1
|
Bakitian FA. A Comprehensive Review of the Contemporary Methods for Enhancing Osseointegration and the Antimicrobial Properties of Titanium Dental Implants. Cureus 2024; 16:e68720. [PMID: 39238921 PMCID: PMC11376426 DOI: 10.7759/cureus.68720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2024] [Indexed: 09/07/2024] Open
Abstract
Titanium dental implants with various restorative options are popular for replacing missing teeth due to their comfortable fit, excellent stability, natural appearance, and impressive track record in clinical settings. However, challenges such as potential issues with osseointegration, peri-implant bone loss, and peri-implantitis might lead to implant failure, causing concern for patients and dental staff. Surface modification has the potential to significantly enhance the success rate of titanium implants and meet the needs of clinical applications. This involves the application of various physical, chemical, and bioactive coatings, as well as adjustments to implant surface topography, offering significant potential for enhancing implant outcomes in terms of osseointegration and antimicrobial properties. Many surface modification methods have been employed to improve titanium implants, showcasing the diversity of approaches in this field including sandblasting, acid etching, plasma spraying, plasma immersion ion implantation, physical vapor deposition, electrophoretic deposition, electrochemical deposition, anodization, microarc oxidation, laser treatments, sol-gel method, layer-by-layer self-assembly technology, and the adsorption of biomolecules. This article provides a comprehensive overview of the surface modification methods for titanium implants to address issues with insufficient osseointegration and implant-related infections. It encompasses the physical, chemical, and biological aspects of these methods to provide researchers and dental professionals with a robust resource to aid them in their study and practical use of dental implant materials, ensuring they are thoroughly knowledgeable and well-prepared for their endeavors.
Collapse
Affiliation(s)
- Fahad A Bakitian
- Department of Restorative Dentistry, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, SAU
| |
Collapse
|
2
|
Bergamo ETP, de Oliveira PGFP, Campos TMB, Bonfante EA, Tovar N, Boczar D, Nayak VV, Coelho PG, Witek L. Osseointegration of implant surfaces in metabolic syndrome and type-2 diabetes mellitus. J Biomed Mater Res B Appl Biomater 2024; 112:e35382. [PMID: 38355936 PMCID: PMC10883641 DOI: 10.1002/jbm.b.35382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 11/20/2023] [Accepted: 01/27/2024] [Indexed: 02/16/2024]
Abstract
This in vivo study evaluated the bone healing response around endosteal implants with varying surface topography/chemistry in a preclinical, large transitional model induced with metabolic syndrome (MS) and type-2 diabetes mellitus (T2DM). Fifteen Göttingen minipigs were randomly distributed into two groups: (i) control (normal diet, n = 5) and (ii) O/MS (cafeteria diet for obesity induction, n = 10). Following obesity induction, five minipigs from the obese/metabolic syndrome (O/MS) group were further allocated, randomly, into the third experimental group: (iii) T2DM (cafeteria diet + streptozotocin). Implants with different surface topography/chemistry: (i) dual acid-etched (DAE) and (ii) nano-hydroxyapatite coating over the DAE surface (NANO), were placed into the right ilium of the subjects and allowed to heal for 4 weeks. Histomorphometric evaluation of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO) within implant threads were performed using histomicrographs. Implants with NANO surface presented significantly higher %BIC (~26%) and %BAFO (~35%) relative to implants with DAE surface (%BIC = ~14% and %BAFO = ~28%, p < .025). Data as a function of systemic condition presented significantly higher %BIC (~28%) and %BAFO (~42%) in the control group compared with the metabolically compromised groups (O/MS: %BIC = 14.35% and %BAFO = 26.24%, p < .021; T2DM: %BIC = 17.91% and %BAFO = 26.12%, p < .021) with no significant difference between O/MS and T2DM (p > .05). Statistical evaluation considering both factors demonstrated significantly higher %BIC and %BAFO for the NANO surface relative to DAE implant, independent of systemic condition (p < .05). The gain increase of %BIC and %BAFO for the NANO compared with DAE was more pronounced in O/MS and T2DM subjects. Osseointegration parameters were significantly reduced in metabolically compromised subjects compared with healthy subjects. Nanostructured hydroxyapatite-coated surfaces improved osseointegration relative to DAE, regardless of systemic condition.
Collapse
Affiliation(s)
- Edmara T P Bergamo
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Paula G F P de Oliveira
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- CESUPA, Department of Periodontology, University Center of State of Para, Belem, Para, Brazil
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Department of Physics, Technological Institute of Aeronautics, São José dos Campos, São Paulo, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Nick Tovar
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Oral and Maxillofacial Surgery, NYU Langone Medical Center and Bellevue, Hospital Center, New York, New York, USA
| | - Daniel Boczar
- Department of Surgery, University of Washington, Seattle, Washington, USA
| | - Vasudev Vivekanand Nayak
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Paulo G Coelho
- Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
- DeWitt Daughtry Family Department of Surgery, Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lukasz Witek
- Biomaterials Division, NYU Dentistry, New York, New York, USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, Brooklyn, New York, USA
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, New York, USA
| |
Collapse
|
3
|
Li J, Zheng Y, Yu Z, Kankala RK, Lin Q, Shi J, Chen C, Luo K, Chen A, Zhong Q. Surface-modified titanium and titanium-based alloys for improved osteogenesis: A critical review. Heliyon 2024; 10:e23779. [PMID: 38223705 PMCID: PMC10784177 DOI: 10.1016/j.heliyon.2023.e23779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 01/16/2024] Open
Abstract
As implantable materials, titanium, and its alloys have garnered enormous interest from researchers for dental and orthopedic procedures. Despite their success in wide clinical applications, titanium, and its alloys fail to stimulate osteogenesis, resulting in poor bonding strength with surrounding bone tissue. Optimizing the surface topology and altered compositions of titanium and titanium-based alloys substantially promotes peri-implant bone regeneration. This review summarizes the utilization and importance of various osteogenesis components loaded onto titanium and its alloys. Further, different surface-modification methods and the release efficacy of loaded substances are emphasized. Finally, we summarize the article with prospects. We believe that further investigation studies must focus on identifying novel loading components, exploring various innovative, optimized surface-modification methods, and developing a sustained-release system on implant surfaces to improve peri-implant bone formation.
Collapse
Affiliation(s)
- Jingling Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Yaxin Zheng
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Zihe Yu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Ranjith Kumar Kankala
- Institute of Biomaterials and Tissue Engineering, Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen, 361021, China
| | - Qianying Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Jingbo Shi
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Chao Chen
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Kai Luo
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Aizheng Chen
- Institute of Biomaterials and Tissue Engineering, Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen, 361021, China
| | - Quan Zhong
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| |
Collapse
|
4
|
Kim UG, Choi JY, Lee JB, Yeo ISL. Platelet-rich plasma alone is unable to trigger contact osteogenesis on titanium implant surfaces. Int J Implant Dent 2022; 8:25. [PMID: 35666399 PMCID: PMC9170848 DOI: 10.1186/s40729-022-00427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Osseointegration consists of bidirectional bone formation around modified implant surfaces by contact osteogenesis and distance osteogenesis. This study tested whether contact osteogenesis on the surface of a modified titanium (Ti) implant is stimulated by cytokines in the blood. METHODS In the first two types of experiments, sandblasted, large-grit, acid-etched Ti implants and turned Ti tubes were inserted into rabbit tibiae. To exclude the influence of distance osteogenesis, the tubes were inserted into the tibiae, and implants were placed inside the tubes. In a third type of experiment, the implants and tubes were inserted into the rabbit tibiae, and platelet-rich plasma (PRP) or recombinant human bone morphogenetic protein-2 (rhBMP-2) was applied topically. Four weeks after implantation, undecalcified specimens were prepared for histomorphometry. Bone-to-implant contact (BIC) and bone area per tissue (BA) were measured, and the data were analysed using one-way ANOVA at a significance level of 0.05. RESULTS When the response of bone to Ti tubes with implants was compared to that without implants (first experiment), little bone formation was found inside the tubes. The mean BIC of implant specimens inside the tubes was 21.41 ± 13.81% in a second experiment that evaluated bone responses to implants with or without Ti tubes. This mean BIC value was significantly lower than that in the implant-only group (without tubes) (47.32 ± 12.09%, P = 0.030). The third experiment showed that rhBMP-2 significantly increased contact osteogenesis on the implant surface, whereas PRP had no effect (mean BIC: 66.53 ± 14.06% vs. 16.34 ± 15.98%, P = 0.004). CONCLUSIONS Platelet-rich plasma alone is unable to trigger contact osteogenesis on the modified titanium implant surface.
Collapse
Affiliation(s)
- Ung-Gyu Kim
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - Jung-You Choi
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jun-Beom Lee
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-ro, Jongro-gu, Seoul, 03080, Korea. .,Dental Research Institute, Seoul National University, Seoul, Korea.
| |
Collapse
|
5
|
Feng F, Wu Y, Xin H, Chen X, Guo Y, Qin D, An B, Diao X, Luo H. Surface Characteristics and Biocompatibility of Ultrafine-Grain Ti after Sandblasting and Acid Etching for Dental Implants. ACS Biomater Sci Eng 2019; 5:5107-5115. [PMID: 33455258 DOI: 10.1021/acsbiomaterials.9b00579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This study investigated the surface characteristics and biocompatibility of ultrafine-grain pure titanium (UFG Ti) after sandblasting and acid etching (SLA) treatment to determine an effective method for modification of UFG Ti dental implants. The UFG Ti was processed by equal-channel angular pressing (ECAP). The micromorphology, roughness, and wettability of its surface were studied after SLA modification in different conditions. Rat bone marrow mesenchymal stem cells were subsequently seeded onto the specimens to evaluate the biocompatibility of cell adhesion, proliferation, and differentiation compared with commercially pure titanium (CP Ti). The results showed that surface characteristics of UFG Ti were affected by the pressure of sandblasting and acid etching time in addition to material properties. The favorable hierarchical porous structure that would benefit cell adhesion was formed on the UFG Ti surface when the pressure of sandblasting was 0.6 MPa and the acid etching time was 5 min; at this time, UFG Ti promoted proliferation and differentiation to a greater extent than CP Ti because of its excellent wettability. From this study, it could be seen that UFG Ti can be used as a dental implant material after proper surface modification.
Collapse
Affiliation(s)
- Fan Feng
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| | - Yulu Wu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| | - Haitao Xin
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| | - Xiaoqiang Chen
- Department of Plastic and Burn Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an 710038, China
| | - Yazhou Guo
- School of Aeronautics, Northwestern Polytechnical University, Xi'an 710072, China
| | - Dongyang Qin
- School of Aeronautics, Northwestern Polytechnical University, Xi'an 710072, China
| | - Baili An
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| | - Xiaoou Diao
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| | - Huiwen Luo
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China
| |
Collapse
|
6
|
Osteointegrative and microgeometric comparison between micro-blasted and alumina blasting/acid etching on grade II and V titanium alloys (Ti-6Al-4V). J Mech Behav Biomed Mater 2019; 97:288-295. [PMID: 31146202 DOI: 10.1016/j.jmbbm.2019.05.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 03/20/2019] [Accepted: 05/16/2019] [Indexed: 11/20/2022]
Abstract
This study evaluated the effect of alumina-blasted/acid-etched (AB/AE) or microabrasive blasting (C3-Microblasted) surface treatment on the osseointegration of commercially-pure Ti (grade II) and Ti-6Al-4V alloy (grade V) implants compared to as-machined surfaces. Surface characterization was performed by scanning electron microscopy and optical interferometry (IFM) to determine roughness parameters (Sa and Sq, n = 3 per group). One-hundred forty-four implants were placed in the radii of 12 beagle dogs, for histological (n = 72, bone-to-implant contact - BIC and bone-area-fraction occupancy -BAFO) and torque to interface failure test at 3 and 6 weeks (n = 72). SEM and IFM revealed a significant increase in surface texture for AB/AE and C3-Microblasted surfaces compared to machined surface, regardless of titanium substrate. Torque-to-interface failure test showed significant increase in values from as-machined to AB/AE and to C3-Microblasted. Considering time in vivo, alloy grade, and surface treatment, the C3-microblasted presented higher mean BIC values relative to AB/AE and machined surfaces for both alloy types. BAFO levels were significantly higher for both textured surfaces groups relative to the machined group at 3 weeks, but differences were not significant between the three surfaces for each alloy type at 6 weeks. Surface treatment resulted in roughness that improved osseointegration in Grade II and V titanium substrates.
Collapse
|
7
|
Yang BC, Zhou XD, Yu HY, Wu Y, Bao CY, Man Y, Cheng L, Sun Y. [Advances in titanium dental implant surface modification]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:124-129. [PMID: 31168977 PMCID: PMC7030153 DOI: 10.7518/hxkq.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/02/2019] [Indexed: 02/05/2023]
Abstract
Titanium dental implants have wide clinical application due to their many advantages, including comfort, aesthetics, lack of damage to adjacent teeth, and significant clinical effects. However, the failure of osseointegration, bone resorption, and peri-implantitis limits their application. Physical-chemical and bioactive coatings on the surface of titanium implants could improve the successful rate of dental implants and meet the clinical application requirements. This paper reviews the characteristics of surface modification of titanium implants from the aspects of physics, chemistry, and biology. Results provide information for research and clinical application of dental implant materials.
Collapse
Affiliation(s)
- Bang-Cheng Yang
- Engineering Research Center in Biomaterials, Sichuan University & Sichuan Guojia Biomaterials Co., Ltd, Chengdu 610064, China
| | - Xue-Dong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hai-Yang Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yao Wu
- Engineering Research Center in Biomaterials, Sichuan University & Sichuan Guojia Biomaterials Co., Ltd, Chengdu 610064, China
| | - Chong-Yun Bao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Man
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Conservative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yao Sun
- Dept. of Implantology, School & Hospital of Stomatology, Tongji University, Shanghai 200072, China
| |
Collapse
|
8
|
Spies BC, Fross A, Adolfsson E, Bagegni A, Doerken S, Kohal RJ. Stability and aging resistance of a zirconia oral implant using a carbon fiber-reinforced screw for implant-abutment connection. Dent Mater 2018; 34:1585-1595. [PMID: 30180975 DOI: 10.1016/j.dental.2018.08.290] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/16/2018] [Accepted: 08/18/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the long-term stability of a metal-free zirconia two-piece implant assembled with a carbon fiber-reinforced (CRF) screw by means of transformation propagation, potential changes in surface roughness, the gap size of the implant-abutment connection, and fracture load values. METHODS In a combined procedure, two-piece implants made from alumina-toughened zirconia were dynamically loaded (107 cycles) and hydrothermally aged (85°, 60days). Implants made from titanium (Ti) and a titanium-zirconium (TiZr) alloy with a titanium abutment screw served as control. Transformation propagation (ATZ) and gap size of the IAC were monitored at cross-sections by scanning electron microscopy (SEM). Furthermore, changes in surface roughness of ATZ implants were measured. Finally, implants were statically loaded to fracture. Linear regression models and pairwise comparisons were used for statistical analyses. RESULTS Independent of the implant bulk material, dynamic loading/hydrothermal aging did not decrease fracture resistance (p=0.704). All test and control implants fractured at mean loads >1100N. Gap size of the IAC remained stable (<5μm) or decreased. None of the CFR screws fractured during static or dynamic loading. Monoclinic layer thickness of ATZ implants increased by 2-3μm at surfaces exposed to water, including internal surfaces of the IAC. No changes in surface roughness were observed. SIGNIFICANCE Combined hydrothermal aging and dynamic loading did not affect the above-mentioned parameters of the evaluated two-piece ATZ implant. Mean fracture loads >1100N suggest a reliable clinical application.
Collapse
Affiliation(s)
- Benedikt C Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, Berlin, Germany.
| | - Alexander Fross
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | | | - Aimen Bagegni
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Sam Doerken
- Medical Center - University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany
| | - Ralf-Joachim Kohal
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| |
Collapse
|
9
|
In Vivo Evaluation of Dual Acid-Etched and Grit-Blasted/Acid-Etched Implants With Identical Macrogeometry in High-Density Bone. IMPLANT DENT 2018; 26:815-819. [PMID: 29064857 DOI: 10.1097/id.0000000000000672] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Based on the current evidence, the effect of implant macrogeometry has a significant influence on osseointegration. Thus, this study evaluated histomorphometrically and histologically the bone response to acid-etched in comparison to grit-blasted/acid-etched (GB) and machined control (C) surfaced implants possessing identical macrogeometry placed in high-density bone. MATERIALS AND METHODS Implant surface topography of the 3 different surfaced implants has previously been characterized. The macrogeometry of the implants were conical, and healing chambers were created in the cortical regions. The 3 groups were placed in the external mandibular body of adult male sheep (n = 5). After 6 weeks in vivo, all samples were retrieved for histologic observation and histomorphometry (eg, bone-to-implant contact [BIC] and bone area fraction occupancy [BAFO]). RESULTS No statistical difference was observed for BIC and for BAFO, although there was a tendency that the mean values for BAFO was higher for the textured surface groups. CONCLUSIONS It is suggested that the effect of surface topography is minimal in high-density bone and osseointegration seemed to be macrogeometry dependent.
Collapse
|
10
|
Abstract
OBJECTIVES During the last decades, several changes of paradigm have modified our view on how biomaterials' surface characteristics influence the bioresponse. After becoming aware of the role of a certain microroughness for improved cellular contact and osseointegration of dental titanium implants, the likewise important role of surface energy and wettability was increasingly strengthened. Very recently, synergistic effects of nanoscaled topographical features and hydrophilicity at the implant/bone interface have been reported. METHODS Questions arise about which surface roughness and wetting data are capable to predict the bioresponse and, ultimately, the clinical performance. Current methods and approaches applied for topographical, wetting and surface energetic analyses are highlighted. Current knowledge of possible mechanisms explaining the influence of roughness and hydrophilicity at the biological interface is presented. RESULTS Most marketed and experimental surfaces are based on commonly available additive or subtractive surface modifying methods such as blasting, etching or anodizing. Different height, spatial, hybrid and functional roughness parameters have been identified as possible candidates able to predict the outcome at hard and soft tissue interfaces. Likewise, hydrophilic implants have been proven to improve the initial blood contact, to support the wound healing and thereby accelerating the osseointegration. SIGNIFICANCE There is clear relevance for the influence of topographical and wetting characteristics on a macromolecular and cellular level at endosseous implant/biosystem interfaces. However, we are still far away from designing sophisticated implant surfaces with the best possible, selective functionality for each specific tissue or cavity interface. Firstly, because our knowledge of the respective surface related reactions is at best fragmentary. Secondly, because manufacturing of multi-scaled complex surfaces including distinct nanotopographies, wetting properties, and stable cleanliness is still a technical challenge and far away from being reproducibly transferred to implant surfaces.
Collapse
|
11
|
Kournetas N, Spintzyk S, Schweizer E, Sawada T, Said F, Schmid P, Geis-Gerstorfer J, Eliades G, Rupp F. Comparative evaluation of topographical data of dental implant surfaces applying optical interferometry and scanning electron microscopy. Dent Mater 2017; 33:e317-e327. [PMID: 28587722 DOI: 10.1016/j.dental.2017.04.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Comparability of topographical data of implant surfaces in literature is low and their clinical relevance often equivocal. The aim of this study was to investigate the ability of scanning electron microscopy and optical interferometry to assess statistically similar 3-dimensional roughness parameter results and to evaluate these data based on predefined criteria regarded relevant for a favorable biological response. METHODS Four different commercial dental screw-type implants (NanoTite Certain Prevail, TiUnite Brånemark Mk III, XiVE S Plus and SLA Standard Plus) were analyzed by stereo scanning electron microscopy and white light interferometry. Surface height, spatial and hybrid roughness parameters (Sa, Sz, Ssk, Sku, Sal, Str, Sdr) were assessed from raw and filtered data (Gaussian 50μm and 5μm cut-off-filters), respectively. Data were statistically compared by one-way ANOVA and Tukey-Kramer post-hoc test. For a clinically relevant interpretation, a categorizing evaluation approach was used based on predefined threshold criteria for each roughness parameter. RESULTS The two methods exhibited predominantly statistical differences. Dependent on roughness parameters and filter settings, both methods showed variations in rankings of the implant surfaces and differed in their ability to discriminate the different topographies. Overall, the analyses revealed scale-dependent roughness data. Compared to the pure statistical approach, the categorizing evaluation resulted in much more similarities between the two methods. SIGNIFICANCE This study suggests to reconsider current approaches for the topographical evaluation of implant surfaces and to further seek after proper experimental settings. Furthermore, the specific role of different roughness parameters for the bioresponse has to be studied in detail in order to better define clinically relevant, scale-dependent and parameter-specific thresholds and ranges.
Collapse
Affiliation(s)
- N Kournetas
- Department of Operative Dentistry, School of Dentistry, University of Athens, Greece
| | - S Spintzyk
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - E Schweizer
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - T Sawada
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - F Said
- University Hospital Tübingen, Center for Dentistry and Oral Medicine, Department of Prosthodontics, Tübingen, Germany
| | - P Schmid
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - J Geis-Gerstorfer
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany
| | - G Eliades
- Department of Biomaterials, School of Dentistry, University of Athens, Greece
| | - F Rupp
- University Hospital Tübingen, Section Medical Materials Science & Technology, Tübingen, Germany.
| |
Collapse
|
12
|
Comparison of Removal Torques for Implants With Hydroxyapatite-Blasted and Sandblasted and Acid-Etched Surfaces. IMPLANT DENT 2016; 25:581-7. [PMID: 27540839 DOI: 10.1097/id.0000000000000458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Sandblasted and acid-etched (SLA) implants are widely known and used by many practitioners. A resorbable blasting media (RBM) surface is produced by blasting with bioceramic particles. We studied the correlation between the particle sizes of the media and the biomechanical force, evaluating the removal torque of hydroxyapatite-blasted implants. MATERIALS AND METHODS Commercial SLA implants comprised the control group, and RBM surface-treated implants of the same size and design comprised the experimental group. These implants were installed on both sides of rabbits' tibiae. Four weeks after the implants were installed, the implant removal torque was measured using a digital torque device. The roughness of the implant surface was analyzed using field-emission scanning electron microscopy and confocal laser scanning microscopy. RESULTS Both groups of surface textures exhibited a regular porosity. The 2 groups exhibited different surface roughness. No significant differences in removal torques were observed between the control and experimental groups. CONCLUSION There were no significant differences in our measures of osseointegration between hydroxyapatite-blasted and SLA implants.
Collapse
|
13
|
Coelho PG, Gil LF, Neiva R, Jimbo R, Tovar N, Lilin T, Bonfante EA. Microrobotized blasting improves the bone-to-textured implant response. A preclinical in vivo biomechanical study. J Mech Behav Biomed Mater 2015; 56:175-182. [PMID: 26703231 DOI: 10.1016/j.jmbbm.2015.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/06/2015] [Accepted: 11/09/2015] [Indexed: 01/25/2023]
Abstract
This study evaluated the effect of microrobotized blasting of titanium endosteal implants relative to their manually blasted counterparts. Two different implant systems were utilized presenting two different implant surfaces. Control surfaces (Manual) were fabricated by manually grit blasting the implant surfaces while experimental surfaces (Microblasted) were fabricated through a microrobotized system that provided a one pass grit blasting routine. Both surfaces were created with the same ~50µm average particle size alumina powder at ~310KPa. Surfaces were then etched with 37% HCl for 20min, washed, and packaged through standard industry procedures. The surfaces were characterized through scanning electron microscopy (SEM) and optical interferometry, and were then placed in a beagle dog radius model remaining in vivo for 3 and 6 weeks. The implant removal torque was recorded and statistical analysis evaluated implant system and surface type torque levels as a function of time in vivo. Histologic sections were qualitatively evaluated for tissue response. Electron microscopy depicted textured surfaces for both manual and microblasted surfaces. Optical interferometry showed significantly higher Sa, Sq, values for the microblasted surface and no significant difference for Sds and Sdr values between surfaces. In vivo results depicted that statistically significant gains in biomechanical fixation were obtained for both implant systems tested at 6 weeks in vivo, while only one system presented significant biomechanical gain at 3 weeks. Histologic sections showed qualitative higher amounts of new bone forming around microblasted implants relative to the manually blasted group. Microrobotized blasting resulted in higher biomechanical fixation of endosteal dental implants and should be considered as an alternative for impant surface manufacturing.
Collapse
Affiliation(s)
- Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University, 433 1st Ave., Room 844, New York, NY 10010, USA; Director for Research, Department of Periodontology and Implant Dentistry, New York University College of Dentistry, 345E 24th Street, New York, NY 10010, USA; Affiliated Faculty, Department of Engineering, New York University Abu Dhabi, PO Box 129188, Abu Dhabi, United Arab Emirates
| | - Luiz F Gil
- Department of Dentistry, Division of Oral and Maxillofacial Surgery, Universidade Federal de Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, s/n-Trindade, Florianópolis, SC 88040-900, Brazil
| | - Rodrigo Neiva
- Department of Periodontology, University of Florida at Gainesville, 1395 Center Dr, Gainesville, FL 32610, USA
| | - Ryo Jimbo
- Department of Prosthodontics, Malmo University, Malmo 205 06, Sweden
| | - Nick Tovar
- Department of Biomaterials and Biomimetics, New York University, 433 1st Ave., Room 844, New York, NY 10010, USA
| | - Thomas Lilin
- École Nationale Vétérinaire d׳Alfort, 7 Avenue du Général de Gaulle, 94704 Mainsons-Alfort, France
| | - Estevam A Bonfante
- Department of Prosthodontics, University of Sao Paulo - Bauru College of Dentistry, Alameda Otávio Pinheiro Brisola 9-75, Bauru, SP 17.012-901, Brazil.
| |
Collapse
|
14
|
Gil LF, Marin C, Teixeira H, Marão HF, Tovar N, Khan R, Bonfante EA, Janal M, Coelho PG. The effect of controlled microrobotized blasting on implant surface texturing and early osseointegration. J Biomater Appl 2015; 30:900-7. [PMID: 26508287 DOI: 10.1177/0885328215605952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Surface topography modifications have become a key strategy for hastening the host-to-implant response to implantable materials. The present study evaluated the effect of three different carefully controlled surface texture patterns achieved through microrobotized blasting (controlled to high, medium and low roughness) relative to a larger scale blasting procedure (control) in early osseointegration in a canine model. Four commercially pure grade 2 titanium alloy implants (one of each surface) were bilaterally placed in the radii of six beagle dogs and allowed end points of 1 and 6 weeks in vivo. Following sacrifice, implants in bone were non-decalcified processed for bone morphologic and histometric (bone-to-implant contact; bone area fraction occupancy) evaluation. Surface topography was characterized by scanning electron microscopy and optical interferometry. Results showed initial osteogenic tissue interaction at one week and new bone in intimate contact with all implant surfaces at 6 weeks. At 1 and 6 weeks in vivo, higher bone-to-implant and bone area fraction occupancy were observed for the high texture pattern microrobotized blasted surface relative to others.
Collapse
Affiliation(s)
- Luiz F Gil
- Universidade Federal de Santa Catarina, Department of Dentistry, Florianopolis, Brazil
| | - Charles Marin
- UNIGRANRIO University, Postgraduate Program in Dentistry, Duque de Caxias, Brazil
| | - Hellen Teixeira
- University of Pennsylvania, School of Dental Medicine, Department of Orthodontics, Philadelphia, PA, USA (for Dr. Hellen Teixeira)
| | - Heloisa F Marão
- São Paulo State University, Department of Surgery and Integrated Clinics, Araçatuba, Brazil
| | - Nick Tovar
- New York University, Department of Biomaterials and Biomimetics, New York, USA
| | - Rehan Khan
- New York University, Department of Biomaterials and Biomimetics, New York, USA
| | - Estevam A Bonfante
- University of Sao Paulo - Bauru College of Dentistry, Department of Prosthodontics, Bauru, SP, Brazil (for Estevam A. Bonfante)
| | - Malvin Janal
- Department of Epidemiology and Health Promotion, New York University College of Dentistry (for Dr. Malvin Janal)
| | - Paulo G Coelho
- University of Pennsylvania, School of Dental Medicine, Department of Orthodontics, Philadelphia, PA, USA (for Dr. Hellen Teixeira) New York University, Department of Biomaterials and Biomimetics, New York, USA Director for Implant Research, Department of Periodontology and Implant Dentistry, New York University, New York, NY, USA (For Dr. Paulo G. Coelho) Affiliated Faculty, Department of Engineering, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates. (For Dr. Paulo G. Coelho)
| |
Collapse
|
15
|
Surface Characterization and In Vivo Evaluation of Dual Acid-Etched and Grit-Blasted/Acid-Etched Implants in Sheep. IMPLANT DENT 2015; 24:256-62. [DOI: 10.1097/id.0000000000000248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Histomorphometry and Bone Mechanical Property Evolution Around Different Implant Systems at Early Healing Stages. IMPLANT DENT 2013; 22:596-603. [DOI: 10.1097/id.0b013e31829f1f4b] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
17
|
Characteristics of 2 Different Commercially Available Implants with or without Nanotopography. Int J Dent 2013; 2013:769768. [PMID: 24223592 PMCID: PMC3808707 DOI: 10.1155/2013/769768] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/21/2013] [Indexed: 12/19/2022] Open
Abstract
The aim of this study was to assess histologically and histomorphometrically the early bone forming properties after 3 weeks for 2 commercially available implants, one supposedly possessing nanotopography and one without, in a rabbit femur model. Twenty-four implants divided equally into 2 groups were utilized in this study. The first group (P-I MICRO+NANO) was a titanium oxide (TiO2) microblasted and noble gas ion bombarded surface while the second group (Ospol) was anodic oxidized surface with calcium and phosphate incorporation. The implants were placed in the rabbit femur unicortically and were allowed to heal for 3 weeks. After euthanasia, the samples were subjected to histologic sectioning and bone-implant contact and bone area were evaluated histomorphometrically under an optical microscope. The histomorphometric evaluation presented that the P-I MICRO+NANO implants demonstrated significantly higher new bone formation as compared to the Ospol implants. Within the limitations of this study, the results suggested that nanostructures presented significantly higher bone formation after 3 weeks in vivo, and the effect of chemistry was limited, which is indicative that nanotopography is effective at early healing periods.
Collapse
|
18
|
Surface Characterization and Clinical Review of Two Commercially Available Implants. IMPLANT DENT 2013; 22:507-18. [DOI: 10.1097/id.0b013e318294308f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|