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Matsuura T, Komatsu K, Cheng J, Park G, Ogawa T. Beyond microroughness: novel approaches to navigate osteoblast activity on implant surfaces. Int J Implant Dent 2024; 10:35. [PMID: 38967690 PMCID: PMC11226592 DOI: 10.1186/s40729-024-00554-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/15/2024] [Indexed: 07/06/2024] Open
Abstract
Considering the biological activity of osteoblasts is crucial when devising new approaches to enhance the osseointegration of implant surfaces, as their behavior profoundly influences clinical outcomes. An established inverse correlation exists between osteoblast proliferation and their functional differentiation, which constrains the rapid generation of a significant amount of bone. Examining the surface morphology of implants reveals that roughened titanium surfaces facilitate rapid but thin bone formation, whereas smooth, machined surfaces promote greater volumes of bone formation albeit at a slower pace. Consequently, osteoblasts differentiate faster on roughened surfaces but at the expense of proliferation speed. Moreover, the attachment and initial spreading behavior of osteoblasts are notably compromised on microrough surfaces. This review delves into our current understanding and recent advances in nanonodular texturing, meso-scale texturing, and UV photofunctionalization as potential strategies to address the "biological dilemma" of osteoblast kinetics, aiming to improve the quality and quantity of osseointegration. We discuss how these topographical and physicochemical strategies effectively mitigate and even overcome the dichotomy of osteoblast behavior and the biological challenges posed by microrough surfaces. Indeed, surfaces modified with these strategies exhibit enhanced recruitment, attachment, spread, and proliferation of osteoblasts compared to smooth surfaces, while maintaining or amplifying the inherent advantage of cell differentiation. These technology platforms suggest promising avenues for the development of future implants.
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Affiliation(s)
- Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - James Cheng
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
| | - Gunwoo Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA.
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA.
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Komatsu K, Matsuura T, Cheng J, Kido D, Park W, Ogawa T. Nanofeatured surfaces in dental implants: contemporary insights and impending challenges. Int J Implant Dent 2024; 10:34. [PMID: 38963524 PMCID: PMC11224214 DOI: 10.1186/s40729-024-00550-1] [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: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Dental implant therapy, established as standard-of-care nearly three decades ago with the advent of microrough titanium surfaces, revolutionized clinical outcomes through enhanced osseointegration. However, despite this pivotal advancement, challenges persist, including prolonged healing times, restricted clinical indications, plateauing success rates, and a notable incidence of peri-implantitis. This review explores the biological merits and constraints of microrough surfaces and evaluates the current landscape of nanofeatured dental implant surfaces, aiming to illuminate strategies for addressing existing impediments in implant therapy. Currently available nanofeatured dental implants incorporated nano-structures onto their predecessor microrough surfaces. While nanofeature integration into microrough surfaces demonstrates potential for enhancing early-stage osseointegration, it falls short of surpassing its predecessors in terms of osseointegration capacity. This discrepancy may be attributed, in part, to the inherent "dichotomy kinetics" of osteoblasts, wherein increased surface roughness by nanofeatures enhances osteoblast differentiation but concomitantly impedes cell attachment and proliferation. We also showcase a controllable, hybrid micro-nano titanium model surface and contrast it with commercially-available nanofeatured surfaces. Unlike the commercial nanofeatured surfaces, the controllable micro-nano hybrid surface exhibits superior potential for enhancing both cell differentiation and proliferation. Hence, present nanofeatured dental implants represent an evolutionary step from conventional microrough implants, yet they presently lack transformative capacity to surmount existing limitations. Further research and development endeavors are imperative to devise optimized surfaces rooted in fundamental science, thereby propelling technological progress in the field.
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Affiliation(s)
- Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - James Cheng
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, USA
| | - Daisuke Kido
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Wonhee Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
- Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA.
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA.
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA.
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Park G, Matsuura T, Komatsu K, Ogawa T. Optimizing implant osseointegration, soft tissue responses, and bacterial inhibition: A comprehensive narrative review on the multifaceted approach of the UV photofunctionalization of titanium. J Prosthodont Res 2024:JPR_D_24_00086. [PMID: 38853001 DOI: 10.2186/jpr.jpr_d_24_00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Titanium implants have revolutionized restorative and reconstructive therapy, yet achieving optimal osseointegration and ensuring long-term implant success remain persistent challenges. In this review, we explore a cutting-edge approach to enhancing implant properties: ultraviolet (UV) photofunctionalization. By harnessing UV energy, photofunctionalization rejuvenates aging implants, leveraging and often surpassing the intrinsic potential of titanium materials. The primary aim of this narrative review is to offer an updated perspective on the advancements made in the field, providing a comprehensive overview of recent findings and exploring the relationship between UV-induced physicochemical alterations and cellular responses. There is now compelling evidence of significant transformations in titanium surface chemistry induced by photofunctionalization, transitioning from hydrocarbon-rich to carbon pellicle-free surfaces, generating superhydrophilic surfaces, and modulating the electrostatic properties. These changes are closely associated with improved cellular attachment, spreading, proliferation, differentiation, and, ultimately, osseointegration. Additionally, we discuss clinical studies demonstrating the efficacy of UV photofunctionalization in accelerating and enhancing the osseointegration of dental implants. Furthermore, we delve into recent advancements, including the development of one-minute vacuum UV (VUV) photofunctionalization, which addresses the limitations of conventional UV methods as well as the newly discovered functions of photofunctionalization in modulating soft tissue and bacterial interfaces. By elucidating the intricate relationship between surface science and biology, this body of research lays the groundwork for innovative strategies aimed at enhancing the clinical performance of titanium implants, marking a new era in implantology.
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Affiliation(s)
- Gunwoo Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
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Komatsu K, Matsuura T, Suzumura T, Ogawa T. Genome-wide transcriptional responses of osteoblasts to different titanium surface topographies. Mater Today Bio 2023; 23:100852. [PMID: 38024842 PMCID: PMC10663851 DOI: 10.1016/j.mtbio.2023.100852] [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: 05/25/2023] [Revised: 10/21/2023] [Accepted: 10/29/2023] [Indexed: 12/01/2023] Open
Abstract
This is the first genome-wide transcriptional profiling study using RNA-sequencing to investigate osteoblast responses to different titanium surface topographies, specifically between machined, smooth and acid-etched, microrough surfaces. Rat femoral osteoblasts were cultured on machine-smooth and acid-etched microrough titanium disks. The culture system was validated through a series of assays confirming reduced osteoblast attachment, slower proliferation, and faster differentiation on microrough surfaces. RNA-sequencing analysis of osteoblasts at an early stage of culture revealed that gene expression was highly correlated (r = 0.975) between the two topographies, but 1.38 % genes were upregulated and 0.37 % were downregulated on microrough surfaces. Upregulated transcripts were enriched for immune system, plasma membrane, response to external stimulus, and positive regulation to stimulus processes. Structural mapping confirmed microrough surface-promoted gene sharing and networking in signaling pathways and immune system/responses. Target-specific pathway analysis revealed that Rho family G-protein signaling pathways and actin genes, responsible for the formation of stress fibers, cytoplasmic projections, and focal adhesion, were upregulated on microrough surfaces without upregulation of core genes triggered by cell-to-cell interactions. Furthermore, disulfide-linked or -targeted extracellular matrix (ECM) or membranous glycoproteins such as laminin, fibronectin, CD36, and thrombospondin were highly expressed on microrough surfaces. Finally, proliferating cell nuclear antigen (PCNA) and cyclin D1, whose co-expression reduces cell proliferation, were upregulated on microrough surfaces. Thus, osteoblasts on microrough surfaces were characterized by upregulation of genes related to a wide range of functions associated with the immune system, stress/stimulus responses, proliferation control, skeletal and cytoplasmic signaling, ECM-integrin receptor interactions, and ECM-membranous glycoprotein interactions, furthering our knowledge of the surface-dependent expression of osteoblastic biomarkers on titanium.
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Affiliation(s)
- Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA, 90095, USA
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, 113-8549, Japan
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA, 90095, USA
| | - Toshikatsu Suzumura
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA, 90095, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA, 90095, USA
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Kitajima H, Hirota M, Osawa K, Iwai T, Saruta J, Mitsudo K, Ogawa T. Optimization of blood and protein flow around superhydrophilic implant surfaces by promoting contact hemodynamics. J Prosthodont Res 2023; 67:568-582. [PMID: 36543189 DOI: 10.2186/jpr.jpr_d_22_00225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
PURPOSE We examined blood and protein dynamics potentially influenced by implant threads and hydrophilic/hydrophobic states of implant surfaces. METHODS A computational fluid dynamics model was created for a screw-shaped implant with a water contact angle of 70° (hydrophobic surface) and 0° (superhydrophilic surface). Movements and density of blood and fibrinogen as a representative wound healing protein were visualized and quantified during constant blood inflow. RESULTS Blood plasma did not occupy 40-50% of the implant interface or the inside of threads around hydrophobic implants, whereas such blood voids were nearly completely eliminated around superhydrophilic implants. Whole blood field vectors were disorganized and random within hydrophobic threads but formed vortex nodes surrounded by stable blood streams along the superhydrophilic implant surface. The averaged vector within threads was away from the implant surface for the hydrophobic implant and towards the implant surface for the superhydrophilic implant. Rapid and massive whole blood influx into the thread zone was only seen for the superhydrophilic implant, whereas a line of conflicting vectors formed at the entrance of the thread area of the hydrophobic implant to prevent blood influx. The fibrinogen density was up to 20-times greater at the superhydrophilic implant interface than the hydrophobic one. Fibrinogen density was higher at the interface than outside the threads only for the superhydrophilic implant. CONCLUSIONS Implant threads and surface hydrophilicity have profound effects on vector and distribution of blood and proteins. Critically, implant threads formed significant biological voids at the interface that were negated by superhydrophilicity-induced contact hemodynamics.
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Affiliation(s)
- Hiroaki Kitajima
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Makoto Hirota
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, Yokohama, Japan
| | - Kohei Osawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Juri Saruta
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
- Department of Education Planning, School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
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Kemuriyama S, Aita H, Maida T, Kawamura N, Nezu T, Iijima M, Endo K, Koshino H. Effect of photofunctionalization on titanium bone-implant integration in ovariectomized rats. Dent Mater J 2023; 42:11-18. [PMID: 36123044 DOI: 10.4012/dmj.2022-081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Osteoporosis is considered a risk factor for osseointegration during implant treatment. Photofunctionalization of titanium has been shown to improve bone-based cell adhesion, proliferation, and functional expression, increasing the bone-implant contact rate and bone-implant integration strength. This study aimed to test the hypothesis that photofunctionalization is effective for implant fixation using an osteoporosis rat model. In the biomechanical push-in test, the bone-implant integration strength of the photofunctionalization treatment group was 1.53 times that of the control group (p<0.05). These values implied that photofunctionalization restored the ovariectomy-induced low bone-implant integration strength to normal states. In the micro-CT analysis, the BV/TV of the photofunctionalization treatment group was 1.32 times that of the control group (p<0.05). These values implied that photofunctionalization restored the ovariectomy-induced low peri-implant bone formation to normal states. These results indicate that photofunctionalization treatment increased peri-implant bone formation and bone-implant integration strength in ovariectomized rats.
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Affiliation(s)
- Shuhei Kemuriyama
- Division of Geriatric Dentistry, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido
| | - Hideki Aita
- Division of Geriatric Dentistry, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido
| | - Takeo Maida
- Division of Advanced Prosthodontics, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
| | | | - Takashi Nezu
- Division of Biomaterials and Bioengineering, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
| | - Masahiro Iijima
- Division of Orthodontics and Dentofacial Orthopedics, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido
| | - Kazuhiko Endo
- Division of Biomaterials and Bioengineering, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
| | - Hisashi Koshino
- Division of Occlusion and Removable Prosthodontics, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido
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Decomposing Organic Molecules on Titanium with Vacuum Ultraviolet Light for Effective and Rapid Photofunctionalization. J Funct Biomater 2022; 14:jfb14010011. [PMID: 36662058 PMCID: PMC9861116 DOI: 10.3390/jfb14010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
Ultraviolet (UV) photofunctionalization counteracts the biological aging of titanium to increase the bioactivity and osseointegration of titanium implants. However, UV photofunctionalization currently requires long treatment times of between 12 min and 48 h, precluding routine clinical use. Here, we tested the ability of a novel, xenon excimer lamp emitting 172 nm vacuum UV (VUV) to decompose organic molecules coated on titanium as a surrogate of photofunctionalization. Methylene blue as a model organic molecule was coated on grade 4 commercially pure titanium and treated with four UV light sources: (i) ultraviolet C (UVC), (ii) high-energy UVC (HUVC), (iii) proprietary UV (PUV), and (iv) VUV. After one minute of treatment, VUV decomposed 57% of methylene blue compared with 2%, 36%, and 42% for UVC, HUVC, and PUV, respectively. UV dose-dependency testing revealed maximal methylene blue decomposition with VUV within one minute. Equivalent decomposition was observed on grade 5 titanium alloy specimens, and placing titanium specimens in quartz ampoules did not compromise efficacy. Methylene blue was decomposed even on polymethyl methacrylate acrylic specimens at 20-25% lower efficiency than on titanium specimens, indicating a relatively small contribution of titanium dioxide-mediated photocatalytic decomposition to the total decomposition. Load-testing revealed that VUV maintained high efficacy of methylene blue decomposition regardless of the coating density, whereas other UV light sources showed low efficacy with thin coatings and plateauing efficacy with thicker coatings. This study provides foundational data on rapid and efficient VUV-mediated organic decomposition on titanium. In synergy with quartz ampoules used as containers, VUV has the potential to overcome current technical challenges hampering the clinical application of UV photofunctionalization.
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Kitajima H, Hirota M, Komatsu K, Isono H, Matsuura T, Mitsudo K, Ogawa T. Ultraviolet Light Treatment of Titanium Microfiber Scaffolds Enhances Osteoblast Recruitment and Osteoconductivity in a Vertical Bone Augmentation Model: 3D UV Photofunctionalization. Cells 2022; 12:cells12010019. [PMID: 36611812 PMCID: PMC9818481 DOI: 10.3390/cells12010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Vertical bone augmentation to create host bone prior to implant placement is one of the most challenging regenerative procedures. The objective of this study is to evaluate the capacity of a UV-photofunctionalized titanium microfiber scaffold to recruit osteoblasts, generate intra-scaffold bone, and integrate with host bone in a vertical augmentation model with unidirectional, limited blood supply. Scaffolds were fabricated by molding and sintering grade 1 commercially pure titanium microfibers (20 μm diameter) and treated with UVC light (200-280 nm wavelength) emitted from a low-pressure mercury lamp for 20 min immediately before experiments. The scaffolds had an even and dense fiber network with 87% porosity and 20-50 mm inter-fiber distance. Surface carbon reduced from 30% on untreated scaffold to 10% after UV treatment, which corresponded to hydro-repellent to superhydrophilic conversion. Vertical infiltration testing revealed that UV-treated scaffolds absorbed 4-, 14-, and 15-times more blood, water, and glycerol than untreated scaffolds, respectively. In vitro, four-times more osteoblasts attached to UV-treated scaffolds than untreated scaffolds three hours after seeding. On day 2, there were 70% more osteoblasts on UV-treated scaffolds. Fluorescent microscopy visualized confluent osteoblasts on UV-treated microfibers two days after seeding but sparse and separated cells on untreated microfibers. Alkaline phosphatase activity and osteocalcin gene expression were significantly greater in osteoblasts grown on UV-treated microfiber scaffolds. In an in vivo model of vertical augmentation on rat femoral cortical bone, the interfacial strength between innate cortical bone and UV-treated microfiber scaffold after two weeks of healing was double that observed between bone and untreated scaffold. Morphological and chemical analysis confirmed seamless integration of the innate cortical and regenerated bone within microfiber networks for UV-treated scaffolds. These results indicate synergy between titanium microfiber scaffolds and UV photofunctionalization to provide a novel and effective strategy for vertical bone augmentation.
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Affiliation(s)
- Hiroaki Kitajima
- Division of Regenerative and Reconstructive Sciences and Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Makoto Hirota
- Division of Regenerative and Reconstructive Sciences and Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 236-0004, Kanagawa, Japan
- Correspondence: ; Tel./Fax: +81-45-785-8438
| | - Keiji Komatsu
- Division of Regenerative and Reconstructive Sciences and Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Hitoshi Isono
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Takanori Matsuura
- Division of Regenerative and Reconstructive Sciences and Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan
| | - Takahiro Ogawa
- Division of Regenerative and Reconstructive Sciences and Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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Chang LC. Clinical Applications of Photofunctionalization on Dental Implant Surfaces: A Narrative Review. J Clin Med 2022; 11:jcm11195823. [PMID: 36233693 PMCID: PMC9571244 DOI: 10.3390/jcm11195823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Dental implant therapy is a common clinical procedure for the restoration of missing teeth. Many methods have been used to promote osseointegration for successful implant therapy, including photofunctionalization (PhF), which is defined as the modification of titanium surfaces after ultraviolet treatment. It includes the alteration of the physicochemical properties and the enhancement of biological capabilities, which can alter the surface wettability and eliminate hydrocarbons from the implant surface by a biological aging process. PhF can also enhance cellular migration, attachment, and proliferation, thereby promoting osseointegration and coronal soft tissue seal. However, PhF did not overcome the dental implant challenge of oral cancer cases. It is necessary to have more clinical trials focused on complex implant cases and non-dental fields in the future.
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Affiliation(s)
- Li-Ching Chang
- Department of Dentistry, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan;
- Institute of Nursing and Department of Nursing, Chang Gung University of Science and Technology, Chiayi 61363, Taiwan
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Kitajima H, Komatsu K, Matsuura T, Ozawa R, Saruta J, Taleghani SR, Cheng J, Ogawa T. Impact of nano-scale trabecula size on osteoblastic behavior and function in a meso-nano hybrid rough biomimetic zirconia model. J Prosthodont Res 2022; 67:288-299. [PMID: 35858802 DOI: 10.2186/jpr.jpr_d_22_00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE A novel implant model consisting of meso-scale cactus-inspired spikes and nano-scale bone-inspired trabeculae was recently developed to optimize meso-scale roughness on zirconia. In this model, the meso-spike dimension had a significant impact on osteoblast function. To explore how different nano-textures impact this model, here we examined the effect of different nano-trabecula sizes on osteoblast function while maintaining the same meso-spike conformation. METHODS Zirconia disks with meso-nano hybrid surfaces were created by laser etching. The meso-spikes were fixed to 40 μm high, whereas the nano-texture was etched as large and small trabeculae of average Feret diameter 237.0 and 134.1 nm, respectively. A polished surface was also prepared. Rat bone marrow-derived and human mesenchymal stromal cell-induced osteoblasts were cultured on these disks. RESULTS Hybrid rough surfaces, regardless of nano-trabecula dimension, robustly promoted the osteoblastic differentiation of both rat and human osteoblasts compared to those on polished surfaces. Hybrid surfaces with small nano-trabeculae further enhanced osteoblastic differentiation compared with large nano-trabeculae. However, the difference in osteoblastic differentiation between small and large nano-trabeculae was much smaller than the difference between the polished and hybrid rough surfaces. The nano-trabecula size did not influence osteoblast attachment and proliferation, or protein adsorption. Both hybrid surfaces were hydro-repellent. The atomic percentage of surface carbon was lower on the hybrid surface with small nano-trabeculae. CONCLUSIONS Small nano-trabeculae promoted osteoblastic differentiation more than large nano-trabeculae when combined with meso-scale spikes. However, the biological impact of different nano-trabeculae was relatively small compared with that of different dimensions of meso-spikes.
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Affiliation(s)
- Hiroaki Kitajima
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
| | - Ryotaro Ozawa
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
| | - Juri Saruta
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
| | - Samira Rahim Taleghani
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
| | - James Cheng
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology and the Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue, Los Angeles, CA 90095-1668
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Improvement in Osseointegration of Titanium Dental Implants after Exposure to Ultraviolet-C Light for Various Times: an Experimental Study in Beagle Dogs. J Oral Maxillofac Surg 2022; 80:1389-1397. [DOI: 10.1016/j.joms.2022.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/10/2022] [Accepted: 04/23/2022] [Indexed: 12/11/2022]
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Ultraviolet Treatment of Titanium to Enhance Adhesion and Retention of Oral Mucosa Connective Tissue and Fibroblasts. Int J Mol Sci 2021; 22:ijms222212396. [PMID: 34830275 PMCID: PMC8617952 DOI: 10.3390/ijms222212396] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 01/16/2023] Open
Abstract
Peri-implantitis is an unsolved but critical problem with dental implants. It is postulated that creating a seal of gingival soft tissue around the implant neck is key to preventing peri-implantitis. The objective of this study was to determine the effect of UV surface treatment of titanium disks on the adhesion strength and retention time of oral connective tissues as well as on the adherence of mucosal fibroblasts. Titanium disks with a smooth machined surface were prepared and treated with UV light for 15 min. Keratinized mucosal tissue sections (3 × 3 mm) from rat palates were incubated for 24 h on the titanium disks. The adhered tissue sections were then mechanically detached by agitating the culture dishes. The tissue sections remained adherent for significantly longer (15.5 h) on the UV-treated disks than on the untreated control disks (7.5 h). A total of 94% of the tissue sections were adherent for 5 h or longer on the UV-treated disks, whereas only 50% of the sections remained on the control disks for 5 h. The adhesion strength of the tissue sections to the titanium disks, as measured by tensile testing, was six times greater after UV treatment. In the culture studies, mucosal fibroblasts extracted from rat palates were attached to titanium disks by incubating for 24, 48, or 96 h. The number of attached cells was consistently 15–30% greater on the UV-treated disks than on the control disks. The cells were then subjected to mechanical or chemical (trypsinization) detachment. After mechanical detachment, the residual cell rates on the UV-treated surfaces after 24 and 48 h of incubation were 35% and 25% higher, respectively, than those on the control surfaces. The remaining rate after chemical detachment was 74% on the control surface and 88% on the UV-treated surface for the cells cultured for 48 h. These trends were also confirmed in mouse embryonic fibroblasts, with an intense expression of vinculin, a focal adhesion protein, on the UV-treated disks even after detachment. The UV-treated titanium was superhydrophilic, whereas the control titanium was hydrophobic. X-ray photoelectron spectroscopy (XPS) chemical analysis revealed that the amount of carbon at the surface was significantly reduced after UV treatment, while the amount of TiOH molecules was increased. These ex vivo and in vitro results indicate that the UV treatment of titanium increases the adhesion and retention of oral mucosa connective tissue as a result of increased resistance of constituent fibroblasts against exogenous detachment, both mechanically and chemically, as well as UV-induced physicochemical changes of the titanium surface.
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Osteoblast Attachment Compromised by High and Low Temperature of Titanium and Its Restoration by UV Photofunctionalization. MATERIALS 2021; 14:ma14195493. [PMID: 34639891 PMCID: PMC8509491 DOI: 10.3390/ma14195493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 01/19/2023]
Abstract
Titanium implants undergo temperature fluctuations during manufacturing, transport, and storage. However, it is unknown how this affects their bioactivity. Herein, we explored how storage (six months, dark conditions) and temperature fluctuations (5-50 °C) affected the bioactivity of titanium implants. Stored and fresh acid-etched titanium disks were exposed to different temperatures for 30 min under wet or dry conditions, and their hydrophilicity/hydrophobicity and bioactivity (using osteoblasts derived from rat bone marrow) were evaluated. Ultraviolet (UV) treatment was evaluated as a method of restoring the bioactivity. The fresh samples were superhydrophilic after holding at 5 or 25 °C under wet or dry conditions, and hydrophilic after holding at 50 °C. In contrast, all the stored samples were hydrophobic. For both fresh and stored samples, exposure to 5 or 50 °C reduced osteoblast attachment compared to holding at 25 °C under both wet and dry conditions. Regression analysis indicated that holding at 31 °C would maximize cell attachment (p < 0.05). After UV treatment, cell attachment was the same or better than that before temperature fluctuations. Overall, titanium surfaces may have lower bioactivity when the temperature fluctuates by ≥20 °C (particularly toward lower temperatures), independent of the hydrophilicity/hydrophobicity. UV treatment was effective in restoring the temperature-compromised bioactivity.
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Surface treatment of 3D printed porous Ti6Al4V implants by ultraviolet photofunctionalization for improved osseointegration. Bioact Mater 2021; 7:26-38. [PMID: 34466715 PMCID: PMC8377410 DOI: 10.1016/j.bioactmat.2021.05.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 12/16/2022] Open
Abstract
Three-dimensional (3D)-printed porous Ti6Al4V implants play an important role in the reconstruction of bone defects. However, its osseointegration capacity needs to be further improved, and related methods are inadequate, especially lacking customized surface treatment technology. Consequently, we aimed to design an omnidirectional radiator based on ultraviolet (UV) photofunctionalization for the surface treatment of 3D-printed porous Ti6Al4V implants, and studied its osseointegration promotion effects in vitro and in vivo, while elucidating related mechanisms. Following UV treatment, the porous Ti6Al4V scaffolds exhibited significantly improved hydrophilicity, cytocompatibility, and alkaline phosphatase activity, while preserving their original mechanical properties. The increased osteointegration strength was further proven using a rabbit condyle defect model in vivo, in which UV treatment exhibited a high efficiency in the osteointegration enhancement of porous Ti6Al4V scaffolds by increasing bone ingrowth (BI), the bone-implant contact ratio (BICR), and the mineralized/osteoid bone ratio. The advantages of UV treatment for 3D-printed porous Ti6Al4V implants using the omnidirectional radiator in the study were as follows: 1) it can significantly improve the osseointegration capacity of porous titanium implants despite the blocking out of UV rays by the porous structure; 2) it can evenly treat the surface of porous implants while preserving their original topography or other morphological features; and 3) it is an easy-to-operate low-cost process, making it worthy of wide clinical application. An omnidirectional radiator based on ultraviolet photofunctionalization was invented.. The omnidirectional radiator can evenly treat the surface of the porous implants.. The present method can enhance osteoinetegration of porous Ti6Al4V implants in a convenient way with a low cost.
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15
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UV Light-Generated Superhydrophilicity of a Titanium Surface Enhances the Transfer, Diffusion and Adsorption of Osteogenic Factors from a Collagen Sponge. Int J Mol Sci 2021; 22:ijms22136811. [PMID: 34202795 PMCID: PMC8268603 DOI: 10.3390/ijms22136811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/14/2021] [Accepted: 06/21/2021] [Indexed: 02/07/2023] Open
Abstract
It is a significant challenge for a titanium implant, which is a bio-inert material, to recruit osteogenic factors, such as osteoblasts, proteins and blood effectively when these are contained in a biomaterial. The objective of this study was to examine the effect of ultraviolet (UV)-treatment of titanium on surface wettability and the recruitment of osteogenic factors when they are contained in an atelocollagen sponge. UV treatment of a dental implant made of commercially pure titanium was performed with UV-light for 12 min immediately prior to the experiments. Superhydrophilicity on dental implant surfaces was generated with UV-treatment. The collagen sponge containing blood, osteoblasts, or albumin was directly placed on the dental implant. Untreated implants absorbed only a little blood from the collagen sponge, while the UV-treated implants absorbed blood rapidly and allowed it to spread widely, almost over the entire implant surface. Blood coverage was 3.5 times greater for the UV-treated implants (p < 0.001). Only 6% of the osteoblasts transferred from the collagen sponge to the untreated implants, whereas 16% of the osteoblasts transferred to the UV-treated implants (p < 0.001). In addition, a weight ratio between transferred albumin on the implant and measured albumin adsorbed on the implant was 17.3% in untreated implants and 38.5% in UV-treated implants (p < 0.05). These results indicated that UV treatment converts a titanium surface into a superhydrophilic and bio-active material, which could recruite osteogenic factors even when they were contained in a collagen sponge. The transfer and subsequent diffusion and adsorption efficacy of UV-treated titanium surfaces could be useful for bone formation when titanium surfaces and osteogenic factors are intervened with a biomaterial.
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Pesce P, Menini M, Santori G, Giovanni ED, Bagnasco F, Canullo L. Photo and Plasma Activation of Dental Implant Titanium Surfaces. A Systematic Review with Meta-Analysis of Pre-Clinical Studies. J Clin Med 2020; 9:jcm9092817. [PMID: 32878146 PMCID: PMC7565759 DOI: 10.3390/jcm9092817] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Ultraviolet (UV) and non-thermal plasma functionalization are surface treatment modalities that seem able to improve osseointegration. The aim of this systematic review and meta-analysis is to assess the effect of the two methods and possible differences. Materials and Methods: The systematic research of pre-clinical animal studies was conducted up to May 2020 in the databases PubMed/Medline, Scopus and the Cochrane Lybrary. A meta-analysis was performed by using the DerSimonian–Laird estimator in random-effects models. Results: Through the digital search, 518 articles were identified; after duplicate removal and screening process 10 papers were included. Four studies evaluating UV treatment in rabbits were included in the meta-analysis. The qualitative evaluation of the included studies showed that both UV photofunctionalization and non-thermal plasma argon functionalization of titanium implant surfaces might be effective in vivo to improve the osseointegration. The meta-analysis on four studies evaluating UV treatment in rabbits showed that bone to implant contact values (expressed as standardized mean differences and raw mean differences) were significantly increased in the bio-activated groups when follow-up times were relatively homogeneous, although a high heterogeneity (I2 > 75%) was found in all models. Conclusions: The present systematic review and meta-analysis on pre-clinical studies demonstrated that chair-side treatment of implants with UV or non-thermal plasma appear to be effective for improving osseointegration. This systematic review supports further clinical trials on this topic.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (P.P.); (M.M.); (G.S.); (E.D.G.); (F.B.)
| | - Maria Menini
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (P.P.); (M.M.); (G.S.); (E.D.G.); (F.B.)
| | - Gregorio Santori
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (P.P.); (M.M.); (G.S.); (E.D.G.); (F.B.)
| | - Emanuele De Giovanni
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (P.P.); (M.M.); (G.S.); (E.D.G.); (F.B.)
| | - Francesco Bagnasco
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, 16132 Genoa, Italy; (P.P.); (M.M.); (G.S.); (E.D.G.); (F.B.)
| | - Luigi Canullo
- Private Practice, Via Nizza, 46, 00198 Rome, Italy
- Correspondence: ; Tel.: +39-347-6201-976
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Liu C, Sun M, Wang Y, Zhu T, Ye G, You D, Dong L, Zhao W, Cheng K, Weng W, Zhang YS, Yu M, Wang H. Ultraviolet Radiant Energy-Dependent Functionalization Regulates Cellular Behavior on Titanium Dioxide Nanodots. ACS APPLIED MATERIALS & INTERFACES 2020; 12:31793-31803. [PMID: 32485098 DOI: 10.1021/acsami.0c07761] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Titanium dioxide (TiO2) photofunctionalization has been demonstrated as an effective surface modification method for the osseointegration of implants. However, the insufficient understanding of the mechanism underlying photofunctionalization limits its clinical applications. Here, we report an ultraviolet (UV) radiant energy-dependent functionalization on TiO2 nanodots (TN) surfaces. We found the cell adhesion, proliferation, and osteogenic differentiation gradually increased with the accumulation of UV radiant energy (URE). The optimal functionalizing treatment energy was found to be 2000 mJ/cm2, which could regulate cell-specific behaviors on TN surfaces. The enhanced cell behaviors were regulated by the adsorption and functional site exposure of the extracellular matrix (ECM) proteins, which were the result of the surface physicochemical changes induced by the URE. The correlation between the URE and the reconstruction of surface hydroxyl groups was considered as an alternative mechanism of this energy-dependent functionalization. We also demonstrated the synergistic effects of FAK-RHOA and ERK1/2 signaling pathways on mediating the URE-dependent cell behaviors. Overall, this study provides a novel insight into the mechanisms of photofunctionalization, guiding the design of implants and the clinical practice of photofunctionalization.
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Affiliation(s)
- Chao Liu
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
| | - Mouyuan Sun
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
| | - Yu Wang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
| | - Tianer Zhu
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
| | - Guanchen Ye
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
| | - Dongqi You
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
| | - Lingqing Dong
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
- School of Materials Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Wenquan Zhao
- The First Affiliated Hospital of Medical College, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Kui Cheng
- School of Materials Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Wenjian Weng
- School of Materials Science and Engineering, Zhejiang University, Hangzhou 310027, China
| | - Yu Shrike Zhang
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts 02139, United States
| | - Mengfei Yu
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
| | - Huiming Wang
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou 310003, China
- The First Affiliated Hospital of Medical College, Zhejiang University School of Medicine, Hangzhou 310003, China
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18
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Dini C, Nagay BE, Magno MB, Maia LC, Barão VAR. Photofunctionalization as a suitable approach to improve the osseointegration of implants in animal models-A systematic review and meta-analysis. Clin Oral Implants Res 2020; 31:785-802. [PMID: 32564392 DOI: 10.1111/clr.13627] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To determine whether photofunctionalization influences dental implant osseointegration. MATERIAL AND METHODS Data on osseointegration rates were extracted from 8 databases, based on bone-to-implant contact (BIC) and pushout tests. Internal validity was accessed through the SYRCLE risk of bias tool for animal experimental studies. Meta-analyses were performed for investigation of the influence of photofunctionalization on implant osseointegration, with a random effect and a confidence interval of 95%. The certainty of evidence was accessed through the GRADE approach. RESULTS Thirty-four records were identified, and 10 were included in the meta-analysis. Photofunctionalized implants showed higher mean values for BIC in rabbits (MD 6.92 [1.01, 12.82], p = .02), dogs (MD 23.70 [10.23, 37.16], p = .001), rats (MD 20.93 [12.91, 28.95], p < .0001), and in the pooled BIC analyses (MD 14.23 [7.80, 20.66], p < .0001) compared to those in control implants in the overall assay. Conversely, at late healing periods, the pooled BIC meta-analyses showed no statistically significant differences (p > .05) for photofunctionalized and control implants at 12 weeks of follow-up. For pushout analysis, photofunctionalized implants presented greater bone strength integration (MD 19.92 [13.88, 25.96], p < .0001) compared to that of control implants. The heterogeneity between studies ranged from "not important" to "moderate" for rabbits I2 = 24%, dogs I2 = 0%, rats I2 = 0%, and pooled BIC (I2 = 49%), while considerable heterogeneity was observed for pushouts (I2 = 90%). CONCLUSION Photofunctionalization improves osseointegration in the initial healing period of implants, as summarized from available data from rabbit, dog, and rat in vivo models.
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Affiliation(s)
- Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Bruna Egumi Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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UV-Pre-Treated and Protein-Adsorbed Titanium Implants Exhibit Enhanced Osteoconductivity. Int J Mol Sci 2020; 21:ijms21124194. [PMID: 32545509 PMCID: PMC7349557 DOI: 10.3390/ijms21124194] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/10/2020] [Indexed: 12/18/2022] Open
Abstract
Titanium materials are essential treatment modalities in the medical field and serve as a tissue engineering scaffold and coating material for medical devices. Thus, there is a significant demand to improve the bioactivity of titanium for therapeutic and experimental purposes. We showed that ultraviolet light (UV)-pre-treatment changed the protein-adsorption ability and subsequent osteoconductivity of titanium. Fibronectin (FN) adsorption on UV-treated titanium was 20% and 30% greater after 1-min and 1-h incubation, respectively, than that of control titanium. After 3-h incubation, FN adsorption on UV-treated titanium remained 30% higher than that on the control. Osteoblasts were cultured on titanium disks after 1-h FN adsorption with or without UV-pre-treatment and on titanium disks without FN adsorption. The number of attached osteoblasts during the early stage of culture was 80% greater on UV-treated and FN-adsorbed (UV/FN) titanium than on FN-adsorbed (FN) titanium; osteoblasts attachment on UV/FN titanium was 2.6- and 2.1-fold greater than that on control- and UV-treated titanium, respectively. The alkaline phosphatase activity of osteoblasts on UV/FN titanium was increased 1.8-, 1.8-, and 2.4-fold compared with that on FN-adsorbed, UV-treated, and control titanium, respectively. The UV/FN implants exhibited 25% and 150% greater in vivo biomechanical strength of bone integration than the FN- and control implants, respectively. Bone morphogenetic protein-2 (BMP-2) adsorption on UV-treated titanium was 4.5-fold greater than that on control titanium after 1-min incubation, resulting in a 4-fold increase in osteoblast attachment. Thus, UV-pre-treatment of titanium accelerated its protein adsorptivity and osteoconductivity, providing a novel strategy for enhancing its bioactivity.
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Sanchez-Perez A, Cachazo-Jiménez C, Sánchez-Matás C, Martín-de-Llano JJ, Davis S, Carda-Batalla C. Effects of Ultraviolet Photoactivation on Osseointegration of Commercial Pure Titanium Dental Implant After 8 Weeks in a Rabbit Model. J ORAL IMPLANTOL 2020; 46:101-107. [PMID: 31905048 DOI: 10.1563/aaid-joi-d-19-00122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study investigated whether a 6-Watt ultraviolet C-lamp was capable of producing photofunctionalization on commercial implants during a medium observation term of 8 weeks. A total of 20 implants were inserted in 5 New Zealand rabbits, with each animal receiving 2 implants per tibia (one photofunctionalized and one untreated), according to a previously established randomization sequence. All implants were inserted by a single surgeon following the manufacturer's instructions. Histological analysis was performed by an evaluator who was blinded to the treatment condition. After 8 weeks of healing, the 2 groups showed no statistically significant differences in terms of bone-to-implant contact. Compared to control implants, the photofunctionalized implants showed improved wettability and more homogenous results. Within the limits of the present study, the use of this 6-W ultraviolet C-lamp, for an irradiation time of 15 minutes at a distance of 15 cm, did not improve the percentages of bone-to-implant contact in rabbits at an osseointegration time of 8 weeks.
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Affiliation(s)
| | | | | | | | - Scott Davis
- Private practice in Port Macquarie and Coffs Harbour, NSW Australia
| | - Carmen Carda-Batalla
- Department of Pathology, Medicine and Dentistry, University of Valencia, Spain; INCLIVA, Valencia, Spain
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21
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Taniyama T, Saruta J, Mohammadzadeh Rezaei N, Nakhaei K, Ghassemi A, Hirota M, Okubo T, Ikeda T, Sugita Y, Hasegawa M, Ogawa T. UV-Photofunctionalization of Titanium Promotes Mechanical Anchorage in A Rat Osteoporosis Model. Int J Mol Sci 2020; 21:ijms21041235. [PMID: 32059603 PMCID: PMC7072956 DOI: 10.3390/ijms21041235] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 12/14/2022] Open
Abstract
Effects of UV-photofunctionalization on bone-to-titanium integration under challenging systemic conditions remain unclear. We examined the behavior and response of osteoblasts from sham-operated and ovariectomized (OVX) rats on titanium surfaces with or without UV light pre-treatment and the strength of bone-implant integration. Osteoblasts from OVX rats showed significantly lower alkaline phosphatase, osteogenic gene expression, and mineralization activities than those from sham rats. Bone density variables in the spine were consistently lower in OVX rats. UV-treated titanium was superhydrophilic and the contact angle of ddH2O was ≤5°. Titanium without UV treatment was hydrophobic with a contact angle of ≥80°. Initial attachment to titanium, proliferation, alkaline phosphatase activity, and gene expression were significantly increased on UV-treated titanium compared to that on control titanium in osteoblasts from sham and OVX rats. Osteoblastic functions compromised by OVX were elevated to levels equivalent to or higher than those of sham-operated osteoblasts following culture on UV-treated titanium. The strength of in vivo bone-implant integration for UV-treated titanium was 80% higher than that of control titanium in OVX rats and even higher than that of control implants in sham-operated rats. Thus, UV-photofunctionalization effectively enhanced bone-implant integration in OVX rats to overcome post-menopausal osteoporosis-like conditions.
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Affiliation(s)
- Takashi Taniyama
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
- Department of Orthopedic Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1 Shinyamashita, Yokohama 231-8682, Kanagawa, Japan
| | - Juri Saruta
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
- Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, 82 Inaoka, Yokosuka 238-8580, Kanagawa, Japan
- Correspondence: ; Tel./Fax: +81-46-822-9537
| | - Naser Mohammadzadeh Rezaei
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
| | - Kourosh Nakhaei
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
| | - Amirreza Ghassemi
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
| | - Makoto Hirota
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, 4-57 Urafune-cho, Yokohama 232-0024, Kanagawa, Japan
| | - Takahisa Okubo
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
| | - Takayuki Ikeda
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
| | - Yoshihiko Sugita
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
| | - Masakazu Hasegawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA; (T.T.); (N.M.R.); (K.N.); (A.G.); (M.H.); (T.O.); (T.I.); (Y.S.); (M.H.); (T.O.)
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Liddell RS, Liu Z, Mendes VC, Davies JE. Relative contributions of implant hydrophilicity and nanotopography to implant anchorage in bone at Early Time Points. Clin Oral Implants Res 2019; 31:49-63. [DOI: 10.1111/clr.13546] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 08/29/2019] [Accepted: 09/08/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Robert S. Liddell
- Dental Research Institute Faculty of Dentistry University of Toronto Toronto ON Canada
| | - Zhen‐Mei Liu
- Dental Research Institute Faculty of Dentistry University of Toronto Toronto ON Canada
| | - Vanessa C. Mendes
- Dental Research Institute Faculty of Dentistry University of Toronto Toronto ON Canada
| | - John E. Davies
- Dental Research Institute Faculty of Dentistry University of Toronto Toronto ON Canada
- Institute of Biomaterials and Biomedical Engineering University of Toronto Toronto ON Canada
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23
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Saruta J, Sato N, Ishijima M, Okubo T, Hirota M, Ogawa T. Disproportionate Effect of Sub-Micron Topography on Osteoconductive Capability of Titanium. Int J Mol Sci 2019; 20:ijms20164027. [PMID: 31426563 PMCID: PMC6720784 DOI: 10.3390/ijms20164027] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/16/2019] [Accepted: 08/17/2019] [Indexed: 12/14/2022] Open
Abstract
Titanium micro-scale topography offers excellent osteoconductivity and bone-implant integration. However, the biological effects of sub-micron topography are unknown. We compared osteoblastic phenotypes and in vivo bone and implant integration abilities between titanium surfaces with micro- (1-5 µm) and sub-micro-scale (0.1-0.5 µm) compartmental structures and machined titanium. The calculated average roughness was 12.5 ± 0.65, 123 ± 6.15, and 24 ± 1.2 nm for machined, micro-rough, and sub-micro-rough surfaces, respectively. In culture studies using bone marrow-derived osteoblasts, the micro-rough surface showed the lowest proliferation and fewest cells attaching during the initial stage. Calcium deposition and expression of osteoblastic genes were highest on the sub-micro-rough surface. The bone-implant integration in the Sprague-Dawley male rat femur model was the strongest on the micro-rough surface. Thus, the biological effects of titanium surfaces are not necessarily proportional to the degree of roughness in osteoblastic cultures or in vivo. Sub-micro-rough titanium ameliorates the disadvantage of micro-rough titanium by restoring cell attachment and proliferation. However, bone integration and the ability to retain cells are compromised due to its lower interfacial mechanical locking. This is the first report on sub-micron topography on a titanium surface promoting osteoblast function with minimal osseointegration.
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Affiliation(s)
- Juri Saruta
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA.
| | - Nobuaki Sato
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Manabu Ishijima
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Takahisa Okubo
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Makoto Hirota
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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24
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The Effect of Ultraviolet Photofunctionalization on a Titanium Dental Implant with Machined Surface: An In Vitro and In Vivo Study. MATERIALS 2019; 12:ma12132078. [PMID: 31261627 PMCID: PMC6650865 DOI: 10.3390/ma12132078] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 06/22/2019] [Accepted: 06/26/2019] [Indexed: 11/17/2022]
Abstract
Ultraviolet (UV) photofunctionalization has been suggested as an effective method to enhance the osseointegration of titanium surface. In this study, machined surface treated with UV light (M + UV) was compared to sandblasted, large-grit, acid-etched (SLA) surface through in vitro and in vivo studies. Groups of titanium specimens were defined as machined (M), SLA, and M + UV for the disc type, and M + UV and SLA for the implant. The discs and implants were assessed using scanning electron microscopy, confocal laser scanning microscopy, electron spectroscopy for chemical analysis, and the contact angle. Additionally, we evaluated the cell attachment, proliferation assay, and real-time polymerase chain reaction for the MC3T3-E1 cells. In a rabbit tibia model, the implants were examined to evaluate the bone-to-implant contact ratio and the bone area. In the M + UV group, we observed the lower amount of carbon, a 0°-degree contact angle, and enhanced osteogenic cell activities (p < 0.05). The histomorphometric analysis showed that a higher bone-to-implant contact ratio was found in the M + UV implant at 10 days (p < 0.05). In conclusion, the UV photofunctionalization of a Ti dental implant with M surface attained earlier osseointegration than SLA.
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Matsumoto MA, de Abreu Furquim EM, Gonçalves A, Santiago-Júnior JF, Saraiva PP, Cardoso CL, Munerato MS, Okamoto R. Aged rats under zoledronic acid therapy and oral surgery. J Craniomaxillofac Surg 2017; 45:781-787. [PMID: 28318924 DOI: 10.1016/j.jcms.2017.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 11/30/2016] [Accepted: 02/03/2017] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Aging brings a number of health conditions that can compromise the healing process in elderly individuals, significantly when it comes to bone tissue. The aim of the present study was to analyze the effects of zoledronic acid (ZL) therapy on socket healing of aged male rats. MATERIALS AND METHODS Twenty-four Wistar male rats, 20 months old, underwent surgical procedures for the extraction of the upper right incisor and were divided into two groups according to the treatment: Control (C) - intravenous (IV) 0.9% saline, ZL - 0.035 mg/kg of IV zoledronic acid, both every 15 days. At the fifth dose of both substances, tooth extractions were performed and the animals were euthanized after 14 and 28 days. RESULTS IV administration of ZL caused OPG-RANKL system imbalance, resulting in deficient bone formation and remodeling and alteration of osteoclast morphology, as well as maintaining persistent inflammation during the healing period. CONCLUSIONS IV administration of ZL delayed extracted dental socket healing of aged rats, but not enough to cause osteonecrosis, raising a question about different responses to IV BP therapy considering animal age.
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Affiliation(s)
- Mariza Akemi Matsumoto
- São Paulo State University (Unesp) (Head: Prof. W. R. Poi), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Brazil.
| | - Elisa Mara de Abreu Furquim
- São Paulo State University (Unesp) (Head: Prof. W. R. Poi), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Brazil
| | - Alaíde Gonçalves
- São Paulo State University (Unesp) (Head: Prof. W. R. Poi), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Brazil
| | | | - Patrícia Pinto Saraiva
- School of Dentistry, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, Bauru, SP, Brazil
| | - Camila Lopes Cardoso
- School of Dentistry, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, Bauru, SP, Brazil
| | - Marcelo Salles Munerato
- School of Dentistry, Sagrado Coração University - USC, Rua Irmã Arminda 10-50, Bauru, SP, Brazil
| | - Roberta Okamoto
- São Paulo State University (Unesp) (Head: Prof. W. R. Poi), School of Dentistry, Araçatuba, Rua José Bonifácio 1193, Araçatuba, SP, Brazil
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