The biocompatibility of SLA-treated titanium implants

Does strontium coated titanium implants enhance the osseointegration in animal models under osteoporotic condition? A systematic review and meta-analysis

PURPOSE

The aim of this study was to systematically review the literature to address the effect of strontium modified titanium implants on the osseointegration in the presence of osteoporotic conditions through animal models.

MATERIALS AND METHODS

The databases (PubMed, Scopus, Web of Science, and EBSCO) were searched electronically, and manual searches were performed till December 2022 to identify preclinical studies on the osseointegration of strontium coated titanium implants in animals with induced osteoporotic conditions. The primary outcomes were the bone-implant contact percentage (BIC%), bone area (BA) from the histomorphometric analysis, and the osseointegration parameters from biomechanical tests; the secondary outcomes were the osseointegration parameters from the micro computed tomography.

RESULTS

Nineteen articles were included for the quantitative analysis on basis of the inclusion criteria. The results revealed that Sr-modified implants showed a significant 19.05% increase in BIC, and 15.01% increase in BA. The results of biomechanical tests indicated a significant effect in favor of Sr-coated implants. Furthermore, Results of the secondary outcomes supported the significant advantages of Sr-coated implants over the un-coated implants. The overall, systematic analysis of implants osteointegration parameters proved a significant increase in favor of Sr-coated titanium implants (P < 0.01).

CONCLUSION

The present results provide evidence that strontium-coated titanium implants enhanced the osseointegration in animal models under osteoporotic condition as this surface modification techniques have improved the mechanical and biological properties of the titanium implants.

Surgical Drainage and Simultaneous Sinus Floor Augmentation in Patients with Chronic Maxillary Sinusitis

Chronic maxillary sinusitis accompanied by severe thickening of the sinus mucosa, blockage of the ostium, and patient-reported symptoms requires preoperative assessment and treatment by an otolaryngologist before maxillary sinus floor augmentation (MSFA). Prescription of antibiotics and nasal saline irrigation are the first choice of treatment; however, endoscopic sinus surgery is considered when the treatment's effect is limited and drug resistance is observed. Nevertheless, MSFA performed in the presence of sinus pathologies have been reported to have favorable results when the lesions are managed properly. This report presents cases of two patients who required MSFA but were diagnosed with chronic maxillary sinusitis (case 1 with nasal sinusitis and case 2 with dental sinusitis). After 2 weeks of antibiotic therapy, endoscopic surgery was recommended due to minimal changes in the size of the sinus lesion; however, the patients refused because of improved self-reported symptoms. Therefore, intraoral surgical drainage was planned as an alternative treatment. A large bony window was prepared at the lateral wall of the maxillary sinus, and a long intentional incision was made to improve access for the suction tip in various directions and depths into the sinus cavity. Thorough suction of the purulent exudate and saline irrigation were performed through this access. The size of the perforated area was reduced along with the elevation of the Schneiderian membrane from the sinus floor, and simultaneous bone grafting with implant placement was performed. Prosthesis was delivered after 6-8 months. At 1-year follow-up after loading, favorable outcomes of implant survival and maintenance of augmented bone height were observed, with no recurrence of postoperative sinusitis. Within the limitations of the present case report, thorough sinus drainage and saline irrigation during maxillary sinus floor augmentation resolved sinus infection in patients with chronic maxillary sinusitis with short-term clinical outcomes.

Bio-Inspired Micro- and Nano-Scale Surface Features Produced by Femtosecond Laser-Texturing Enhance TiZr-Implant Osseointegration

Surface design plays a critical role in determining the integration of dental implants with bone tissue. Femtosecond laser-texturing has emerged as a breakthrough technology offering excellent uniformity and reproducibility in implant surface features. However, when compared to state-of-the-art sandblasted and acid-etched surfaces, laser-textured surface designs typically underperform in terms of osseointegration. This study investigates the capacity of a bio-inspired femtosecond laser-textured surface design to enhance osseointegration compared to state-of-the-art sandblasted & acid-etched surfaces. Laser-texturing facilitates the production of an organized trabeculae-like microarchitecture with superimposed nano-scale laser-induced periodic surface structures on both 2D and 3D samples of titanium-zirconium-alloy. Following a boiling treatment to modify the surface chemistry, improving wettability to a contact angle of 10°, laser-textured surfaces enhance fibrin network formation when in contact with human whole blood, comparable to state-of-the-art surfaces. In vitro experiments demonstrate that laser-textured surfaces significantly outperform state-of-the-art surfaces with a 2.5-fold higher level of mineralization by bone progenitor cells after 28 days of culture. Furthermore, in vivo evaluations reveal superior biomechanical integration of laser-textured surfaces after 28 days of implantation. Notably, during abiological pull-out tests, laser-textured surfaces exhibit comparable performance, suggesting that the observed enhanced osseointegration is primarily driven by the biological response to the surface.

Evaluation of Fibrin Clot Interaction with Dental Implant after Different Surface Treatments: An In Vitro Study

AIM

The current study was carried out to assess the interaction between fibrin clots and dental implants following various surface treatments.

MATERIALS AND METHODS

In this investigation, 45 dental implants with dimensions of 16 mm in length and 5 mm in diameter were utilized. They were divided up into three groups, each consisting of fifteen samples. Group I: Control; Group II: Ultraviolet (UV) light treated; and group III: Sandblasted and acid-etching (SLA) treated. Healthy volunteers' venous blood samples were drawn into vacutainer tubes without the use of anticoagulants. The samples were centrifuged for 3 minutes at 2700 rpm in a table centrifuge. The entire implant was submerged in room-temperature liquid fibrinogen for 60 minutes. Then, scanning electronic microscopy (SEM) was used to examine each sample. The inter- and intragroup assessments were obtained using the Mann-Whitney U test and the Kruskal-Wallis test; p-values less than 0.05 were regarded as statistically significant.

RESULTS

The maximum adhesion of fibrin clot was found in SLA treated group (2.42 ± 0.10) followed by the UV light-treated group (2.18 ± 0.08) and control group (1.20 ± 0.02). There was a statistically significant difference found between the three surface-treated groups (p < 0.001).

CONCLUSION

All surface-treatment methods exhibit adhesion between the implant surface and the fibrin clot. However, the highest adherence of fibrin clot was found in SLA treated group compared to the UV light-treated and control group.

CLINICAL SIGNIFICANCE

The physical and chemical characteristics of an implant's surface have a significant impact on the way blood clots organize. At the interface between the implant and the bone, blood clot production can initiate and facilitate the healing process. How to cite this article: Jalaluddin M, Ramanna PK, Swain M, et al. Evaluation of Fibrin Clot Interaction with Dental Implant after Different Surface Treatments: An In Vitro Study. J Contemp Dent Pract 2024;25(3):276-279.

Microscopic in-situ analysis of the mucosal healing around implants treated by protease activated receptor 4-agonist peptide or perpendicularly protruded type I collagen in rats

Enhanced mucosal sealing around titanium implants can reduce complications such as peri-implantitis. The present study aims to investigate the mucosal healing at the early stage around the protease activated receptor 4-agonist peptide (PAR4-AP)- or perpendicularly protruded type I collagen (pCol)-treated titanium implants. A total of 72 implants were placed in 36 rats in the study. Following extractions, two tissue-level implants among the following three different surfaces, PAR4-AP-coated (PAR4 group, n = 24), pCol-treated (pCol group, n = 24) and non-treated (control group, n = 24) ones, were placed in the maxillae of each rat based on a split-mouth design. The specimens retrieved at 8 h (n = 8 per group), 3 days (n = 8 per group), and 2 weeks (n = 8 per group), were immunostained and tissue-cleared, and the signals of laminin-5 and collagen fibers were observed under multiphoton microscopy. Statistical analyses were performed using linear mixed model with post hoc tests to compare differences between the groups. While there was no intergroup difference at 8 h, the laminin-5 at 3 days was more abundant near the PAR4-group-surface, and its area was significantly larger in the PAR4 group (0.0204 ± 0.0194 mm2 ) than the control (0.0019 ± 0.0025 mm2 , p = .001) and pCol (0.0023 ± 0.0022 mm2 , p < .001) groups. The pCol group showed a significantly larger area of collagen fibers (0.0230 ± 0.0148 mm2 ) compared to the control (0.0035 ± 0.0051 mm2 , p = .002) and PAR4 (0.0031 ± 0.0057 mm2 , p < .001) groups at 3 days. At 3 days and 2 weeks, the collagen fiber orientation of the pCol group showed a more perpendicular manner compared to the control and PAR4 groups. The signal of basal lamina and collagen fibers were stronger around the PAR4-AP- and pCol-treated titanium surfaces, respectively during the early healing stage. This could have implications for improved mucosal sealing around dental implants, potentially reducing complications such as peri-implantitis.

The Impact of Mechanical Debridement Techniques on Titanium Implant Surfaces: A Comparison of Sandblasted, Acid-Etched, and Femtosecond Laser-Treated Surfaces

This study evaluated the effects of various mechanical debridement methods on the surface roughness (Ra) of dental implants, comparing femtosecond laser-treated surfaces with conventionally machined and sandblasted with large-grit sand and acid-etched (SLA) implant surfaces. The fabrication of grade 4 titanium (Ti) disks (10 mm in diameter and 1 mm thick) and the SLA process were carried out by a dental implant manufacturer (DENTIS; Daegu, Republic of Korea). Subsequently, disk surfaces were treated with various methods: machined, SLA, and femtosecond laser. Disks of each surface-treated group were post-treated with mechanical debridement methods: Ti curettes, ultrasonic scaler, and Ti brushes. Scanning electron microscopy, Ra, and wettability were evaluated. Statistical analysis was performed using the Kruskal-Wallis H test, with post-hoc analyses conducted using the Bonferroni correction (α = 0.05). In the control group, no significant difference in Ra was observed between the machined and SLA groups. However, femtosecond laser-treated surfaces exhibited higher Ra than SLA surfaces (p < 0.05). The application of Ti curette or brushing further accentuated the roughness of the femtosecond laser-treated surfaces, whereas scaling reduced the Ra in SLA surfaces. Femtosecond laser-treated implant surfaces, with their unique roughness and compositional attributes, are promising alternatives in dental implant surface treatments.

In Vitro Study of Zirconia Surface Modification for Dental Implants by Atomic Layer Deposition

Zirconia is a promising material for dental implants; however, an appropriate surface modification procedure has not yet been identified. Atomic layer deposition (ALD) is a nanotechnology that deposits thin films of metal oxides or metals on materials. The aim of this study was to deposit thin films of titanium dioxide (TiO₂), aluminum oxide (Al₂O₃), silicon dioxide (SiO₂), and zinc oxide (ZnO) on zirconia disks (ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn, respectively) using ALD and evaluate the cell proliferation abilities of mouse fibroblasts (L929) and mouse osteoblastic cells (MC3T3-E1) on each sample. Zirconia disks (ZR; diameter 10 mm) were fabricated using a computer-aided design/computer-aided manufacturing system. Following the ALD of TiO₂, Al₂O₃, SiO₂, or ZnO thin film, the thin-film thickness, elemental distribution, contact angle, adhesion strength, and elemental elution were determined. The L929 and MC3T3-E1 cell proliferation and morphologies on each sample were observed on days 1, 3, and 5 (L929) and days 1, 4, and 7 (MC3T3-E1). The ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn thin-film thicknesses were 41.97, 42.36, 62.50, and 61.11 nm, respectively, and their average adhesion strengths were 163.5, 140.9, 157.3, and 161.6 mN, respectively. The contact angle on ZR-Si was significantly lower than that on all the other specimens. The eluted Zr, Ti, and Al amounts were below the detection limits, whereas the total Si and Zn elution amounts over two weeks were 0.019 and 0.695 ppm, respectively. For both L929 and MC3T3-E1, the cell numbers increased over time on ZR, ZR-Ti, ZR-Al, and ZR-Si. Particularly, cell proliferation in ZR-Ti exceeded that in the other samples. These results suggest that ALD application to zirconia, particularly for TiO₂ deposition, could be a new surface modification procedure for zirconia dental implants.

Influence of Dental Titanium Implants with Different Surface Treatments Using Femtosecond and Nanosecond Lasers on Biofilm Formation

This study aimed to evaluate the impact of different surface treatments (machined; sandblasted, large grit, and acid-etched (SLA); hydrophilic; and hydrophobic) on dental titanium (Ti) implant surface morphology, roughness, and biofilm formation. Four groups of Ti disks were prepared using distinct surface treatments, including femtosecond and nanosecond lasers for hydrophilic and hydrophobic treatments. Surface morphology, wettability, and roughness were assessed. Biofilm formation was evaluated by counting the colonies of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) at 48 and 72 h. Statistical analysis was conducted to compare the groups using the Kruskal-Wallis H test and the Wilcoxon signed-rank test (α = 0.05). The analysis revealed that the hydrophobic group had the highest surface contact angle and roughness (p < 0.05), whereas the machined group had significantly higher bacterial counts across all biofilms (p < 0.05). At 48 h, the lowest bacterial counts were observed in the SLA group for Aa and the SLA and hydrophobic groups for Pg and Pi. At 72 h, low bacterial counts were observed in the SLA, hydrophilic, and hydrophobic groups. The results indicate that various surface treatments affect implant surface properties, with the hydrophobic surface using femtosecond laser treatment exerting a particularly inhibitory effect on initial biofilm growth (Pg and Pi).

Nanostructured Calcium-Incorporated Surface Compared to Machined and SLA Dental Implants-A Split-Mouth Randomized Case/Double-Control Histological Human Study

Background: Implant surface topography is a key element in achieving osseointegration. Nanostructured surfaces have shown promising results in accelerating and improving bone healing around dental implants. The main objective of the present clinical and histological study is to compare, at 4 and 6 weeks, (w) bone-to-implant contact in implants having either machined surface (MAC), sandblasted, large grit, acid-etched implant surface (SLA) medium roughness surface or a nanostructured calcium-incorporated surface (XPEED®). Methods: 35 mini-implants of 3.5 × 8.5 mm with three different surface treatments (XPEED® (n = 16)—SLA (n = 13)—MAC (n = 6), were placed in the posterior maxilla of 11 patients (6 females and 5 males) then, retrieved at either 4 or 6w in a randomized split-mouth study design. Results: The BIC rates measured at 4w and 6w respectively, were: 16.8% (±5.0) and 29.0% (±3.1) for MAC surface; 18.5% (±2.3) and 33.7% (±3.3) for SLA surface; 22.4% (±1.3) and 38.6% (±3.2) for XPEED® surface. In all types of investigated surfaces, the time factor appeared to significantly increase the bone to implant contact (BIC) rate (p < 0.05). XPEED® surface showed significantly higher BIC values when compared to both SLA and MAC values at 4w (p < 0.05). Also, at 6w, both roughened surfaces (SLA and XPEED®) showed significantly higher values (p < 0.05) than turned surface (MAC). Conclusions: Nanostructured Calcium titanate coating is able to enhance bone deposition around implants at early healing stages.

Titanium-protein nanocomposites as new biomaterials produced by high-pressure torsion

The development of new biomaterials with outstanding mechanical properties and high biocompatibility has been a significant challenge in the last decades. Nanocrystalline metals have provided new opportunities in producing high-strength biomaterials, but the biocompatibility of these nanometals needs to be improved. In this study, we introduce metal-protein nanocomposites as high-strength biomaterials with superior biocompatibility. Small proportions of bovine serum albumin (2 and 5 vol%), an abundant protein in the mammalian body, are added to titanium, and two nanocomposites are synthesized using a severe plastic deformation process of high-pressure torsion. These new biomaterials show not only a high hardness similar to nanocrystalline pure titanium but also exhibit better biocompatibility (including cellular metabolic activity, cell cycle parameters and DNA fragmentation profile) compared to nano-titanium. These results introduce a pathway to design new biocompatible composites by employing compounds from the human body.

Titanium and titanium alloys in dentistry: current trends, recent developments, and future prospects

Many implant materials have been used in various dental applications depending on their efficacy and availability. A dental implant must possess the required characteristics, such as biocompatibility, corrosion & wear resistance, adequate mechanical properties, osseointegration, etc., to ensure its safe and optimum use. This review analyzes various aspects of titanium (Ti) and Ti alloys, including properties, manufacturing processes, surface modifications, applications as dental implants, and limitations. In addition, it also presents a perception of recent advances in Ti-based implant materials and the futuristic development of innovative dental implants.

Chemically-induced osteogenic cells for bone tissue engineering and disease modeling

Cell reprogramming can satisfy the demands of obtaining specific cell types for applications such as tissue regeneration and disease modeling. Here we report the reprogramming of human fibroblasts to produce chemically-induced osteogenic cells (ciOG), and explore the potential uses of ciOG in bone repair and disease treatment. A chemical cocktail of RepSox, forskolin, and phenamil was used for osteogenic induction of fibroblasts by activation of RUNX2 expression. Following a maturation, the cells differentiated toward an osteoblast phenotype that produced mineralized nodules. Bulk and single-cell RNA sequencing identified a distinct ciOG population. ciOG formed mineralized tissue in an ectopic site of immunodeficiency mice, unlike the original fibroblasts. Osteogenic reprogramming was modulated under engineered culture substrates. When generated on a nanofiber substrate ciOG accelerated bone matrix formation in a calvarial defect, indicating that the engineered biomaterial promotes the osteogenic capacity of ciOG in vivo. Furthermore, the ciOG platform recapitulated the genetic bone diseases Proteus syndrome and osteogenesis imperfecta, allowing candidate drug testing. The reprogramming of human fibroblasts into osteogenic cells with a chemical cocktail thus provides a source of specialized cells for use in bone tissue engineering and disease modeling.

Surface properties and biocompatibility of sandblasted and acid-etched titanium-zirconium binary alloys with various compositions

Ti-Zr alloys have been investigated as an alternative to commercially pure Ti (c.p.Ti). According to our previous studies on the mechanical properties of Ti-Zr alloys, a Zr proportion in the range of 30-50 mol% has competitive advantages over Ti-10Zr and c.p.Ti. The aim of this study is to evaluate the biological response to Ti-Zr alloys with different compositions and their surface characteristics. Alloy surfaces are modified by sandblasting and sulfuric acid etching. As a result, similar surface structures are observed for c.p.Ti, Ti-10Zr, and Ti-30Zr, whereas Ti-50Zr does not form a micro-rough structure by the same treatment process. No significant difference is found in the viability of cells on c.p.Ti, Ti-10Zr, and Ti-30Zr, whereas lower cell attachment levels are detected on Ti-50Zr. In summary, Ti-30Zr reliably forms a micro-rough structure, which provides one evidence for its application in a new dental implant material.

Bacteria co-culture adhesion on different texturized zirconia surfaces

Zirconia is becoming reckoned as a promising solution for different applications, in particular those within the dental implant investigation field. It has been proved to successfully overcome important limitations of the commonly used titanium implants. The adhesion of microorganisms to the implants, in particular of bacteria, may govern the success or the failure of a dental implant, as the accumulation of bacteria on the peri-implant bone may rapidly evolve into periodontitis. However, bacterial adhesion on different zirconia architectures is still considerably unknown. Therefore, the adhesion of Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa to zirconia surfaces with different finishings was evaluated and compared to a titanium surface. The adhesion interaction between S. aureus and P. aeruginosa was also evaluated using a co-culture since these bacteria are infamous due to their common presence in chronic wound infections. Results showed that different bacterium species possess different properties which influence their propensity to adhere to different roughness levels and architectures. E. coli revealed a higher propensity to adhere to zirconia channelled surfaces (7.15 × 10⁶ CFU/mL), whereas S. aureus and P. aeruginosa adhered more to the titanium control group (1.07 × 10⁵ CFU/mL and 8.43 × 10⁶ CFU/mL, respectively). Moreover, the co-culture denoted significant differences on the adhesion behaviour of bacteria. Despite not having shown an especially better behaviour regarding bacterial adhesion, zirconia surfaces with micro-channels are expected to improve the vascularization around the implants and ultimately enhance osseointegration, thus being a promising solution for dental implants.

Extension and Limits of Depolarization-Fringe Contrast Roughness Method in Sub-Micron Domain

To guarantee quality standards for the industry, surface properties, particularly those of roughness, must be considered in many areas of application. Today, several methods are available on the market, but some damage the surface to be tested as they measure it by contact. A non-contact method for the precise estimation of sub-micron roughness values is presented, which can be used as an extension of existing roughness measurement techniques to improve them further considering the depolarized light reflected by the sample. This setup is based on a Michelson interferometer, and by introducing a quarter-wave plate on a half part of the reference mirror, the surface roughness can be directly derived by measuring the fringe contrasts. This article introduces a simple model describing the intensity distortions resulting from the microscopic roughness in divided interferograms when considering depolarization. This work aimed to extend the measurement range of the technique developed in a previous work, in which depolarization effects are taken into account. For verification, the experimental results were compared with the fringe contrast technique, which does not consider the depolarization of the scattered light, especially regarding the extended wavelength interval, highlighting the limits of the technique. In addition, simulations of the experiments are presented. For comparison, the reference values of the sample roughness were also generated by measurements with a stylus profiler.

Osseointegration of Sandblasted and Acid-Etched Implant Surfaces. A Histological and Histomorphometric Study in the Rabbit

Titanium surface is an important factor in achieving osseointegration during the early wound healing of dental implants in alveolar bone. The purpose of this study was to evaluate sandblasted-etched surface implants to investigate the osseointegration. In the present study, we used two different types of sandblasted-etched surface implants, an SLA™ surface and a Nanoblast Plus™ surface. Roughness and chemical composition were evaluated by a white light interferometer microscope and X-ray photoelectron spectroscopy, respectively. The SLA™ surface exhibited the higher values (Ra 3.05 μm) of rugosity compared to the Nanoblast Plus™ surface (Ra 1.78 μm). Both types of implants were inserted in the femoral condyles of ten New Zealand white rabbits. After 12 weeks, histological and histomorphometric analysis was performed. All the implants were osseointegrated and no signs of infection were observed. Histomorphometric analysis revealed that the bone–implant contact % (BIC) ratio was similar around the SLA™ implants (63.74 ± 13.61) than around the Nanoblast Plus™ implants (62.83 ± 9.91). Both implant surfaces demonstrated a favorable bone response, confirming the relevance of the sandblasted-etched surface on implant osseointegration.

Development of hydrofluoric acid-cleaned silicon nitride implants for periprosthetic infection eradication and bone regeneration enhancement

Orthopedic implant is commonly associated with occurrence or relapse of osteomyelitis. This study developed a hydrofluoric acid (HF) cleaned silicon nitride (Si₃N₄) implant Si₃N₄_AC for osteomyelitis control and established a rat tibial osteomyelitis model to evaluate its efficacy on eradicating periprosthetic infection and enhancing bone regeneration. In vitro studies revealed Si₃N₄_AC had improved biocompatibility and inhibited Staphylococcus aureus adhesion. A custom-made Si₃N₄_AC implant was prepared and inserted into the rat tibia longitudinal cavity inoculated with Staphylococcus aureus. The in vivo bacteriostatic and osteogenic efficacies of Si₃N₄_AC implant were evaluated by histological, microbiological and Micro-CT analyses and compared with implants of pure Ti and Si₃N₄ . Si₃N₄_AC implant group revealed 99.5% inhibition of periprosthetic Staphylococcus aureus compared to the osteomyelitis group after 14 days post-operation. Implant-adhering bacteria density of Si₃N₄_AC was also much lower than pure Ti and Si₃N₄. In addition, micro-CT evaluation of peri-implant bone formation under the condition of periprosthetic osteomyelitis after 30 days post-surgery confirmed the osteogenic ability of Si₃N₄_AC. Taken together, Si₃N₄_AC can be an effective orthopedic biomaterial to eradicate periprosthetic infection and enhance bone regeneration.

Characterization of Titanium Surface Modification Strategies for Osseointegration Enhancement

As biocompatible metallic materials, titanium and its alloys have been widely used in the orthopedic field due to their superior strength, low density, and ease of processing. However, further improvement in biological response is still required for rapid osseointegration. Here, various Ti surface-treatment technologies were applied: hydroxyapatite blasting, sand blasting and acid etching, anodic oxidation, and micro-arc oxidation. The surface characteristics of specimens subjected to these techniques were analyzed in terms of structure, elemental composition, and wettability. The adhesion strength of the coating layer was also assessed for the coated specimens. Biocompatibility was compared via tests of in vitro attachment and proliferation of pre-osteoblast cells.

Effects of surface sub-micrometer topography following oxalic acid treatment on bone quantity and quality around dental implants in rabbit tibiae

Background

To explore the effects of topographical modification of titanium substrates at submicron level by oxalic acid treatment on bone quality and quantity around dental implants in rabbit tibiae.

Methods

A total of 60 blasted CP-grade IV titanium dental implants were used. Twenty-eight control implant surfaces were treated with a mixture of HCl/H₂SO₄, whereas 28 other test implant surfaces were treated with oxalic acid following HCl/H₂SO₄ treatment. Two randomly selected sets of control or test implants were placed in randomly selected proximal tibiae of 14 female Japanese white rabbits. Euthanasia was performed 4 and 8 weeks post-implant placement. Bone to implant contact (BIC), bone area fraction (BAF), ratios of mature and immature bone to total bone, and the amount and types of collagen fibers were evaluated quantitatively. Two control and two test implants were used to analyze surface characteristics.

Results

Treatment by oxalic acid significantly decreased Sa and increased Ra of test implant surfaces. BIC in test implants was increased without alteration of BAF and collagen contents at 4 and 8 weeks after implant placement when compared with control implants. The ratios of immature and mature bone to total bone differed significantly between groups at 4 weeks post-implantation. Treatment by oxalic acid increased type I collagen and decreased type III collagen in bone matrices around test implants when compared with control implants at 8 weeks after implant placement. The effects of topographical changes of implant surfaces induced by oxalic acid on BAF, mature bone, collagen contents, and type I collagen were significantly promoted with decreased immature bone formation and type III collagen in the later 4 weeks post-implantation.

Conclusions

Treatment of implant surfaces with oxalic acid rapidly increases osseointegration from the early stages after implantation. Moreover, submicron topographical changes of dental implants induced by oxalic acid improve bone quality based on bone maturation and increased production of type I collagen surrounding dental implants in the late stage after implant placement.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40729-020-00275-x.

Influence of Three Dental Implant Surfaces on Cell Viability and Bone Behavior. An In Vitro and a Histometric Study in a Rabbit Model

The chemical composition and the surface characteristics of dental implants are factors that have a decisive effect on the osseointegration process. The surface characterization at the compositional and topographic level of three dental implants available in the market was performed with different surface treatments: (1) sandblasted and acid etched surface (SLA), (2) hydroxyapatite (HA) and tricalcium phosphate (TCP) blasted surface (HA/TCP), and (3) HA-blasted and non-etching acid washed surface (HA + AW). In addition, an in vitro viability study of MG-63 osteoblast cells was performed with a JC-1 test. To complete the study, an in vivo study was conducted in New Zealand rabbits. The study analyzed the histometric characteristics of the bone formed around the implants at the level of area, volume, bone density, accumulated bone density, and bone–implant contact (BIC). The rabbits were sacrificed at 6 weeks after implants were placed in the tibial metaphysis. No statistically significant differences were observed at the level of cell viability or histometric parameters between the different study groups (p > 0.05). SLA and HA/TCP surfaces were the ones that obtained a higher BIC value. Taking into account the limitations of this study, it can be concluded that the different implant surfaces analyzed favor a good bone response.

Preparation of Nanoscale Semi-IPNs with an Interconnected Microporous Structure via Cationic Polymerization of Bio-Based Tung Oil in a Homogeneous Solution of Poly(ε-caprolactone)

Nanoscale semi-interpenetrating polymer networks of bio-based poly(ε-caprolactone) (PCL) and polymerized tung oil have been prepared via in situ cationic polymerization and compatibilization in a homogeneous solution. This novel blending technique produced a nanoscale morphology of poly(ε-caprolactone) with average particle sizes as small as 100 nm dispersed in a cross-linked tung oil matrix for 20 and 30 wt % PCL blend compositions. In addition, the exothermic cationic polymerization of tung oil in the presence of the PCL homogeneous solution created a microporous morphology with open three-dimensional interconnected cluster structures. The porous morphology was found to be composition-dependent (the pore size and interconnectivity decreased with increasing PCL content in the blend). The values of the cross-link density and storage modulus in the glassy state for fully cured samples increased significantly and reached a maximum for the 20 wt % PCL blend. This simple, versatile, low-cost strategy for preparing nanoscale and interconnected three-dimensional cluster structures with a microporous morphology and desired properties should be widely applicable for new polymer systems.

Influence of the Titanium Implant Surface Treatment on the Surface Roughness and Chemical Composition

The implant surface features affect the osseointegration process. Different surface treatment methods have been applied to improve the surface topography and properties. Trace of different elements may appear on the implant surface, which can modify surface properties and may affect the body’s response. The aim was to evaluate the roughness based on the surface treatment received and the amount and type of trace elements found. Ninety implants (nine different surface treatment) were evaluated. Roughness parameters were measured using white-light-interferometry (WLI). The arithmetical mean for R_a, R_q, R_t, and R_z of each implant system was calculated, and Fisher’s exact test was applied, obtaining R_a values between 0.79 and 2.89 µm. Surface chemical composition was evaluated using X-ray photoelectron spectroscopy (XPS) at two times: as received by the manufacturer (AR) and after sputter-cleaning (SC). Traces of several elements were found in all groups, decreasing in favor of the Ti concentration after the sputter-cleaning. Within the limitations of this study, we can conclude that the surface treatment influences the roughness and the average percentage of the trace elements on the implant surface. The cleaning process at the implant surface should be improved by the manufacturer before assembling the implant.

Evaluation of the Peri-Implant Bone Level around Platform-Switched Dental Implants: A Retrospective 3-Year Radiographic Study

OBJECTIVE

To describe remodeling of the mesial and distal marginal bone level around platform-switched (PS) and platform-matched (PM) dental implants that were sandblasted with large grit and etched with acid over a three-year period.

MATERIALS AND METHODS

Digital periapical radiographs were obtained at the following time-points: during Stage I of the surgical placement of dental implants, before loading, immediately after loading (baseline), and one, three, six, 12, and 36 months after loading for measuring the horizontal and vertical marginal bone levels.

RESULTS

Sixty implants were successfully osseointegrated during the overall observation period. Vertical marginal bone levels for the PS and PM dental implants were 0.78 ± 0.77 and 0.98 ± 0.81 mm, respectively, whereas the horizontal marginal bone levels for the PS and PM implants were 0.84 ± 0.45 and 0.98 ± 0.68 mm, respectively. During the time leading up to the procedure until 36 months after the procedure, the average vertical marginal bone level resulted in less bone loss for the PS and PM groups-0.96 ± 1.28 and 0.30 ± 1.15 mm, respectively (p < 0.05). The mean levels of the horizontal marginal bone also showed increases of 0.48 ± 1.01 mm in the PS and 0.37 ± 0.77 mm in the PM groups from the time before loading until 36 months after the procedure. However, these increases were not statistically significant (p > 0.05).

CONCLUSION

PS dental implants appeared to be more effective than PM implants for minimizing the mean marginal vertical and horizontal marginal bone loss during the three-year period. Regardless of which abutment connection was used, the dental implant in the present retrospective investigation exhibited minimal marginal bone remodeling, thus indicating long-term stability.

Comparison between Sandblasted Acid-Etched and Oxidized Titanium Dental Implants: In Vivo Study

The surface modifications of titanium dental implants play important roles in the enhancement of osseointegration. The objective of the present study was to test two different implant surface treatments on a rabbit model to investigate the osseointegration. The tested surfaces were: a) acid-etched surface with sandblasting treatment (SA) and b) an oxidized implant surface (OS). The roughness was measured by an interferometeric microscope with white light and the residual stress of the surfaces was measured with X-ray residual stress Bragg–Bentano diffraction. Six New Zealand white rabbits were used for the in vivo study. Implants with the two different surfaces (SA and OS) were inserted in the femoral bone. After 12 weeks of implantation, histological and histomorphometric analyses of the blocks containing the implants and the surrounding bone were performed. All the implants were correctly implanted and no signs of infection were observed. SA and OS surfaces were both surrounded by newly formed trabeculae. Histomorphometric analysis revealed that the bone–implant contact % (BIC) was higher around the SA implants (53.49 ± 8.46) than around the OS implants (50.94 ± 16.42), although there were no significant statistical differences among them. Both implant surfaces (SA and OS) demonstrated a good bone response with significant amounts of newly formed bone along the implant surface after 12 weeks of implantation. These results confirmed the importance of the topography and physico–chemical properties of dental implants in the osseointegration.

Superficial Characteristics of Titanium after Treatment of Chorreated Surface, Passive Acid, and Decontamination with Argon Plasma

(1) Background. Titanium is characterized by its biocompatibility, resistance to maximum stress, and fatigue and non-toxicity. The composition, surface structure, and roughness of titanium have a key and direct influence on the osseointegration processes when it is used in the form of dental implants. The objective of the present study is to characterize, at chemical, superficial, and biological levels, the result of the application of the sandblasted with large-grit and acid-etched (SLA) treatment consisting of coarse-grained and double-passivated acid blasting with subsequent decontamination with argon plasma on the surface of titanium implants type IV. (2) Methods. Four Oxtein^® dental implants (Zaragoza, Spain) were investigated with the following coding: Code L63713T (titanium grade IV, 3.75 mm in diameter, and 13 mm in length). The surface of the implants was SLA type obtained from coarse-grained, double passivated acid, and decontaminated with argon plasma. The samples were in their sealed packages and were opened in our laboratory. The X-ray photoelectron spectroscopy (XPS) technique was used to characterize the chemical composition of the surface, and the scanning electronic microscope (SEM) technique was used to perform topographic surface evaluation. Cell cultures were also performed on both surfaces. (3) Results. The superficial chemical analysis of the studied samples presented the following components, approximately, expressed in atomic percentage: O: 39%; Ti: 18%; C: 39%; N: 2%; and Si: 1%. In the same way, the topographic analysis values were obtained in the evaluated roughness parameters: R_a: 1.5 μm ± 0.02%; R_q: 1.31 μm ± 0.33; R_z: 8.98 μm ± 0.73; R_p: 5.12 μm ± 0.48; R_v: 3.76 μm ± 0.51; and R_c: 4.92 μm ± 0.24. At a biological level, the expression of osteocalcin was higher (p < 0.05) on the micro-rough surface compared to that machined at 48 and 96 h of culture. (4) Conclusions. The data obtained in our study indicate that the total carbon content, the relative concentration of titanium, and the roughness of the treatment performed on the implants are in agreement with those found in the literature. Further, the roughness of the treatment performed on the implants throws a spongy, three-dimensional surface suitable for bone growth on it. The biological results found are compatible with the clinical use of the surface tested.

Osteogenic Nanofibrous Coated Titanium Implant Results in Enhanced Osseointegration: In Vivo Preliminary Study in a Rabbit Model

A titanium implant surface when coated with biodegradable, highly porous, osteogenic nanofibrous coating has shown enhanced intrinsic osteoinductive and osteoconductive properties. This coating mimics extracellular matrix resulting in differentiation of stem cells present in the peri-implant niche to osteoblast and hence results in enhanced osseointegration of the implant. The osteogenic nanofibrous coating (ONFC) consists of poly-caprolactone, gelatin, nano-sized hydroxyapatite, dexamethasone, ascorbic acid and beta-glycerophosphate. ONFC exhibits optimum mechanical properties to support mesenchymal stem cells and steer their osteogenic differentiation. ONFC was subjected to various characterization tests like scanning electron microscopy, Fourier-transform infrared spectroscopy, x-ray diffractometry, thermal degradation, biomineralization, mechanical properties, wettability and proliferation assay. In pre-clinical animal trials, the coated implant showed enhanced new bone formation when placed in the tibia of rabbit. This novel approach toward implant bone integration holds significant promise for its easy and economical coating thus marking the beginning of new era of electrospun osteogenic nanofibrous coated bone implants.

Dental Implant Surrounding Marginal Bone Level Evaluation: Platform Switching versus Platform Matching-One-Year Retrospective Study

The benefits and feasibility of platform switching have been discussed in several studies, reporting lesser crestal bone loss in platform-switched implants than in platform-matched implants. Objective. The aim of the present study was to observe the changes in vertical and horizontal marginal bone levels in platform-switched and platform-matched dental implants. Materials and Methods. 51 patients received 60 dental implants in the present study over a 1-year period. Measurement was performed between the implant shoulder and the most apical and horizontal marginal defect by periapical radiographs to examine the changes of peri-implant alveolar bone before and 12 months after prosthodontic restoration delivery. Results. These marginal bone measurements showed a bone gain of 0.23 ± 0.58 mm in the vertical gap and 0.22 ± 0.53 mm in the horizontal gap of platform matching, while in platform switching a bone gain of 0.93 ± 1 mm (P < 0.05) in the vertical gap and 0.50 ± 0.56 mm in the horizontal gap was found. The average vertical gap reduction from the baseline until 12 months was 0.92 ± 1.11 mm in platform switching and 0.29 ± 0.85 mm in platform matching (P < 0.05). Conclusions. Within the limitations of the present study, platform switching seemed to be more effective for a better peri-implant alveolar bone vertical and horizontal gap reduction at 1 year.

Osteo Growth Induction titanium surface treatment reduces ROS production of mesenchymal stem cells increasing their osteogenic commitment

Surface characteristics play a special role for the biological performance of implants and several strategies are available to this end. The OGI (Osteo Growth Induction) titanium surface is a surface, obtained by applying a strong acid onto the blasted surface. The aim of this in-vitro study is to evaluate in vitro the osteoproperties of OGI surfaces on Mesenchymal Stem cells derived from dental pulp. Our results confirm that this treatment exert a positive effect on mitochondrial homeostasis, as shown by a decrease in ROS production related to environmental stress on the mitochondria. Morphological and molecular biology analyses confirmed more over that the DPSC cultured on the OGI surfaces appeared more spread in comparison to those grown on control titanium surface and real time PCR and biochemical data clearly demonstrated the increase of osteoconductive properties of the OGI treatment. In conclusion, our results suggest that mesenchymal stem cells sensitively respond to surface properties related to OGI treatment enhancing their osteogenic activities.

Enhancement of osseointegration by direct coating of rhBMP-2 on target-ion induced plasma sputtering treated SLA surface for dental application

Owing to the excellent bioactive properties of recombinant human bone morphogenetic proteins (rhBMPs), dentistry considers them as a fascinating adjuvant alternative for enhancing bone regeneration and bone-to-implant junction in the early implantation stages. However, stable loading and delivery efficiency of rhBMPs on the implant surfaces involve major concerns because of the harsh wearing condition under load during implantation. In this study, to achieve successful rhBMP-2 delivery, a nanoporous surface structure is introduced on the sandblasting with large grit and acid-etching (SLA)-treated titanium (Ti) surface via the tantalum (Ta) target-ion induced plasma sputtering (TIPS) technique. Unlike oxidation-induced surface nanoporous fabrications on a Ti surface, TIPS-treated surfaces provide excellent structural unity of the nanoporous structure with the substrate due to their etching-based fabrication mechanism. SLA/TIPS-treated Ti exhibits distinct nanoporous structures on the microscale surface geometry and better hydrophilicity compared with SLA-treated Ti. A sufficiently empty nanoporous surface structure combined with the hydrophilic property of SLA/TIPS-treated Ti facilitates the formation of a thick and uniform coating layer of rhBMP-2 on the surface without any macro- and microcoagulation. Compared with the SLA-treated Ti surface, the amount of coated rhBMP-2 increases up to 63% on the SLA/TIPS-treated Ti surface. As a result, the in vitro pre-osteoblast cell response of the SLA/TIPS-treated Ti surface, especially cell adhesion and differentiation behaviors, improves remarkably. A bone-regenerating direct comparison between the rhBMP-2-coated SLA-treated and SLA/TIPS-treated Ti is conducted on a defective dog mandible model. After 8 weeks of implantation surgery, SLA/TIPS-treated Ti with rhBMP-2 exhibits a better degree of contact area for the implanted bone, which mineralizes new bones around the implant. Quantitative results of bone-in-contact ratio and new bone volume also show significantly higher values for the SLA/TIPS-treated Ti with the rhBMP-2 specimen. These results confirm that an SLA/TIPS-treated surface is a suitable rhBMP-2 carrier for a dental implant to achieve early and strong osseointegration of Ti dental implants.

Adhesion of Porphyromonas gingivalis and Tannerella forsythia to dentin and titanium with sandblasted and acid etched surface coated with serum and serum proteins - An in vitro study

OBJECTIVE

To evaluate the adhesion of selected bacterial strains incl. expression of important virulence factors at dentin and titanium SLA surfaces coated with layers of serum proteins.

METHODS

Dentin- and moderately rough SLA titanium-discs were coated overnight with human serum, or IgG, or human serum albumin (HSA). Thereafter, Porphyromonas gingivalis, Tannerella forsythia, or a six-species mixture were added for 4h and 24h. The number of adhered bacteria (colony forming units; CFU) was determined. Arg-gingipain activity of P. gingivalis and mRNA expressions of P. gingivalis and T. forsythia proteases and T. forsythia protease inhibitor were measured.

RESULTS

Coating specimens never resulted in differences exceeding 1.1 log10 CFU, comparing to controls, irrespective the substrate. Counts of T. forsythia were statistically significantly higher at titanium than dentin, the difference was up to 3.7 log10 CFU after 24h (p=0.002). No statistically significant variation regarding adhesion of the mixed culture was detected between surfaces or among coatings. Arg-gingipain activity of P. gingivalis was associated with log10 CFU but not with the surface or the coating. Titanium negatively influenced mRNA expression of T. forsythia protease inhibitor at 24h (p=0.026 uncoated, p=0.009 with serum).

CONCLUSIONS

The present findings indicate that: a) single bacterial species (T. forsythia) can adhere more readily to titanium SLA than to dentin, b) low expression of T. forsythia protease inhibitor may influence the virulence of the species on titanium SLA surfaces in comparison with teeth, and c) surface properties (e.g. material and/or protein layers) do not appear to significantly influence multi-species adhesion.

Comparison of Removal Torques for Implants With Hydroxyapatite-Blasted and Sandblasted and Acid-Etched Surfaces

PURPOSE

Sandblasted and acid-etched (SLA) implants are widely known and used by many practitioners. A resorbable blasting media (RBM) surface is produced by blasting with bioceramic particles. We studied the correlation between the particle sizes of the media and the biomechanical force, evaluating the removal torque of hydroxyapatite-blasted implants.

MATERIALS AND METHODS

Commercial SLA implants comprised the control group, and RBM surface-treated implants of the same size and design comprised the experimental group. These implants were installed on both sides of rabbits' tibiae. Four weeks after the implants were installed, the implant removal torque was measured using a digital torque device. The roughness of the implant surface was analyzed using field-emission scanning electron microscopy and confocal laser scanning microscopy.

RESULTS

Both groups of surface textures exhibited a regular porosity. The 2 groups exhibited different surface roughness. No significant differences in removal torques were observed between the control and experimental groups.

CONCLUSION

There were no significant differences in our measures of osseointegration between hydroxyapatite-blasted and SLA implants.

Application of chemical mechanical polishing process on titanium based implants

Modification of the implantable biomaterial surfaces is known to improve the biocompatibility of metallic implants. Particularly, treatments such as etching, sand-blasting or laser treatment are commonly studied to understand the impact of nano/micro roughness on cell attachment. Although, the currently utilized surface modification techniques are known to improve the amount of cell attachment, it is critical to control the level of attachment due to the fact that promotion of bioactivity is needed for prosthetic implants while the cardiac valves, which are also made of titanium, need demotion of cells attachment to be able to function. In this study, a new alternative is proposed to treat the implantable titanium surfaces by chemical mechanical polishing (CMP) technique. It is demonstrated that the application of CMP on the titanium surface helps in modifying the surface roughness of the implant in a controlled manner (inducing nano-scale smoothness or controlled nano/micro roughness). Simultaneously, it is observed that the application of CMP limits the bacteria growth by forming a protective thin surface oxide layer on titanium implants. It is further shown that there is an optimal level of surface roughness where the cell attachment reaches a maximum and the level of roughness is controllable through CMP.

Relevant aspects in the surface properties in titanium dental implants for the cellular viability

Roughness and topographical features are the most relevant of the surface properties for a dental implant for its osseointegration. For that reason, we studied the four surfaces more used in titanium dental implants: machined, sandblasted, acid etching and sandblasted plus acid etching. The roughness and wettability (contact angle and surface free energy) was studied by means 3D-interferometric microscope and sessile drop method. Normal human gingival fibroblasts (HGF) were obtained from small oral mucosa biopsies and were used for cell cultures. To analyze cell integrity, we first quantified the total amount of DNA and LDH released from dead cells to the culture medium. Then, LIVE/DEAD assay was used as a combined method assessing cell integrity and metabolism. All experiments were carried out on each cell type cultured on each Ti material for 24h, 48h and 72h. To evaluate the in vivo cell adhesion capability of each Ti surface, the four types of discs were grafted subcutaneously in 5 Wistar rats. Sandblasted surfaces were significantly rougher than acid etching and machined. Wettability and surface free energy decrease when the roughness increases in sand blasted samples. This fact favors the protein adsorption. The DNA released by cells cultured on the four Ti surfaces did not differ from that of positive control cells (p>0.05). The number of cells per area was significantly lower (p<0.05) in the sand-blasted surface than in the machined and surface for both cell types (7±2 cells for HGF and 10±5 cells for SAOS-2). The surface of the machined-type discs grafted in vivo had a very small area occupied by cells and/or connective tissue (3.5%), whereas 36.6% of the sandblasted plus acid etching surface, 75.9% of sandblasted discs and 59.6% of acid etching discs was covered with cells and connective tissue. Cells cultured on rougher surfaces tended to exhibit attributes of more differentiated osteoblasts than cells cultured on smoother surfaces. These surface properties justify that the sandblasted implants is able to significantly increase bone contact and bone growth with very good osseointegration results in vivo.

The effects of hierarchical micro/nanosurfaces decorated with TiO2 nanotubes on the bioactivity of titanium implants in vitro and in vivo

In the present work, a hierarchical hybrid micro/nanostructured titanium surface was obtained by sandblasting with large grit and acid etching (SLA), and nanotubes of different diameters (30 nm, 50 nm, and 80 nm) were superimposed by anodization. The effect of each SLA-treated surface decorated with nanotubes (SLA + 30 nm, SLA + 50 nm, and SLA + 80 nm) on osteogenesis was studied in vitro and in vivo. The human MG63 osteosarcoma cell line was used for cytocompatibility evaluation, which showed that cell adhesion and proliferation were dramatically enhanced on SLA + 30 nm. In comparison with cells grown on the other tested surfaces, those grown on SLA + 80 nm showed an enhanced expression of osteogenesis-related genes. Cell spread was also enhanced on SLA + 80 nm. A canine model was used for in vivo evaluation of bone bonding. Histological examination demonstrated that new bone was formed more rapidly on SLA-treated surfaces with nanotubes (especially SLA + 80 nm) than on those without nanotubes. All of these results indicate that SLA + 80 nm is favorable for promoting the activity of osteoblasts and early bone bonding.

Surface Modifications and Their Effects on Titanium Dental Implants

This review covers several basic methodologies of surface treatment and their effects on titanium (Ti) implants. The importance of each treatment and its effects will be discussed in detail in order to compare their effectiveness in promoting osseointegration. Published literature for the last 18 years was selected with the use of keywords like titanium dental implant, surface roughness, coating, and osseointegration. Significant surface roughness played an important role in providing effective surface for bone implant contact, cell proliferation, and removal torque, despite having good mechanical properties. Overall, published studies indicated that an acid etched surface-modified and a coating application on commercial pure titanium implant was most preferable in producing the good surface roughness. Thus, a combination of a good surface roughness and mechanical properties of titanium could lead to successful dental implants.

Evaluation of the Surface Characteristics of Various Implant Abutment Materials Using Confocal Microscopy and White Light Interferometry

PURPOSE

The purpose of this study was to evaluate the surface characteristics of various implant abutment materials, such as of titanium alloy (Ti6Al4V; Ma), machined cobalt-chrome-molybdenum alloy (CCM), titanium nitride coating on a titanium alloy disc (TiN), anodic oxidized titanium alloy disc (AO), composite resin coating on a titanium alloy disc (Res), and zirconia disc (Zr), using confocal microscopy and white light interferometry. Measurements from the 2 methods were evaluated to see if these methods would give equivalent results. The precision of measurements were evaluated by the coefficient of variation.

MATERIALS AND METHODS

Five discs each of Ma, CCM, TiN, AO, Res, and Zr were used. The surface roughness was evaluated by confocal laser microscopy and white light interferometry.

RESULTS

Confocal microscopy showed that the Res group showed significantly greater Ra, Rq, Rz, Sa, Sq, and Sz values compared with those of the Ma group (P < 0.05). The white light interferometry results showed that the Res group had significantly higher Ra, Rq, Rz, Rt, Sa, Sq, Sz, and Sdr values compared with the Ma group (P < 0.05). All the roughness parameters obtained from the 2 methods differed, and the Sa values of the Zr group from confocal microscopy were greater by 0.163 μm than those obtained by white light interferometry. Least difference was seen in the TiN group where the difference was 0.058 μm.

CONCLUSION

Roughness parameters of different abutment materials varied significantly. Precision of measurement differed according to the characteristics of the material used. White light interferometry could be recommended for measurement of TiN and AO. Confocal microscopy gave more precise measurements for Ma and CCM groups. The optical characteristics of the surface should be considered before choosing the examination method.

Instrumentation With Ultrasonic Scalers Facilitates Cleaning of the Sandblasted and Acid-Etched Titanium Implants

Mechanical instrumentation is widely used to debride dental implants, but this may alter the surface properties of titanium, which in turn may influence bacterial adhesion and make it more difficult to remove the biofilm. This in vitro study was performed (1) to assess the amount of biofilm formation on a sand-blasted and acid-etched titanium fixture treated with ultrasonic scalers with metal, plastic, and carbon tips and (2) to evaluate how this treatment of titanium surfaces affects implant cleaning by brushing with dentifrice. The titanium fixtures were treated with various ultrasonic scaler tips, and surface roughness parameters were measured by confocal microscopy. Biofilm was formed on the treated fixtures by using pooled saliva from 10 subjects, and the quantity of the adherent bacteria was compared with crystal violet assay. The fixture surfaces with biofilm were brushed for total of 30 seconds with a toothbrush with dentifrice. The bacteria remaining on the brushed fixture surfaces were quantified by scanning electron microscopy. Surface changes were evident, and the changes of the surfaces were more discernible when metal tips were used. A statistically significant decrease in roughness value (arithmetic mean height of the surface) was seen in the 2 metal-tip groups and the single plastic-tip group. After brushing with dentifrice, the treated surfaces in all the treatment groups showed significantly fewer bacteria compared with the untreated surfaces in the control group, and the parts of the surfaces left untreated in the test groups. Within the limits of this study, treatment of titanium fixture surfaces with ultrasonic metal, plastic, or carbon tips significantly enhanced the bacterial removal efficacy of brushing. Thorough instrumentation that smooths the whole exposed surface may facilitate maintenance of the implants.

Titania nanostructures: a biomedical perspective

A systematic and comprehensive summary of various TNS-based biomedical research with a special emphasis on drug-delivery, tissue engineering, biosensor, and anti-bacterial applications.