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Nevins M, Chen CY, Parma-Benfenati S, Kim DM. Gas Plasma Treatment Improves Titanium Dental Implant Osseointegration-A Preclinical In Vivo Experimental Study. Bioengineering (Basel) 2023; 10:1181. [PMID: 37892911 PMCID: PMC10604242 DOI: 10.3390/bioengineering10101181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
Recent technological advancements led to the development of various plasma-based technologies for post-packaging modifications. The purpose of the present preclinical in vivo study was to assess the safety and efficacy of a novel chairside nonthermal gas plasma treatment for enhancing osseointegration of titanium implants. Six male mixed foxhounds underwent extraction of mandibular premolars and first molars, and the sockets healed for 42 days. Canine mandibles were randomized to receive either plasma-treated (test) or non-plasma-treated (control) dental implants. A total of 36 implants were placed in six animals, and they were sacrificed at 2 weeks (two animals), 4 weeks (two animals), and 6 weeks (two animals) after the implant surgery. When the radiographic analysis was performed, the changes in bone level were not statistically significant between the two groups at 2 weeks and 4 weeks. The difference became significant at 6 weeks (p = 0.016), indicating more bone loss from baseline to 6 weeks for the control group. The bone-to-implant contact (BIC) appeared to be higher for the test groups at all time points, and the BIC was significantly higher for the test group at 4 weeks (p = 0.046). In conclusion, this study underscored the potential of nonthermal plasma treatment in enhancing implant osseointegration.
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Affiliation(s)
- Myron Nevins
- Department of Oral Medicine, Infection and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.N.); (C.-Y.C.)
| | - Chia-Yu Chen
- Department of Oral Medicine, Infection and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.N.); (C.-Y.C.)
| | | | - David M. Kim
- Department of Oral Medicine, Infection and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA 02115, USA; (M.N.); (C.-Y.C.)
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2
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Wang C, Wang X, Lu R, Cao X, Yuan D, Chen S. Influence of surface nanotopography and wettability on early phases of peri-implant soft tissue healing: an in-vivo study in dogs. BMC Oral Health 2023; 23:651. [PMID: 37684664 PMCID: PMC10492342 DOI: 10.1186/s12903-023-03347-7] [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: 04/27/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND It is well established that nanotopography and wettability of implant surfaces contribute to osseointegration and long-term implant success. However, the effects of a hydrogenated surface with nanotubular and superhydrophilic properties on peri-implant soft tissue remain unclear. This study was designed to study the impact of a modified abutment surface on early soft tissue integration compared with a machined surface. METHODS Thirty-six implants were placed at the bone level in the bilateral mandible of six beagles, followed by healing abutments belonging to the standard machined Ti-6Al-4V alloy abutments (TC4-M), anodized abutments with nanotubes (TC4-Nano), and hydrogenated abutments (TC4-H/Nano) groups, which were randomly screwed to the implants. After two and four weeks of wound healing, the animals were euthanized for histological evaluation. RESULTS A superhydrophilic nanotubular surface developed on the hydrogenated abutment. Histological and histometric analyses revealed similar peri-implant soft tissue healing and dimensions for the three types of abutments at two and four weeks. Connective tissue (CT) length was longer around TC4-H/Nano abutments compared with standard abutments; however, the differences were not statistically significant. Moreover, collagen fibers in the TC4-H/Nano group extended and were attached perpendicularly to the superhydrophilic surface. CONCLUSIONS Our results revealed that the soft tissue interface adjacent to the hydrogenated abutment is comparable to that of the machined abutment. A tendency of increased CT length and perpendicular collagen fibers was observed around the modified abutment. This study suggests that nanotubular/superhydrophilic surfaces could be a promising modification to enhance soft tissue sealing. However, comprehensive studies should be conducted to evaluate the peri-implant soft tissue around the modified abutment immunohistochemically, histopathologically, and clinically.
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Affiliation(s)
- Caiyun Wang
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Xin Wang
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Ran Lu
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Xu Cao
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Dingxiang Yuan
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Su Chen
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.
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An Experimental Anodized and Low-Pressure Oxygen Plasma-Treated Titanium Dental Implant Surface-Preliminary Report. Int J Mol Sci 2023; 24:ijms24043603. [PMID: 36835015 PMCID: PMC9958761 DOI: 10.3390/ijms24043603] [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: 12/27/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Chemical composition and physical parameters of the implant surface, such as roughness, regulate the cellular response leading to implant bone osseointegration. Possible implant surface modifications include anodization or the plasma electrolytic oxidation (PEO) treatment process that produces a thick and dense oxide coating superior to normal anodic oxidation. Experimental modifications with Plasma Electrolytic Oxidation (PEO) titanium and titanium alloy Ti6Al4V plates and PEO additionally treated with low-pressure oxygen plasma (PEO-S) were used in this study to evaluate their physical and chemical properties. Cytotoxicity of experimental titanium samples as well as cell adhesion to their surface were assessed using normal human dermal fibroblasts (NHDF) or L929 cell line. Moreover, the surface roughness, fractal dimension analysis, and texture analysis were calculated. Samples after surface treatment have substantially improved properties compared to the reference SLA (sandblasted and acid-etched) surface. The surface roughness (Sa) was 0.59-2.38 µm, and none of the tested surfaces had cytotoxic effect on NHDF and L929 cell lines. A greater cell growth of NHDF was observed on the tested PEO and PEO-S samples compared to reference SLA sample titanium.
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Huang CL, Huang KT, Lee TM. The biological responses of osteoblasts on titanium: Effect of oxygen level and surface roughness. J Formos Med Assoc 2023:S0929-6646(23)00009-8. [PMID: 36732135 DOI: 10.1016/j.jfma.2023.01.009] [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: 11/22/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND/PURPOSE Due to the general application of in vitro test, cell culture is generally selected to evaluate the cytocompatibility of devices and materials. The choice of test condition should depend on the probable site and clinical application. The oxygen content of human body could be estimated around 5%∼12%, and the oxygen level of healing bone fracture range from 0.8%∼3.8%%. However, materials for bone implant are traditionally evaluated under laboratory normoxia condition (21% O2) in vitro. The aim was to study the effect of oxygen level on osteoblast upon high stiffness titanium with different roughness. METHODS After sandblasted and acid-etched (SLA) process, we create titanium surfaces with four different roughness. The differentiation and proliferation of MC3T3-E1 osteoblast cultured on SLA-treated specimens were evaluated in designed chamber with oxygen level of 1%, 5%, 10%, 21%. RESULTS By scanning electron microscopy, all samples had sub-micro pit inside the micro-holes upon SLA-treated Ti disk surface. The decrease of oxygen level from 21% to 5% promoted osteoblast growth of SLA-treated specimens, but 1% O2 delayed cell proliferation. The surface roughness of specimens influenced osteoblast cell differentiation. The differentiation and proliferation ability of the cells upon SLA-treated specimens is proportional to oxygen level. CONCLUSION Our results demonstrated that 5% O2 will easily discriminate osteoblasts responses on different SLA-treated specimens. These results suggest that hypoxia (5% O2) environment is better model for biological evaluation of bone-related materials.
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Affiliation(s)
- Chih-Ling Huang
- Center for Fundamental Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Ting Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Tzer-Min Lee
- School of Dentistry, National Cheng Kung University, Tainan, Taiwan; Institute of Oral Medicine, National Cheng Kung University, Tainan, Taiwan; Taiwan Instrument Research Institute, National Applied Research Laboratories, Hsinchu, Taiwan.
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Hadzik J, Kubasiewicz-Ross P, Gębarowski T, Waloszczyk N, Maciej A, Stolarczyk A, Gedrange T, Dominiak M, Szajna E, Simka W. An Experimental Anodized Titanium Surface for Transgingival Dental Implant Elements-Preliminary Report. J Funct Biomater 2023; 14:jfb14010034. [PMID: 36662081 PMCID: PMC9861871 DOI: 10.3390/jfb14010034] [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: 12/14/2022] [Revised: 12/27/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
The characteristics such as microtopography, physical and chemical properties influence the behavior of an implant in a soft tissue. Anodization-as a potent method of titanium alloy surface modification-of the transgingival abutment or healing screw, has achieved some improvement. One of the possible surface treatment method is low-pressure radiofrequency oxygen plasma treatment. The aim of the study was to evaluate the chemical properties and cytocompatibility of the experimental surface. Titanium discs made of grade-23 titanium alloy (Ti-6Al-4V) anodized (A sample) with different voltage parameters (28, 67, 78, and 98 V) were included in the study. Half of the samples regarded as the "S" group were additionally treated with low-pressure radiofrequency oxygen plasma treatment. The surfaces were characterized using scanning electron microscopy, X-ray spectroscopy and Raman spectroscopy, and electrochemically investigated via a corrosion test. Furthermore, two cell lines were used, including the CHO-compatible reference line and a primary human fibroblast line for the MTT assay; direct (contact) cytotoxicity of the materials was tested with the cells, and the growth of fibroblasts on the surfaces of the different materials was tested. The morphology of the "S"-treated samples did not differ from the morphology of only-anodized samples. However, the oxygen concentration on the surface in that group slightly increased by about 1% as a result of post-trial treatment. The highest corrosion resistance was observed for both A-78 V and S-78 V samples. The cytotoxicity assay revealed no changes in cell morphology or vitality. The MTT test proved comparable culture viability among all groups; however, the "S" samples showed statistically significantly higher fibroblast proliferation and adhesion scores compared to the "A" samples. Through the in vitro study, the low-pressure radiofrequency oxygen plasma treatment of the anodized Ti-6Al-4V alloy presented itself as an auspicious option in the field of transgingival element surface modification of implants.
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Affiliation(s)
- Jakub Hadzik
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
| | - Paweł Kubasiewicz-Ross
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
- Correspondence: (P.K.-R.); (W.S.)
| | - Tomasz Gębarowski
- Department of Biostructure and Animal Physiology, Wroclaw University of Environmental and Life Sciences, 51-631 Wroclaw, Poland
| | - Natalia Waloszczyk
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Artur Maciej
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | | | - Tomasz Gedrange
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
- Department of Orthodontics, TU Dresden, 01069 Dresden, Germany
| | - Marzena Dominiak
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, 50-425 Wroclaw, Poland
| | - Ernest Szajna
- WEA Techlab sp. z o.o., 41-301 Dąbrowa Górnicza, Poland
| | - Wojciech Simka
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
- Correspondence: (P.K.-R.); (W.S.)
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Lee H, Jeon HJ, Jung A, Kim J, Kim JY, Lee SH, Kim H, Yeom MS, Choe W, Gweon B, Lim Y. Improvement of osseointegration efficacy of titanium implant through plasma surface treatment. Biomed Eng Lett 2022; 12:421-432. [PMID: 36238369 PMCID: PMC9551159 DOI: 10.1007/s13534-022-00245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/30/2022] [Accepted: 08/17/2022] [Indexed: 11/27/2022] Open
Abstract
A novel plasma treatment source for generating cylindrical plasma on the surface of titanium dental implants is developed herein. Using the titanium implant as an electrode and the packaging wall as a dielectric barrier, a dielectric barrier discharge (DBD) plasma was generated, allowing the implant to remain sterile. Numerical and experimental investigations were conducted to determine the optimal discharge conditions for eliminating hydrocarbon impurities, which are known to degrade the bioactivity of the implant. XPS measurement confirmed that plasma treatment reduced the amount of carbon impurities on the implant surface by approximately 60%. Additionally, in vitro experiments demonstrated that the surface treatment significantly improved cell adhesion, proliferation, and differentiation. Collectively, we proposed a plasma treatment source for dental implants that successfully removes carbon impurities and facilitate the osseointegration of SLA implants.
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Affiliation(s)
- Hyungyu Lee
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology (KAIST), 34141 Daejeon, Republic of Korea
| | - Hyun Jeong Jeon
- Plasmapp Co., Ltd, 372 Dongbu-daero, 18151 Osan-si, Gyeonggi-do Republic of Korea
| | - Ara Jung
- Department of Mechanical Engineering, Sejong University, 05006 Seoul, Republic of Korea
| | - Jinwoo Kim
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology (KAIST), 34141 Daejeon, Republic of Korea
| | - Jun Young Kim
- Plasmapp Co., Ltd, 372 Dongbu-daero, 18151 Osan-si, Gyeonggi-do Republic of Korea
| | - Seung Hun Lee
- Plasmapp Co., Ltd, 372 Dongbu-daero, 18151 Osan-si, Gyeonggi-do Republic of Korea
| | - Hosu Kim
- Plasmapp Co., Ltd, 372 Dongbu-daero, 18151 Osan-si, Gyeonggi-do Republic of Korea
| | - Moon Seop Yeom
- Seoul Top Dental Clinic, 345 Omok-ro, Yangchun-gu, 07999 Seoul, Republic of Korea
| | - Wonho Choe
- Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology (KAIST), 34141 Daejeon, Republic of Korea
| | - Bomi Gweon
- Department of Mechanical Engineering, Sejong University, 05006 Seoul, Republic of Korea
| | - Youbong Lim
- Plasmapp Co., Ltd, 372 Dongbu-daero, 18151 Osan-si, Gyeonggi-do Republic of Korea
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7
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Zhou W, Wang X, Li Z, Zhao H, Weir MD, Cheng L, Xu HHK, Huang X. Novel dual-functional implants via oxygen non-thermal plasma and quaternary ammonium to promote osteogenesis and combat infections. Dent Mater 2021; 38:169-182. [PMID: 34924200 DOI: 10.1016/j.dental.2021.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/08/2021] [Accepted: 12/02/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Implant-related infections are a primary reason for implant failures that affect millions of patients. It is of paramount importance to develop novel implants that possess the dual functions of osteogenesis-promotion and antibacterial activity. The objectives of this study were to: (1) develop novel dual-functional titanium (Ti) implants by combining oxygen non-thermal plasma and covalent bonding of antibacterial organosilicon quaternary ammonium monomers; (2) investigate the physicochemical properties, bioactivity and antibacterial effects of the modified implants for the first time. METHODS Surface characteristics of the modified Ti surfaces were tested. Adherence and viability of rat bone marrow-derived stem cells (rBMSCs) on the surface were evaluated. Metabolic activity of biofilm on the surfaces were measured. The stability of the dual-function after 5000 thermal cycles was also evaluated. RESULTS The presence of chemical bonding between Ti and organosilicon monomers demonstrated covalent immobilization of the antibacterial agents. The water contact angle of the treated Ti surfaces decreased from 70.98 ± 3.68° to 59.86 ± 4.91°. The adhesion and proliferation of rBMSCs on the modified Ti were increased by 40%, compared to control group (P < 0.05). The metabolic level of biofilms on modified Ti were reduced by more than half, compared to control (P < 0.05). The modified Ti implants exhibited cell-promotion and antibacterial stability after thermal cycles. SIGNIFICANCE The new dual-functional Ti implant is promising to promote osteogenesis while simultaneously preventing infections. Furthermore, the novel surface modification and processing methods have applicability to enhancing a wide range of other implants to improve bioactivity and combat infections.
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Affiliation(s)
- Wen Zhou
- Postdoctoral workstation & Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China; Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA; State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xianlong Wang
- Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Medical University, Fuzhou, 350122 Fujian, China
| | - Zhen Li
- Postdoctoral workstation & Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Hongyan Zhao
- Postdoctoral workstation & Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, 21201, USA.
| | - Xiaojing Huang
- Postdoctoral workstation & Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China.
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8
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Synthesis and Characterization of a Novel Biocompatible Alloy, Ti-Nb-Zr-Ta-Sn. Int J Mol Sci 2021; 22:ijms221910611. [PMID: 34638960 PMCID: PMC8509052 DOI: 10.3390/ijms221910611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 12/14/2022] Open
Abstract
Many current-generation biomedical implants are fabricated from the Ti-6Al-4V alloy because it has many attractive properties, such as low density and biocompatibility. However, the elastic modulus of this alloy is much larger than that of the surrounding bone, leading to bone resorption and, eventually, implant failure. In the present study, we synthesized and performed a detailed analysis of a novel low elastic modulus Ti-based alloy (Ti-28Nb-5Zr-2Ta-2Sn (TNZTS alloy)) using a variety of methods, including scanning electron microscopy, transmission electron microscopy, X-ray diffraction, and tensile test. Additionally, the in vitro biocompatibility of the TNZTS alloy was evaluated using SCP-1, SaOs-2, and THP-1 cell lines and primary human osteoblasts. Compared to Ti-6Al-4V, the elastic modulus of TNZTS alloy was significantly lower, while measures of its in vitro biocompatibility are comparable. O2 plasma treatment of the surface of the alloy significantly increased its hydrophilicity and, hence, its in vitro biocompatibility. TNZTS alloy specimens did not induce the release of cytokines by macrophages, indicating that such scaffolds would not trigger inflammatory responses. The present results suggest that the TNZTS alloy may have potential as an alternative to Ti-6Al-4V.
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9
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Multifunctional natural polymer-based metallic implant surface modifications. Biointerphases 2021; 16:020803. [PMID: 33906356 DOI: 10.1116/6.0000876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
High energy traumas could cause critical damage to bone, which will require permanent implants to recover while functionally integrating with the host bone. Critical sized bone defects necessitate the use of bioactive metallic implants. Because of bioinertness, various methods involving surface modifications such as surface treatments, the development of novel alloys, bioceramic/bioglass coatings, and biofunctional molecule grafting have been utilized to effectively integrate metallic implants with a living bone. However, the applications of these methods demonstrated a need for an interphase layer improving bone-making to overcome two major risk factors: aseptic loosening and peri-implantitis. To accomplish a biologically functional bridge with the host to prevent loosening, regenerative cues, osteoimmunomodulatory modifications, and electrochemically resistant layers against corrosion appeared as imperative reinforcements. In addition, interphases carrying antibacterial cargo were proven to be successful against peri-implantitis. In the literature, metallic implant coatings employing natural polymers as the main matrix were presented as bioactive interphases, enabling rapid, robust, and functional osseointegration with the host bone. However, a comprehensive review of natural polymer coatings, bridging and grafting on metallic implants, and their activities has not been reported. In this review, state-of-the-art studies on multifunctional natural polymer-based implant coatings effectively utilized as a bone tissue engineering (BTE) modality are depicted. Protein-based, polysaccharide-based coatings and their combinations to achieve better osseointegration via the formation of an extracellular matrix-like (ECM-like) interphase with gap filling and corrosion resistance abilities are discussed in detail. The hypotheses and results of these studies are examined and criticized, and the potential future prospects of multifunctional coatings are also proposed as final remarks.
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Li P, Gao Z, Tan Z, Xiao J, Wei L, Chen Y. New developments in anti-biofilm intervention towards effective management of orthopedic device related infections (ODRI's). BIOFOULING 2021; 37:1-35. [PMID: 33618584 DOI: 10.1080/08927014.2020.1869725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/15/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
Orthopedic device related infections (ODRI's) represent a difficult to treat situation owing to their biofilm based nature. Biofilm infections once established are difficult to eradicate even with an aggressive treatment regimen due to their recalcitrance towards antibiotics and immune attack. The involvement of antibiotic resistant pathogens as the etiological agent further worsens the overall clinical picture, pressing on the need to look into alternative treatment strategies. The present review highlightes the microbiological challenges associated with treatment of ODRI's due to biofilm formation on the implant surface. Further, it details the newer anti-infective modalities that work either by preventing biofilm formation and/or through effective disruption of the mature biofilms formed on the medical implant. The study, therefore aims to provide a comprehensive insight into the newer anti-biofilm interventions (non-antibiotic approaches) and a better understanding of their mechanism of action essential for improved management of orthopedic implant infections.
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Affiliation(s)
- Ping Li
- Department of Orthopedics, Ya'an People's Hospital, Yaan City, China
| | - Zhenwu Gao
- Department of Orthopedics, Shanxi Bethune Hospital, Taiyuan City, China
| | - Zhenwei Tan
- Department of Orthopedics, Western Theater Air Force Hospital of PLA, Chengdu, China
| | - Jun Xiao
- Department of Orthopedics, Ya'an People's Hospital, Yaan City, China
| | - Li Wei
- Nursing Department, Three Gorges Hospital Affiliated to Chongqing University, Chongqing, China
| | - Yirui Chen
- Department of Orthopedics, Three Gorges Hospital Affiliated to Chongqing University, Chongqing, China
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11
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Simulation analysis of impact damage to the bone tissue surrounding a dental implant. Sci Rep 2020; 10:6927. [PMID: 32332927 PMCID: PMC7181623 DOI: 10.1038/s41598-020-63666-5] [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: 09/15/2019] [Accepted: 03/31/2020] [Indexed: 12/03/2022] Open
Abstract
Dental implant may suffer transient external impacts. To simulate the effect of impact forces on bone damage is very important for evaluation of damage and guiding treatment in clinics. In this study, an animal model was established by inserting an implant into the femoral condyle of New Zealand rabbit. Implant with good osseointegration was loaded with impact force. A three-dimensional finite element model was established based on the data of the animal model. Damage process to bone tissue was simulated with Abaqus 6.13 software combining dynamic mechanical properties of the femur. The characteristics of bone damage were analyzed by comparing the results of animal testing with numerical simulation data. After impact, cortical bone around the implant and trabecular at the bottom of the implant were prone to damage. The degree of damage correlated with the direction of loading and the magnitude of the impact. Lateral loading was most likely performed to damage cancellous bone. The stress wave formed by the impact force can damage the implant–bone interface and peri-implant trabeculae. The data from numerical simulations were consistent with data from animal experiments, highlighting the importance of a thorough examination and evaluation based on the patient’s medical history.
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12
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Asensio G, Vázquez-Lasa B, Rojo L. Achievements in the Topographic Design of Commercial Titanium Dental Implants: Towards Anti-Peri-Implantitis Surfaces. J Clin Med 2019; 8:E1982. [PMID: 31739615 PMCID: PMC6912779 DOI: 10.3390/jcm8111982] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
Titanium and its alloys constitute the gold standard materials for oral implantology in which their performance is mainly conditioned by their osseointegration capacity in the host's bone. We aim to provide an overview of the advances in surface modification of commercial dental implants analyzing and comparing the osseointegration capacity and the clinical outcome exhibited by different surfaces. Besides, the development of peri-implantitis constitutes one of the most common causes of implant loss due to bacteria colonization. Thus, a synergic response from industry and materials scientists is needed to provide reliable technical and commercial solutions to this issue. The second part of the review focuses on an update of the recent findings toward the development of new materials with osteogenic and antibacterial capacity that are most likely to be marketed, and their correlation with implant geometry, biomechanical behavior, biomaterials features, and clinical outcomes.
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Affiliation(s)
- Gerardo Asensio
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
| | - Blanca Vázquez-Lasa
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
- Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, 28029 Madrid, Spain
| | - Luis Rojo
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
- Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, 28029 Madrid, Spain
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