Anodized-hydrothermally treated titanium with a nanotopographic surface structure regulates integrin-α6β4 and laminin-5 gene expression in adherent murine gingival epithelial cells

Fit and forget: The future of dental implant therapy via nanotechnology

Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.

Craniofacial therapy: advanced local therapies from nano-engineered titanium implants to treat craniofacial conditions

Nano-engineering-based tissue regeneration and local therapeutic delivery strategies show significant potential to reduce the health and economic burden associated with craniofacial defects, including traumas and tumours. Critical to the success of such nano-engineered non-resorbable craniofacial implants include load-bearing functioning and survival in complex local trauma conditions. Further, race to invade between multiple cells and pathogens is an important criterion that dictates the fate of the implant. In this pioneering review, we compare the therapeutic efficacy of nano-engineered titanium-based craniofacial implants towards maximised local therapy addressing bone formation/resorption, soft-tissue integration, bacterial infection and cancers/tumours. We present the various strategies to engineer titanium-based craniofacial implants in the macro-, micro- and nano-scales, using topographical, chemical, electrochemical, biological and therapeutic modifications. A particular focus is electrochemically anodised titanium implants with controlled nanotopographies that enable tailored and enhanced bioactivity and local therapeutic release. Next, we review the clinical translation challenges associated with such implants. This review will inform the readers of the latest developments and challenges related to therapeutic nano-engineered craniofacial implants.

Nonthermal Plasma Brush Treatment on Titanium and Zirconia To Improve Periabutment Epithelium Formation

The peri-implant soft tissue with inferior adhesion takes a long healing period to form, which is undesirable for the reaction around the peri-implant soft tissues. The aim of this study is to improve the physicochemical properties of titanium (Ti) and zirconia (ZrO₂) implant abutments and shorten the formation period of periabutment epithelium tissue. A nonthermal atmospheric plasma brush (NTAPB, N) was employed for Ti and ZrO₂ activation. The surface topographies, roughness, crystallinity, wettability, and chemical elements of the abutment materials were examined. The epithelial cell behavior analysis and tissue remodeling of the periabutment epithelial tissue were performed in vitro and in vivo. N-Ti and N-ZrO₂ had a similar good surface wettability, with a 65 and 70% increase in oxygen content and a 70 and 75% decrease in carbon content, respectively. Both N-Ti and N-ZrO₂ showed excellent adhesion, spread, and proliferation of epithelial cells in vitro, with improved adhesion molecule expression levels compared to untreated samples. N-Ti and N-ZrO₂ abutments were placed in the implantation sites of rats. From week 2 to week 6 after implantation, N-Ti and N-ZrO₂ had similar periabutment epithelium tissue formation, and both had increased plectin-positive and laminin γ2-positive cell numbers compared to Ti and ZrO₂. The NTAPB shows promising abutment modification abilities. It promotes the expression levels of adhesion molecules and the epithelial cell performance, which later leads to a quicker formation and remodeling of the important periabutment epithelial tissue.

Dental Implant Nano-Engineering: Advances, Limitations and Future Directions

Titanium (Ti) and its alloys offer favorable biocompatibility, mechanical properties and corrosion resistance, which makes them an ideal material choice for dental implants. However, the long-term success of Ti-based dental implants may be challenged due to implant-related infections and inadequate osseointegration. With the development of nanotechnology, nanoscale modifications and the application of nanomaterials have become key areas of focus for research on dental implants. Surface modifications and the use of various coatings, as well as the development of the controlled release of antibiotics or proteins, have improved the osseointegration and soft-tissue integration of dental implants, as well as their antibacterial and immunomodulatory functions. This review introduces recent nano-engineering technologies and materials used in topographical modifications and surface coatings of Ti-based dental implants. These advances are discussed and detailed, including an evaluation of the evidence of their biocompatibility, toxicity, antimicrobial activities and in-vivo performances. The comparison between these attempts at nano-engineering reveals that there are still research gaps that must be addressed towards their clinical translation. For instance, customized three-dimensional printing technology and stimuli-responsive, multi-functional and time-programmable implant surfaces holds great promise to advance this field. Furthermore, long-term in vivo studies under physiological conditions are required to ensure the clinical application of nanomaterial-modified dental implants.

Orchestrating soft tissue integration at the transmucosal region of titanium implants

Osseointegration at the bone-implant interface and soft tissue integration (STI) at the trans-mucosal region are crucial for the long-term success of dental implants, especially in compromised patient conditions. The STI quality of conventional smooth and bio-inert titanium-based implants is inferior to that of natural tissue (i.e. teeth), and hence various surface modifications have been suggested. This review article compares and contrasts the various modification strategies (physical, chemical and biological) utilized to enhance STI of Ti implants. It also details the STI challenges associated with conventional Ti-based implants, current surface modification strategies and cutting-edge nano-engineering solutions. The topographical, biological and therapeutic advances achievable via electrochemically anodized Ti implants with TiO₂ nanotubes/nanopores are highlighted. Finally, the status and future directions of such nano-engineered implants is discussed, with emphasis on bridging the gap between research and clinical translation.

Physicochemical properties of anodized-hydrothermally treated titanium with a nanotopographic surface structure promote osteogenic differentiation in dental pulp stem cells

PURPOSE

Implants made of anodized-hydrothermally treated commercially pure titanium with a nanotopographic surface structure (SA-treated c.p.Ti) may advantageously promote contact osteogenesis during the early stages of healing. We hypothesized that utilizing SA-treated c.p.Ti with dental pulp stem cells (DPSCs) might improve osteoconduction during the process of osseointegration. This in vitro study investigated the effect of initial adhesion of DPSCs to SA-treated c.p.Ti compared with conventional c.p.Ti and anodic oxide (AO) c.p.Ti.

METHODS

DPSCs were obtained from the mandibular incisors of Sprague-Dawley rats and cultured without osteogenic induction medium on c.p.Ti, AO c.p.Ti, and SA-treated c.p.Ti disks for up to 14 days. The morphology, proliferation, and differentiation of DPSCs were assessed by scanning electron microscopy, an MTT assay, and Alizarin Red S staining, respectively. A real-time quantitative polymerase chain reaction was used to quantify the mRNA expression of osteocalcin, osteopontin, and bone sialoprotein.

RESULTS

On all disks, the DPSCs appeared flattened with the formation of extensions over time. The filopodium-like extensions were closely bound to the SA-treated c.p.Ti surface. The proliferation of DPSCs was not significantly different among the c.p.Ti treatments. However, DPSCs on SA-treated c.p.Ti showed the greatest mRNA levels of osteopontin, osteocalcin, and bone sialoprotein, as well as increased Alizarin Red S staining.

CONCLUSIONS

The results of the present in vitro study demonstrate that the surface properties of SA-treated c.p.Ti disks enhance osteogenic differentiation of DPSCs and may facilitate mineralized matrix formation on SA-treated c.p.Ti implant surfaces, which can enhance early bone regeneration.

Surface modification via plasmid-mediated pLAMA3-CM gene transfection promotes the attachment of gingival epithelial cells to titanium sheets in vitro and improves biological sealing at the transmucosal sites of titanium implants in vivo

Although titanium implants have been applied in dental clinics to replace lost teeth and to restore masticatory function for decades, strategies to design the surface of the transmucosal sites of implants to achieve ideal and predictable biological sealing following implantation remain to be optimized. In this study, we hypothesized that gingival epithelial cell (GEC) adhesion and new tissue attachment to titanium sheets/implants could be promoted by the release of plasmid pLAMA3-CM (encoding a motif of the C-terminal globular domain of LAMA3) from a titanium surface. To test this hypothesis, a chitosan/collagen (Chi/Col) coating was immobilized on the surfaces of titanium substrates with nanotube topography (NT-Ti) through cathodic electrophoretic deposition; it was found that pLAMA3-CM could be released from the coating in a highly sustained manner. After culturing on titanium with nanotube topography coated by Chi/Col with the plasmid pLAMA3-CM (Chi/Col/pLAMA3-CM-Ti), human GECs (hGECs) were found to effectively uptake the incorporated plasmids, which resulted in improved attachment, as evidenced by morphological and immunofluorescence analyses. In addition, Chi/Col/pLAMA3-CM-Ti induced better biological sealing at transmucosal sites following immediate implantation into Sprague-Dawley rats. Our findings indicate that the modification of titanium implants by plasmid-mediated pLAMA3-CM gene transfection points to a practical strategy for optimizing biological sealing around the transmucosal sites of implants.

Cell culture models of oral mucosal barriers: A review with a focus on applications, culture conditions and barrier properties

Understanding the function of oral mucosal epithelial barriers is essential for a plethora of research fields such as tumor biology, inflammation and infection diseases, microbiomics, pharmacology, drug delivery, dental and biomarker research. The barrier properties are comprised by a physical, a transport and a metabolic barrier, and all these barrier components play pivotal roles in the communication between saliva and blood. The sum of all epithelia of the oral cavity and salivary glands is defined as the blood-saliva barrier. The functionality of the barrier is regulated by its microenvironment and often altered during diseases. A huge array of cell culture models have been developed to mimic specific parts of the blood-saliva barrier, but no ultimate standard in vitro models have been established. This review provides a comprehensive overview about developed in vitro models of oral mucosal barriers, their applications, various cultivation protocols and corresponding barrier properties.

Micro-/nano-topography of selective laser melting titanium enhances adhesion and proliferation and regulates adhesion-related gene expressions of human gingival fibroblasts and human gingival epithelial cells

Background

Selective laser melting (SLM) titanium is an ideal option to manufacture customized implants with suitable surface modification to improve its bioactivity. The peri-implant soft tissues form a protective tissue barrier for the underlying osseointegration. Therefore, original microrough SLM surfaces should be treated for favorable attachment of surrounding soft tissues.

Material and methods

In this study, anodic oxidation (AO) was applied on the microrough SLM titanium substrate to form TiO₂ nanotube arrays. After that, calcium phosphate (CaP) nanoparticles were embedded into the nanotubes or the interval of nanotubes by electrochemical deposition (AOC). These two samples were compared to untreated (SLM) samples and accepted mechanically polished (MP) SLM titanium samples. Scanning electron microscopy, energy dispersive spectrometry, X-ray diffraction, surface roughness, and water contact angle measurements were used for surface characterization. The primary human gingival epithelial cells (HGECs) and human gingival fibroblasts (HGFs) were cultured for cell assays to determine adhesion, proliferation, and adhesion-related gene expressions.

Results

For HGECs, AOC samples showed significantly higher adhesion, proliferation, and adhesion-related gene expressions than AO and SLM samples (P<0.05) and similar exceptional ability in above aspects to MP samples. At the same time, AOC samples showed the highest adhesion, proliferation, and adhesion-related gene expressions for HGFs (P<0.05).

Conclusion

By comparison between each sample, we could confirm that both anodic oxidation and CaP nanoparticles had improved bioactivity, and their combined utilization may likely be superior to mechanical polishing, which is most commonly used and widely accepted. Our results indicated that creating appropriate micro-/nano-topographies can be an effective method to affect cell behavior and increase the stability of the peri-implant mucosal barrier on SLM titanium surfaces, which contributes to its application in dental and other biomedical implants.

The impact of photofunctionalized gold nanoparticles on osseointegration

OBJECTIVES

The aims of this study were to create a new surface topography using simulated body fluids (SBF) and Gold Nanoparticles (GNPs) and then to assess the influence of UV Photofunctionalization (PhF) on the osteogenic capacity of these surfaces.

MATERIALS AND METHODS

Titanium plates were divided into six groups All were acid etched with 67% Sulfuric acid, 4 were immersed in SBF and 2 of these were treated with 10 nm GNPs. Half of the TiO2 plates were photofunctionalized to be compared with the non-PhF ones. Rat's bone marrow stem cells were seeded into the plates and then CCK8 assay, cell viability assay, immunofluorescence, and Scanning electron microscopy (SEM) were done after 24 hours. Gene expression analysis was done using real time quantitative PCR (qPCR) one week later to check for the mRNA expression of Collagen-1, Osteopontin and Osteocalcin. Alkaline phosphatase (ALP) activity was assessed after 2 weeks of cell seeding.

RESULTS

Our new topography has shown remarkable osteogenic potential. The new surface was the most biocompatible, and the 10 nm GNPs did not show any cytotoxicity. There was a significant increase in bioactivity, enhanced gene expressions and ALP activity.

CONCLUSIONS

GNPs enhances osteogenic differentiation of stem cells and Photofunctionalizing GNPs highly increases this. We have further created a novel highly efficient topography which highly enhances the speed and extent of osseointegration. This may have great potential for improving treatment outcomes for implant, maxillofacial as well as orthopedic patients.

Amelotin gene expression is temporarily being upregulated at the initiation of apoptosis induced by TGFβ1 in mouse gingival epithelial cells

Amelotin (AMTN) is expressed and secreted by ameloblasts in the maturation stage of amelogenesis and persist with low levels in the junctional epithelium (JE) of erupted teeth. The purpose of this study is to investigate the transcriptional regulation of the AMTN gene by transforming growth factor beta1 (TGFβ1) in gingival epithelial (GE1) cells in the apoptosis phase. Apoptosis was evaluated by the fragmentation of chromosomal DNA and TUNEL staining. A real-time PCR was carried out to examine the AMTN mRNA levels induced by TGFβ1 and Smad3 overexpression. Transient transfection analyses were completed using the various lengths of mouse AMTN gene promoter constructs with or without TGFβ1. Chromatin immunoprecipitation (ChIP) assays were performed to investigate the Smad3 bindings to the AMTN gene promoter by TGFβ1. TGFβ1-induced apoptosis in GE1 cells were detected at 24 and 48 h by DNA fragmentation and TUNEL staining. AMTN mRNA levels increased at 6 h and reached maximum at 24 h in GE1 cells. Luciferase activities of the mouse AMTN gene promoter constructs were induced by TGFβ1. The results of the ChIP assays showed that there was an increase in Smad3 binding to Smad-binding element (SBE)#1 and SBE#2 after stimulation by TGFβ1. Immunohistochemical localization of AMTN was detected in the JE, and the AMTN protein levels in Smad3-deficient mice were decreased compared with wild-type mice. AMTN mRNA levels were induced at the initiation of apoptosis by TGFβ1, which mediated through the Smad3 bindings to SBEs in the mouse AMTN gene promoter.

Increased affinity of endothelial cells to NiTi using ultraviolet irradiation: An in vitro study

Nickel-titanium alloy (NiTi) is one of the most popular materials used endovascularly because of its shape memory and superelasticity. The NiTi device needs to be covered by endothelial cells after being placed in the blood vessel to reduce ischemic complications. The objective of this study was to examine the impact of ultraviolet (UV) irradiation on the biocompatibility of NiTi surfaces with endothelial cells. NiTi sheets were treated with UV irradiation for 48 h and human aorta derived endothelial cells were used in this study. UV irradiation converted the NiTi surface to hydrophilic state and increased albumin adsorption. The number of endothelial cell migration, attachment, proliferation as well as their metabolic activity were significantly increased on UV treated NiTi. This study provides the first evidence of the photoactivation of NiTi surfaces by UV irradiation and demonstrates improved biocompatibility of UV-treated NiTi surfaces with vascular endothelial cells. These results suggest that UV irradiation may promote endothelialization of NiTi devices in blood vessels. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 1034-1038, 2018.

Enhanced intracellular signaling pathway in osteoblasts on ultraviolet lighttreated hydrophilic titanium

Ultraviolet (UV) light treatment of titanium immediately prior to use, or photofunctionalization, reactivates the time-dependent degradation of bioactivity of titanium (biological aging of titanium) and increases its osseointegration capacity beyond the inherent maximal level. Although the initial osteoblast attachment is reportedly enhanced on UV-treated titanium surfaces, the detailed mechanism behind the increase in osseointegration is unknown. This study examined the potential modulation of intracellular signaling pathway in osteoblasts on UV-treated titanium surfaces. Rat bone marrow-derived osteoblasts were cultured on 4-week-old, new, and UV-treated titanium surfaces. The new and UV-treated surfaces were superhydrophilic, whereas the 4-week-old surface was hydrophobic. Although the rate of protein adsorption was similarly increased on the new and UV-treated surfaces compared with the 4-week-old surface, the number of attached cells and their spreading behavior were further enhanced on the UV-treated surface. This additional enhancement was associated with the remarkably upregulated expression of paxillin and phospho-paxillin and exclusive upregulation of Rho GTPase family genes. This study provides with the first molecular evidence of the enhanced initial behavior of osteoblasts on UV-treated titanium surfaces. The enhancement was accentuated and distinct from the new titanium surface with similar hydrophilicity, suggesting that surface properties other than the level of hydrophilicity are responsible.

Effects of the nanotopographic surface structure of commercially pure titanium following anodization-hydrothermal treatment on gene expression and adhesion in gingival epithelial cells

The long-term stability and maintenance of endosseous implants with anodized-hydrothermally treated commercially pure titanium surfaces and a nanotopographic structure (SA-treated c.p.Ti) depend on the barrier function provided by the interface between the transmucosal portion of the implant surface and the peri-implant epithelium. This study investigated the effects of extracellular and intracellular gene expression in adherent gingival epithelial cells cultured for 1-7 days on SA-treated c.p.Ti implant surfaces compared to anodic oxide (AO) c.p.Ti and c.p.Ti disks. Scanning electron microscopy (SEM) showed filopodium-like extensions bound closely to the nanotopographic structure of SA-treated c.p.Ti at day 7 of culture. Gene expressions of focal adhesion kinase, integrin-α6β4, and laminin-5 (α3, β3, γ2) were significantly higher on SA-treated c.p.Ti than on c.p.Ti or AO c.p.Ti after 7 days (P<0.05). Our results confirmed that gingival epithelial cells adhere to SA-treated c.p.Ti as the transmucosal portion of an implant, and that this interaction markedly improves expression of focal adhesion molecules and enhances the epithelial cell phenotype. The cellular gene expression responses driving extracellular and intracellular molecular interactions thus play an important role in maintenance at the interface between SA-treated c.p.Ti implant surfaces and the gingival epithelial cells.