1
|
López-García S, Pérez-Guzmán N, Rodríguez-Lozano FJ, Pecci-Lloret MP, García-Bernal D, Murcia L, Oñate-Sánchez RE, Llena C. Biological Effects of New Chemical-Mechanical Caries Removal Products on Human Dental Pulp Stem Cells. Caries Res 2024:1-13. [PMID: 38959874 DOI: 10.1159/000540119] [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: 08/15/2023] [Accepted: 05/24/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION The aim of this study was to compare the biological effects of four chemical caries removal materials and to assess their cytotoxicity using human dental pulp stem cells (hDPSCs). METHODS The products evaluated are: 1 - papain-based product (BRIX 3000®); 2 - papain/chloramine based products (NATURAL-CARE and Papacárie Duo®); and 3 - chloramine based product (Cariesolut). The following in vitro experiments were carried out: IC50 measurement, cell metabolic activity (MTT) assay, cell migration, immunofluorescence experiment, cell apoptosis analysis, and reactive oxygen species (ROS) production analysis. Statistical analyses were performed using one-way ANOVA followed by Tukey's post hoc test (p < 0.05). RESULTS The IC50 values were: Brix 3000: 0.596%; Papacárie Duo: 0.052%; NATURAL CARE: 1.034%; and Cariesolut: 0.020%. The MTT assays showed non-adequate cell viability of all chemical-mechanical caries removal tested at 2% at 24, 48, and 72 h (p < 0.001). The same behaviour was observed at 0.1% in the Papacárie Duo and Cariesolut groups. In contrast, 0.1% of Brix 3000 at all times and NATURAL CARE at 24 h treated cells showed cell viability rates similar to the control group. At 0.01% only Brix 3000 did not show statistically significant differences at any time. Delayed cell migration was observed in all hDPSCs treated with Papacárie Duo and Cariesolut (p < 0.01 and p < 0.001). Phalloidin staining images showed a high confluence of cells in the presence of NATURAL CARE, similar to the control group. On the contrary, no cells were observed in Brix 3000 and Cariesolut at 2% and 0.1% concentrations. Papacárie Duo showed cells at all concentrations, but hDPSCs treated at 0.01% concentration exhibited better proliferation and spreading than those in the control group. Apoptosis essay showed that Brix 3000 at both 0.1% and 0.01% had a percentage of live cells higher than 99%, with 68.4% live cells at 2%, 3.69% early apoptotic cells, and 27.9% late apoptotic cells. Conversely, the rest of the materials showed an abundance of apoptotic cells, even at low concentrations. 0.1% and 0.01% of BRIX 3000 did not affect the ROS production levels, while 2% of BRIX 3000 counterpart very significantly increased the percentage of CM-H2DCFDA positive cells. Again, all concentrations of Cariesolut showed significantly higher levels of ROS production than those observed in control cells. CONCLUSION Our results suggest that Brix 3000 would be the most suitable material for chemical caries removal, with Papacárie Duo and NATURAL CARE also being good options, and discourage the use of Cariesolut due to its low cytocompatibility on dental pulp stem cells.
Collapse
Affiliation(s)
- Sergio López-García
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| | - Nuria Pérez-Guzmán
- Department of Dermatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia, Spain
| | - Francisco J Rodríguez-Lozano
- Department of Dermatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia, Spain
| | - María Pilar Pecci-Lloret
- Department of Dermatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia, Spain
| | - David García-Bernal
- Department of Biochemistry, Molecular Biology B and Immunology, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia, Spain
| | - Laura Murcia
- Department of Health Sciences, Catholic University San Antonio of Murcia, Murcia, Spain
| | - Ricardo E Oñate-Sánchez
- Department of Dermatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, IMIB Pascual Parrilla, Murcia, Spain
| | - Carmen Llena
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, Valencia, Spain
| |
Collapse
|
2
|
Mora A, García-Bernal D, Rodríguez-Lozano FJ, Sanz JL, Forner L, Ghilotti J, Lozano A, López-García S. Biocompatibility, bioactivity and immunomodulatory properties of three calcium silicate-based sealers: an in vitro study on hPDLSCs. Clin Oral Investig 2024; 28:416. [PMID: 38969964 PMCID: PMC11226489 DOI: 10.1007/s00784-024-05812-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 06/29/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVES To assess the biocompatibility, bioactivity, and immunomodulatory properties of three new calcium silicate cement-based sealers: Ceraseal (CS), Totalfill BC Sealer (TFbc) and WellRoot ST (WR-ST) on human periodontal ligament stem cells (hPDLSCs). MATERIALS AND METHODS HPDLSCs were isolated from extracted third molars from healthy patients. Eluates (1:1, 1:2, and 1:4 ratio) and sample discs of CS, TFbc and WR-ST after setting were prepared. A series of assays were performed: cell characterization, cell metabolic activity (MTT assay) cell attachment and morphology (SEM assay), cell migration (wound-healing assay), cytoskeleton organization (phaloidin-based assay); IL-6 and IL-8 release (ELISA); differentiation marker expression (RT-qPCR assay), and cell mineralization (Alizarin Red S staining). HPDLSCs cultured in unconditioned (negative control) or osteogenic (positive control) culture media were used as a comparison. Statistical significance was established at p < 0.05. RESULTS All the tested sealers exhibited similar results in the cytocompatibility assays (cell metabolic activity, migration, attachment, morphology, and cytoskeleton organization) compared with a negative control group. CS and TFbc exhibited an upregulation of at least one osteo/cementogenic marker compared to the negative and positive control groups. CS and TFbc also showed a significantly higher calcified nodule formation than the negative and positive control groups. Both the marker expression and calcified nodule formation were significantly higher in CS-treated cells than TFbc treated cells. WR-ST exhibited similar results to the control group. CS and TFbc-treated cells exhibited a significant downregulation of IL-6 after 72 h of culture compared to the negative control group (p < 0.05). CONCLUSION All the tested sealers exhibited an adequate cytocompatibility. CS significantly enhances cell differentiation by upregulating the expression of key genes associated with bone and cementum formation. Additionally, CS was observed to facilitate the mineralization of the extracellular matrix effectively. In contrast, the effects of TFbc and WR-ST on these processes were less pronounced compared to CS. Furthermore, both CS and TFbc exhibited an anti-inflammatory potential, contributing to their potential therapeutic benefits in regenerative endodontics. CLINICAL RELEVANCE This is the first study to compare the biological properties and immunomodulatory potential of Ceraseal, Totalfill BC Sealer, and WellRoot ST. The results act as supporting evidence for their use in root canal treatment.
Collapse
Affiliation(s)
- Alejandro Mora
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, 30008, Spain
| | - David García-Bernal
- Department of Biochemistry, Molecular Biology B and Immunology, Faculty of Medicine, Biomedical Research Institute (IMIB), University of Murcia, Murcia, 30120, Spain
| | - Francisco Javier Rodríguez-Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, 30008, Spain
| | - José Luis Sanz
- Department of Stomatology, Faculty of Medicine and Dentistry Universitat de València, C/ Gascó Oliag 1, Valencia, 46010, Spain.
| | - Leopoldo Forner
- Department of Stomatology, Faculty of Medicine and Dentistry Universitat de València, C/ Gascó Oliag 1, Valencia, 46010, Spain
| | - James Ghilotti
- Department of Stomatology, Faculty of Medicine and Dentistry Universitat de València, C/ Gascó Oliag 1, Valencia, 46010, Spain
| | - Adrián Lozano
- Department of Stomatology, Faculty of Medicine and Dentistry Universitat de València, C/ Gascó Oliag 1, Valencia, 46010, Spain
| | - Sergio López-García
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, Murcia, 30008, Spain
| |
Collapse
|
3
|
López-García S, Sanz JL, Oñate-Sánchez RE, Forner L, García-Bernal D, Murcia L, Rodríguez-Lozano FJ, Llena C. In vitro biocompatibility of ammonia-free silver fluoride products on human dental pulp stem cells. Tissue Cell 2024; 86:102283. [PMID: 38113650 DOI: 10.1016/j.tice.2023.102283] [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: 10/01/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Silver fluoride (SF) is a preventive and therapeutic option for dental pathological processes involving structural alterations of the hard tissues, either during their formation or those caused by caries or other pathological reasons. This study aimed to compare the biological properties of two commercial SF products, one of them with ammonium (Riva Star; SDF) and the other ammonium-free (Riva Star Aqua; AgF), both with or without potassium iodide (KI), by the assessment of the cytotoxicity of the materials' eluates. METHODS Human dental pulp stem cells (hDPSCs) were obtained from healthy 18-23-year-old donors. Three dilutions were prepared for the tested materials (0.005%, 0.0005%, and 0.0001%). The following groups were assessed: (AgF, AgF+KI, SDF, SDF+KI, KI, negative control). A series of cytocompatibility assays were performed: MTT assay, IC50 assay, wound healing (migration) assay, cell cytoskeleton staining, analysis of cell apoptosis and necrosis, and reactive oxygen species production. The normality in the distribution of the data was previously confirmed via a Q-Q plot. Statistical significance was tested using one way ANOVA and Tukey's post hoc test. RESULTS The incorporation of KI improved the cytocompatibility of both SF products in terms of viability, migration, morphology, apoptosis, and reactive oxygen species production. This difference was higher in the AgF group. The lowest dilutions of SF+KI and AgF+KI showed a similar cytocompatibility to that of the control group (MTT assay (p > 0.05 after 24, 48, and 72 h of culture); migration assay (p > 0.05 after 24, 48, and 72 h of culture); reactive oxygen species production (p > 0.05 after 72 h of culture). SIGNIFICANCE Riva Star Aqua shows lower cytotoxicity than Riva Star on hDPSCs. It can be considered as a good alternative in the conservative treatment of dental caries and in the preservation and remineralisation of viable dentine tissue.
Collapse
Affiliation(s)
| | - José Luis Sanz
- Department of Stomatology, Universitat de València, 46010 Valencia, Spain
| | - Ricardo E Oñate-Sánchez
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain.
| | - Leopoldo Forner
- Department of Stomatology, Universitat de València, 46010 Valencia, Spain
| | - David García-Bernal
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain
| | - Laura Murcia
- Department of Health Sciences, Catholic University San Antonio of Murcia, 30107 Murcia, Spain
| | - Francisco J Rodríguez-Lozano
- Department of Dermatology, Stomatology, Radiology and Physical Medicine, Morales Meseguer Hospital, Faculty of Medicine, IMIB-Arrixaca, University of Murcia, 30008 Murcia, Spain
| | - Carmen Llena
- Department of Stomatology, Universitat de València, 46010 Valencia, Spain
| |
Collapse
|
4
|
Tuna T, Wein M, Altmann B, Steinberg T, Fischer J, Att W. Effect of Hydrogen Peroxide on the Surface and Attractiveness of Various Zirconia Implant Materials on Human Osteoblasts: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:961. [PMID: 36769968 PMCID: PMC9918077 DOI: 10.3390/ma16030961] [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: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The aim of this in vitro study was to investigate the effect of hydrogen peroxide (H2O2) on the surface properties of various zirconia-based dental implant materials and the response of human alveolar bone osteoblasts. For this purpose, discs of two zirconia-based materials with smooth and roughened surfaces were immersed in 20% H2O2 for two hours. Scanning electron and atomic force microscopy showed no topographic changes after H2O2-treatment. Contact angle measurements (1), X-ray photoelectron spectroscopy (2) and X-ray diffraction (3) indicated that H2O2-treated surfaces (1) increased in hydrophilicity (p < 0.05) and (2) on three surfaces the carbon content decreased (33-60%), while (3) the monoclinic phase increased on all surfaces. Immunofluorescence analysis of the cell area and DNA-quantification and alkaline phosphatase activity revealed no effect of H2O2-treatment on cell behavior. Proliferation activity was significantly higher on three of the four untreated surfaces, especially on the smooth surfaces (p < 0.05). Within the limitations of this study, it can be concluded that exposure of zirconia surfaces to 20% H2O2 for 2 h increases the wettability of the surfaces, but also seems to increase the monoclinic phase, especially on roughened surfaces, which can be considered detrimental to material stability. Moreover, the H2O2-treatment has no influence on osteoblast behavior.
Collapse
Affiliation(s)
- Taskin Tuna
- Department of Prosthodontics and Biomaterials, School of Dentistry, RWTH University Aachen, Pauwelsstr. 30, 52062 Aachen, Germany
| | - Martin Wein
- Division of Oral Biotechnology, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Brigitte Altmann
- G.E.R.N. Research Center for Tissue Replacement, Regeneration & Neogenesis, Department of Prosthetic Dentistry, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Thorsten Steinberg
- Division of Oral Biotechnology, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Jens Fischer
- Division of Biomaterials and Technology, Clinic for Reconstructive Dentistry University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland
| | - Wael Att
- Department of Prosthodontics, School of Dental Medicine Tufts University, Boston, MA 02111, USA
| |
Collapse
|
5
|
Rohr N, Schönenberger AJ, Fischer J. Influence of Surface Treatment and Accelerated Ageing on Biaxial Flexural Strength and Hardness of Zirconia. MATERIALS (BASEL, SWITZERLAND) 2023; 16:910. [PMID: 36769917 PMCID: PMC9917567 DOI: 10.3390/ma16030910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/10/2023] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
The aim was to investigate how the surface treatment and the process of accelerated ageing of zirconia for dental implants affect the biaxial flexural strength and hardness. Zirconia discs with a diameter of 12.6 mm were subjected to either one of the following treatments: polishing (Zp); polishing and heat treatment at 1250 °C for 1 h (Zpt); machining (Zm); machining and heat treatment (Zmt); or sandblasting, acid-etching, and heat treatment (Z14) (n = 45 per group). Biaxial flexural strength and Martens hardness (HM) were measured without further treatment and after accelerated ageing for 5 h or 5 × 5 h according to ISO 13356 (n = 15 per group). Two-way ANOVA was applied to test the effect of surface treatment and ageing (α = 0.05). The reliability of the specimens was described with Weibull two-parameter distribution of biaxial flexural strength data. Overall, the surface treatment (p < 0.001) and ageing (p = 0.012) revealed a significant effect on biaxial flexural strength values, while HM was only affected by the surface treatment (p < 0.001) but not ageing (p = 0.160). Surface treatment significantly affected HM (p < 0.001) but not ageing (p = 0.160). The applied surface treatments affected the biaxial flexural strength and HM of zirconia. For accelerated ageing, a duration of both 5 h and 5 × 5 h is recommended to evaluate the effect of surface treatments. Zm was the most reliable surface as it was least affected by ageing and provided low standard deviations of biaxial flexural strength values.
Collapse
|
6
|
Nakai H, Inokoshi M, Nozaki K, Yoshihara K, Matsukawa A, Nagaoka N, Tonprasong W, Minakuchi S. Osteoblast Response of Additively Manufactured Zirconia and Alumina-Toughened Zirconia. MATERIALS (BASEL, SWITZERLAND) 2022; 15:8685. [PMID: 36500180 PMCID: PMC9739127 DOI: 10.3390/ma15238685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Zirconia ceramics have been widely used in dentistry. Herein, we assess the surface morphology, surface texture, and osteoblast response of additively manufactured zirconia and alumina-toughened zirconia (ATZ) in comparison with titanium. The surface roughness, contact angle, and surface microstructure of titanium sandblasted with large-grit alumina and subsequently acid-etched using 18% HCl and 49% H2SO4 (SLA-titanium), uniaxially pressed zirconia (UP zirconia), additively manufactured zirconia (AM zirconia), and additively manufactured ATZ (AM ATZ) were investigated. Moreover, the cell viability, alkaline phosphatase (ALP) activity, and gene expression of type I collagen on these materials were evaluated. The data were statistically analyzed using one-way ANOVA with Tukey's post hoc test. SLA-titanium showed the highest surface roughness and contact angle. The other three materials showed comparable surface roughness and contact angles. Micro- and nanoroughness were observed on the surface of SLA-titanium. UP zirconia and AM zirconia had similar surface morphologies. The cell viability, ALP activity, and gene expression of type I collagen on AM zirconia were comparable to or better than those on SLA-titanium. Our results indicate that AM zirconia is a promising material for zirconia dental implants.
Collapse
Affiliation(s)
- Hiroto Nakai
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Masanao Inokoshi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Kosuke Nozaki
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Kumiko Yoshihara
- Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), 2217-14 Hayashicho, Takamatsu 761-0395, Japan
- Department of Pathology & Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita, Okayama 700-8558, Japan
| | - Akihiro Matsukawa
- Department of Pathology & Experimental Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita, Okayama 700-8558, Japan
| | - Noriyuki Nagaoka
- Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, 2-5-1 Shikatacho, Kita, Okayama 700-8558, Japan
| | - Watcharapong Tonprasong
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, 99 Village No.9, Phitsanulok-Nakhon Sawan Road, Tha Pho, Mueang Phitsanulok District, Phitsanulok 65000, Thailand
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| |
Collapse
|
7
|
Surface Structure of Zirconia Implants: An Integrative Review Comparing Clinical Results with Preclinical and In Vitro Data. MATERIALS 2022; 15:ma15103664. [PMID: 35629692 PMCID: PMC9143528 DOI: 10.3390/ma15103664] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 01/27/2023]
Abstract
Background: The purpose of this review was to analyze and correlate the findings for zirconia implants in clinical, preclinical and in vitro cell studies in relation to surface structure. Methods: Electronic searches were conducted to identify clinical, preclinical and in vitro cell studies on zirconia implant surfaces. The primary outcomes were mean bone loss (MBL) for clinical studies, bone-to-implant contact (BIC) and removal torque (RT) for preclinical studies and cell spreading, cell proliferation and gene expression for cell studies. The secondary outcomes included comparisons of data found for those surfaces that were investigated in all three study types. Results: From 986 screened titles, 40 studies were included for data extraction. In clinical studies, only micro-structured surfaces were investigated. The lowest MBL was reported for sandblasted and subsequently etched surfaces, followed by a sinter and slurry treatment and sandblasted surfaces. For BIC, no clear preference of one surface structure was observable, while RT was slightly higher for micro-structured than smooth surfaces. All cell studies showed that cell spreading and cytoskeletal formation were enhanced on smooth compared with micro-structured surfaces. Conclusions: No correlation was observed for the effect of surface structure of zirconia implants within the results of clinical, preclinical and in vitro cell studies, underlining the need for standardized procedures for human, animal and in vitro studies.
Collapse
|
8
|
Stability of Cantilever Fixed Dental Prostheses on Zirconia Implants. MATERIALS 2022; 15:ma15103633. [PMID: 35629659 PMCID: PMC9144678 DOI: 10.3390/ma15103633] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 01/13/2023]
Abstract
Background: The objective was to determine the optimal connector size and position within zirconia disks for implant-supported cantilever fixed dental prostheses (ICFDP). Methods: Two-unit ICFDPs (n = 60) were designed for the premolar region with connector sizes of either 9 or 12 mm2 and positioned in the enamel or dentin layer of two different types of zirconia disks. The restorations were milled and cemented onto zirconia implants. After simulated chewing for 1.2 Mio cycles, the fracture load was measured and fractures were analyzed. Results: No fractures of ICFDPs or along the implants were detected after simulated aging. The mean fracture load values were significantly higher for a connector size of 9 mm2 (951 N) compared with 12 mm2 (638 N). For the zirconia material with a higher biaxial flexural strength, the fracture load values were increased from 751 to 838 N, but more implant fractures occurred. The position within the zirconia disk did not influence the fracture load. Conclusions: A connector size of 9 mm2 and a zirconia material with a lower strength should be considered when designing ICFDPS on zirconia implants to reduce the risk of fractures along the intraosseous implant portion.
Collapse
|
9
|
Haugen HJ, Chen H. Is There a Better Biomaterial for Dental Implants than Titanium?—A Review and Meta-Study Analysis. J Funct Biomater 2022; 13:jfb13020046. [PMID: 35645254 PMCID: PMC9149859 DOI: 10.3390/jfb13020046] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/28/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
This article focuses on preclinical studies and reviews the available evidence from the literature on dental implant and abutment materials in the last decade. Specifically, different peri-implantitis materials and how surface modifications may affect the peri-implant soft-tissue seal and subsequently delay or hinder peri-implantitis are examined. This review analyzed more than 30 studies that were Randomized Controlled Trials (RCTs), Controlled Clinical Trials (CCTs), or prospective case series (CS) with at least six months of follow-up. Meta-analyses were performed to make a comparison between different implant materials (titanium vs. zirconia), including impact on bone changes, probing depth, plaque levels, and peri-implant mucosal inflammation, as well as how the properties of the implant material and surface modifications would affect the peri-implant soft-tissue seal and peri-implant health conditions. However, there was no clear evidence regarding whether titanium is better than other implant materials. Clinical evidence suggests no difference between different implant materials in peri-implant bone stability. The metal analysis offered a statistically significant advantage of zirconia implants over titanium regarding developing a favorable response to the alveolar bone.
Collapse
Affiliation(s)
- Håvard J. Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
- Correspondence:
| | - Hongyu Chen
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180, USA;
| |
Collapse
|
10
|
Jaeggi M, Gyr S, Astasov-Frauenhoffer M, Zitzmann NU, Fischer J, Rohr N. Influence of different zirconia surface treatments on biofilm formation in vitro and in situ. Clin Oral Implants Res 2022; 33:424-432. [PMID: 35137461 PMCID: PMC9304171 DOI: 10.1111/clr.13902] [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: 08/23/2021] [Revised: 01/10/2022] [Accepted: 01/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine if the surface treatment of zirconia affects biofilm formation in an in vitro three-species biofilm model and in situ. MATERIAL AND METHODS Zirconia surfaces considered for the transmucosal portion of a zirconia implant were compared with polished pure titanium grade 4 (Tp). Discs 13 mm in diameter of either polished (Zp), polished and heat-treated (Zpt), machined (Zm), machined and heat-treated (Zmt) and sandblasted, etched and heat-treated (Z14) zirconia were fabricated. Surface roughness and wettability of specimens was measured. Biofilm formation was evaluated by safranin staining and scanning electron microscopy (SEM) using a three-species model, and intraorally with 16 volunteers carrying oral splints in two independent experiments. Relative biofilm formation was compared with Kruskal-Wallis followed by Bonferroni post-hoc test (α=0.05). RESULTS In vitro biofilm formation with optical density values on Zp (0.14±0.01), Zpt (0.14±0.02), Zm (0.13±0.01) and Zmt (0.13±0.01) was significantly lower than on Tp (0.21±0.05) and Z14 (0.20±0.04) (p<0.05). In situ biofilm formation was significantly higher on Z14 (0.56±0.45) (p<0.05), while no significant differences in optical density were observed among Zp (0.25±0.20), Zm (0.36±0.34) and Tp (0.28±0.22). SEM analysis supported quantitative findings. CONCLUSIONS In the in vitro three-species biofilm model differences in material and surface roughness affected biofilm formation. In situ biofilm formation was mainly affected by the surface roughness of the specimens. Polishing of zirconia is recommended to reduce biofilm formation while heat-treatment has no significant effect.
Collapse
Affiliation(s)
- Marco Jaeggi
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Sharon Gyr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Monika Astasov-Frauenhoffer
- Department of Research, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Jens Fischer
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Nadja Rohr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland.,Department of Research, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| |
Collapse
|
11
|
Wagner G, Eggers B, Duddeck D, Kramer FJ, Bourauel C, Jepsen S, Deschner J, Nokhbehsaim M. Influence of cold atmospheric plasma on dental implant materials - an in vitro analysis. Clin Oral Investig 2021; 26:2949-2963. [PMID: 34907458 PMCID: PMC8898257 DOI: 10.1007/s00784-021-04277-w] [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: 06/15/2021] [Accepted: 11/01/2021] [Indexed: 12/25/2022]
Abstract
Background and objectives Alterations in the microenvironment of implant surfaces could influence the cellular crosstalk and adhesion patterns of dental implant materials. Cold plasma has been described to have an influence on cells, tissues, and biomaterials. Hence, the mechanisms of osseointegration may be altered by non-thermal plasma treatment depending on different chemical compositions and surface coatings of the biomaterial. The aim of the present study is to investigate the influence of cold atmospheric plasma (CAP) treatment on implant surfaces and its biological and physicochemical side effects. Materials and methods Dental implant discs from titanium and zirconia with different surface modifications were treated with CAP at various durations. Cell behavior and adhesion patterns of human gingival fibroblast (HGF-1) and osteoblast-like cells (MG-63) were examined using scanning electron microscopy and fluorescence microscopy. Surface chemical characterization was analyzed using energy-dispersive X-ray spectroscopy (EDS). Quantitative analysis of cell adhesion, proliferation, and extracellular matrix formation was conducted including real-time PCR. Results CAP did not affect the elemental composition of different dental implant materials. Additionally, markers for cell proliferation, extracellular matrix formation, and cell adhesion were differently regulated depending on the application time of CAP treatment in MG-63 cells and gingival fibroblasts. Conclusions CAP application is beneficial for dental implant materials to allow for faster proliferation and adhesion of cells from the surrounding tissue on both titanium and zirconia implant surfaces with different surface properties. Clinical relevance The healing capacity provided through CAP treatment could enhance osseointegration of dental implants and has the potential to serve as an effective treatment option in periimplantitis therapy.
Collapse
Affiliation(s)
- Gunar Wagner
- Department of Periodontology, Operative and Preventive Dentistry, Center of Dento-Maxilo-Facial Medicine, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany.
| | - Benedikt Eggers
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111, Bonn, Germany
| | - Dirk Duddeck
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, University Charité Berlin, 14197, Berlin, Germany.,Research Department, CleanImplant Foundation, 10117, Berlin, Germany
| | - Franz-Josef Kramer
- Department of Oral Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111, Bonn, Germany.,Department of Cranio-Maxillofacial Surgery, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111, Bonn, Germany
| | - Christoph Bourauel
- Department of Oral Technology, School of Dentistry, University of Bonn, 53111, Bonn, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, Center of Dento-Maxilo-Facial Medicine, University of Bonn, Welschnonnenstr. 17, 53111, Bonn, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University of Mainz, 55131, Mainz, Germany
| | - Marjan Nokhbehsaim
- Section of Experimental Dento-Maxillo-Facial Medicine, Center of Dento-Maxillo-Facial Medicine, University of Bonn, 53111, Bonn, Germany
| |
Collapse
|
12
|
Rohr N, Balmer M, Jung RE, Kohal RJ, Spies BC, Hämmerle CHF, Fischer J. Influence of zirconia implant surface topography on first bone implant contact within a prospective cohort study. Clin Implant Dent Relat Res 2021; 23:593-599. [PMID: 34047019 DOI: 10.1111/cid.13013] [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: 01/19/2021] [Revised: 04/12/2021] [Accepted: 04/29/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Although 5-year clinical data exist for different zirconia implants, no analysis has yet been performed focusing on how the surface topography of the implant affects clinical parameters. PURPOSE To analyze the influence of zirconia implant topography on first bone implant contact (fBIC). MATERIALS AND METHODS In a prospective two-center cohort investigation 63 zirconia implants were evaluated at implant placement, prosthetic delivery, 1, 3, and 5 years. The distance (DIB) between implant shoulder and fBIC was measured at each time point in periapical radiographs at mesial and distal sites. Two-way ANOVA/Bonferroni was used to analyze the effects of time and center (α < 0.05). RESULTS Between the centers, the mean DIB varied significantly at implant placement (Freiburg [FR]: 1.4 ± 0.6 mm; Zurich [ZH]: 0.8 ± 0.5 mm). Thereafter, no statistically significant difference in DIB was observed, neither between centers nor between time points (prosthetic delivery: FR: 1.9 ± 0.6 mm, ZH: 1.7 ± 0.8 mm; 1 year: FR: 1.8 ± 0.6 mm, ZH: 1.6 ± 0.8 mm; 3 years: FR: 1.9 ± 0.8 mm, ZH: 1.7 ± 0.8 mm; 5 years: FR: 1.9 ± 0.8 mm, ZH 1.8 ± 0.6 mm). The overall mean DIB at prosthetic delivery to 5 years of both centers (1.8 ± 0.7 mm) is located within the transition zone between the smooth neck and the moderately rough intraosseous part (1.6-2.0 mm from the implant shoulder). However, individual DIB values are ranging from 0.1 to 4.2 mm overlapping the transition zone. CONCLUSIONS The standard deviation of the DIB indicates that the fBIC establishes on moderately rough and smooth surfaces. Consequently, soft tissue adapts to both topographies as well.
Collapse
Affiliation(s)
- Nadja Rohr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Marc Balmer
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ralf J Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Benedikt C Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jens Fischer
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| |
Collapse
|
13
|
The Anchorage of Bone Cells onto an Yttria-Stabilized Zirconia Surface with Mild Nano-Micro Curved Profiles. Dent J (Basel) 2020; 8:dj8040127. [PMID: 33182602 PMCID: PMC7712018 DOI: 10.3390/dj8040127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 01/16/2023] Open
Abstract
The high biocompatibility, good mechanical properties, and perfect esthetics of ceramic dental materials motivate investigation into their suitability as an endosseous implant. Osseointegration at the interface between bone and implant surface, which is a criterion for dental implant success, is dependent on surface chemistry and topography. We found out earlier that osteoblasts on sharp-edged micro-topographies revealed an impaired cell phenotype and function and the cells attempted to phagocytize these spiky elevations in vitro. Therefore, micro-structured implants used in dental surgery should avoid any spiky topography on their surface. The sandblasted, acid-etched, and heat-treated yttria-stabilized zirconia (cer.face®14) surface was characterized by scanning electron microscopy and energy dispersive X-ray. In vitro studies with human MG-63 osteoblasts focused on cell attachment and intracellular stress level. The cer.face 14 surface featured a landscape with nano-micro hills that was most sinusoidal-shaped. The mildly curved profile proved to be a suitable material for cell anchorage. MG-63 cells on cer.face 14 showed a very low reactive oxygen species (ROS) generation similar to that on the extracellular matrix protein collagen I (Col). Intracellular adenosine triphosphate (ATP) levels were comparable to Col. Ceramic cer.face 14, with its sinusoidal-shaped surface structure, facilitates cell anchorage and prevents cell stress.
Collapse
|