegration acceleration, we used two common micro/nano-modified techniques and demonstrated elevations of both the osteo-differentiation potential and Pink1/Parkin pathway of osteoblasts. Moreover, the Pink1/Parkin pathway exhibited an upward trend during osteoblast differentiation. However, when osteoblasts were treated with CCCP, a Pink1/Parkin inducer, the osteo-differentiation potential decreased. Our further study showed that the small GTPase Rab7, which was inhibited by CCCP, was essential for the Pink1/Parkin pathway. Upon Pink1 or Rab7 knockdown, the pro-osteogenic effect of micro/nano-modified Ti surfaces was significantly weakened. The present results demonstrated that Rab7 activation was essential for active mitophagy and osteogenesis. In addition, Rab7 was confirmed to mediate the process of autophagosome formation. Our findings provide novel insights into new targets for osseointegration promotion, regardless of Ti surface characteristics.
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Affiliation(s)
- Cuizhu Tang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Jiali Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Ruogu Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Jingping Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Chengcheng Yin
- School and Hospital of Stomatology, China Medical University, Shenyang 110002, China.,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang 110002, China
| | - Yang Yang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Yinghong Zhou
- School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia.
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
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17
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Makary C, Menhall A, Lahoud P, An HW, Park KB, Traini T. Nanostructured Calcium-Incorporated Surface Compared to Machined and SLA Dental Implants-A Split-Mouth Randomized Case/Double-Control Histological Human Study. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:357. [PMID: 36678110 PMCID: PMC9866326 DOI: 10.3390/nano13020357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
Background: Implant surface topography is a key element in achieving osseointegration. Nanostructured surfaces have shown promising results in accelerating and improving bone healing around dental implants. The main objective of the present clinical and histological study is to compare, at 4 and 6 weeks, (w) bone-to-implant contact in implants having either machined surface (MAC), sandblasted, large grit, acid-etched implant surface (SLA) medium roughness surface or a nanostructured calcium-incorporated surface (XPEED®). Methods: 35 mini-implants of 3.5 × 8.5 mm with three different surface treatments (XPEED® (n = 16)—SLA (n = 13)—MAC (n = 6), were placed in the posterior maxilla of 11 patients (6 females and 5 males) then, retrieved at either 4 or 6w in a randomized split-mouth study design. Results: The BIC rates measured at 4w and 6w respectively, were: 16.8% (±5.0) and 29.0% (±3.1) for MAC surface; 18.5% (±2.3) and 33.7% (±3.3) for SLA surface; 22.4% (±1.3) and 38.6% (±3.2) for XPEED® surface. In all types of investigated surfaces, the time factor appeared to significantly increase the bone to implant contact (BIC) rate (p < 0.05). XPEED® surface showed significantly higher BIC values when compared to both SLA and MAC values at 4w (p < 0.05). Also, at 6w, both roughened surfaces (SLA and XPEED®) showed significantly higher values (p < 0.05) than turned surface (MAC). Conclusions: Nanostructured Calcium titanate coating is able to enhance bone deposition around implants at early healing stages.
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Affiliation(s)
- Christian Makary
- Oral Surgery Department, Saint Joseph University, Beirut P.O. Box 1104-2020, Lebanon
| | - Abdallah Menhall
- Oral Surgery Department, Saint Joseph University, Beirut P.O. Box 1104-2020, Lebanon
| | - Pierre Lahoud
- Oral Surgery Department, Saint Joseph University, Beirut P.O. Box 1104-2020, Lebanon
| | - Hyun-Wook An
- Department of Dental Science, Kyungpook National University, Daehak-ro, Buk-gu, Daegu 41566, Republic of Korea
| | - Kwang-Bum Park
- Daegu Mir Dental Hospital, Jung-gu, Daegu 41934, Republic of Korea
| | - Tonino Traini
- Department of Innovative Technologies in Medicine & Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
- Electron Microscopy Laboratory, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
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18
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Witek L, Parente PEL, Torroni A, Greenberg M, Nayak VV, Hacquebord JH, Coelho PG. Evaluation of instrumentation and pedicle screw design for posterior lumbar fixation: A pre‐clinical
in vivo/ex vivo
ovine model. JOR Spine 2023. [DOI: 10.1002/jsp2.1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Lukasz Witek
- Biomaterials Division New York University College of Dentistry New York New York USA
- Department of Biomedical Engineering New York University Tandon School of Engineering Brooklyn New York USA
| | | | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery New York University School of Medicine New York New York USA
| | - Michael Greenberg
- Biomaterials Division New York University College of Dentistry New York New York USA
| | - Vasudev Vivekanand Nayak
- Biomaterials Division New York University College of Dentistry New York New York USA
- Department of Mechanical and Aerospace Engineering New York University Tandon School of Engineering Brooklyn New York USA
| | - Jacques Henri Hacquebord
- Hansjörg Wyss Department of Plastic Surgery New York University School of Medicine New York New York USA
- Department of Orthopedic Surgery New York University School of Medicine New York New York USA
| | - Paulo G. Coelho
- Division of Plastic Surgery, Department of Surgery University of Miami Miller School of Medicine Miami Florida USA
- Department of Biochemistry and Molecular Biology University of Miami Miller School of Medicine Miami Florida USA
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19
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Mussi MC, Ribeiro FV, Corrêa MG, Salmon CR, Pimentel SP, Cirano FR, Casati MZ. Impact of a modified implant macrogeometry on biomechanical parameters and bone-related markers in rats. Braz Oral Res 2023; 37:e44. [PMID: 37132731 DOI: 10.1590/1807-3107bor-2023.vol37.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/17/2022] [Indexed: 05/04/2023] Open
Abstract
This study investigated the impact of a modified implant macrogeometry on peri-implant healing and its effect on bone-related molecules in rats. Eighteen rats received one implant in each tibia: the control group received implants with conventional macrogeometry and the test group received implants with modified macrogeometry. After 30 days, the implants were removed for biomechanical analysis and the bone tissue around them was collected for quantifying gene expression of OPN, Runx2, β-catenin, BMP-2, Dkk1, and RANKL/OPG. Calcein and tetracycline fluorescent markers were used for analyzing newly formed bone at undecalcified sections of the tibial implants. These fluorescent markers showed continuous bone formation at cortical bone width and sparse new bone formed along the medullary implant surface in both groups. However, higher counter-torque values and upregulation of OPN expression were achieved by test implants when compared to controls. The modified macrogeometry of implants optimized peri-implant healing, favoring the modulation of OPN expression in the osseous tissue around the implants.
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Affiliation(s)
- Mounir Colares Mussi
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | | | - Monica Grazieli Corrêa
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | | | - Suzana Peres Pimentel
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fabiano Ribeiro Cirano
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
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20
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Benalcázar Jalkh EB, Tovar N, Arbex L, Kurgansky G, Torroni A, Gil LF, Wall B, Kohanbash K, Bonfante EA, Coelho PG, Witek L. Effect of leukocyte-platelet-rich fibrin in bone healing around dental implants placed in conventional and wide osteotomy sites: A pre-clinical study. J Biomed Mater Res B Appl Biomater 2022; 110:2705-2713. [PMID: 35771197 DOI: 10.1002/jbm.b.35122] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 04/20/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Leukocyte-platelet-rich fibrin (L-PRF) has been suggested for gap management for immediate implant placement when the distance is greater than 2 mm. However, there remains a paucity in hierarchically designed research to support this application. The present study aimed to evaluate the effect of L-PRF on the osseointegration parameters of dental implants placed after conventional osteotomy of surgically created bone defects that simulate post extraction sockets in a canine model after 3, 6, and 12 weeks in vivo. Eighty dental implants (Intra-Lock, Boca Raton, FL) were placed in the radius of 13 beagle dogs. The experiment consisted of 4 groups (n = 20 implants/group): 1) Regular osteotomy (Reg n/L-PRF); 2) Regular osteotomy and implant placement with L-PRF membrane (Reg L-PRF); 3) Wide osteotomy with no gap management performed, where an osteotomy/bony defect (6 mm of diameter and ~5 mm deep) was created to simulate immediate implant placement in post-extraction sockets, and the gap was left for spontaneous healing (Wide nL-PRF); and 4) Wide osteotomy with L-PRF gap management (Wide L-PRF). L-PRF membranes were obtained by blood drawn from each subject and centrifuged at 2700 rpm (408 RCF-clot) for 12 min. In the experimental groups where L-PRF was utilized, the membrane was inserted into the osteotomy site prior to implant placement. Six dogs had implants placed in the radius for 3 weeks; and 7 dogs had implants placed in the left radius for 6 weeks and in the right radius for 12 weeks. At the corresponding experimental time points, samples were harvested, and subjected to histological processing for qualitative and quantitative analyses, via bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO). Qualitative analysis demonstrated increased amounts of bone formation around the implant and within the healing chambers over time for all groups. While comparable histological features were observed for both Reg groups (L-PRF and nL-PRF), the gap management performed in Wide L-PRF group resulted in effective gap filling with improved bone growth in close proximity to the implant surface. Quantitative analyses of BIC and BAFO yielded higher values for both variables at 3 weeks for Wide L-PRF (~38% and ~56% respectively) compared to Wide nL-PRF (~20% for BIC and BAFO) (p < .03). No statistical differences were detected between Wide groups at 6 and 12 weeks, neither between Reg groups, independent of the association with or without the L-PRF membrane at all healing times. L-PRF placed within wide osteotomies, prior to implant placement, resulted in increased early bone formation compared to unfilled wide osteotomies at the early healing time (3 weeks in vivo).
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Affiliation(s)
- Ernesto B Benalcázar Jalkh
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Bauru, Brazil
| | - Nick Tovar
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, New York, USA
| | - Leticia Arbex
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Gregory Kurgansky
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, New York, USA
| | - Luiz F Gil
- Department of Morphological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Brittany Wall
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Kimia Kohanbash
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo, Bauru School of Dentistry, Bauru, Brazil
| | - Paulo G Coelho
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, New York, USA.,Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA.,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division - Department of Molecular Pathobiology, New York University College of Dentistry, New York, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
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21
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Punnoose K, Kumar G A, B M, Govindarajulu R, V A, A E, Babu J S, C S, Nayyar AS. Osseodensification implant site preparation technique and subsequent implant stability: A pilot study. J Orthod Sci 2022; 11:50. [PMID: 36411812 PMCID: PMC9674936 DOI: 10.4103/jos.jos_45_22] [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: 05/21/2022] [Revised: 06/02/2022] [Accepted: 07/11/2022] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The objective of the present study was to evaluate and compare primary and secondary implant stability of conical endosteal implants placed using osseodensification osteotomy and conventional osteotomy techniques. MATERIALS AND METHODS The present invivo study was designed as a prospective, observational study in which a total of 26 endosteal implants were placed in the posterior edentulous regions of upper and lower jaws in 13 patients divided into two groups, Group A and Group B. In Group A, implants were placed using osseodensification osteotomy technique while in Group B, conventional osteotomy technique was used. Primary implant stability was measured in both groups immediately after implant placement while secondary implant stability was measured in both groups at an interval of 4 months. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.00 (SPSS Inc., Chicago, IL, USA) while an independent t-test, also, called Student's t-test was used to conduct the analysis. RESULTS The mean value of primary implant stability in Group A was found to be 74.5 as against that in Group B which was 62.08 (P-value 0.001). Likewise, the mean value of secondary implant stability in Group A after 4 months' interval was 70.92 while in Group B, it was found to be 63.69 (P-value 0.001). CONCLUSIONS The dental implants placed with the osseodensification technique showed higher mean primary and secondary implant stability values when compared to implants placed by the conventional technique.
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Affiliation(s)
- Kurian Punnoose
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Ha’il, Ha’il, Kingdom of Saudi Arabia
| | - Arun Kumar G
- Department of Prosthodontics and Crown and Bridge, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - Mahesh B
- Department of Prosthodontics and Crown and Bridge, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - Rajtilak Govindarajulu
- Department of Prosthodontics and Crown and Bridge, RVS Dental College and Hospital, Coimbatore, Tamil Nadu, India
| | - Amalorpavam V
- Department of Prosthodontics and Crown and Bridge, Rajas Dental College and Hospital, Kavalkinaru, Tirunelveli, Tamil Nadu, India
| | - Ebinu A
- Department of Prosthodontics and Crown and Bridge, Noorul Islam College of Dental Sciences, Thiruvananthapuram, Kerala, India
| | - Suresh Babu J
- Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha’il, Ha’il, Kingdom of Saudi Arabia
| | - Swarnalatha C
- Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha’il, Ha’il, Kingdom of Saudi Arabia
| | - Abhishek Singh Nayyar
- Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India,Address for correspondence: Dr. Abhishek Singh Nayyar, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India. E-mail:
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22
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Abstract
Surface characteristics are an important factor for long-term clinical success of dental implants. Alterations of implant surface characteristics accelerate or improve osseointegration by interacting with the physiology of bone healing. Dental implant surfaces have been traditionally modified at the microlevel. Recently, researchers have actively investigated nano-modifications in dental implants. This review explores implant surface modifications that enhance biological response at the interface between a bone and the implant.
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Affiliation(s)
- In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongro-Gu, Seoul 03080, Korea.
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23
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Effects of Different Titanium Surface Treatments on Adhesion, Proliferation and Differentiation of Bone Cells: An In Vitro Study. J Funct Biomater 2022; 13:jfb13030143. [PMID: 36135578 PMCID: PMC9503392 DOI: 10.3390/jfb13030143] [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: 08/08/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to evaluate the impacts of different sandblasting procedures in acid etching of Ti6Al4V surfaces on osteoblast cell behavior, regarding various physicochemical and topographical parameters. Furthermore, differences in osteoblast cell behavior between cpTi and Ti6Al4V SA surfaces were evaluated. Sandblasting and subsequent acid etching of cpTi and Ti6Al4V discs was performed with Al2O3 grains of different sizes and with varying blasting pressures. The micro- and nano-roughness of the experimental SA surfaces were analyzed via confocal, atomic force and scanning electron microscopy. Surface free energy and friction coefficients were determined. hFOB 1.19 cells were seeded to evaluate adhesion, proliferation and osteoblastic differentiation for up to 12 d via crystal violet assays, MTT assays, ALP activity assays and Alizarin Red staining assays. Differences in blasting procedures had significant impacts on surface macro- and micro-topography. The crystal violet assay revealed a significant inverse relationship between blasting grain size and hFOB cell growth after 7 days. This trend was also visible in the Alizarin Red assays staining after 12 d: there was significantly higher biomineralization visible in the group that was sandblasted with smaller grains (F180) when compared to standard-grain-size groups (F70). SA samples treated with reduced blasting pressure exhibited lower hFOB adhesion and growth capabilities at initial (2 h) and later time points for up to 7 days, when compared to the standard SA surface, even though micro-roughness and other relevant surface parameters were similar. Overall, etched-only surfaces consistently exhibited equivalent or higher adhesion, proliferation and differentiation capabilities when compared to all other sandblasted and etched surfaces. No differences were found between cpTi and Ti6Al4V SA surfaces. Subtle modifications in the blasting protocol for Ti6Al4V SA surfaces significantly affect the proliferative and differentiation behavior of human osteoblasts. Surface roughness parameters are not sufficient to predict osteoblast behavior on etched Ti6Al4V surfaces.
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24
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Cheng YC, Ewers R, Morgan K, Hirayama M, Murcko L, Morgan J, Bergamo ETP, Bonfante EA. Antiresorptive therapy and dental implant survival: an up to 20-year retrospective cohort study in women. Clin Oral Investig 2022; 26:6569-6582. [PMID: 36001145 DOI: 10.1007/s00784-022-04609-4] [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: 12/28/2021] [Accepted: 06/26/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the effects of antiresorptive treatment on the survival of plateau-root form dental implants. MATERIALS AND METHODS Patients undergoing antiresorptive therapy via oral or intravenous administration as well as patients not undergoing antiresorptive therapy and healthy control patients were included in this retrospective cohort study. In total, 1472 implants placed in 631 postmenopausal patients (M: 66.42 ± 9.10 years old), who were followed for a period of up to 20 years (8.78 ± 5.68 years). Kaplan-Meier survival analysis was performed, and univariate and multivariate Cox regression, clustered by each patient, was used to evaluate and study factors affecting the survival of their implants. RESULTS Implants placed in patients undergoing oral antiresorptive treatment presented significantly higher survival rates, than implants placed in the osteoporosis/osteopenia control cohort (p value < 0.001), and similar survival rates, when compared to healthy controls (p value = 0.03). Additionally, clustered univariate and multivariate Cox regression analysis also revealed higher implant survival when oral antiresorptive drugs (p value = 0.01 and 0.007, respectively) were used, and lower implant survival in the presence of untreated osteoporosis/osteopenia (p value = 0.002 and 0.005, respectively). Overall, the 20-year implant survival in osteoporotic patients undergoing antiresorptive therapy was 94%. For the failed implants, newly replaced implants in patients under antiresorptive treatment presented a 10-year survival of 89%. CONCLUSIONS Long-term plateau-root form implant survival in osteoporotic patients taking oral antiresorptives was similar to a healthy population and significantly higher than the untreated controls. CLINICAL RELEVANCE These results suggest that plateau-root form implants provide a robust solution for treating tooth loss in patients, who are undergoing antiresorptive therapy.
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Affiliation(s)
- Yu-Chi Cheng
- Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rolf Ewers
- University Hospital for Cranio-Maxillofacial and Oral Surgery and CMF Institute Vienna, Vienna, Austria
| | | | | | | | | | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil.
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo - Bauru School of Dentistry, 9-75 Octavio Pinheiro Brizola, Bauru, SP, 17012-901, Brazil
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25
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Martins SHL, Cadore UB, Novaes AB, Messora MR, Ghiraldini B, Bezerra FJB, Botticelli D, de Souza SLS. Evaluation of Bone Response to a Nano HA Implant Surface on Sinus Lifting Procedures: Study in Rabbits. J Funct Biomater 2022; 13:jfb13030122. [PMID: 35997460 PMCID: PMC9397014 DOI: 10.3390/jfb13030122] [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: 07/20/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the bone response to two different implant surfaces on sinus lift procedures in rabbits. Bilateral sinus lifting with inorganic bovine bone associated with collagen membrane and immediate implantation were performed in 16 rabbits. Custom mini-implants were randomly installed in the prepared sites: one side received a double acid-etched (DAE) surface and the other a nano-hydroxyapatite (NHA) surface. The animals were euthanized 30 and 60 days after surgery, and biopsies were collected for microtomographic and histomorphometric analysis. After 30 days, no intra- and inter-group statistical differences were observed in microtomographic analysis, while at 60 days, bone analysis showed statistically significant differences between groups (p < 0.05) for all the evaluated parameters. Histomorphometric analysis showed, after 30 days, mean % of Bone-to-Implant Contact (BIC) for DAE and NHA of 31.70 ± 10.42% vs. 40.60 ± 10.22% (p > 0.05), respectively; for % of Bone Area Fraction Occupancy (BAFO), mean values were 45.43 ± 3.597% for DAE and 57.04 ± 5.537% for NHA (p < 0.05). After 60 days, mean %BIC and %BAFO for DAE and NHA implants were statistically significant (p < 0.05). The NHA surface showed superior biological features compared to the DAE treatment, promoting higher bone formation around the implants in an experimental model of bone repair in a grafted area.
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Affiliation(s)
- Sergio H. L. Martins
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Uislen B. Cadore
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Arthur B. Novaes
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Michel R. Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Bruna Ghiraldini
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Fabio J. B. Bezerra
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
| | - Daniele Botticelli
- ARDEC (Ariminum Research & Dental Education Center) Academy, Viale Giovanni Pascoli 67, 47923 Rimini, Italy
| | - Sergio L. S. de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto 14040-904, SP, Brazil
- Correspondence: ; Tel.: +55-16-3315-3980
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26
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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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27
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Contemporary Concepts in Osseointegration of Dental Implants: A Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6170452. [PMID: 35747499 PMCID: PMC9213185 DOI: 10.1155/2022/6170452] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022]
Abstract
In a society highly conscious of esthetics, prosthetic rehabilitation of lost teeth with tissue-integrated implants has gained wide acceptance and demand by patients and clinicians. The backbone of these tissue-integrated implants is the biotechnical process of osseointegration. Although the concept has been introduced and discussed for ages, the deepening knowledge about its cellular and molecular mechanisms has led the researchers to borrow further into the factors influencing the process of osseointegration. This has aided in the hastening and improving the process of osseointegration by exploiting several, even the minutest, details and events taking place in this natural process. Recently, due to the high esthetic expectations of the patients, the implants are being loaded immediately, which demands a high degree of implant stability. Implant stability, especially secondary stability, largely depends on bone formation and integration of implants to the osseous tissues. Various factors that influence the rate and success of osseointegration can either be categorized as those related to implant characteristics like the physical and chemical macro- and microdesign of implants or the bone characteristics like the amount and quality of bone and the local and systemic host conditions, or the time or protocol followed for the functional loading of the dental implant. To address the shortcomings in osseointegration due to any of the factors, it is mandatory that continuous and reliable monitoring of the status of osseointegration is done. This review attempts to encompass the mechanisms, factors affecting, and methods to assess osseointegration, followed by a discussion on the recent advances and future perspectives in dental implantology to enhance the process of osseointegration. The review was aimed at igniting the inquisitive minds to usher further the development of technology that enhances osseointegration.
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Wang Z, Li B, Cai Q, Li X, Yin Z, Li B, Li Z, Meng W. Advances and Prospects in Antibacterial-Osteogenic Multifunctional Dental Implant Surface. Front Bioeng Biotechnol 2022; 10:921338. [PMID: 35685091 PMCID: PMC9171039 DOI: 10.3389/fbioe.2022.921338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022] Open
Abstract
In recent years, dental implantation has become the preferred protocol for restoring dentition defects. Being the direct contact between implant and bone interface, osseointegration is the basis for implant exerting physiological functions. Nevertheless, biological complications such as insufficient bone volume, poor osseointegration, and postoperative infection can lead to implant failure. Emerging antibacterial-osteogenic multifunctional implant surfaces were designed to make up for these shortcomings both during the stage of forming osseointegration and in the long term of supporting the superstructure. In this mini-review, we summarized the recent antibacterial-osteogenic modifications of the dental implant surface. The effects of these modifications on biological performance like soft tissue integration, bone osteogenesis, and immune response were discussed. In addition, the clinical findings and prospects of emerging antibacterial-osteogenic implant materials were also discussed.
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Affiliation(s)
- Zixuan Wang
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Oral Biomedical Engineering, Changchun, China
| | - Baosheng Li
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Qing Cai
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Xiaoyu Li
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Zhaoyi Yin
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Birong Li
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Zhen Li
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Weiyan Meng
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
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Nanoporous Titanium Enriched with Calcium and Phosphorus Promotes Human Oral Osteoblast Bioactivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106212. [PMID: 35627749 PMCID: PMC9141428 DOI: 10.3390/ijerph19106212] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/05/2022] [Accepted: 05/16/2022] [Indexed: 12/12/2022]
Abstract
Implant surfaces are known to influence the osseointegration process; therefore, their modifications represent an important subject of investigation. On this basis, the purpose of this study was to evaluate the response of human oral osteoblasts (hOBs) to three different GR4 titanium discs: Machined, double-etched (Osteopore), and double-etched, surface-enriched with calcium and phosphorus (CaP) (Nanopore). The superficial topography was investigated with scanning electron microscopy (SEM) and the sessile drop technique. To test cellular response and osteoinductive properties, the following points were evaluated: (i) proliferation by MTS assay after 2 and 5 days; (ii) adhesion by multiphoton microscopy at day 2; (iii) the interaction with Ti discs by blue toluidine staining at day 5; (iv) alkaline phosphatase (ALP) activity by ALP assay after 14 days; (v) calcium deposition by alizarin red staining and by cetylpyridinium chloride after 14 days. The SEM analysis showed that Nanopore and Osteopore surfaces were characterized by the same micro-topography. Nanopore and Osteopore discs, compared to Machined, stimulated higher osteoblast proliferation and showed more osteoinductive properties by promoting the ALP activity and calcium deposition. In conclusion, the CaP treatment on DAE surfaces seemed to favor the oral osteoblast response, encouraging their use for in vivo applications.
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de Carvalho Formiga M, Grzech-Leśniak K, Moraschini V, Shibli JA, Neiva R. Effects of Osseodensification on Immediate Implant Placement: Retrospective Analysis of 211 Implants. MATERIALS 2022; 15:ma15103539. [PMID: 35629566 PMCID: PMC9147081 DOI: 10.3390/ma15103539] [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: 03/18/2022] [Revised: 05/07/2022] [Accepted: 05/12/2022] [Indexed: 01/14/2023]
Abstract
Osseodensification is a new method of bone instrumentation for dental implant placement that preserves bulk bone and increases primary implant stability, and may accelerate the implant rehabilitation treatment period and provide higher success and survival rates than conventional methods. The aim of this retrospective study was to evaluate and discuss results obtained on immediate implant placement with immediate and delayed loading protocols under Osseodensification bone instrumentation. This study included private practice patients that required dental implant rehabilitation, between February 2017 and October 2019. All implants were placed under Osseodensification and had to be in function for at least 12 months to be included on the study. A total of 211 implants were included in the study, with a 98.1% total survival rate (97.9% in the maxilla and 98.5% in the mandible). For immediate implants with immediate load, 99.2% survival rate was achieved, and 100% survival rate for immediate implant placement without immediate load cases. A total of four implants were lost during this period, and all of them were lost within two months after placement. Within the limitations of this study, it can be concluded that Osseodensification bone instrumentation provided similar or better results on survival rates than conventional bone instrumentation.
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Affiliation(s)
| | - Kinga Grzech-Leśniak
- Laser Laboratory Oral Surgery Department, Medical University of Wroclaw, 50-425 Wroclaw, Poland;
| | - Vittorio Moraschini
- Department of Periodontology, Veiga de Almeida University, Rio de Janeiro 20271-020, Brazil;
| | - Jamil Awad Shibli
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos 07023-040, Brazil
- Correspondence:
| | - Rodrigo Neiva
- Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
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Kim JC, Lee M, Yeo ISL. Three interfaces of the dental implant system and their clinical effects on hard and soft tissues. MATERIALS HORIZONS 2022; 9:1387-1411. [PMID: 35293401 DOI: 10.1039/d1mh01621k] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Anatomically, the human tooth has structures both embedded within and forming part of the exterior surface of the human body. When a tooth is lost, it is often replaced by a dental implant, to facilitate the chewing of food and for esthetic purposes. For successful substitution of the lost tooth, hard tissue should be integrated into the implant surface. The microtopography and chemistry of the implant surface have been explored with the aim of enhancing osseointegration. Additionally, clinical implant success is dependent on ensuring that a barrier, comprising strong gingival attachment to an abutment, does not allow the infiltration of oral bacteria into the bone-integrated surface. Epithelial and connective tissue cells respond to the abutment surface, depending on its surface characteristics and the materials from which it is made. In particular, the biomechanics of the implant-abutment connection structure (i.e., the biomechanics of the interface between implant and abutment surfaces, and the screw mechanics of the implant-abutment assembly) are critical for both the soft tissue seal and hard tissue integration. Herein, we discuss the clinical importance of these three interfaces: bone-implant, gingiva-abutment, and implant-abutment.
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Affiliation(s)
- Jeong Chan Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul 03080, Korea
| | - Min Lee
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongro-Gu, Seoul 03080, Korea.
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Tardelli J, da Costa Valente M, Macedo A, dos Reis A. Evaluation of Biomechanical and Stress Distribution of Different Dental Implant Designs: Primary Stability and Photoelastic Analysis. Ing Rech Biomed 2022. [DOI: 10.1016/j.irbm.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tian Y, Zheng H, Zheng G, Hu P, Li Y, Lin Y, Gao Q, Yao X, Gao R, Li C, Wu X, Sui L. Hierarchical microgroove/nanopore topography regulated cell adhesion to enhance osseointegration around intraosseous implants in vivo. Biomater Sci 2021; 10:560-580. [PMID: 34907409 DOI: 10.1039/d1bm01657a] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Implant surface topography plays a crucial role in achieving successful implantation. Simple and controllable surface topographical modifications are considered a promising method to accelerate bone osseointegration for biomedical applications. Moreover, comprehension of the mechanism between surface topography and cell osteogenic differentiation is vital for the manipulation of these processes to promote bone tissue regeneration. In this study, we investigated the effects of implant surfaces with various sized hierarchical microgroove/nanopore topographies on cell adhesion, osteogenesis, and their underlying mechanism both in vitro and in vivo. Our findings reveal that a titanium surface with an appropriately sized microgroove/nanopore topography (SLM-1MAH) exhibits the more satisfactory adhesive and osteogenic efficiency than the clinically used sand-blasted, large-grit, and acid-etched (SLA) surface. The underlying molecular mechanism lies in the activation of the integrin α2-PI3K-Akt signaling pathway, where the SLM-1MAH surface increased the protein expressions of integrin α2 (Itga2), phosphatidylinositol 3-kinase (PI3K), and phosphorylated serine/threonine kinase Akt (p-Akt) to enhance osteogenesis and osseointegration. Furthermore, the SLM-1MAH surface also displays better osseointegration efficiency with stronger bonding strength than that on the SLA surface. This work provides a novel strategy for implant surface topography design to improve bone-implant osseointegration.
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Affiliation(s)
- Yujuan Tian
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China. .,Department of Cell Biology, 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Tianjin Key Laboratory of Medical Epigenetics, Tianjin Medical University, Tianjin, 300070, China.
| | - Huimin Zheng
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China. .,Department of Cell Biology, 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Tianjin Key Laboratory of Medical Epigenetics, Tianjin Medical University, Tianjin, 300070, China.
| | - Guoying Zheng
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China.
| | - Penghui Hu
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China.
| | - Ying Li
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China.
| | - Yi Lin
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China.
| | - Qian Gao
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China. .,Department of Cell Biology, 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Tianjin Key Laboratory of Medical Epigenetics, Tianjin Medical University, Tianjin, 300070, China.
| | - Xiaoyu Yao
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China.
| | - Rui Gao
- International Education College, Tianjin University of Traditional Chinese Medicine, Tianjin, 300070, China
| | - Changyi Li
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China.
| | - Xudong Wu
- Department of Cell Biology, 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Tianjin Key Laboratory of Medical Epigenetics, Tianjin Medical University, Tianjin, 300070, China.
| | - Lei Sui
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Tianjin, 300070, China.
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Enhanced Extracellular Matrix Deposition on Titanium Implant Surfaces: Cellular and Molecular Evidences. Biomedicines 2021; 9:biomedicines9111710. [PMID: 34829938 PMCID: PMC8615957 DOI: 10.3390/biomedicines9111710] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 02/06/2023] Open
Abstract
The surface structure of the titanium dental implants can modulate the activity of mesenchymal stem cells in order to promote the upregulation of osteoblastic related genes and the release of extracellular matrix (ECM) components. The present work was focused on the in vitro evaluation of the interaction of human periodontal ligament stem cells (hPDLSCs) and two different implant titanium surfaces topography (CTRL and TEST). This study was aimed at analyzing the cytotoxicity of the dental implant surfaces, the cellular adhesion capacity, and the improvement in the release of ECM molecules in an in vitro model. These parameters were carried out by means of the microscopic evaluation, viability assays, immunofluorescence, Western blot and RT-PCR investigations. The knowledge of the cell/implant interaction is essential for implant healing in order to obtain a more performing surfaces that promote the ECM release and provide the starting point to initiate the osseointegration process.
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Aesthetic Outcomes of Early Occlusal Loaded SLA Dental Implants with Hydroxyl Ion Modified Surface-A 12 Months Prospective Study. MATERIALS 2021; 14:ma14216353. [PMID: 34771884 PMCID: PMC8585409 DOI: 10.3390/ma14216353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022]
Abstract
Background: Many efforts have been made recently to arrange a newer, more hydrophilic and more osteoconductive implant surface. One of the possible options in this matter is modification with hydroxyl ion. Materials and Methods: Forty implants with the diameters 3.5 and 4.0 mm were inserted as a single missing tooth restoration protocol in the frontal aspect of the maxilla. All implants were loaded early in a 4 week period. Prior to and during the surgery, the following indices were considered: height of keratinized tissue, the thickness of soft tissue, and the initial level of bone tissue. After 12 months, the implant and the tissues in its direct vicinity were evaluated once more with the following indices: marginal bone loss (MBL), height of keratinized tissue (HKT), probing pocket depth (PPD), pink and white aesthetics scores (PES, WES), as well as pain sensations combined with the procedure (VAS). All results were related to the diameter of the implant and thickness of periodontal biotype. Results: High aesthetic outcomes were reported regardless of soft tissue thickness and implant diameter. The VAS score was higher for the 4.0 implant group, and the thickness of soft tissue had no influence on VAS. In case of implantation in thin or soft tissue, higher MBL levels were reported (0.26 mm), while in case of a thick phenotype, MBL was 0.06 mm. Conclusions: Hydrophilic surface implants can be used for a protocol of early functional occlusal loading. The initial thickness of soft tissue does not influence aesthetic outcomes and does not raise pain perception, although it may elevate crestal bone resorption.
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Can the design of the instruments used for undersized osteotomies influence the initial stability of implants installed in low-density bone? An in vitro pilot study. PLoS One 2021; 16:e0257985. [PMID: 34618848 PMCID: PMC8496820 DOI: 10.1371/journal.pone.0257985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/14/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives The aims of this study were to compare the initial implant stability obtained using four different osteotomy techniques in low-density synthetic bone, to evaluate the instrument design in comparison to the implant design, and to determinate a possible correlation between the insertion torque and initial stability quotient (ISQ). Materials and methods Four groups were identified in accordance with the osteotomy technique used (n = 10 implants per group): group G1, osteotomy using the recommended drilling sequence; group G2, osteotomy using an undersized compactor drill; group G3, osteotomy using an undersized drill; and group G4, osteotomy using universal osseodensification drills. Two polyurethane blocks were used: block 1, with a medullary portion of 10 pounds per cubic foot (PCF 10) and with a 1 mm cortical portion of PCF 40, and block 2, with a medullary of PCF 15 and with a 2 mm cortical portion of PCF 40. Tapered implants of 4 mm in diameter and 11 mm in length were used. The insertion torque (IT) and ISQ were measured. The dimensions of the final instrument used in each group and the dimensions of the implant were used to calculate the total area of each part, and these data were compared. Results Differences between the four groups were found for IT and ISQ values depending on the technique used for the osteotomy in the two synthetic bone models (p < 0.0001). All groups showed lower values of initial stability in block 1 than in block 2. Conclusions Undersized osteotomies with instruments designed according to the implant body significantly increased the initial stability values compared to beds prepared with universal drills and using the drilling sequence standardized by the manufacturer.
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Benalcázar Jalkh EB, Parra M, Torroni A, Nayak VV, Tovar N, Castellano A, Badalov RM, Bonfante EA, Coelho PG, Witek L. Effect of supplemental acid-etching on the early stages of osseointegration: A preclinical model. J Mech Behav Biomed Mater 2021; 122:104682. [PMID: 34311324 DOI: 10.1016/j.jmbbm.2021.104682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 06/03/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the effect of two surface modifications on early osseointegration parameters of conical implants in a translational pre-clinical model. MATERIALS AND METHODS Conical implants with progressive trapezoidal threads and healing chambers were evaluated consisting of two different surface conditions: 1) Implacil surface (IMP Sur), and 2) Implacil surface + Supplemental Acid-etching (IMP Sur + AE). Surface characterization comprised of the evaluation of roughness parameters (Sa, Sq and Sdr), surface energy and contact angle. Subsequently, implants were installed in the ilium crest of nine female sheep (weighing ~65 kg). Torque out, histological and histomorphometric analyses were conducted after 3 and 6 weeks in-vivo. The percentage of bone to implant contact (%BIC) and bone area fraction occupancy within implant threads (%BAFO) were quantified, and the results were analyzed using a general linear mixed model analysis as function of surface treatment and time in-vivo. RESULTS Supplemental acid etching significantly increased Sa and Sq roughness parameters without compromising the surface energy or contact angle, and no significant differences with respect to Sdr. Torque-out testing yielded significantly higher values for IMP Sur + AE in comparison to the IMP Sur at 3- (62.78 ± 15 and 33.49 ± 15 N.cm, respectively) and 6-weeks (60.74 ± 15 and 39.80 ± 15 N.cm, respectively). Histological analyses depicted similar osseointegration features for both surfaces, where an intramembranous-type healing pattern was observed. At histomorphometric analyses, IMP Sur + AE implants yielded higher values of BIC in comparison to IMP Sur at 3- (40.48 ± 38 and 27.98 ± 38%, respectively) and 6-weeks (45.86 ± 38 and 34.46 ± 38%, respectively). Both groups exhibited a significant increase in %BAFO from 3 (~35%) to 6 weeks (~44%), with no significant differences between surface treatments. CONCLUSION Supplemental acid-etching and its interplay with implant thread design, positively influenced the BIC and torque-out resistance at early stages of osseointegration.
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Affiliation(s)
- Ernesto B Benalcázar Jalkh
- University of Sao Paulo - Bauru School of Dentistry, Department of Prosthodontics and Periodontology, Bauru, SP, Brazil; Department of Biomaterials, New York University College of Dentistry, New York, NY, USA
| | - Marcelo Parra
- PhD Program in Morphological Sciences, Center of Excellence in Morphological and Surgical Studies Faculty of Medicine, Universidad de La Frontera, Temuco, Chile; Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA
| | - Vasudev Vivekanand Nayak
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA; Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - Nick Tovar
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA; Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, NY, USA
| | - Arthur Castellano
- Mackenzie Evangelical School of Medicine Paraná, Curitiba, Brazil; Federal University of Parana, Curitiba, Brazil
| | - Rafael M Badalov
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA
| | - Estevam A Bonfante
- University of Sao Paulo - Bauru School of Dentistry, Department of Prosthodontics and Periodontology, Bauru, SP, Brazil
| | - Paulo G Coelho
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA; Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York, NY, USA; Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA
| | - Lukasz Witek
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA; Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY, USA.
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Wo J, Huang SS, Wu DY, Zhu J, Li ZZ, Yuan F. The integration of pore size and porosity distribution on Ti-6A1-4V scaffolds by 3D printing in the modulation of osteo-differentation. J Appl Biomater Funct Mater 2021; 18:2280800020934652. [PMID: 32936027 DOI: 10.1177/2280800020934652] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE In this study, pore size and porosity distribution of porous Ti-6Al-4V scaffolds (pTi) were controlled by 3D printing. The effects of pore size distribution at a constant porosity, or porosity distribution at a constant pore size pertaining to functions of adhesion, proliferation, and differentiation of the mouse embryonic osteoblast precursor (MC3T3-E1) cells were researched separately. METHODS 3D printing was used to design five groups of pTi, designated as PS300/HP, PS300/LP, PS500/HP, PS500/LP, and PS800/HP based on pore size and porosity distribution. MC3T3-E1 cells were cultured on pTi, and non-porous Ti-6Al-4V samples (npTi) were prepared as control. The pTi was characterized with the scanning electron microscopy (SEM). MC3T3-E1 cells were stained via AlamarBlue assay and viability and proliferation analyzed. The mRNA levels of alkaline phosphatase (ALP), osteocalcin (OCN), collagentype-1 (Col-1), and runt-related transcription factor 2 (Runx2) in MC3T3-E1 cells were analyzed by real-time PCR analysis. RESULTS The average pore size and porosity of pTi were recorded as (301 ± 9 μm, 58.8 ± 1.8%), (300 ± 9 μm, 43.4 ± 1.3%), (501 ± 11 μm, 58.3 ± 1.2%), (499 ± 12 μm, 42.7 ± 1.1%), and (804 ± 10 μm, 58.9 ± 1.3%), respectively. SEM images confirmed active attachment of cells and oriented with the direction of metal rod after pTi/MC3T3-E1 co-culture for 3 and 7 days. In addition, MC3T3-E1 cells grown on the PS800/HP displayed significantly higher proliferation compared with each group after 3 days incubation (p < 0.05). Moreover, cells showed some degree of proliferation in all groups, with the highest value recorded for PS800/HP after culture for 7 days (p < 0.05). The gene expression pattern of ALP, OCN, Col-1, and Runx2 confirmed that these were down-regulated when pore size increased or porosity decreased of pTi (p < 0.05). CONCLUSION The pTi facilitated the adhesion and differentiation of osteoblast when pore size decreased or porosity increased. The scaffold model resembles physical modification with porous structures, which has potential application in the surface modifications of Ti implant.
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Affiliation(s)
- Jin Wo
- Jinan University, Guangzhou, Guangdong, China.,Spinal Surgery Department, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | | | - Dong-Ying Wu
- Spinal Surgery Department, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jun Zhu
- Spinal Surgery Department, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | | | - Feng Yuan
- Spinal Surgery Department, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
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The role of autophagy in the process of osseointegration around titanium implants with micro-nano topography promoted by osteoimmunity. Sci Rep 2021; 11:18418. [PMID: 34531513 PMCID: PMC8446058 DOI: 10.1038/s41598-021-98007-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 09/01/2021] [Indexed: 02/08/2023] Open
Abstract
Osteoimmunity plays an important role in the process of implant osseointegration. Autophagy is a conservative metabolic pathway of eukaryotic cells, but whether the interaction between autophagy and osteoimmunity plays a key role in osseointegration remains unclear. In this study, we prepared smooth titanium disks and micro-nano topography titanium disks, to study the immune microenvironment of RAW264.7 cells, and prepared the conditioned medium to study the effect of immune microenvironment on the osteogenesis and autophagy of MC3T3-E1 cells. Autophagy inhibitor 3-MA was used to inhibit autophagy to observe the change of expression of osteogenic markers. The results showed that the micro-nano topography titanium disks could stimulate RAW264.7 cells to differentiate into M2 type, forming an anti-inflammatory immune microenvironment; compared with the control group, the anti-inflammatory immune microenvironment promoted the proliferation and differentiation of osteoblasts better. The anti-inflammatory immune environment activated the autophagy level of osteoblasts, while the expression of osteogenic markers was down-regulated after inhibition of autophagy. These results indicate that anti-inflammatory immune microenvironment can promote cell proliferation and osteogenic differentiation, autophagy plays an important role in this process. This study further explains the mechanism of implant osseointegration in osteoimmune microenvironment, and provides reference for improving implant osseointegration.
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40
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Moradi H, Beh Aein R, Youssef G. Multi-objective design optimization of dental implant geometrical parameters. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3511. [PMID: 34302714 DOI: 10.1002/cnm.3511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 04/23/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
In-silico investigations are becoming an integral part of the development of novel biomedical devices, including dental implants. Using computer simulations can streamline the process by tuning different geometrical and structural features, emphasizing the osseointegration of the implant design a priori, leading to the optimal designs in preparation for in-vivo trails. This research aims to elucidate the interrelationship between 12 geometrical variables that holistically define the shape of the implant. The approach to achieve optimality hinged on coupling the finite element analysis results with the fractional factorial design method. The latter was used to determine the most influential variables during the screening process, followed by the parameter optimization process using the response surface method, regarding four different objectives, namely: bone-implant contact area, volume of trabecular bone dead cells, volume of cortical bone dead cells, and axial displacement. This resulted in reducing the number of virtual experiments and substantially decreasing the computational cost without compromising the accuracy of the solution. It was found that the optimized values improved the performance significantly. The validity of all models was verified by comparing optimized responses with simulation results. A sensitivity analysis was performed on all five optimized models to address the effect of friction coefficient on the implant-bone joint interaction. It was shown that the mechanical behavior of implant-bone would be independent in higher friction coefficients. The significance of this study is demonstrated in determining the most effective and optimized values of all possible geometrical parameters considering their singular or interactive effects.
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Affiliation(s)
- Hamidreza Moradi
- Department of Mechanical Engineering and Engineering Science, The University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Roozbeh Beh Aein
- D.M.D. Department of Dentistry, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary
| | - George Youssef
- Experimental Mechanics Laboratory, Mechanical Engineering Department, San Diego State University, California, USA
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Gulati K, Zhang Y, Di P, Liu Y, Ivanovski S. Research to Clinics: Clinical Translation Considerations for Anodized Nano-Engineered Titanium Implants. ACS Biomater Sci Eng 2021; 8:4077-4091. [PMID: 34313123 DOI: 10.1021/acsbiomaterials.1c00529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Titania nanotubes (TNTs) fabricated on titanium orthopedic and dental implants have shown significant potential in "proof of concept" in vitro, ex vivo, and short-term in vivo studies. However, most studies do not focus on a clear direction for future research towards clinical translation, and there exists a knowledge gap in identifying key research challenges that must be addressed to progress to the clinical setting. This review focuses on such challenges with respect to anodized titanium implants modified with TNTs, including optimized fabrication on clinically utilized microrough surfaces, clinically relevant bioactivity assessments, and controlled/tailored local release of therapeutics. Further, long-term in vivo investigations in compromised animal models under loading conditions are needed. We also discuss and detail challenges and progress related to the mechanical stability of TNT-based implants, corrosion resistance/electrochemical stability, optimized cleaning/sterilization, packaging/aging, and nanotoxicity concerns. This extensive, clinical translation focused review of TNTs modified Ti implants aims to foster improved understanding of key research gaps and advances, informing future research in this domain.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
| | - Yifan Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology and National Clinical Research Centre for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology and National Clinical Research Centre for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yan Liu
- Laboratory of Biomimetic Nanomaterials, Department of Orthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Sašo Ivanovski
- The University of Queensland, School of Dentistry, Herston, Queensland 4006, Australia
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Rathee G, Bartwal G, Rathee J, Mishra YK, Kaushik A, Solanki PR. Emerging Multimodel Zirconia Nanosystems for High‐Performance Biomedical Applications. ADVANCED NANOBIOMED RESEARCH 2021. [DOI: 10.1002/anbr.202100039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Garima Rathee
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
| | - Gaurav Bartwal
- Hemwati Nandan Bahuguna Garhwal University Birla Campus, Pauri Garhwal Srinagar Uttarakhand 246174 India
| | - Jyotsna Rathee
- CSE Department Deenbandhu Chhoturam University of Science and Technology Murthal Haryana 131039 India
| | - Yogendra Kumar Mishra
- Mads Clausen Institute NanoSYD University of Southern Denmark Alison 2 6400 Sønderborg Denmark
| | - Ajeet Kaushik
- NanoBioTech Laboratory Department of Natural Sciences, Division of Sciences, Art, and Mathematics Florida Polytechnic University Lakeland FL 33805 USA
| | - Pratima R. Solanki
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
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The Use of Lasers in Dental Materials: A Review. MATERIALS 2021; 14:ma14123370. [PMID: 34207048 PMCID: PMC8234179 DOI: 10.3390/ma14123370] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/02/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022]
Abstract
Lasers have been well integrated in clinical dentistry for the last two decades, providing clinical alternatives in the management of both soft and hard tissues with an expanding use in the field of dental materials. One of their main advantages is that they can deliver very low to very high concentrated power at an exact point on any substrate by all possible means. The aim of this review is to thoroughly analyze the use of lasers in the processing of dental materials and to enlighten the new trends in laser technology focused on dental material management. New approaches for the elaboration of dental materials that require high energy levels and delicate processing, such as metals, ceramics, and resins are provided, while time consuming laboratory procedures, such as cutting restorative materials, welding, and sintering are facilitated. In addition, surface characteristics of titanium alloys and high strength ceramics can be altered. Finally, the potential of lasers to increase the adhesion of zirconia ceramics to different substrates has been tested for all laser devices, including a new ultrafast generation of lasers.
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44
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Innovative Surface Modification Procedures to Achieve Micro/Nano-Graded Ti-Based Biomedical Alloys and Implants. COATINGS 2021. [DOI: 10.3390/coatings11060647] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Due to the growing aging population of the world, and as a result of the increasing need for dental implants and prostheses, the use of titanium and its alloys as implant materials has spread rapidly. Although titanium and its alloys are considered the best metallic materials for biomedical applications, the need for innovative technologies is necessary due to the sensitivity of medical applications and to eliminate any potentially harmful reactions, enhancing the implant-to-bone integration and preventing infection. In this regard, the implant’s surface as the substrate for any reaction is of crucial importance, and it is accurately addressed in this review paper. For constructing this review paper, an internet search was performed on the web of science with these keywords: surface modification techniques, titanium implant, biomedical applications, surface functionalization, etc. Numerous recent papers about titanium and its alloys were selected and reviewed, except for the section on forthcoming modern implants, in which extended research was performed. This review paper aimed to briefly introduce the necessary surface characteristics for biomedical applications and the numerous surface treatment techniques. Specific emphasis was given to micro/nano-structured topographies, biocompatibility, osteogenesis, and bactericidal effects. Additionally, gradient, multi-scale, and hierarchical surfaces with multifunctional properties were discussed. Finally, special attention was paid to modern implants and forthcoming surface modification strategies such as four-dimensional printing, metamaterials, and metasurfaces. This review paper, including traditional and novel surface modification strategies, will pave the way toward designing the next generation of more efficient implants.
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Bergamo ETP, Zahoui A, Barrera RB, Huwais S, Coelho PG, Karateew ED, Bonfante EA. Osseodensification effect on implants primary and secondary stability: Multicenter controlled clinical trial. Clin Implant Dent Relat Res 2021; 23:317-328. [PMID: 34047046 PMCID: PMC8362055 DOI: 10.1111/cid.13007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/16/2021] [Accepted: 04/26/2021] [Indexed: 12/12/2022]
Abstract
Background Osseodensification (OD) has shown to improve implant stability; however, the influences of implant design, dimensions, and surgical site characteristics are unknown. Purpose To compare the insertion torque (IT) and temporal implant stability quotients (ISQ) of implants placed via OD or subtractive drilling (SD). Materials and Methods This multicenter controlled clinical trial enrolled 56 patients, whom were in need of at least 2 implants (n = 150 implants). Patients were treated with narrow, regular, or wide implants and short, regular, or long implants in the anterior or posterior region of the maxilla or in the posterior region of the mandible. Osteotomies were performed following manufacturers recommendation. IT was recorded with a torque indicator. ISQ was recorded with resonance frequency analysis immediately after surgery, 3 and 6 weeks. Results Data complied as a function of osteotomy indicated significantly higher IT for OD relative to SD. OD outperformed conventional SD for all pairwise comparisons of arches (maxilla and mandible) and areas operated (anterior and posterior), diameters and lengths of the implants, except for short implants. Overall, ISQ data also demonstrated significantly higher values for OD compared to SD regardless of the healing period. Relative to immediate readings, ISQ values significantly decreased at 3 weeks, returning to immediate levels at 6 weeks; however, ISQ values strictly remained above 68 throughout healing time for OD. Data as a function of arch operated and osteotomy, area operated and osteotomy, implant dimensions and osteotomy, also exhibited higher ISQ values for OD relative to SD on pairwise comparisons, except for short implants. Conclusions OD demonstrated higher IT and temporal ISQ values relative to SD, irrespective of arch and area operated as well as implant design and dimension, with an exception for short implants. Future studies should focus on biomechanical parameters and bone level change evaluation after loading.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
| | - Raúl Bravo Barrera
- Implantology Postgraduate Program, San Sebastian University, Santiago, Chile
| | - Salah Huwais
- Department of Periodontology, Postgraduate Program, University of Illinois at Chicago College of Dentistry, Chicago, Illinois, USA
| | - Paulo G Coelho
- Department of Biomimetics and Biomaterials, NYU College of Dentistry, New York City, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, New York City, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, New York University Grossman School of Medicine, New York City, New York, USA
| | - Edward Dwayne Karateew
- Department of Periodontology, Postgraduate Program, University of Illinois at Chicago College of Dentistry, Chicago, Illinois, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of Sao Paulo Bauru School of Dentistry, Bauru, Sao Paulo, Brazil
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Nobles KP, Janorkar AV, Williamson RS. Surface modifications to enhance osseointegration-Resulting material properties and biological responses. J Biomed Mater Res B Appl Biomater 2021; 109:1909-1923. [PMID: 33871951 DOI: 10.1002/jbm.b.34835] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 02/26/2021] [Accepted: 03/14/2021] [Indexed: 12/18/2022]
Abstract
As life expectancy and the age of the general population increases so does the need for improved implants. A major contributor to the failure of implants is poor osseointegration, which is typically described as the direct connection between bone and implant. This leads to unnecessary complications and an increased burden on the patient population. Modification of the implant surfaces through novel techniques, such as varying topography and/or applying coatings, has become a popular method to enhance the osseointegration capability of implants. Recent research has shown that particular surface features influence how bone cells interact with a material; however, it is unknown which exact features achieve optimal bone integration. In this review, current methods of modifying surfaces will be highlighted, and the resulting surface characteristics and biological responses are discussed. Review of the current strategies of surface modifications found that many coating types are more advantageous when used in combination; however, finding a surface modification that utilizes the mutual beneficial effects of important surface characteristics while still maintaining commercial viability is where future challenges exist.
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Affiliation(s)
- Kadie P Nobles
- Department of Biomedical Materials Science, School of Dentistry, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Amol V Janorkar
- Department of Biomedical Materials Science, School of Dentistry, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Randall S Williamson
- Department of Biomedical Materials Science, School of Dentistry, University of Mississippi Medical Center, Jackson, Mississippi, USA
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47
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Bergamo ETP, Bastos TMC, Lopes ACO, de Araujo Júnior ENS, Coelho PG, Benalcazar Jalkh EB, Zahoui A, Bonfante EA. Physicochemical and mechanical characterization of a fiber-reinforced composite used as frameworks of implant-supported prostheses. Dent Mater 2021; 37:e443-e453. [PMID: 33865619 DOI: 10.1016/j.dental.2021.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/31/2020] [Accepted: 03/29/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To characterize the physicochemical and mechanical properties of a milled fiber-reinforced composite (FRC) for implant-supported fixed dental prostheses (FDPs). METHODS For FRC characterization, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction, Fourier-transformed infrared spectrometry, simultaneous thermogravimetric analysis and differential scanning calorimetry were performed. For fatigue testing, 3-unit FRC frameworks were fabricated with conventional (9 mm2 connector area) and modified designs (12 mm2 connector area and 2.5 mm-height lingual extension). A hybrid resin composite was veneered onto the frameworks. FDPs were subjected to step-stress accelerated-life fatigue testing until fracture or suspension. Use level probability Weibull curves at 300 N were plotted and the reliability for 100,000 cycles at 300, 600 and 800 N was calculated. Fractographic analysis was performed by stereomicroscope and SEM. RESULTS The FRC consisted of an epoxy resin (∼25%) matrix reinforced with inorganic particles and glass fibers (∼75%). Multi-layer continuous regular-geometry fibers were densely arranged in a parallel and bidirectional fashion in the resin matrix. Fatigue analysis demonstrated high probability of survival (99%) for FDPs at 300 N, irrespective of framework design. Conventional FDPs showed a progressive decrease in the reliability at 600 (84%) and 800 N (19%), whereas modified FDPs reliability significantly reduced only at 800 N (75%). The chief failure modes for FRC FDPs were cohesive fracture of the veneering composite on lower loads and adhesive fracture of the veneering composite at higher loads. SIGNIFICANCE Milled epoxy resin matrix reinforced with glass fibers composite resulted in high probability of survival in the implant-supported prosthesis scenario.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil.
| | - Tiago M C Bastos
- Department of Physics, Technological Institute of Aeronautics, 50 Marechal Eduardo Gomes, 12228-900, São José dos Campos, SP, Brazil
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Everardo N S de Araujo Júnior
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Hansjorg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, 345 24th Street, 10010, New York City, NY, USA
| | - Ernesto B Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil; Department of Biomaterials and Biomimetics, Hansjorg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, 345 24th Street, 10010, New York City, NY, USA
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
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Liu Y, Rui Z, Cheng W, Song L, Xu Y, Li R, Zhang X. Characterization and evaluation of a femtosecond laser-induced osseointegration and an anti-inflammatory structure generated on a titanium alloy. Regen Biomater 2021; 8:rbab006. [PMID: 33738120 PMCID: PMC7955712 DOI: 10.1093/rb/rbab006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/05/2021] [Accepted: 01/14/2021] [Indexed: 02/07/2023] Open
Abstract
Cell–material interactions during early osseointegration of the bone–implant interface are critical and involve crosstalk between osteoblasts and osteoclasts. The surface properties of titanium implants also play a critical role in cell–material interactions. In this study, femtosecond laser treatment and sandblasting were used to alter the surface morphology, roughness and wettability of a titanium alloy. Osteoblasts and osteoclasts were then cultured on the resulting titanium alloy disks. Four disk groups were tested: a polished titanium alloy (pTi) control; a hydrophilic micro-dislocation titanium alloy (sandblasted Ti (STi)); a hydrophobic nano-mastoid Ti alloy (femtosecond laser-treated Ti (FTi)); and a hydrophilic hierarchical hybrid micro-/nanostructured Ti alloy [femtosecond laser-treated and sandblasted Ti (FSTi)]. The titanium surface treated by the femtosecond laser and sandblasting showed higher biomineralization activity and lower cytotoxicity in simulated body fluid and lactate dehydrogenase assays. Compared to the control surface, the multifunctional titanium surface induced a better cellular response in terms of proliferation, differentiation, mineralization and collagen secretion. Further investigation of macrophage polarization revealed that increased anti-inflammatory factor secretion and decreased proinflammatory factor secretion occurred in the early response of macrophages. Based on the above results, the synergistic effect of the surface properties produced an excellent cellular response at the bone–implant interface, which was mainly reflected by the promotion of early ossteointegration and macrophage polarization.
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Affiliation(s)
- Yang Liu
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, China.,Institute of Medical Service Support, Institute of Systems Engineering, Academy of Military Sciences, Tianjin, China
| | - Zhongying Rui
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Wei Cheng
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, China.,Institute of Medical Service Support, Institute of Systems Engineering, Academy of Military Sciences, Tianjin, China
| | - Licheng Song
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, China.,Institute of Medical Service Support, Institute of Systems Engineering, Academy of Military Sciences, Tianjin, China
| | - Yunqiang Xu
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Ruixin Li
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin 300041, China
| | - Xizheng Zhang
- Institute of Medical Service Support, Institute of Systems Engineering, Academy of Military Sciences, Tianjin, China
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Bergamo ETP, Yamaguchi S, Coelho PG, Lopes ACO, Lee C, Bonfante G, Benalcázar Jalkh EB, de Araujo-Júnior ENS, Bonfante EA. Survival of implant-supported resin-matrix ceramic crowns: In silico and fatigue analyses. Dent Mater 2021; 37:523-533. [PMID: 33483102 DOI: 10.1016/j.dental.2020.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/20/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the fatigue survival, failure mode, and maximum principal stress (MP Stress) and strain (MP Strain) of resin-matrix ceramic systems used for implant-supported crowns. METHODS Identical molar crowns were milled using four resin-matrix ceramics (n = 21/material): (i) Shofu Hard, (ii) Cerasmart (iii) Enamic, and (iv) Shofu HC. Crowns were cemented on the abutments, and the assembly underwent step-stress accelerated-life testing. Use level probability Weibull curves at 300 N were plotted and the reliability at 300, 500 and 800 N was calculated for a mission of 50,000 cycles. Fractographic analysis was performed using stereomicroscope and scanning electron microscope. MP Stress and MP Strain were determined by finite element analysis. RESULTS While fatigue dictated failures for Cerasmart (β > 1), material strength controlled Shofu Hard, Enamic, and Shofu HC failures (β < 1). Shofu HC presented lower reliability at 300 N (79%) and 500 N (59%) than other systems (>90%), statistically different at 500 N. Enamic (57%) exhibited a significant reduction in the probability of survival at 800 N, significantly lower than Shofu Hard and Cerasmart; however, higher than Shofu HC (12%). Shofu Hard and Cerasmart (>93%) demonstrated no significant difference for any calculated mission (300-800 N). Failure mode predominantly involved resin-matrix ceramic fracture originated from occlusal cracks, corroborating with the MP Stress and Strain location, propagating through the proximal and cervical margins. SIGNIFICANCE All resin-matrix ceramics crowns demonstrated high probability of survival in a physiological molar load, whereas Shofu Hard and Cerasmart outperformed Enamic and Shofu HC at higher loads. Material fracture comprised the main failure mode.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil.
| | - Satoshi Yamaguchi
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, 565-0871, Suita, Osaka, Japan
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Hansjorg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, 345 24th Street, 10010, New York City, NY, USA
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Chunwoo Lee
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, 565-0871, Suita, Osaka, Japan
| | - Gerson Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Everardo N S de Araujo-Júnior
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
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50
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Yu M, Wan Y, Ren B, Wang H, Zhang X, Qiu C, Liu A, Liu Z. 3D Printed Ti-6Al-4V Implant with a Micro/Nanostructured Surface and Its Cellular Responses. ACS OMEGA 2020; 5:31738-31743. [PMID: 33344827 PMCID: PMC7745418 DOI: 10.1021/acsomega.0c04373] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/23/2020] [Indexed: 06/12/2023]
Abstract
Three-dimensional (3D) printing technology has been proved to be a powerful tool for the free-form fabrication of titanium (Ti) implants. However, the surface quality of 3D printed Ti implants is not suitable for clinical application directly. Therefore, surface modification of 3D printed Ti implants is required in order to achieve good biocompatibility and osseointegration. In this study, a novel surface modification method of 3D printed Ti-6Al-4V implants has been proposed, which combined acid etching with hydrothermal treatment to construct micro/nanostructures. Polished TC4 sheets (P), electron beam melting Ti sheets (AE), and micro/nanostructured Ti sheets (AMH) were used in this study to evaluate the effects of different surface morphologies on cellular responses. The surface morphology and 3D topography after treatment were detected via scanning electron microscopy and laser scanning microscopy. The results illustrated that a hierarchical structure comprising micro-valleys and nanowires with a surface roughness of 14.388 μm was successfully constructed. Compared with group P samples, the hydrophilicity of group AMH samples significantly increased with a reduced water contact angle from 54.9° to 4.5°. Cell culture experiments indicated that the micro/nanostructures on the material surface could enhance the cell adhesion and proliferation of MC3T3s. The microstructure could enhance bone-to-implant contact, and the nanostructure could directly interact with some cell membrane receptors. Overall, this study proposes a new strategy to construct micro/nanostructures on the surface of 3D printed Ti-6Al-4V implants and may further serve as a potential modification method for better osteogenesis ability.
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Affiliation(s)
- Mingzhi Yu
- Key
Laboratory of High Efficiency and Clean Manufacturing, School of Mechanical
Engineering, Shandong University, Jinan 250061, China
| | - Yi Wan
- Key
Laboratory of High Efficiency and Clean Manufacturing, School of Mechanical
Engineering, Shandong University, Jinan 250061, China
| | - Bing Ren
- Department
of Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida 32611, United States
| | - Hongwei Wang
- Key
Laboratory of High Efficiency and Clean Manufacturing, School of Mechanical
Engineering, Shandong University, Jinan 250061, China
| | - Xiao Zhang
- Key
Laboratory of High Efficiency and Clean Manufacturing, School of Mechanical
Engineering, Shandong University, Jinan 250061, China
| | - Cheng Qiu
- Cheeloo
College of Medicine, Shandong University, Jinan, Shandong 250012, China
| | - Anqi Liu
- Key
Laboratory of High Efficiency and Clean Manufacturing, School of Mechanical
Engineering, Shandong University, Jinan 250061, China
| | - Zhanqiang Liu
- Key
Laboratory of High Efficiency and Clean Manufacturing, School of Mechanical
Engineering, Shandong University, Jinan 250061, China
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