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Hussain B, Grytten JI, Rongen G, Sanz M, Haugen HJ. Surface Topography Has Less Influence on Peri-Implantitis than Patient Factors: A Comparative Clinical Study of Two Dental Implant Systems. ACS Biomater Sci Eng 2024; 10:4562-4574. [PMID: 38916970 PMCID: PMC11234333 DOI: 10.1021/acsbiomaterials.3c01809] [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: 12/02/2023] [Revised: 06/15/2024] [Accepted: 06/17/2024] [Indexed: 06/27/2024]
Abstract
OBJECTIVES This study aims to assess the risk of peri-implantitis (PI) onset among different implant systems and evaluate the severity of the disease from a population of patients treated in a university clinic. Furthermore, this study intends to thoroughly examine the surface properties of the implant systems that have been identified and investigated. MATERIAL AND METHODS Data from a total of six hundred and 14 patients were extracted from the Institute of Clinical Dentistry, Dental Faculty, University of Oslo. Subject- and implant-based variables were collected, including the type of implant, date of implant installation, medical records, recall appointments up to 2022, periodontal measurements, information on diabetes, smoking status, sex, and age. The outcome of interest was the diagnosis of PI, defined as the occurrence of bleeding on probing (BoP), peri-implant probing depth (PD) ≥ 5 mm, and bone loss (BL). Data were analyzed using multivariate linear and logistic regression. Scanning electron microscopy, light laser profilometer, and X-ray photoelectron spectroscopy were utilized for surface and chemical analyses. RESULTS Among the patients evaluated, 6.8% were diagnosed with PI. A comparison was made between two different implant systems: Dentsply Sirona, OsseospeedTM and Straumann SLActive, with mean follow-up times of 3.84 years (SE: 0.15) and 3.34 years (SE: 0.15), respectively. The surfaces have different topographies and surface chemistry. However, no significant association was found between PI and implant surface/system, including no difference in the onset or severity of the disease. Nonetheless, plaque control was associated with an increased risk of developing PI, along with the gender of the patient. Furthermore, patients suffering from PI exhibited increased BL in the anterior region. CONCLUSION No differences were observed among the evaluated implant systems, although the surfaces have different topography and chemistry. Factors that affected the risk of developing PI were plaque index and male gender. The severity of BL in patients with PI was more pronounced in the anterior region. Consequently, our findings show that success in implantology is less contingent on selecting implant systems and more on a better understanding of patient-specific risk factors, as well as on implementing biomaterials that can more effectively debride dental implants.
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Affiliation(s)
- Badra Hussain
- Department
of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo 0316, Norway
| | | | - Gunnar Rongen
- Institute
of Community Dentistry, University of Oslo, Oslo 0316, Norway
| | - Mariano Sanz
- Section
of Periodontology, Faculty of Odontology, University Complutense of Madrid, Madrid 28040, Spain
- ETEP
(Etiology and Therapy of Periodiontal and Peri-Implant Diseases) Research
Group, Complutense University, Madrid 28040, Spain
| | - Håvard Jostein Haugen
- Department
of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo 0316, Norway
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Haugen HJ, Chen H. Is There a Better Biomaterial for Dental Implants than Titanium?—A Review and Meta-Study Analysis. J Funct Biomater 2022; 13:jfb13020046. [PMID: 35645254 PMCID: PMC9149859 DOI: 10.3390/jfb13020046] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/28/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
This article focuses on preclinical studies and reviews the available evidence from the literature on dental implant and abutment materials in the last decade. Specifically, different peri-implantitis materials and how surface modifications may affect the peri-implant soft-tissue seal and subsequently delay or hinder peri-implantitis are examined. This review analyzed more than 30 studies that were Randomized Controlled Trials (RCTs), Controlled Clinical Trials (CCTs), or prospective case series (CS) with at least six months of follow-up. Meta-analyses were performed to make a comparison between different implant materials (titanium vs. zirconia), including impact on bone changes, probing depth, plaque levels, and peri-implant mucosal inflammation, as well as how the properties of the implant material and surface modifications would affect the peri-implant soft-tissue seal and peri-implant health conditions. However, there was no clear evidence regarding whether titanium is better than other implant materials. Clinical evidence suggests no difference between different implant materials in peri-implant bone stability. The metal analysis offered a statistically significant advantage of zirconia implants over titanium regarding developing a favorable response to the alveolar bone.
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Affiliation(s)
- Håvard J. Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
- Correspondence:
| | - Hongyu Chen
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180, USA;
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Ogura A, Yamaguchi S, Le PTM, Yamamoto K, Omori M, Inoue K, Kato-Kogoe N, Nakajima Y, Nakano H, Ueno T, Yamada T, Mori Y. The effect of simple heat treatment on apatite formation on grit-blasted/acid-etched dental Ti implants already in clinical use. J Biomed Mater Res B Appl Biomater 2021; 110:392-402. [PMID: 34323348 DOI: 10.1002/jbm.b.34915] [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: 12/02/2020] [Revised: 05/24/2021] [Accepted: 06/27/2021] [Indexed: 11/11/2022]
Abstract
Grit-blasted/acid-etched titanium dental implants have a moderately roughened surface that is suitable for cell adhesion and exhibits faster osseointegration. However, the roughened surface does not always maintain stable fixation over a long period. In this study, a simple heat treatment at 600°C was performed on a commercially available dental Ti implant with grit-blasting/acid-etching, and its effect on mineralization capacity was assessed by examining apatite formation in a simulated body fluid (SBF). The as-purchased implant displayed a moderately roughened surface at the micrometer scale. Its surface was composed of titanium hydride accompanied by a small amount of alumina particles derived from the grit-blasting. Heat treatment transformed the titanium hydride into rutile without evidently changing the surface morphology. The immersion in SBF revealed that apatite formed on the heated implant at 7 days. Furthermore, apatite formed on the Ti rod surface within 1 day when the metal was subjected to acid and heat treatment without blasting. These indicate that apatite formation was conferred on the commercially available dental implant by simple heat treatment, although its induction period was slightly affected by alumina particles remaining on the implant surface. The heat-treated implant should achieve stronger and more stable bone bonding due to its apatite formation.
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Affiliation(s)
- Ayano Ogura
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan.,Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Seiji Yamaguchi
- Department of Biomedical Science, College of Life and Health Sciences, Chubu University, Kasugai, Japan
| | - Phuc Thi Minh Le
- Department of Biomedical Science, College of Life and Health Sciences, Chubu University, Kasugai, Japan.,Institute of Biotechnology, Vietnam Academy of Science and Technology, Hanoi, Vietnam
| | - Kayoko Yamamoto
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan
| | - Michi Omori
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan
| | - Kazuya Inoue
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan
| | - Nahoko Kato-Kogoe
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan
| | - Yoichiro Nakajima
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan
| | - Hiroyuki Nakano
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan
| | - Takaaki Ueno
- Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Faculty of Medicine, Osaka Medical College, Takatsuki, Japan
| | - Tomohiro Yamada
- Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yoshihide Mori
- Section of Oral and Maxillofacial Surgery, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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4
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Orchestrating soft tissue integration at the transmucosal region of titanium implants. Acta Biomater 2021; 124:33-49. [PMID: 33444803 DOI: 10.1016/j.actbio.2021.01.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/03/2021] [Accepted: 01/05/2021] [Indexed: 12/20/2022]
Abstract
Osseointegration at the bone-implant interface and soft tissue integration (STI) at the trans-mucosal region are crucial for the long-term success of dental implants, especially in compromised patient conditions. The STI quality of conventional smooth and bio-inert titanium-based implants is inferior to that of natural tissue (i.e. teeth), and hence various surface modifications have been suggested. This review article compares and contrasts the various modification strategies (physical, chemical and biological) utilized to enhance STI of Ti implants. It also details the STI challenges associated with conventional Ti-based implants, current surface modification strategies and cutting-edge nano-engineering solutions. The topographical, biological and therapeutic advances achievable via electrochemically anodized Ti implants with TiO2 nanotubes/nanopores are highlighted. Finally, the status and future directions of such nano-engineered implants is discussed, with emphasis on bridging the gap between research and clinical translation.
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Hultin K, Eriksson A, Backe C, Johansson U, Bougas K. A Pilot Study with Randomised Controlled Design Comparing TiZr Alloy Dental Implants to Ti Implants. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2020; 11:e3. [PMID: 33598111 PMCID: PMC7875101 DOI: 10.5037/jomr.2020.11403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/28/2020] [Indexed: 11/16/2022]
Abstract
Objectives Evidence on the clinical performance of recently introduced dental implants in titanium-zirconium alloy is sparse. The aim of the present pilot study with randomized controlled design is to compare changes in supporting structures around dental titanium-zirconium alloy implants to commercially pure titanium implants. Material and Methods The present material includes consecutive patients referred to a specialist clinic in Sweden. Two patient groups treated with dental implants in two different materials - titanium (Ti) and titanium-zirconium (TiZr) - were defined after block randomisation for smoking. In total, 40 implants installed in 21 patients were available for one-year follow-up. Marginal bone level, soft tissue height and width of keratinised mucosa were registered at baseline and at one-year follow-up. Results At implant level, the test group (TiZr) yielded significant marginal bone loss (P < 0.001) after one year. Additionally, marginal bone loss after one year was significantly higher for TiZr implants (P < 0.001) as compared to traditional Ti implants. Soft tissue dimensions were stable throughout the evaluation time for both implant materials. Conclusions One-year results indicate more pronounced initial marginal bone loss for dental implants in titanium-zirconium alloy as compared to implants made of commercially pure titanium.
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Affiliation(s)
- Kristina Hultin
- Department of Prosthodontics, Södra Älvsborg Hospital, BoråsSweden
| | - Annelie Eriksson
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Christina Backe
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Ulf Johansson
- Department of Oral and Maxillofacial Surgery, Södra Älvsborg Hospital, BoråsSweden
| | - Kostas Bougas
- Department of Periodontology, Södra Älvsborg Hospital, BoråsSweden
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6
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Structural and Chemical Hierarchy in Hydroxyapatite Coatings. MATERIALS 2020; 13:ma13194447. [PMID: 33036441 PMCID: PMC7579587 DOI: 10.3390/ma13194447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 02/04/2023]
Abstract
Hydroxyapatite coatings need similarly shaped splats as building blocks and then a homogeneous microstructure to unravel the structural and chemical hierarchy for more refined improvements to implant surfaces. Coatings were thermally sprayed with differently sized powders (20–40, 40–63 and 63–80 µm) to produce flattened homogeneous splats. The surface was characterized for splat shape by profilometry and Atomic force microscopy (AFM), crystal size by AFM, crystal orientation by X-ray diffraction (XRD) and structural variations by XRD. Chemical composition was assessed by phase analysis, but variations in chemistry were detected by XRD and Raman spectroscopy. The resulting surface electrical potential was measured by Kelvin probe AFM. Five levels of structural hierarchy were suggested: the coating, the splat, oriented crystals, alternate layers of oxyapatite and hydroxyapatite (HAp) and the suggested anion orientation. Chemical hierarchy was present over a lower range of order for smaller splats. Coatings made from smaller splats exhibited a greater electrical potential, inferred to arise from oxyapatite, and supplemented by ordered OH− ions in a rehydroxylated surface layer. A model has been proposed to show the influence of structural hierarchy on the electrical surface potential. Structural hierarchy is proposed as a means to further refine the properties of implant surfaces.
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Rahmati M, Frank MJ, Walter SM, Monjo MC, Satué M, Reseland JE, Lyngstadaas SP, Haugen HJ. Osteoimmunomodulatory Effects of Enamel Matrix Derivate and Strontium Coating Layers: A Short- and Long-Term In Vivo Study. ACS APPLIED BIO MATERIALS 2020; 3:5169-5181. [PMID: 32954227 PMCID: PMC7493216 DOI: 10.1021/acsabm.0c00608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/23/2020] [Indexed: 12/22/2022]
Abstract
Over the past few years, surface modification of implant surfaces has gained substantial attention as a promising solution to avoid the failure of biomaterials after implantation. Although researchers suggest several strategies for surface functionalization of titanium-based implants, only a few studies have compared the osteoimmunomodulatory effects of ionic nanostructures and biofunctionalization in the same biological model. Enamel matrix derivate (EMD) and strontium are both known for their positive influences on bone cell responses. In this study, we functionalized the titanium-zirconium implant surface with EMD and strontium using an electrochemical cathodic polarization method. Afterward, we evaluated the osteoimmunomodulatory effects of EMD or strontium coated titanium-zirconium implants in the tibia of eight Gray Bastard Chinchilla rabbits. We performed 2 and 3D micro-CT, wound fluid, histologic, and histomorphometric analyses on bone tissues after 4- and 8-weeks of implantation. Although the results could indicate some differences between groups regarding the bone quality, there was no difference in bone amount or volume. EMD stimulated higher ALP activity and lower cytotoxicity in wound fluid, as well as a lower expression of inflammatory markers after 8 weeks indicating its osteoimmunomodulatory effects after implantation. Overall, the results suggested that ionic nanostructure modification and biofunctionalization might be useful in regulating the immune responses to implants.
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Affiliation(s)
- Maryam Rahmati
- Department
of Biomaterials, Institute for Clinical Dentistry, University of Oslo, PO Box 1109
Blindern, NO-0317 Oslo, Norway
| | - Matthias Johannes Frank
- Department
of Biomaterials, Institute for Clinical Dentistry, University of Oslo, PO Box 1109
Blindern, NO-0317 Oslo, Norway
- Institute
of Medical and Polymer Engineering, Chair of Medical Engineering, Technische Universität München, Boltzmannstrasse 15, 85748 Garching, Germany
| | - Sebastian Martin Walter
- Department
of Biomaterials, Institute for Clinical Dentistry, University of Oslo, PO Box 1109
Blindern, NO-0317 Oslo, Norway
- Institute
of Medical and Polymer Engineering, Chair of Medical Engineering, Technische Universität München, Boltzmannstrasse 15, 85748 Garching, Germany
| | - Marta Cabrer Monjo
- Department
of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of Balearic
Islands, ES-07122 Palma, Spain
- Balearic
Islands Health Institute (IdISBa), ES-07010 Palma, Spain
| | - Maria Satué
- Department
of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of Balearic
Islands, ES-07122 Palma, Spain
- Balearic
Islands Health Institute (IdISBa), ES-07010 Palma, Spain
- Department
of Biomedical Sciences, University of Veterinary
Medicine, 1210 Vienna, Austria
| | - Janne Elin Reseland
- Department
of Biomaterials, Institute for Clinical Dentistry, University of Oslo, PO Box 1109
Blindern, NO-0317 Oslo, Norway
| | - Ståle Petter Lyngstadaas
- Department
of Biomaterials, Institute for Clinical Dentistry, University of Oslo, PO Box 1109
Blindern, NO-0317 Oslo, Norway
| | - Håvard Jostein Haugen
- Department
of Biomaterials, Institute for Clinical Dentistry, University of Oslo, PO Box 1109
Blindern, NO-0317 Oslo, Norway
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Kaiser F, Scharnweber D, Bierbaum S, Wolf-Brandstetter C. Success and side effects of different treatment options in the low current attack of bacterial biofilms on titanium implants. Bioelectrochemistry 2020; 133:107485. [DOI: 10.1016/j.bioelechem.2020.107485] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 12/15/2022]
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9
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Hydrogen Interaction with Deep Surface Modified Zr-1Nb Alloy by High Intensity Ti Ion Implantation. METALS 2018. [DOI: 10.3390/met8121081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A deep surface modified TiZr layer was fabricated by high-intensity low-energy titanium ion implantation into zirconium alloy Zr-1Nb. Gas-phase hydrogenation was performed to evaluate protective properties of the modified layer against hydrogen permeation into Zr-1Nb alloy. The effects of ion implantation and hydrogen on microstructure, phase composition and elemental distribution of TiZr layer were analyzed by scanning electron microscopy, X-ray diffraction, and glow-discharge optical emission spectroscopy, respectively. It was revealed that TiZr layer (~10 μm thickness) is represented by α′ + α(TiZr) lamellar microstructure with gradient distribution of Ti through the layer depth. It was shown that the formation of TiZr layer provides significant reduction of hydrogen uptake by zirconium alloy at 400 and 500 °C. Hydrogenation of the modified layer leads to refinement of lamellar plates and formation of more homogenous microstructure. Hydrogen desorption from Ti-implanted Zr-1Nb alloy was analyzed by thermal desorption spectroscopy. Hydrogen interaction with the surface modified TiZr layer, as well as its resistance properties, are discussed.
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Cordeiro JM, Faverani LP, Grandini CR, Rangel EC, da Cruz NC, Nociti Junior FH, Almeida AB, Vicente FB, Morais BR, Barão VA, Assunção WG. Characterization of chemically treated Ti-Zr system alloys for dental implant application. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 92:849-861. [DOI: 10.1016/j.msec.2018.07.046] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 06/11/2018] [Accepted: 07/18/2018] [Indexed: 12/21/2022]
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Surface Modification of Ti-35Nb-10Ta-1.5Fe by the Double Acid-Etching Process. MATERIALS 2018; 11:ma11040494. [PMID: 29587427 PMCID: PMC5951340 DOI: 10.3390/ma11040494] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 03/18/2018] [Accepted: 03/22/2018] [Indexed: 11/17/2022]
Abstract
Surface topography and composition influence the osteoblastic proliferation and osseointegration rates, which favor the biomechanical stability of bone anchoring and implants. In recent years, beta titanium alloys have been developed, and are composed of biocompatible elements, have low elastic modulus, high corrosion resistance, and mechanical properties to improve the long performance behavior of biomaterials. In the present research, the influence of the acid-etching process was studied in Ti6Al4V ELI and Ti35Nb10Ta1.5Fe. Samples were etched in a two-step acid treatment. Surface roughness parameters were quantified under a confocal microscope, topography was studied by scanning electron microscopy, and surface composition was analyzed with energy dispersive X-ray spectroscopy. The results revealed that the two-step acid treatment changes the topography of the β alloy, increases the surface area, and changes the chemical composition of the surface. Two differentiated regions were identified in the Ti35Nb10Ta1.5Fe alloy after the acid-etching process: The α + β region with higher values of mean roughness due to the lower chemical resistance of this region; and the β region with lower values of roughness parameters.
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Chrcanovic BR, Wennerberg A, Martins MD. Influence of Temperature and Acid Etching Time on the Superficial Characteristics of Ti. MATERIALS RESEARCH 2015; 18:963-970. [DOI: 10.1590/1516-1439.014115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
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13
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Liang J, Song R, Huang Q, Yang Y, Lin L, Zhang Y, Jiang P, Duan H, Dong X, Lin C. Electrochemical construction of a bio-inspired micro/nano-textured structure with cell-sized microhole arrays on biomedical titanium to enhance bioactivity. Electrochim Acta 2015. [DOI: 10.1016/j.electacta.2015.06.100] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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14
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Valderrama P, Blansett JA, Gonzalez MG, Cantu MG, Wilson TG. Detoxification of Implant Surfaces Affected by Peri-Implant Disease: An Overview of Non-surgical Methods. Open Dent J 2014; 8:77-84. [PMID: 24894571 PMCID: PMC4040927 DOI: 10.2174/1874210601408010077] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 02/05/2014] [Accepted: 02/12/2014] [Indexed: 11/22/2022] Open
Abstract
Objective: The aim of this review is to summarize the findings of studies that have evaluated non-surgical approaches for detoxification of implant body surfaces in vitro and in vivo, and to evaluate clinical trials on the use of these methodologies for treating peri-implant disease. Materials and methods: A literature search was conducted using MEDLINE (Pubmed) from 1966 to 2013. In vitro and in vivo studies as well as clinical trials on non-surgical therapy were evaluated. The outcome variables were the ability of the therapeutic method to eliminate the biofilm and endotoxins from the implant surface, the changes in clinical parameters including probing depth, clinical attachment levels, bleeding on probing; radiographic bone fill and histological re-osseointegration. Results: From 134 articles found 35 were analyzed. The findings, advantages and disadvantages of using lasers as well as mechanical and chemical methods are discussed. Most of the in vivo and human studies used combination therapies which makes determining the efficacy of one specific method difficult. Most human studies are case series with short term longitudinal analysis without survival or failure reports. Conclusion: Complete elimination of the biofilms is difficult to achieve using these approaches. All therapies induce changes of the chemical and physical properties of the implant surface. Re-osseointegration may be difficult to achieve if not impossible without surgical access to ensure thorough debridement of the defect and detoxification of the implant surface. Combination protocols for non-surgical treatment of peri-implantitis in humans have shown some positive clinical results but long-term evaluation to evaluate the validity and reliability of the techniques is needed.
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Affiliation(s)
- Pilar Valderrama
- Department of Periodontics, Texas A & M University, Baylor College of Dentistry, Dallas, Texas 3302 Gaston Avenue, Dallas Texas 75246
| | - Jonathan A Blansett
- Department of Periodontics, Texas A & M University, Baylor College of Dentistry, Dallas, Texas 3302 Gaston Avenue, Dallas Texas 75246
| | - Mayra G Gonzalez
- Universidad de Panama, Facultad De, Odontologia Estafeta Universitaria Apartado 3366, Panama City, Panama, 3366
| | - Myrna G Cantu
- Universidad Autonoma de Nuevo Leon, Dr. Eduardo Aguirre Pequeno Street, Mitras Centro Monterrey, Mexico 64460
| | - Thomas G Wilson
- Private Practice of Periodontics, 5465 Blair Rd, Ste 200, Dallas Texas 75231
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15
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Chrcanovic BR, Martins MD. Study of the influence of acid etching treatments on the superficial characteristics of Ti. MATERIALS RESEARCH 2014; 17:373-380. [DOI: 10.1590/s1516-14392014005000042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
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16
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Frank MJ, Walter MS, Rubert M, Thiede B, Monjo M, Reseland JE, Haugen HJ, Lyngstadaas SP. Cathodic Polarization Coats Titanium Based Implant Materials with Enamel Matrix Derivate (EMD). MATERIALS 2014; 7:2210-2228. [PMID: 28788564 PMCID: PMC5453263 DOI: 10.3390/ma7032210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 03/05/2014] [Accepted: 03/10/2014] [Indexed: 01/09/2023]
Abstract
The idea of a bioactive surface coating that enhances bone healing and bone growth is a strong focus of on-going research for bone implant materials. Enamel matrix derivate (EMD) is well documented to support bone regeneration and activates growth of mesenchymal tissues. Thus, it is a prime candidate for coating of existing implant surfaces. The aim of this study was to show that cathodic polarization can be used for coating commercially available implant surfaces with an immobilized but functional and bio-available surface layer of EMD. After coating, XPS revealed EMD-related bindings on the surface while SIMS showed incorporation of EMD into the surface. The hydride layer of the original surface could be activated for coating in an integrated one-step process that did not require any pre-treatment of the surface. SEM images showed nano-spheres and nano-rods on coated surfaces that were EMD-related. Moreover, the surface roughness remained unchanged after coating, as it was shown by optical profilometry. The mass peaks observed in the matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy (MALDI-TOF MS) analysis confirmed the integrity of EMD after coating. Assessment of the bioavailability suggested that the modified surfaces were active for osteoblast like MC3M3-E1 cells in showing enhanced Coll-1 gene expression and ALP activity.
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Affiliation(s)
- Matthias J Frank
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, P.O. Box 1109 Blindern, Oslo NO-0317, Norway.
- Institute of Medical and Polymer Engineering, Technische Universität München, Boltzmannstrasse 15, Garching 85748, Germany.
| | - Martin S Walter
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, P.O. Box 1109 Blindern, Oslo NO-0317, Norway.
- Institute of Medical and Polymer Engineering, Technische Universität München, Boltzmannstrasse 15, Garching 85748, Germany.
| | - Marina Rubert
- Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma de Mallorca ES-07122, Spain.
| | - Bernd Thiede
- The Biotechnology Centre of Oslo, University of Oslo, P.O. Box 1125 Blindern, Oslo NO-0317, Norway.
| | - Marta Monjo
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, P.O. Box 1109 Blindern, Oslo NO-0317, Norway.
- Department of Fundamental Biology and Health Sciences, Research Institute on Health Sciences (IUNICS), University of Balearic Islands, Palma de Mallorca ES-07122, Spain.
| | - Janne E Reseland
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, P.O. Box 1109 Blindern, Oslo NO-0317, Norway.
| | - Håvard J Haugen
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, P.O. Box 1109 Blindern, Oslo NO-0317, Norway.
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, P.O. Box 1109 Blindern, Oslo NO-0317, Norway.
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Xing R, Lyngstadaas SP, Ellingsen JE, Taxt-Lamolle S, Haugen HJ. The influence of surface nanoroughness, texture and chemistry of TiZr implant abutment on oral biofilm accumulation. Clin Oral Implants Res 2014; 26:649-56. [PMID: 25906328 DOI: 10.1111/clr.12354] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to examine surface nanoroughness, texture and chemistry of dental implant abutment and to investigate how these parameters influence oral biofilm formation in healthy subjects. MATERIALS AND METHODS Eight different nanorough TiZr surfaces were produced by polishing, machining, cathodic polarization and acid etching. Surface topography was examined using field emission scanning electron microscope and a blue light laser profilometer. Surface chemistry was analyzed by secondary ion mass spectrometry and X-ray photoelectron spectroscopy. Surface hydrophilicity was tested by measuring contact angle on the surfaces. A human in vivo study using a splint model was employed to evaluate oral biofilm accumulation on these surfaces. RESULTS Different surface textures (flat, grooved and irregular) were created with nanoroughness from 29 to 214 nm. Some test surfaces were incorporated with hydrogen by cathodic polarization and/or acid etching with HCl/H(2)SO(4). Nanoroughness (S(a)) positively correlated with microbial adhesion. Biofilm accumulation was less pronounced on flat and grooved than on irregular surfaces. No significant association between hydrogen content or hydrophilicity of the surface and biofilm accumulation was observed. CONCLUSIONS Nanoroughness (< 214 nm) and surface texture influence oral biofilm accumulation independent of surface chemistry and hydrophilicity. Surface hydrogen, which has previously been shown to promote fibroblast growth, does not affect biofilm formation.
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Affiliation(s)
- Rui Xing
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, Oslo, Norway
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18
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Human gingival fibroblasts function is stimulated on machined hydrided titanium zirconium dental implants. J Dent 2014; 42:30-8. [DOI: 10.1016/j.jdent.2013.11.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/14/2013] [Accepted: 11/10/2013] [Indexed: 11/30/2022] Open
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19
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Frank MJ, Walter MS, Tiainen H, Rubert M, Monjo M, Lyngstadaas SP, Haugen HJ. Coating of metal implant materials with strontium. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2013; 24:2537-2548. [PMID: 23888353 DOI: 10.1007/s10856-013-5007-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 07/16/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to show that cathodic polarization can be used for coating commercial implant surfaces with an immobilized but functional and bioavailable surface layer of strontium (Sr). Moreover, this study assessed the effect of fluorine on Sr-attachment. X-ray photoelectron spectroscopy revealed that addition of fluorine (F) to the buffer during coating increased surface Sr-amounts but also changed the chemical surface composition by adding SrF2 alongside of SrO whereas pre-treatment of the surface by pickling in hydrofluoric acid appeared to hinder Sr-attachment. Assessment of the bio-availability hinted at a positive effect of Sr on cell differentiation given that the surface reactivity of the original surface remained unchanged. Additional SrF2 on the surface appeared to reduce undesired surface contamination while maintaining the surface micro-topography and micro-morphology. Anyhow, this surface modification revealed to create nano-nodules on the surface.
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Affiliation(s)
- Matthias J Frank
- Department of Biomaterials, Institute for Clinical Dentistry, University of Oslo, PO Box 1109, Blindern, 0317, Oslo, Norway
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20
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Xing R, Salou L, Taxt-Lamolle S, Reseland JE, Lyngstadaas SP, Haugen HJ. Surface hydride on titanium by cathodic polarization promotes human gingival fibroblast growth. J Biomed Mater Res A 2013; 102:1389-98. [PMID: 23733604 DOI: 10.1002/jbm.a.34819] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/21/2013] [Accepted: 05/21/2013] [Indexed: 11/07/2022]
Abstract
Connective tissue seal to dental abutment is crucial for peri-implant health. Several efforts have been made previously to optimize abutment surfaces, but no consensus has been reached regarding the optimal surface architecture and/or composition for soft tissue seal. Here, we report on experiments using cathodic polarization in organic acids to optimize titanium (Ti) surfaces for use as abutments. The three main factors affecting surface topography and chemistry were electrolyte composition, current density, and polarization time. Under identical conditions, oxalic acid created rougher surfaces than tartaric acid and acetic acid, and acetic acid produced more surface hydride. Surface hydride amount was suggested to first increase and then decrease with current density from 1 mA/cm(2) to 15 mA/cm(2) . The complexity of the surface topography and hydride production both increased with polarization time. Proliferation rate of human gingival fibroblasts (HGFs) was positively correlated with surface hydride content, suggesting the positive effect of surface hydride on connective tissue growth around dental abutment. Changes in surface topography and hydrophilicity did not significantly influence HGF growth.
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Affiliation(s)
- Rui Xing
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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