Integration of fluoridated implants in onlay autogenous bone grafts – An experimental study in the rabbit tibia

Carbon Nanomaterials Modified Biomimetic Dental Implants for Diabetic Patients

Dental implants are used broadly in dental clinics as the most natural-looking restoration option for replacing missing or highly diseased teeth. However, dental implant failure is a crucial issue for diabetic patients in need of dentition restoration, particularly when a lack of osseointegration and immunoregulatory incompetency occur during the healing phase, resulting in infection and fibrous encapsulation. Bio-inspired or biomimetic materials, which can mimic the characteristics of natural elements, are being investigated for use in the implant industry. This review discusses different biomimetic dental implants in terms of structural changes that enable antibacterial properties, drug delivery, immunomodulation, and osseointegration. We subsequently summarize the modification of dental implants for diabetes patients utilizing carbon nanomaterials, which have been recently found to improve the characteristics of biomimetic dental implants, including through antibacterial and anti-inflammatory capabilities, and by offering drug delivery properties that are essential for the success of dental implants.

The Influence of Type 2 Diabetes Mellitus on the Osseointegration of Titanium Implants With Different Surface Modifications-A Histomorphometric Study in High-Fat Diet/Low-Dose Streptozotocin-Treated Rats

OBJECTIVES

Type 2 diabetes mellitus (T2DM) is a systemic disease that also compromises the bone healing capacity. In healthy individuals, surface modifications of dental implants are proven to increase bone response and implant success. The aim of this study was to clarify if the surface modifications also improve osseointegration in a setting with diabetes mellitus.

METHODS

T2DM was induced in 7 rats by a high-fat diet/low-dose streptozotocin injection. All animals received a hydroxyapatite (HA) implant, a sandblasted and acid-etched (SLA) implant, and a standard machined titanium implant for control in the tibia. After 4 weeks, thin-ground sections were produced, and the volume of new bone formation (nBV/TV) and bone-to-implant contact (nB.I/Im.I) were histomorphometrically analyzed.

RESULTS

Both surface modifications led to an increase of osseointegration compared with the machined surface implant in rats with T2DM. nBV/TV was highest in the SLA implants, whereas nB.I/Im.I was highest in the HA group. Regardless of the surface modification, a superordinate regional pattern of new bone formation over the length of the implant was observed.

CONCLUSIONS

Implants with HA coating and SLA surface modifications seem to have the potential to increase osseointegration also in T2DM rats when compared with a conventional machined surface.

Comparing the effect of strontium-functionalized and fluoride-modified surfaces on early osseointegration

BACKGROUND

Studies have shown that medical devices comprising strontium contribute to bone healing and osseointegration. The aim of this study was to evaluate the in vivo performance of surface-functionalized implants (Ti-Sr-O) showing predictable release characteristics of strontium and compare it to performance a commercially available fluoride-modified surface.

METHODS

Ti-Sr-O functionalized, fluoride-modified,  Grade 4 titanium implants were inserted in the femoral condyle of adult male New Zealand white rabbits. Atomic absorption spectrometry (AAS) was utilized to monitor strontium blood serum levels. Two weeks after insertion, histomorphometric evaluation was performed with respect to bone-to-implant contact (BIC%) and bone formation (BF%) using defined regions of interest.

RESULTS

Mean values for BIC% showed a comparable degree of osseointegration for Ti-Sr-O and the fluoride-modified surface, while BF% revealed a significant difference in increased BF with Ti-Sr-O. AAS measurements did not indicate any influence of the Ti-Sr-O modified implants on the strontium blood serum concentrations.

CONCLUSIONS

Within the limitations of this study, it was shown that the Ti-Sr-O coating, with sustained release characteristics of strontium, enhanced bone apposition and, thus, could find practical applications, e.g., within the field of medical implantology.

Behavior of Osteoblast-Like Cells on a β-Tricalcium Phosphate Synthetic Scaffold Coated With Calcium Phosphate and Magnesium

OBJECTIVES

Tricalcium phosphate (TCP) is one of the most useful synthetic scaffolds for bone grafts and has several advantages. However, the rapid degradation of TCP makes it less osteoconductive than the other candidates, and represents a major shortcoming. To overcome this problem, the authors investigated magnesium (Mg) and/or hydroxyapatite (HA) coating on a β-TCP substrate using a sputtering technique.

METHODS

Biocompatibility tests were carried out on β-TCP discs that were either uncoated (TCP), coated with HA by radio frequency magnetron sputtering (HA-TCP), coated with Mg by DC sputtering (Mg-TCP), or multicoated with Mg and HA by DC and radio frequency magnetron sputtering (MgHA-TCP).

RESULTS

Cells showed similar morphology in all 4 groups, and were widely spread, had flattened elongated shapes, and were connected to adjacent cells by pseudopods. An MTT assay revealed higher cell proliferation on HA-TCP, Mg-TCP, and MgHA-TCP compared with TCP at 3 and 5 days. MgHA-TCP also showed significantly higher alkaline phosphatase activity levels compared with TCP, HA-TCP, and Mg-TCP (P < 0.05).

CONCLUSIONS

Results suggest that Mg-coated β-TCP could have great potential as a bone graft material for future applications in hard tissue regeneration.

Osteoconductive composite graft based on bacterial synthesized hydroxyapatite nanoparticles doped with different ions: From synthesis to in vivo studies

To repair damaged bone tissues, osteoconductive bone graft substitutes are required for enhancement of the regenerative potential of osteoblast cells. Nanostructured hydroxyapatite is a bioactive ceramic used for bone tissue engineering purposes. In this study, carbonate hydroxyapatite (cHA) and zinc-magnesium substituted hydroxyapatite (Zn-Mg-HA) nanoparticles were synthesized via biomineralization method using Enterobacter aerogenes. The structural phase composition and the morphology of the samples were analyzed using appropriate powder characterization methods. Next, a composite graft was fabricated by using polyvinyl alcohol and both cHA and Zn-Mg-HA samples. In vivo osteogenic potential of the graft was then investigated in a rabbit tibial osteotomy model. Histological, radiological and morphological studies showed that the graft was mineralized by the newly formed bone tissue without signs of inflammation or infection after 4 weeks of implantation. These histomorphometric results suggest that the fabricated graft can function as a potent osteoconductive bone tissue substitute.

Analysis of implant-failure predictors in the posterior maxilla: a retrospective study of 1395 implants

The aim of this study was to analyze predictors for dental implant failure in the posterior maxilla. A database was created to include patients being treated with dental implants posterior to the maxillary cuspids. Independent variables thought to be predictive of potential implant failure included (1) sinus elevation, (2) implant length, (3) implant diameter, (4) indication, (5) implant region, (6) timepoint of implant placement, (7) one-vs. two-stage augmentation, and (8) healing mode. Cox regression analysis was used to evaluate the influence of predictors 1-3 on implant failure as dependent variable. The predictors 4-9 were analyzed strictly descriptively. The final database included 592 patients with 1395 implants. The overall 1- and 5-year implant survival rates were 94.8% and 88.6%, respectively. The survival rates for sinus elevation vs. placement into native bone were 94.4% and 95.4%, respectively (p = 0.33). The survival rates for the short (<10 mm), the middle (10-13 mm) and the long implants (>13 mm) were 100%, 89% and 76.8%, respectively (middle-vs. long implants p = 0.62). The implant survival rates for the small- (<3.6 mm), the middle- (3.6-4.5 mm) and the wide diameter implants (>4.5 mm) were 92.5%, 87.9% and 89.6%, respectively (p = 0.0425). None of the parameters evaluated were identified as predictor of implant failure in the posterior maxilla.