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Hassan TH, Ayappali Kalluvalappil N. Allergic reaction of poly-ether-ether-ketone versus titanium implants: A posttest-only control group design experimental study using a rabbit model. Clin Implant Dent Relat Res 2024; 26:671-678. [PMID: 38573022 DOI: 10.1111/cid.13323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/02/2024] [Accepted: 02/18/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE The aim of this study was to determine clinically and genetically the allergic effects of titanium and poly-ether-ether-ketone (PEEK) implants following loading in rabbit tibias. MATERIALS AND METHODS This study included 18 white New Zealand male rabbits (n = 18) divided evenly into three groups: control, titanium (Ti), and PEEK (P). Clinically, the allergenic effect of titanium and PEEK was investigated by detecting the effect on lymph nodes. Furthermore, RT-PCR and ELISA were used to detect the expression of certain genes IL-6, TNF-α, OPG, RANKL, and RUNX-2 through both types of implants. RESULTS Our findings demonstrated that titanium implants induced enlarged lymph nodes, which PEEK did not. Overall, RT-PCR and ELISA techniques revealed that Ti implants had higher expression of the inflammatory genes IL-6 and TNF-α. Ti had the highest expression in OPG findings, while PEEK had the lowest. RANKL expression was highest in the control group and lowest in the PEEK group. RUNX-2 is the highest for the control group and the lowest for the titanium group. CONCLUSION Although titanium implants elicited greater allergy responses than PEEK implants, titanium has the highest expression of bone formation genes and the lowest expression of bone resorption genes, making it preferable to PEEK.
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Affiliation(s)
- Tamer Hamed Hassan
- College of Dentistry, University of Science and Technology of Fujairah, UAE
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2
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Kamel NA, Wissa DA, Abd-El-Messieh SL. Novel nano composites from Citrus limon and Citrullus colocynthis agricultural wastes for biomedical applications. Sci Rep 2024; 14:17343. [PMID: 39069554 PMCID: PMC11284205 DOI: 10.1038/s41598-024-67423-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 07/11/2024] [Indexed: 07/30/2024] Open
Abstract
In recent years, academic and industrial research has focused on using agro-waste for energy and new material production to promote sustainable development and lessen environmental issues. In this study, new nanocomposites based on polyvinyl alcohol (PVA)-Starch using two affordable agricultural wastes, Citrus limon peels (LP) and Citrullus colocynthis (Cc) shells and seeds powders with different concentrations (2, 5, 10, and 15 wt%) as bio-fillers were prepared. The nanocomposites were characterized by Dielectric Spectroscopy, Fourier-Transform Infrared (FTIR), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), and water swelling ratio. The antimicrobial properties of the nanocomposites against Escherichia coli, Staphylococcus aureus, and Candida albicans were examined to investigate the possibility of using such composites in biomedical applications. Additionally, the biocompatibility of the composites on human normal fibroblast cell lines (HFB4) was tested using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. The results demonstrate that the filler type and concentration strongly affect the film's properties. The permittivity ε', dielectric loss ε″ and conductivity σdc increased by increasing filler content but still in the insulators range that recommend such composites to be used in the insulation purposes. Both bio fillers control the water uptake, and the samples filled with LP were more water resistant. The polyvinyl alcohol/starch incorporated with 5 wt% LP and Cc have antimicrobial effects against all the tested microorganisms. Increasing the filler content has a negative impact on cell viability.
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Affiliation(s)
- Nagwa A Kamel
- Microwave Physics and Dielectrics Department, Physics Research Institute, National Research Centre, Giza, Egypt.
| | - D A Wissa
- Solid State Physics Department, Physics Research Institute, National Research Centre, Giza, Egypt
| | - Salwa L Abd-El-Messieh
- Microwave Physics and Dielectrics Department, Physics Research Institute, National Research Centre, Giza, Egypt
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Kandaswamy E, Harsha M, Joshi VM. Titanium corrosion products from dental implants and their effect on cells and cytokine release: A review. J Trace Elem Med Biol 2024; 84:127464. [PMID: 38703537 DOI: 10.1016/j.jtemb.2024.127464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Titanium is considered to be an inert material owing to the ability of the material to form a passive titanium oxide layer. However, once the titanium oxide layer is lost, it can lead to exposure of the underlying titanium substructure and can undergo corrosion. SUMMARY The article explores the role of titanium ions and particles from dental implants on cells, cytokine release, and on the systemic redistribution of these particles as well as theories proposed to elucidate the effects of these particles on peri-implant inflammation based on evidence from in-vitro, human, and animal studies. Titanium particles and ions have a pro-inflammatory and cytotoxic effect on cells and promote the release of pro-inflammatory mediators like cytokines. Three theories to explain etiopathogenesis have been proposed, one based on microbial dysbiosis, the second based on titanium particles and ions and the third based on a synergistic effect between microbiome and titanium particles on the host. CONCLUSION There is clear evidence from in-vitro and limited human and animal studies that titanium particles released from dental implants have a detrimental effect on cells directly and through the release of pro-inflammatory cytokines. Future clinical and translational studies are required to clarify the role of titanium particles and ions in peri-implant inflammation and the etiopathogenesis of peri-implantitis.
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Affiliation(s)
- Eswar Kandaswamy
- Department of Periodontics, LSUHSC, School of Dentistry, 100 Florida Avenue, New Orleans, LA 70119, USA
| | - M Harsha
- Department of Oral Pathology & Microbiology, Yogita Dental College & Hospital, Naringi Riverside, At Post Tal Dist. SH104, Khed, Maharashtra 415709, India
| | - Vinayak M Joshi
- Department of Periodontics, LSUHSC, School of Dentistry, 100 Florida Avenue, New Orleans, LA 70119, USA.
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Zhang X, Zhou W, Xi W. Advancements in incorporating metal ions onto the surface of biomedical titanium and its alloys via micro-arc oxidation: a research review. Front Chem 2024; 12:1353950. [PMID: 38456182 PMCID: PMC10917964 DOI: 10.3389/fchem.2024.1353950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024] Open
Abstract
The incorporation of biologically active metallic elements into nano/micron-scale coatings through micro-arc oxidation (MAO) shows significant potential in enhancing the biological characteristics and functionality of titanium-based materials. By introducing diverse metal ions onto titanium implant surfaces, not only can their antibacterial, anti-inflammatory and corrosion resistance properties be heightened, but it also promotes vascular growth and facilitates the formation of new bone tissue. This review provides a thorough examination of recent advancements in this field, covering the characteristics of commonly used metal ions and their associated preparation parameters. It also highlights the diverse applications of specific metal ions in enhancing osteogenesis, angiogenesis, antibacterial efficacy, anti-inflammatory and corrosion resistance properties of titanium implants. Furthermore, the review discusses challenges faced and future prospects in this promising area of research. In conclusion, the synergistic approach of micro-arc oxidation and metal ion doping demonstrates substantial promise in advancing the effectiveness of biomedical titanium and its alloys, promising improved outcomes in medical implant applications.
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Affiliation(s)
- Xue’e Zhang
- Jiangxi Province Key Laboratory of Oral Biomedicine, School of Stomatology, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
| | - Wuchao Zhou
- Jiangxi Province Key Laboratory of Oral Biomedicine, The Affiliated Stomatological Hospital, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
| | - Weihong Xi
- Jiangxi Province Key Laboratory of Oral Biomedicine, The Affiliated Stomatological Hospital, Jiangxi Medical College, Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang University, Nanchang, China
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5
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Makurat-Kasprolewicz B, Ossowska A. Electrophoretically deposited titanium and its alloys in biomedical engineering: Recent progress and remaining challenges. J Biomed Mater Res B Appl Biomater 2024; 112:e35342. [PMID: 37905698 DOI: 10.1002/jbm.b.35342] [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: 03/26/2023] [Revised: 08/23/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023]
Abstract
Over the past decade, titanium implants have gained popularity as the number of performed implantation operations has significantly increased. There are a number of methods for modifying the surface of biomaterials, which are aimed at extending the life of titanium implants. The developments in this field in recent years have required a comprehensive discussion of all the properties of electrophoretically deposited coatings on titanium and its alloys, taking into account their bioactivity. The development that took place in this field in recent years required a comprehensive discussion of all the properties of coatings electrophoretically deposited on titanium and its alloys, with particular emphasis on their bioactivity. Herein, we attempt to assess the influence of the electrophoretic deposition (EPD) process parameters on these coatings' biological and mechanical properties. Particular attention has been addressed to the in-vitro and in-vivo studies conducted hitherto. We have seen an increased interest in using titanium alloys without the addition of toxic compounds and gaps in the EPD field such as the uncommon endeavors to develop a "Design of experiments" approach as well as the lack of assessment of the surface free energy and detailed topography of electrophoretically deposited coatings. The exact correlation of coating properties with EPD process parameters still seems explicitly not understood, necessitating more future investigations. Ipso facto, the exact mechanism of particle agglomeration and Hamaker's law need to be fathomable.
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Affiliation(s)
| | - Agnieszka Ossowska
- Faculty of Mechanical Engineering and Ship Technology, Gdansk University of Technology, Gdańsk, Poland
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Mostafa D, Kassem YM, Omar SS, Shalaby Y. Nano-topographical surface engineering for enhancing bioactivity of PEEK implants (in vitro-histomorphometric study). Clin Oral Investig 2023; 27:6789-6799. [PMID: 37847259 PMCID: PMC10630241 DOI: 10.1007/s00784-023-05291-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES Dental implants are currently becoming a routine treatment decision in dentistry. Synthetic polyetheretherketone (PEEK) polymer is a prevalent component of dental implantology field. The current study aimed to assess the influence of Nd:YAG laser nano-topographical surface engineering combined with ultraviolet light or platelet rich fibrin on the bioactivity and osseointegration of PEEK implants in laboratory and animal testing model. MATERIALS AND METHODS Computer Aided Design-Computer Aided Manufacturing (CAD CAM) discs of PEEK were used to fabricate PEEK discs (8 mm × 3 mm) N = 36 and implant cylinders (3 mm × 6 mm) N = 72. Specimens were exposed to Nd:YAG laser at wavelength 1064 nm, and surface roughness topography/Ra parameter was recorded in nanometer using atomic force microscopy. Laser modified specimens were divided into three groups: Nd:YAG laser engineered surfaces (control), Nd:YAG laser/UV engineered surfaces and Nd:YAG laser/PRF engineered surfaces (N = 12 discs-N = 24 implants). In vitro bioactivity test was performed, and precipitated apatite minerals were assessed with X-ray diffraction analysis (XRD) and scanning electron microscopy (SEM). In vivo histomorphometric analysis was performed in rabbits with BIC% calculation. RESULTS Ra mean value of PEEK laser engineered surfaces was 125.179 nm. For the studied groups, XRD patterns revealed distinctive peaks of different apatite minerals that were demonstrated by SEM as dispersed surface aggregations. There was a significant increase in the BIC% from control group 56.43 (0.97) to laser/UV surfaces 77.30 (0.78) to laser/PRF 84.80 (1.29) (< 0.0001). CONCLUSIONS Successful engineered nano-topographical biomimetic PEEK implant could be achieved by Nd:YAG laser technique associated with improving bioactivity. The combination with UV or PRF could be simple and economic methods to gain more significant improvement of PEEK implant surface bioactivity with superior osteointegration.
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Affiliation(s)
- Dawlat Mostafa
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
- College of Dentistry, The Arab Academy for Science and Technology and Maritime Transport (AASTMT), El-Alamein, Egypt.
| | - Youssef M Kassem
- Prosthodontic Department, LSUHSC School of Dentistry, LSU Health Science Center, New Orleans, LA, USA
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Leonardi de Oliveira Rigotti R, Dias Corpa Tardelli J, Cândido dos Reis A. Influence of antibacterial surface treatment on dental implants on cell viability: A systematic review. Heliyon 2023; 9:e13693. [PMID: 36895374 PMCID: PMC9988489 DOI: 10.1016/j.heliyon.2023.e13693] [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: 09/23/2022] [Revised: 02/02/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
There is no consensus in the literature about the best non-cytotoxic antibacterial surface treatment for dental implants. Critically evaluate the existing literature and answer the question: "which surface treatment for dental implants made of titanium and its alloys has the greatest non-cytotoxic antibacterial activity for osteoblastic cells?" This systematic review was registered in the Open Science Framework (osf.io/8fq6p) and followed the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. The search strategy was applied to four databases. Articles were selected that evaluated in both studies the properties of 1) antibacterial activity and 2) cytotoxicity on osteoblastic cells of titanium and their alloy dental implants when treated superficially. Systematic reviews, book chapters, observational studies, case reports, articles that studied non-dental implants, and articles that evaluated only the development of surface treatment were excluded. The Joanna Briggs Institute, a quasi-experimental study assessment tool, was adapted to assess the risk of bias. The search strategy found 1178 articles in the databases after removing duplicates in EndNote Web, resulting in 1011 articles to be evaluated by title and abstract, of which 21 were selected for full reading, of which 12 were included by eligibility criteria, and nine were excluded. Quantitative synthesis could not be performed due to the heterogeneity of the data (surface treatment, antibacterial assay, bacteria strain, cell viability assay, and cell type). Risk of bias assessment showed that ten studies were classified as low risk and two studies as moderate risk. The evaluated literature allowed us to conclude that: 1) The literature surveyed did not allow answering the question due to the heterogeneity of the studies; 2) Ten of the 12 studies evaluated presented surface treatments with non-cytotoxic antibacterial activity; 3) Adding nanomaterials, QPEI, BG, and CS, reduce the chances of bacterial resistance by controlling their adhesion by electrical forces.
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Affiliation(s)
- Renan Leonardi de Oliveira Rigotti
- Department of Dental Materials and Prosthesis; School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Juliana Dias Corpa Tardelli
- Department of Dental Materials and Prosthesis; School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Andréa Cândido dos Reis
- Department of Dental Materials and Prosthesis; School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil
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Muñoz-Vazquez J, Chavez-Granados PA, Hernandez-Gomez G, Scougall-Vilchis RJ, Hiroshi S, Garcia-Contreras R. Effects of Nitrurized Titanium on Microhardness and Human Dental Pulp Stem Cell Adhesion and Differentiation. J Long Term Eff Med Implants 2023; 33:31-39. [PMID: 36734925 DOI: 10.1615/jlongtermeffmedimplants.2022044424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
To compare the Vickers microhardness, surface roughness, initial adhesion, and osteogenic differentiation on titanium (Ti) and nitrurized titanium (NTi) plates were treated by UV irradiation and chitosan. Each plate was subjected to Vickers hardness with a pressure of 2.9 N for 10 seconds and roughness evaluation by atomic force microscope (AFM) analysis. Three groups of each type of plates were tested: control (C), ultraviolet irradiation (UV), and chitosan (Q). The UV group was exposed to UV-irradiation for 20 min at 253.7 nm (52 μW/cm2). The Q group was coated with 1% chitosan, and the C group had no treatment. The osteoblasts (2 × 106 cells/mL) were inoculated in each group for 60 min and their viability was determined by the MTT bioassay. Osteogenic differentiation was performed over 4 weeks and determined by alizarin red staining. The mean was analyzed with the Shapiro-Wilks, Kruskall-Wallis, and Mann-Whitney U tests of normality (n = 9/gp). The NTi plates hardness (125.1 ± 4.01 HV) was higher (P = 0.026) than the Ti plates (121.3 ± 2.23 HV). The surface topography was: NTi (Ra = 0.098 μm) and Ti (Ra = 0.212 μm). The quantification of cell adhesion was: Ti + Q = 123 ± 4.9% (P < 0.05) < NTi + Q = 107 ± 3.3% < Ti = 100 ± 10.7% < NTi = 72 ± 6.8% < NTi + UV = 71 ± 4.4% < Ti + UV = 69 ± 3.5%, regardless the plates, the presence of chitosan induce a faster osteogenic differentiation. The Ti + Q plates tested the highest cell attachment and osteogenic adhesion suggesting their potential use of chitosan for cell-implant interaction.
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Affiliation(s)
- Jimena Muñoz-Vazquez
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES) León Unit, Predio el Saucillo y el Potrero, Comunidad de los Tepetates, el Potrero, 37684 León, México
| | - Patricia Alejandra Chavez-Granados
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES) León Unit, Predio el Saucillo y el Potrero, Comunidad de los Tepetates, el Potrero, 37684 León, México
| | - Gabriela Hernandez-Gomez
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES) León Unit, Predio el Saucillo y el Potrero, Comunidad de los Tepetates, el Potrero, 37684 León, México; Periodontics and Oral implantology Area, National School of Higher Studies (ENES) León Unit, Predio el Saucillo y el Potrero, Comunidad de los Tepetates, el Potrero, 37684 León, México
| | - Rogelio Jose Scougall-Vilchis
- Centro de Investigación y Estudios Avanzados en Odontología (CIEAO), Facultad de Odontología, Universidad Autónoma del Estado de México, Toluca, Estado de México, México
| | - Sakagami Hiroshi
- Meikai University Research Institute of Odontology (M-RIO), Saitama, Japan
| | - Rene Garcia-Contreras
- Interdisciplinary Research Laboratory (LII), Nanostructures and Biomaterials Area, National School of Higher Studies (ENES) León Unit, Predio el Saucillo y el Potrero, Comunidad de los Tepetates, El Potrero, 37684 León, Mexico
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Ozkan A, Çakır DA, Tezel H, Sanajou S, Yirun A, Baydar T, Erkekoglu P. Dental Implants and Implant Coatings: A Focus on Their Toxicity and Safety. J Environ Pathol Toxicol Oncol 2023; 42:31-48. [PMID: 36749088 DOI: 10.1615/jenvironpatholtoxicoloncol.2022043467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Dental implants are medical devices that are surgically inserted into the patient's jawbone by an orthodontist to act as roots of missing teeth. After the implantation, the maxilla or mandible integrates with the surface of the dental implant. This process, called "osseointegration," is an important period to ensure the long-term use of dental implants and prevent implant failures. Metal implants are the most used implant materials. However, they have disadvantages such as corrosion, metal ion release from metal implant surfaces and associated toxicity. To avoid these adverse effects and improve osseointegration, alternative dental implant materials such as ceramics, polymers, composites, and novel surface modification technologies have been developed. The safety of these materials are also of concern for toxicologists. This review will give general information about dental implant materials, osseointegration and successful implantation process. Moreover, we will focus on the new surface coatings materials for of dental implants and their toxicity and safety concerns will be discussed.
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Affiliation(s)
- Atakan Ozkan
- TOBB University of Economics and Technology, Faculty of Engineering, Department of Biomedical Engineering, Ankara, Turkey
| | - Deniz Arca Çakır
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey; Hacettepe University Vaccine Institute, Department of Vaccinology, Ankara, Turkey
| | - Hülya Tezel
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Sonia Sanajou
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Anil Yirun
- Hacettepe University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Sıhhiye 06100, Ankara, Turkey; Çukurova University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Adana, Turkey
| | - Terken Baydar
- Hacettepe University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Pinar Erkekoglu
- Hacettepe University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Sıhhiye 06100, Ankara, Turkey; Hacettepe University Vaccine Institute, Department of Vaccinology, Ankara, Turkey
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10
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Santos Beato P, Poologasundarampillai G, Nommeots-Nomm A, Kalaskar DM. Materials for 3D printing in medicine: metals, polymers, ceramics, and hydrogels. 3D Print Med 2023. [DOI: 10.1016/b978-0-323-89831-7.00002-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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11
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Attik N, Phantarasmy M, Abouelleil H, Chevalier C, Barraco A, Grosgogeat B, Lafon A. Comparison of the Biological Behavior and Topographical Surface Assessment of a Minimally Invasive Dental Implant and a Standard Implant: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15217540. [PMID: 36363140 PMCID: PMC9655689 DOI: 10.3390/ma15217540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/03/2022] [Accepted: 10/20/2022] [Indexed: 05/31/2023]
Abstract
The current study aimed to assess the topographical and physical properties of a minimally invasive implant (MagiCore®: MC®, InnosBioSurg, IBS) and to evaluate its biological behavior compared to a gold standard implant (NobelParallel™: NB™, Nobel Biocare™). After surface characterization, the biological behavior assessment was conducted regarding human gingival fibroblasts (hGF) and osteoblast-like cells (MG63). Roughness values for NBTM were Ra = 1.28 µm and for MC® they were Ra = 2.02 µm. Alamar BlueTM assay LIVE/DEADTM staining results indicated equivalent biological development regarding both cell types for the two implants. Significant enhancement was found for hGF ALP activity in the presence of the two tested implants in a time-dependent manner from day 7 to day 14 (** p < 0.01). Alizarin red staining demonstrated significant calcium deposition enhancement when cells were interfaced with the NB™ compared to the MC® implant (** p < 0.05). Moreover, SEM and confocal imaging revealed good cell adhesion with a denser cellular layer on the MC® than the NB™ surface. The MC® cytocompatibility was ranked as equivalent to the gold standard implant despite the surface properties differences. These findings provide new insights about the minimally invasive implant’s biological behavior and its potential clinical implication in different implantology situations.
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Affiliation(s)
- Nina Attik
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
| | - Marina Phantarasmy
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
| | - Hazem Abouelleil
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
| | - Charlène Chevalier
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
| | - Aurore Barraco
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Hospices Civils de Lyon, Service d’Odontologie, 69003 Lyon, France
| | - Brigitte Grosgogeat
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
- Hospices Civils de Lyon, Service d’Odontologie, 69003 Lyon, France
| | - Arnaud Lafon
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne, France
- Faculté d’Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69372 Lyon, France
- Hospices Civils de Lyon, Service d’Odontologie, 69003 Lyon, France
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12
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Arakelyan M, Spagnuolo G, Iaculli F, Dikopova N, Antoshin A, Timashev P, Turkina A. Minimization of Adverse Effects Associated with Dental Alloys. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7476. [PMID: 36363067 PMCID: PMC9658402 DOI: 10.3390/ma15217476] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
Metal alloys are one of the most popular materials used in current dental practice. In the oral cavity, metal structures are exposed to various mechanical and chemical factors. Consequently, metal ions are released into the oral fluid, which may negatively affect the surrounding tissues and even internal organs. Adverse effects associated with metallic oral appliances may have various local and systemic manifestations, such as mouth burning, potentially malignant oral lesions, and local or systemic hypersensitivity. However, clear diagnostic criteria and treatment guidelines for adverse effects associated with dental alloys have not been developed yet. The present comprehensive literature review aims (1) to summarize the current information related to possible side effects of metallic oral appliances; (2) to analyze the risk factors aggravating the negative effects of dental alloys; and (3) to develop recommendations for diagnosis, management, and prevention of pathological conditions associated with metallic oral appliances.
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Affiliation(s)
- Marianna Arakelyan
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Flavia Iaculli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80138 Napoli, Italy
| | - Natalya Dikopova
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
| | - Artem Antoshin
- Institute for Regenerative Medicine, Sechenov University, 119991 Moscow, Russia
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov University, 119991 Moscow, Russia
| | - Peter Timashev
- Institute for Regenerative Medicine, Sechenov University, 119991 Moscow, Russia
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov University, 119991 Moscow, Russia
- Chemistry Department, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Anna Turkina
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
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13
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Hasan J, Bright R, Hayles A, Palms D, Zilm P, Barker D, Vasilev K. Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants. ACS Biomater Sci Eng 2022; 8:4697-4737. [PMID: 36240391 DOI: 10.1021/acsbiomaterials.2c00540] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.
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Affiliation(s)
- Jafar Hasan
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia
| | - Richard Bright
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Andrew Hayles
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Dennis Palms
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
| | - Peter Zilm
- Adelaide Dental School, University of Adelaide, Adelaide, 5005, South Australia, Australia
| | - Dan Barker
- ANISOP Holdings, Pty. Ltd., 101 Collins St, Melbourne VIC, 3000 Australia
| | - Krasimir Vasilev
- Academic Unit of STEM, University of South Australia, Mawson Lakes, SA 5095, Australia.,College of Medicine and Public Health, Flinders University, Bedford Park 5042, South Australia, Australia
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14
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In-vitro biocompatibility evaluation of cast Ni–Ti alloy produced by vacuum arc melting technique for biomedical and dental applications. CHEMICAL PAPERS 2022. [DOI: 10.1007/s11696-022-02523-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThe investigated cast Ni50–Ti50 shape memory alloy was prepared using a vacuum arc furnace. The cast samples were subjected to in-vitro biocompatibility studies according to ISO 10993-12:2004, and compared to other samples Ni–Ti orthodontic wires commercially available at the dental market. The cast samples were hydroxyapatite-coated using the electrodeposition technique. The effect of surface treatment on the coating quality was addressed. The hydroxyapatite-coated samples were investigated using electrochemical impedance (EIS) and potentiodynamic techniques. Coated samples were also examined using a scanning electron microscope to inspect the coating morphology. Cytotoxicity tests on MG63 and H9C2 cell lines showed the safety and biocompatibility of the cast NiTi alloy, with a direct relationship between the incubation period of the tested samples and cell viability. Well-adhered hydroxyapatite coating was obtained on the surface-treated NiTi samples using the electrodeposition technique. EDS analysis showed a hydroxyapatite coating having a calcium to phosphorus ratio close to that of the natural bone. Electrochemical tests indicated that the highest corrosion resistance was obtained for the uncoated samples followed by the anodized sample and finally the hydroxyapatite-coated samples due to their high porosity.
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15
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Osman MA, Alamoush RA, Kushnerev E, Seymour KG, Watts DC, Yates JM. Biological response of epithelial and connective tissue cells to titanium surfaces with different ranges of roughness: An in-vitro study. Dent Mater 2022; 38:1777-1788. [DOI: 10.1016/j.dental.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/22/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
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16
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Whulanza Y, Azadi A, Supriadi S, Rahman S, Chalid M, Irsyad M, Nadhif M, Kreshanti P. Tailoring mechanical properties and degradation rate of maxillofacial implant based on sago starch/polylactid acid blend. Heliyon 2022; 8:e08600. [PMID: 35028440 PMCID: PMC8741438 DOI: 10.1016/j.heliyon.2021.e08600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/21/2021] [Accepted: 12/09/2021] [Indexed: 12/04/2022] Open
Abstract
A polymeric bone implants have a distinctive advantage compared to metal implants due to their degradability in the local bone host. The usage of degradable implant prevents the need for an implant removal surgery especially if they fixated in challenging position such as maxillofacial area. Additionally, this fixation system has been widely applied in fixing maxillofacial fracture in child patients. An ideal degradable implant has a considerable mass degradation rate that proved structural integrity to the healing bone. At this moment, poly(lactic acid) (PLA) or poly(lactic-co-glycolic acid) (PLGA) are the most common materials used as degradable implant. This composition of materials has a degradation rate of more than a year. A long degradation rate increases the long-term biohazard risk for the bone host. Therefore, a faster degradation rate with adequate strength of implant is the focal point of this research. This study tailored the tunable degradability of starch with strength properties of PLA. Blending system of starch and PLA has been reported widely, but none of them were aimed to be utilized as medical implant. Here, various concentrations of sago starch/PLA and Polyethylene glycol (PEG) were composed to meet the requirement of maxillofacial miniplate implant. The implant was realized using an injection molding process to have a six-hole-miniplate with 1.2 mm thick and 34 mm length. The specimens were physiochemically characterized through X-ray diffraction, differential scanning calorimetry, thermogravimetric analysis, and Fourier Transform Infrared spectroscopy. It is found that the microstructure and chemical interactions of the starch/PLA/PEG polymers are correlated with the mechanical characteristics of the blends. Compared to a pure PLA miniplate, the sago starch/PLA/PEG blend shows a 60-80% lower tensile strength and stiffness. However, the flexural strength and elongation break are improved. A degradation study was conducted to observe the mass degradation rate of miniplate for 10 weeks duration. It is found that a maximum concentration of 20% sago starch and 10% of PEG in the PLA blending has promising properties as desired. The blends showed a 100-150% higher degradability rate compared to the pure PLA or a commercial miniplate. The numerical simulation was conducted and confirmed that the miniplate in the mandibular area were shown to be endurable with standard applied loading. The mechanical properties resulted from the experimental work was applied in the Finite Element Analysis to find that our miniplate were in acceptable level. Lastly, the in-vitro test showed that implants are safe to human cell with viability more than 80%. These findings shall support the use of this miniplate in rehabilitating mandibular fractures with faster degradation with acceptance level of mechanical characteristic specifically in case of 4-6 weeks bone union.
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Affiliation(s)
- Y. Whulanza
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
| | - A. Azadi
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Indonesian Agency for Agricultural Research and Development, Indonesia
| | - S. Supriadi
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
| | - S.F. Rahman
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
- Department of Electrical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
| | - M. Chalid
- Department of Metallurgical and Material Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
| | - M. Irsyad
- Department of Mechanical Engineering, Faculty of Engineering, Universitas Indonesia, Indonesia
- Medical Technology Cluster, Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Indonesia
| | - M.H. Nadhif
- Medical Technology Cluster, Indonesian Medical Education and Research Institute (IMERI), Faculty of Medicine, Universitas Indonesia, Indonesia
- Department of Medical Physics, Faculty of Medicine, Universitas Indonesia, Indonesia
| | - P. Kreshanti
- Research Center on Biomedical Engineering, Universitas Indonesia, Indonesia
- Plastic Reconstructive and Aesthetic Surgery Division, Department of Surgery, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Indonesia
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The role of autophagy in the process of osseointegration around titanium implants with micro-nano topography promoted by osteoimmunity. Sci Rep 2021; 11:18418. [PMID: 34531513 PMCID: PMC8446058 DOI: 10.1038/s41598-021-98007-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 09/01/2021] [Indexed: 02/08/2023] Open
Abstract
Osteoimmunity plays an important role in the process of implant osseointegration. Autophagy is a conservative metabolic pathway of eukaryotic cells, but whether the interaction between autophagy and osteoimmunity plays a key role in osseointegration remains unclear. In this study, we prepared smooth titanium disks and micro-nano topography titanium disks, to study the immune microenvironment of RAW264.7 cells, and prepared the conditioned medium to study the effect of immune microenvironment on the osteogenesis and autophagy of MC3T3-E1 cells. Autophagy inhibitor 3-MA was used to inhibit autophagy to observe the change of expression of osteogenic markers. The results showed that the micro-nano topography titanium disks could stimulate RAW264.7 cells to differentiate into M2 type, forming an anti-inflammatory immune microenvironment; compared with the control group, the anti-inflammatory immune microenvironment promoted the proliferation and differentiation of osteoblasts better. The anti-inflammatory immune environment activated the autophagy level of osteoblasts, while the expression of osteogenic markers was down-regulated after inhibition of autophagy. These results indicate that anti-inflammatory immune microenvironment can promote cell proliferation and osteogenic differentiation, autophagy plays an important role in this process. This study further explains the mechanism of implant osseointegration in osteoimmune microenvironment, and provides reference for improving implant osseointegration.
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Primožič J, Poljšak B, Jamnik P, Kovač V, Čanadi Jurešić G, Spalj S. Risk Assessment of Oxidative Stress Induced by Metal Ions Released from Fixed Orthodontic Appliances during Treatment and Indications for Supportive Antioxidant Therapy: A Narrative Review. Antioxidants (Basel) 2021; 10:1359. [PMID: 34572993 PMCID: PMC8471328 DOI: 10.3390/antiox10091359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/13/2022] Open
Abstract
The treatment with fixed orthodontic appliances could have an important role in the induction of oxidative stress and associated negative consequences. Because of the simultaneous effects of corrosion, deformation, friction, and mechanical stress on fixed orthodontic appliances during treatment, degradation of orthodontic brackets and archwires occurs, causing higher concentrations of metal ions in the oral cavity. Corroded appliances cause the release of metal ions, which may lead to the increased values of reactive oxygen species (ROS) due to metal-catalyzed free radical reactions. Chromium, iron, nickel, cobalt, titanium, and molybdenum all belong to the group of transition metals that can be subjected to redox reactions to form ROS. The estimation of health risk due to the amount of heavy metals released and the level of selected parameters of oxidative stress generated for the time of treatment with fixed orthodontic appliances is presented. Approaches to avoid oxidative stress and recommendations for the preventive use of topical or systemic antioxidants during orthodontic treatment are discussed.
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Affiliation(s)
- Jasmina Primožič
- Department of Orthodontics and Jaw Orthopedics, Medical Faculty, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia;
| | - Borut Poljšak
- Laboratory of Oxidative Stress Research, Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, SI-1000 Ljubljana, Slovenia;
| | - Polona Jamnik
- Biotechnical Faculty, University of Ljubljana, SI-1000 Ljubljana, Slovenia;
| | - Vito Kovač
- Laboratory of Oxidative Stress Research, Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, SI-1000 Ljubljana, Slovenia;
| | - Gordana Čanadi Jurešić
- Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia;
| | - Stjepan Spalj
- Department of Orthodontics, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia;
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Kunrath MF, Muradás TC, Penha N, Campos MM. Innovative surfaces and alloys for dental implants: What about biointerface-safety concerns? Dent Mater 2021; 37:1447-1462. [PMID: 34426019 DOI: 10.1016/j.dental.2021.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The present review article aimed to discuss the recent technologies employed for the development of dental implants, mainly regarding innovative surface treatments and alternative alloys, emphasizing the bio-tribocorrosion processes. METHODS An electronic search applying specific MeSH terms was carried out in PubMed and Google Scholar databases to collect data until August 2021, considering basic, pre-clinical, clinical and review studies. The relevant articles (n=111), focused on innovative surface treatments for dental implants and their potential undesirable biological effects, were selected and explored. RESULTS Novel texturization methodologies for dental implants clearly provided superficial and structural atomic alterations in micro- and nanoscale, promoting different mechanical-chemical interactions when applied in the clinical set. Some particulate metals released from implant surfaces, their degradation products and/or contaminants exhibited local and systemic reactions after implant installation and osseointegration, contributing to unexpected treatment drawbacks and adverse effects. Therefore, there is an urgent need for development of pre-clinical and clinical platforms for screening dental implant devices, to predict the biointerface reactions as early as possible during the development phases. SIGNIFICANCE Modern surface treatments and innovative alloys developed for dental implants are not completely understood regarding their integrity during long-term clinical function, especially when considering the bio-tribocorrosion process. From this review, it is possible to assume that degradation and contamination of dental surfaces might be associated within peri-implant inflammation and cumulative long-lasting systemic toxicity. The in-depth comprehension of the biointerface modifications on these novel surface treatments might preclude unnecessary expenses and postoperative complications involving osseointegration failures.
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Affiliation(s)
- Marcel F Kunrath
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Thaís C Muradás
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Maria M Campos
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Osseointegration of Sandblasted and Acid-Etched Implant Surfaces. A Histological and Histomorphometric Study in the Rabbit. Int J Mol Sci 2021; 22:ijms22168507. [PMID: 34445213 PMCID: PMC8395172 DOI: 10.3390/ijms22168507] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/01/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
Titanium surface is an important factor in achieving osseointegration during the early wound healing of dental implants in alveolar bone. The purpose of this study was to evaluate sandblasted-etched surface implants to investigate the osseointegration. In the present study, we used two different types of sandblasted-etched surface implants, an SLA™ surface and a Nanoblast Plus™ surface. Roughness and chemical composition were evaluated by a white light interferometer microscope and X-ray photoelectron spectroscopy, respectively. The SLA™ surface exhibited the higher values (Ra 3.05 μm) of rugosity compared to the Nanoblast Plus™ surface (Ra 1.78 μm). Both types of implants were inserted in the femoral condyles of ten New Zealand white rabbits. After 12 weeks, histological and histomorphometric analysis was performed. All the implants were osseointegrated and no signs of infection were observed. Histomorphometric analysis revealed that the bone–implant contact % (BIC) ratio was similar around the SLA™ implants (63.74 ± 13.61) than around the Nanoblast Plus™ implants (62.83 ± 9.91). Both implant surfaces demonstrated a favorable bone response, confirming the relevance of the sandblasted-etched surface on implant osseointegration.
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21
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Räägel H, Turley A, Fish T, Franson J, Rollins T, Campbell S, Jorgensen MR. Medical Device Industry Approaches for Addressing Sources of Failing Cytotoxicity Scores. Biomed Instrum Technol 2021. [PMID: 34043008 DOI: 10.2345/0890-8205-55.2.69] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To ensure patient safety, medical device manufacturers are required by the Food and Drug Administration and other regulatory bodies to perform biocompatibility evaluations on their devices per standards, such as the AAMI-approved ISO 10993-1:2018 (ANSI/AAMI/ISO 10993-1:2018).However, some of these biological tests (e.g., systemic toxicity studies) have long lead times and are costly, which may hinder the release of new medical devices. In recent years, an alternative method using a risk-based approach for evaluating the toxicity (or biocompatibility) profile of chemicals and materials used in medical devices has become more mainstream. This approach is used as a complement to or substitute for traditional testing methods (e.g., systemic toxicity endpoints). Regardless of the approach, the one test still used routinely in initial screening is the cytotoxicity test, which is based on an in vitro cell culture system to evaluate potential biocompatibility effects of the final finished form of a medical device. However, it is known that this sensitive test is not always compatible with specific materials and can lead to failing cytotoxicity scores and an incorrect assumption of potential biological or toxicological adverse effects. This article discusses the common culprits of in vitro cytotoxicity failures, as well as describes the regulatory-approved methodology for cytotoxicity testing and the approach of using toxicological risk assessment to address clinical relevance of cytotoxicity failures for medical devices. Further, discrepancies among test results from in vitro tests, use of published half-maximal inhibitory concentration data, and the derivation of their relationship to tolerable exposure limits, reference doses, or no observed adverse effect levels are highlighted to demonstrate that although cytotoxicity tests in general are regarded as a useful sensitive screening assays, specific medical device materials are not compatible with these cellular/in vitro systems. For these cases, the results should be analyzed using more clinically relevant approaches (e.g., through chemical analysis or written risk assessment).
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Räägel H, Turley A, Fish T, Franson J, Rollins T, Campbell S, Jorgensen MR. Medical Device Industry Approaches for Addressing Sources of Failing Cytotoxicity Scores. Biomed Instrum Technol 2021; 55:69-84. [PMID: 34043008 PMCID: PMC8641414 DOI: 10.2345/0899-8205-55.2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
To ensure patient safety, medical device manufacturers are required by the Food and Drug Administration and other regulatory bodies to perform biocompatibility evaluations on their devices per standards, such as the AAMI-approved ISO 10993-1:2018 (ANSI/AAMI/ISO 10993-1:2018).However, some of these biological tests (e.g., systemic toxicity studies) have long lead times and are costly, which may hinder the release of new medical devices. In recent years, an alternative method using a risk-based approach for evaluating the toxicity (or biocompatibility) profile of chemicals and materials used in medical devices has become more mainstream. This approach is used as a complement to or substitute for traditional testing methods (e.g., systemic toxicity endpoints). Regardless of the approach, the one test still used routinely in initial screening is the cytotoxicity test, which is based on an in vitro cell culture system to evaluate potential biocompatibility effects of the final finished form of a medical device. However, it is known that this sensitive test is not always compatible with specific materials and can lead to failing cytotoxicity scores and an incorrect assumption of potential biological or toxicological adverse effects. This article discusses the common culprits of in vitro cytotoxicity failures, as well as describes the regulatory-approved methodology for cytotoxicity testing and the approach of using toxicological risk assessment to address clinical relevance of cytotoxicity failures for medical devices. Further, discrepancies among test results from in vitro tests, use of published half-maximal inhibitory concentration data, and the derivation of their relationship to tolerable exposure limits, reference doses, or no observed adverse effect levels are highlighted to demonstrate that although cytotoxicity tests in general are regarded as a useful sensitive screening assays, specific medical device materials are not compatible with these cellular/in vitro systems. For these cases, the results should be analyzed using more clinically relevant approaches (e.g., through chemical analysis or written risk assessment).
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Affiliation(s)
- Helin Räägel
- Helin Räägel, PhD, is a senior biocompatibility expert at Nelson Laboratories in Salt Lake City, UT.
| | - Audrey Turley
- Audrey Turley, BS, is a senior biocompatibility expert at Nelson Laboratories in Salt Lake City, UT.
| | - Trevor Fish
- Trevor Fish, MS, is a toxicologist at Nelson Laboratories in Salt Lake City, UT.
| | - Jeralyn Franson
- Jeralyn Franson, MS, is an associate technical consultant at Nelson Laboratories in Salt Lake City, UT.
| | - Thor Rollins
- Thor Rollins, BS, is a director of toxicology and E&L consulting at Nelson Laboratories in Salt Lake City, UT.
| | - Sarah Campbell
- Sarah Campbell, PhD, DABT, is a principal toxicologist at Nelson Laboratories in Salt Lake City, UT, and a title in the College of Pharmacy at the University of Utah, in Salt Lake City, UT.
| | - Matthew R. Jorgensen
- Matthew R Jorgensen, PhD, DABT, is a chemist, materials scientist, and toxicologist at Nelson Laboratories in Salt Lake City, UT.
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Silva GAF, Faot F, da Silva WJ, Del Bel Cury AA. Does implant surface hydrophilicity influence the maintenance of surface integrity after insertion into low-density artificial bone? Dent Mater 2020; 37:e69-e84. [PMID: 33234316 DOI: 10.1016/j.dental.2020.10.024] [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: 01/08/2020] [Revised: 08/05/2020] [Accepted: 10/24/2020] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate the influence of hydrophilicity on the surface integrity of implants after insertion in low-density artificial bone and to determine the distribution of titanium (Ti) particles along the bone bed. METHODS Forty-eight dental implants with different designs (Titamax Ex, Facility, Alvim, and Drive) and surface treatments (Neoporos® and Aqua™) were inserted into artificial bone blocks with density compatible with bone type III-IV. Hydrophobic Neoporos® surfaces were obtained by sandblasting and acid etching while hydrophilic Aqua™ surfaces were obtained by sandblasting, acid etching, and storage in an isotonic 0.9% NaCl solution. The surface integrity was evaluated by Scanning Electron Microscope (SEM) and the surface roughness parameters (Sa, Sp, Ssk, Sdr, Spk, Sk, and Svk) and surface area were measured with Laser Scanning Confocal Microscopy before and after installation. Bone beds were inspected with Digital Microscopy and micro X-Ray Fluorescence (μ-XRF) to analyze the metallic element distribution along the bone bed. RESULTS Acqua™ implants had higher initial Sa and a pronounced reduction of Sa and Sp during insertion, compared to NeoPoros® implants. After insertion, Sa and Sp of Acqua™ and NeoPoros® implants equalized, differing only between designs of Acqua™ implants. Surface damage was observed after insertion, mainly in the apical region. Facility implants that are made of TiG5 released fewer debris particles, while the highest Ti intensity was detected in the cervical region of the Titamax Ex Acqua™ and Drive Acqua™ implants. SIGNIFICANCE Physicochemical modifications to achieve surface hydrophilicity created a rougher surface that was more susceptible to surface alterations, resulting in more Ti particle release into the bone bed during surgical insertion. The higher Ti intensities detected in the cervical region of bone beds may be related to peri-implantitis and marginal bone resorption.
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Affiliation(s)
| | - Fernanda Faot
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Wander José da Silva
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Campinas, SP, Brazil.
| | - Altair Antoninha Del Bel Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Campinas, SP, Brazil.
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Kovač V, Poljšak B, Primožič J, Jamnik P. Are Metal Ions That Make up Orthodontic Alloys Cytotoxic, and Do They Induce Oxidative Stress in a Yeast Cell Model? Int J Mol Sci 2020; 21:ijms21217993. [PMID: 33121155 PMCID: PMC7662645 DOI: 10.3390/ijms21217993] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
Compositions of stainless steel, nickel-titanium, cobalt-chromium and β-titanium orthodontic alloys were simulated with mixtures of Fe, Ni, Cr, Co, Ti and Mo metal ions as potential oxidative stress-triggering agents. Wild-type yeast Saccharomyces cerevisiae and two mutants ΔSod1 and ΔCtt1 were used as model organisms to assess the cytotoxicity and oxidative stress occurrence. Metal mixtures at concentrations of 1, 10, 100 and 1000 µM were prepared out of metal chlorides and used to treat yeast cells for 24 h. Every simulated orthodontic alloy at 1000 µM was cytotoxic, and, in the case of cobalt-chromium alloy, even 100 µM was cytotoxic. Reactive oxygen species and oxidative damage were detected for stainless steel and both cobalt-chromium alloys at 1000 µM in wild-type yeast and 100 µM in the ΔSod1 and ΔCtt1 mutants. Simulated nickel-titanium and β-titanium alloy did not induce oxidative stress in any of the tested strains.
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Affiliation(s)
- Vito Kovač
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, 1000 Ljubljana, Slovenia; (V.K.); (B.P.)
| | - Borut Poljšak
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot 5, 1000 Ljubljana, Slovenia; (V.K.); (B.P.)
| | - Jasmina Primožič
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia;
| | - Polona Jamnik
- Biotechnical Faculty, University of Ljubljana, Jamnikarjeva ulica 101, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-3203-729
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Mat-Baharin NH, Razali M, Mohd-Said S, Syarif J, Muchtar A. Influence of alloying elements on cellular response and in-vitro corrosion behavior of titanium-molybdenum-chromium alloys for implant materials. J Prosthodont Res 2020; 64:490-497. [DOI: 10.1016/j.jpor.2020.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 01/08/2020] [Accepted: 01/17/2020] [Indexed: 11/17/2022]
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A tailored positively-charged hydrophobic surface reduces the risk of implant associated infections. Acta Biomater 2020; 114:421-430. [PMID: 32711080 DOI: 10.1016/j.actbio.2020.07.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/18/2020] [Accepted: 07/17/2020] [Indexed: 01/10/2023]
Abstract
Implant-associated infections is one of the most challenging post-operative complications in bone-related implantations. To tackle this clinical issue, we developed a low-cost and durable surface coating for medical grade titanium implants that uses positively charged silane molecules. The in vitro antimicrobial tests revealed that the titanium surface coated with (3-aminopropyl) triethoxysilane, which has the appropriate length of hydrophobic alkyl chain and positive charged amino group, suppressed more than 90% of the initial bacterial adhesion of S. aureus, P. aeruginosa, and E. coli after 30 min of incubation. In terms of growth inhibitory rate, the treated surface was able to reduce 75.7% ± 11.9% of bacterial growth after a 24-hour culturing, thereby exhibiting superior anti-biofilm formation in the late stage. When implanted into the rat model infected by S. aureus, the treated surface eliminated the implant-associated infection through the mechanism of inhibition of bacterial adhesion on the implant surface. Additionally, the treated surface was highly compatible with mammalian cells. In general, our design demonstrated its potential for human clinical trials as a low-cost and effective antibacterial strategy to minimize post-operative implant-related bacterial infection.
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Stevanović M, Djošić M, Janković A, Nešović K, Kojić V, Stojanović J, Grujić S, Matić Bujagić I, Rhee KY, Mišković-Stanković V. Assessing the Bioactivity of Gentamicin-Preloaded Hydroxyapatite/Chitosan Composite Coating on Titanium Substrate. ACS OMEGA 2020; 5:15433-15445. [PMID: 32637818 PMCID: PMC7331062 DOI: 10.1021/acsomega.0c01583] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/09/2020] [Indexed: 05/03/2023]
Abstract
The electrophoretic deposition process (EPD) was utilized to produce bioactive hydroxyapatite/chitosan (HAP/CS) and hydroxyapatite/chitosan/gentamicin (HAP/CS/Gent) coatings on titanium. The bioactivity of newly synthesized composite coatings was investigated in the simulated body fluid (SBF) and examined by X-ray diffraction, Fourier transform infrared spectroscopy, and field emission scanning electron microscopy. The obtained results revealed carbonate-substituted hydroxyapatite after immersion in SBF, emphasizing the similarity of the biomimetically grown HAP with the naturally occurring apatite in the bone. The formation of biomimetic HAP was confirmed by electrochemical impedance spectroscopy and polarization measurements, through the decrease in corrosion current density and coating capacitance values after 28-day immersion in SBF. The osseointegration ability was further validated by measuring the alkaline phosphatase activity (ALP) indicating the favorable osseopromotive properties of deposited coatings (significant increase in ALP levels for both HAP/CS (3.206 U mL-1) and HAP/CS/Gent (4.039 U mL-1) coatings, compared to the control (0.900 U mL-1)). Drug-release kinetics was investigated in deionized water at 37 °C by high-performance liquid chromatography coupled with mass spectrometry. Release profiles revealed the beneficial "burst-release effect" (∼21% of gentamicin released in the first 48 h) as a potentially promising solution against the biofilm formation in the initial period. When tested against human and mice fibroblast cells (MRC-5 and L929), both composite coatings showed a noncytotoxic effect (viability >85%), providing a promising basis for further medical application trials.
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Affiliation(s)
- Milena Stevanović
- Faculty
of Technology and Metallurgy, University
of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia
| | - Marija Djošić
- Institute
for Technology of Nuclear and Other Mineral Raw Materials (ITNMS), Bulevar Franš d’Eperea
86, 11000 Belgrade, Serbia
| | - Ana Janković
- Faculty
of Technology and Metallurgy, University
of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia
| | - Katarina Nešović
- Faculty
of Technology and Metallurgy, University
of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia
| | - Vesna Kojić
- Oncology
Institute of Vojvodina, Faculty of Medicine, University of Novi Sad, Put Dr Goldmana 4, 21204 Sremska Kamenica, Serbia
| | - Jovica Stojanović
- Institute
for Technology of Nuclear and Other Mineral Raw Materials (ITNMS), Bulevar Franš d’Eperea
86, 11000 Belgrade, Serbia
| | - Svetlana Grujić
- Faculty
of Technology and Metallurgy, University
of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia
| | - Ivana Matić Bujagić
- Faculty
of Technology and Metallurgy, University
of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia
| | - Kyong Yop Rhee
- Department
of Mechanical Engineering, Kyung Hee University, Yongin 446-701, South Korea
| | - Vesna Mišković-Stanković
- Faculty
of Technology and Metallurgy, University
of Belgrade, Karnegijeva 4, 11000 Belgrade, Serbia
- Department
of Mechanical Engineering, Kyung Hee University, Yongin 446-701, South Korea
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Comprehensive Evaluation of the Biological Properties of Surface-Modified Titanium Alloy Implants. J Clin Med 2020; 9:jcm9020342. [PMID: 31991841 PMCID: PMC7073575 DOI: 10.3390/jcm9020342] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/18/2020] [Accepted: 01/22/2020] [Indexed: 12/15/2022] Open
Abstract
An increasing interest in the fabrication of implants made of titanium and its alloys results from their capacity to be integrated into the bone system. This integration is facilitated by different modifications of the implant surface. Here, we assessed the bioactivity of amorphous titania nanoporous and nanotubular coatings (TNTs), produced by electrochemical oxidation of Ti6Al4V orthopedic implants' surface. The chemical composition and microstructure of TNT layers was analyzed by X-ray photoelectron spectroscopy (XPS) and X-ray diffraction (XRD). To increase their antimicrobial activity, TNT coatings were enriched with silver nanoparticles (AgNPs) with the chemical vapor deposition (CVD) method and tested against various bacterial and fungal strains for their ability to form a biofilm. The biointegrity and anti-inflammatory properties of these layers were assessed with the use of fibroblast, osteoblast, and macrophage cell lines. To assess and exclude potential genotoxicity issues of the fabricated systems, a mutation reversal test was performed (Ames Assay MPF, OECD TG 471), showing that none of the TNT coatings released mutagenic substances in long-term incubation experiments. The thorough analysis performed in this study indicates that the TNT5 and TNT5/AgNPs coatings (TNT5-the layer obtained upon applying a 5 V potential) present the most suitable physicochemical and biological properties for their potential use in the fabrication of implants for orthopedics. For this reason, their mechanical properties were measured to obtain full system characteristics.
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Chen Z, Patwari M, Liu D. Cytotoxicity of orthodontic temporary anchorage devices on human periodontal ligament fibroblasts in vitro. Clin Exp Dent Res 2019; 5:648-654. [PMID: 31890301 PMCID: PMC6934351 DOI: 10.1002/cre2.230] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 07/08/2019] [Accepted: 07/18/2019] [Indexed: 01/21/2023] Open
Abstract
Objectives The objective of this study is to test cytotoxicity of four brands of commercially available orthodontic temporary anchorage devices (TADs). Setting and sample population Twenty-four (six for each brand, i.e., Aarhus [AO]; Dual top [RMO]; Vector TAS [ORMCO]; and Unitek TAD [3M UNITEK]) TADs were tested. Materials and methods Twenty-four (six for each brand, i.e., Aarhus [AO]; Dual top [RMO]; Vector TAS [ORMCO]; and Unitek TAD [3M UNITEK]) TADs were individually incubated in complete cell culture medium and shaken at a rate of 1.5 rpm at 37°C for 30 days to extract possible toxic substances in conditioned media (CM). To test cytotoxicity, human periodontal ligament fibroblasts were cultured and exposed to the CM for 24 hr, followed by the examinations of morphological changes, cell viability (MTT assay), and cell damage (lactate dehydrogenase [LDH] assay). Results No morphological changes were observed in any of the four brands of TADs compared with the negative control. LDH assay showed that none of the four brands of TADs caused significant cell damage after CM treatment compared with the negative control (P > .05). No significant differences were found between any of the four brands of TADs (P > .05). MTT assay showed similar results as did the LDH assay, except for a statistically significant difference found in the TADs from 3M UNITEK compared with the negative control (P = .047). Conclusions According to the International Standard Organization standards, except for the TAD from 3M, none of the other three brands of commercially available TADs (from AO, RMO, and ORMCO) exhibited significant cytotoxicity, suggesting their safe clinical applications.
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Affiliation(s)
- Zhibin Chen
- Department of PeriodontologyPeking University School of StomatologyBeijingP.R. China
| | - Manika Patwari
- Private Practice, Ridgeview Dental GroupMenomonee FallWaukesha CountyWisconsin
| | - Dawei Liu
- Department of Developmental Sciences/Orthodontics, School of DentistryMarquette UniversityMilwaukeeWisconsin
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Wei T, Li J, Sun H, Jiang M, Yang Y, Luo X, Liu T. Verification of osteoblast differentiation on airborne-particle abrasion, large-grit, acid-etched surface of titanium implants regulated by yes-associated protein and transcriptional coactivator with PDZ-binding motif. J Oral Sci 2019; 61:431-440. [PMID: 31327805 DOI: 10.2334/josnusd.18-0112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Although airborne-particle abrasion, large-grit, acid-etched (SLA) surface technology can promote implant osseointegration; its mechanism remains unclear. By preparing the SLA titanium (Ti) plate (SLA Ti) and Polished Ti plate (Polished Ti), this experiment investigates the expression and distribution of the Yes-associated protein (YAP) and transcriptional coactivator with the PDZ-binding motif (TAZ) in MC3T3-E1 cells. In addition, gene YAP and TAZ silencing on the SLA Ti was conducted to observe changes in the osteoblast differentiation markers, runt-related transcription factor-2 (Runx2) and bone sialoprotein (BSP). The results demonstrated that SLA Ti surface microtopography could induce YAP/TAZ's transfer from the cytoplasm to the nuclei of MC3T3-E1 cells. The expression of YAP/TAZ increased in terms of mRNA and protein. After silencing the YAP/TAZ genes, Runx2 and BSP decreased, suggesting that YAP/TAZ plays an important regulatory role in this process. Meanwhile, the results also showed that SLA microtopography enhanced the expression of integrins α1, α2, and β1. After silencing the integrin α1, α2, and β1 genes, YAP and TAZ decreased in terms of mRNA and protein. Therefore, this experiment was the first to confirm that SLA surface microtopography facilitates osteoblast differentiation by regulating YAP/TAZ and confirms that the process can be related to integrins α1, α2, and β1.
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Affiliation(s)
- Ting Wei
- Department of Prosthodontics, School of Stomatology, Shandong University.,Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University
| | - Jiayi Li
- Department of Oral and Maxillofacial-Head Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Huiqiang Sun
- Department of Prosthodontics, School of Stomatology, Shandong University.,Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University
| | - Mengyang Jiang
- Department of Prosthodontics, School of Stomatology, Shandong University
| | - Yun Yang
- Department of Prosthodontics, School of Stomatology, Shandong University
| | - Xiayan Luo
- Department of Prosthodontics, School of Stomatology, Shandong University
| | - Tingsong Liu
- Department of Prosthodontics, School of Stomatology, Shandong University
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Swedan S, Shubair Z, Almaaytah A. Synergism of cationic antimicrobial peptide WLBU2 with antibacterial agents against biofilms of multi-drug resistant Acinetobacter baumannii and Klebsiella pneumoniae. Infect Drug Resist 2019; 12:2019-2030. [PMID: 31372010 PMCID: PMC6636432 DOI: 10.2147/idr.s215084] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/23/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The activity of the cationic antimicrobial peptide WLBU2 was evaluated against planktonic cells and biofilms of multi-drug resistant (MDR) Acinetobacter baumannii and Klebsiella pneumoniae, alone and in combination with classical antimicrobial agents. Methods Control American Type Culture Collection (ATCC) strains and MDR clinical isolates of A. baumannii and K. pneumoniae were utilized. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of WLBU2 alone and in combination with antimicrobials were determined by classical methods. The Calgary biofilm device was used to determine the minimum biofilm eradication concentration (MBEC). The MTT assay was used to determine the cytotoxicity of agents on eukaryotic cells. The electrophoretic mobility shift assay was used to evaluate the ability of WLBU2 to bind bacterial DNA. Results The WLBU2 MIC and MBC values were identical indicating bactericidal activity. The MIC/MBC values ranged from 1.5625 to 12.5 µM. At these concentrations, Vero cells and human skin fibroblasts were viable. The MBEC of WLBU2 ranged from 25 to 200 µM. A significant loss of eukaryotic cell viability was observed at the MBEC range. The combination of sub-inhibitory concentrations of WLBU2 with amoxicillin-clavulanate or ciprofloxacin for K. pneumoniae, and with tobramycin or imipenem for A. baumannii, demonstrated synergism, leading to a significant decrease in MIC and MBEC values for some isolates and ATCC strains. However, all combinations were associated with considerable loss in eukaryotic cells’ viability. WLBU2 did not demonstrate the ability to bind bacterial plasmid DNA. Conclusion WLBU2 in combination with antimicrobials holds promise in eradication of MDR pathogens.
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Affiliation(s)
- Samer Swedan
- Jordan University of Science and Technology, Department of Medical Laboratory Sciences, Irbid, Jordan
| | - Zaina Shubair
- Jordan University of Science and Technology, Department of Medical Laboratory Sciences, Irbid, Jordan
| | - Ammar Almaaytah
- Jordan University of Science and Technology, Department of Pharmaceutical Technology, Irbid, Jordan
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Comparison between Sandblasted Acid-Etched and Oxidized Titanium Dental Implants: In Vivo Study. Int J Mol Sci 2019; 20:ijms20133267. [PMID: 31277204 PMCID: PMC6651692 DOI: 10.3390/ijms20133267] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/29/2019] [Accepted: 06/30/2019] [Indexed: 12/23/2022] Open
Abstract
The surface modifications of titanium dental implants play important roles in the enhancement of osseointegration. The objective of the present study was to test two different implant surface treatments on a rabbit model to investigate the osseointegration. The tested surfaces were: a) acid-etched surface with sandblasting treatment (SA) and b) an oxidized implant surface (OS). The roughness was measured by an interferometeric microscope with white light and the residual stress of the surfaces was measured with X-ray residual stress Bragg–Bentano diffraction. Six New Zealand white rabbits were used for the in vivo study. Implants with the two different surfaces (SA and OS) were inserted in the femoral bone. After 12 weeks of implantation, histological and histomorphometric analyses of the blocks containing the implants and the surrounding bone were performed. All the implants were correctly implanted and no signs of infection were observed. SA and OS surfaces were both surrounded by newly formed trabeculae. Histomorphometric analysis revealed that the bone–implant contact % (BIC) was higher around the SA implants (53.49 ± 8.46) than around the OS implants (50.94 ± 16.42), although there were no significant statistical differences among them. Both implant surfaces (SA and OS) demonstrated a good bone response with significant amounts of newly formed bone along the implant surface after 12 weeks of implantation. These results confirmed the importance of the topography and physico–chemical properties of dental implants in the osseointegration.
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Sfondrini MF, Gandini P, Alcozer R, Vallittu PK, Scribante A. Failure load and stress analysis of orthodontic miniscrews with different transmucosal collar diameter. J Mech Behav Biomed Mater 2018; 87:132-137. [PMID: 30059839 DOI: 10.1016/j.jmbbm.2018.07.032] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/13/2018] [Accepted: 07/23/2018] [Indexed: 02/07/2023]
Abstract
Miniscrews have been introduced in orthodontics as temporary anchorage devices (TADs), in order to move the correct teeth and avoid other elements to slide toward a wrong direction. Moreover the ease of use of TADs encouraged clinicians to use miniscrews also for non-conventional purposes, as fixation in mandibular fracture, mini-implant supported temporary pontics, miniscrew-assisted rapid palatal expanders and distalizers. These applications develop higher forces, so TAD fracture can be an unwanted complication. Some authors analyzed torsional loads but no studies measured forces required to bend the screws and ultimate flexural strength. Accordingly, in the present report, Ti-6Al-4V TADs were mechanically evaluated. Seven different diameters of screws were tested: 1.3 mm (Aarhus Screw, Medicon), 1.5 mm (Spider Screw, HDC), 1.6 mm (Aarhus Screw, Medicon), 1.7 mm (Ortho Easy, Forestadent), 1.8 mm (Ortho Implant, 3 M), 1.9 mm (Spider Screw, HDC) and 2.0 mm (Storm, Kristal). The forces to bend the titanium TADs were measured at 0.1 mm, 0.2 mm magnitude of deflections and at maximum load (as peak before screw fracture) in air with a universal testing machine. Statistical analyses were performed. Both at 0.1 mm and at 0.2 mm deflections and at maximum load, the significantly highest forces were reported with 1.7, 1.8, 1.9, and 2.0 mm TADs. The lowest values were reported with 1.6, 1.5, and 1.3 mm mini-implants. No significant differences were reported between 1.6 mm and 1.7 mm screws. It was found that load values in N versus stress in MPa were not fully comparable when screws with small and larger diameter were compared. Therefore, when placing a miniscrew for applications that need maximum shear bending resistance, these results would be considered in order to reduce risk of unwanted fracture.
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Affiliation(s)
- Maria Francesca Sfondrini
- Unit of Orthodontics and Paediatric Dentistry - Section of Dentistry - Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy
| | - Paola Gandini
- Unit of Orthodontics and Paediatric Dentistry - Section of Dentistry - Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy
| | - Roberto Alcozer
- Unit of Orthodontics and Paediatric Dentistry - Section of Dentistry - Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy
| | - Pekka K Vallittu
- Department of Biomaterial Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland; City of Turku, Welfare Division, Turku, Finland
| | - Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry - Section of Dentistry - Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Piazzale Golgi 2, 27100 Pavia, Italy.
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Finke H, Koos B, Fischer-Brandies H, Es-Souni M. In vitro biocompatibility of orthodontic miniscrews with human gingival fibroblast and SAOS-2 osteoblast cultures. J Orofac Orthop 2018; 79:328-336. [PMID: 30014178 DOI: 10.1007/s00056-018-0143-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 04/29/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Miniscrews are an important choice for orthodontic anchorage. Yet reports on failures do exist, and attempts have been made to elucidate the causes. Clinical outcomes may be compromised not only by the mechanical implications of miniscrew design and the location of anchorage but also by poor biocompatibility. Hence, this study deals with the surface roughness and elemental composition of miniscrews and how these properties may affect the in vitro biocompatibility of four commercially available miniscrews. METHODS Most of the currently available miniscrews are made of TiAl6V4, an alloy widely considered to be biocompatible. The samples tested in this study included four similarly dimensioned TiAl6V4 products from different manufacturers: tomas® by Dentaurum, OrthoEasy® by Forestadent®, Dual Top™ by Jeil Medical/Promedia, and LOMAS by Mondeal®. The surface properties of these products were characterized by scanning electron microscopy (SEM) and energy-dispersive X‑ray spectroscopy (EDX). Cytotoxicity was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and agar overlay assays according to ISO 10993-5. RESULTS The miniscrew products were found to show variations in surface-finish quality pertaining to topography and chemical composition, with the latter departing slightly from the manufacturers' specifications. MTT assays yielded rates of cell culture viability in excess of 90%, and agar overlay assays did not reveal decoloration beyond the specimen outlines in any of the experimental groups tested. CONCLUSIONS The four miniscrew products exhibited some minor, but statistically significant, differences in microtopography, alloy composition, and biological inertness. Cytotoxicity testing revealed that all four products should be considered non-cytotoxic, thus, ruling out poor biocompatibility as a cause of miniscrew failure.
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Affiliation(s)
- Hannah Finke
- Department of Orthodontics, University of Tübingen, Osianderstr. 2-8, 72076, Tübingen, Germany. .,Department of Orthodontics, University Hospital of Schleswig-Holstein Campus Kiel, Kiel, Germany.
| | - Bernd Koos
- Department of Orthodontics, University of Tübingen, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Helge Fischer-Brandies
- Department of Orthodontics, University Hospital of Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Martha Es-Souni
- Department of Orthodontics, University Hospital of Schleswig-Holstein Campus Kiel, Kiel, Germany
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Hindy A, Farahmand F, Tabatabaei FS. In vitro biological outcome of laser application for modification or processing of titanium dental implants. Lasers Med Sci 2017; 32:1197-1206. [PMID: 28451816 DOI: 10.1007/s10103-017-2217-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 04/19/2017] [Indexed: 02/03/2023]
Abstract
There are numerous functions for laser in modern implant dentistry including surface treatment, surface coating, and implant manufacturing. As laser application may potentially improve osseointegration of dental implants, we systematically reviewed the literature for in vitro biological responses to laser-modified or processed titanium dental implants. The literature was searched in PubMed, ISI Web, and Scopus, using keywords "titanium dental implants," "laser," "biocompatibility," and their synonyms. After screening the 136 references obtained, 28 articles met the inclusion criteria. We found that Nd:YAG laser was the most commonly used lasers in the treatment or processing of titanium dental implants. Most of the experiments used cell attachment and cell proliferation to investigate bioresponses of the implants. The most commonly used cells in these assays were osteoblast-like cells. Only one study was conducted in stem cells. These in vitro studies reported higher biocompatibility in laser-modified titanium implants. It seems that laser radiation plays a vital role in cell response to dental implants; however, it is necessary to accomplish more studies using different laser types and parameters on various cells to offer a more conclusive result.
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Affiliation(s)
- Ahmed Hindy
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Evin, Tehran, 1983963113, Iran
| | - Farzam Farahmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Fahimeh Sadat Tabatabaei
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Evin, Tehran, 1983963113, Iran. .,Department of Tissue Engineering, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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36
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Poologasundarampillai G, Nommeots-Nomm A. Materials for 3D printing in medicine. 3D Print Med 2017. [DOI: 10.1016/b978-0-08-100717-4.00002-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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37
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Regenerative Endodontic Procedures: A Perspective from Stem Cell Niche Biology. J Endod 2017; 43:52-62. [DOI: 10.1016/j.joen.2016.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 08/19/2016] [Accepted: 09/09/2016] [Indexed: 12/14/2022]
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38
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A Novel In Vitro System for Comparative Analyses of Bone Cells and Bacteria under Electrical Stimulation. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5178640. [PMID: 28044132 PMCID: PMC5164905 DOI: 10.1155/2016/5178640] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/28/2016] [Accepted: 11/01/2016] [Indexed: 11/29/2022]
Abstract
Electrical stimulation is a promising approach to enhance bone regeneration while having potential to inhibit bacterial growth. To investigate effects of alternating electric field stimulation on both human osteoblasts and bacteria, a novel in vitro system was designed. Electric field distribution was simulated numerically and proved by experimental validation. Cells were stimulated on Ti6Al4V electrodes and in short distance to electrodes. Bacterial growth was enumerated in supernatant and on the electrode surface and biofilm formation was quantified. Electrical stimulation modulated gene expression of osteoblastic differentiation markers in a voltage-dependent manner, resulting in significantly enhanced osteocalcin mRNA synthesis rate on electrodes after stimulation with 1.4VRMS. While collagen type I synthesis increased when stimulated with 0.2VRMS, it decreased after stimulation with 1.4VRMS. Only slight and infrequent influence on bacterial growth was observed following stimulations with 0.2VRMS and 1.4VRMS after 48 and 72 h, respectively. In summary this novel test system is applicable for extended in vitro studies concerning definition of appropriate stimulation parameters for bone cell growth and differentiation, bacterial growth suppression, and investigation of general effects of electrical stimulation.
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Galli S, Jimbo R, Naito Y, Berner S, Dard M, Wennerberg A. Chemically modified titanium-zirconium implants in comparison with commercially pure titanium controls stimulate the early molecular pathways of bone healing. Clin Oral Implants Res 2016; 28:1234-1240. [DOI: 10.1111/clr.12947] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Silvia Galli
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Ryo Jimbo
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
- Department of Oral and Maxillofacial Surgery and Oral Medicine; Faculty of Odontology; Malmö University; Malmö Sweden
| | - Yoshihito Naito
- Oral Implant Center; Tokushima University Hospital; Tokushima Japan
| | | | - Michel Dard
- Institut Straumann AG; Basel Switzerland
- College of Dentistry; New York University; New York NY USA
| | - Ann Wennerberg
- Department of Prosthodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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40
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Sartoretto SC, Alves ATNN, Zarranz L, Jorge MZ, Granjeiro JM, Calasans-Maia MD. Hydrophilic surface of Ti6Al4V-ELI alloy improves the early bone apposition of sheep tibia. Clin Oral Implants Res 2016; 28:893-901. [DOI: 10.1111/clr.12894] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2016] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - Laila Zarranz
- Department of Prosthesis; Fluminense Federal University; Niterói RJ Brazil
| | - Mônica Z. Jorge
- Department of Prosthesis; Fluminense Federal University; Niterói RJ Brazil
| | - José M. Granjeiro
- Department of Oral Surgery; Fluminense Federal University; Niterói RJ Brazil
- Department of Oral Surgery; Fluminense Federal University; Niterói, RJ, Brazil and Bioengineering Division; National Institute of Metrology; Quality and Technology; Duque de Caxias RJ Brazil
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He X, Reichl FX, Wang Y, Michalke B, Milz S, Yang Y, Stolper P, Lindemaier G, Graw M, Hickel R, Högg C. Analysis of titanium and other metals in human jawbones with dental implants - A case series study. Dent Mater 2016; 32:1042-51. [PMID: 27298240 DOI: 10.1016/j.dental.2016.05.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/23/2015] [Accepted: 05/31/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to measure titanium (Ti) content in human jawbones and to show that Ti was released from dental implants inserted into these jawbones. METHODS Seven samples from four human subjects with dental implants were analysed as test group and six bone samples of similar topographical regions from six human subjects without implants served as control. The contents of various elements in human jawbones were detected by inductively coupled plasma optical emission spectrometry. The distributions of various isotopes in human mandibular bone were measured with laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS). Histological analyses of undecalcified, Giemsa-Eosin stained mandible sections were performed by light microscopy and particles were identified in human bone marrow by scanning electron microscope-energy dispersive X-ray analysis. RESULTS In test group only Ti content was significantly higher compared to control group. The mean contents of Ti were 1940μg/kg in test group and 634μg/kg in control group. The highest Ti content detected in human mandibular bone was 37,700μg/kg-bone weight. In samples 4-7 (human subjects II-IV), increased Ti intensity was also detected by LA-ICP-MS in human mandibular tissues at a distance of 556-1587μm from implants, and the intensity increased with decreasing distance from implants. Particles with sizes of 0.5-40μm were found in human jawbone marrow tissues at distances of 60-700μm from implants in samples 4-7. SIGNIFICANCE Ti released from dental implants can be detected in human mandibular bone and bone marrow tissues, and the distribution of Ti in human bone was related to the distance to the implant.
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Affiliation(s)
- Xiuli He
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Franz-Xaver Reichl
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Yan Wang
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Bernhard Michalke
- Research Unit Analytical Biogeochemistry, Helmholtz Zentrum Munich - German Research Center for Environmental Health (GmbH), Ingolstaedter Landstraße 1, 85764 Neuherberg, Germany
| | - Stefan Milz
- Department of Anatomy II - Neuroanatomy, Ludwig-Maximilians-University of Munich, Pettenkoferstr. 11, 80336 Munich, Germany
| | - Yang Yang
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Philipp Stolper
- Fogra Forschungsgesellschaft Druck e.V., Streitfeldstr 1, 81673 Munich, Germany
| | - Gabriele Lindemaier
- Institute of Forensic Medicine, Ludwig-Maximilian-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Matthias Graw
- Institute of Forensic Medicine, Ludwig-Maximilian-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Reinhard Hickel
- Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany
| | - Christof Högg
- Department of Operative/Restorative Dentistry, Periodontology and Pedodontics, Ludwig-Maximilians-University of Munich, Goethestr. 70, 80336 Munich, Germany; Walther-Straub-Institute of Pharmacology and Toxicology, Ludwig-Maximilians-University of Munich, Nussbaumstr. 26, 80336 Munich, Germany.
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Vu NB, Truong NH, Dang LT, Phi LT, Ho NTT, Pham TN, Phan TP, Pham PV. In vitro and in vivo biocompatibility of Ti-6Al-4V titanium alloy and UHMWPE polymer for total hip replacement. BIOMEDICAL RESEARCH AND THERAPY 2016. [DOI: 10.7603/s40730-016-0014-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Relevant aspects in the surface properties in titanium dental implants for the cellular viability. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 64:1-10. [PMID: 27127022 DOI: 10.1016/j.msec.2016.03.049] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 01/02/2016] [Accepted: 03/14/2016] [Indexed: 11/21/2022]
Abstract
Roughness and topographical features are the most relevant of the surface properties for a dental implant for its osseointegration. For that reason, we studied the four surfaces more used in titanium dental implants: machined, sandblasted, acid etching and sandblasted plus acid etching. The roughness and wettability (contact angle and surface free energy) was studied by means 3D-interferometric microscope and sessile drop method. Normal human gingival fibroblasts (HGF) were obtained from small oral mucosa biopsies and were used for cell cultures. To analyze cell integrity, we first quantified the total amount of DNA and LDH released from dead cells to the culture medium. Then, LIVE/DEAD assay was used as a combined method assessing cell integrity and metabolism. All experiments were carried out on each cell type cultured on each Ti material for 24h, 48h and 72h. To evaluate the in vivo cell adhesion capability of each Ti surface, the four types of discs were grafted subcutaneously in 5 Wistar rats. Sandblasted surfaces were significantly rougher than acid etching and machined. Wettability and surface free energy decrease when the roughness increases in sand blasted samples. This fact favors the protein adsorption. The DNA released by cells cultured on the four Ti surfaces did not differ from that of positive control cells (p>0.05). The number of cells per area was significantly lower (p<0.05) in the sand-blasted surface than in the machined and surface for both cell types (7±2 cells for HGF and 10±5 cells for SAOS-2). The surface of the machined-type discs grafted in vivo had a very small area occupied by cells and/or connective tissue (3.5%), whereas 36.6% of the sandblasted plus acid etching surface, 75.9% of sandblasted discs and 59.6% of acid etching discs was covered with cells and connective tissue. Cells cultured on rougher surfaces tended to exhibit attributes of more differentiated osteoblasts than cells cultured on smoother surfaces. These surface properties justify that the sandblasted implants is able to significantly increase bone contact and bone growth with very good osseointegration results in vivo.
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Jemat A, Ghazali MJ, Razali M, Otsuka Y. Surface Modifications and Their Effects on Titanium Dental Implants. BIOMED RESEARCH INTERNATIONAL 2015; 2015:791725. [PMID: 26436097 PMCID: PMC4575991 DOI: 10.1155/2015/791725] [Citation(s) in RCA: 254] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 06/15/2015] [Accepted: 06/16/2015] [Indexed: 11/25/2022]
Abstract
This review covers several basic methodologies of surface treatment and their effects on titanium (Ti) implants. The importance of each treatment and its effects will be discussed in detail in order to compare their effectiveness in promoting osseointegration. Published literature for the last 18 years was selected with the use of keywords like titanium dental implant, surface roughness, coating, and osseointegration. Significant surface roughness played an important role in providing effective surface for bone implant contact, cell proliferation, and removal torque, despite having good mechanical properties. Overall, published studies indicated that an acid etched surface-modified and a coating application on commercial pure titanium implant was most preferable in producing the good surface roughness. Thus, a combination of a good surface roughness and mechanical properties of titanium could lead to successful dental implants.
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Affiliation(s)
- A. Jemat
- Department of Mechanical & Materials Engineering, Faculty of Engineering and Built Environment, UKM, 43600 Bangi, Selangor Darul Ehsan, Malaysia
| | - M. J. Ghazali
- Department of Mechanical & Materials Engineering, Faculty of Engineering and Built Environment, UKM, 43600 Bangi, Selangor Darul Ehsan, Malaysia
| | - M. Razali
- Department of Peridontology, Faculty of Dentistry, National University of Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
| | - Y. Otsuka
- Department of System Safety, Nagaoka University of Technology, 1603-1 Kamitomioka-Cho, Nagaoka-shi, Niigata 940-2188, Japan
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An Overview of Internal Fixation Implant Metallurgy and Galvanic Corrosion Effects. J Hand Surg Am 2015; 40:1703-10, 1710.e1-4. [PMID: 26143030 DOI: 10.1016/j.jhsa.2015.03.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 02/28/2015] [Accepted: 03/14/2015] [Indexed: 02/02/2023]
Abstract
Orthopedic and hand surgery implants for internal fixation of fractures have evolved substantially over the past 50 years. Newer metal compositions have been used, and new standards have been applied to older alloys, resulting in modern implants with unique physical properties and better clinical performances. Conventional wisdom has long dictated that implanting different metals should be avoided, but few guidelines exist regarding the safety of using in proximity implant systems of dissimilar metals. To better characterize the landscape of internal fixation implant metallurgy, we have compiled the recommendations and conclusions of the currently available and pertinent literature.
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Martín-Cameán A, Jos A, Cameán AM, Solano E, Iglesias-Linares A. Genotoxic and cytotoxic effects and gene expression changes induced by fixed orthodontic appliances in oral mucosa cells of patients: a systematic review. Toxicol Mech Methods 2015; 25:440-7. [PMID: 26156198 DOI: 10.3109/15376516.2015.1062951] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
CONTEXT The accumulation of chronic or severe acute DNA and cellular damage in oral mucosa cells is one of the main factors that help initiate a wide range of malignant lesions in the oral cavity. There has been considerable controversy in the literature about the effect of such sustained genotoxic and cytotoxic damage to oral mucosa cells. OBJECTIVE The aim of this systematic review, reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, is to investigate the effects of such interventions. METHODS Electronic and manual searches were performed (15 May 2015) for Randomized Clinical Trials/quasi-Randomized Clinical Trials that analyzed the genotoxic/cytotoxic effects of these types of oral appliances in humans. A primary outcome (cell/DNA damage) and a number of secondary outcomes were examined. Two reviewers carried out the study selection and performed a "risk of bias" assessment [Cochrane Collaboration's tool]. Wherever possible the meta-analysis was conducted on homogenous groups. RESULTS From the electronic search (2797), 6 studies met the eligibility criteria. Most studies (5/6) observed significant differences in most comparisons at the short-term (1-3 months) and long-term (24-48 months) evaluations, with respect to critically acute genotoxic/cytotoxic effects. Some of the studies (2/3) concluded that the post-removable effects at DNA/cellular levels were not significant (p > 0.05) with respect to the controls. CONCLUSIONS Acute DNA/cellular damage in oral mucosa cells is induced by orthodontic appliances. Nevertheless, even though these effects were no longer detected after removing the appliances, more rigorous RCTs are needed to explore the extent to which acquired damage can be observed in the oral mucosa.
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Affiliation(s)
- Ana Martín-Cameán
- a Department of Stomatology , School of Dentistry, University of Seville , Seville , Spain
| | - Angeles Jos
- b Area of Toxicology, Faculty of Pharmacy , University of Seville , Seville , Spain , and
| | - Ana M Cameán
- b Area of Toxicology, Faculty of Pharmacy , University of Seville , Seville , Spain , and
| | - Enrique Solano
- a Department of Stomatology , School of Dentistry, University of Seville , Seville , Spain
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Martín-Cameán A, Jos Á, Mellado-García P, Iglesias-Linares A, Solano E, Cameán AM. In vitro and in vivo evidence of the cytotoxic and genotoxic effects of metal ions released by orthodontic appliances: A review. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2015; 40:86-113. [PMID: 26093195 DOI: 10.1016/j.etap.2015.05.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 05/13/2015] [Accepted: 05/16/2015] [Indexed: 06/04/2023]
Abstract
Intraoral fixed orthodontic appliances are frequently used in the clinical practice of dentistry. They are made from alloys containing different metals at various percentages. The use of these appliances leads to the long-term exposure of patients to these materials, and the potential toxic effects of this exposure raises concerns about patient safety. Thus, the biocompatibility (corrosion behaviour and toxicity) of these materials has to be evaluated prior to clinical use. In the present report, the most recent studies in the scientific literature examining metal ion release from orthodontic appliances and the toxic effects of these ions have been reviewed with a special focus on cytotoxicity and genotoxicity. Previous studies suggest that a case-by-case safety evaluation is required to take into account the increasing variability of materials, their composition and the manufacturing processes. Moreover, in vivo toxicity studies in regard to metal release, cytotoxicity and genotoxicity are still scarce. Therefore, in vitro and in vivo monitoring studies are needed to establish cause-effect relationships between metal ion release and biomarkers of cytotoxicity and genotoxicity. Further investigations could be performed to elucidate the toxic mechanisms involved in the observed effects with a special emphasis on oxidative damage.
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Affiliation(s)
- Ana Martín-Cameán
- Stomatology Department, School of Dentistry, University of Sevilla, Spain.
| | - Ángeles Jos
- Area of Toxicology, Faculty of Pharmacy, University of Sevilla, Spain
| | | | | | - Enrique Solano
- Stomatology Department, School of Dentistry, University of Sevilla, Spain
| | - Ana M Cameán
- Area of Toxicology, Faculty of Pharmacy, University of Sevilla, Spain
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Catauro M, Papale F, Bollino F, Piccolella S, Marciano S, Nocera P, Pacifico S. Silica/quercetin sol-gel hybrids as antioxidant dental implant materials. SCIENCE AND TECHNOLOGY OF ADVANCED MATERIALS 2015; 16:035001. [PMID: 27877802 PMCID: PMC5099839 DOI: 10.1088/1468-6996/16/3/035001] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 03/26/2015] [Accepted: 03/27/2015] [Indexed: 06/01/2023]
Abstract
The development of biomaterials with intrinsic antioxidant properties could represent a valuable strategy for preventing the onset of peri-implant diseases. In this context, quercetin, a naturally occurring flavonoid, has been entrapped at different weight percentages in a silica-based inorganic material by a sol-gel route. The establishment of hydrogen bond interactions between the flavonol and the solid matrix was ascertained by Fourier transform infrared spectroscopy. This technique also evidenced changes in the stretching frequencies of the quercetin dienonic moiety, suggesting that the formation of a secondary product occurs. Scanning electron microscopy was applied to detect the morphology of the synthesized materials. Their bioactivity was shown by the formation of a hydroxyapatite layer on sample surface soaked in a fluid that simulates the composition of human blood plasma. When the potential release of flavonol was determined by liquid chromatography coupled with ultraviolet and electrospray ionization tandem mass spectrometry techniques, the eluates displayed a retention time that was 0.5 min less than quercetin. Collision-activated dissociation mass spectrometry and untraviolet-visible spectroscopy were in accordance with the release of a quercetin derivative. The antiradical properties of the investigated systems were evaluated by DPPH and ABTS methods, whereas the 2,7-dichlorofluorescein diacetate assay highlighted their ability to inhibit the H2O2-induced intracellular production of reactive oxygen species in NIH-3T3 mouse fibroblast cells. Data obtained, along with data gathered from the MTT cytotoxicity test, revealed that the materials that entrapped the highest amount of quercetin showed notable antioxidant effectiveness.
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Affiliation(s)
- Michelina Catauro
- Department of Industrial and Information Engineering, Second University of Naples, Via Roma 29, 81031 Aversa, Italy
| | - Ferdinando Papale
- Department of Industrial and Information Engineering, Second University of Naples, Via Roma 29, 81031 Aversa, Italy
| | - Flavia Bollino
- Department of Industrial and Information Engineering, Second University of Naples, Via Roma 29, 81031 Aversa, Italy
| | - Simona Piccolella
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Via Vivaldi 43, 81100 Caserta, Italy
| | - Sabina Marciano
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Via Vivaldi 43, 81100 Caserta, Italy
| | - Paola Nocera
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Via Vivaldi 43, 81100 Caserta, Italy
| | - Severina Pacifico
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, Second University of Naples, Via Vivaldi 43, 81100 Caserta, Italy
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Oliveira DP, Palmieri A, Carinci F, Bolfarini C. Gene expression of human osteoblasts cells on chemically treated surfaces of Ti-6Al-4V-ELI. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 51:248-55. [PMID: 25842132 DOI: 10.1016/j.msec.2015.03.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 02/13/2015] [Accepted: 03/09/2015] [Indexed: 11/17/2022]
Abstract
Surface modifications of titanium alloys are useful methods to enhance the biological stability of intraosseous implants and to promote a well succeeded osseointegration in the early stages of implantation. This work aims to investigate the influence of chemically modified surfaces of Ti-6Al-4V-ELI (extra-low interstitial) on the gene expression of human osteoblastic (HOb) cells. The surface treatments by acid etching or acid etching plus alkaline treatment were carried out to modify the topography, effective area, contact angle and chemical composition of the samples. The surface morphology was investigated using: scanning electron microscopy (SEM) and confocal laser-scanning microscope (CLSM). Roughness measurements and effective surface area were obtained using the CLSM. Surface composition was analysed by energy dispersive X-ray spectroscopy (EDX) and by X-Ray Diffraction (XRD). The expression levels of some bone related genes (ALPL, COL1A1, COL3A1, SPP1, RUNX2, and SPARC) were analysed using real-time Reverse Transcription Polymerase Chain Reaction (real-time RT-PCR). The results showed that all the chemical modifications studied in this work influenced the surface morphology, wettability, roughness, effective area and gene expression of human osteoblasts. Acid phosphoric combined to alkaline treatment presented a more accelerated gene expression after 7days while the only phosphoric etching or chloride etching combined to alkaline treatment presented more effective responses after 15days.
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Affiliation(s)
- D P Oliveira
- Department of Materials Engineering, Federal University of São Carlos, São Carlos, Brazil.
| | - A Palmieri
- Department of D.M.C.C.C., Section of Maxillofacial and Plastic Surgery, University of Ferrara, Ferrara, Italy
| | - F Carinci
- Department of D.M.C.C.C., Section of Maxillofacial and Plastic Surgery, University of Ferrara, Ferrara, Italy
| | - C Bolfarini
- Department of Materials Engineering, Federal University of São Carlos, São Carlos, Brazil
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Chikarakara E, Fitzpatrick P, Moore E, Levingstone T, Grehan L, Higginbotham C, Vázquez M, Bagga K, Naher S, Brabazon D. In vitro
fibroblast and pre-osteoblastic cellular responses on laser surface modified Ti–6Al–4V. Biomed Mater 2014; 10:015007. [DOI: 10.1088/1748-6041/10/1/015007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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