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Menini M, Delucchi F, Bagnasco F, Baldi D, Canullo L, Setti P, Migliorati M, Simetti E, Pesce P. Shock Absorption Capacity of High-Performance Polymers for Dental Implant-Supported Restorations: In Vitro Study. Dent J (Basel) 2024; 12:111. [PMID: 38668023 PMCID: PMC11048904 DOI: 10.3390/dj12040111] [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: 01/23/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Restorative materials might significantly affect load transmission in peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used for implant-supported prostheses. METHODS A masticatory robot was used to compare the shock absorption capacity of veneered and non-veneered polyetherketoneketone (PEKK), Pekkton®ivory (Cendres+Mètaux), and the glass fiber-reinforced composite (GFRC), TRINIATM (Bicon). Five identical sample crowns for each of the three groups were tested. Forces transmitted at the simulated peri-implant bone were recorded and statistically analyzed. RESULTS The statistical analysis of forces transmitted at the simulated dental implant revealed significant differences between the materials tested and between these materials and zirconia, glass ceramic, composite resin, and acrylic resin. Only differences between PEKK and veneered PEKK and between PEKK and one of the previously tested composite resins were not statistically significant. PEKK samples demonstrated significantly greater shock absorption capacity compared to GFRC. CONCLUSIONS PEKK revealed optimal shock absorption capacity. Further studies are needed to evaluate its efficacy in the case of long-span prostheses with reduced prosthetic volume.
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Affiliation(s)
- Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Francesca Delucchi
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Francesco Bagnasco
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Domenico Baldi
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Luigi Canullo
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | | | - Marco Migliorati
- Orthodontic Division, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy;
| | - Enrico Simetti
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genova, 16132 Genova, Italy
| | - Paolo Pesce
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
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Harfouche N, Marie P, Dragoe D, Le H, Thébault P, Bilot C, Fouchet A, Rouden J, Baudoux J, Lepoittevin B. Antibacterial Zirconia Surfaces from Organocatalyzed Atom-Transfer Radical Polymerization. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1775. [PMID: 38673132 PMCID: PMC11051261 DOI: 10.3390/ma17081775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Antibacterial coatings are becoming increasingly attractive for application in the field of biomaterials. In this framework, we developed polymer coating zirconia with antibacterial activity using the "grafting from" methodology. First, 1-(4-vinylbenzyl)-3-butylimidazolium chloride monomer was synthesized. Then, the surface modification of zirconia substrates was performed with this monomer via surface-initiated photo atom transfer radical polymerization for antibacterial activity. X-ray photoelectron spectroscopy, ellipsometry, static contact angle measurements, and an atomic force microscope were used to characterize the films for each step of the surface modification. The results revealed that cationic polymers could be successfully deposited on the zirconia surfaces, and the thickness of the grafted layer steadily increased with polymerization time. Finally, the antibacterial adhesion test was used to evaluate the antibacterial activity of the modified zirconia substrates, and we successfully showed the antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa strains.
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Affiliation(s)
- Nesrine Harfouche
- LCMT, UMR 6507, ENSICAEN, UNICAEN, CNRS, Normandie Université, 14000 Caen, France (J.B.)
| | - Philippe Marie
- CIMAP, UMR 6252, ENSICAEN, UNICAEN, CNRS, Normandie Université, 14000 Caen, France
| | - Diana Dragoe
- ICMMO, UMR 8182, CNRS, Université Paris-Saclay, 91405 Orsay, France
| | - Hung Le
- INSA Rouen Normandie, PBS UMR 6270, CNRS, Normandie Université, Université de Rouen Normandie, 76000 Rouen, France
| | - Pascal Thébault
- INSA Rouen Normandie, PBS UMR 6270, CNRS, Normandie Université, Université de Rouen Normandie, 76000 Rouen, France
| | - Christelle Bilot
- CRISMAT, ENSICAEN, UNICAEN, CNRS, Normandie Université, 14000 Caen, France
| | - Arnaud Fouchet
- CRISMAT, ENSICAEN, UNICAEN, CNRS, Normandie Université, 14000 Caen, France
| | - Jacques Rouden
- LCMT, UMR 6507, ENSICAEN, UNICAEN, CNRS, Normandie Université, 14000 Caen, France (J.B.)
| | - Jérôme Baudoux
- LCMT, UMR 6507, ENSICAEN, UNICAEN, CNRS, Normandie Université, 14000 Caen, France (J.B.)
| | - Bénédicte Lepoittevin
- LCMT, UMR 6507, ENSICAEN, UNICAEN, CNRS, Normandie Université, 14000 Caen, France (J.B.)
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Rodríguez-Lozano FJ, López-García S, Sánchez-Bautista S, Pérez-López J, Raigrodski AJ, Revilla-León M. Effect of milled and lithography-based additively manufactured zirconia (3Y-TZP) on the biological properties of human osteoblasts. J Prosthet Dent 2023; 130:889-896. [PMID: 35264309 DOI: 10.1016/j.prosdent.2022.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Lithography-based additively manufactured (AM) zirconia has been used to fabricate dental implants and custom barriers for guided bone regeneration procedures. However, studies on the effect of AM zirconia on the biological properties of human osteoblasts are lacking. PURPOSE The purpose of this in vitro study was to compare the effect of milled and lithography-based AM zirconia on the biological properties of normal human osteoblasts (NHOsts), as well as to compare the chemical composition between the milled and lithography-based AM 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) zirconia. MATERIAL AND METHODS Three mol percentage yttria-stabilized tetragonal zirconia polycrystal disks (Ø6×2-mm) were fabricated using subtractive milling (Priti multidisc ZrO2 monochrome) (M group) and lithography-based additive manufacturing methods (LithaCon 3Y 210) (AM group) (n=10). NHOsts were exposed to different material extracts (1:1, 1:2, and 1:4) and cytotoxicity, cell migration, cell morphology, and cell attachment biological tests were completed. Additionally, for morphological and chemical analysis, a scanning electronic microscopy with energy-dispersive X-ray analysis (SEM/EDX) evaluation was completed. Data were analyzed by using 1-way ANOVA and the Dunnett test (α=.05). RESULTS Substantial cell attachment and spreading were observed in both material surfaces. The presence of zirconium was evident in both groups, although the percentage of zirconium in the AM group (64.7%) was slightly higher than in the M group (52.6%). When NHOsts were cultured in the presence of the different material eluates, the M and AM groups exhibited similar NHOst viability and migration rates when compared with untreated cells; no significant differences were found (P>.05). CONCLUSIONS The lithography-based AM zirconia tested showed adequate cytocompatibility without differences when compared with the milled zirconia (M group) specimens. Slight chemical element composition differences were found between milled and lithography-based AM zirconia.
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Affiliation(s)
| | - Sergio López-García
- Researcher, Cellular Therapy and Hematopoietic Transplant Unit, Hematology Department, Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - Sonia Sánchez-Bautista
- Assistant Professor, Department of Health Sciences, Catholic University of Murcia, Murcia, Spain
| | | | - Ariel J Raigrodski
- Private practice, Lynnwood, Wash; Affiliate Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
| | - Marta Revilla-León
- Affiliate Assistant Professor Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
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Piza MMT, Bergamo ETP, Campos TMB, Carvalho LF, Goulart CA, Gutierres E, Lopes ACO, Benalcazar Jalkh EB, Bonfante EA. Alumina-toughened zirconia nanocomposite: Aging effect on microstructural, optical, and mechanical properties. Dent Mater 2023; 39:1022-1031. [PMID: 37775460 DOI: 10.1016/j.dental.2023.09.005] [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: 03/13/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES To process an alumina-toughened zirconia (ATZ) nanocomposite and to characterize its crystalline phases, microstructure, residual stress, mechanical and optical properties before and after two different artificial aging methodologies. METHODS Disc-shaped specimens were obtained through uniaxial pressing of a commercial ATZ powder comprised of 80%ZrO2 / 20%Al2O3, with a particle size of 50 nm and 150 nm, respectively. Sintering was performed at 1500ºC for 2 h. Groups were established according to the aging protocol as immediate (ATZ-I) and aged either in autoclave (ATZ-A) or hydrothermal reactor (ATZ-R) at 134 ºC for 20 h at 2.2 bar. Crystalline phases and microstructure were assessed by X-ray diffraction (XRD) and scanning electron microscopy (SEM), respectively. Residual stress was evaluated by Raman spectroscopy. Contrast Ratio (CR) and Translucency Parameter (TP) were calculated to characterize optical properties. Mechanical properties were analyzed through Vickers microhardness, fracture toughness, and biaxial flexural strength test. RESULTS XRD spectra of both aging protocols revealed the presence of monoclinic zirconia (20-31%), where higher phase transformation was observed after aging in hydrothermal reactor. Optical properties evaluation demonstrated high opacity (CR: 0.99) and masking ability (TP: 0.26), with no significant differences after aging. Raman spectroscopy evidenced the presence of residual compressive stresses in the aged groups, being significantly higher for ATZ-R (-215.2 MPa). As-sintered specimens revealed hardness of ∼12.3 GPa and fracture toughness of ∼1.9 MPa.m1/2. Characteristic strength was 740 MPa for ATZ-I, 804 MPa for ATZ-A, and 879 MPa for ATZ-R, with significant differences between groups. Weibull modulus ranged from 16.5 to 18.8. All groups demonstrated high reliability up to 500 MPa stress missions (99-100%), with no significant differences after aging. SIGNIFICANCE The experimental ATZ nanocomposite presented high opacity and a high Weibull modulus. While aging created internal compressive stress responsible for an increase in characteristic strength, the nanocomposite was susceptible to hydrothermal degradation. Further studies are required to evaluate its degradation kinetics at low temperatures.
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Affiliation(s)
- Mariana M T Piza
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil.
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil; Department of Physics, Technological Institute of Aeronautics, São José dos Campos, SP, Brazil
| | - Laura F Carvalho
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Celso A Goulart
- São Paulo State University, School of Sciences and Engineering, Tupã, SP, Brazil
| | - Eliezer Gutierres
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Ernesto B Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
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Helal E, Gierthmuehlen PC, Bonfante EA, Campos TMB, Prott LS, Langner R, Spitznagel FA. Influence of straight versus angulated screw channel titanium bases on failure loads of two-piece ceramic and titanium implants restored with screw-retained monolithic crowns: An in-vitro study. Clin Oral Implants Res 2023; 34:1217-1229. [PMID: 37565379 DOI: 10.1111/clr.14157] [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: 05/13/2023] [Revised: 07/13/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To analyze the influence of titanium-base (straight [SSC]/angulated-screw-channel [ASC]) on failure-loads and bending-moments of two-piece ceramic and titanium-zirconium implants restored with monolithic-zirconia crowns after fatigue. MATERIALS AND METHODS Thirty-two anterior monolithic-screw-retained zirconia crowns were divided into four groups (n = 8/group) according to the factors: (1) type of implant material: two-piece titanium-zirconium implant (Ti-Zr; control-group) versus two-piece ceramic implant (CI; test-group) and (2) type of titanium-base: SSC (0° angle) versus ASC (25°). An intact implant was used for field emission gun-scanning electronic microscopy (FEG-SEM) characterization and Raman spectroscopy for phase analyses and residual stress quantification. All samples were exposed to fatigue with thermodynamic loading (1.2-million-cycles, 49 N, 1.6 Hz, 5-55°C) at a 30° angle. Surviving specimens were loaded until failure (SLF) and bending moments were recorded. Failed samples were examined using light microscope and SEM. Statistical analyses included ANOVA and Mann-Whitney U-test. RESULTS Raman-spectroscopy revealed the presence of residual compressive stresses. FEG-SEM revealed a roughened surface between threads and polished surface at the cervical-collar of the ceramic implant. All samples survived fatigue and were free of complications. Mean bending-moments (±SD) were: Ti-Zr-0: 241 ± 45 N cm, Ti-Zr-25: 303 ± 86 N cm, CI-0: 326 ± 58 N cm, CI-25: 434 ± 71 N cm. Titanium-base and implant-material had significant effects in favor of ASC titanium bases (p = .001) and ceramic-implants (p < .001). Failure analysis after SLF revealed severe fractures in ceramic implants, whereas titanium implants were restricted to plastic deformation. CONCLUSIONS Ceramic and titanium implants exhibited high reliability after fatigue, with no failures. From a mechanical perspective, titanium bases with ASC can be recommended for both ceramic and titanium implants and are safe for clinical application.
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Affiliation(s)
- E Helal
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - P C Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - E A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - T M B Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - L S Prott
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - R Langner
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- Institute of Neuroscience and Medicine, Brain and Behavior (INM-7), Research Center Jülich, Jülich, Germany
| | - F A Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Wang X, Cui H, Chen Z, Wang L, Chen J, Yi M, Xiao G, Zhang J, Chen H, Xu C. MC design and FIB preparation of a YSZ biochemical material microstructure. J Mech Behav Biomed Mater 2023; 147:106152. [PMID: 37776762 DOI: 10.1016/j.jmbbm.2023.106152] [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: 08/02/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
Aiming at the difficulty of traditional machining of Y2O3-ZrO2 (YSZ) inert ceramic materials, a different method using focused ion beam to selectively create nanoscale microscale structures on the surface of materials was proposed. The sputtering yield, surface damage, and the energy loss of YSZ materials was investigated using the SRIM software using the Monte Carlo method. It is shown that the sputtering yield increases with ion energy in the range 0-30 keV, reaching a maximum of 9.4 atoms/ion at 30 keV. At an ion beam voltage of 30 keV, the most severe damage to the material is 8 mm on the surface. At the same time, the main forms of energy loss in the treatment are phonon energy loss and ionization energy loss, of which phonon energy loss due to the recoil atoms is the largest. In addition, we continue to perform focused ion beam processing experiments on YSZ materials, combining previous MC modeling to optimize different operating conditions such as ion beam, voltage and processing mode. The optimized processing parameters are 30 keV and 2.5 nA. It is shown that the quality of the deep grooves gradually improves with decreasing ion beam current at the same ion beam voltage. However, an excessively small ion beam current leads to an excessively large depth of the deep grooves and lengthy processing times.
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Affiliation(s)
- Xintian Wang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Hao Cui
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Zhaoqiang Chen
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Shandong Machinery Design and Research Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250031, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China.
| | - Li Wang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Jun Chen
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Mingdong Yi
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Guangchun Xiao
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Shandong Machinery Design and Research Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250031, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Jingjie Zhang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Hui Chen
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Chonghai Xu
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Shandong Machinery Design and Research Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250031, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
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Suzumura T, Matsuura T, Komatsu K, Sugita Y, Maeda H, Ogawa T. Vacuum Ultraviolet (VUV) Light Photofunctionalization to Induce Human Oral Fibroblast Transmigration on Zirconia. Cells 2023; 12:2542. [PMID: 37947620 PMCID: PMC10647316 DOI: 10.3390/cells12212542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
Soft tissue adhesion and sealing around dental and maxillofacial implants, related prosthetic components, and crowns are a clinical imperative to prevent adverse outcomes of periodontitis and periimplantitis. Zirconia is often used to fabricate implant components and crowns. Here, we hypothesized that UV treatment of zirconia would induce unique behaviors in fibroblasts that favor the establishment of a soft tissue seal. Human oral fibroblasts were cultured on zirconia specimens to confluency before placing a second zirconia specimen (either untreated or treated with one minute of 172 nm vacuum UV (VUV) light) next to the first specimen separated by a gap of 150 µm. After seven days of culture, fibroblasts only transmigrated onto VUV-treated zirconia, forming a 2.36 mm volume zone and 5.30 mm leading edge. Cells migrating on VUV-treated zirconia were enlarged, with robust formation of multidirectional cytoplastic projections, even on day seven. Fibroblasts were also cultured on horizontally placed and 45° and 60° tilted zirconia specimens, with the latter configurations compromising initial attachment and proliferation. However, VUV treatment of zirconia mitigated the negative impact of tilting, with higher tilt angles increasing the difference in cellular behavior between control and VUV-treated specimens. Fibroblast size, perimeter, and diameter on day seven were greater than on day one exclusively on VUV-treated zirconia. VUV treatment reduced surface elemental carbon and induced superhydrophilicity, confirming the removal of the hydrocarbon pellicle. Similar effects of VUV treatment were observed on glazed zirconia specimens with silica surfaces. One-minute VUV photofunctionalization of zirconia and silica therefore promotes human oral fibroblast attachment and proliferation, especially under challenging culture conditions, and induces specimen-to-specimen transmigration and sustainable photofunctionalization for at least seven days.
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Affiliation(s)
- Toshikatsu Suzumura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Yoshihiko Sugita
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Hatsuhiko Maeda
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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Thu MK, Kang YS, Kwak JM, Jo YH, Han JS, Yeo ISL. Comparison between bone-implant interfaces of microtopographically modified zirconia and titanium implants. Sci Rep 2023; 13:11142. [PMID: 37429939 DOI: 10.1038/s41598-023-38432-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/07/2023] [Indexed: 07/12/2023] Open
Abstract
The aim of this study was to investigate the surface characteristics and evaluate the bone-implant interfaces of injection molded zirconia implants with or without surface treatment and compare them with those of conventional titanium implants. Four different zirconia and titanium implant groups (n = 14 for each group) were prepared: injection-molded zirconia implants without surface treatment (IM ZrO2); injection-molded zirconia implants with surface treatment via sandblasting (IM ZrO2-S); turned titanium implants (Ti-turned); and titanium implants with surface treatments via sandblasting with large-grit particles and acid-etching (Ti-SLA). Scanning electron microscopy, confocal laser scanning microscopy, and energy dispersive spectroscopy were used to assess the surface characteristics of the implant specimens. Eight rabbits were used, and four implants from each group were placed into the tibiae of each rabbit. Bone-to-implant contact (BIC) and bone area (BA) were measured to evaluate the bone response after 10-day and 28-day healing periods. One-way analysis of variance with Tukey's pairwise comparison was used to find any significant differences. The significance level was set at α = 0.05. Surface physical analysis showed that Ti-SLA had the highest surface roughness, followed by IM ZrO2-S, IM ZrO2, and Ti-turned. There were no statistically significant differences (p > 0.05) in BIC and BA among the different groups according to the histomorphometric analysis. This study suggests that injection-molded zirconia implants are reliable and predictable alternatives to titanium implants for future clinical applications.
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Affiliation(s)
- Myint Kyaw Thu
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - Young Suk Kang
- 618th Medical Company (Dental Area Support)/Dental Health Activity-Korea, Camp Humphreys, APO, AP, 96297, USA
| | - Jeong Min Kwak
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - Ye-Hyeon Jo
- Dental Research Institute, Seoul National University, Seoul, 03080, Korea
| | - Jung-Suk Han
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea.
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9
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Hayashi T, Asakura M, Koie S, Hasegawa S, Mieki A, Aimu K, Kawai T. In Vitro Study of Zirconia Surface Modification for Dental Implants by Atomic Layer Deposition. Int J Mol Sci 2023; 24:10101. [PMID: 37373249 DOI: 10.3390/ijms241210101] [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: 05/21/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Zirconia is a promising material for dental implants; however, an appropriate surface modification procedure has not yet been identified. Atomic layer deposition (ALD) is a nanotechnology that deposits thin films of metal oxides or metals on materials. The aim of this study was to deposit thin films of titanium dioxide (TiO2), aluminum oxide (Al2O3), silicon dioxide (SiO2), and zinc oxide (ZnO) on zirconia disks (ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn, respectively) using ALD and evaluate the cell proliferation abilities of mouse fibroblasts (L929) and mouse osteoblastic cells (MC3T3-E1) on each sample. Zirconia disks (ZR; diameter 10 mm) were fabricated using a computer-aided design/computer-aided manufacturing system. Following the ALD of TiO2, Al2O3, SiO2, or ZnO thin film, the thin-film thickness, elemental distribution, contact angle, adhesion strength, and elemental elution were determined. The L929 and MC3T3-E1 cell proliferation and morphologies on each sample were observed on days 1, 3, and 5 (L929) and days 1, 4, and 7 (MC3T3-E1). The ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn thin-film thicknesses were 41.97, 42.36, 62.50, and 61.11 nm, respectively, and their average adhesion strengths were 163.5, 140.9, 157.3, and 161.6 mN, respectively. The contact angle on ZR-Si was significantly lower than that on all the other specimens. The eluted Zr, Ti, and Al amounts were below the detection limits, whereas the total Si and Zn elution amounts over two weeks were 0.019 and 0.695 ppm, respectively. For both L929 and MC3T3-E1, the cell numbers increased over time on ZR, ZR-Ti, ZR-Al, and ZR-Si. Particularly, cell proliferation in ZR-Ti exceeded that in the other samples. These results suggest that ALD application to zirconia, particularly for TiO2 deposition, could be a new surface modification procedure for zirconia dental implants.
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Affiliation(s)
- Tatsuhide Hayashi
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Masaki Asakura
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Shin Koie
- Department of Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Shogo Hasegawa
- Department of Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Akimichi Mieki
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Koki Aimu
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Tatsushi Kawai
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
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10
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Shailaja N, Arulmozhi M, Balraj B, Siva C. Corallocarpus epigaeus mediated synthesis of ZnO/CuO integrated ZrO2 nanoparticles for enhanced in-vitro antibacterial, antifungal and antidiabetic activities. J INDIAN CHEM SOC 2023. [DOI: 10.1016/j.jics.2023.100991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
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11
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Alves D, Faria-Almeida R, Azevedo A, Liñares A, Muñoz F, Blanco-Carrion J. Immediate placement of one-piece zirconia implants with or without xenograft into the buccal gap. Soft tissues as secondary outcomes of an experimental in vivo study. Clin Oral Implants Res 2023; 34:342-350. [PMID: 36740730 DOI: 10.1111/clr.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 11/26/2022] [Accepted: 01/12/2023] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To histologically evaluate soft tissue healing following immediately placed one-piece zirconia implant and grafting a xenograft into the buccal gap. MATERIALS AND METHODS The third and fourth premolars (PM3 and PM4) in both quadrants of the mandible of nine dogs were used for this experiment. Those teeth were removed flapless and implants were placed into the distal sockets in a lingual position. In one side of the jaw, the gap between the implant and the socket walls was grafted (test) while no grafting was performed in the contralateral side (control), randomly selected. After 6 months of healing, biopsies were obtained and prepared for histological analysis. Soft tissue measures like supracrestal soft tissue height (STH), length of barrier epithelium (BE), and connective tissue (CTC) were measured at buccal and lingual surfaces. RESULTS The marginal mucosa was in a coronal position on the test side compared with the control side. At the buccal surface, the BE was longer in the test side than in the control side, while the CTC was longer in the control side than in the test side. For the STH (BE + CTC), the difference between the groups was not statistically significant. CONCLUSION The placement of a xenograft into the gap between a 1-piece zirconia implant and the buccal wall in dogs modified the process of soft tissue healing, providing less soft tissue recession. The gap size seems to have a modifying effect on the application of this protocol.
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Affiliation(s)
- Daniel Alves
- Department Oral Surgery, School of Dental Medicine, University of Porto, Porto, Portugal
| | - Ricardo Faria-Almeida
- Department Oral Surgery, School of Dental Medicine, University of Porto, Porto, Portugal
| | - Alvaro Azevedo
- Department Statistics, School of Dental Medicine, University of Porto, Porto, Portugal.,EPIUnit - Institute of Public Health, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Antonio Liñares
- Professor of Periodontology at the University of Santiago de Compostela, Lugo, Spain
| | - Fernando Muñoz
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, University of Santiago de Compostela, Lugo, Spain
| | - Juan Blanco-Carrion
- Grupo de Investigación en Odontología Médico-Quirúrgica (OMEQUI), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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12
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Tang S, Ding N, Zhang Z. Polycrystalline particulates synthesized on zirconia for enhanced bioactivity: An in vitro study. J Biomed Mater Res B Appl Biomater 2023; 111:117-126. [PMID: 35841321 DOI: 10.1002/jbm.b.35138] [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: 04/27/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 11/06/2022]
Abstract
Zirconia is a promising material for dental implant with its excellent biocompatibility, good mechanical properties, and esthetic effect similar to natural teeth. To improve the bioactivity and osteogenic properties of zirconia, pre-sintered zirconia discs were divided into C, T3 , T5 , and T7 group. Group C was as control. T3 , T5 , and T7 groups were soaked in hydrofluoric acid (HF) for 30, 50, and 70 s, respectively. Then, they were placed into CaCl2 solution and heated in NaOH solution. After sintering, the samples were characterized by scanning electron microscopy, energy dispersive spectrometry, and X-ray diffraction, which confirmed the ZrO2 polycrystalline particulates in situ synthesized on the treated sample discs. The surface roughness of the treated samples was increased with the prolonged of acid treatment time (p < .05), while the three-point bending strength did not decrease significantly (p > .05). MC3T3-E1 cells were cultured on zirconia discs to evaluate the bioactivity and osteogenic effect of modified zirconia. The living&dead fluorescence staining and CCK-8 assay showed that the specimens were non-toxic and significantly promoted cell proliferation. In addition, the cell proliferation was enhanced with the increase of zirconia surface roughness. Polycrystalline particles modified zirconia were beneficial to cell spreading. After osteogenic induction, MC3T3-E1 cells inoculated on modified zirconia exhibited higher alkaline phosphatase activity, mineralization activity and up-regulated osteogenesis-related gene expression. Above all, in situ synthesized polycrystalline particulates significantly improve the biological activity of zirconia, which will promote the widespread application of zirconia implants.
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Affiliation(s)
- Shuang Tang
- Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China
| | - Ning Ding
- Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China
| | - Zutai Zhang
- Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China
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13
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Atalay P, Öztaş DD. Fatigue resistance and fracture strength of narrow-diameter one-piece zirconia implants with angled abutments. J ESTHET RESTOR DENT 2022; 34:1060-1067. [PMID: 35855644 DOI: 10.1111/jerd.12944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Zirconia implants are assumed to satisfy the esthetic requirements that titanium implants cannot meet, however, there are not enough studies in the literature about narrow-diameter and angled zirconia implants that can be preferred especially in the anterior region. This in vitro study aimed to evaluate the fatigue resistance and fracture strength of narrow-diameter zirconia implants with angled abutments. MATERIALS AND METHODS Forty-eight one-piece experimental zirconia implants and monolithic zirconia crowns were produced from 3-YTZP blanks. The implant diameters (3.0 or 3.7 mm) and the restoration types were determined according to three intraoral regions (upper central incisors, lower central incisors, and upper canine), and abutments were designed as straight or 15° angled. The samples were subjected to chewing simulation corresponding to 5 years of clinical performance and then the static loading test. The survival rates of groups were measured by the Kaplan-Meier log-rank test, and the fracture load values were estimated by using Kruskal-Wallis and Mann-Whitney U tests (p < 0.05). RESULTS All 3.0 mm diameter implants failed the fatigue test. The fatigue resistance of the implants with angled abutments was significantly lower than the straight abutments, and different crown designs were found to affect survival rates significantly. The fracture strengths of the surviving groups were above the maximum physiological chewing forces, and the differences were not significant. CONCLUSIONS The implant diameter, abutment angle, and restoration type have a significant effect on the fatigue behavior of zirconia implants. CLINICAL SIGNIFICANCE The fracture strengths of the one-piece zirconia implants with a 3.7 mm diameter and a 15° abutment angle are above the chewing forces for the anterior intraoral region.
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Affiliation(s)
- Pelin Atalay
- Department of Prosthodontics, Faculty of Dentistry, University of Niğde Ömer Halisdemir, Niğde, Turkey
| | - Doğan Derya Öztaş
- Department of Prosthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
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14
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Chopra D, Jayasree A, Guo T, Gulati K, Ivanovski S. Advancing dental implants: Bioactive and therapeutic modifications of zirconia. Bioact Mater 2022; 13:161-178. [PMID: 35224299 PMCID: PMC8843948 DOI: 10.1016/j.bioactmat.2021.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/22/2021] [Accepted: 10/06/2021] [Indexed: 12/16/2022] Open
Abstract
Zirconium-based implants have gained popularity in the dental implant field owing to their corrosion resistance and biocompatibility, attributed to the formation of a native zirconia (ZrO2) film. However, enhanced bioactivity and local therapy from such implants are desirable to enable the earlier establishment and improved long-term maintenance of implant integration, especially in compromised patient conditions. As a result, surface modification of zirconium-based implants have been performed using various physical, chemical and biological techniques at the macro-, micro-, and nano-scales. In this extensive review, we discuss and detail the development of Zr implants covering the spectrum from past and present advancements to future perspectives, arriving at the next generation of highly bioactive and therapeutic nano-engineered Zr-based implants. The review provides in-depth knowledge of the bioactive/therapeutic value of surface modification of Zr implants in dental implant applications focusing on clinical translation.
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Affiliation(s)
| | | | | | - Karan Gulati
- Corresponding authors. School of Dentistry, University of Queensland, 288 Herston Road, Herston QLD, 4006, Australia.
| | - Sašo Ivanovski
- Corresponding authors. School of Dentistry, University of Queensland, 288 Herston Road, Herston QLD, 4006, Australia.
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15
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AK B, Eroğlu EG, Ertugrul AS, Öztürk AB, Yılmaz ŞN. Non-Destructive Removal of Dental Implant by Using the Cryogenic Method. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58070849. [PMID: 35888569 PMCID: PMC9319264 DOI: 10.3390/medicina58070849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/26/2022]
Abstract
Background and Objectives: The gold standard for a successful prosthetic approach is the osseointegration of an implant. However, this integration can be a problem in cases where the implant needs to be removed. Removing the implant with minimal damage to the surrounding tissues is important. Osteocytes cannot survive below −2 °C, but epithelial cells, fibroblasts, and other surrounding tissue cells can. Remodeling can be triggered by cryotherapy at temperatures that specifically affect osteocyte necrosis. In this study, we aimed to develop a method for reversing the osseointegration mechanism and for protecting the surrounding tissues by bone remodeling induced by CO2 cryotherapy. Materials and Methods: In this study, eight 2.8 mm diameter, one-piece mini implants were used in New Zealand rabbit tibias. Two control and six implants were tested in this study. After 2 months of osseointegration, a reverse torque force method was used to remove all osseointegrated implants at 5, 10, 20, and 30 Ncm. The osseointegration of the implants was proven by periotest measurements. Changes in bone tissue were examined in histological sections stained with toluidine blue after rabbit sacrifice. The number of lacunae with osteocyte, empty lacunae, and lacunae greater than 5 µm and the osteon number in a 10,000 µm2 area were calculated. Cryotherapy was applied to the test implants for 1 min, 2 min, and 5 min. Three implants were subjected to cryotherapy at −40 °C, and the other implants were subjected to cryotherapy at −80 °C. Results: Empty lacunae, filled osteocytes, lacunae >5 µm, and the osteon count around the implant applied at −40 °C were not significantly different from the control implants. The application of −40 °C for 1 min was found to cause minimal damage to the bone cells. The implants, which were applied for 1 min and 2 min, were successfully explanted on the 2nd day with the 5 Ncm reverse torque method. Test implants, which were applied cold for 5 min, were explanted on day 1. Tissue damage was detected in all test groups at −80 °C. Conclusions: The method of removing implants with cryotherapy was found to be successful in −40 °C freeze−thaw cycles applied three times for 1 min. To prove implant removal with cryotherapy, more implant trials should be conducted.
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Affiliation(s)
- Burak AK
- Periodontology Department, Faculty of Dentistry, Mersin University, 33343 Mersin, Turkey
- Correspondence:
| | - Emre Gürkan Eroğlu
- Periodontology Department, Faculty of Dentistry, Izmir Katip Çelebi University, 35620 Izmir, Turkey; (E.G.E.); (A.S.E.)
| | - Abdullah Seckin Ertugrul
- Periodontology Department, Faculty of Dentistry, Izmir Katip Çelebi University, 35620 Izmir, Turkey; (E.G.E.); (A.S.E.)
| | - Ayla Batu Öztürk
- Department of Histology and Embryology, School of Medicine, Mersin University, 33343 Mersin, Turkey; (A.B.Ö.); (Ş.N.Y.)
| | - Şakir Necat Yılmaz
- Department of Histology and Embryology, School of Medicine, Mersin University, 33343 Mersin, Turkey; (A.B.Ö.); (Ş.N.Y.)
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16
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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.
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17
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Ban S. Classification and Properties of Dental Zirconia as Implant Fixtures and Superstructures. MATERIALS 2021; 14:ma14174879. [PMID: 34500970 PMCID: PMC8432657 DOI: 10.3390/ma14174879] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Various types of zirconia are widely used for the fabrication of dental implant superstructures and fixtures. Zirconia-alumina composites, such as ATZ and NanoZR, are adequate for implant fixtures because they have excellent mechanical strength in spite of insufficient esthetic properties. On the other hand, yttria-stabilized zirconia has been used for implant superstructures because of sufficient esthetic properties. They are classified to 12 types with yttria content, monochromatic/polychromatic, uniform/hybrid composition, and monolayer/multilayer. Zirconia with a higher yttria content has higher translucency and lower mechanical strength. Fracture strength of superstructures strongly depends on the strength on the occlusal contact region. It suggests that adequate zirconia should be selected as the superstructure crown, depending on whether strength or esthetics is prioritized. Low temperature degradation of zirconia decreases with yttria content, but even 3Y zirconia has a sufficient durability in oral condition. Although zirconia is the hardest dental materials, zirconia restorative rarely subjects the antagonist teeth to occlusal wear when it is mirror polished. Furthermore, zirconia has less bacterial adhesion and better soft tissue adhesion when it is mirror polished. This indicates that zirconia has advantageous for implant superstructures. As implant fixtures, zirconia is required for surface modification to obtain osseointegration to bone. Various surface treatments, such as roughening, surface activation, and coating, has been developed and improved. It is concluded that an adequately selected zirconia is a suitable material as implant superstructures and fixtures because of mechanically, esthetically, and biologically excellent properties.
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Affiliation(s)
- Seiji Ban
- Department of Dental Materials Science, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
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18
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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.
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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
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Kunrath MF, Gupta S, Lorusso F, Scarano A, Noumbissi S. Oral Tissue Interactions and Cellular Response to Zirconia Implant-Prosthetic Components: A Critical Review. MATERIALS 2021; 14:ma14112825. [PMID: 34070589 PMCID: PMC8198172 DOI: 10.3390/ma14112825] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 12/20/2022]
Abstract
Background: Dental components manufactured with zirconia (ZrO2) represent a significant percentage of the implant prosthetic market in dentistry. However, during the last few years, we have observed robust clinical and pre-clinical scientific investigations on zirconia both as a prosthetic and an implantable material. At the same time, we have witnessed consistent technical and manufacturing updates with regards to the applications of zirconia which appear to gradually clarify points which until recently were not well understood. Methods: This critical review evaluated the “state of the art” in relation to applications of this biomaterial in dental components and its interactions with oral tissues. Results: The physico-chemical and structural properties as well as the current surface treatment methodologies for ZrO2 were explored. A critical investigation of the cellular response to this biomaterial was completed and the clinical implications discussed. Finally, surface treatments of ZrO2 demonstrate that excellent osseointegration is possible and provide encouraging prospects for rapid bone adhesion. Furthermore, sophisticated surface treatment techniques and technologies are providing impressive oral soft tissue cell responses thus leading to superior biological seal. Conclusions: Dental devices manufactured from ZrO2 are structurally and chemically stable with biocompatibility levels allowing for safe and long-term function in the oral environment.
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Affiliation(s)
- Marcel F. Kunrath
- Dentistry Department, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), P.O. Box 6681, Porto Alegre 90619-900, RS, Brazil;
- Materials and Nanoscience Laboratory, Pontifical Catholic University of Rio Grande do Sul (PUCRS), P.O. Box 6681, Porto Alegre 90619-900, RS, Brazil
| | - Saurabh Gupta
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Master Dental Science, Universitat Jaume I, 12071 Castellón de la Plana, Spain
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
| | - Antonio Scarano
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
- Correspondence: ; Tel.: +08713554084
| | - Sammy Noumbissi
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20901, USA; (S.G.); (S.N.)
- Department of Innovative Technologies in Medicine & Dentistry, University of Chieti-Pescara, Via dei Vestini, 31-66100 Chieti, CH, Italy;
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20
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Iijima N, Homma S, Nakano R, Hayashi S, Hirano T, Iijima T, Yajima Y. Fatigue properties of hollow zirconia implants. Dent Mater J 2021; 40:885-893. [PMID: 33692224 DOI: 10.4012/dmj.2020-248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective of this study was to clarify the fatigue behavior of hollow yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) specimens assuming its use for two-piece implants. The fatigue properties of a solid specimen (which simulated a one-piece implant) and 3 types of hollow specimens (which simulated two-piece implants) were evaluated. Specimens were either solid with a diameter of 4.0 mm (S) or hollow with an inner diameter of 3.0 mm and outer diameters of 4.0 mm (H0.5), 4.5 mm (H0.75), or 5.0 mm (H1.0). For each group, 25 specimens were prepared followed by blast and acid etch treatment. Static fracture and cyclic fatigue tests were conducted by modifying the methods provided in ISO6872. Fracture modes were determined by observing the surfaces under a scanning electron microscope. As a result, the cyclic fatigue load of S and H1.0 were similar, and hollow specimens with outer diameters greater than 0.75 mm displayed the ability to withstand molar occlusal forces.
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Affiliation(s)
- Noriko Iijima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Shinya Homma
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Ryotaro Nakano
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Shota Hayashi
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Tomoki Hirano
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Toshihiko Iijima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Yasutomo Yajima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
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21
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Bergamo ETP, Cardoso KB, Lino LFO, Campos TMB, Monteiro KN, Cesar PF, Genova LA, Thim GP, Coelho PG, Bonfante EA. Alumina-toughened zirconia for dental applications: Physicochemical, mechanical, optical, and residual stress characterization after artificial aging. J Biomed Mater Res B Appl Biomater 2020; 109:1135-1144. [PMID: 33314536 DOI: 10.1002/jbm.b.34776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/23/2020] [Accepted: 11/28/2020] [Indexed: 01/01/2023]
Abstract
To characterize the physicomechanical properties of an alumina-toughened zirconia (ATZ). ATZ synthesis consisted of the addition of alumina particles in an yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP) matrix. Specimens were obtained by uniaxial and isostatic pressing ATZ and 3Y-TZP powders and sintering at 1600°C/1 h and 1550°C/1 h, respectively. Crystalline content and residual stress were evaluated using X-ray diffraction (XRD). Microstructure was characterized by scanning electron microscopy (SEM). Optical properties were determined by reflectance test. Mechanical properties were assessed by biaxial flexural strength test. All analyses were performed before and after aging (134°C, 20 h, 2 bar). XRD and SEM revealed a typical ATZ and 3Y-TZP crystalline content, chiefly tetragonal phase, with a dense polycrystalline matrix, though a smaller grain size for ATZ. Aging triggered a similar monoclinic transformation for both systems; however, ATZ exhibited higher residual compressive stresses than 3Y-TZP. While as-processed 3Y-TZP demonstrated significantly higher characteristic strength relative to ATZ, no significant difference was observed after aging (~215 MPa increase in the ATZ strength). ATZ presented significantly higher opacity relative to 3Y-TZP, although aging significantly increased the translucency of both systems (increase difference significantly higher in the 3Y-TZP compared to ATZ). ATZ physicomechanical properties support its applicability in the dental field, with a lower detrimental effect of aging relative to 3Y-TZP.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Karina B Cardoso
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Lucas F O Lino
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Tiago M B Campos
- Department of Physics, Aeronautics Technological Institute, São José dos Campos, SP, Brazil
| | - Kelli N Monteiro
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Paulo F Cesar
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Luis A Genova
- Center of Materials Science and Technology, Institute of Research in Nuclear Energy, São Paulo, SP, Brazil
| | - Gilmar P Thim
- Department of Physics, Aeronautics Technological Institute, São José dos Campos, SP, Brazil
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Hansjörg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, New York City, NY, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
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22
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Bioinstructive Micro-Nanotextured Zirconia Ceramic Interfaces for Guiding and Stimulating an Osteogenic Response In Vitro. NANOMATERIALS 2020; 10:nano10122465. [PMID: 33317084 PMCID: PMC7764817 DOI: 10.3390/nano10122465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/01/2020] [Accepted: 12/05/2020] [Indexed: 01/17/2023]
Abstract
Osseous implantology’s material requirements include a lack of potential for inducing allergic disorders and providing both functional and esthetic features for the patient’s benefit. Despite being bioinert, Zirconia ceramics have become a candidate of interest to be used as an alternative to titanium dental and cochlear bone-anchored hearing aid (BAHA) implants, implying the need for endowing the surface with biologically instructive properties by changing basic parameters such as surface texture. Within this context, we propose anisotropic and isotropic patterns (linear microgroove arrays, and superimposed crossline microgroove arrays, respectively) textured in zirconia substrates, as bioinstructive interfaces to guide the cytoskeletal organization of human mesenchymal stem cells (hMSCs). The designed textured micro-nano interfaces with either steep ridges and microgratings or curved edges, and nanoroughened walls obtained by direct femtosecond laser texturing are used to evaluate the hMSC response parameters and osteogenic differentiation to each topography. Our results show parallel micro line anisotropic surfaces are able to guide cell growth only for the steep surfaces, while the curved ones reduce the initial response and show the lowest osteogenic response. An improved osteogenic phenotype of hMSCs is obtained when grown onto isotropic grid/pillar-like patterns, showing an improved cell coverage and Ca/P ratio, with direct implications for BAHA prosthetic development, or other future applications in regenerating bone defects.
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23
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Microwave assisted sol-gel synthesis of bioactive zirconia nanoparticles – Correlation of strength and structure. J Mech Behav Biomed Mater 2020; 112:104012. [DOI: 10.1016/j.jmbbm.2020.104012] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 11/21/2022]
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24
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Assessment of Force Retention between Milled Metallic and Ceramic Telescopic Crowns with Different Taper Angles Used for Oral Rehabilitation. MATERIALS 2020; 13:ma13214814. [PMID: 33126581 PMCID: PMC7663722 DOI: 10.3390/ma13214814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 11/17/2022]
Abstract
The present study assessed the retention forces corresponding to different telescopic systems used in removable prosthetic dentures. The telescopic systems were represented by Co–Cr alloy or zirconia-based primary crowns and Co–Cr secondary crowns. All crowns were manufactured using computer-aided design/computer-aided manufacturing technology (CAD/CAM). Two types of reference abutment teeth (upper canine and first upper molar) were selected in order to obtain the telescopic crowns and two taper angles—of 0° and 2°—were used for the design of the crowns. A number of 120 samples of telescopic crowns were obtained and subjected to mechanical tests, following a specific protocol, on a mechanical testing equipment. The retention of the telescopic systems was evaluated for different sets of cycles (up to 360), represented by movements that simulate the intraoral insertion and disinsertion of the telescopic systems. The present study highlights that the telescopic systems in which the primary crown is made of zirconia ceramics presents more advantages than those made of Co–Cr. All telescopic systems studied, highlighted that by modifying the taper angle from 0° to 2°, the retention forces have decreased, irrespective of the materials used for the fabrication of the primary crown, suggesting that by using a taper angle of 0°, which is known to be ideal, more efficient, and reliable prosthesis can be developed. Thus, even though the ceramic–metallic telescopic system exhibited the highest retention, all telescopic crowns evaluated registered values between 2–7 N, indicating that they are suitable for clinical use.
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Guo S, Liu N, Liu K, Li Y, Zhang W, Zhu B, Gu B, Wen N. Effects of carbon and nitrogen plasma immersion ion implantation on bioactivity of zirconia. RSC Adv 2020; 10:35917-35929. [PMID: 35517098 PMCID: PMC9056952 DOI: 10.1039/d0ra05853j] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/06/2020] [Indexed: 01/11/2023] Open
Abstract
Zirconia is considered the most promising alternative material to titanium implants. However, zirconia is a biologically inert material and its surface modification is essential to obtain efficient osseointegration. Plasma immersion ion implantation (PIII) is a controllable and flexible approach that constructs functional groups on the surface of biomaterials and enhances osteogenic ability of host osteoclast cells. Zirconia disks were randomly divided into 4 groups (n = 50/group): (1) Blank, (2) C60N0, (3) C60N6, and (4) C60N18. Carbon and nitrogen plasma immersion ion implantation on zirconia (C and N2-PIII) surface modification was completed with the corresponding parameters. When zirconia was modified by carbon and nitrogen plasma implantation, a new chemical structure was formed on the material surface while the surface roughness of the material remained unaltered. The nitrogen-containing functional groups with high potential were introduced but the bulk crystal structure of zirconia was not changed, indicating that the stability of zirconia was not affected. In vitro data showed that zirconia with high surface potential promoted adhesion, proliferation, and osteogenic differentiation of BMSCs. C60N6 was found to be superior to the other groups. Our results demonstrate that a zirconia surface modified by C and N2-PIII can introduce desirable nitrogen functional groups and create a suitable extracellular environment to promote BMSCs biological activity. Taken together, these results suggest that C and N2-PIII modified zirconia is a promising material for use in the field of medical implantation. Zirconia is considered the most promising alternative material to titanium implants.![]()
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Affiliation(s)
- Shuqin Guo
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947.,Department of Stomatology, Beijing Railway Construction Hospital, China Railway Construction Corporation 40 Fuxing Road, Haidian District Beijing 100855 China
| | - Na Liu
- Department of Stomatology, Hainan Hospital, Chinese PLA General Hospital Sanya 572013 Hainan Province China
| | - Ke Liu
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Beijing 100190 China
| | - Ying Li
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Wei Zhang
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Beijing 100190 China
| | - Biao Zhu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Bin Gu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Ning Wen
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
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26
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Alqurashi H, Khurshid Z, Syed AUY, Rashid Habib S, Rokaya D, Zafar MS. Polyetherketoneketone (PEKK): An emerging biomaterial for oral implants and dental prostheses. J Adv Res 2020; 28:87-95. [PMID: 33384878 PMCID: PMC7770505 DOI: 10.1016/j.jare.2020.09.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/29/2020] [Accepted: 09/08/2020] [Indexed: 12/16/2022] Open
Abstract
Polyetherketoneketone (PEKK) is a new evolving polymeric material. The present article comprehensively reviewed an overview of various applications of PEKK in prosthodontics and oral implantology, highlighting its prospects for clinical applications. PEKK biomaterials is an elastic material with good shock absorbance and fracture resistance and present ultra-high performance among all thermoplastic composites for excellent mechanical strength, chemical resistance, and high thermal stability. Available articles on PEKK for dental applications were reviewed from January 1957 to August 2020) using MEDLINE/PubMed, Web of Science, and ScienceDirect resources. PEKK presents suitable physical, mechanical, and chemical properties for applications in prosthodontics and oral implantology. PEKK has good potential for a wide range of dental applications, including tooth restorations, crowns, bridge, endoposts, denture framework, implant-supported fixed prosthesis, and dental implants. PEKK dental implants have shown lesser stress shielding compared to titanium for dental implant applications. Further modifications and improving material properties can result in broader applications in the field of dentistry. Long term evaluations are needed as PEKK is recently applied in dentistry, and there are limited studies published on PEKK.
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Affiliation(s)
- Hatim Alqurashi
- School of Clinical Dentistry, University of Sheffield, United Kingdom.,Department of Preventive Dental Sciences, School of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Zohaib Khurshid
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Azeem Ul Yaqin Syed
- Department of Prosthodontics and Dental Implantology, College of Dentistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Bangkok 10400, Thailand
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Madinah Al Munawwarah, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
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27
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Rohr N, Fricke K, Bergemann C, Nebe JB, Fischer J. Efficacy of Plasma-Polymerized Allylamine Coating of Zirconia after Five Years. J Clin Med 2020; 9:jcm9092776. [PMID: 32867239 PMCID: PMC7565740 DOI: 10.3390/jcm9092776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 12/19/2022] Open
Abstract
Plasma-polymerized allylamine (PPAAm) coatings of titanium enhance the cell behavior of osteoblasts. The purpose of the present study was to evaluate a PPAAm nanolayer on zirconia after a storage period of 5 years. Zirconia specimens were directly coated with PPAAm (ZA0) or stored in aseptic packages at room temperature for 5 years (ZA5). Uncoated zirconia specimens (Zmt) and the micro-structured endosseous surface of a zirconia implant (Z14) served as controls. The elemental compositions of the PPAAm coatings were characterized and the viability, spreading and gene expression of human osteoblastic cells (MG-63) were assessed. The presence of amino groups in the PPAAm layer was significantly decreased after 5 years due to oxidation processes. Cell viability after 24 h was significantly higher on uncoated specimens (Zmt) than on all other surfaces. Cell spreading after 20 min was significantly higher for Zmt = ZA0 > ZA5 > Z14, while, after 24 h, spreading also varied significantly between Zmt > ZA0 > ZA5 > Z14. The expression of the mRNA differentiation markers collagen I and osteocalcin was upregulated on untreated surfaces Z14 and Zmt when compared to the PPAAm specimens. Due to the high biocompatibility of zirconia itself, a PPAAm coating may not additionally improve cell behavior.
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Affiliation(s)
- Nadja Rohr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, 4058 Basel, Switzerland;
- Department of Cell Biology, Rostock University Medical Center, 18057 Rostock, Germany; (C.B.); (J.B.N.)
- Correspondence: ; Tel.: +41-612-672-799
| | - Katja Fricke
- Leibniz Institute for Plasma Science and Technology e.V. (INP), 17489 Greifswald, Germany;
| | - Claudia Bergemann
- Department of Cell Biology, Rostock University Medical Center, 18057 Rostock, Germany; (C.B.); (J.B.N.)
| | - J Barbara Nebe
- Department of Cell Biology, Rostock University Medical Center, 18057 Rostock, Germany; (C.B.); (J.B.N.)
| | - Jens Fischer
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, 4058 Basel, Switzerland;
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2020; 124:274-349. [PMID: 32811666 DOI: 10.1016/j.prosdent.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/20/2023]
Abstract
This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.
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Zhang J, Li Y, Li J, Shi Y, Hu J, Yang G. Surfce Functionalized via AdLAMA3 Multilayer Coating for Re-epithelization Around Titanium Implants. Front Bioeng Biotechnol 2020; 8:624. [PMID: 32596232 PMCID: PMC7300264 DOI: 10.3389/fbioe.2020.00624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/21/2020] [Indexed: 11/29/2022] Open
Abstract
The peri-implant epithelium (PIE) forms a crucial seal between the oral environment and the implant surface. Compared with the junctional epithelium (JE), the biological sealing of PIE is fragile, which lacks hemidesmosomes (HDs) and internal basal lamina (extracellular matrix containing laminin332, IBL) on the upper part of the interface. In the study, we aim to prepare a coating with good biocompatibility and ability to immobilize the recombinant adenovirus vector of LAMA3 (AdLAMA3) for promoting the re-epithelization of PIE. The titanium surface functionalized with AdLAMA3 was established via layer-by-layer assembly technique and antibody-antigen specific binding. The biological evaluations including cell adhesion and the re-epithelization of PIE were investigated. The results in vitro demonstrated that the AdLAMA3 coating could improve epithelial cell attachment and cell spreading in the early stage. In vivo experiments indicated that the AdLAMA3 coating on the implant surface has the potential to accelerate the healing of the PIE, and could promote the expression of laminin α3 and the formation of hemidesmosomes. This study might provide a novel approach and experimental evidence for the precise attachment of LAMA3 to titanium surfaces. The process could improve the re-epithelization of PIE.
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Affiliation(s)
- Jing Zhang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Yongzheng Li
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Jialu Li
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Yuan Shi
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Jinxing Hu
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
| | - Guoli Yang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Zhejiang University School of Stomatology, Hangzhou, China
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30
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Crystal structure of zirconia affects osteoblast behavior. Dent Mater 2020; 36:905-913. [DOI: 10.1016/j.dental.2020.04.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/27/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
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Rohr N, Zeller B, Matthisson L, Fischer J. Surface structuring of zirconia to increase fibroblast viability. Dent Mater 2020; 36:779-786. [PMID: 32354484 DOI: 10.1016/j.dental.2020.03.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/19/2020] [Accepted: 03/26/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The neck area of zirconia implants or abutments is currently either machined, polished and in some cases additionally heat-treated. The aim of the present study was to determine how the surface topography and crystalline structure of zirconia affects the viability of human gingival fibroblasts (HGF-1). METHODS Zirconia discs with a diameter of 13mm were either polished [Zp], polished and heat-treated [Zpt], machined [Zm], machined and heat-treated [Zmt] or sandblasted, etched and heat-treated [Z14] which is the surface topography of the endosseous part of a zirconia implant. The specimen surfaces were analyzed using scanning electron microscopy (SEM), characterized in terms of monoclinic to tetragonal phase ratio, storage effect on wettability and roughness. The viability and morphology of HGF-1 cells was then tested on all surfaces after 24h. RESULTS The effect of the heat-treatment was visualized for the polished specimens with SEM. Contact angle of water was significantly decreased after 2 weeks air storage of the zirconia. Cell viability was significantly higher on smooth surfaces (Zpt, Zm, Zmt) when compared to Z14. HGF-1 cells spread very flat and attached tightly to the smoother surfaces Zp, Zpt, Zm and Zmt while on Z14, cells did not fully extend into the etched morphology of zirconia and stretched over longer distances. SIGNIFICANCE For the structuring of the neck part of zirconia implants or abutments, a smooth surface with exposed grains might be suggested as the optimal substrate for human gingival fibroblasts. The wettability with water of zirconia decreases with prolonged air storage.
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Affiliation(s)
- Nadja Rohr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
| | - Barbara Zeller
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Lea Matthisson
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Jens Fischer
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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32
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Has zirconia made a material difference in implant prosthodontics? A review. Dent Mater 2020; 36:1-8. [DOI: 10.1016/j.dental.2019.08.100] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 12/17/2022]
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33
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Cabello-Domínguez G, Pérez-López J, Veiga-López B, González D, Revilla-León M. Maxillary zirconia and mandibular composite resin-lithium disilicate-modified PEEK fixed implant-supported restorations for a completely edentulous patient with an atrophic maxilla and mandible: A clinical report. J Prosthet Dent 2019; 124:403-410. [PMID: 31870613 DOI: 10.1016/j.prosdent.2019.10.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
Bimaxillary implant-supported restorations for edentulous patients must include a comprehensive diagnosis, treatment plan, and careful selection of the restorative materials. The present clinical report described a completely edentulous patient rehabilitated with a zirconia framework with a facial ceramic veneer on the maxillary arch and a modified polyetheretherketone (PEEK) framework with gingival composite resin and cemented lithium disilicate crowns on the mandibular arch. The rationale for this combination of restorative materials is reviewed.
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Affiliation(s)
| | | | | | | | - Marta Revilla-León
- Assistant Professor and Assistant Program Director AEGD, College of Dentistry, Texas A&M University, Dallas, Texas; Affiliate Assistant Professor Graduate Prosthodontics, University of Washington, Seattle, Wash; Researcher, Revilla Research Center, Madrid, Spain.
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Iinuma Y, Hirota M, Hayakawa T, Ohkubo C. Surrounding Tissue Response to Surface-Treated Zirconia Implants. MATERIALS 2019; 13:ma13010030. [PMID: 31861679 PMCID: PMC6981750 DOI: 10.3390/ma13010030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022]
Abstract
Yttria-stabilized tetragonal zirconia polycrystals (Y-TZP), which are partially stabilized zirconia, have been used for fabricating dental implants. This study investigated the soft tissue attachment, the collagen fiber orientation to zirconia at different surface conditions, and the bone response using implantation experiments in animals. The zirconia implant surfaces were treated with ultraviolet irradiation (UV), a combination of large-grit sandblasting and hydrofluoric acid etching (blastedHF), and a combination of blastedHF and UV (blastedHF+UV). The surface treated with blastedHF and blastedHF+UV appeared rough and hydrophilic. The surface treated with blastedHF+UV appeared to be superhydrophilic. Subsequently, tapered cylindrical zirconia implants were placed in the alveolar sockets of the maxillary molars of rats. The bone-to-implant contact ratio of blastedHF and blastedHF+UV implants was significantly higher than that of the non-treated controls and UV-treated implants. The four different surface-treated zirconia implants demonstrated tight soft tissue attachments. Perpendicularly oriented collagen fibers towards zirconia implants were more prominent in blastedHF and blastedHF+UV implants compared to the controls and UV-treated implants. The area of the soft tissue attachment was the greatest with the perpendicularly oriented collagen fibers of blastedHF+UV-treated implants. In conclusion, blastedHF+UV treatment could be beneficial for ensuring greater soft-tissue attachment for zirconia implants.
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Affiliation(s)
- Yohei Iinuma
- Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan;
- Correspondence: ; Tel.: +81-45580-8421
| | - Masatsugu Hirota
- School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan; (M.H.); (T.H.)
| | - Tohru Hayakawa
- School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan; (M.H.); (T.H.)
| | - Chikahiro Ohkubo
- Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan;
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Solderer A, Al‐Jazrawi A, Sahrmann P, Jung R, Attin T, Schmidlin PR. Removal of failed dental implants revisited: Questions and answers. Clin Exp Dent Res 2019; 5:712-724. [PMID: 31890309 PMCID: PMC6934347 DOI: 10.1002/cre2.234] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022] Open
Abstract
Objectives This narrative review is aiming on showing reasons for implant failure, removal techniques, and respective clinical considerations; further, the survival rate of implants in previous failed sites is examined. Materials and methods Questions have been formulated, answered, and discussed through a literature search including studies assessing implant failure and removal up to 2018. Results Studies describing reasons for implant failure, implant removal techniques, and the reinsertion of implants in a previous failed site (n = 12) were included. To date, peri-implantitis is the main reason for late implant failure (81.9%). Trephine burs seem to be the best-known method for implant removal. Nevertheless, the counter-torque-ratchet-technique, because of the low invasiveness, should be the first choice for the clinician. Regarding zirconia implant removal, only scarce data are available. Implantation in previously failed sites irrespective of an early or late failure results in 71% to 100% survival over 5 years. Conclusion If removal is required, interventions should be based on considerations regarding minimally invasive access and management as well as predictable healing. (Post)Operative considerations should primarily depend on the defect type and the consecutive implantation plans.
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Affiliation(s)
- Alex Solderer
- Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
| | | | - Philipp Sahrmann
- Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
| | - Ronald Jung
- Clinic of Reconstructive DentistryUniversity of ZurichZurichSwitzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive DentistryUniversity of ZurichZurichSwitzerland
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Clinical performance of zirconia implants: A meta-review. J Prosthet Dent 2019; 123:419-426. [PMID: 31451193 DOI: 10.1016/j.prosdent.2019.05.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022]
Abstract
STATEMENT OF PROBLEM The clinical effectiveness of zirconia implants as an alternative to titanium implants is still controversial. PURPOSE The purpose of this analysis was to identify and evaluate systematic reviews reporting on the clinical outcomes of zirconia implants for oral rehabilitation. MATERIAL AND METHODS An electronic search was undertaken on MEDLINE, Embase, and the Cochrane Oral Health Reviews databases up to December 24, 2018, without language restriction. Eligible reviews were screened and assessed. The eligibility criteria were systematic reviews or meta-analyses, implant survival rate, implant success, marginal bone loss, peri-implant soft tissue status, and biologic and functional complications of zirconia implants. Two review authors independently evaluated the quality assessment of the secondary studies by applying the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. RESULTS Nine reviews fulfilled the inclusion criteria and were evaluated. Seven reviews were classified as moderate and 2 as high quality. The overall AMSTAR's quality of these reports was moderate. In the primary studies contained in these reviews, zirconia implant clinical outcomes were found to be similar or inferior to those for titanium implants. The few primary clinical studies contained in these reviews were not homogeneous among each other, presented poor methodology, and only offered promising short-term outcomes due to the lack of long-term follow-ups. CONCLUSIONS Based on this meta-review, in spite of short-term promising results of zirconia implants, evidence with long term is lacking.
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Lee DJ, Ryu JS, Shimono M, Lee KW, Lee JM, Jung HS. Differential Healing Patterns of Mucosal Seal on Zirconia and Titanium Implant. Front Physiol 2019; 10:796. [PMID: 31333481 PMCID: PMC6616312 DOI: 10.3389/fphys.2019.00796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 06/06/2019] [Indexed: 11/13/2022] Open
Abstract
Zirconia implants have become an alternative to titanium implants due to several advantages. The zirconia implant is relatively esthetic and highly resistant to bacteria. While biomaterial studies for zirconia implants have considerably accumulated, in vivo studies have not yet progressed. In the present study, the functional and biological properties of zirconia implants were analyzed thorough in vitro and in vivo studies. The proliferation properties of periodontal cells on the discs of machined surface titanium, hydroxyapatite coated titanium and zirconia were analyzed, and zirconia was shown to be favorable. In addition, small implant fixtures that can be applied to the jawbone of mice were manufactured and transplanted to C57BL/6 mice. The adhesion molecules expression patterns in peri-implant mucosa suggest a stronger mucosal seal and more adequate prevention of peri-implant epithelium (PIE) elongation in the zirconia implant when compared with other conventional materials. Differential laminin-332 expression in peri-implant mucosa of zirconia implants seems to regulate the PIE elongation. In conclusion, zirconia was found to be promising and advantageous with regards to the mucosal seal. And biological width (BW) of peri-implant mucosa is more desirable in zirconia implants compared to conventional titanium implants.
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Affiliation(s)
- Dong-Joon Lee
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Oral Science Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Joon-Sang Ryu
- Department of Prosthodontics, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - Masaki Shimono
- Department of Pathology, Tokyo Dental College, Tokyo, Japan
| | - Keun-Woo Lee
- Department of Prosthodontics, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jong-Min Lee
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Oral Science Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea
| | - Han-Sung Jung
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Oral Science Research Center, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, South Korea.,Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
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