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Hori Y, Amari Y, Ohnishi H, Seo H, Chi YC, Botticelli D, Xavier SP, Baba S. Application of the break-even point to express the bone dynamics around implants. Oral Maxillofac Surg 2024; 28:605-612. [PMID: 37589916 DOI: 10.1007/s10006-023-01176-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/12/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE The aim of this study was to apply the break-even point concept to express the dynamics of bone formation and resorption around implants. METHODS Published data on new bone and parent bone densities around implants from one human and three dog studies were selected and used for analysis. The break-even point (BEP) of the bone density (BD) was assessed. The BEP is the point at which, in a graph, the lines representing the formation of new bone and resorption of old bone intersect. BEP is expressed in time (x; days) of occurrence and percentage of bone (y; %) at which the break-even point occurs and illustrates the grade of bone modeling. The sooner the occurrence, the faster the bone formation in relation to the resorption of the old bone. RESULTS In the marrow and cortical compartments, BEP of bone density occurred after 7.9 days (BD% 24.5%) and >30 days, respectively. Different surfaces presented similar BEP, ranging between 9.7 and 11.2 days (BD% 19.1-22.5%). BEP at implants installed in the human maxilla occurred after 29-30.4 days (BD% 28.3-29.6%). CONCLUSION The present study showed that the parameters used to express the break-even point can provide information on the influence of the model used, surface characteristics, and bone quality on bone modeling/remodeling around implants.
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Affiliation(s)
- Yoshihiko Hori
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
| | - Yoshiyuki Amari
- Department of Operative Dentistry, Nihon University School of Dentistry, Tokyo, Japan
| | - Hiroyuki Ohnishi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
| | - Hitoshi Seo
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
| | - Yeh-Chun Chi
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
| | | | - Samuel Porfirio Xavier
- Oral and Maxillofacial Surgery and Periodontology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Shunsuke Baba
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
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2
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Yu YM, Lu YP, Zhang T, Zheng YF, Liu YS, Xia DD. Biomaterials science and surface engineering strategies for dental peri-implantitis management. Mil Med Res 2024; 11:29. [PMID: 38741175 DOI: 10.1186/s40779-024-00532-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption, ultimately resulting in implant failure. Dental implants for clinical use barely have antibacterial properties, and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis. Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque. However, it is particularly important to prevent the occurrence of peri-implantitis rather than treatment. Therefore, the current research spot has focused on improving the antibacterial properties of dental implants, such as the construction of specific micro-nano surface texture, the introduction of diverse functional coatings, or the application of materials with intrinsic antibacterial properties. The aforementioned antibacterial surfaces can be incorporated with bioactive molecules, metallic nanoparticles, or other functional components to further enhance the osteogenic properties and accelerate the healing process. In this review, we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration. Furthermore, we summarized the obstacles existing in the process of laboratory research to reach the clinic products, and propose corresponding directions for future developments and research perspectives, so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy, biological safety, and osteogenic property.
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Affiliation(s)
- Ya-Meng Yu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Yu-Pu Lu
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, 100081, China
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China
| | - Ting Zhang
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
| | - Yu-Feng Zheng
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China.
| | - Yun-Song Liu
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
| | - Dan-Dan Xia
- Department of Dental Materials, Peking University School and Hospital of Stomatology, Beijing, 100081, China.
- National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.
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3
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Ivanovski S, Lee RSB, Fernandez-Medina T, Pinto N, Andrade C, Quirynen M. Impact of autologous platelet concentrates on the osseointegration of dental implants. Periodontol 2000 2024. [PMID: 38647020 DOI: 10.1111/prd.12563] [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: 11/10/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 04/25/2024]
Abstract
Osseointegration is defined as the direct deposition of bone onto biomaterial devices, most commonly composed from titanium, for the purpose of anchoring dental prostheses. The use of autologous platelet concentrates (APC) has the potential to enhance this process by modifying the interface between the host and the surface of the titanium implant. The rationale is to modify the implant surface and implant-bone interface via "biomimicry," a process whereby the deposition of the host's own proteins and extracellular matrix enhances the biocompatibility of the implant and hence accelerates the osteogenic healing process. This review of the available evidence reporting on the effect of APC on osseointegration explores in vitro laboratory studies of the interaction of APC with different implant surfaces, as well as the in vivo and clinical effects of APC on osseointegration in animal and human studies. The inherent variability associated with using autologous products, namely the unique composition of each individual's blood plasma, as well as the great variety in APC protocols, combination of biomaterials, and clinical/therapeutic application, makes it is difficult to make any firm conclusions about the in vivo and clinical effects of APC on osseointegration. The available evidence suggests that the clinical benefits of adding PRP and the liquid form of L-PRF (liquid fibrinogen) to any implant surface appear to be limited. The application of L-PRF membranes in the osteotomy site, however, may produce positive clinical effects at the early stage of healing (up to 6 weeks), by promoting early implant stability and reducing marginal bone loss, although no positive longer term effects were observed. Careful interpretation and cautious conclusions should be drawn from these findings as there were various limitations in methodology. Future studies should focus on better understanding of the influence of APCs on the biomaterial surface and designing controlled preclinical and clinical studies using standardized APC preparation and application protocols.
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Affiliation(s)
- Sašo Ivanovski
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Ryan S B Lee
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
| | - Tulio Fernandez-Medina
- School of Dentistry, Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), The University of Queensland, Brisbane, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
| | - Nelson Pinto
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Catherine Andrade
- Department of Periodontology and Implantology, Faculty of Dentistry, Universidad de Los Andes, Santiago, Chile
| | - Marc Quirynen
- Department of Oral Health Sciences, Katholieke Universiteit Leuven (Periodontology), University Hospitals Leuven, Leuven, Belgium
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Pereira R, Maia P, Rios-Santos JV, Herrero-Climent M, Rios-Carrasco B, Aparicio C, Gil J. Influence of Titanium Surface Residual Stresses on Osteoblastic Response and Bacteria Colonization. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1626. [PMID: 38612139 PMCID: PMC11012676 DOI: 10.3390/ma17071626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024]
Abstract
Grit basting is the most common process applied to titanium dental implants to give them a roughness that favors bone colonization. There are numerous studies on the influence of roughness on osseointegration, but the influence of the compressive residual stress associated with this treatment on biological behavior has not been determined. For this purpose, four types of surfaces have been studied using 60 titanium discs: smooth, smooth with residual stress, rough without stress, and rough with residual stress. Roughness was studied by optic interferometry; wettability and surface energy (polar and dispersive components) by contact angle equipment using three solvents; and residual stresses by Bragg-Bentano X-ray diffraction. The adhesion and alkaline phosphatase (ALP) levels on the different surfaces were studied using Saos-2 osteoblastic cultures. The bacterial strains Streptococcus sanguinis and Lactobacillus salivarius were cultured on different surfaces, determining the adhesion. The results showed that residual stresses lead to increased hydrophilicity on the surfaces, as well as an increase in surface energy, especially on the polar component. From the culture results, higher adhesion and higher ALP levels were observed in the discs with residual stresses when compared between smooth and roughened discs. It was also found that roughness was the property that mostly influenced osteoblasts' response. Bacteria colonize rough surfaces better than smooth surfaces, but no changes are observed due to residual surface tension.
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Affiliation(s)
- Rita Pereira
- Facultad de Odontología, Universidad de Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (R.P.); (J.V.R.-S.); (B.R.-C.)
| | - Paulo Maia
- Facultade Ciências da Saúde, Universidad Europeia de Lisboa,1500-210 Lisboa, Portugal;
| | - Jose Vicente Rios-Santos
- Facultad de Odontología, Universidad de Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (R.P.); (J.V.R.-S.); (B.R.-C.)
| | | | - Blanca Rios-Carrasco
- Facultad de Odontología, Universidad de Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (R.P.); (J.V.R.-S.); (B.R.-C.)
| | - Conrado Aparicio
- Facultad de Odontología, Universitat Internacional de Catalunya, c/ Josep Trueta s/n, 08195 Sant Cugat del Vallés, Spain;
| | - Javier Gil
- Bioengineering Institute of Technology, Universidad Internacional de Catalunya, c/ Josep Trueta s/n, 08195 Sant Cugat del Vallés, Spain
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Scarano A, Khater AGA, Gehrke SA, Inchingolo F, Tari SR. Animal Models for Investigating Osseointegration: An Overview of Implant Research over the Last Three Decades. J Funct Biomater 2024; 15:83. [PMID: 38667540 PMCID: PMC11051165 DOI: 10.3390/jfb15040083] [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: 02/24/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024] Open
Abstract
Dental implants and bone augmentation are among dentistry's most prevalent surgical treatments; hence, many dental implant surfaces and bone grafts have been researched to improve bone response. Such new materials were radiologically, histologically, and histomorphometrically evaluated on animals before being used on humans. As a result, several studies used animals to evaluate novel implant technologies, biocompatibility, surgical techniques, and osseointegration strategies, as preclinical research on animal models is essential to evaluate bioactive principles (on cells, compounds, and implants) that can act through multiple mechanisms and to predict animal behavior, which is difficult to predict from in vitro studies alone. In this study, we critically reviewed all research on different animal models investigating the osseointegration degree of new implant surfaces, reporting different species used in the osseointegration research over the last 30 years. Moreover, this is the first study to summarize reviews on the main animal models used in the translational research of osseointegration, including the advantages and limitations of each model and determining the ideal location for investigating osseointegration in small and large animal models. Overall, each model has advantages and disadvantages; hence, animal selection should be based on the cost of acquisition, animal care, acceptability to society, availability, tolerance to captivity, and housing convenience. Among small animal models, rabbits are an ideal model for biological observations around implants, and it is worth noting that osseointegration was discovered in the rabbit model and successfully applied to humans.
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Affiliation(s)
- Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara, 66100 Chieti, Italy;
| | - Ahmad G. A. Khater
- Faculty of Oral and Dental Medicine, Egyptian Russian University (ERU), Badr City 11829, Egypt;
- Health Affairs Directorate, Egyptian Ministry of Health and Population, Banisuif 62511, Egypt
| | | | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Sergio Rexhep Tari
- Department of Innovative Technologies in Medicine and Dentistry, University of Chieti–Pescara, 66100 Chieti, Italy;
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Kuyl EV, Parel PM, Agarwal AR, Gu A, Harris AB, Rao S, Golladay GJ, Thakkar SC. The Association Between Oral Bone Mineral Density-Reducing Medications and the Risk of 2-Year Implant-Related Complications Following Total Knee Arthroplasty. J Arthroplasty 2024:S0883-5403(24)00209-2. [PMID: 38467202 DOI: 10.1016/j.arth.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Certain medications interfere with the bone remodeling process and may potentially increase the risk of complications after total knee arthroplasty (TKA). As patients undergoing TKA may be taking these bone mineral density (BMD)-reducing medications, it is unclear as to whether and which medications impact TKA outcomes. Therefore, the purpose of this study was to observe the impact of various BMD-reducing medications on 2-year implant-related complications following TKA. METHODS A retrospective analysis of patients undergoing primary TKA was conducted using a national administrative claims database. Patients were identified if they were taking any known BMD-reducing medication and were compared to control patients. To control for confounders associated with taking multiple agents, multivariable logistic regression analyses were conducted for each 2-year outcome (all-cause revision, loosening-indicated revision, and periprosthetic fracture--indicated revision), with the output recorded as odds ratios (ORs). RESULTS In our study, 502,927 of 1,276,209 TKA patients (39.4%) were taking at least one BMD-reducing medication perioperatively. On multivariable analysis, medications associated with a higher likelihood of 2-year all-cause revision included first- and second-generation antipsychotics (SGAs) (OR: 1.42 and 1.26, respectively), selective serotonin reuptake inhibitors (SSRIs) (OR: 1.14), glucocorticoids (1.13), and proton pump inhibitors (PPIs) (OR: 1.23) (P < .05 for all). Medications associated with a higher likelihood of 2-year periprosthetic fracture included SGAs (OR: 1.51), SSRIs (OR: 1.27), aromatase inhibitors (OR: 1.29), and PPIs (OR: 1.42) (P < .05 for all). CONCLUSIONS Of the drug classes observed, the utilization of perioperative PPIs, SSRIs, glucocorticoids, first-generation antipsychotics, and SGAs was associated with the highest odds of all-cause revision. Our findings suggest a relationship between these medications and BMD-related complications; however, further studies should seek to determine the causality of these relationships.
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Affiliation(s)
- Emile-Victor Kuyl
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Philip M Parel
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Amil R Agarwal
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Alex Gu
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Andrew B Harris
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, Maryland
| | - Sandesh Rao
- Washington Orthopaedics and Sports Medicine, Washington, District of Columbia
| | - Gregory J Golladay
- Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia
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7
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Kanayama M, Ferri M, Guzon FMM, Asano A, Alccayhuaman KAA, Rossi EFD, Botticelli D. Influence on marginal bone levels at implants equipped with blades aiming to control the lateral pressure on the cortical bone. An experimental study in dogs. Oral Maxillofac Surg 2024:10.1007/s10006-024-01228-z. [PMID: 38429433 DOI: 10.1007/s10006-024-01228-z] [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: 11/20/2023] [Accepted: 02/18/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND To avoid cortical compression, several implant systems have included in the protocol dedicated drills aimed at widening the cortical region of osteotomy. However, the manual execution of this operation does not guarantee the necessary precision. Hence, the present study aimed to determine the optimal size of the recipient site at the level of the alveolar crest in relation to the size of the coronal region of the implant to achieve the best healing result. MATERIALS AND METHODS Blades of different diameters were incorporated into the coronal part of the implant to prepare the cortical region of the mandibular alveolar bone crest in different dimensions in relation to the collar of the implant. The differences in diameter of the blades in relation to the collar of the implant were as follows: one control group, -175 μm, and three test groups, 0 μm, + 50 μm, or + 200 μm. RESULTS The marginal bone loss (MBL) at the buccal aspect was 0.7 mm, 0.5 mm, 0.2 mm, and 0.7 mm in the - 175 μm, 0.0 μm, + 50 μm, + 200 μm groups, respectively. The differences were statistically significant between group + 50 μm and control group - 175 μm (p = 0.019), and between + 50 μm and + 200 μm (p < 0.01) groups. The level of osseointegration at the buccal aspect was more coronally located in the test groups than in the control group, whereas the bone-to-implant contact percentage was higher in the + 50 μm and + 200 μm groups. However, these differences were not statistically significant. CONCLUSIONS The lowest bone crest resorption and highest levels of osseointegration were observed in the 0.0 μm and + 50 μm groups. The cortical region where the blades had performed their cutting action showed regular healing with perfect hard and soft tissues sealing in all the groups. Cortical blades gathered bone particles, particularly in the + 200 μm group, which were incorporated into the newly formed bone. The results from the present experiment provide support to the use of blades that produce a marginal gap of 50 μm after implant insertion.
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Affiliation(s)
| | - Mauro Ferri
- Private Practice, Cartagena de Indias, 130001, Colombia
| | - Fernando M Muñoz Guzon
- Ibonelab SL, Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - Akihisa Asano
- Department of Oral Implantology, Osaka Dental University, 8-1 Kuzuhahanazonocho, Hirakata, Osaka, 573-1121, Japan
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Shu T, Wang X, Li M, Ma S, Cao J, Sun G, Lai T, Liu S, Li A, Qu Z, Pei D. Nanoscaled Titanium Oxide Layer Provokes Quick Osseointegration on 3D-Printed Dental Implants: A Domino Effect Induced by Hydrophilic Surface. ACS NANO 2024; 18:783-797. [PMID: 38117950 DOI: 10.1021/acsnano.3c09285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Three-dimensional printing is a revolutionary strategy to fabricate dental implants. Especially, 3D-printed dental implants modified with nanoscaled titanium oxide layer (H-SLM) have impressively shown quick osseointegration, but the accurate mechanism remains elusive. Herein, we unmask a domino effect that the hydrophilic surface of the H-SLM facilitates blood wetting, enhances the blood shear rate, promotes blood clotting, and changes clot features for quick osseointegration. Combining computational fluid dynamic simulation and biological verification, we find a blood shear rate during blood wetting of the hydrophilic H-SLM 1.2-fold higher than that of the raw 3D-printed implant, which activates blood clot formation. Blood clots formed on the hydrophilic H-SLM demonstrate anti-inflammatory and pro-osteogenesis effects, leading to a 1.5-fold higher bone-to-implant contact and a 1.8-fold higher mechanical anchorage at the early stage of osseointegration. This mechanism deepens current knowledge between osseointegration speed and implant surface characteristics, which is instructive in surface nanoscaled modification of multiple 3D-printed intrabony implants.
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Affiliation(s)
- Tianyu Shu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Xueliang Wang
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Meng Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shaoyang Ma
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Jiao Cao
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Guo Sun
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Tao Lai
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Shaobao Liu
- State Key Laboratory of Mechanics and Control for Aerospace Structures, Nanjing University of Aeronautics and Astronautics, Nanjing 210016, China
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
| | - Zhiguo Qu
- MOE Key Laboratory of Thermo-Fluid Science and Engineering, School of Energy and Power Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an 710049, China
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Yong CW, Sng TJH, Choo SHJ, Chew JRJ, Islam I. Implant presence-triggered osteonecrosis: A scoping review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101759. [PMID: 38184196 DOI: 10.1016/j.jormas.2024.101759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/17/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024]
Abstract
Unlike medication-related osteonecrosis of the jaw (MRONJ), implant presence-triggered osteonecrosis of the jaw (IPTO) is not well appreciated. Recent reports have suggested a mechanical aetiology unique to osseointegrated dental implants that may be responsible for this phenomenon. A scoping review was performed to consolidate the available evidence. Two reviewers independently searched the PubMed, EMBASE, CINAHL, and Cochrane Library databases. The study was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) extension for scoping reviews. Studies that described or evaluated the development of IPTO in osseointegrated implants, which were placed prior to the commencement of anti-resorptive or anti-angiogenic agents, were included. Twenty-three (23) articles were included in this study. Patient characteristics, aetiopathogenesis, presentation, and treatment of the disease were evaluated. Most studies suggested a 6-month period between dental implant insertion and the commencement of anti-resorptive therapy as a criterion for IPTO. Both infective and mechanical processes were reported to be involved in the pathogenesis of IPTO. Most patients required surgical intervention to achieve resolution. While there are several knowledge gaps regarding IPTO, the evidence points towards a continuum in the pathogenesis of the disease, whereby there is a mechanical cause followed by secondary infection. Similar to typical MRONJ, the severity and treatment required also vary. Persistent peri‑implantitis features around a dental implant should alert the clinician to the possibility of IPTO in patients taking anti-resorptive or anti-angiogenic agents. Prompt identification of the disease may play a role in timely management or appropriate referrals.
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Affiliation(s)
- Chee Weng Yong
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Timothy Jie Han Sng
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Sophia Hui Jia Choo
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Jacob Ren Jie Chew
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore
| | - Intekhab Islam
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, 119085, Singapore; National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, 119085, Singapore.
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10
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Lechner J, von Baehr V, Notter F, Schick F. Osseointegration and osteoimmunology in implantology: assessment of the immune sustainability of dental implants using advanced sonographic diagnostics: research and case reports. J Int Med Res 2024; 52:3000605231224161. [PMID: 38259068 PMCID: PMC10807457 DOI: 10.1177/03000605231224161] [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: 07/27/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE Bone marrow defects of the jaw (BMDJ) surrounding dental implants, in combination with impaired bone-to-implant contact (BIC), are difficult to detect in X-rays. This study evaluated BMDJ surrounding titanium (Ti-Impl) and ceramic (Cer-Impl) dental implants and incomplete BIC using a new trans-alveolar ultrasonography device (TAU) with numerical scaling for BIC. METHODS The titanium stimulation test (Ti-Stim) was used to detect immune overactivation in response to titanium. Bone density surrounding implants was measured using TAU. We also validated osteoimmune dysregulation. RESULTS TAU values showed reduced BIC and decreased osseointegration for Ti-Impl. Moreover, TAU values in the Cer-Impl group were more than twice those in the Ti-Impl cohort. The multiplex analysis of C-C motif chemokine 5 (CCL5, also known as RANTES) expression revealed a 20-fold increase in BMDJ surrounding Ti-Impl. Higher levels of CCL5 inflammation were present in the positive Ti-Stim group. CONCLUSIONS Our data indicate that Cer-Impl have an osteoimmune advantage over Ti-Impl. The key determinant for osteoimmune sustainability appears to be the absence of inflammation at the implant site. We therefore recommend the use of TAU to assess the implant site prior to implantation.
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Affiliation(s)
| | - Volker von Baehr
- Department of Immunology and Allergology, Institute for Medical Diagnostics, Berlin, Germany
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11
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Leelasukseree R, Chouyratchakarn W, Phutiyothin C, Pikwong F, Srisopar O, Baipaywad P, Udomsom S, Mongkolpathumrat P, Supanchart C, Kumphune S. Recombinant human secretory leukocyte protease inhibitor (rhSLPI) coated titanium enhanced human osteoblast adhesion and differentiation. Sci Rep 2023; 13:23013. [PMID: 38155270 PMCID: PMC10754898 DOI: 10.1038/s41598-023-50565-8] [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: 06/29/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023] Open
Abstract
Osseointegration is vital to success in orthopedic and dental reconstructions with implanted materials. The bone matrix or cells-particularly osteoblasts-are required to achieve functional contact on the implant surface. Osteoblast induction is therefore essential for osteogenesis to occur. Enhancement of osteoblast adhesion, proliferation, and differentiation, particularly by implant surface modifications, have been found challenging to develop. Secretory Leukocyte Protease Inhibitor (SLPI), a cation ionic protein with anti-inflammatory and anti-bacterial activities, showed activation in osteoblast proliferation and differentiation. However, the effects of coating recombinant human (rh) SLPI on a titanium alloy surface on human osteoblast adhesion, proliferation, and differentiation has never been investigated. In this study, titanium alloys (Ti-6Al-4V) were coated with rhSLPI, while human osteoblast adhesion, proliferation, differentiation, actin cytoskeletal organization, and gene expressions involved in cell adhesion and differentiation were investigated. The results indicate that coating titanium with 10-100 µg/ml rhSLPI enhanced the physical properties of the Ti surface and enhanced human osteoblast (hFOB 1.19) cell adhesion, activated actin dynamic, enhanced adhesive forces, upregulated integrins α1, α2, and α5, enhanced cell proliferation, mineralization, alkaline phosphatase activity, and upregulated ALP, OCN, and Runx2. This is the first study to demonstrate that coating SLPI on titanium surfaces enhances osseointegration and could be a candidate molecule for surface modification in medical implants.
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Affiliation(s)
- Radchanon Leelasukseree
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Wannapat Chouyratchakarn
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Chayanisa Phutiyothin
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Faprathan Pikwong
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Onnicha Srisopar
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Phornsawat Baipaywad
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Suruk Udomsom
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand
| | - Podsawee Mongkolpathumrat
- Cardio-Thoracic Technology Program, Chulabhorn International College of Medicine (CICM), Cooperative Learning Center, Thammasat University (Rangsit Center), Piyachart 2, 99 Moo 18 Klong Luang, Rangsit, Pathumthani, 12120, Thailand
| | - Chayarop Supanchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sarawut Kumphune
- Biomedical Engineering and Innovation Research Center, Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand.
- Biomedical Engineering Institute (BMEI), Chiang Mai University, Mueang Chiang Mai District, Chiang Mai, 50200, Thailand.
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12
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Ren C, Chen W, Chen J, Mao C, Liao C, Liu J. The fusion of keratinized epithelium, an indication of early implant placement in the aesthetic area: an animal study. BMC Oral Health 2023; 23:1016. [PMID: 38115040 PMCID: PMC10729501 DOI: 10.1186/s12903-023-03755-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND In the period of the early implant placement, the socket is mainly occupied by provisional matrix (PM). Keratinized epithelium (KE) is critical for primary wound closure. Although both KE and PM are important, the detailed relationship among migrating KE, PM formation and indication of the early implant placement is still unclear. OBJECTIVE This research aimed to locate a healing stage of KE with highest osteogenic PM formation after tooth extraction, which could be treated as the optimal time point for early implant placement. MATERIAL AND METHODS Mice were sacrificed on days 1, 2, 3, 4 and 6 after incisor extraction. Clinical, histological, and immunohistochemical evaluations of the extraction sockets were performed, and statistical analyses were conducted. We then inserted implants into the PM with the greatest bioactivity and observed its osseointegration pattern for 3, 10, 17 and 30 days. RESULT When KE fusion was reached, sockets were dominated by PM with the greatest expression of osteocalcin (OC, P < 0.05) and high levels of CD34 and Runx2. OC and Runx2 expression were positively correlated with KE coverage (P < 0.05). When the implant was inserted at 4 days' healing, the PM maintained its osteogenic ability, and osseointegration proceeded perfectly. CONCLUSION The migration of KE was correlated with the formation of highly osteogenic and angiogenic PM. And the fusion of KE could be treated as an indication for early implant placement.
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Affiliation(s)
- Chengyan Ren
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Weihui Chen
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China.
| | - Jiangping Chen
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuanqing Mao
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Caiyu Liao
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Jianan Liu
- Department of Oral and Maxillofacial Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Fujian Key Laboratory of Oral Diseases & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
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13
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Khaohoen A, Sornsuwan T, Chaijareenont P, Poovarodom P, Rungsiyakull C, Rungsiyakull P. Biomaterials and Clinical Application of Dental Implants in Relation to Bone Density-A Narrative Review. J Clin Med 2023; 12:6924. [PMID: 37959389 PMCID: PMC10649288 DOI: 10.3390/jcm12216924] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Titanium has been the material of choice for dental implant fixtures due to its exceptional qualities, such as its excellent balance of rigidity and stiffness. Since zirconia is a soft-tissue-friendly material and caters to esthetic demands, it is an alternative to titanium for use in implants. Nevertheless, bone density plays a vital role in determining the material and design of implants. Compromised bone density leads to both early and late implant failures due to a lack of implant stability. Therefore, this narrative review aims to investigate the influence of implant material/design and surgical technique on bone density from both biomechanical and biological standpoints. Relevant articles were included for analysis. Dental implant materials can be fabricated from titanium, zirconia, and PEEK. In terms of mechanical and biological aspects, titanium is still the gold standard for dental implant materials. Additionally, the macro- and microgeometry of dental implants play a role in determining and planning the appropriate treatment because it can enhance the mechanical stress transmitted to the bone tissue. Under low-density conditions, a conical titanium implant design, longer length, large diameter, reverse buttress with self-tapping, small thread pitch, and deep thread depth are recommended. Implant material, implant design, surgical techniques, and bone density are pivotal factors affecting the success rates of dental implant placement in low-density bone. Further study is required to find the optimal implant material for a clinical setting's bone state.
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Affiliation(s)
- Angkoon Khaohoen
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Tanapon Sornsuwan
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok 65000, Thailand;
| | - Pisaisit Chaijareenont
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Pongsakorn Poovarodom
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
| | - Chaiy Rungsiyakull
- Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (A.K.); (P.C.); (P.P.)
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14
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Nayak VV, Slavin B, Bergamo ETP, Boczar D, Slavin BR, Runyan C, Tovar N, Witek L, Coelho PG. Bone Tissue Engineering (BTE) of the Craniofacial Skeleton, Part I: Evolution and Optimization of 3D-Printed Scaffolds for Repair of Defects. J Craniofac Surg 2023; 34:2016-2025. [PMID: 37639650 PMCID: PMC10592373 DOI: 10.1097/scs.0000000000009593] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/25/2023] [Indexed: 08/31/2023] Open
Abstract
Bone tissue regeneration is a complex process that proceeds along the well-established wound healing pathway of hemostasis, inflammation, proliferation, and remodeling. Recently, tissue engineering efforts have focused on the application of biological and technological principles for the development of soft and hard tissue substitutes. Aim is directed towards boosting pathways of the healing process to restore form and function of tissue deficits. Continued development of synthetic scaffolds, cell therapies, and signaling biomolecules seeks to minimize the need for autografting. Despite being the current gold standard treatment, it is limited by donor sites' size and shape, as well as donor site morbidity. Since the advent of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing (AM) techniques (3D printing), bioengineering has expanded markedly while continuing to present innovative approaches to oral and craniofacial skeletal reconstruction. Prime examples include customizable, high-strength, load bearing, bioactive ceramic scaffolds. Porous macro- and micro-architecture along with the surface topography of 3D printed scaffolds favors osteoconduction and vascular in-growth, as well as the incorporation of stem and/or other osteoprogenitor cells and growth factors. This includes platelet concentrates (PCs), bone morphogenetic proteins (BMPs), and some pharmacological agents, such as dipyridamole (DIPY), an adenosine A 2A receptor indirect agonist that enhances osteogenic and osteoinductive capacity, thus improving bone formation. This two-part review commences by presenting current biological and engineering principles of bone regeneration utilized to produce 3D-printed ceramic scaffolds with the goal to create a viable alternative to autografts for craniofacial skeleton reconstruction. Part II comprehensively examines recent preclinical data to elucidate the potential clinical translation of such 3D-printed ceramic scaffolds.
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Affiliation(s)
- Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Blaire Slavin
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Edmara TP Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
- Biomaterials Division - NYU College of Dentistry, New York, NY, USA
| | - Daniel Boczar
- Department of Surgery, University of Washington, Seattle, WA USA
| | - Benjamin R. Slavin
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Christopher Runyan
- Department of Plastic and Reconstructive Surgery, Wake Forest School of Medicine; Winston-Salem, NC, USA
| | - Nick Tovar
- Biomaterials Division - NYU College of Dentistry, New York, NY, USA
- Department of Oral and Maxillofacial Surgery, New York University, Langone Medical Center and Bellevue Hospital Center, New York, NY, USA
| | - Lukasz Witek
- Biomaterials Division - NYU College of Dentistry, New York, NY, USA
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Paulo G. Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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15
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Liñares A, Dopico J, Magrin G, Blanco J. Critical review on bone grafting during immediate implant placement. Periodontol 2000 2023; 93:309-326. [PMID: 37658586 DOI: 10.1111/prd.12516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 09/03/2023]
Abstract
In the last 20 years, immediate implant placement has been proposed as a predictable protocol to replace failing teeth. The research conducted in preclinical and clinical studies have focused on soft and hard tissue changes following tooth extraction and immediate implant placement. Different approaches for hard and soft tissue grafting together with provisional restorations have been proposed to compensate tissue alterations. This review analyzed some relevant clinical and preclinical literature focusing on the impact of bone grafting procedures on immediate implant placement in terms of hard and soft tissue changes, aesthetic results, and patient-related outcomes.
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Affiliation(s)
- Antonio Liñares
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Dopico
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Magrin
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Dentistry, Centre for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianopolis, Brazil
| | - Juan Blanco
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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16
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Li J, Wu X, Liang Z, Wei Z, Chen Z, Wang Y, Li W, Zhang W, Yang R, Qiu H, Li X, Li Q, Chen J. A programmed surface on dental implants sequentially initiates bacteriostasis and osseointegration. Colloids Surf B Biointerfaces 2023; 230:113477. [PMID: 37544027 DOI: 10.1016/j.colsurfb.2023.113477] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/18/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Osteogenesis surrounding dental implants is initiated by a series of early physiological events, including the inflammatory response. However, the persistence of an anti-infection surface often results in compromised histocompatibility and osseointegration. Here, we presented a programmed surface containing both silver nanoparticles (AgNPs) and silver ions (Ag+) with a heterogeneous structure and time-dependent functionalities. The AgNPs were located at the surface of the heparin-chitosan polyelectrolyte coating (PEM), whereas Ag+ was distributed at both the surface and inside of the coating under optimized conditions (pH=4). The optimized coating (Ag-4) exhibited potent bactericidal activity at the early stage (12 and 24 h after inoculation) and a sustained antibacterial efficacy in the subsequent stage (one or two weeks), as it gradually depleted. Furthermore, compared to coatings with sustained high silver concentrations in bacteria-cell coculture experiments, the degradable Ag-4 coating demonstrated improved cytocompatibility, better cell viability, and morphology over time. At a later stage (within one month), the in vivo test revealed that Ag-4-coated titanium had superior histocompatibility and osteogenesis outcomes compared to bare titanium in a bacteria-exposed environment. The programmed surface of dental implants presented in this study offers innovative ideas for sequential antibacterial effects and osseointegration.
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Affiliation(s)
- Jiaojiao Li
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Xiaoqin Wu
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Zhaojia Liang
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Zhangao Wei
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Zirui Chen
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Yankai Wang
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Wei Li
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Weibo Zhang
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China
| | - Runhuai Yang
- Department of Biomedical Engineering, Anhui Medical University, Hefei 230032, China
| | - Hua Qiu
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China.
| | - Xiangyang Li
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China.
| | - Quanli Li
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China.
| | - Jialong Chen
- Stomatologic Hospital and College, Anhui Medical University, Key Laboratory of Oral Diseases Research of Anhui Province, Hefei, Anhui 230032, China.
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17
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Lee SH, Yun PY, Yi YJ, Kim YK, Lee HJ, Jo DW. Low Bone Density Predictability of CBCT and Its Relation to Primary Stability of Tapered Implant Design: A Pilot Study. J ORAL IMPLANTOL 2023; 49:556-563. [PMID: 35881816 DOI: 10.1563/aaid-joi-d-21-00159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 04/04/2022] [Accepted: 05/31/2022] [Indexed: 11/22/2022]
Abstract
Research regarding bone density assessment using cone beam computed tomography (CBCT) in low bone density regions is sparse. This in vitro study aimed to evaluate the predictability of CBCT for low bone density regions and its correlations with primary implant stability when placing tapered design implants with a stepped osteotomy. Eighteen porcine mandibular condyles were used as simulated low bone density regions. Hounsfield units (HU), obtained via multislice computed tomography, and gray values (GVs), obtained via CBCT, were measured 3 times at 1-month intervals. The maximum implant insertion torque (MIT) and implant stability quotient (ISQ) were recorded as the taper design implants were placed using a stepped osteotomy. Hounsfield units and GV were measured as 335.05-803.07 and 389.98-906.40, respectively. For repeated measurements of HU and GV, the intraclass correlation coefficients were 0.989 and 0.980; the corresponding value for mean HU and GV was 0.768. Bland-Altman plots showed a mean difference between HU and GV of -78.15. Pearson correlation coefficients revealed a strong correlation between HU and GV (r = 0.91, P < .01). The mean ± SD values for MIT and ISQ were 36.44 ± 6.64 Ncm and 80.85 ± 2.03, respectively, but no statistically significant correlations were found with GV and HU. Within the study's limitations, GV showed similar bone density estimation compared with HU in soft bones. Tapered implant placement with a stepped osteotomy achieved stable primary implant stability in soft bones. However, these in vitro results need to be approved in further clinical studies.
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Affiliation(s)
- Sang-Hoon Lee
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Pil-Young Yun
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Yang-Jin Yi
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Deuk-Won Jo
- Department of Prosthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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18
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Anitua E, Eguia A, Alkhraisat MH. Extra-short implants (≤ 6.5 mm in length) in atrophic and non-atrophic sites to support screw-retained full-arch restoration: a retrospective clinical study. Int J Implant Dent 2023; 9:29. [PMID: 37702800 PMCID: PMC10499764 DOI: 10.1186/s40729-023-00499-7] [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: 05/26/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE Increasing scientific evidence support extending the application of short dental implants to non-atrophic dental arches. The purpose of this study has been the evaluation of extra-short implants (≤ 6.5 mm in length) that were placed in atrophic and non-atrophic anatomical sites to support the same prosthesis. METHODS For that, a retrospective study was conducted by including complete dentures that were solely supported by extra-short implants in the maxilla and/or the mandible. Clinical data about patients, implants, anatomy, and prosthesis were obtained. Statistical analysis was performed to assess implant- and prosthesis-survival, changes in the marginal bone level and prosthetic complications. RESULTS A total of 87 implants in 15 screw-retained complete dentures were assessed. None of the prostheses nor the extra-short implant failed during the follow-up of 27.2 ± 15.4 months. The changes in the mesial and distal marginal bone level were + 0.15 ± 0.51 mm and + 0.11 ± 0.50 mm, respectively. Comparing the implants according to the availability of sufficient bone to place longer implants, indicated the absence of significant differences in the changes of the mesial marginal bone level. However, the changes in the distal marginal bone level showed a statistically significant difference in favor of implants that were placed in non-atrophic sites. Two events of screw loosening were reported that were resolved by retightening the screws. CONCLUSIONS Implant- and prosthesis-related outcomes support the use of extra-short implants in atrophic and non-atrophic site to support complete prosthesis.
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Affiliation(s)
- Eduardo Anitua
- Private Practice in Oral Implantology, Clínica Eduardo Anitua Foundation, C/ Jose Maria Cagigal 19, 01007, Vitoria, Spain.
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain.
- BTI Biotechnology Institute, Vitoria, Spain.
| | - Asier Eguia
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
- University of the Basque Country UPV/EHU, Leioa (Bizkaia), Spain
| | - Mohammad Hamdan Alkhraisat
- University Institute for Regenerative Medicine and Oral Implantology, UIRMI (UPV/EHU-Fundación Eduardo Anitua), Vitoria, Spain
- BTI Biotechnology Institute, Vitoria, Spain
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19
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Rosas-Díaz JC, Malpartida-Carrillo V, Córdova-Limaylla NE, Guerrero ME, Palomino-Zorrilla JJ, Cervantes-Ganoza LA, Cayo-Rojas CF. Resonance Frequency Analysis Mapping During Implant Healing Using a Nanostructured Hydroxyapatite Surface. J Int Soc Prev Community Dent 2023; 13:365-372. [PMID: 38124725 PMCID: PMC10729884 DOI: 10.4103/jispcd.jispcd_265_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/02/2021] [Accepted: 10/16/2021] [Indexed: 11/11/2022] Open
Abstract
Aim Stability measured by resonance frequency analysis (RFA) is an important factor to be considered in the success of dental implant treatments, which can be evaluated from the implant stability quotient (ISQ). The aim of the present case series was to map the RFA during healing of implants with nanostructured hydroxyapatite surface to describe the behavior of ISQ values related to individual factors. Materials and Methods Twenty-three implants were placed in eight patients by conventional surgical protocol, and ISQ values were monitored from the day of implant placement until week 20. To obtain the ISQ values, an Osstell device was used and the placed implants were grouped in proportional amounts to describe the ISQ behavior considering the length (≤10 or >10 mm), the diameter (3.5 or 4.3 mm), the insertion torque (<40 N-cm or ≥40 N-cm), and the placement area (maxilla or mandible). Results All the implants assessed decreased their values in the first 3 weeks after placement. Subsequently, the ISQ values increased by amounts similar to those obtained at the time of the placement and even more. Implants with length >10 mm, diameter 4.3 mm, and insertion torque ≥40 N-cm showed the highest ISQ values. Conclusions A decrease in the ISQ values of dental implants with nanostructured hydroxyapatite surface was evidenced between weeks 2 and 3 considering length, diameter, insertion torque, and maxillary or mandibular placement site.
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Affiliation(s)
| | | | | | - Maria Eugenia Guerrero
- Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Department of Medico Surgical Stomatology, Lima, Peru
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20
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Bergamo ET, Witek L, Ramalho I, Lopes ACO, Vivekanand Nayak V, Bonfante EA, Tovar N, Torroni A, Coelho PG. Bone healing around implants placed in subjects with metabolically compromised systemic conditions. J Biomed Mater Res B Appl Biomater 2023; 111:1664-1671. [PMID: 37184298 PMCID: PMC10330391 DOI: 10.1002/jbm.b.35264] [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: 09/26/2022] [Revised: 02/28/2023] [Accepted: 05/02/2023] [Indexed: 05/16/2023]
Abstract
The aim of this study was to evaluate the bone healing of tight-fit implants placed in the maxilla and mandible of subjects compromised with metabolic syndrome (MS) and type-2 Diabetes Mellitus (T2DM). Eighteen Göttingen minipigs were randomly distributed into three groups: (i) control (normal diet), (ii) MS (cafeteria diet for obesity induction), (iii) T2DM (cafeteria diet for obesity induction + Streptozotocin for T2DM induction). Maxillary and mandibular premolars and molar were extracted. After 8 weeks of healing, implants with progressive small buttress threads were placed, and allowed to integrate for 6 weeks after which the implant/bone blocks were retrieved for histological processing. Qualitative and quantitative histomorphometric analyses (percentage of bone-to-implant contact, %BIC, and bone area fraction occupancy within implant threads, %BAFO) were performed. The bone healing process around the implant occurred predominantly through interfacial remodeling with subsequent bone apposition. Data as a function of systemic condition yielded significantly higher %BIC and %BAFO values for healthy and MS relative to T2DM. Data as a function of maxilla and mandible did not yield significant differences for either %BIC and %BAFO. When considering both factors, healthy and MS subjects had %BIC and %BAFO trend towards higher values in the mandible relative to maxilla, whereas T2DM yielded higher %BIC and %BAFO in the maxilla relative to mandible. All systemic conditions presented comparable levels of %BIC and %BAFO in the maxilla; healthy and MS presented significantly higher %BIC and %BAFO relative to T2DM in the mandible. T2DM presented lower amounts of bone formation around implants relative to MS and healthy. Implants placed in the maxilla and in the mandible showed comparable amounts of bone in proximity to implants.
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Affiliation(s)
- Edmara T.P. Bergamo
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Lukasz Witek
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, NY USA
| | - Ilana Ramalho
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Adolfo CO Lopes
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Vasudev Vivekanand Nayak
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Mechanical and Aerospace Engineering, Tandon School of Engineering, Brooklyn, NY USA
| | - Estevam A Bonfante
- Department of Prosthodontics, University of Sao Paulo, School of Dentistry, Sao Paulo, SP, Brazil
| | - Nick Tovar
- Biomaterials Division - Department of Molecular Pathobiology NYU Dentistry, New York, NY USA
- Department of Oral and Maxillofacial Surgery, NYU Langone Medical Center and Bellevue, Hospital Center, New York, NY USA
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, Grossman School of Medicine, New York University, New York, NY USA
| | - Paulo G. Coelho
- Division of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
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21
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Kanazirski N, Vladova D, Neychev D, Raycheva R, Kanazirska P. Effect of Er:YAG Laser Exposure on the Amorphous Smear Layer in the Marginal Zone of the Osteotomy Site for Placement of Dental Screw Implants: A Histomorphological Study. J Funct Biomater 2023; 14:376. [PMID: 37504871 PMCID: PMC10381257 DOI: 10.3390/jfb14070376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023] Open
Abstract
The placement of dental screw implants typically involves the use of rotary techniques and drills to create a bone bed. This study explores the potential benefits of combining this method with an Er:YAG laser. Split osteotomies were performed on 10 jaws of euthanized domestic pigs (Sus scrofa domestica), with 12 mandibular implant osteotomies in each jaw, divided into 4 groups. In order to make a comprehensive assessment of the effect of Er:YAG lasers, histomorphological techniques were used to measure the reduction in amorphous layer thickness after Er:YAG laser treatment, both with and without the placement of dental screw implants from different manufacturers. Following bone decalcification and staining, the thickness of the amorphous layer was measured in four groups: Group A-osteotomy performed without Er:YAG laser treatment-had amorphous layer thicknesses ranging from 21.813 to 222.13 µm; Group B-osteotomy performed with Er:YAG laser treatment-had amorphous layer thicknesses ranging from 6.08 to 64.64 µm; Group C-an implant placed in the bone without laser treatment-had amorphous layer thicknesses of 5.90 to 54.52 µm; and Group D-an implant placed after bone treatment with Er:YAG laser-had amorphous layer thicknesses of 1.29 to 7.98 µm. The examination and photomicrodocumentation was performed using a LEICA DM1000 LED microscope (Germany) and LAS V 4.8 software (Leica Application Suite V4, Leica Microsystems, Germany). When comparing group A to group B and group C to D, statistically significant differences were indicated (p-value = 0.000, p < 0.05). The study demonstrates the synergistic effects and the possibility of integrating lasers into the conventional implantation protocol. By applying our own method of biomodification, the smear layer formed during rotary osteotomy can be reduced using Er:YAG lasers. This reduction leads to a narrower peri-implant space and improved bone-to-implant contact, facilitating accelerated osseointegration.
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Affiliation(s)
- Nikolay Kanazirski
- Department of Oral Surgery, Faculty of Dental Medicine, Medical University-Plovdiv, 4000 Plovdiv, Bulgaria
| | - Diyana Vladova
- Department of Veterinary Anatomy, Histology and Embryology, Faculty of Veterinary Medicine, Trakia University, 6000 Stara Zagora, Bulgaria
| | - Deyan Neychev
- Department of Oral Surgery, Faculty of Dental Medicine, Medical University-Plovdiv, 4000 Plovdiv, Bulgaria
| | - Ralitsa Raycheva
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University-Plovdiv, 4000 Plovdiv, Bulgaria
| | - Petya Kanazirska
- Department of Imaging Diagnostics, Dental Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University-Plovdiv, 4000 Plovdiv, Bulgaria
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22
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Pacheco-Vergara MJ, Benalcázar-Jalkh EB, Nayak VV, Bergamo ETP, Cronstein B, Zétola AL, Weiss FP, Grossi JRA, Deliberador TM, Coelho PG, Witek L. Employing Indirect Adenosine 2 A Receptors (A 2AR) to Enhance Osseointegration of Titanium Devices: A Pre-Clinical Study. J Funct Biomater 2023; 14:308. [PMID: 37367272 DOI: 10.3390/jfb14060308] [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: 02/24/2023] [Revised: 04/20/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
The present study aimed to evaluate the effect of dipyridamole, an indirect adenosine 2A receptors (A2AR), on the osseointegration of titanium implants in a large, translational pre-clinical model. Sixty tapered, acid-etched titanium implants, treated with four different coatings ((i) Type I Bovine Collagen (control), (ii) 10 μM dipyridamole (DIPY), (iii) 100 μM DIPY, and (iv) 1000 μM DIPY), were inserted in the vertebral bodies of 15 female sheep (weight ~65 kg). Qualitative and quantitative analysis were performed after 3, 6, and 12 weeks in vivo to assess histological features, and percentages of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO). Data was analyzed using a general linear mixed model analysis with time in vivo and coating as fixed factors. Histomorphometric analysis after 3 weeks in vivo revealed higher BIC for DIPY coated implant groups (10 μM (30.42% ± 10.62), 100 μM (36.41% ± 10.62), and 1000 μM (32.46% ± 10.62)) in comparison to the control group (17.99% ± 5.82). Further, significantly higher BAFO was observed for implants augmented with 1000 μM of DIPY (43.84% ± 9.97) compared to the control group (31.89% ± 5.46). At 6 and 12 weeks, no significant differences were observed among groups. Histological analysis evidenced similar osseointegration features and an intramembranous-type healing pattern for all groups. Qualitative observation corroborated the increased presence of woven bone formation in intimate contact with the surface of the implant and within the threads at 3 weeks with increased concentrations of DIPY. Coating the implant surface with dipyridamole yielded a favorable effect with regard to BIC and BAFO at 3 weeks in vivo. These findings suggest a positive effect of DIPY on the early stages of osseointegration.
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Affiliation(s)
- Maria Jesus Pacheco-Vergara
- Center for Craniofacial Molecular Biology, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089, USA
| | - Ernesto Byron Benalcázar-Jalkh
- Department of Prosthodontic and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-901, SP, Brazil
| | - Vasudev V Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Edmara T P Bergamo
- Department of Prosthodontic and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-901, SP, Brazil
- Division of Biomaterials, New York University College of Dentistry, 345 E 24th St., Room 902D, New York, NY 10010, USA
| | - Bruce Cronstein
- Department of Medicine, New York University Langone Medical Center, New York, NY 10016, USA
| | - André Luis Zétola
- Oral and Maxillofacial Surgeon, Chairman of Implantology, SOEPAR, Curitiba 80730-000, PR, Brazil
| | | | | | | | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Division of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Lukasz Witek
- Division of Biomaterials, New York University College of Dentistry, 345 E 24th St., Room 902D, New York, NY 10010, USA
- Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY 11201, USA
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23
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Teixeira JFL, de Souza JAC, Magalhães FAC, de Oliveira GJPL, de Santis JB, de Souza Costa CA, de Souza PPC. Laser-Modified Ti Surface Improves Paracrine Osteogenesis by Modulating the Expression of DKK1 in Osteoblasts. J Funct Biomater 2023; 14:jfb14040224. [PMID: 37103314 PMCID: PMC10145280 DOI: 10.3390/jfb14040224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
Titanium surface modifications are widely used to modulate cellular behavior by recognition of topographical cues. However, how those modifications affect the expression of mediators that will influence neighboring cells is still elusive. This study aimed to evaluate the effects of conditioned media from osteoblasts cultured on laser-modified titanium surfaces on the differentiation of bone marrow cells in a paracrine manner and to analyze the expression of Wnt pathway inhibitors. Mice calvarial osteoblasts were seeded on polished (P) and Yb:YAG laser-irradiated (L) Ti surfaces. Osteoblast culture media were collected and filtered on alternate days to stimulate mice BMCs. Resazurin assay was performed every other day for 20 days to check BMC viability and proliferation. After 7 and 14 days of BMCs maintained with osteoblasts P and L-conditioned media, alkaline phosphatase activity, Alizarin Red staining, and RT-qPCR were performed. ELISA of conditioned media was conducted to investigate the expression of Wnt inhibitors Dickkopf-1 (DKK1) and Sclerostin (SOST). BMCs showed increased mineralized nodule formation and alkaline phosphatase activity. The L-conditioned media enhanced the BMC mRNA expression of bone-related markers Bglap, Alpl, and Sp7. L-conditioned media decreased the expression of DKK1 compared with P-conditioned media. The contact of osteoblasts with Yb:YAG laser-modified Ti surfaces induces the regulation of the expression of mediators that affect the osteoblastic differentiation of neighboring cells. DKK1 is among these regulated mediators.
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Affiliation(s)
- Jorge Felipe Lima Teixeira
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | | | | | | | - José Bernardo de Santis
- Department of Basic and Oral Biology, Bone Research Lab, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil
| | - Carlos Alberto de Souza Costa
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University, Araraquara 14801-385, Brazil
| | - Pedro Paulo Chaves de Souza
- Innovation in Biomaterials Laboratory (iBioM), School of Dentistry, Federal University of Goiás, Goiânia 74605-020, Brazil
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24
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Lubis RT, Azhari A, Pramanik F. Analysis of Bone Density and Bone Morphometry by Periapical Radiographs in Dental Implant Osseointegration Process. Int J Dent 2023; 2023:4763961. [PMID: 37051187 PMCID: PMC10085658 DOI: 10.1155/2023/4763961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
Objective. This research aimed to analyze the differences in bone density and bone morphometry by periapical implant radiography in the dental implant osseointegration stages. Methods. This experimental research uses 12 periapical radiographs of tibial bones from a New Zealand white rabbit (Oryctolagus cuniculus). The analysis was performed on day 3, 14, and 28 of the osseointegration stages with density, trabecular thickness (Tb.Th.), trabecular separation (Tb.Sp.), and trabecular number (Tb.N.) as parameters. The implant used is a titanium alloy and coated by SA (sunblasted with alumina acid) of 4 mm in diameter and 7 mm in length. The radiographic assessment of the osseointegration process is obtained with the region of interest (ROI) segmentation results. Additionally, each ROI was analyzed for bone density and morphometry using the open-source ImageJ software with the BoneJ plugin. The significant difference was evaluated by analysis of variance (F-test) with
and nonparametric Kruskal–Wallis test with
. Results. Analysis of the osseointegration images of dental implants at day 3, 14, and 28 with the periapical X-ray modality shows significant differences (
) in the parameters measuring density and trabecular thickness (Tb.Th.). In the variables of trabecular separation (Tb.Sp.) and number (Tb.N.) (
), there is no significant difference. Conclusion. Based on the results, density and trabecular thickness (Tb.Th.) showed a significant difference between healing times. However, trabecular separation (Tb.Sp.) and trabecular number (Tb.N.) showed no difference in healing time.
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Affiliation(s)
- Ratih Trikusumadewi Lubis
- Dentomaxillofacial Radiology Specialist Program, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
| | - Azhari Azhari
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
| | - Farina Pramanik
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
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25
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Contact Guidance Mediated by Hybrid Thread Topography Enhances Osseointegration of As-machined Ti6Al4V Dental Implant. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2023. [DOI: 10.1007/s40883-023-00293-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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26
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Guided Bone Regeneration with Occlusive Titanium Barrier: A Case Report and Clinical Considerations. Biomimetics (Basel) 2023; 8:biomimetics8010106. [PMID: 36975336 PMCID: PMC10046855 DOI: 10.3390/biomimetics8010106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
The need to obtain adequate bone volumes for prosthetic rehabilitation supported by implants, using different techniques and materials, represents an urgent need in modern dentistry. We report a case regarding the management of implant-prosthetic rehabilitation of the first and second upper right molars, in which no less than 4 mm of crestal bone remained to insert two implants. Regeneration of the residual bone was previously performed using a customized titanium barrier and a filler of a blood clot with tricalcium beta phosphate. The bone gain (3 mm) was evaluated by comparing CBCT images, while the implant stability (mean 70) was assessed with the ISQ measurement. A regenerated bone sample was taken for histological analysis. Guided bone regeneration obtained with a titanium barrier and blood clot allowed for the insertion of stable implants in a mature bone without heterologous material.
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27
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Vargas-Moreno VF, Ribeiro MCDO, Gomes RS, Faot F, Del Bel Cury AA, Marcello-Machado RM. Clinical performance of short and extrashort dental implants with wide diameter: A systematic review with meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00010-0. [PMID: 36841707 DOI: 10.1016/j.prosdent.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 02/26/2023]
Abstract
STATEMENT OF PROBLEM Rehabilitation with wide-diameter reduced-length implants has become popular for patients with minimal vertical bone. However, a consensus on the benefits of this approach is lacking. PURPOSE The purpose of this systematic review with meta-analysis was to evaluate the influence of wide compared with regular diameter on the clinical performance of short (<10 mm) and extrashort (≤6 mm) dental implants used for rehabilitations with single crowns, fixed partial dentures, or both, in the posterior region. MATERIAL AND METHODS A search in 6 databases was conducted to select randomized controlled trials (RCTs) and nonrandomized controlled trials (N-RCTs). Five meta-analyses were performed, where the risk ratio (RR) was evaluated. The certainty of evidence was evaluated, and the risk of bias was determined from the Joanna Briggs Institute checklist. RESULTS Fourteen articles were included, 272 wide- and 478 regular-diameter implants. One study presented a low, 3 an unclear, and 11 a high risk of bias. Meta-analyses showed no statistical difference: implant survival, short dental implants in N-RCTs (up to 1 year - RR 1.01 [0.98; 1.03], 1 to 5 years - RR 1.01 [0.94; 1.08], more than 5 years - RR 1.01 [0.97; 1.06]), extrashort dental implants in N-RCTs (RR 1.04 [0.90; 1.20]), RCTs (RR 1.05 [0.88; 1.25]); implant success in N-RCTs (RR 1.01 [0.97; 1.05]); prosthesis success in N-RCTs (RR 1.01 [0.97; 1.05]). CONCLUSIONS Short and extrashort dental implants with a wide and regular diameter appear to be clinically appropriate options for implant-supported posterior restorations, with high survival, success, and prosthesis success rates.
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Affiliation(s)
- Vanessa Felipe Vargas-Moreno
- PhD student, Department of Prosthodontics and Periodontology; Piracicaba Dental School (UNICAMP), Piracicaba, SP, Brazil
| | | | - Rafael Soares Gomes
- Professor, Department of Prosthodontics, Faculty of Technology and Sciences (UniFTC), Salvador, BA, Brazil
| | - Fernanda Faot
- Professor, Department of Restorative Dentistry, Federal University of Pelotas, Pelotas (UFPel), RS, Brazil
| | - Altair Antoninha Del Bel Cury
- Professor, Department of Prosthodontics and Periodontology; Piracicaba Dental School (UNICAMP), Piracicaba, SP, Brazil
| | - Raissa Micaella Marcello-Machado
- Postdoctoral Research Fellow, Department of Prosthodontics and Periodontology; Piracicaba Dental School (UNICAMP), Piracicaba, SP, Brazil.
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28
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Computational assessment of growth of connective tissues around textured hip stem subjected to daily activities after THA. Med Biol Eng Comput 2023; 61:525-540. [PMID: 36534373 DOI: 10.1007/s11517-022-02729-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
Longer-term stability of uncemented femoral stem depends on ossification at bone-implant interface. Although attempts have been made to assess the amount of bone growth using finite element (FE) analysis in combination with a mechanoregulatory algorithm, there has been little research on tissue differentiation patterns on hip stems with proximal macro-textures. The primary goal of this investigation is to qualitatively compare the formation of connective tissues around a femoral implant with/without macro-textures on its proximal surfaces. This study also predicts formation of different tissue phenotypes and their spatio-temporal distribution around a macro-textured femoral stem under routine activities. Results from the study show that non-textured implants (80 to 94%) encourage fibroplasia compared to that in textured implants (71 to 85.38%) under similar routine activity, which might trigger aseptic loosening of implant. Formation of bone was more on medio-lateral sides and towards proximal regions of Gruen zones 2 and 6, which was found to be in line with clinical observations. Fibroplasia was higher under stair climbing (85 to 91%) compared to that under normal walking (71 to 85.38%). This study suggests that stair climbing, although falls under recommended activity, might be detrimental to patient compared to normal walking in the initial rehabilitation period.
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29
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Irandoust S, Müftü S. On computational predictions of fluid flow and its effects on bone healing in dental implant treatments: an investigation of spatiotemporal fluid flow in cyclic loading. Biomech Model Mechanobiol 2023; 22:85-104. [PMID: 36329356 DOI: 10.1007/s10237-022-01633-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
Abstract
Fluid flow in (porous) bone plays an important role in its maintenance, adaptation, and healing after an injury. Experimental and computational studies apply mechanical loading on bone to predict fluid flow development and/or to find its material properties. In most cases, mechanical loading is applied as a linear function in time. Multiple loading functions-with identical peak load and loading frequency-were used to investigate load-induced fluid flow and predict bone healing surrounding a dental implant. Implementing an instantaneous healing stimulus led to major differences in healing predictions for slightly different loading functions. Load-induced fluid flow was found to be displacement-rate dependent with complex spatial-temporal variations and not necessarily symmetrical during loading and unloading phases. Haversine loading resulted in more numerical stability compared to ramped/triangular loading, providing the opportunity for further investigation of the effects of various physiological masticatory loadings. It was concluded that using the average healing stimulus during cyclic loading gives the most robust bone healing predictions.
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Affiliation(s)
- Soroush Irandoust
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, 02115, USA.
| | - Sinan Müftü
- Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, 02115, USA
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30
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Mussi MC, Ribeiro FV, Corrêa MG, Salmon CR, Pimentel SP, Cirano FR, Casati MZ. Impact of a modified implant macrogeometry on biomechanical parameters and bone-related markers in rats. Braz Oral Res 2023; 37:e44. [PMID: 37132731 DOI: 10.1590/1807-3107bor-2023.vol37.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/17/2022] [Indexed: 05/04/2023] Open
Abstract
This study investigated the impact of a modified implant macrogeometry on peri-implant healing and its effect on bone-related molecules in rats. Eighteen rats received one implant in each tibia: the control group received implants with conventional macrogeometry and the test group received implants with modified macrogeometry. After 30 days, the implants were removed for biomechanical analysis and the bone tissue around them was collected for quantifying gene expression of OPN, Runx2, β-catenin, BMP-2, Dkk1, and RANKL/OPG. Calcein and tetracycline fluorescent markers were used for analyzing newly formed bone at undecalcified sections of the tibial implants. These fluorescent markers showed continuous bone formation at cortical bone width and sparse new bone formed along the medullary implant surface in both groups. However, higher counter-torque values and upregulation of OPN expression were achieved by test implants when compared to controls. The modified macrogeometry of implants optimized peri-implant healing, favoring the modulation of OPN expression in the osseous tissue around the implants.
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Affiliation(s)
- Mounir Colares Mussi
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | | | - Monica Grazieli Corrêa
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | | | - Suzana Peres Pimentel
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Fabiano Ribeiro Cirano
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
| | - Marcio Zaffalon Casati
- Universidade Paulista, School of Dentistry, Dental Research Division, São Paulo, SP, Brazil
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Osseointegration Properties of Titanium Implants Treated by Nonthermal Atmospheric-Pressure Nitrogen Plasma. Int J Mol Sci 2022; 23:ijms232315420. [PMID: 36499747 PMCID: PMC9740438 DOI: 10.3390/ijms232315420] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022] Open
Abstract
Pure titanium is used in dental implants owing to its excellent biocompatibility and physical properties. However, the aging of the material during storage is detrimental to the long-term stability of the implant after implantation. Therefore, in this study, we attempted to improve the surface properties and circumvent the negative effects of material aging on titanium implants by using a portable handheld nonthermal plasma device capable of piezoelectric direct discharge to treat pure titanium discs with nitrogen gas. We evaluated the osteogenic properties of the treated samples by surface morphology and elemental analyses, as well as in vitro and in vivo experiments. The results showed that nonthermal atmospheric-pressure nitrogen plasma can improve the hydrophilicity of pure titanium without damaging its surface morphology while introducing nitrogen-containing functional groups, thereby promoting cell attachment, proliferation, and osseointegration to some extent. Therefore, nitrogen plasma treatment may be a promising method for the rapid surface treatment of titanium implants.
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He Y, Gao Y, Ma Q, Zhang X, Zhang Y, Song W. Nanotopographical cues for regulation of macrophages and osteoclasts: emerging opportunities for osseointegration. J Nanobiotechnology 2022; 20:510. [PMID: 36463225 PMCID: PMC9719660 DOI: 10.1186/s12951-022-01721-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
Nanotopographical cues of bone implant surface has direct influences on various cell types during the establishment of osseointegration, a prerequisite of implant bear-loading. Given the important roles of monocyte/macrophage lineage cells in bone regeneration and remodeling, the regulation of nanotopographies on macrophages and osteoclasts has arisen considerable attentions recently. However, compared to osteoblastic cells, how nanotopographies regulate macrophages and osteoclasts has not been properly summarized. In this review, the roles and interactions of macrophages, osteoclasts and osteoblasts at different stages of bone healing is firstly presented. Then, the diversity and preparation methods of nanotopographies are summarized. Special attentions are paid to the regulation characterizations of nanotopographies on macrophages polarization and osteoclast differentiation, as well as the focal adhesion-cytoskeleton mediated mechanism. Finally, an outlook is indicated of coordinating nanotopographies, macrophages and osteoclasts to achieve better osseointegration. These comprehensive discussions may not only help to guide the optimization of bone implant surface nanostructures, but also provide an enlightenment to the osteoimmune response to external implant.
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Affiliation(s)
- Yide He
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
| | - Yuanxue Gao
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
| | - Qianli Ma
- grid.5510.10000 0004 1936 8921Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317 Oslo, Norway
| | - Xige Zhang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Periodontology, School of Stomatology, The Fourth Military Medical University, Shaanxi Xi’an, 710032 China
| | - Yumei Zhang
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
| | - Wen Song
- grid.233520.50000 0004 1761 4404State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Oral Diseases, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, 710032 China
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Lim HK, Lee SJ, Jeong Y, Lee JS, Ryu JJ, Shim JS, Song IS. Clinical Validation of Dental Implant Stability by Newly Designed Damping Capacity Assessment Device during the Healing Period. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1570. [PMID: 36363526 PMCID: PMC9695454 DOI: 10.3390/medicina58111570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 03/08/2024]
Abstract
Background and Objectives: To evaluate the stability of a dental implant and the effectiveness of a newly designed damping capacity assessment device by improving the number of blows and strength evaluated by a prospective clinical study. Materials and Method: The stability of dental implants was measured in 50 implants in a total of 38 patients. Measurements were performed using Anycheck and Periotest M devices, twice in total, divided into buccal and lingual directions. In addition, measurements were performed on the day of surgery, two weeks, one month, two months, and three months after surgery for a total of five times. After the standardization of the measured values, the differences and changes over time for each device were observed. Result: No difference in standardized values between the two devices was observed at any time point. In both devices, stability decreased at two weeks postoperatively but gradually increased thereafter. No differences were observed in the values according to the measurement direction. Conclusions: The damping capacity of Anycheck was similar to that of Periotest M. After a slight decrease in stability two weeks after implant placement, implant stability increased over time.
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Affiliation(s)
- Ho-Kyung Lim
- Department of Oral & Maxillofacial Surgery, Korea University Guro Hospital, Seoul 08308, Korea
| | - Sung-Jae Lee
- Department of Oral & Maxillofacial Surgery, Korea University Anam Hospital, Seoul 02841, Korea
| | - Yujin Jeong
- Department of Biostatistics, Korea University College of Medicine, Seoul 02841, Korea
| | - Jong-Seok Lee
- Department of Prosthodontics, Korea University Anam Hospital, Seoul 02841, Korea
| | - Jae-Jun Ryu
- Department of Prosthodontics, Korea University Anam Hospital, Seoul 02841, Korea
| | - Ji-Suk Shim
- Department of Prosthodontics, Korea University Guro Hospital, Seoul 08308, Korea
| | - In-Seok Song
- Department of Oral & Maxillofacial Surgery, Korea University Anam Hospital, Seoul 02841, Korea
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Abstract
Surface characteristics are an important factor for long-term clinical success of dental implants. Alterations of implant surface characteristics accelerate or improve osseointegration by interacting with the physiology of bone healing. Dental implant surfaces have been traditionally modified at the microlevel. Recently, researchers have actively investigated nano-modifications in dental implants. This review explores implant surface modifications that enhance biological response at the interface between a bone and the implant.
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Affiliation(s)
- 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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Mao C, Yu W, Jin M, Wang Y, Shang X, Lin L, Zeng X, Wang L, Lu E. Mechanobiologically optimized Ti-35Nb-2Ta-3Zr improves load transduction and enhances bone remodeling in tilted dental implant therapy. Bioact Mater 2022; 16:15-26. [PMID: 35386333 PMCID: PMC8958422 DOI: 10.1016/j.bioactmat.2022.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 12/13/2022] Open
Abstract
The tilted implant with immediate function is increasingly used in clinical dental therapy for edentulous and partially edentulous patients with excessive bone resorption and the anatomic limitations in the alveolar ridge. However, peri-implant cervical bone loss can be caused by the stress shielding effect. Herein, inspired by the concept of “materiobiology”, the mechanical characteristics of materials were considered along with bone biology for tilted implant design. In this study, a novel Ti–35Nb–2Ta–3Zr alloy (TNTZ) implant with low elastic modulus, high strength and favorable biocompatibility was developed. Then the human alveolar bone environment was mimicked in goat and finite element (FE) models to investigate the mechanical property and the related peri-implant bone remodeling of TNTZ compared to commonly used Ti–6Al–4V (TC4) in tilted implantation under loading condition. Next, a layer-by-layer quantitative correlation of the FE and X-ray Microscopy (XRM) analysis suggested that the TNTZ implant present better mechanobiological characteristics including improved load transduction and increased bone area in the tilted implantation model compared to TC4 implant, especially in the upper 1/3 region of peri-implant bone that is “lower stress”. Finally, combining the static and dynamic parameters of bone, it was further verified that TNTZ enhanced bone remodeling in “lower stress” upper 1/3 region. This study demonstrates that TNTZ is a mechanobiological optimized tilted implant material that enhances load transduction and bone remodeling. The mechanical properties and deformation mechanisms of Ti–35Nb–2Ta–3Zr alloys were studied. The cell biocompatibility, a layer-by-layer correlation of the finite element and X-ray Microscopy analysis were evaluated. Ti–35Nb–2Ta–3Zr implant improves load transduction and enhances bone remodeling in tilted implantation models. Mechanobiologically optimized Ti–35Nb–2Ta–3Zr alloy meets the clinical application requirements of tilted implant therapy.
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Affiliation(s)
- Chuanyuan Mao
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Weijun Yu
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Min Jin
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Yingchen Wang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Materials Genome Initiative Centre, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xiaoqing Shang
- National Engineering Research Center of Light Alloy Net Forming, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Lu Lin
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Xiaoqin Zeng
- National Engineering Research Center of Light Alloy Net Forming, School of Materials Science and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- Corresponding author.
| | - Liqiang Wang
- State Key Laboratory of Metal Matrix Composites, School of Materials Science and Engineering, Materials Genome Initiative Centre, Shanghai Jiao Tong University, Shanghai, 200240, China
- Corresponding author.
| | - Eryi Lu
- Department of Stomatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
- Corresponding author.
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Shetty S, Nelson B, Knopp B, Schneppendahl J, Kaufmann RA. Strength of Humeral and Ulnar Intramedullary Screw Fixation. J Hand Surg Am 2022; 47:1014.e1-1014.e8. [PMID: 34579980 DOI: 10.1016/j.jhsa.2021.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/19/2021] [Accepted: 07/21/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE The goal of this study was to test the pullout strength of intramedullary (IM) screws from within the humerus to establish their ability to seat an uncemented elbow arthroplasty. METHODS Six humerus and 6 ulna Sawbones specimens were drilled with a drill bit diameter of 5/16 inches, and the inner cortex was hand tapped for a ⅜-16 thread. A ⅜-16 custom-made titanium screw with an outer bolt diameter of 3/8 inches and 16 threads per inch was inserted by hand into the tapped holes. The specimens were then axially tensile loaded at a rate of 5 mm per minute until either the screw began to pull out from the bone or a fracture was noted. RESULTS Intramedullary screw fixation in the humerus achieved an average pullout strength of 1,439 pound-force (6,401 N), and IM screw fixation in the ulna achieved an average pullout strength of 882 pound-force (3,923 N). A fracture was noted in 3 humeral specimens, with 3 screws pulling out. In the ulna, the IM axial load caused a fracture in 5 specimens, and in 1 specimen, the screw pulled out. CONCLUSIONS Our findings demonstrate that IM screw fixation can create a tensile force within the screw that is greater than that required to generate the calculated level of compression between the implant and bone. CLINICAL RELEVANCE This may be beneficial in ensuring fixation between arthroplasty components and bone.
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Affiliation(s)
- Sameer Shetty
- Department of Orthopedics, University of Pittsburgh Medical Center, Bethel Park, PA
| | | | | | - Johannes Schneppendahl
- Department of Orthopaedics and Trauma Surgery, University of Duesseldorf, Düsseldorf, Germany
| | - Robert A Kaufmann
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
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Liang C, Liu X, Yan Y, Sun R, Li J, Geng W. Effectiveness and Mechanisms of Low-Intensity Pulsed Ultrasound on Osseointegration of Dental Implants and Biological Functions of Bone Marrow Mesenchymal Stem Cells. Stem Cells Int 2022; 2022:7397335. [PMID: 36199628 PMCID: PMC9529500 DOI: 10.1155/2022/7397335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022] Open
Abstract
Dental implant restoration is the preferred choice for patients with dentition defects or edentulous patients, and obtaining stable osseointegration is the determining factor for successful implant healing. The risk of implant failure during the healing stage is still an urgent problem in clinical practice due to differences in bone quality at different implant sites and the impact of some systemic diseases on bone tissue metabolism. Low-intensity pulsed ultrasound (LIPUS) is a noninvasive physical intervention method widely recognized in the treatment of bone fracture and joint damage repair. Moreover, many studies indicated that LIPUS could effectively promote the osseointegration of dental implants and improve the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). This review is aimed at investigating the research progress on the use of LIPUS in dental implant medicine from three aspects: (1) discuss the promoting effects of LIPUS on osseointegration and peri-implant bone regeneration, (2) summarize the effects and associated mechanisms of LIPUS on the biological functions of BMSCs, and (3) introduce the application and prospects of LIPUS in the clinical work of dental implantation. Although many challenges need to be overcome in the future, LIPUS is bound to be an efficient and convenient therapeutic method to improve the dental implantation success rate and expand clinical implant indications.
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Affiliation(s)
- Chao Liang
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Xiu Liu
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Yuwei Yan
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Rongxin Sun
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Jun Li
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
- Beijing Institute of Dental Research, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
| | - Wei Geng
- Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing 100050, China
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Glauser R, Schupbach P. Early bone formation around immediately placed two-piece tissue-level zirconia implants with a modified surface: an experimental study in the miniature pig mandible. Int J Implant Dent 2022; 8:37. [PMID: 36103094 PMCID: PMC9474793 DOI: 10.1186/s40729-022-00437-z] [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: 05/18/2022] [Accepted: 09/08/2022] [Indexed: 11/11/2022] Open
Abstract
Purpose To histologically examine early bone formation around transmucosal implants and to evaluate the influence of surface characteristics on early peri-implant bone healing using a miniature pig model. For this, commercially available dental implants with a rough zirconia (YTZP) surface were compared to surface-modified Ti control implants at 4 and 8 weeks after placement. Methods Immediately following the extraction of six mandibular premolars, 20 two-piece, tissue-level, screw-shaped YTZP implants (Patent™ Standard Zirconia Implant ø4.1 × 11 mm) with a modified rough blasted before sintering surface were inserted in four adult miniature pigs. In addition, four titanium (Ti) tissue-level implants (Straumann® Standard RN ø4.1 × 10 mm Roxolid®) with a moderate surface (SLActive®), one per animal, were placed as control implants. A histological analysis was performed on the hard tissues after 4 and 8 weeks of transmucosal healing.
Results The results show a high rate of osseointegration of the test YTZP dental implants at 4 and 8 weeks following insertion. At 4 weeks, a bone-to-implant contact ratio (BIC) of 73.7% (SD ± 16.8) for the test implants (n = 10) and 58.5% for the first control implant was achieved. The second control implant had to be excluded from analysis. At 8 weeks, a BIC of 82.4% (SD ± 16.9) for the test implants (n = 9) and 93.6% (SD ± 9.1) (n = 2) for the control implant was achieved. No statistical difference was observed comparing 4 and 8 weeks YTZP data (p = 0.126). Conclusions The results indicate a predictable osseointegration of immediate zirconia implants with a modified YTZP implant surface and a high degree of BIC present at 4 weeks following insertion. After 8 weeks of healing both the zirconia implants and the Ti implants show a BIC indicating full osseointegration. Further studies involving a larger sample size with more time points are needed to confirm these results.
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Sousa V, Mardas N, Spratt D, Hassan IA, Walters NJ, Beltrán V, Donos N. The Effect of Microcosm Biofilm Decontamination on Surface Topography, Chemistry, and Biocompatibility Dynamics of Implant Titanium Surfaces. Int J Mol Sci 2022; 23:ijms231710033. [PMID: 36077428 PMCID: PMC9456268 DOI: 10.3390/ijms231710033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
Since the inception of dental implants, a steadily increasing prevalence of peri-implantitis has been documented. Irrespective of the treatment protocol applied for the management of peri-implantitis, this biofilm-associated pathology, continues to be a clinical challenge yielding unpredictable and variable levels of resolution, and in some cases resulting in implant loss. This paper investigated the effect of microcosm biofilm in vitro decontamination on surface topography, wettability, chemistry, and biocompatibility, following decontamination protocols applied to previously infected implant titanium (Ti) surfaces, both micro-rough -Sandblasted, Large-grit, Acid-etched (SLA)-and smooth surfaces -Machined (M). Microcosm biofilms were grown on SLA and M Ti discs. These were treated with TiBrushes (TiB), combination of TiB and photodynamic therapy (PDT), combination of TiB and 0.2%CHX/1%NaClO, plus or minus Ultraviolet-C (UV-C) radiation. Surface topography was evaluated by Scanning Electron Microscopy (SEM) and Laser Surface Profilometry. Surface function was analysed through wettability analysis. Surface chemistry evaluation of the discs was performed under SEM/Energy-dispersive X-ray spectroscopy (EDX) and X-ray photoelectron spectroscopy (XPS). Biocompatibility was tested with the cytocompatibility assay using human osteoblast-like osteosarcoma cell line (MG-63) cells. Elemental analysis of the discs disclosed chemical surface alterations resulting from the different treatment modalities. Titanium, carbon, oxygen, sodium, aluminium, silver, were identified by EDX as the main components of all the discs. Based on the data drawn from this study, we have shown that following the decontamination of Ti surfaces the biomaterial surface chemistry and topography was altered. The type of treatment and Ti surface had a significant effect on cytocompatibility (p = 0.0001). Although, no treatment modality hindered the titanium surface biocompatibility, parameters such as the use of chemical agents and micro-rough surfaces had a higher cytotoxic effect in MG-63 cells. The use of smooth surfaces, and photofunctionalisation of the TiO2 layer had a beneficial effect on cytocompatibility following decontamination.
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Affiliation(s)
- Vanessa Sousa
- Periodontology and Periodontal Medicine, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, Kings College London, Guy’s and St Thomas’ NHS Foundation Trust, London SE1 9RT, UK
- Correspondence:
| | - Nikos Mardas
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
| | - Dave Spratt
- Microbial Diseases, Eastman Dental Institute, University College London, London WC1E 6BT, UK
| | - Iman A. Hassan
- Materials Chemistry Centre, Department of Chemistry, University College London, 20 Gordon Street, London WC1H 0AJ, UK
| | - Nick J. Walters
- Natural Resources Institute Finland, Latokartanonkaari 9, 00790 Helsinki, Finland
| | - Víctor Beltrán
- Clinical Investigation and Dental Innovation Center, Dental School and Center for Translational Medicine, Universidad de La Frontera, Temuco 4780000, Chile
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Centre for Oral Immunobiology & Regenerative Medicine, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University London, London E1 2AD, UK
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Canullo L, Iacono R, Pires Godoy E, Punzo A, Cavicchia A, Gianfreda F, Bollero P. Hybrid Funnel Technique: A Novel Approach for Implant Site Preparation: A Pilot Study. Dent J (Basel) 2022; 10:dj10090157. [PMID: 36135152 PMCID: PMC9497956 DOI: 10.3390/dj10090157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Different techniques and tools have been developed for implant site preparation. In this clinical scenario, Hybrid Funnel Technique (HFT), a novel osteotomy procedure, has been proposed. (2) Aim: The aim of this retrospective observational study was to consider the different responses to compression of the histological bony compartments (cancellus and cortical). HFT involves the use of multiple drills for the cortical layer preparation and of an osteotome for the osteocompaction of the cancellous bone. (3) Materials and Methods: Following computer-supported implant planning and guided surgery, 10 osteotomies with HFT were performed and 10 implants with the same length and diameter were placed in seven healthy and no daily smoking patients. Periapical X-ray and intraoral photographs were performed at baseline and after 12 months of follow-up to evaluate marginal bone level (MBL) changes and aesthetic results obtained from implant prosthetic rehabilitation. (4) Results: At 1 year of follow-up, 100% of the implants were successfully integrated, MBL change mean value was 0.17 mm ± 0.21. No differences in terms of MBL were noted between thin and thick biotypes. Pink esthetic score (PES) and white esthetic score (WES), assessed one year after definitive restoration placement, were 7.5 ± 2.3 and 8.5 ± 1.1, respectively. (5) Conclusions: Based on the findings of this preliminary clinical study, HFT has led to stability of peri-implant tissues and could represent a reliable technique for surgical preparation of the implant site.
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Affiliation(s)
- Luigi Canullo
- Department of Periodontology, University of Bern, 3012 Bern, Switzerland
| | - Roberta Iacono
- F.A.S Screening for Prevention and Oral Health, Department of Oral and Maxillofacial Science, Sapienza University of Rome, 00185 Rome, Italy
| | - Eduardo Pires Godoy
- Department of Oral Biology, Faculty of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil
| | | | - Alessio Cavicchia
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Francesco Gianfreda
- Department of Industrial Engineering, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Correspondence:
| | - Patrizio Bollero
- Department of System Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
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Titanium nanotopography induces osteocyte lacunar-canalicular networks to strengthen osseointegration. Acta Biomater 2022; 151:613-627. [PMID: 35995407 DOI: 10.1016/j.actbio.2022.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/20/2022]
Abstract
Osteocyte network architecture is closely associated with bone turnover. The cellular mechanosensing system regulates osteocyte dendrite formation by enhancing focal adhesion. Therefore, titanium surface nanotopography might affect osteocyte network architecture and improve the peri-implant bone tissue quality, leading to strengthened osseointegration of bone-anchored implants. We aimed to investigate the effects of titanium nanosurfaces on the development of osteocyte lacunar-canalicular networks and osseointegration of dental implants. Alkaline etching created titanium nanosurfaces with anisotropically patterned dense nanospikes, superhydrophilicity, and hydroxyl groups. MLO-Y4 mouse osteocyte-like cells cultured on titanium nanosurfaces developed neuron-like dendrites with increased focal adhesion assembly and gap junctions. Maturation was promoted in osteocytes cultured on titanium nanosurfaces compared to cells cultured on machined or acid-etched micro-roughened titanium surfaces. Osteocytes cultured in type I three-dimensional collagen gels for seven days on nano-roughened titanium surfaces displayed well-developed interconnectivity with highly developed dendrites and gap junctions compared to the poor interconnectivity observed on the other titanium surfaces. Even if superhydrophilicity and hydroxyl groups were maintained, the loss of anisotropy-patterned nanospikes reduced expression of gap junction in osteocytes cultured on alkaline-etched titanium nanosurfaces. Four weeks after placing the titanium nanosurface implants in the upper jawbone of wild-type rats, osteocytes with numerous dendrites were found directly attached to the implant surface, forming well-developed lacunar-canalicular networks around the nano-roughened titanium implants. The osseointegration strength of the nano-roughened titanium implants was significantly higher than that of the micro-roughened titanium implants. These data indicate that titanium nanosurfaces promote osteocyte lacunar-canalicular network development via nanotopographical cues and strengthen osseointegration. STATEMENT OF SIGNIFICANCE: The clinical stability of bone-anchoring implant devices is influenced by the bone quality. The osteocyte network potentially affects bone quality and is established by the three-dimensional (3D) connection of neuron-like dendrites of well-matured osteocytes within the bone matrix. No biomaterials are known to regulate formation of the osteocyte network. The present study provides the first demonstration that titanium nanosurfaces with nanospikes created by alkali-etching treatment enhance the 3D formation of osteocyte networks by promoting osteocyte dendrite formation and maturation by nanotopographic cues, leading to strengthened osseointegration of titanium implants. Osteocytes attached to the titanium nanosurfaces via numerous cellular projections. The success of osteocyte regulation by nanotechnology paves the way for development of epoch-making technologies to control bone quality.
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Sun R, Bai L, Yang Y, Ding Y, Zhuang J, Cui J. Nervous System-Driven Osseointegration. Int J Mol Sci 2022; 23:ijms23168893. [PMID: 36012155 PMCID: PMC9408825 DOI: 10.3390/ijms23168893] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Implants are essential therapeutic tools for treating bone fractures and joint replacements. Despite the in-depth study of osseointegration for more than fifty years, poor osseointegration caused by aseptic loosening remains one of the leading causes of late implant failures. Osseointegration is a highly sophisticated and spatiotemporal process in vivo involving the immune response, angiogenesis, and osteogenesis. It has been unraveled that the nervous system plays a pivotal role in skeletal health via manipulating neurotrophins, neuropeptides, and nerve cells. Herein, the research related to nervous system-driven osseointegration was systematically analyzed and reviewed, aiming to demonstrate the prominent role of neuromodulation in osseointegration. Additionally, it is indicated that the implant design considering the role of neuromodulation might be a promising way to prevent aseptic loosening.
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Affiliation(s)
- Ruoyue Sun
- Key Laboratory for Ultrafine Materials of Ministry of Education, College of Materials Science and Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Long Bai
- Institute of Translational Medicine, Shanghai University, Shanghai 200444, China
- Frontiers Science Center for Materiobiology and Dynamic Chemistry, East China University of Science and Technology, Shanghai 200237, China
- Correspondence: (J.C.); (L.B.)
| | - Yaru Yang
- College of Materials and Textile Engineering, Jiaxing University, Jiaxing 314001, China
| | - Yanshu Ding
- Key Laboratory for Ultrafine Materials of Ministry of Education, College of Materials Science and Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Jingwen Zhuang
- Key Laboratory for Ultrafine Materials of Ministry of Education, College of Materials Science and Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Jingyuan Cui
- Key Laboratory for Ultrafine Materials of Ministry of Education, College of Materials Science and Engineering, East China University of Science and Technology, Shanghai 200237, China
- Frontiers Science Center for Materiobiology and Dynamic Chemistry, East China University of Science and Technology, Shanghai 200237, China
- Correspondence: (J.C.); (L.B.)
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Development of a new preclinical model to study early implant loss: a validation study in the beagle dog. Clin Oral Investig 2022; 26:6805-6815. [PMID: 35882681 PMCID: PMC9643266 DOI: 10.1007/s00784-022-04642-3] [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: 01/13/2022] [Accepted: 07/12/2022] [Indexed: 12/03/2022]
Abstract
Objectives To develop a new preclinical model to study early implant loss, where local infection conditions would impair the implant osseointegration. Materials and methods Forty-eight smooth, 2.9-mm diameter experimental implants were placed in the mandible of 8 beagle dogs (3 in each side). In half of the animals (test group, n = 24 implants), the implants received ligatures around the implant-abutment connection. In the other half, no ligatures were placed (control group, n = 24 implants). Four weeks later, implants were extracted in a flapless approach and standard 3.3-mm diameter SLActive implants were placed into the same osteotomy site without any further drilling. Eight weeks after the second implantation, animals were sacrificed and analyzed in terms of implant survival. Results After 8 weeks of healing, 4 implants were lost in the control group and 14 in the test group. This corresponded to a 17.4% of early implant loss in the control group and 58.3% in the test. Most of the early failures occurred within the first 5 weeks of healing. Conclusions Implants placed in a pre-contaminated site present higher early loss than those placed in a non-contaminated site. This study represents a valid and robust preclinical model to study mechanisms and reduction of early implant loss as new technologies become available. Clinical relevance Scientific rationale for the study: There is lack of animal models to study early implant loss. Thus, a proposal of a new model is presented. With the validation of this model, new technologies can be implemented to prevent early implant loss.
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Guo X, Lu H, Liu C, Zhang Y, Bi L. Effects of Super-Activated Platelet Lysate on Early Healing of Tooth Extraction Sockets in Rats. Drug Des Devel Ther 2022; 16:2213-2227. [PMID: 35860524 PMCID: PMC9289175 DOI: 10.2147/dddt.s363766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/30/2022] [Indexed: 12/28/2022] Open
Abstract
Purpose To evaluate the effect of super-activated platelet lysate (sPL) on wound healing of tooth extraction sockets in rats. Methods Rat models of the tooth extraction socket were established. Thirty-six rats were divided into control and sPL groups and sacrificed on days 7, 14, and 28 after tooth extraction. Bone formation in tooth extraction sockets were observed by microscopic computed tomography (micro-CT) and hematoxylin and eosin (HE) staining; osteoprotegerin (OPG), receptor activator of nuclear factor kappa-Β ligand (RANKL), interleukin 6(IL-6), and tumor necrosis factor-alpha (TNF-α) proteins were detected by immunohistochemistry; and chemokine and osteogenic gene expressions were detected by polymerase chain reaction (PCR). Results sPL accelerated soft tissue wound healing in the extraction socket of rats. Micro-CT showed that the amount of bone formation and bone volume fraction were higher in the sPL group than the control 14 days after extraction. HE staining showed promotion of the formation of bony trabeculae by sPL in the apical third of the extraction socket 7 days after extraction and more mature and organized bony trabeculae in the sPL group than the control 14 days after extraction; mature bony trabeculae filling most of the fossa with lesser bone porosity in the socket in the sPL group than the control 28 days after extraction. Immunohistochemistry showed that sPL induced OPG expressions 7 and 14 days after tooth extraction but did not affect the RANKL expression while transiently promoting the IL-6 expression 7 days after extraction. PCR showed that sPL promoted chemokine expressions 7 and 14 days after extraction. The expressions of osteogenesis-related factors were higher in the sPL group than the control 7 and 28 days after extraction, while the opposite trend was observed 14 days after extraction. Conclusion sPL has a transient pro-inflammatory effect and promotes soft tissue healing and bone formation during early wound healing of extraction sockets in rats.
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Affiliation(s)
- Xiaorui Guo
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, People's Republic of China.,State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, People's Republic of China
| | - Huiying Lu
- National and Local Joint Stem Cell Research & Engineering Center for Aging Diseases, Tian Qing Stem Cell Co., Ltd, Harbin, 150028, People's Republic of China
| | - Chunxiang Liu
- National and Local Joint Stem Cell Research & Engineering Center for Aging Diseases, Tian Qing Stem Cell Co., Ltd, Harbin, 150028, People's Republic of China
| | - Yi Zhang
- National and Local Joint Stem Cell Research & Engineering Center for Aging Diseases, Tian Qing Stem Cell Co., Ltd, Harbin, 150028, People's Republic of China
| | - Liangjia Bi
- Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, 150001, People's Republic of China
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Zhang J, Zhao C, Sheng R, Lin K, Wang X, Zhang S. Construction of a Hierarchical Micro-/Submicro-/Nanostructured 3D-Printed Ti6Al4V Surface Feature to Promote Osteogenesis: Involvement of Sema7A through the ITGB1/FAK/ERK Signaling Pathway. ACS APPLIED MATERIALS & INTERFACES 2022; 14:30571-30581. [PMID: 35776897 DOI: 10.1021/acsami.2c06454] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Constructing hierarchical hybrid structures is considered a facile method to improve the osseointegration of implants. Herein, a hierarchical micro-/submicro-/nanostructured surface feature of Ti6Al4V implants (3DAT group) was successfully constructed by combining the inherently formed three-dimensional (3D)-printed microscale topography, acid-etched sub-micropits, and anodized nanotubes. Compared with the classical SLA surface, the microscale topography and sub-micropits increased the three-dimensional space for the cell growth and mechanical stability of implants, while the modification of nanotubes dramatically improved the surface hydrophilicity, protein adsorption, and biomineralization. Most importantly, the 3DAT surface feature possessed excellent osteogenic performance in vitro and in vivo, with the involvement of semaphorin 7A (Sema7A) as revealed by RNA-seq through the ITGB1/FAK/ERK signaling pathway. The present study suggested that the hierarchically structured surface design strategy could accelerate the osseointegration rate of 3D-printed Ti6Al4V implants, promising personalized reconstruction of bone defects.
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Affiliation(s)
- Jinkai Zhang
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
- Department of Orthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, China
| | - Cancan Zhao
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
| | - Ruilong Sheng
- CQM-Centro de Química da Madeira, Universidade da Madeira, Campus da Penteada, Funchal 9000-390, Madeira, Portugal
| | - Kaili Lin
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
| | - Xudong Wang
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
| | - Shilei Zhang
- Department of Oral and Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
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Wu X, Ye M, Sun J, Yan Q, Shi B, Xia H. Patient-reported outcome measures following surgeries in implant dentistry and associated factors: a cross-sectional study. BMJ Open 2022; 12:e059730. [PMID: 35710257 PMCID: PMC9207936 DOI: 10.1136/bmjopen-2021-059730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES We aimed to evaluate the patient-reported outcome measures (PROMs) of dental implant surgeries and analyse the associated indicators. DESIGN A cross-sectional study design was used. SETTING Department of Oral Implantology, Hospital of Stomatology, Wuhan University (May 2020-April 2021). PARTICIPANTS Participants with missing teeth in need of implant-supported rehabilitation. INTERVENTIONS Dental implant placement and/or bone augmentation procedures. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was discomfort on postoperative day 1, measured using a numerical rating scale (NRS). Secondary outcomes included pain and anxiety during surgery; discomfort on postoperative days 3, 7 and 14; and post-surgical complications. RESULTS A total of 366 participants were included, of which 288 (78.7%) and 328 (89.7%) reported no to mild pain and anxiety (NRS 0-3) during surgery, respectively. The proportion of patients reporting discomfort decreased from postoperative day 1 (57.7%) to day 3 (36.1%) and day 7 (17.5%). The most frequent postoperative adverse events were pain and swelling. Patient-related factors (age, sex, smoking, alcohol consumption, history of periodontitis, and pain and anxiety during surgery) and surgery-related factors (type and extent of surgical procedure) were analysed. The factors associated with the severity of discomfort after surgery included alcohol consumption, pain perception during surgery, bone augmentation procedures and age (p<0.05). Similarly, the factors associated with the duration of discomfort included alcohol consumption, pain perception during surgery and age (p<0.05). CONCLUSIONS PROMs related to dental implant surgeries can be predicted using certain risk indicators. Alcohol consumption, pain during surgery and age were associated with discomfort following dental implant surgery.
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Affiliation(s)
- Xinyu Wu
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Mengjie Ye
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jiahui Sun
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qi Yan
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Haibin Xia
- The State Key Laboratory Breeding Base of Basic Sciences of Stomatology & Key Laboratory of Oral Biomedicine, Ministry of Education (Hubei-MOST KLOS & KLOBM), Department of Oral Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Ghanem M, Heikal L, Abdel Fattah H, El Ashwah A, Fliefel R. The Effect of Coenzyme Q10/Collagen Hydrogel on Bone Regeneration in Extraction Socket Prior to Implant Placement in Type II Diabetic Patients: A Randomized Controlled Clinical Trial. J Clin Med 2022; 11:jcm11113059. [PMID: 35683447 PMCID: PMC9181497 DOI: 10.3390/jcm11113059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/14/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The healing of an extraction socket leads to alveolar ridge resorption that can hinder future implant placement and further rehabilitation with special concerns in diabetes mellitus. Coenzyme Q10 (CoQ10) has been developed as a new material for alveolar socket augmentation. The aim of this study was to investigate the effect of CoQ10 hydrogel on bone regeneration after extraction of mandibular teeth in Type II diabetic patients. Methods: This trial was registered under the number NCT05122299 and included eighteen patients. The hydrogel was first prepared and characterized. After tooth extraction, the hydrogel was placed in the extraction sockets. Bone formation was evaluated three months after tooth extraction. Results: The bone density was significantly higher in the CoQ10 group than the other two groups measured on cone beam computed tomography (CBCT). The relative gene expression of Runt-related transcription factor 2 (RUNX2) and Osteopontin (OPN) showed significant increase in the presence of CoQ10. Histomorphometry revealed significantly less fibrous tissue in the CoQ10 group in comparison to the control or collagen group. Conclusion: The local application of CoQ10 after tooth extraction provided a simple, inexpensive, yet effective treatment facilitating bone formation and healing in the extraction sockets of diabetic patients.
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Affiliation(s)
- Mostafa Ghanem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Champollion Street, Alexandria 21526, Egypt; (M.G.); (A.E.A.)
| | - Lamia Heikal
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Champollion Street, Alexandria 21526, Egypt;
| | - Hagar Abdel Fattah
- Department of Oral Biology, Faculty of Dentistry, Alexandria University, Champollion Street, Alexandria 21526, Egypt;
| | - Adham El Ashwah
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Champollion Street, Alexandria 21526, Egypt; (M.G.); (A.E.A.)
| | - Riham Fliefel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Champollion Street, Alexandria 21526, Egypt; (M.G.); (A.E.A.)
- Experimental Surgery and Regenerative Medicine (ExperiMed), Ludwig-Maximilians University (LMU), Fraunhoferstrasse 20, 82152 Planegg-Martinsried, Germany
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig Maximilians University, Lindwurmstrasse 2a, 80337 Munich, Germany
- Correspondence: or
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Chen Y, Li J, Shi J, Ning D, Feng J, Lin W, He F, Xie Z. Ipriflavone suppresses NLRP3 inflammasome activation in host response to biomaterials and promotes early bone healing. J Clin Periodontol 2022; 49:814-827. [PMID: 35569032 DOI: 10.1111/jcpe.13647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/26/2022] [Accepted: 05/10/2022] [Indexed: 12/23/2022]
Abstract
AIM Emerging studies have shown that immune response to biomaterial implants plays a central role in bone healing. Ipriflavone is clinically used for osteoporosis. However, the mechanism of ipriflavone in immune response to implants in early stages of osseointegration remains unclear. In this study, we aimed to investigate the potential role of ipriflavone in early bone healing process and uncover the underlying mechanism. MATERIALS AND METHODS We carried out histological examination as well as analysis of proinflammatory cytokines and NLRP3 inflammasome activation in a tibial implantation mouse model with intra-peritoneal injection of ipriflavone. In addition, we explored the mechanism of ipriflavone in the regulation of NLRP3 inflammasome activation in macrophages. RESULTS In vivo, ipriflavone ameliorated host inflammatory response related to NLRP3 inflammasome activation at implantation sites, characterized by reductions of inflammatory cell infiltration and proinflammatory cytokine interleukin-1β levels. Ipriflavone treatment also showed beneficial effects on early osseointegration. Further investigations of the molecular mechanism showed that the suppression of NLRP3 inflammasome acts upstream of NLRP3 oligomerization through abrogating the production of reactive oxygen species. CONCLUSIONS These results revealed an anti-inflammatory role of ipriflavone in NLRP3 inflammasome activation through improving mitochondrial function. This study provides a new strategy for the development of immune-regulated biomaterials and treatment options for NLRP3-related diseases.
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Affiliation(s)
- Yun Chen
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Jia Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Jue Shi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Dandan Ning
- Academy of Chinese Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Jianying Feng
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Weiwei Lin
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Zhijian Xie
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
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Tamimi I, Carnero P, Bautista D, Gonzalez D, Rodrigo P, Bravo MJ, Gómez A, Tamimi F, Garcia de Quevedo D. Proton Pump Inhibitors and the Risk of Early Aseptic Loosening in Hip and Knee Arthroplasty. Geriatr Orthop Surg Rehabil 2022; 13:21514593221091664. [PMID: 35433100 PMCID: PMC9006357 DOI: 10.1177/21514593221091664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 03/26/2022] [Accepted: 03/31/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction The use of proton pump inhibitors (PPIs) has been associated with a higher risk of osteoporotic fractures and non-unions rates. However, the relation between the use of PPIs and the development of aseptic loosening in arthroplasty procedures has not been studied. The objective of this study is to analyze the relation between the use of PPIs, and the risk of early aseptic loosening in total knee arthroplasty (TKA) and total hip arthroplasty (THA). Materials and methods A nested case-control study was conducted on patients who were subjected THA or TKA in our center between 2010 and 2014. Cases were patients subjected to revision surgery due to early aseptic loosening during the study period. Cases were matched with controls who did not require any type of revision surgery by type of joint replacement (THA/TKA), gender, age (+/- 2 years), and follow-up time (±6 months). Odds Ratios were adjusted to potential confounders. Results The crude and adjusted ORs (95% CI) of undergoing revision surgery for aseptic loosening following primary total knee arthroplasty or total hip arthroplasty, were 6.25 (2.04-19.23) and 6.10 (1.71-21.73), respectively, for any use PPIs compared with non-users. Crude and adjusted ORs, were 11.6 (2.93-45.88) and 17.1 (2.41-121.66), respectively, for patients with a Proportion of Days Covered (PDC) for PPIs <.5 (Table 2). In addition, the crude and adjusted ORs of undergoing revision surgery, were 5.05 (1.59-16.02) and 5.01 (1.36-18.44), respectively, for patients with a PDC for PPIs ≥.5. Discussion These results suggest that PPIs should be used with caution in patients with TKA and THA, and that the use of these drugs should not be prolonged unless there was a justifiable indication. Conclusions The use of PPIs and was associated with a higher risk of early aseptic loosening in patients subjected to THA and TKA.
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Affiliation(s)
- Iskandar Tamimi
- Hospital Regional Universitario de Málaga, Málaga, Spain.,Complejo Hospitalario Integral Privado, Málaga, Spain.,Facultad de Medicina, Universidad de Málaga, Spain
| | | | | | - David Gonzalez
- Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Pablo Rodrigo
- Hospital Regional Universitario de Málaga, Málaga, Spain
| | | | - Abel Gómez
- Complejo Hospitalario Integral Privado, Málaga, Spain
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Sant’Anna HR, Casati MZ, Mussi MC, Cirano FR, Pimentel SP, Ribeiro FV, Corrêa MG. Peri-Implant Repair Using a Modified Implant Macrogeometry in Diabetic Rats: Biomechanical and Molecular Analyses of Bone-Related Markers. MATERIALS 2022; 15:ma15062317. [PMID: 35329768 PMCID: PMC8953263 DOI: 10.3390/ma15062317] [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: 01/26/2022] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023]
Abstract
DM has a high prevalence worldwide and exerts a negative influence on bone repair around dental implants. Modifications of the microgeometry of implants have been related to positive results in bone repair. This study assessed, for the first time, the influence of an implant with modified macrodesign based on the presence of a healing chamber in the pattern of peri-implant repair under diabetic conditions. Thirty Wistar rats were assigned to receive one titanium implant in each tibia (Control Implant (conventional macrogeometry) or Test Implant (modified macrogeometry)) according to the following groups: Non-DM + Control Implant; Non-DM + Test Implant; DM + Control Implant; DM + Test Implant. One month from the surgeries, the implants were removed for counter-torque, and the bone tissue surrounding the implants was stored for the mRNA quantification of bone-related markers. Implants located on DM animals presented lower counter-torque values in comparison with Non-DM ones, independently of macrodesign (p < 0.05). Besides, higher biomechanical retention levels were observed in implants with modified macrogeometry than in the controls in both Non-DM and DM groups (p < 0.05). Moreover, the modified macrogeometry upregulated OPN mRNA in comparison with the control group in Non-DM and DM rats (p < 0.05). Peri-implant bone repair may profit from the use of implants with modified macrogeometry in the presence of diabetes mellitus, as they offer higher biomechanical retention and positive modulation of important bone markers in peri-implant bone tissue.
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