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Shrivas S, Samaur H, Yadav V, Boda SK. Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration. ACS Biomater Sci Eng 2024; 10:1966-1987. [PMID: 38530973 DOI: 10.1021/acsbiomaterials.3c01555] [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] [Indexed: 03/28/2024]
Abstract
A holistic biointegration of percutaneous bone-anchored metallic prostheses with both hard and soft tissues dictates their longevity in the human body. While titanium (Ti) has nearly solved osseointegration, soft tissue integration of percutaneous metallic prostheses is a perennial problem. Unlike the firm soft tissue sealing in biological percutaneous structures (fingernails and teeth), foreign body response of the skin to titanium (Ti) leads to inflammation, epidermal downgrowth and inferior peri-implant soft tissue sealing. This review discusses various implant surface treatments/texturing and coatings for osseointegration, soft tissue integration, and against bacterial attachment. While surface microroughness by SLA (sandblasting with large grit and acid etched) and porous calcium phosphate (CaP) coatings improve Ti osseointegration, smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings encourage soft tissue attachment. However, the inferior peri-implant soft tissue sealing compared to natural teeth can lead to peri-implantitis. Toward this end, the application of smart multifunctional bioadhesives with strong adhesion to soft tissues, mechanical resilience, durability, antibacterial, and immunomodulatory properties for soft tissue attachment to metallic prostheses is proposed.
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Affiliation(s)
- Sangeeta Shrivas
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Harshita Samaur
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Vinod Yadav
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Sunil Kumar Boda
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
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Areid N, Abushahba F, Riivari S, Närhi T. Effect of TiO 2 Abutment Coatings on Peri-Implant Soft Tissue Behavior: A Systematic Review of In Vivo Studies. Int J Dent 2024; 2024:9079673. [PMID: 38533472 PMCID: PMC10965279 DOI: 10.1155/2024/9079673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/21/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
Establishing a proper soft tissue adhesion around the implant abutment is essential to prevent microbial invasion, inhibit epithelial downgrowth, and obtain an optimal healing process. This systematic review aims to evaluate the real potential of TiO2 coating on the behavior of peri-implant soft tissue health and maintenance. A specific aim was to evaluate clinically and histologically the effect of TiO2 abutment coating on epithelial and connective tissue attachment. Electronic database searches were conducted from 1990 to 2023 in MEDLINE/PubMed and the Web of Science databases. In total, 15 out of 485 publications were included. Eight studies involved humans, and seven were animal studies. Exposure time ranges from 2 days to 5 years. The peri-implant soft tissue evaluations included clinical assessment (plaque index (PI), peri-implant probing pocket depth (PPD), and bleeding on probing (BoP)), histological as well as histomorphometric analysis. The Office of Health Assessment and Translation (OHAT) Risk of Bias Rating Tool for Human and Animal Studies was used to evaluate the overall quality of the studies included in the review. The results showed some variation but remained within acceptable limits. Within the limitations of this systematic review, the present findings suggest that TiO2 coatings seem to influence soft tissue healing. TiO2-coated abutments with a roughness value between 0.2 and 0.5 μm enhance soft tissue health. Sol-gel-derived TiO2 coatings induced better soft tissue attachment than noncoated machined abutment surfaces. The anodized titanium abutments demonstrate comparable clinical and histological outcomes to conventional machined abutments. However, there was variation among the included studies concerning TiO2 coating characteristics and the measured outcomes used to evaluate the soft tissue response, and therefore, quantitative analysis was not feasible. Long-term in vivo studies with standardized soft tissue analysis and coating surface parameters are necessary before a definitive conclusion can be drawn. OSF Registration No.: 10.17605/OSF.IO/E5RQV.
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Affiliation(s)
- Nagat Areid
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku FI-20520, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku FI-20520, Finland
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku FI-20520, Finland
- Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Libyan International Medical University (LIMU), Benghazi 339P+62Q, Libya
| | - Sini Riivari
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku FI-20520, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Turku FI-20520, Finland
- Wellbeing Services County of South-West Finland, Turku FI-20521, Finland
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Canullo L, Donato A, Savadori P, Radovanovic S, Iacono R, Rakic M. Effect of argon plasma abutment activation on soft tissue healing: RCT with histological assessment. Clin Implant Dent Relat Res 2024; 26:226-236. [PMID: 37853303 DOI: 10.1111/cid.13286] [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: 06/11/2023] [Revised: 09/27/2023] [Accepted: 09/30/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To assess the peri-implant soft tissue profiles between argon plasma treatment (PT) and non-treated (NPT) healing abutments by comparing clinical and histological parameters 2 months following abutment placement. MATERIALS AND METHODS Thirty participants were randomly assigned to argon-plasma treatment abutments group (PT) or non-treated abutments (NPT) group. Two months after healing abutment placement, soft peri-implant tissues and abutment were harvested, and histological and clinical parameters including plaque index, bleeding on probing, and keratinized mucosa diameter (KM) were assessed. Specialized stainings (hematoxylin-eosin and picrocirious red) coupled with immunohistochemistry (vimentin, collagen, and CK10) were performed to assess soft tissue inflammation and healing, and the collagen content keratinization. In addition to standard statistical methods, machine learning algorithms were applied for advanced soft tissue profiling between the test and control groups. RESULTS PT group showed lower plaque accumulation and inflammation grade (6.71% vs. 13.25%, respectively; p-value 0.02), and more advanced connective tissue healing and integration compared to NPT (31.77% vs. 23.3%, respectively; p = 0.009). In the control group, more expressed keratinization was found compared to the PT group, showing significantly higher CK10 (>47.5%). No differences in KM were found between the groups. SIGNIFICANCE PT seems to be a promising protocol for guided peri-implant soft tissue morphogenesis reducing plaque accumulation and inflammation, and stimulating collagen and soft tissue but without effects on epithelial tissues and keratinization.
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Affiliation(s)
- Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy
- Department of Periodontology, University of Bern, Bern, Switzerland
| | | | - Paolo Savadori
- Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Maxillo-Facial Surgery and Dental Unit, Milan, Italy
| | - Sandro Radovanovic
- Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia
| | - Roberta Iacono
- Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Mia Rakic
- Facultad de Odontologia, Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Universidad Complutense de Madrid, Madrid, Spain
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Pesce P, Del Fabbro M, Menini M, De Giovanni E, Annunziata M, Khijmatgar S, Canullo L. Effects of abutment materials on peri-implant soft tissue health and stability: A network meta-analysis. J Prosthodont Res 2023; 67:506-517. [PMID: 37081626 DOI: 10.2186/jpr.jpr_d_22_00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
PURPOSE This systematic review aimed to evaluate the effect of the abutment material on peri-implant soft tissue health and stability. STUDY SELECTION An electronic and hand search was conducted until February 2022. Only prospective randomized trials (RCTs) and controlled clinical trials (CCTs) comparing titanium abutments with abutments made of different materials, with a follow-up of at least 6 months, were selected by two independent reviewers. Data on marginal bone loss (MBL) and peri-implant tissue indexes, i.e., plaque index (PI), bleeding on probing (BOP), probing depth (PD), and recession (REC), were collected. The risk of bias for RCTs and non-RCTs was evaluated according to the tool reported in the Cochrane Handbook for Systematic Reviews of Interventions and the ROBINS-I tool, respectively. Both pairwise and network meta-analyses (NMA) were performed. RESULTS We included 18 relevant studies from 1,437 identified studies. Overall, 612 patients were treated, and 848 abutments were inserted. Five studies presented a low risk of bias. Pairwise meta-analysis showed that, as compared to titanium, zirconia abutments presented a significantly reduced MBL (0.20 mm, 95% Confidence Interval CI [0.14-0.26], P < 0.00001). No significant differences were found for the other outcomes. In the NMA, zirconia abutments demonstrated an 83.3% probability of achieving the highest rank in PI, an 87.0% in BOP, and a 65.0% in PD outcome, suggesting that zirconia abutments generally performed better than titanium and alumina abutments. CONCLUSIONS Within the limits of the present study, zirconia abutments seem a viable alternative to titanium ones.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Menini
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Emanuele De Giovanni
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
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Cascos R, Celemín-Viñuela A, Mory-Rubiños N, Gómez-Polo C, Ortega R, Agustín-Panadero R, Gómez-Polo M. Influence of the Use of Transepithelial Abutments vs. Titanium Base Abutments on Microgap Formation at the Dental Implant-Abutment Interface: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6532. [PMID: 37834669 PMCID: PMC10573618 DOI: 10.3390/ma16196532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023]
Abstract
This in vitro study aimed to assess the presence of microgaps at the implant-abutment interface in monolithic zirconia partial implant-supported fixed prostheses on transepithelial abutments versus Ti-base abutments. METHODS Sixty conical connection dental implants were divided into two groups (n = 30). The control group consisted of three-unit bridge monolithic zirconia connected to two implants by a transepithelial abutment. The test group consisted of monolithic zirconia three-unit restoration connected to two implants directly by a titanium base (Ti-base) abutment. The sample was subjected to thermocycling (10,000 cycles at 5 °C to 55 °C, dwelling time 50 s) and chewing simulation (300,000 cycles, under 200 N at frequencies of 2 Hz, at a 30° angle). The microgap was evaluated at six points (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual) of each implant-abutment interface by using a scanning electron microscope (SEM). The data were analyzed using the Mann-Whitney U tests (p > 0.05). RESULTS The SEM analysis showed a smaller microgap at the implant-abutment interface in the control group (0.270 μm) than in the test group (3.902 μm). Statistically significant differences were observed between both groups (p < 0.05). CONCLUSIONS The use or not of transepithelial abutments affects the microgap size. The transepithelial abutments group presented lower microgap values at the interface with the implant than the Ti-base group in monolithic zirconia partial implant-supported fixed prostheses. However, both groups had microgap values within the clinically acceptable range.
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Affiliation(s)
- Rocío Cascos
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
- Department of Nursing and Estomatology, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, 28670 Madrid, Spain;
| | - Alicia Celemín-Viñuela
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
| | - Nataly Mory-Rubiños
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
| | - Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain;
| | - Rocío Ortega
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, 28670 Madrid, Spain;
| | - Rubén Agustín-Panadero
- Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de València, 46010 Valencia, Spain;
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (A.C.-V.); (N.M.-R.); (M.G.-P.)
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Wang C, Wang X, Lu R, Cao X, Yuan D, Chen S. Influence of surface nanotopography and wettability on early phases of peri-implant soft tissue healing: an in-vivo study in dogs. BMC Oral Health 2023; 23:651. [PMID: 37684664 PMCID: PMC10492342 DOI: 10.1186/s12903-023-03347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND It is well established that nanotopography and wettability of implant surfaces contribute to osseointegration and long-term implant success. However, the effects of a hydrogenated surface with nanotubular and superhydrophilic properties on peri-implant soft tissue remain unclear. This study was designed to study the impact of a modified abutment surface on early soft tissue integration compared with a machined surface. METHODS Thirty-six implants were placed at the bone level in the bilateral mandible of six beagles, followed by healing abutments belonging to the standard machined Ti-6Al-4V alloy abutments (TC4-M), anodized abutments with nanotubes (TC4-Nano), and hydrogenated abutments (TC4-H/Nano) groups, which were randomly screwed to the implants. After two and four weeks of wound healing, the animals were euthanized for histological evaluation. RESULTS A superhydrophilic nanotubular surface developed on the hydrogenated abutment. Histological and histometric analyses revealed similar peri-implant soft tissue healing and dimensions for the three types of abutments at two and four weeks. Connective tissue (CT) length was longer around TC4-H/Nano abutments compared with standard abutments; however, the differences were not statistically significant. Moreover, collagen fibers in the TC4-H/Nano group extended and were attached perpendicularly to the superhydrophilic surface. CONCLUSIONS Our results revealed that the soft tissue interface adjacent to the hydrogenated abutment is comparable to that of the machined abutment. A tendency of increased CT length and perpendicular collagen fibers was observed around the modified abutment. This study suggests that nanotubular/superhydrophilic surfaces could be a promising modification to enhance soft tissue sealing. However, comprehensive studies should be conducted to evaluate the peri-implant soft tissue around the modified abutment immunohistochemically, histopathologically, and clinically.
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Affiliation(s)
- Caiyun Wang
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Xin Wang
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Ran Lu
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Xu Cao
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Dingxiang Yuan
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China
| | - Su Chen
- Laboratory of Biomaterials and Biomechanics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.
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Tang K, Luo ML, Zhou W, Niu LN, Chen JH, Wang F. The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies. Bioact Mater 2023; 27:348-361. [PMID: 37180640 PMCID: PMC10172871 DOI: 10.1016/j.bioactmat.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/23/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.
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Affiliation(s)
- Kai Tang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Meng-Lin Luo
- Institute of Stomatology & Oral Maxilla Facial Key Laboratory, The First Medical Center, Chinese PLA General Hospital & Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhou
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Li-Na Niu
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ji-Hua Chen
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
| | - Fu Wang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
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Razali M, Chai WL, Omar RA, Ngeow WC. Contour Analysis of Three-Dimensional Peri-Implant Mucosal Model as an Endpoint Analysis of Photofunctionalization Effects on Implant Abutment Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5529. [PMID: 37629819 PMCID: PMC10456501 DOI: 10.3390/ma16165529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION The objective of this study was to examine the effect of photofunctionalization on the soft-tissue contour formed at the interface of various abutment materials using end-point analyses obtained from the three-dimensional oral mucosal model (3D-OMMs). METHODS Commercially pure titanium (CPTi), alumina-toughened zirconia (ATZ), and yttria-stabilized zirconia (YSZ) made into discs shapes were classified into two groups: UV-treated (PTx) and non-treated (NTx). The materials in PTx groups were exposed to UV light for 12 min. Human gingival fibroblasts and TR146 epithelial cell lines co-cultured on the acellular dermal membrane were used to construct the 3D-OMM. After 4 days of culture, the discs were inserted into the holes prepared within the membrane of 3D-OMMs. The contour formed by the tissue was evaluated after 14 days of culture. RESULTS The UV treatment of abutment materials resulted in the formation of more non-pocket-tissue types among the PTx group (p = 0.002). Of all materials tested, soft tissue contour around YSZ showed higher scores for the non-pocket type in both non- and UV-treated groups. CONCLUSIONS The non-pocket type of tissue attachment was frequently found in all surfaces modified by photofunctionalization, particularly zirconia. The 3D-OMM can be used to evaluate the biological endpoints of implant surface modifications.
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Affiliation(s)
- Masfueh Razali
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (W.L.C.); (R.A.O.)
| | - Ros Anita Omar
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (W.L.C.); (R.A.O.)
| | - Wei Cheong Ngeow
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
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Baus-Domínguez M, Maza-Solano S, Vázquez-Pachón C, Flores-Cerero M, Torres-Lagares D, Serrera-Figallo MÁ, Macías-García L. Behaviour of the Peri-Implant Soft Tissue with Different Rehabilitation Materials on Implants. Polymers (Basel) 2023; 15:3321. [PMID: 37571215 PMCID: PMC10422441 DOI: 10.3390/polym15153321] [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: 07/02/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: Mucointegration seems to gain interest when talking about success in the maintenance of dental implants. As we well know, collagen fibres cannot be inserted due to the lack of root structure on the implant surface, so the structural integration of peri-implant tissues that provide a firm seal around implants seems to be of interest when it comes to ensuring the survival of dental implants. To achieve a good epithelial barrier, the physicochemical characteristics of the surfaces of the restorative materials are of vital importance; therefore, the objective of this study is to analyse the histological behaviour of the peri-implant soft tissues in three different restorative materials. (2) Methods: Histological analysis of biopsied peri-implant keratinised mucosa, inflammatory epithelium and connective tissue in contact with a reinforced composite (BRILLIANT Crios), a cross-linked polymethylmethacrylate (TELIO CAD), and a hybrid ceramic (Vita Enamic), restored on a customised Atlantis-type abutment (Dentsply Sirona) between 60 and 180 days after restoration. (3) Results: A greater number of cells per mm2 of keratinised epithelium is observed in the reinforced composite, which could indicate greater surface roughness with greater inflammatory response. In this way, the greater number of lymphocytes and the lateral cellular composition of the inflammatory cells confirm the greater inflammatory activity towards that material. The best material to rehabilitate was hybrid ceramic, as it shows a better cellular response. (4) Conclusions: Knowing the limitations of the proposed study, despite the fact that greater inflammation is observed in the reinforced composite relative to the other materials studied, no statistically significant differences were found.
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Affiliation(s)
- María Baus-Domínguez
- Instituto de Biomedicina de Sevilla, IBiS/Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain; (M.B.-D.); (S.M.-S.); (C.V.-P.); (M.F.-C.); (D.T.-L.)
| | - Serafín Maza-Solano
- Instituto de Biomedicina de Sevilla, IBiS/Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain; (M.B.-D.); (S.M.-S.); (C.V.-P.); (M.F.-C.); (D.T.-L.)
| | - Celia Vázquez-Pachón
- Instituto de Biomedicina de Sevilla, IBiS/Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain; (M.B.-D.); (S.M.-S.); (C.V.-P.); (M.F.-C.); (D.T.-L.)
| | - Marta Flores-Cerero
- Instituto de Biomedicina de Sevilla, IBiS/Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain; (M.B.-D.); (S.M.-S.); (C.V.-P.); (M.F.-C.); (D.T.-L.)
| | - Daniel Torres-Lagares
- Instituto de Biomedicina de Sevilla, IBiS/Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain; (M.B.-D.); (S.M.-S.); (C.V.-P.); (M.F.-C.); (D.T.-L.)
| | - María-Ángeles Serrera-Figallo
- Instituto de Biomedicina de Sevilla, IBiS/Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, C/Avicena S/N, 41009 Sevilla, Spain; (M.B.-D.); (S.M.-S.); (C.V.-P.); (M.F.-C.); (D.T.-L.)
| | - Laura Macías-García
- Departamento de Citología e Histología Normal y Patológica, Facultad de Medicina, Universidad de Sevilla, Avda. Sánchez-Pizjuán S/N, 41009 Sevilla, Spain
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10
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Areid N, Riivari S, Abushahba F, Shahramian K, Närhi T. Influence of Surface Characteristics of TiO 2 Coatings on the Response of Gingival Cells: A Systematic Review of In Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2533. [PMID: 36984413 PMCID: PMC10056999 DOI: 10.3390/ma16062533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 06/18/2023]
Abstract
The soft tissue-implant interface requires the formation of epithelium and connective tissue seal to hinder microbial infiltration and prevent epithelial down growth. Nanoporous titanium dioxide (TiO2) surface coatings have shown good potential for promoting soft tissue attachment to implant surfaces. However, the impact of their surface properties on the biological response of gingival cells needs further investigation. This systematic review aimed to investigate the cellular behavior of gingival cells on TiO2-implant abutment coatings based on in vitro studies. The review was performed to answer the question: "How does the surface characteristic of TiO2 coatings influence the gingival cell response in in vitro studies?". A search in MEDLINE/PubMed and the web of science databases from 1990 to 2022 was performed using keywords. A quality assessment of the studies selected was performed using the SciRAP method. A total of 11 publications were selected from the 289 studies that fulfilled the inclusion criteria. The mean reporting and methodologic quality SciRAP scores were 82.7 ± 6.4/100 and 87 ± 4.2/100, respectively. Within the limitations of this in vitro systematic review, it can be concluded that the TiO2 coatings with smooth nano-structured surface topography and good wettability improve gingival cell response compared to non-coated surfaces.
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Affiliation(s)
- Nagat Areid
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
| | - Sini Riivari
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
| | - Faleh Abushahba
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
| | - Khalil Shahramian
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
- Turku Clinical Biomaterials Center (TCBC), University of Turku, FI-20014 Turku, Finland
| | - Timo Närhi
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, FI-20014 Turku, Finland
- Turku Clinical Biomaterials Center (TCBC), University of Turku, FI-20014 Turku, Finland
- Oral Health Care, Wellbeing services county of Southwest Finland, P.O. Box 52, FIN-20521 Turku, Finland
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11
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Wen Y, Dong H, Lin J, Zhuang X, Xian R, Li P, Li S. Response of Human Gingival Fibroblasts and Porphyromonas gingivalis to UVC-Activated Titanium Surfaces. J Funct Biomater 2023; 14:jfb14030137. [PMID: 36976061 PMCID: PMC10051447 DOI: 10.3390/jfb14030137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
Ultraviolet (UV) photofunctionalization has been demonstrated to synergistically improve the osteoblast response and reduce biofilm formation on titanium (Ti) surfaces. However, it remains obscure how photofunctionalization affects soft tissue integration and microbial adhesion on the transmucosal part of a dental implant. This study aimed to investigate the effect of UVC (100–280 nm) pretreatment on the response of human gingival fibroblasts (HGFs) and Porphyromonas gingivalis (P. g.) to Ti-based implant surfaces. The smooth and anodized nano-engineered Ti-based surfaces were triggered by UVC irradiation, respectively. The results showed that both smooth and nano-surfaces acquired super hydrophilicity without structural alteration after UVC photofunctionalization. UVC-activated smooth surfaces enhanced the adhesion and proliferation of HGFs compared to the untreated smooth ones. Regarding the anodized nano-engineered surfaces, UVC pretreatment weakened the fibroblast attachment but had no adverse effects on proliferation and the related gene expression. Additionally, both Ti-based surfaces could effectively inhibit P. g. adhesion after UVC irradiation. Therefore, the UVC photofunctionalization could be more potentially favorable to synergistically improve the fibroblast response and inhibit P. g. adhesion on the smooth Ti-based surfaces.
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Affiliation(s)
- Yin Wen
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Hao Dong
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Jiating Lin
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Xianxian Zhuang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Ruoting Xian
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
- Correspondence: (P.L.); (S.L.)
| | - Shaobing Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou 510280, China
- First Clinical Medical College, Xinjiang Medical University, Urumqi 830011, China
- The First People’s Hospital of Kashgar Region, Kashgar 844000, China
- Correspondence: (P.L.); (S.L.)
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12
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Pera F, Menini M, Alovisi M, Crupi A, Ambrogio G, Asero S, Marchetti C, Canepa C, Merlini L, Pesce P, Carossa M. Can Abutment with Novel Superlattice CrN/NbN Coatings Influence Peri-Implant Tissue Health and Implant Survival Rate Compared to Machined Abutment? 6-Month Results from a Multi-Center Split-Mouth Randomized Control Trial. MATERIALS (BASEL, SWITZERLAND) 2022; 16:ma16010246. [PMID: 36614586 PMCID: PMC9821948 DOI: 10.3390/ma16010246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/12/2022] [Accepted: 12/23/2022] [Indexed: 05/12/2023]
Abstract
Background: The aim of the present multi-center split-mouth randomized control trial was to investigate the effect on peri-implant tissue of abutment with chromium nitride/ niobium nitride (CrN/NbN) coatings (superlattice) compared to traditional machined surface. Methods: Two adjacent posterior implants were inserted in 20 patients. A machined abutment was randomly screwed on either the mesial or distal implant, while a superlattice abutment was screwed on the other one. Implant survival rate, peri-implant probing depth (PPD), plaque index (PI), and bleeding index (BI) were collected 6 months after surgery, while marginal bone loss (MBL) was evaluated at T0 and T6.; Results: Implant survival rate was 97.7%. A total MBL of 0.77 ± 0.50 mm was recorded for superlattice abutments, while a mean MBL of 0.79 ± 0.40 mm was recorded for the abutment with machined surface. A mean PPD of 1.3 ± 0.23 mm was recorded for the superlattice Group, and a mean PPD of 1.31 ± 0.3 was recorded for the machined surface Group. PI was of 0.55 ± 0.51 for superlattice Group and 0.57 ± 0.50 for machined Group, while BI was of 0.47 ± 0.49 for superlattice Group and of 0.46 ± 0.40 for the machined one. No statistically significant difference was highlighted between the two Groups (p > 0.05). Conclusions: After a 6-month observational period, no statistically significant differences were highlighted between superlattice abutment and traditional machined abutment. Further in vitro studies as well as clinical research with longer follow-ups are required to better investigate the surface properties of the novel abutments’ superlattice coating and its effect on the oral tissues.
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Affiliation(s)
- Francesco Pera
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy
| | - Maria Menini
- Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy
| | - Armando Crupi
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy
| | - Giulia Ambrogio
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy
| | - Sofia Asero
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy
| | - Carlotta Marchetti
- Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Camilla Canepa
- Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Laura Merlini
- Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Massimo Carossa
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, 10126 Turin, Italy
- Correspondence:
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13
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2022; 128:248-330. [PMID: 36096911 DOI: 10.1016/j.prosdent.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/23/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.
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Roth LA, Bastos MF, Melo MA, Barão VAR, Costa RC, Giro G, Souza JGS, Grzech-Leśniak K, Shibli JA. The Potential Role of a Surface-Modified Additive-Manufactured Healing Abutment on the Expression of Integrins α2, β1, αv, and β6 in the Peri-Implant Mucosa: A Preliminary Human Study. Life (Basel) 2022; 12:life12070937. [PMID: 35888027 PMCID: PMC9316083 DOI: 10.3390/life12070937] [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: 06/06/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
The stability of peri-implant soft tissues is essential for long-term success. Integrins play a vital role in biological processes through developing and maintaining cell interactions; however, few studies have evaluated the effects of modifications to abutment surfaces on cell adhesion across integrin expression. Therefore, this pilot study assessed the influence of different surface topographies of titanium healing abutments prepared by additive manufacturing (AM) on the gene expression levels of the integrin subunits α2, β1, αv, and β6 in the human peri-implant mucosa. Thirteen healthy adults were included. Depending on the number of required implants, the subjects were distributed in different groups as a function of healing abutment topography: group 1 (fully rough surface); group 2 (upper machined + lower rough); group 3 (rough upper surface + lower machined); group 4 (fully machined). A total of 40 samples (n = 10/group) of the peri-implant mucosa around the abutments were collected 30 days after implant placement, and subsequently, the gene expression levels were evaluated using real-time PCR. The levels of gene expression of β1-subunit integrin were upregulated for individuals receiving fully rough surface abutments compared with the other surface topographies (p < 0.05). However, the healing abutment topography did not affect the gene expression levels of the α2, αv, and β6 integrin subunits in the human peri-implant mucosa (p > 0.05). This preliminary study suggested that controlled modifications of the surface topography of titanium healing abutments produced by AM may influence the quality of the peri-implant mucosa in the early stages of the soft tissue healing process.
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Affiliation(s)
- Leandro Amadeu Roth
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (L.A.R.); (M.A.M.); (G.G.); (J.G.S.S.); or (J.A.S.)
| | - Marta Ferreira Bastos
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, Rua. Taquari, 546, São Paulo 03166-000, SP, Brazil;
| | - Marcelo A. Melo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (L.A.R.); (M.A.M.); (G.G.); (J.G.S.S.); or (J.A.S.)
| | - Valentim A. R. Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba 13414-903, SP, Brazil; (V.A.R.B.); (R.C.C.)
| | - Raphael C. Costa
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas—UNICAMP, Piracicaba 13414-903, SP, Brazil; (V.A.R.B.); (R.C.C.)
| | - Gabriela Giro
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (L.A.R.); (M.A.M.); (G.G.); (J.G.S.S.); or (J.A.S.)
| | - João Gabriel Silva Souza
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (L.A.R.); (M.A.M.); (G.G.); (J.G.S.S.); or (J.A.S.)
- Dental Science School (Faculdade de Ciências Odontológicas—FCO), Av. Waldomiro Marcondes Oliveira, 20-Ibituruna, Montes Claros 39401-303, MG, Brazil
| | - Kinga Grzech-Leśniak
- Department of Oral Surgery, Wroclaw Medical University, 50-367 Wroclaw, Poland
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23298, USA
- Correspondence:
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, SP, Brazil; (L.A.R.); (M.A.M.); (G.G.); (J.G.S.S.); or (J.A.S.)
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15
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Histologic Evaluation of Soft Tissues around Dental Implant Abutments: A Narrative Review. MATERIALS 2022; 15:ma15113811. [PMID: 35683109 PMCID: PMC9181750 DOI: 10.3390/ma15113811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/13/2022] [Accepted: 05/25/2022] [Indexed: 01/28/2023]
Abstract
The basis for dental implant success comes not only with the titanium implant osseointegration but also depends on other factors such as the development of a soft tissue barrier, which protects the peri-implant bone from the oral environment. The characteristics of surfaces in contact with peri-implant soft tissues may affect the capacity of peri-implant mucosal cells to create a tight seal around the implant, thus influencing long-term implant success. Many histological studies on animals have been conducted on different materials to better understand their influence on peri-implant soft tissues, with the limitation that results from animal studies cannot be fully translated in humans. The aim of this review paper was to analyze the literature focusing on histological clinical studies in humans which have examined different materials or different surface treatments and their effects on peri-implant soft tissues. The research was conducted according to the following PICO question: “Do different implant/abutment materials affect peri-implant soft tissues adhesion and health?”. Nine articles were analyzed in this review. The results of this review show the influence of different abutment materials on the peri-implant soft tissues, and the need of further research regarding the effect that abutment materials, surface treatments, and surface properties have on soft tissues.
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16
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Kim JC, Lee M, Yeo ISL. Three interfaces of the dental implant system and their clinical effects on hard and soft tissues. MATERIALS HORIZONS 2022; 9:1387-1411. [PMID: 35293401 DOI: 10.1039/d1mh01621k] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Anatomically, the human tooth has structures both embedded within and forming part of the exterior surface of the human body. When a tooth is lost, it is often replaced by a dental implant, to facilitate the chewing of food and for esthetic purposes. For successful substitution of the lost tooth, hard tissue should be integrated into the implant surface. The microtopography and chemistry of the implant surface have been explored with the aim of enhancing osseointegration. Additionally, clinical implant success is dependent on ensuring that a barrier, comprising strong gingival attachment to an abutment, does not allow the infiltration of oral bacteria into the bone-integrated surface. Epithelial and connective tissue cells respond to the abutment surface, depending on its surface characteristics and the materials from which it is made. In particular, the biomechanics of the implant-abutment connection structure (i.e., the biomechanics of the interface between implant and abutment surfaces, and the screw mechanics of the implant-abutment assembly) are critical for both the soft tissue seal and hard tissue integration. Herein, we discuss the clinical importance of these three interfaces: bone-implant, gingiva-abutment, and implant-abutment.
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Affiliation(s)
- Jeong Chan Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul 03080, Korea
| | - Min Lee
- Department of Bioengineering, University of California, Los Angeles, CA 90095, USA
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongro-Gu, Seoul 03080, Korea.
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17
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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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18
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Gianfreda F, Bollero P, Muzzi M, Di Giulio A, Nicolai E, Canullo L. The Effects of Ultrasonic Scaling and Air-Abrasive Powders on the Decontamination of 9 Implant-Abutment Surfaces: Scanning Electron Analysis and In Vitro Study. Dent J (Basel) 2022; 10:dj10030036. [PMID: 35323237 PMCID: PMC8947291 DOI: 10.3390/dj10030036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 12/20/2022] Open
Abstract
(1) Background: The aim of this study is to understand from a microscopic point of view whether bicarbonate air-abrasive powders associated with ultrasonic instruments can decontaminate nine different surfaces used for the abutment/implant junction. Fibroblast growth was carried out on decontaminated surface in order to understand if there are significative differences in terms of biocompatibility. (2) Methods: After taking samples of patient plaque, nine different surfaces were contaminated and analyzed by SEM, then their wettability was evaluated. Fibroblasts were cultured on the decontaminated surfaces to understand their ability to establish a connective tissue seal after decontamination. The results were analyzed from a statistical point of view to hypothesize a mathematical model capable of explaining the properties of the surfaces. (3) Results: A negative correlation between roughness and contamination has been demonstrated, whereas a weak correlation was observed between wettability and decontamination capacity. All surfaces were topographically damaged after the decontamination treatment. Grade 5 titanium surfaces appear tougher, whereas anodized surfaces tend to lose the anodizing layer. (4) Conclusions: further studies will be needed to fully understand how these decontaminated surfaces affect the adhesion, proliferation and differentiation of fibroblasts and osteoblasts.
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Affiliation(s)
- Francesco Gianfreda
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Patrizio Bollero
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Maurizio Muzzi
- Department of Science, University Roma Tre, Viale G. Marconi, 446, 00146 Rome, Italy; (M.M.); (A.D.G.)
| | - Andrea Di Giulio
- Department of Science, University Roma Tre, Viale G. Marconi, 446, 00146 Rome, Italy; (M.M.); (A.D.G.)
| | - Eleonora Nicolai
- Department of Experimental Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy;
| | - Luigi Canullo
- Independent Researcher, 00198 Rome, Italy
- Correspondence:
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The Association of the One-Abutment at One-Time Concept with Marginal Bone Loss around the SLA and Platform Switch and Conical Abutment Implants. J Clin Med 2021; 11:jcm11010074. [PMID: 35011814 PMCID: PMC8745541 DOI: 10.3390/jcm11010074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 12/22/2022] Open
Abstract
Objectives: Repeated abutment disconnection/reconnection may compromise the mucosal barrier and result in crestal bone level changes. The clinical significance of this phenomenon is not yet clear, as most studies on this topic are short-term. Therefore, the aim of the present study was to evaluate the influence of abutment disconnections and reconnections on peri-implant marginal bone loss over a medium-term follow-up period. Material and methods: Twenty-one patients (6 men and 15 women) with a mean age 66.23 ± 9.35 year at the time of implant placement were included. All patients who received two adjacent nonsubmerged implants were randomly assigned into one of the two groups: definitive multiunit abutments (DEFs) connected to the implant that were not removed (test group) or healing abutments (HEAs) placed at surgery, which were disconnected and reconnected 3–5 times during the prosthetic phase (control group). Peri-implant marginal bone levels (MBL) were measured through periapical X-rays images acquired immediately after the surgery (baseline), at 4–7 months immediately after prosthetic delivery, and at 1-year and 3-year follow-up visits. Results: No implant was lost or presented bone loss of more than 1.9 mm during the 3-year follow-up; thus, the survival and success rate was 100%. Peri-implant mucositis was noticed in 38.1% DEFs and 41.9% of HEAs at the 3-year follow-up assessment. At the end of 3 years, the MBL was −0.35 ± 0.69 mm for participants in the DEFs group and −0.57 ± 0.80 mm for the HEAs group, with significant statistical difference between groups. Conclusions: Immediate connection of the multiunit abutments reduced bone loss in comparison with 3–5 disconnections noted in the healing abutments 3 years after prosthetic delivery. However, the difference between the groups was minimal; thus, the clinical relevance of those results is doubtful.
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20
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Influence of Anodized Titanium Surfaces on the Behavior of Gingival Cells in Contact with: A Systematic Review of In Vitro Studies. CRYSTALS 2021. [DOI: 10.3390/cryst11121566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Electrochemically anodized (EA) surfaces promise enhanced biological properties and may be a solution to ensure a seal between peri-implant soft tissues and dental transmucosal components. However, the interaction between the modified nano-structured surface and the gingival cells needs further investigation. The aim of this systematic review is to analyze the biological response of gingival cells to EA titanium surfaces in in vitro studies with a score-based reliability assessment. A protocol aimed at answering the following focused question was developed: “How does the surface integrity (e.g., topography and chemistry) of EA titanium influence gingival cell response in in vitro studies?”. A search in three computer databases was performed using keywords. A quality assessment of the studies selected was performed using the SciRAP method. A total of 14 articles were selected from the 216 eligible papers. The mean reporting and the mean methodologic quality SciRAP scores were 87.7 ± 7.7/100 and 77.8 ± 7.8/100, respectively. Within the limitation of this review based on in vitro studies, it can be safely speculated that EA surfaces with optimal chemical and morphological characteristics enhance gingival fibroblast response compared to conventional titanium surfaces. When EA is combined with functionalization, it also positively influences gingival epithelial cell behavior.
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21
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Zheng Z, Ao X, Xie P, Zheng X, Lee K, Chen W. Nonthermal Plasma Brush Treatment on Titanium and Zirconia To Improve Periabutment Epithelium Formation. ACS Biomater Sci Eng 2021; 7:5039-5047. [PMID: 34637254 DOI: 10.1021/acsbiomaterials.1c00895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The peri-implant soft tissue with inferior adhesion takes a long healing period to form, which is undesirable for the reaction around the peri-implant soft tissues. The aim of this study is to improve the physicochemical properties of titanium (Ti) and zirconia (ZrO2) implant abutments and shorten the formation period of periabutment epithelium tissue. A nonthermal atmospheric plasma brush (NTAPB, N) was employed for Ti and ZrO2 activation. The surface topographies, roughness, crystallinity, wettability, and chemical elements of the abutment materials were examined. The epithelial cell behavior analysis and tissue remodeling of the periabutment epithelial tissue were performed in vitro and in vivo. N-Ti and N-ZrO2 had a similar good surface wettability, with a 65 and 70% increase in oxygen content and a 70 and 75% decrease in carbon content, respectively. Both N-Ti and N-ZrO2 showed excellent adhesion, spread, and proliferation of epithelial cells in vitro, with improved adhesion molecule expression levels compared to untreated samples. N-Ti and N-ZrO2 abutments were placed in the implantation sites of rats. From week 2 to week 6 after implantation, N-Ti and N-ZrO2 had similar periabutment epithelium tissue formation, and both had increased plectin-positive and laminin γ2-positive cell numbers compared to Ti and ZrO2. The NTAPB shows promising abutment modification abilities. It promotes the expression levels of adhesion molecules and the epithelial cell performance, which later leads to a quicker formation and remodeling of the important periabutment epithelial tissue.
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Affiliation(s)
- Zheng Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiaogang Ao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Peng Xie
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiao Zheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
| | - Kevin Lee
- Department of Stomatology, Medical College of Soochow University, Suzhou, Jiangsu Province 215123, China
| | - Wenchuan Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China.,Department of Oral Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610065, China
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Qu Y, Liu L. Zirconia Materials for Dental Implants: A Literature Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687983] [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
Titanium is currently the most commonly used material for manufacturing dental implants. However, its potential toxic effects and the gray color have resulted in increasing requests for metal-free treatment options. Zirconia is a type of ceramic materials that has been extensively used in medicine field, such as implant abutments and various joint replacement appliances. Amounts of clinical evaluations have indicated good biocompatibility for zirconia products. Besides, its toothlike color, low affinity for plaque and outstanding mechanical and chemical properties have made it an ideal candidate for dental implants. The aim of this study is to review the laboratory and clinical papers about several kinds of zirconia materials and zirconia surface modification techniques. Although there are plenty of literatures on these topics, most of the researches focused on the mechanical properties of the materials or based on cell and animal experiments. Randomized clinical trials on zirconia materials are still urgently needed to validate their application as dental implants.
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23
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Abstract
Implant supported dental prostheses are increasingly used in dental practice. The aim of this narrative review is to present the influence of transmucosal surface of prosthetic abutment and implant on peri-implant tissue. The article describes causes of bone loss around the dental implant. Moreover, properties of different materials are compared and discussed. The advantages, disadvantages, and biomechanical concept of different implant-abutment connections are presented. The location of connections in relation to the bone level and the influence of microgap between the abutment and implant are described. Additionally, the implant abutments for cemented and screwed prosthetic restorations are compared. The influence of implant and abutment surface at the transmucosal level on peri-implant soft tissue is discussed. Finally, the biological aspect of abutment-implant connection is analyzed.
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The Effect of Different Cleaning Protocols of Polymer-Based Prosthetic Materials on the Behavior of Human Gingival Fibroblasts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217753. [PMID: 33114133 PMCID: PMC7660342 DOI: 10.3390/ijerph17217753] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022]
Abstract
Dental implant abutment and prosthetic materials, their surface treatment, and cleaning modalities are important factors for the formation of a peri-implant soft tissue seal and long-term stability of bone around the implant. This study aimed to investigate the influence of a polymeric material surface cleaning method on the surface roughness, water contact angle, and human gingival fibroblasts (HGF) proliferation. Polymeric materials tested: two types of milled polymethylmethacrylate (PMMA-Ker and PMMA-Bre), three-dimensionally (3D) printed polymethylmethacrylate (PMMA-3D), polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Titanium (Ti) and zirconia oxide ceramics (ZrO-HT) were used as positive controls. A conventional surface cleaning protocol (CCP) was compared to a multi-step research cleaning method (RCP). Application of the RCP method allowed to reduce Sa values in all groups from 0.14-0.28 µm to 0.08-0.17 µm (p < 0.05 in PMMA-Ker and PEEK groups). Moreover, the water contact angle increased in all groups from 74-91° to 83-101° (p < 0.05 in the PEKK group), except ZrO-HT-it was reduced from 98.7 ± 4.5° to 69.9 ± 6.4° (p < 0.05). CCP resulted in higher variability of HGF viability after 48 and 72 h. RCP application led to higher HGF viability in PMMA-3D and PEKK groups after 48 h, but lower for the PMMA-Ker group (p < 0.05). After 72 h, no significant differences in HGF viability between both cleaning methods were observed. It can be concluded that the cleaning method of the polymeric materials affected surface roughness, contact angle, and HGF viability at 48 h.
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Enhanced Human Gingival Fibroblast Response and Reduced Porphyromonas gingivalis Adhesion with Titania Nanotubes. BIOMED RESEARCH INTERNATIONAL 2020; 2020:5651780. [PMID: 32596329 PMCID: PMC7298314 DOI: 10.1155/2020/5651780] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/24/2020] [Accepted: 05/23/2020] [Indexed: 01/06/2023]
Abstract
Successful dental implants rely on stable osseointegration and soft-tissue integration. Titania nanotubes (TNTs) with a diameter of 100 nm could increase the mesenchymal stem cell response and simultaneously decrease Staphylococcus aureus adhesion. However, the interactions between the modified surface and surrounding soft tissues are still unknown. In the present study, we fully investigated the biological behavior of human gingival fibroblasts (HGFs) and the adhesion of Porphyromonas gingivalis (P. gingivalis). TNTs were synthesized on titanium (Ti) surfaces by electrochemical anodization at 10, 30, and 60 V, and the products were denoted as NT10, NT30, and NT60, respectively. NT10 (diameter: 30 nm) and NT30 (diameter: 100 nm) could enhance the HGF functions, such as cell attachment and proliferation and extracellular matrix- (ECM-) related gene expressions, with the latter showing higher enhancement. NT60 (diameter: 200 nm) clearly impaired cell adhesion and proliferation and ECM-related gene expressions. Bacterial adhesion on the TNTs decreased and reached the lowest value on NT30. Therefore, NT30 without pharmaceuticals can be used to substantially enhance the HGF response and reduce P. gingivalis adhesion to the utmost, thus demonstrating significant potential in the transgingival part of dental implants.
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