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Shayeb MA, Elfadil S, Abutayyem H, Shqaidef A, Marrapodi MM, Cicciù M, Minervini G. Bioactive surface modifications on dental implants: a systematic review and meta-analysis of osseointegration and longevity. Clin Oral Investig 2024; 28:592. [PMID: 39392473 PMCID: PMC11469970 DOI: 10.1007/s00784-024-05958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 09/22/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND Bioactive surface modifications have been proposed to enhance osseointegration and longevity of dental implants. This study aimed to systematically review and perform a meta-analysis on the effectiveness of various bioactive coatings in promoting bone integration and improving implant longevity. METHODS A systematic review was conducted, including studies that investigated bioactive surface modifications on titanium dental implants. Outcomes of interest were bone-to-implant contact (BIC) and implant longevity over a 30-day period. Data were extracted and analyzed using RevMan 5 (version 5.4.1), with forest plots generated to represent the mean difference (MD) and 95% confidence intervals (CI) under a random effects model. RESULTS The meta-analysis showed a significant improvement in BIC for surface-modified implants, with an overall MD of 7.29 (95% CI [2.94, 11.65]). Heterogeneity analysis indicated moderate heterogeneity (Tau² = 18.57, Chi² = 16.08, df = 8, P = 0.04, I² = 50%). The test for overall effect yielded Z = 3.28 (P = 0.001). For implant longevity, the overall MD was 7.52 (95% CI [3.18, 11.85]), with moderate heterogeneity (Tau² = 17.28, Chi² = 14.95, df = 8, P = 0.06, I² = 47%). The test for overall effect yielded Z = 3.40 (P = 0.0007). CONCLUSION Bioactive surface changes significantly improved osseointegration and lifespan of dental implants. Collagen-based coatings consistently encouraged early bone integration, while BMP-2 combinations were effective for osseointegration. Optimizing bioactive agent doses and combinations was critical for achieving desired outcomes.
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Affiliation(s)
- Maher Al Shayeb
- Department of Clinical Sciences, College of Dentistry, Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE.
| | - Sittana Elfadil
- Department of Clinical Sciences, College of Dentistry, Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE
| | - Huda Abutayyem
- Department of Clinical Sciences, College of Dentistry, Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE
| | - Abedalrahman Shqaidef
- Department of Clinical Sciences, College of Dentistry, Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan
| | - Maria Maddalena Marrapodi
- Department of Woman, Child and General and Specialist Surgery, University of Campania "Luigi Vanvitelli", Naples, 80121, Italy.
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, 80121, Italy.
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
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2
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Matos FG, Stremel ACA, Lipinski LC, Cirelli JA, Dos Santos FA. Dental implants in large animal models with experimental systemic diseases: A systematic review. Lab Anim 2023; 57:489-503. [PMID: 37021606 DOI: 10.1177/00236772221124972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
This systematic review aims to identify and discuss the most used methodologies in pre-clinical studies for the evaluation of the implementation of dental implants in systemically compromised pigs and sheep. This study provides support and guidance for future research, as well as for the prevention of unnecessary animal wastage and sacrifice. Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) was used as a guideline; electronic searches were performed in PubMed, Scopus, Scielo, Web of Science, Embase, Science Direct, Brazilian Bibliography of Dentistry, Latin American and Caribbean Literature in Health Sciences, Directory of Open Access Journals, Database of Abstracts of Reviews of Effects, and gray literature until January 2022 (PROSPERO/CRD42021270119). Sixty-eight articles were chosen from the 2439 results. Most studies were conducted in pigs, mainly the Göttinger and Domesticus breeds. Healthy animals with implants installed in the jaws were predominant among the pig studies. Of the studies evaluating the effect of systemic diseases on osseointegration, 42% were performed in osteoporotic sheep, 32% in diabetic sheep, and 26% in diabetic pigs. Osteoporosis was primarily induced by bilateral ovariectomy and mainly assessed by X-ray densitometry. Diabetes was induced predominantly by intravenous streptozotocin and was confirmed by blood glucose analysis. Histological and histomorphometric analyses were the most frequently employed in the evaluation of osseointegration. The animal models presented unique methodologies for each species in the studies that evaluated dental implants in the context of systemic diseases. Understanding the most commonly used techniques will help methodological choices and the performance of future studies in implantology.
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Affiliation(s)
| | | | | | - Joni Augusto Cirelli
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of São Paulo (Unesp), Brazil
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3
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Wang J, Yu W, Shi R, Yang S, Zhang J, Han X, Zhou Z, Gao W, Li Y, Zhao J. Osseointegration behavior of carbon fiber reinforced polyetheretherketone composites modified with amino groups: An in vivo study. J Biomed Mater Res B Appl Biomater 2023; 111:505-512. [PMID: 36191250 DOI: 10.1002/jbm.b.35167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 08/31/2022] [Accepted: 09/14/2022] [Indexed: 01/21/2023]
Abstract
Polyetheretherketone (PEEK) has become increasingly popular in dentistry and orthopedics due to its excellent chemical stability, reliable biosafety, and low elastic modulus. However, PEEK's biomechanical strength and bioactivity are limited and need to be increased as an implant material. The previous study in vitro has shown that the amino-functionalized carbon fiber reinforced PEEK (A-30%-CPEEK) possessed enhanced mechanical property and bioactivity. This study aims to evaluate the effect of amino groups modification on the osseointegration behavior of carbon fiber reinforced PEEK (30%-CPEEK) in rabbits. Herein, 30%-CPEEK and A-30%-CPEEK implant discs were implanted in rabbit skulls for 5 weeks, with pure titanium implants serving as a control. The bone-forming ability and osseointegration in vivo were systematically investigated by micro-computed tomography analysis, scanning electron microscope observation, and histological evaluation. Our results showed that all detection parameters were significantly different between the A-30%-CPEEK and 30%-CPEEK groups, favoring those in the A-30%-CPEEK, whose appraisal parameters were equal to or better than pure titanium. Therefore, this study supported the importance of amino groups in facilitating the new bone formation and bone-implant integration, suggesting that A-30%-CPEEK with enhanced osseointegration will be a promising material for dental or orthopedic implants.
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Affiliation(s)
- Junyan Wang
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
| | - Wanqi Yu
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Ruining Shi
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Shihui Yang
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Jingjie Zhang
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Xiao Han
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Zhe Zhou
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Weijia Gao
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Yongli Li
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China
| | - Jinghui Zhao
- Department of Dental Implantology, Hospital of Stomatology, Jilin University, Changchun, China.,Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Hospital of Stomatology, Jilin University, Changchun, China
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4
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López-Valverde N, Aragoneses J, López-Valverde A, Quispe-López N, Rodríguez C, Aragoneses JM. Effectiveness of biomolecule-based bioactive surfaces, on os-seointegration of titanium dental implants: A systematic review and meta-analysis of in vivo studies. Front Bioeng Biotechnol 2022; 10:986112. [PMID: 36225604 PMCID: PMC9548556 DOI: 10.3389/fbioe.2022.986112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/12/2022] [Indexed: 12/09/2022] Open
Abstract
Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically active substances have been proposed. MEDLINE [via Pubmed], Embase and Web of Science were searched with the terms “titanium dental implants”, “surface properties”, “bioactive surface modifications”, “biomolecules”, “BMP”, “antibacterial agent”, “peptide”, “collagen”, “grown factor”, “osseointegration”, “bone apposition”, “osteogenic”, “osteogenesis”, “new bone formation”, “bone to implant contact”, “bone regeneration” and “in vivo studies”, until May 2022. A total of 10,697 references were iden-tified and 26 were included to analyze 1,109 implants, with follow-ups from 2 to 84 weeks. The ARRIVE guidelines and the SYRCLE tool were used to evaluate the methodology and scientific evidence. A meta-analysis was performed (RevMan 2020 software, Cochane Collaboration) with random effects that evaluated BIC at 4 weeks, with subgroups for the different coatings. The heterogeneity of the pooled studies was very high (95% CI, I2 = 99%). The subgroup of BMPs was the most favorable to coating. Surface modification of Ti implants by organic bioactive molecules seems to favor osseointegration in the early stages of healing, but long-term studies are necessary to corroborate the results of the experimental studies.
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Affiliation(s)
- Nansi López-Valverde
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Javier Aragoneses
- Department of Medicine and Medical Specialties, Faculty of Health Sciences, Universidad Alcalá de Henares, Madrid, Spain
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
- *Correspondence: Antonio López-Valverde,
| | - Norberto Quispe-López
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, Salamanca, Spain
| | - Cinthia Rodríguez
- Department of Dentistry, Universidad Federico Henríquez y Carvajal, Santo Domingo, Dominican Republic
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5
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Grossi JRA, Deliberador TM, Giovanini AF, Zielak JC, Sebstiani AM, Gonzaga CC, Coelho PG, Zétola AL, Weiss FP, Benalcázar Jalkh EB, Storrer CLM, Witek L. Effects of local single dose administration of parathormone on the early stages of osseointegration: A pre-clinical study. J Biomed Mater Res B Appl Biomater 2022; 110:1806-1813. [PMID: 35218605 DOI: 10.1002/jbm.b.35038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 12/27/2021] [Accepted: 02/09/2022] [Indexed: 11/06/2022]
Abstract
The present study aimed to evaluate the effect of parathormone (PTH) administered directly to the implant's surface prior to insertion, using a large translational animal model. Sixty titanium implants were divided into four groups: (i) Collagen, control group, where implants were coated with Type-I Bovine-collagen, and three experimental groups, where implants received varying doses of PTH: (ii) 12.5, (iii) 25, and (iv) 50 μg, prior to placement. Fifteen female sheep (~2 years old, weighing ~65 kg) received four implants in an interpolated fashion in C3, C4 or C5 vertebral bodies. After 3-, 6- and 12-weeks, samples were harvested, histologically processed, qualitatively and quantitatively assessed for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). BIC yielded lower values at 6-weeks for 50 μg relative to the control group, with no significant differences, when compared to the 12.5- and 25-μg. No significant differences were detected at 6-weeks between collagen, 12.5- and 25-μg groups. At 3- and 12-weeks, no differences were detected for BIC among PTH groups. With respect to BAFO, no significant differences were observed between the control and experimental groups independent of PTH concentration and time in vivo. Qualitative observations at 3-weeks indicated the presence of a more mature bone near the implant's surface with the application of PTH, however, no significant differences in new bone formation or healing patterns were observed at 6- and 12-weeks. Single local application of different concentrations of PTH on titanium implant's surface did not influence the osseointegration at any time-point evaluation in low-density bone.
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Affiliation(s)
| | | | | | - João César Zielak
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | | | - Carla Castiglia Gonzaga
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Paulo G Coelho
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York, New York, USA.,Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
| | - André Luis Zétola
- Department of Oral and Maxillofacial Surgery, Universidade Positivo, Curitiba, Paraná, Brazil
| | - Fernando P Weiss
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA
| | - Ernesto B Benalcázar Jalkh
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, São Paulo, Brazil
| | | | - Lukasz Witek
- Department of Biomaterials, New York University College of Dentistry, New York, New York, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, USA
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6
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Effectiveness of Biofunctionalization of Titanium Surfaces with Phosphonic Acid. Biomedicines 2021; 9:biomedicines9111663. [PMID: 34829894 PMCID: PMC8615956 DOI: 10.3390/biomedicines9111663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/30/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
Surface functionalization of dental implant surfaces has been a developing field in biomaterial research. This study aimed to obtain self-assembled monolayers (SAMs) using carboxyethylphosphonic acid on the surface of titanium (Ti) screws, and assessed the surface characteristics, biomechanical, and cellular behavior on the obtained specimens. This study had three groups, i.e., a control (untreated screws), a test group treated with phosphonic acid, and a third group with treated acid and bone morphogenetic protein (BMP-2) for in vitro analysis of cell lines. The assessed parameters included surface wettability, surface characteristics using scanning electron microscopy (SEM), protein immobilization, and cellular behavior of fibroblasts and mesenchymal stem cells of adipose tissue (MSCat cells). For surface wettability, a Welch test was performed to compare the contact angles between control (67 ± 1.83) and test (18.84 ± 0.72) groups, and a difference was observed in the mean measurements, but was not statistically significant. The SEM analysis showed significant surface roughness on the test screws and the cellular behavior of fibroblasts, and MSCat cells were significantly improved in this group, with fibroblasts having a polygonal shape with numerous vesicles and MSCat cells stable and uniformly coating the test Ti surface. Surface biofunctionalization of Ti surfaces with phosphonic acid showed promising results in this study, but remains to be clinically validated for its applications.
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7
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Chen JC, Chen CH, Chang KC, Liu SM, Ko CL, Shih CJ, Sun YS, Chen WC. Evaluation of the Grafting Efficacy of Active Biomolecules of Phosphatidylcholine and Type I Collagen on Polyether Ether Ketone: In Vitro and In Vivo. Polymers (Basel) 2021; 13:polym13132081. [PMID: 34202722 PMCID: PMC8271559 DOI: 10.3390/polym13132081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 01/17/2023] Open
Abstract
Biomolecule grafting on polyether ether ketone (PEEK) was used to improve cell affinity caused by surface inertness. This study demonstrated the sequence-polished (P) and sulfonated (SA) PEEK modification to make a 3D structure, active biomolecule graftings through PEEK silylation (SA/SI) and then processed with phosphatidylcholine (with silylation of SA/SI/PC; without SA/PC) and type I collagen (COL I, with silylation of SA/SI/C; without SA/C). Different modified PEEKs were implanted for 4, 8, and 12 weeks for histology. Sulfonated PEEK of SA showed the surface roughness was significantly increased; after the silylation of SA/SI, the hydrophilic nature was remarkably improved. The biomolecules were effectively grafted through silylation, and the cells showed improved attachment after 1 h. Furthermore, the SA/SI/PC group showed good in vitro mineralization. The new bone tissues were integrated into the 3D porous structures of SA/SI/PC and SA/SI/C in vivo making PEEK a potential alternative to metals in orthopedic implants.
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Affiliation(s)
- Jian-Chih Chen
- Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Chih-Hua Chen
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung 407, Taiwan; (C.-H.C.); (K.-C.C.); (S.-M.L.); (C.-L.K.)
| | - Kai-Chi Chang
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung 407, Taiwan; (C.-H.C.); (K.-C.C.); (S.-M.L.); (C.-L.K.)
| | - Shih-Ming Liu
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung 407, Taiwan; (C.-H.C.); (K.-C.C.); (S.-M.L.); (C.-L.K.)
| | - Chia-Ling Ko
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung 407, Taiwan; (C.-H.C.); (K.-C.C.); (S.-M.L.); (C.-L.K.)
| | - Chi-Jen Shih
- Department of Fragrance and Cosmetic Science, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Ying-Sui Sun
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan;
| | - Wen-Cheng Chen
- Advanced Medical Devices and Composites Laboratory, Department of Fiber and Composite Materials, Feng Chia University, Taichung 407, Taiwan; (C.-H.C.); (K.-C.C.); (S.-M.L.); (C.-L.K.)
- Department of Fragrance and Cosmetic Science, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Dental Medical Devices and Materials Research Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Correspondence:
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Wang T, Ni G, Furushima T, Diao H, Zhang P, Chen S, Fogarty CE, Jiang Z, Liu X, Li H. Mg alloy surface immobilised with caerin peptides acquires enhanced antibacterial ability and putatively improved corrosion resistance. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 121:111819. [PMID: 33579462 DOI: 10.1016/j.msec.2020.111819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 01/04/2023]
Abstract
Magnesium (Mg) has mechanical properties similar to human bones and Mg alloy is considered ideal medical implant material. However, the high velocity of degradation inside the human inner environment severely hampers the usage of Mg alloys. In this study, caerin peptide 1.9 (F3) and a modified sequence of caerin 1.1 (F1) with anti-bacterial activity, were covalently immobilised on the surface of Mg alloys by plasma chemical click reaction. The in vitro antibacterial activity and corrosion resistance of these caerin peptide-immobilised Mg alloys were investigated in Dulbecco's Modified Eagle Medium (DMEM) solution. Un-immobilised Mg alloy sample, blank drug-sensitive tablet (BASD) and a commonly used antibiotics Tazocin were used for comparison. Results showed that peptide immobilised Mg samples showed observable improved corrosion resistance and prolonged antibacterial effect compared to non-immobilised Mg alloy and free caerin peptides. These results indicate that coating Mg alloy with caerin peptides obviously increases the alloy's antibacterial ability and putatively improves the corrosion resistance in vitro. The mechanism underlying the prolonged antibacterial effect for annealed Mg alloys immobilised with the peptides (especially F3) remains unclear, which worth further experimental and theoretical investigation.
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Affiliation(s)
- Tianfang Wang
- Genecology Research Centre, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
| | - Guoying Ni
- Genecology Research Centre, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia; The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou 510080, China
| | - Tsuyoshi Furushima
- Institute of Industrial Science, Department of Mechanical and Biofunctional Systems, The University of Tokyo, 4-6-1, Komaba, Meguro, Tokyo 153-8505, Japan
| | - Hui Diao
- Centre for Microscopy and Microanalysis, University of Queensland, St. Lucia, QLD 4072, Australia
| | - Pingping Zhang
- Cancer Research Institute, First People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Shu Chen
- Cancer Research Institute, First People's Hospital of Foshan, Foshan, Guangdong 528000, China
| | - Conor E Fogarty
- Genecology Research Centre, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia
| | - Zhengyi Jiang
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, Faculty of Engineering and Information Sciences, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia
| | - Xiaosong Liu
- Genecology Research Centre, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia; Cancer Research Institute, First People's Hospital of Foshan, Foshan, Guangdong 528000, China.
| | - Hejie Li
- Genecology Research Centre, University of the Sunshine Coast, Maroochydore DC, QLD 4558, Australia; Institute of Industrial Science, Department of Mechanical and Biofunctional Systems, The University of Tokyo, 4-6-1, Komaba, Meguro, Tokyo 153-8505, Japan.
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Weber M, Wehrhan F, Deschner J, Sander J, Ries J, Möst T, Bozec A, Gölz L, Kesting M, Lutz R. The Special Developmental Biology of Craniofacial Tissues Enables the Understanding of Oral and Maxillofacial Physiology and Diseases. Int J Mol Sci 2021; 22:ijms22031315. [PMID: 33525669 PMCID: PMC7866214 DOI: 10.3390/ijms22031315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 11/21/2022] Open
Abstract
Maxillofacial hard tissues have several differences compared to bones of other localizations of the human body. These could be due to the different embryological development of the jaw bones compared to the extracranial skeleton. In particular, the immigration of neuroectodermally differentiated cells of the cranial neural crest (CNC) plays an important role. These cells differ from the mesenchymal structures of the extracranial skeleton. In the ontogenesis of the jaw bones, the development via the intermediate stage of the pharyngeal arches is another special developmental feature. The aim of this review was to illustrate how the development of maxillofacial hard tissues occurs via the cranial neural crest and pharyngeal arches, and what significance this could have for relevant pathologies in maxillofacial surgery, dentistry and orthodontic therapy. The pathogenesis of various growth anomalies and certain syndromes will also be discussed.
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Affiliation(s)
- Manuel Weber
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
- Correspondence: ; Tel.: +49-9131-854-3749
| | - Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
- Private Office for Maxillofacial Surgery, 91781 Weißenburg, Germany
| | - James Deschner
- Department of Periodontology and Operative Dentistry, University of Mainz, 55131 Mainz, Germany;
| | - Janina Sander
- Private Office for Oral Surgery, 96049 Bamberg, Germany;
| | - Jutta Ries
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
| | - Tobias Möst
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
| | - Aline Bozec
- Department of Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Lina Gölz
- Department of Orthodontics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany;
| | - Marco Kesting
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (F.W.); (J.R.); (T.M.); (M.K.); (R.L.)
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10
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López-Valverde N, Flores-Fraile J, Ramírez JM, Macedo de Sousa B, Herrero-Hernández S, López-Valverde A. Bioactive Surfaces vs. Conventional Surfaces in Titanium Dental Implants: A Comparative Systematic Review. J Clin Med 2020; 9:jcm9072047. [PMID: 32610687 PMCID: PMC7408888 DOI: 10.3390/jcm9072047] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/17/2020] [Accepted: 06/21/2020] [Indexed: 12/15/2022] Open
Abstract
Animal studies and the scarce clinical trials available that have been conducted suggest that bioactive surfaces on dental implants could improve the osseointegration of such implants. The purpose of this systematic review was to compare the effectiveness of osseointegration of titanium (Ti) dental implants using bioactive surfaces with that of Ti implants using conventional surfaces such as sandblasted large-grit acid-etched (SLA) or similar surfaces. Applying the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, the MEDLINE, PubMed Central and Web of Science databases were searched for scientific articles in April 2020. The keywords used were “dental implants”, “bioactive surfaces”, “biofunctionalized surfaces”, and “osseointegration”, according to the question: “Do bioactive dental implant surfaces have greater osseointegration capacity compared with conventional implant surfaces?” Risk of bias was assessed using the Cochrane Collaboration tool. 128 studies were identified, of which only 30 met the inclusion criteria: 3 clinical trials and 27 animal studies. The average STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) and ARRIVE (Animal Research: Reporting of In Vivo Experiments) scores were 15.13 ± 2.08 and 17.7±1.4, respectively. Implant stability quotient (ISQ) was reported in 3 studies; removal torque test (RTT)—in 1 study; intraoral periapical X-ray and microcomputed tomography radiological evaluation (RE)—in 4 studies; shear force (SF)—in 1 study; bone-to-implant contact (BIC)—in 12 studies; and BIC and bone area (BA) jointly—in 5 studies. All animal studies reported better bone-to-implant contact surface for bioactive surfaces as compared to control implants with a statistical significance of p < 0.05. Regarding the bioactive surfaces investigated, the best results were yielded by the one where mechanical and chemical treatment methods of the Ti surfaces were combined. Hydroxyapatite (HA) and calcium–phosphate (Ca–Ph) were the most frequently used bioactive surfaces. According to the results of this systematic review, certain bioactive surfaces have a positive effect on osseointegration, although certain coating biomolecules seem to influence early peri-implant bone formation. Further and more in-depth research in this field is required to reduce the time needed for osseointegration of dental implants.
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Affiliation(s)
- Nansi López-Valverde
- Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (N.L.-V.); (J.F.-F.); (S.H.-H.)
| | - Javier Flores-Fraile
- Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (N.L.-V.); (J.F.-F.); (S.H.-H.)
| | - Juan Manuel Ramírez
- Department of Morphological Sciences, University of Cordoba, Avenida Menéndez Pidal s/n, 14071 Cordoba, Spain;
| | - Bruno Macedo de Sousa
- Institute for Occlusion and Orofacial Pain Faculty of Medicine, University of Coimbra, Polo I - Edifício Central Rua Larga, 3004-504 Coimbra, Portugal;
| | - Silvia Herrero-Hernández
- Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (N.L.-V.); (J.F.-F.); (S.H.-H.)
| | - Antonio López-Valverde
- Department of Surgery, University of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), 37007 Salamanca, Spain; (N.L.-V.); (J.F.-F.); (S.H.-H.)
- Correspondence:
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11
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Rao S, Hashemi Astaneh S, Villanueva J, Silva F, Takoudis C, Bijukumar D, Souza JCM, Mathew MT. Physicochemical and in-vitro biological analysis of bio-functionalized titanium samples in a protein-rich medium. J Mech Behav Biomed Mater 2019; 96:152-164. [PMID: 31035066 DOI: 10.1016/j.jmbbm.2019.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/17/2019] [Accepted: 03/19/2019] [Indexed: 01/04/2023]
Abstract
The long-term survivability of the implants is strongly influenced by the osseointegration aspects of the metal-bone interface. In this study, biological materials such as fibrinogen and fibrin are used to functionalize titanium surfaces to enhance the ability of implants to interact with human tissues for accelerated osseointegration. The biofunctionalized samples that were assessed by White Light Microscope, Scanning Electron Microscope and Water Contact Angle for surface properties proved samples etched with HF/HNO3 to be better than HCl/H2SO4 in terms of having optimum roughness and hydrophilicity for our further experiments. To further investigate the in vitro osseointegration of the biofunctionalized samples, Osteoblasts were cultured on the surfaces to assess cell proliferation, adhesion, gene expression as well as the mineralization process. Further bacterial adhesion (Enterococcus faecalis) and electrochemical evaluation of surface coating stability were carried out. Results of the study show that the biofunctionalized surfaces provided high cell proliferation, adherence, gene expression, and mineralization compared to other control surfaces hence proving them to have efficient and enhanced osseointegration. Also, bacterial adhesion studies show that there is no augmented growth of bacteria on the biofunctionalized samples in comparison to control surfaces. Electrochemical studies proved the existence of a stable protein layer on the bio functionalized surfaces. Such a method can reduce the time for osseointegration that can decrease risks in early failures of implants due to its enhanced hydrophilicity and cytocompatibility.
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Affiliation(s)
- Shradha Rao
- Department of Biomedical Science, University of Illinois College of Medicine at Rockford, USA
| | - Sarah Hashemi Astaneh
- Department of Chemical Engineering, the University of Illinois at Chicago, (UIC), Chicago, USA
| | - Jose Villanueva
- Department of Restorative Dentistry, College of Dentistry, UIC, Chicago, IL, USA
| | - Filipe Silva
- Center for MicroElectromechanical Systems (CMEMS-UMINHO), Universidade do Minho, Portugal
| | - Christos Takoudis
- Department of Chemical Engineering, the University of Illinois at Chicago, (UIC), Chicago, USA; Department of Bioengineering, University of Illinois at Chicago (UIC), Chicago, USA
| | - Divya Bijukumar
- Department of Biomedical Science, University of Illinois College of Medicine at Rockford, USA
| | - Júlio C M Souza
- Department of Biomedical Science, University of Illinois College of Medicine at Rockford, USA; Department of Dental Sciences, University Institute of Health Sciences (IUCS-CESPU), Grandra 4585-116, Portugal
| | - Mathew T Mathew
- Department of Biomedical Science, University of Illinois College of Medicine at Rockford, USA; Department of Bioengineering, University of Illinois at Chicago (UIC), Chicago, USA.
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12
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Liao J, Wu S, Li K, Fan Y, Dunne N, Li X. Peptide‐modified bone repair materials: Factors influencing osteogenic activity. J Biomed Mater Res A 2019; 107:1491-1512. [DOI: 10.1002/jbm.a.36663] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/29/2019] [Accepted: 02/14/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Jie Liao
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of EducationSchool of Biological Science and Medical Engineering, Beihang University Beijing 100083 China
| | - Shuai Wu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of EducationSchool of Biological Science and Medical Engineering, Beihang University Beijing 100083 China
| | - Kun Li
- State Key Laboratory of Powder MetallurgyCentral South University Changsha 410083 China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of EducationSchool of Biological Science and Medical Engineering, Beihang University Beijing 100083 China
- Beijing Advanced Innovation Center for Biomedical EngineeringBeihang University Beijing 100083 China
| | - Nicholas Dunne
- Centre for Medical Engineering ResearchSchool of Mechanical and Manufacturing Engineering, Dublin City University Stokes Building, Collins Avenue, Dublin 9 Ireland
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of EducationSchool of Biological Science and Medical Engineering, Beihang University Beijing 100083 China
- Beijing Advanced Innovation Center for Biomedical EngineeringBeihang University Beijing 100083 China
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Enhanced osteogenic differentiation of human mesenchymal stem cells on Ti surfaces with electrochemical nanopattern formation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 99:1174-1181. [PMID: 30889651 DOI: 10.1016/j.msec.2019.02.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/03/2019] [Accepted: 02/12/2019] [Indexed: 12/20/2022]
Abstract
Titanium (Ti) and its alloys are mainly used for dental and orthopedic applications due to their excellent biocompatibility and mechanical properties. However, their intrinsic bioinertness often quotes as a common complaint for biomedical applications. Herein, we produced nanopattern Ti surfaces with 10 nm nanopores in 120 nm dimples by electrochemical nanopattern formation (ENF), and evaluated the osteogenic differentiation of human mesenchymal stem cells (hMSCs) on the nanopattern Ti surfaces. The ENF surfaces were obtained by removing the TiO2 nanotube (NT) layers prepared by an anodization process. To determine the in vitro effects of the ENF surface, cell proliferation assay, alkaline phosphatase activity assay, alizarin red staining, western blotting, and immunocytochemistry were performed. Atomic force microscopy and scanning electron microscopy analysis show that the ENF surface has an ultrafine surface roughness with highly aligned nanoporous morphology. hMSCs on ENF surfaces exhibit increased proliferation and enhanced osteogenic differentiation as compared to the ordered TiO2 nanotubular and compact TiO2 surfaces. Surface modification with the ENF process is a promising technique for fabricating osteointegrative implant materials with a highly bioactive, rigid and purified nano surfaces.
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Farkasdi S, Pammer D, Rácz R, Hriczó-Koperdák G, Szabó BT, Dobó-Nagy C, Kerémi B, Blazsek J, Cuisinier F, Wu G, Varga G. Development of a quantitative preclinical screening model for implant osseointegration in rat tail vertebra. Clin Oral Investig 2018; 23:2959-2973. [PMID: 30374828 PMCID: PMC7398390 DOI: 10.1007/s00784-018-2661-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/25/2018] [Indexed: 11/24/2022]
Abstract
Objectives Functional tooth replacement and bone regeneration are parts of the daily practice in modern dentistry, but well-reproducible and relatively inexpensive experimental models are still missing. We aimed to develop a new small animal model to monitor osseointegration utilizing the combination of multiple evaluation protocols. Material and methods After cutting the tail between the C4 and C5 vertebrae in Wistar rats, costume made, parallel walled, non-threaded implants were placed into the center of the tail parallel with its longitudinal axis using a surgical guide. Osseointegration of the titanium implants was followed between 4 and 16 weeks after surgery applying axial extraction force, and resonance frequency analysis as functional tests, and histomorphometry and micro-CT as structural evaluations. Results In functional tests, we observed that both methods are suitable for the detection of the time-dependent increase in osseointegration, but the sensitivity of the pull-out technique (an approximately five times increase with rather low standard error) was much higher than that of the resonance frequency analysis. In structural evaluations, changes in the detected bone implant contact values measured by histomorphometry (yielding 1.5 times increase, with low variations of data) were more reliable than micro-CT based evaluations to screen the developments of contact between bone and implant. Conclusion Our results provide evidence that the caudal vertebrae osseointegration model is useful for the preclinical evaluation of implant integration into the bone. Clinical relevance The combination of the biomechanical and structural tests offers a well-reproducible small animal system that can be suitable for studying the integration of various implant materials and surface treatments.
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Affiliation(s)
- Sándor Farkasdi
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Dávid Pammer
- Department of Materials Science and Engineering, Budapest University of Technology and Economics, Budapest, Hungary
| | - Róbert Rácz
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Gergely Hriczó-Koperdák
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Bence Tamás Szabó
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary
| | - Beáta Kerémi
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - József Blazsek
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary
| | - Frederic Cuisinier
- Laboratoire Bioingénierie et Nanosciences EA4203, Université Montpellier, Montpellier, France
| | - Gang Wu
- Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije University Amsterdam and University of Amsterdam, Amsterdam, The Netherlands
| | - Gábor Varga
- Department of Oral Biology, Semmelweis University, Nagyvárad tér 4., Budapest, 1089, Hungary.
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Effect of Surgical Installation of Dental Implants on Surface Topography and Its Influence on Osteoblast Proliferation. Int J Dent 2018; 2018:4089274. [PMID: 30416524 PMCID: PMC6207882 DOI: 10.1155/2018/4089274] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/26/2018] [Accepted: 09/27/2018] [Indexed: 11/17/2022] Open
Abstract
Surface treatment alone does not determine the final microtopography of a dental implant, which can be influenced by implant design and the surgical procedure. This study investigated the effect of surgical placement of dental implants with same surface treatments on surface roughness. Three implants (SIN) of each group with different macrogeometries (Strong, Stylus, and Tryon) were analyzed using laser interferometry and scanning electron microscopy to evaluate surface topography. All threaded regions of the implants, namely, top, flank, and valley, were analyzed individually. Relevant surface parameters (Sa, Ssk, Sku, Str, and Sdq) were calculated for the different regions on each implant before (B) (n = 9) and after (A) (n = 9) placement into porcine rib bones. The behavior and proliferation of a preosteoblastic cell line MC3T3-E1 on titanium surface, cell viability, and osteopontin secretion were evaluated after 24 h, 48 h, and 96 h, also before (n = 18) and after (n = 18) implant placement into porcine ribs bone. As results, the valleys of all implants had an increase in Sa values after implant placement. By contrast, the tops of the Stylus A implant and the flanks of the Tryon A implant showed a significant decrease in mean height of the irregularities (Sa), 0.16 µm and 1.25 µm, respectively. The Stylus implant presented significantly (p < 0.05) higher asymmetry values on the distribution curve for irregularity heights (Sku) in all regions after insertion into bone (6.99 for tops, 9.54 for flanks, and 17.64 for valleys), indicating a greater preponderance of peaks over valleys. An increase in roughness gradients (Sdq) was observed for all macrogeometries after insertion into bone. The cell culture results showed no significant difference (p > 0.05) for all macrogeometries after bone placement. In conclusion, a subtle change in implant surface roughness was detected after insertion into bone for all the macrogeometries, without significantly affecting the cellular parameters studied.
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Lai M, Yan X, Jin Z. The response of bone cells to titanium surfaces modified by simvastatin-loaded multilayered films. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2018; 29:1895-1908. [PMID: 30156968 DOI: 10.1080/09205063.2018.1517483] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to enhance cytocompatibility of titanium substrates by loading a multilayer film of chitosan (Chi), gelatin (Gel) and simvastatin (SV). This was fabricated using a spin-assisted layer-by-layer (LBL) technique. The surface properties of the different substrates were characterized by field emission scanning electron microscopy (FE-SEM), atomic force microscope (AFM), X-ray photoelectron spectroscopy (XPS) and contact angle measurement, respectively. Simvastatin release in vitro was measured by ultraviolet-visible spectrophotometer. A well morphology with filopodia extensions was observed in mesenchymal stem cells (MSCs) grown on simvastatin loaded multilayered films-modified titanium substrates. After 7, 14 and 21 days of culture, the simvastatin loaded multilayered films increased cell proliferation, improved osteoblastic differentiation of alkaline phosphatase (ALP) and mineralization. Additionally, osteoclast diffentiation marker tartrate-resistant acid phosphatase (TRAP) was decreased in simvastatin loaded multilayered films. This study provides a new insight for the fabrication of titanium-based implants to enhance osseointegration especially for osteoporosis patients in orthopedic application.
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Affiliation(s)
- Min Lai
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
| | - Xufeng Yan
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
| | - Ziyang Jin
- a School of Life Science , Jiangsu Normal University , Xuzhou , Jiangsu , China
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Effect of Different Morphology of Titanium Surface on the Bone Healing in Defects Filled Only with Blood Clot: A New Animal Study Design. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4265474. [PMID: 30175131 PMCID: PMC6106843 DOI: 10.1155/2018/4265474] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/22/2018] [Indexed: 12/25/2022]
Abstract
Background The objective of the present histologic animal study was to analyze whether roughness of the titanium surface can influence and/or stimulate the bone growth in defects filled with the blood using a rabbit tibia model. Materials and Methods Forty sets (implant and abutment), dental implant (3.5 mm in diameter and 7 mm in length) plus healing abutment (2.5 mm in diameter), were inserted in the tibiae of 10 rabbits. Moreover, twenty titanium discs were prepared. The abutment and discs were treated by 4 different methods and divided into 4 groups: (group A) machined abutments (smooth); (group B) double acid etching treatment; (group C) treatment with blasting with particles of aluminum oxide blasted plus acid conditioning; (group D) treatment with thorough blasting with particles of titanium oxide plus acid conditioning. The discs were used to characterize the surfaces by a profilometer and scanning electronic microscopy. Results After 8 weeks, the new bone formation around the sets of the samples was analyzed qualitatively and quantitatively in relation to bone height from the base of the implant and presence of osteocytes. Group C (1.50±0.20 mm) and group D (1.62±0.18 mm) showed bone growth on the abutment with higher values compared to group A (0.94±0.30 mm) and group B (1.19±0.23 mm), with significant difference between the groups (P < 0.05). In addition, osteocyte presence was higher in groups with surface treatment related to machined (P < 0.05). Conclusions Within the limitations of the present study, it was possible to observe that there is a direct relationship between the roughness present on the titanium surface and the stimulus for bone formation, since the presence of larger amounts of osteocytes on SLA surfaces evidenced this fact. Furthermore, the increased formation of bone tissue in height demonstrates that there is an important difference between the physical and chemical methods used for surface treatment.
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18
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Peri-Implant Bone Behavior after Single Drill versus Multiple Sequence for Osteotomy Drill. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9756043. [PMID: 29850594 PMCID: PMC5925187 DOI: 10.1155/2018/9756043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 02/07/2018] [Indexed: 11/26/2022]
Abstract
Objectives The present study aims to compare the drilling protocol effect on osseointegration event in three commercially available titanium dental implants with different drill protocol using a rabbit tibia model. Materials and Methods Three different drilling sequences were compared as follows: drilling sequence using a single unique drill of 4.2 mm conical implant (Group 1), drilling sequence using 3 consecutive cylindrical drills for a 4.1 mm cylindrical implant (Group 2), and drilling sequence using 3 consecutive conical drills for a 4.3 mm conical implant (Group 3). For each group, 18 drilling procedures and implant placements were performed, totalizing 54 commercially available titanium dental implants. The samples were removed 6 weeks after implantation. Resonance frequency analyses (RFA) were performed immediately after the implantation, and at 6 weeks removal torque test (RTt) and histological analysis were performed. Results The RFA measured showed statistical difference between the groups in time 1 and no significant statistical differences in time 2 (p > 0.05). In the RTt no significant difference was found between the 3 groups tested. Histomorphometric analysis showed no significant difference between groups in the bone-to-implant contact% (p > 0.05). Conclusion In the present preclinical study, osteotomy using a single bur did not show differences regarding the proposed and evaluated tests parameters for assessing the peri-implant behavior.
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Moraschini V, Almeida DCF, Calasans-Maia JA, Diuana Calasans-Maia M. The ability of topical and systemic statins to increase osteogenesis around dental implants: a systematic review of histomorphometric outcomes in animal studies. Int J Oral Maxillofac Surg 2018; 47:1070-1078. [PMID: 29352637 DOI: 10.1016/j.ijom.2017.12.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 01/17/2023]
Abstract
The purpose of this systematic review was to evaluate the quantitative histomorphometric outcomes of animal studies investigating statins as a pro-osteogenic agent to enhance the osseointegration of dental implants. Some animal studies have suggested a beneficial action of statins on bone tissue. Electronic and manual literature searches, without date or language restriction, were performed by two independent review authors up to February 2017. Eligibility criteria included animal trials quantitatively analysing the pro-osteogenic effect of statins on dental implants. The quality of the included studies was assessed using the ARRIVE guidelines. The search and selection process yielded 12 studies, published between 2004 and 2015. The experimental animals models used were rats and dogs. The statins used in the studies were simvastatin and fluvastatin, which were administered locally or systemically, or applied to the implant surface. All of the selected studies showed a statistically significant positive effect of statins on bone formation around implants. The mean quality assessment score (ARRIVE) of the studies was 11.5±2.27 out of a possible total of 25 points. The histomorphometric data from available preclinical studies suggest a positive effect of statins on increasing osteogenesis around dental implants.
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Affiliation(s)
- V Moraschini
- Department of Periodontology, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
| | - D C F Almeida
- Department of Implantology, Brazilian Air Force, Odontoclínica de Aeronáutica Santos-Dumont, Rio de Janeiro, Brazil
| | - J A Calasans-Maia
- Department of Orthodontic, School of Dentistry, Fluminense Federal University, Rio de Janeiro, Brazil
| | - M Diuana Calasans-Maia
- Department of Oral Surgery, School of Dentistry, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Tapsir Z, Jamaludin FH, Pingguan-Murphy B, Saidin S. Immobilisation of hydroxyapatite-collagen on polydopamine grafted stainless steel 316L: Coating adhesion and in vitro cells evaluation. J Biomater Appl 2017; 32:987-995. [PMID: 29187035 DOI: 10.1177/0885328217744081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The utilisation of hydroxyapatite and collagen as bioactive coating materials could enhance cells attachment, proliferation and osseointegration. However, most methods to form crystal hydroxyapatite coating do not allow the incorporation of polymer/organic compound due to production phase of high sintering temperature. In this study, a polydopamine film was used as an intermediate layer to immobilise hydroxyapatite-collagen without the introduction of high sintering temperature. The surface roughness, coating adhesion, bioactivity and osteoblast attachment on the hydroxyapatite-collagen coating were assessed as these properties remains unknown on the polydopamine grafted film. The coating was developed by grafting stainless steel 316L disks with a polydopamine film. Collagen type I fibres were then immobilised on the grafted film, followed by the biomineralisation of hydroxyapatite. The surface roughness and coating adhesion analyses were later performed by using AFM instrument. An Alamar Blue assay was used to determine the cytotoxicity of the coating, while an alkaline phosphatase activity test was conducted to evaluate the osteogenic differentiation of human fetal osteoblasts on the coating. Finally, the morphology of cells attachment on the coating was visualised under FESEM. The highest RMS roughness and coating adhesion were observed on the hydroxyapatite-collagen coating (hydroxyapatite-coll-dopa). The hydroxyapatite-coll-dopa coating was non-toxic to the osteoblast cells with greater cells proliferation, greater level of alkaline phosphate production and more cells attachment. These results indicate that the immobilisation of hydroxyapatite and collagen using an intermediate polydopamine is identical to enhance coating adhesion, osteoblast cells attachment, proliferation and differentiation, and thus could be implemented as a coating material on orthopaedic and dental implants.
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Affiliation(s)
- Zafirah Tapsir
- 1 Biomedical Sciences Laboratory, Faculty of Biosciences & Medical Engineering (FBME), 54702 Universiti Teknologi Malaysia , Skudai, Johor, Malaysia
| | - Farah H Jamaludin
- 1 Biomedical Sciences Laboratory, Faculty of Biosciences & Medical Engineering (FBME), 54702 Universiti Teknologi Malaysia , Skudai, Johor, Malaysia
| | - Belinda Pingguan-Murphy
- 2 Biomedical Engineering Department, Faculty of Engineering, 236783 University of Malaya , Kuala Lumpur, Malaysia
| | - Syafiqah Saidin
- 3 IJN-UTM Cardio Centre, 54702 Universiti Teknologi Malaysia , Skudai, Johor, Malaysia
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Cao L, Wang L, Fan L, Xiao W, Lin B, Xu Y, Liang J, Cao B. RGDC Peptide-Induced Biomimetic Calcium Phosphate Coating Formed on AZ31 Magnesium Alloy. MATERIALS 2017; 10:ma10040358. [PMID: 28772717 PMCID: PMC5506929 DOI: 10.3390/ma10040358] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/19/2017] [Accepted: 03/24/2017] [Indexed: 01/23/2023]
Abstract
Magnesium alloys as biodegradable metal implants have received a lot of interest in biomedical applications. However, magnesium alloys have extremely high corrosion rates a in physiological environment, which have limited their application in the orthopedic field. In this study, calcium phosphate compounds (Ca–P) coating was prepared by arginine–glycine–aspartic acid–cysteine (RGDC) peptide-induced mineralization in 1.5 simulated body fluid (SBF) to improve the corrosion resistance and biocompatibility of the AZ31 magnesium alloys. The adhesion of Ca–P coating to the AZ31 substrates was evaluated by a scratch test. Corrosion resistance and cytocompatibility of the Ca–P coating were investigated. The results showed that the RGDC could effectively promote the nucleation and crystallization of the Ca–P coating and the Ca–P coating had poor adhesion to the AZ31 substrates. The corrosion resistance and biocompatibility of the biomimetic Ca–P coating Mg alloys were greatly improved compared with that of the uncoated sample.
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Affiliation(s)
- Lin Cao
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.
| | - Lina Wang
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.
| | - Lingying Fan
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.
| | - Wenjun Xiao
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.
| | - Bingpeng Lin
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.
| | - Yimeng Xu
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.
| | - Jun Liang
- State Key Laboratory of Solid Lubrication, Lanzhou Institute of Chemical Physics, Chinese Academy of Sciences, Lanzhou 730000, China.
| | - Baocheng Cao
- School of Stomatology, Lanzhou University, Lanzhou 730000, China.
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Meng HW, Chien EY, Chien HH. Dental implant bioactive surface modifications and their effects on osseointegration: a review. Biomark Res 2016. [PMID: 27999672 DOI: 10.1186/s40364‐016‐0078‐z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The purpose of this article is to review and update the current developments of biologically active dental implant surfaces and their effect on osseointegration. METHODS PubMed was searched for entries from January 2006 to January 2016. Only in-vivo studies that evaluated the effects of biomolecular coatings on titanium dental implants inserted into the bone of animals or humans were included. RESULTS Thirty four non-review studies provided data and observations were included in this review. Within the criteria, four categories of biomolecular coatings were evaluated. The potential biomolecules include bone morphogenetic proteins in 8 articles, other growth factors in 8 articles, peptides in 5 articles, and extracellular matrix in 13 articles. Most articles had a healing period of 1 to 3 months and the longest time of study was 6 months. In addition, all studies comprised of implants inserted in animals except for one, which evaluated implants placed in both animals and humans. The results indicate that dental implant surface modification with biological molecules seem to improve performance as demonstrated by histomorphometric analysis (such as percentage of bone-to-implant contact and peri-implant bone density) and biomechanical testing (such as removal torque, push-out/pull-out tests, and resonance frequency analysis). CONCLUSIONS Bioactive surface modifications on implant surfaces do not always offer a beneficial effect on osseointegration. Nevertheless, surface modifications of titanium dental implants with biomolecular coatings seem to promote peri-implant bone formation, resulting in enhanced osseointegration during the early stages of healing. However, long-term clinical studies are needed to validate this result. In addition, clinicians must keep in mind that results from animal experiments need not necessarily reflect the human clinical reality.
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Affiliation(s)
- Hsiu-Wan Meng
- Department of Periodontics, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Esther Yun Chien
- College of Dentistry, The Ohio State University, Columbus, OH USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH 43210 USA
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Meng HW, Chien EY, Chien HH. Dental implant bioactive surface modifications and their effects on osseointegration: a review. Biomark Res 2016; 4:24. [PMID: 27999672 PMCID: PMC5155396 DOI: 10.1186/s40364-016-0078-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 11/29/2016] [Indexed: 01/15/2023] Open
Abstract
Background The purpose of this article is to review and update the current developments of biologically active dental implant surfaces and their effect on osseointegration. Methods PubMed was searched for entries from January 2006 to January 2016. Only in-vivo studies that evaluated the effects of biomolecular coatings on titanium dental implants inserted into the bone of animals or humans were included. Results Thirty four non-review studies provided data and observations were included in this review. Within the criteria, four categories of biomolecular coatings were evaluated. The potential biomolecules include bone morphogenetic proteins in 8 articles, other growth factors in 8 articles, peptides in 5 articles, and extracellular matrix in 13 articles. Most articles had a healing period of 1 to 3 months and the longest time of study was 6 months. In addition, all studies comprised of implants inserted in animals except for one, which evaluated implants placed in both animals and humans. The results indicate that dental implant surface modification with biological molecules seem to improve performance as demonstrated by histomorphometric analysis (such as percentage of bone-to-implant contact and peri-implant bone density) and biomechanical testing (such as removal torque, push-out/pull-out tests, and resonance frequency analysis). Conclusions Bioactive surface modifications on implant surfaces do not always offer a beneficial effect on osseointegration. Nevertheless, surface modifications of titanium dental implants with biomolecular coatings seem to promote peri-implant bone formation, resulting in enhanced osseointegration during the early stages of healing. However, long-term clinical studies are needed to validate this result. In addition, clinicians must keep in mind that results from animal experiments need not necessarily reflect the human clinical reality.
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Affiliation(s)
- Hsiu-Wan Meng
- Department of Periodontics, University of Texas School of Dentistry at Houston, Houston, TX USA
| | - Esther Yun Chien
- College of Dentistry, The Ohio State University, Columbus, OH USA
| | - Hua-Hong Chien
- Division of Periodontology, College of Dentistry, The Ohio State University, 305 West 12th Avenue, Columbus, OH 43210 USA
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Gehrke SA, Ramírez-Fernandez MP, Granero Marín JM, Barbosa Salles M, Del Fabbro M, Calvo Guirado JL. A comparative evaluation between aluminium and titanium dioxide microparticles for blasting the surface titanium dental implants: an experimental study in rabbits. Clin Oral Implants Res 2016; 29:802-807. [DOI: 10.1111/clr.12973] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Sergio A. Gehrke
- Biotecnos Research Center; Santa Maria Brazil
- University Catholica San Antonio de Murcia (UCAM); Murcia Spain
| | - María P. Ramírez-Fernandez
- International Dentistry Research Cathedra; Faculty of Medicine; San Antonio Catholic University of Murcia (UCAM); Murcia Spain
| | | | | | - Massimo Del Fabbro
- Research Center in Oral Health; Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; IRCCS Istituto Ortopedico Galeazzi; Milano Italy
| | - José Luis Calvo Guirado
- International Dentistry Research Cathedra; Faculty of Medicine & Dentistry; San Antonio Catholic University of Murcia (UCAM); Murcia Spain
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Bodelón OG, Clemente C, Alobera MA, Aguado-Henche S, Escudero ML, Alonso MCG. Osseointegration of TI6Al4V dental implants modified by thermal oxidation in osteoporotic rabbits. Int J Implant Dent 2016; 2:18. [PMID: 27747710 PMCID: PMC5005616 DOI: 10.1186/s40729-016-0051-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 07/07/2016] [Indexed: 02/05/2023] Open
Abstract
Background In this work, the effect of the heat treatment on Ti6Al4V implants and topical administration of growth hormone to address a better osseointegration in osteoporotic patients has been analysed. Methods The osseointegration process of Ti6Al4V implants modified by oxidation treatment at 700 °C for 1 h and the influence of local administration of growth hormone (GH) in osteoporotic female rabbits after 15 and 30 days of implantation have been studied. Bone response was analysed through densitometric and histomorphometric studies. Characterization of the surface was provided by scanning electron microscopy. Results The oxidation treatment promotes the formation of an oxide scale grown on the Ti6Al4V implants that alters the nanoroughness of the surface. Bone mineral density (BMD) increases from 0.347 ± 0.014 (commercial) to 0.383 ± 0.012 g cm−2 (modified), and bone-to-implant contact (BIC) goes from 48.01 ± 14.78 (commercial) to 55.37 ± 15.31 (modified) after 30 days of implantation. Conclusions The oxidation treatment on the Ti6Al4V dental implants enhances the early bone formation at the longest periods of implantation. No significant differences in the BMD and BIC results in healthy and osteoporotic rabbits were revealed with respect to the local administration of GH in the implantation site.
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Affiliation(s)
- Oscar G Bodelón
- Department of Characterization, Quality and Safety, Institute of Food Science, Technology and Nutrition (ICTAN-CSIC), Madrid, Spain
| | - Celia Clemente
- Department of Human Anatomy and Embryology, School of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - Miguel Angel Alobera
- Stomatology Department IV, Complutense University of Madrid (UCM), Madrid, Spain
| | - Soledad Aguado-Henche
- Department of Human Anatomy and Embryology, School of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - María Lorenza Escudero
- Department of Surface Engineering, Corrosion and Durability, National Center for Metallurgical Research (CENIM), CSIC, Avda. Gregorio del Amo 8, 28040, Madrid, Spain
| | - María Cristina García Alonso
- Department of Surface Engineering, Corrosion and Durability, National Center for Metallurgical Research (CENIM), CSIC, Avda. Gregorio del Amo 8, 28040, Madrid, Spain.
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Wang Z, Hu Z, Zhang D, Zhuo M, Cheng J, Xu X, Xing Y, Fan J. Silencing tumor necrosis factor-alpha in vitro from small interfering RNA-decorated titanium nanotube array can facilitate osteogenic differentiation of mesenchymal stem cells. Int J Nanomedicine 2016; 11:3205-14. [PMID: 27478375 PMCID: PMC4951061 DOI: 10.2147/ijn.s104090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Titanium implants are known for their bone bonding ability. However, the osseointegration may be severely disturbed in the inflammation environment. In order to enhance osseointegration of the implant in an inflamed environment, the small interfering RNA (siRNA) targeting tumor necrosis factor alpha (TNF-α) was used to functionalize titanium surface for gene silencing. The chitosan–tripolyphosphate–hyaluronate complexes were used to formulate nanoparticles (NPs) with siRNA, which were adsorbed directly by the anodized titanium surface. The surface characterization was analyzed by scanning electron microscope, atomic force microscopy, as well as contact angle measurement. The fluorescence microscope was used to monitor the degradation of the layer. The coculture system was established with mesenchymal stem cells (MSCs) grown directly on functionalized titanium surface and RAW264.7 cells (preactivated by lipopolysaccharide) grown upside in a transwell chamber. The transfection and knockdown efficiency of TNF-α in RAW264.7 cells were determined by fluorescence microscope, quantitative polymerase chain reaction, and enzyme-linked immunosorbent assay. The cytoskeleton and osteogenic differentiation of MSCs were also analyzed. Regular vertical aligned nanotubes (~100 nm diameter and ~300 nm length) were generated after anodization of polished titanium. After loading with NPs, the nanotubes were filled and covered by a layer of amorphous particles. The surface topography changed and wettability decreased after covering with NPs. As expected, a burst degradation of the film was observed, which could provide sufficient NPs in the released supernatant and result in transfection and knockdown effects in RAW264.7 cells. The cytoskeleton arrangement of MSCs was elongated and the osteogenic differentiation was also significantly improved on NPs loading surface. In conclusion, the siRNA decorated titanium implant could simultaneously suppress inflammation and improve osteogenesis, which may be suitable for peri-implant bone formation under inflammatory conditions.
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Affiliation(s)
| | - Zhiqiang Hu
- Department of Otorhinolaryngology, No 113 Hospital of PLA, Ningbo
| | - Dawei Zhang
- Department of Orthopaedics, Xijing Hospital of PLA, Xi'an, People's Republic of China
| | | | | | | | | | - Jie Fan
- Department of Otorhinolaryngology, No 113 Hospital of PLA, Ningbo
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Sivolella S, Brunello G, Ferroni L, Berengo M, Meneghello R, Savio G, Piattelli A, Gardin C, Zavan B. A Novel In Vitro Technique for Assessing Dental Implant Osseointegration. Tissue Eng Part C Methods 2016; 22:132-141. [DOI: 10.1089/ten.tec.2015.0158] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Stefano Sivolella
- Section of Dentistry, Department of Neurosciences, University of Padova, Padova, Italy
| | - Giulia Brunello
- Section of Dentistry, Department of Neurosciences, University of Padova, Padova, Italy
| | - Letizia Ferroni
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Mario Berengo
- Section of Dentistry, Department of Neurosciences, University of Padova, Padova, Italy
| | - Roberto Meneghello
- Department of Management and Engineering, University of Padova, Vicenza, Italy
| | - Gianpaolo Savio
- Department of Civil, Environmental and Architectural Engineering, University of Padova, Padova, Italy
| | - Adriano Piattelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Chiara Gardin
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Barbara Zavan
- Department of Biomedical Sciences, University of Padova, Padova, Italy
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Schmitt CM, Koepple M, Moest T, Neumann K, Weisel T, Schlegel KA. In vivo evaluation of biofunctionalized implant surfaces with a synthetic peptide (P-15) and its impact on osseointegration. A preclinical animal study. Clin Oral Implants Res 2015; 27:1339-1348. [PMID: 26567087 DOI: 10.1111/clr.12723] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The overall aim of the study was to investigate a biofunctionalized implant surface with electrochemically deposition of hydroxyapatite and the synthetic peptide (P-15) and its effect on osseointegration. MATERIAL AND METHODS Three modified implant types of ANKYLOS® C/X implants were used; (1) machined implants used as negative control (M, n = 20), (2) implants with the FRIADENT® plus surface (grit blasted and acid-etched) used as positive control (P, n = 20), and (3) implants with a biomimetic surface consisting of hydroxyapatite and the synthetic 15 aminoacids containing peptide P-15 (BP, n = 40). The implants were randomly inserted in the mandibles of 10 beagle dogs following 4 months after tooth extraction (P1-P4). Three animals were sacrificed 2 and 7 days after implant insertion, respectively, and four animals were sacrificed 6 months post implant insertion. Bone-to-implant contacts (BICs) were analyzed via histomorphometrical analyses at five different region of interests (ROIs); two at the middle part on either side of the implant (ROI 1/4), two at the apical part of the implant at each side (ROI 2/3), and one at the tip of the implant (ROI 5). RESULTS All implant surfaces showed a high level of osseointegration and osteoconductivity. The cumulative implant survival rate (CSR) was 93.8%, 100% in the M, 85% in the P, and 95% in the BP group. No statistical difference in BICs at ROI 1/4, 2/3, and 5 could be shown between implant types following 2 and 7 days of healing. BIC values increased in all groups over time. After 6 months of healing the BP group showed superiority in BIC in ROI 2/3 (73.2 ± 15.6%) compared to the P (48.3 ± 10.6%) and M group (66.3 ± 30.2%) with a significant difference between BP and P (P = 0.002). CONCLUSION It is hypothesized, that the surface biofunctionalization improves peri-implant bone formation and remodeling, leading to an increased bone-to implant contact. However, within the limitations of the study set-up no benefit in the early phase of osseointegration could be established for dental implants with P-15 containing surface in this study.
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Affiliation(s)
- Christian M Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Markus Koepple
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Tobias Moest
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Konrad Neumann
- Institute of Medical Biometrics and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Nonhoff J, Moest T, Schmitt CM, Weisel T, Bauer S, Schlegel KA. Establishment of a new pull-out strength testing method to quantify early osseointegration-An experimental pilot study. J Craniomaxillofac Surg 2015; 43:1966-73. [PMID: 26616405 DOI: 10.1016/j.jcms.2015.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 08/27/2015] [Accepted: 10/05/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The animal study aims to evaluate a new experimental model for measuring sole the influence of the surface characteristics independent from implant macro-design on the level of osseointegration by registering the pull-out strength needed for removal of experimental devices with different surfaces from artificial defects. MATERIAL AND METHODS Seventy-two test bodies (36 with the FRIADENT(®) plus surface, 36 with the P15/HAp biofunctionalized surface) were inserted in six adult domestic pigs with artificial calvarial defects. The experimental devices were designed to fit in the defects leaving a gap between the test body and the local bone. After 21 days of healing, the animals were sacrificed and the test bodies were pulled out with a standardised reproducible pull-out device measuring the pull-out strength. The pull-out strength for both groups was compared. RESULTS Twenty-one days after insertion a mean force of 412 ± 142 N for the P15/HAp group and 183 ± 105 N for the FRIADENT(®) plus group was measured for the removal of the specimens from the calvarial bone. The difference between the groups was statistically significant (p < 0.0001). CONCLUSION The experimental set-up seems to be a suitable method when measuring the impact of implant surfaces on the early stage of osseointegration.
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Affiliation(s)
- J Nonhoff
- DENTSPLY Implants Manufacturing GmbH, Mannheim, Germany
| | - T Moest
- Department of Oral and Maxillofacial Surgery, University of Erlangen, Nuremberg, Erlangen, Germany.
| | - Christian Martin Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen, Nuremberg, Erlangen, Germany
| | - T Weisel
- DENTSPLY Implants Manufacturing GmbH, Mannheim, Germany
| | - S Bauer
- DENTSPLY Implants Manufacturing GmbH, Mannheim, Germany
| | - K A Schlegel
- Department of Oral and Maxillofacial Surgery, University of Erlangen, Nuremberg, Erlangen, Germany
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Choi AH, Ben-Nissan B. Calcium phosphate nanocoatings and nanocomposites, part I: recent developments and advancements in tissue engineering and bioimaging. Nanomedicine (Lond) 2015; 10:2249-61. [PMID: 26119630 DOI: 10.2217/nnm.15.57] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A number of materials have been applied as implant coatings and as tissue regeneration materials. Calcium phosphate holds a special consideration, due to its chemical similarity to human bone and, most importantly, its dissolution characteristics, which allow for bone growth and regeneration. The applications of molecular and nanoscale-based biological materials have been and will continue to play an ever increasing role in enhancing and improving the osseointegration of dental and orthopedic implants. More recently, extensive research efforts have been focused on the development and applications of fluorescent nanoparticles and nanocoatings for in vivo imaging and diagnostics as well as devising methods of adding luminescent or fluorescent capabilities to enhance the in vivo functionality of calcium phosphate-based biomedical materials.
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Affiliation(s)
- Andy H Choi
- Faculty of Science, University of Technology, Sydney, NSW, Australia
| | - Besim Ben-Nissan
- Faculty of Science, University of Technology, Sydney, NSW, Australia
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Gehrke SA, da Silva Neto UT. Evaluation of the Surface Treatment on Bone Healing in a Transmucosal 1-mm Area of Implant Abutment: An Experimental Study in the Rabbit Tibia. Clin Implant Dent Relat Res 2015; 18:489-97. [PMID: 26041037 DOI: 10.1111/cid.12332] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The objective of the present study was to investigate the effect on bone tissue healing patterns in 1-mm area treated in the transmucosal surface of the abutment in the tibia of rabbits. MATERIALS AND METHODS Forty-six abutments were divided into two groups: control group (CG) with 14 abutments with smooth surface and experimental group (EG) with 32 abutments presenting a 1-mm area of the transmucosal surface treated through sandblasting with microparticles of titanium oxide followed by acid etching. Five samples of each group were analyzed using an optical laser profilometer for surface roughness characterization. Thirty-six Morse taper implants (3.5 mm in diameter and 7 mm in length) were inserted 1.5 mm subcrestal into the tibiae of nine rabbits. The implants were removed after 8, 10, and 12 weeks for histological analysis. The histological slides were prepared and analyzed qualitatively in relation to the new bone at the interface bone-abutment and quantitatively, in relation to bone height from the base of the implant. These data were computed and statistically compared inside the groups using analysis of variance and the U-test between groups for same time. RESULTS Both groups exhibited bone growth in the direction and over the surface of the abutments, with good healing. However, the EG group showed an increased height of bone formation in the crestal direction, and highly significant differences were observed (p < .001) between these measured values. CONCLUSIONS Under the limitations of the present study, histological follow-up at 8, 10, and 12 weeks showed that transmucosal 1-mm area of implant abutment with treatment of the surface facilitated the maintenance of bone height around the abutment compared with the same abutment with the totally smooth surface.
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Affiliation(s)
- Sergio Alexandre Gehrke
- Biotecnos Research Center, Santa Maria, Brazil.,Catholic University of Uruguay, Montevideo, Uruguay
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Cell adhesion and in vivo osseointegration of sandblasted/acid etched/anodized dental implants. Int J Mol Sci 2015; 16:10324-36. [PMID: 25955650 PMCID: PMC4463648 DOI: 10.3390/ijms160510324] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 04/08/2015] [Accepted: 04/29/2015] [Indexed: 11/17/2022] Open
Abstract
The authors describe a new type of titanium (Ti) implant as a Modi-anodized (ANO) Ti implant, the surface of which was treated by sandblasting, acid etching (SLA), and anodized techniques. The aim of the present study was to evaluate the adhesion of MG-63 cells to Modi-ANO surface treated Ti in vitro and to investigate its osseointegration characteristics in vivo. Four different types of Ti implants were examined, that is, machined Ti (control), SLA, anodized, and Modi-ANO Ti. In the cell adhesion study, Modi-ANO Ti showed higher initial MG-63 cell adhesion and induced greater filopodia growth than other groups. In vivo study in a beagle model revealed the bone-to-implant contact (BIC) of Modi-ANO Ti (74.20%±10.89%) was much greater than those of machined (33.58%±8.63%), SLA (58.47%±12.89), or ANO Ti (59.62%±18.30%). In conclusion, this study demonstrates that Modi-ANO Ti implants produced by sandblasting, acid etching, and anodizing improve cell adhesion and bone ongrowth as compared with machined, SLA, or ANO Ti implants. These findings suggest that the application of Modi-ANO surface treatment could improve the osseointegration of dental implant.
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Stadlinger B, Belibasakis G, Bierbaum S. Implantatoberflächen und ihr Einfluss auf das periimplantäre Hartgewebe. ACTA ACUST UNITED AC 2014. [DOI: 10.1007/s12285-013-0388-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Moest T, Koehler F, Prechtl C, Schmitt C, Watzek G, Schlegel KA. Bone formation in peri-implant defects grafted with microparticles: a pilot animal experimental study. J Clin Periodontol 2014; 41:990-8. [PMID: 25131387 DOI: 10.1111/jcpe.12295] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2014] [Indexed: 01/01/2023]
Abstract
AIM This study aimed to evaluate the healing of peri-implant defects grafted with microparticles (MPs). MATERIAL AND METHODS Six domestic pigs received nine standardized defects at the calvaria, and an implant was inserted in the middle of each defect. The space between the implant and lateral bone portion was filled with MP pellets (n = 18) or MP supernatant (n = 18) or left unfilled (n = 18). After 14 and 28 days, three animals were sacrificed and specimens removed for further processing. Samples were microradiographically and histologically analysed. In addition, we immunohistochemically stained for anti-vWF as a marker of angiogenesis. RESULTS In the case of bone regeneration and vessel formation, the null hypothesis can be partially rejected. After 14 and 28 days, no significant difference was observed within groups regarding de novo bone formation, bone density and osseointegration. However, superior vessel formation was found at both time points. CONCLUSION Microparticles represent a promising treatment option to accelerate peri-implant vessel formation. Further studies are needed to investigate the regenerative properties of MPs more precisely.
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Affiliation(s)
- Tobias Moest
- Oral and Maxillofacial Surgery, University Hospital Erlangen, Erlangen, Germany
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Elkarargy A. Biological functionalization of dental implants with fibronectin: a scanning electron microscopic study. Int J Health Sci (Qassim) 2014; 8:57-66. [PMID: 24899880 DOI: 10.12816/0006072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES Early stages of peri-implant bone formation play an essential role in the osseointegration and long-term success of dental implants. Biological implant surface coatings are an emerging technology to enhance the attachment of the implant to the surrounding bone and stimulate bone regeneration. The purpose of this study was to determine the effect of coating the implant surface with fibronectin on osseointegration. MATERIAL AND METHODS The experiment was conducted on a total of twelve New Zealand white mature male rabbits, weight between 2.5-4 kg. Twenty four pure titanium implants were used in this study. Each rabbits received two implants, one implant in each tibia; the implant in the right limb was coated with fibronectin (experimental group), whilst on the contralateral side the implants were placed without coating (control group). Six rabbits were sacrificed for Scanning Electron Microscopic evaluation after 4 and 8 week healing periods. RESULTS The results of the present study demonstrating the mean gap distance between the bone and implant was greater in the control group compared to fibronection group at both observation periods however, the difference between these two groups was not statistically significant. CONCLUSION Thus, it could be suggested that the biological functionalization of dental implants with fibronectin, may influence the integration or biocompatibility and bonding of the implant to the surrounding bone.
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Affiliation(s)
- Amr Elkarargy
- Associate Professor of Periodontology, College of Dentistry, Qassim University, Qassim, Saudi Arabia
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Mueller B, Koch D, Lutz R, Schlegel KA, Treccani L, Rezwan K. A novel one-pot process for near-net-shape fabrication of open-porous resorbable hydroxyapatite/protein composites and in vivo assessment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 42:137-45. [PMID: 25063103 DOI: 10.1016/j.msec.2014.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 04/29/2014] [Accepted: 05/13/2014] [Indexed: 01/25/2023]
Abstract
We present a mild one-pot freeze gelation process for fabricating near-net, complex-shaped hydroxyapatite scaffolds and to directly incorporate active proteins during scaffold processing. In particular, the direct protein incorporation enables a simultaneous adjustment and control of scaffold microstructure, porosity, resorbability and enhancement of initial mechanical and handling stability. Two proteins, serum albumin and lysozyme, are selected and their effect on scaffold stability and microstructure investigated by biaxial strength tests, electron microscopy, and mercury intrusion porosimetry. The resulting hydroxyapatite/protein composites feature adjustable porosities from 50% to 70% and a mechanical strength ranging from 2 to 6 MPa comparable to that of human spongiosa without any sintering step. Scaffold degradation behaviour and protein release are assessed by in vitro studies. A preliminary in vivo assessment of scaffold biocompatibility and resorption behaviour in adult domestic pigs is discussed. After implantation, composites were resorbed up to 50% after only 4 weeks and up to 65% after 8 weeks. In addition, 14% new bone formation after 4 weeks and 37% after 8 weeks were detected. All these investigations demonstrate the outstanding suitability of the one-pot-process to create, in a customisable and reliable way, biocompatible scaffolds with sufficient mechanical strength for handling and surgical insertion, and for potential use as biodegradable bone substitutes and versatile platform for local drug delivery.
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Affiliation(s)
- Berit Mueller
- University of Bremen, Advanced Ceramics, Am Biologischen Garten 2, 28359 Bremen, Germany.
| | - Dietmar Koch
- German Aerospace Center, Ceramic Composite Structures, Pfaffenwaldring 38-40, 70569 Stuttgart, Germany.
| | - Rainer Lutz
- University of Erlangen-Nuremberg, Department of Oral and Maxillofacial Surgery, Glueckstrasse 11, 91054 Erlangen, Germany.
| | - Karl A Schlegel
- University of Erlangen-Nuremberg, Department of Oral and Maxillofacial Surgery, Glueckstrasse 11, 91054 Erlangen, Germany.
| | - Laura Treccani
- University of Bremen, Advanced Ceramics, Am Biologischen Garten 2, 28359 Bremen, Germany.
| | - Kurosch Rezwan
- University of Bremen, Advanced Ceramics, Am Biologischen Garten 2, 28359 Bremen, Germany.
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Coelho PG, Teixeira HS, Marin C, Witek L, Tovar N, Janal MN, Jimbo R. The in vivo effect of P-15 coating on early osseointegration. J Biomed Mater Res B Appl Biomater 2013; 102:430-40. [PMID: 24106136 DOI: 10.1002/jbm.b.33020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Revised: 07/31/2013] [Accepted: 08/10/2013] [Indexed: 11/08/2022]
Abstract
The aim of this study was to evaluate mechanically and morphologically the effect of a specific peptide sequence P-15, when incorporated into implant surfaces. Three types of implants were used for the study: Group A: commercially pure titanium implant (blasted and acid etched) + electrochemical thin calcium phosphate deposition, Group B: commercially pure titanium implant (blasted and acid etched) + electrochemical thin calcium phosphate deposition + P-15 incorporation, and as control, Group C: commercially pure titanium implant (blasted and acid etched). After a topographical characterization, transcortical osteotomies were made, and all implant groups (102 implants per group) were randomly placed bilaterally in the tibiae of adult beagle dogs (n = 24). At, 1, 2, and 4 weeks post-surgery, the animals were sacrificed and the samples were retrieved for removal torque tests, for nano indentation, and for histomorphometrical analysis. The results (mean ± 95% CI) showed that Group B (34.4 ± 8.7%) presented statistically higher bone-to-implant contact than the other groups (A = 23.9 ± 7.8%; C = 21.7 ± 8.3%) at 1 week, indicating an enhanced osteogenesis due to the peptide incorporation. The results suggested that the incorporation of P-15 to implant surfaces increased its bioactivity and the effects were notable especially in the early stages of the healing process.
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Affiliation(s)
- Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York; Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York
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A novel silicon-based electrochemical treatment to improve osteointegration of titanium implants. J Appl Biomater Funct Mater 2013; 11:e106-16. [PMID: 22865574 DOI: 10.5301/jabfm.2012.9419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Titanium and its alloy represent the most commonly used biomaterials worldwide designed for bone-contact under-load applications, which often require specific mechanical properties. In particular, a large number of different biomimetic surface treatments have been developed to speed up the osteointegration process, which facilitates a reduction in recovery time. PURPOSE The aim of this work is to investigate the physical-chemical, mechanical and bioactivity properties of an innovative biomimetic treatment on titanium performed using Anodic Spark Deposition (ASD) electrochemical treatment. METHODS The proposed ASD treatment was obtained in an electrochemical solution containing silicon, calcium, phosphorous and sodium followed by an alkali etching. Surface morphology was characterized using SEM and laser profilometry. Chemical and structural composition was assessed by EDS, ICP/OES and XRD analysis. Vickers micro hardness and static contact angle measurements were performed to assess the surface mechanical properties and wettability. RESULTS The proposed anodization treatment was capable of providing a chemical and morphologic modified titanium oxide layer, adherent and characterized by superhydrophilic properties. The microporous morphology was enriched by calcium, silicon, sodium and phosphorous.After incubation in Kokubo's Simulated Body Fluid (SBF) the treatment showed very high mineralization potential compared to the reference surfaces, accounting for a deposited hydroxyapatite layer as thick as 12 μm after 14 days of SBF incubation. CONCLUSIONS On the basis of the results obtained in this study, we believe that the novel silicon-based ASD biomimetic treatment represents a promising treatment capable of enhancing the osteointegration of titanium for dental and orthopedic applications.
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Gehrke SA, Taschieri S, Del Fabbro M, Coelho PG. Positive Biomechanical Effects of Titanium Oxide for Sandblasting Implant Surface as an Alternative to Aluminium Oxide. J ORAL IMPLANTOL 2013; 41:515-22. [PMID: 24001048 DOI: 10.1563/aaid-joi-d-13-00019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the physico-chemical properties and the in vivo host response of a surface sandblasted with particles of titanium oxide (TiO2) followed by acid etching as an alternative to aluminium oxide. Thirty titanium disks manufactured in the same conditions as the implants and 24 conventional cylindrical implants were used. Half of the implants had a machined surface (Gcon) while in the other half; the surface was treated with particles of TiO2 followed by acid etching (Gexp). Surface characterization was assessed by scanning electron microscope (SEM), energy dispersive X-ray spectrometry (EDS), profilometry, and wettability. For the in vivo test, 12 implants of each group were implanted in the tibia of 6 rabbits, and were reverse torque tested after periods of 30 or 60 days after implantation. Following torque, SEM was utilized to assess residual bone-implant contact. The surface characterization by SEM showed a very homogeneous surface with uniform irregularities for Gexp and a small amount of residues of the blasting procedure, while Gcon presented a surface with minimal irregularities from the machining tools. Wettability test showed decreased contact angle for the Gcon relative to the Gexp. The Gexp removal torque at 30 and 60 days was 28.7%, and 33.2% higher relative to the Gcon, respectively. Blasting the surface with particles of TiO2 represents an adequate option for the surface treatment of dental implants, with minimal risk of contamination by the residual debris from the blasting procedure.
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Affiliation(s)
| | - Silvio Taschieri
- 2 Department of Health Technologies, IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milano, Italy
| | - Massimo Del Fabbro
- 2 Department of Health Technologies, IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Milano, Italy
| | - Paulo Guilherme Coelho
- 3 Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, New York
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Pereira KK, Alves OC, Novaes AB, de Oliveira FS, Yi JH, Zaniquelli O, Wolf-Brandstetter C, Scharnweber D, Variola F, Nanci A, Rosa AL, de Oliveira PT. Progression of Osteogenic Cell Cultures Grown on Microtopographic Titanium Coated With Calcium Phosphate and Functionalized With a Type I Collagen-Derived Peptide. J Periodontol 2013; 84:1199-210. [DOI: 10.1902/jop.2012.120072] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Naturally and synthetic smart composite biomaterials for tissue regeneration. Adv Drug Deliv Rev 2013; 65:471-96. [PMID: 22465488 DOI: 10.1016/j.addr.2012.03.009] [Citation(s) in RCA: 212] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 03/01/2012] [Accepted: 03/07/2012] [Indexed: 11/23/2022]
Abstract
The development of smart biomaterials for tissue regeneration has become the focus of intense research interest. More opportunities are available by the composite approach of combining the biomaterials in the form of biopolymers and/or bioceramics either synthetic or natural. Strategies to provide smart capabilities to the composite biomaterials primarily seek to achieve matrices that are instructive/inductive to cells, or that stimulate/trigger target cell responses that are crucial in the tissue regeneration processes. Here, we review in-depth, recent developments concerning smart composite biomaterials available for delivery systems of biofactors and cells and scaffolding matrices in tissue engineering. Smart composite designs are possible by modulating the bulk and surface properties that mimic the native tissues, either in chemical (extracellular matrix molecules) or in physical properties (e.g. stiffness), or by introducing external therapeutic molecules (drugs, proteins and genes) within the structure in a way that allows sustainable and controllable delivery, even time-dependent and sequential delivery of multiple biofactors. Responsiveness to internal or external stimuli, including pH, temperature, ionic strength, and magnetism, is another promising means to improve the multifunctionality in smart scaffolds with on-demand delivery potential. These approaches will provide the next-generation platforms for designing three-dimensional matrices and delivery systems for tissue regenerative applications.
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von Wilmowsky C, Moest T, Nkenke E, Stelzle F, Schlegel KA. Implants in bone: part II. Research on implant osseointegration: material testing, mechanical testing, imaging and histoanalytical methods. Oral Maxillofac Surg 2013; 18:355-72. [PMID: 23430020 DOI: 10.1007/s10006-013-0397-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 02/04/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE In order to determine whether a newly developed implant material conforms to the requirements of biocompatibility, it must undergo rigorous testing. To correctly interpret the results of studies on implant material osseointegration, it is necessary to have a sound understanding of all the testing methods. The aim of this overview is to elucidate the methods that are used for the experimental evaluation of the osseointegration of implant materials. DISCUSSION In recent decades, there has been a constant proliferation of new materials and surface modifications in the field of dental implants. This continuous development of innovative biomaterials requires a precise and detailed evaluation in terms of biocompatibility and implant healing before clinical use. The current gold standard is in vivo animal testing on well validated animal models. However, long-term outcome studies on patients have to follow to finally validate and show patient benefit. CONCLUSION No experimental set-up can provide answers for all possible research questions. However, a certain transferability of the results to humans might be possible if the experimental set-up is carefully chosen for the aspects and questions being investigated. To enhance the implant survival rate in the rising number of patients with chronic diseases which compromise wound healing and osseointegration, dental implant research on compromised animal models will further gain importance in future.
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Affiliation(s)
- Cornelius von Wilmowsky
- Mund-,Kiefer- und Gesichtschirurgische Klinik Universitätsklinikum Erlangen, Glückstrasse 11, 91054, Erlangen, Germany,
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Aoki K, Alles N, Soysa N, Ohya K. Peptide-based delivery to bone. Adv Drug Deliv Rev 2012; 64:1220-38. [PMID: 22709649 DOI: 10.1016/j.addr.2012.05.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 05/29/2012] [Accepted: 05/29/2012] [Indexed: 01/26/2023]
Abstract
Peptides are attractive as novel therapeutic reagents, since they are flexible in adopting and mimicking the local structural features of proteins. Versatile capabilities to perform organic synthetic manipulations are another unique feature of peptides compared to protein-based medicines, such as antibodies. On the other hand, a disadvantage of using a peptide for a therapeutic purpose is its low stability and/or high level of aggregation. During the past two decades, numerous peptides were developed for the treatment of bone diseases, and some peptides have already been used for local applications to repair bone defects in the clinic. However, very few peptides have the ability to form bone themselves. We herein summarize the effects of the therapeutic peptides on bone loss and/or local bone defects, including the results from basic studies. We also herein describe some possible methods for overcoming the obstacles associated with using therapeutic peptide candidates.
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Affiliation(s)
- Kazuhiro Aoki
- Dept. of Hard Tissue Engineering (Pharmacology), Graduate School, Tokyo Medical & Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan.
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Lutz R, Prechtl C, Nonhoff J, Weisel T, Damien CJ, Schlegel KA. Biofunctionalization of the implant surface with different concentrations of a synthetic peptide (P-15). Clin Oral Implants Res 2012; 24:781-6. [PMID: 22458517 DOI: 10.1111/j.1600-0501.2012.02455.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed at identifying the ideal concentration of a biofunctional surface coating of dental implants with a synthetic peptide (P-15). In a previous study, P-15 was shown to enhance osseointegration parameters. MATERIAL AND METHODS Implants (modified ANKYLOS(®) A8; FRIADENT Plus(®) surface) with five different concentrations (0-400 μg/ml) of a P-15 coating as well as uncoated controls were inserted in the frontal bone of 45 adult domestic pigs. The histomorphometric and microradiographic findings for the coated implants were compared to those for the uncoated ones after 7, 14, and 30 days. RESULTS No significant differences were observed comparing the peri-implant bone density between the coated and uncoated implants The bone-to-implant contact, as the primary histological parameter for osseointegration, showed high rates for all surfaces investigated (between 73.3 ± 17.9% for the control and 81.9 ± 15.2% for P15 20 μg/ml after 30 days). CONCLUSIONS No significant benefit on osseointegration of a biofunctional P-15 coating of dental implants could be displayed in the present study.
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Affiliation(s)
- R Lutz
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
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Taschieri S, Rosano G, Weinstein T, Bortolin M, Del Fabbro M. Treatment of through-and-through bone lesion using autologous growth factors and xenogeneic bone graft: a case report. Oral Maxillofac Surg 2012; 16:57-64. [PMID: 20972590 DOI: 10.1007/s10006-010-0251-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 10/11/2010] [Indexed: 05/30/2023]
Abstract
BACKGROUND This pilot case study aimed at evaluating the possibility of achieving optimal hard and soft tissue regeneration using plasma rich in growth factors (PRGF) and anorganic bovine bone (ABB) for the surgical treatment of a large through-and-through periapical bone lesion. CASE REPORT Maxillary incisors of a patient with through-and-through periapical lesion of endodontic origin were treated using modern endodontic surgical technique with the adjunct of PRGF. The PRGF clot was positioned over the palatal side of the lesion while the remaining bone defect was grafted with PRGF and ABB. A collagen membrane embedded with plasma very rich in growth factors covered the graft. Post-operative pain and swelling were negligible, and soft tissue healing was very fast. One-year clinical and radiographic outcome showed complete healing and functionality. DISCUSSION The addition of PRGF to ABB could improve the regenerative process, reducing postoperative symptoms and resulting in a fast and predictable hard and soft tissue healing.
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Affiliation(s)
- Silvio Taschieri
- Department of Health Technologies, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Via R. Galeazzi 4, 20161 Milan, Italy
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Mueller CK, Thorwarth M, Schmidt M, Schlegel KA, Schultze-Mosgau S. Comparative analysis of osseointegration of titanium implants with acid-etched surfaces and different biomolecular coatings. ACTA ACUST UNITED AC 2011; 112:726-36. [DOI: 10.1016/j.tripleo.2011.01.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 12/07/2010] [Accepted: 01/01/2011] [Indexed: 10/18/2022]
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Schlegel KA, Prechtl C, Möst T, Seidl C, Lutz R, von Wilmowsky C. Osseointegration of SLActive implants in diabetic pigs. Clin Oral Implants Res 2011; 24:128-34. [PMID: 22111960 DOI: 10.1111/j.1600-0501.2011.02380.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Diabetes mellitus is currently classified as a relative contraindication for implant treatment because of microangiopathies with the consequence of impaired bone regeneration and higher rates of implant failure. The study aim was to investigate peri-implant bone formation in a diabetic animal model in comparison to healthy animals and to evaluate the differences between conventional (SLA(®) ) and modified (SLActive(®) ) titanium implant surfaces on osseointegration. MATERIAL AND METHODS Each six implants were placed in the calvaria of 11 diabetic and 4 healthy domestic pigs. At 30 and 90 days after implant placement, the bone-to-implant contact (BIC) and bone density (BD) were appraised. Additionally, the expression of the bone-matrix proteins collagen type I and osteocalcin was evaluated at both points in time by using immunohistochemical staining methods. RESULTS Overall, BIC was reduced in the diabetic group at 30 and 90 days. After 90 days, the SLActive(®) implants showed significantly higher BICs compared with the SLA(®) implants in diabetic animals. Peri-implant BD was higher in the SLActive(®) group at 30 and 90 days in healthy and diabetic animals. Collagen type I protein expression was higher using SLA(®) implants in diabetic pigs at 30 days. Values for osteocalcin expression were not consistent. CONCLUSIONS The results indicate the negative effect of untreated diabetes mellitus on early osseointegration of dental implants. The modified SLA(®) surface (SLActive(®) ) elicited an accelerated osseointegration of dental implants, suggesting that a better prognosis for implant treatment of diabetic patients is possible.
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Affiliation(s)
- K A Schlegel
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
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Effect of oligonucleotide mediated immobilization of bone morphogenic proteins on titanium surfaces. Biomaterials 2011; 33:1315-22. [PMID: 22082620 DOI: 10.1016/j.biomaterials.2011.10.027] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Accepted: 10/11/2011] [Indexed: 02/01/2023]
Abstract
The aim of the present study was to test the hypothesis that oligonucleotides can be used for anchorage and slow release of osteogenic growth factors such as BMP to enhance the osteogenic activity of a titanium implant surface. Strands of 60-mer non-coding DNA oligonucleotides (ODN) were bound to an acid-etched sandblasted cp Ti-surface by nanomechanical fixation using anodic polarization. RhBMP2 that had been conjugated to complementary strands of DNA oligonucleotides was then bound to the anchored ODN strands by hybridization. Binding studies showed a higher binding capacity compared to non-conjugated BMP2. Long term release experiments demonstrated a continuous release from all surfaces that was lowest for the conjugated BMP2 bound to the ODN anchor strands. Proliferation of human bone marrow stroma cells (hBMSC) was significantly increased on these surfaces. Immunofluorescence showed that hBMSC grown on surfaces coated with specifically bound conjugated BMP2 developed significantly higher numbers of focal adhesion points and exhibited significantly higher levels of transcription of osteogenic markers alkaline phosphatase and osteopontin at early intervals. Biological activity (induction of alkaline phosphatase) of conjugated BMP2 released from the surface was comparable to released non-conjugated BMP2, indicating that conjugation did not negatively affect the activity of the released molecules. In conclusion the present study has shown that BMP2 conjugated to ODN strands and hybridized to complementary ODN strands anchored to a titanium surface has led to slow growth factor release and can enhance the osteogenic activity of the titanium surface.
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Bone healing of commercial oral implants with RGD immobilization through electrodeposited poly(ethylene glycol) in rabbit cancellous bone. Acta Biomater 2011; 7:3222-9. [PMID: 21549863 DOI: 10.1016/j.actbio.2011.04.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Revised: 02/22/2011] [Accepted: 04/19/2011] [Indexed: 11/23/2022]
Abstract
Immobilization of RGD peptides on titanium (Ti) surfaces enhances implant bone healing by promoting early osteoblastic cell attachment and subsequent differentiation by facilitating integrin binding. Our previous studies have demonstrated the efficacy of RGD peptide immobilization on Ti surfaces through the electrodeposition of poly(ethylene glycol) (PEG) (RGD/PEG/Ti), which exhibited good chemical stability and bonding. The RGD/PEG/Ti surface promoted differentiation and mineralization of pre-osteoblasts. This study investigated the in vivo bone healing capacity of the RGD/PEG/Ti surface for biomedical application as a more osteoconductive implant surface in dentistry. The RGD/PEG/Ti surface was produced on an osteoconductive implant surface, i.e. the grit blasted micro-rough surface of a commercial oral implant. The osteoconductivity of the RGD/PEG/Ti surface was compared by histomorphometric evaluation with an RGD peptide-coated surface obtained by simple adsorption in rabbit cancellous bone after 2 and 4 weeks healing. The RGD/PEG/Ti implants displayed a high degree of direct bone apposition in cancellous bone and achieved greater active bone apposition, even in areas of poor surrounding bone. Significant increases in the bone to implant contact percentage were observed for RGD/PEG/Ti implants compared with RGD-coated Ti implants obtained by simple adsorption both after 2 and 4 weeks healing (P<0.05). These results demonstrate that RGD peptide immobilization on a Ti surface through electrodeposited PEG may be an effective method for enhancing bone healing with commercial micro-rough surface oral implants in cancellous bone by achieving rapid bone apposition on the implant surface.
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