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Shrivas S, Samaur H, Yadav V, Boda SK. Soft and Hard Tissue Integration around Percutaneous Bone-Anchored Titanium Prostheses: Toward Achieving Holistic Biointegration. ACS Biomater Sci Eng 2024; 10:1966-1987. [PMID: 38530973 DOI: 10.1021/acsbiomaterials.3c01555] [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: 03/28/2024]
Abstract
A holistic biointegration of percutaneous bone-anchored metallic prostheses with both hard and soft tissues dictates their longevity in the human body. While titanium (Ti) has nearly solved osseointegration, soft tissue integration of percutaneous metallic prostheses is a perennial problem. Unlike the firm soft tissue sealing in biological percutaneous structures (fingernails and teeth), foreign body response of the skin to titanium (Ti) leads to inflammation, epidermal downgrowth and inferior peri-implant soft tissue sealing. This review discusses various implant surface treatments/texturing and coatings for osseointegration, soft tissue integration, and against bacterial attachment. While surface microroughness by SLA (sandblasting with large grit and acid etched) and porous calcium phosphate (CaP) coatings improve Ti osseointegration, smooth and textured titania nanopores, nanotubes, microgrooves, and biomolecular coatings encourage soft tissue attachment. However, the inferior peri-implant soft tissue sealing compared to natural teeth can lead to peri-implantitis. Toward this end, the application of smart multifunctional bioadhesives with strong adhesion to soft tissues, mechanical resilience, durability, antibacterial, and immunomodulatory properties for soft tissue attachment to metallic prostheses is proposed.
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Affiliation(s)
- Sangeeta Shrivas
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Harshita Samaur
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Vinod Yadav
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Sunil Kumar Boda
- Department of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
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Song YW, Maekawa S, Sasaki K, Yoshida D, Nagai M, Ishikawa-Nagai S, Da Silva J, Kim DM, Chen CY. Microscopic in-situ analysis of the mucosal healing around implants treated by protease activated receptor 4-agonist peptide or perpendicularly protruded type I collagen in rats. J Biomed Mater Res B Appl Biomater 2024; 112:e35330. [PMID: 37737549 DOI: 10.1002/jbm.b.35330] [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: 01/08/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023]
Abstract
Enhanced mucosal sealing around titanium implants can reduce complications such as peri-implantitis. The present study aims to investigate the mucosal healing at the early stage around the protease activated receptor 4-agonist peptide (PAR4-AP)- or perpendicularly protruded type I collagen (pCol)-treated titanium implants. A total of 72 implants were placed in 36 rats in the study. Following extractions, two tissue-level implants among the following three different surfaces, PAR4-AP-coated (PAR4 group, n = 24), pCol-treated (pCol group, n = 24) and non-treated (control group, n = 24) ones, were placed in the maxillae of each rat based on a split-mouth design. The specimens retrieved at 8 h (n = 8 per group), 3 days (n = 8 per group), and 2 weeks (n = 8 per group), were immunostained and tissue-cleared, and the signals of laminin-5 and collagen fibers were observed under multiphoton microscopy. Statistical analyses were performed using linear mixed model with post hoc tests to compare differences between the groups. While there was no intergroup difference at 8 h, the laminin-5 at 3 days was more abundant near the PAR4-group-surface, and its area was significantly larger in the PAR4 group (0.0204 ± 0.0194 mm2 ) than the control (0.0019 ± 0.0025 mm2 , p = .001) and pCol (0.0023 ± 0.0022 mm2 , p < .001) groups. The pCol group showed a significantly larger area of collagen fibers (0.0230 ± 0.0148 mm2 ) compared to the control (0.0035 ± 0.0051 mm2 , p = .002) and PAR4 (0.0031 ± 0.0057 mm2 , p < .001) groups at 3 days. At 3 days and 2 weeks, the collagen fiber orientation of the pCol group showed a more perpendicular manner compared to the control and PAR4 groups. The signal of basal lamina and collagen fibers were stronger around the PAR4-AP- and pCol-treated titanium surfaces, respectively during the early healing stage. This could have implications for improved mucosal sealing around dental implants, potentially reducing complications such as peri-implantitis.
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Affiliation(s)
- Young Woo Song
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Periodontology, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, South Korea
- Department of Periodontology, Research Institute of Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Shogo Maekawa
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keito Sasaki
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Prosthodontics and Oral Implantology, School of Dental Medicine, Iwate Medical University, Morioka, Japan
| | - Daichi Yoshida
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Prosthodontics and Oral Implantology, School of Dental Medicine, Iwate Medical University, Morioka, Japan
| | - Masazumi Nagai
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shigemi Ishikawa-Nagai
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - John Da Silva
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - David Minjoon Kim
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Chia-Yu Chen
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Tang K, Luo ML, Zhou W, Niu LN, Chen JH, Wang F. The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies. Bioact Mater 2023; 27:348-361. [PMID: 37180640 PMCID: PMC10172871 DOI: 10.1016/j.bioactmat.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/23/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.
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Affiliation(s)
- Kai Tang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Meng-Lin Luo
- Institute of Stomatology & Oral Maxilla Facial Key Laboratory, The First Medical Center, Chinese PLA General Hospital & Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhou
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Li-Na Niu
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ji-Hua Chen
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
| | - Fu Wang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
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Allen BN, Wang Q, Filali Y, Worthington KS, Kacmarynski DSF. Full-Thickness Oral Mucoperiosteal Defects: Challenges and Opportunities. TISSUE ENGINEERING. PART B, REVIEWS 2022; 28:813-829. [PMID: 34409870 PMCID: PMC9469748 DOI: 10.1089/ten.teb.2021.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/10/2021] [Indexed: 11/12/2022]
Abstract
Regenerative engineering strategies for the oral mucoperiosteum, as may be needed following surgeries, such as cleft palate repair and tumor resection, are underdeveloped compared with those for maxillofacial bone. However, critical-size tissue defects left to heal by secondary intention can lead to complications, such as infection, fistula formation, scarring, and midface hypoplasia. This review describes current clinical practice for replacing mucoperiosteal tissue, including autografts and allografts. Potentially paradigm-shifting experimental regenerative engineering strategies for mucoperiosteal wound healing, such as hybrid grafts and engineered matrices, are also discussed. Throughout the review, the advantages and disadvantages of each replacement or regeneration strategy are outlined in the context of clinical outcomes, quality of life for the patient, availability of materials, and cost of care. Finally, future directions for research and development in the area of mucoperiosteum repair are proposed, with an emphasis on identifying globally available and affordable solutions for promoting mucoperiosteal regeneration. Impact statement Unassisted oral mucoperiosteal wound healing can lead to severe complications such as infection, fistulae, scarring, and developmental abnormalities. Thus, strategies for promoting wound healing must be considered when mucoperiosteal defects are incident to oral surgery, as in palatoplasty or tumor resection. Emerging mucoperiosteal tissue engineering strategies, described in this study, have the potential to overcome the limitations of current standard-of-care donor tissue grafts. For example, the use of engineered mucoperiosteal biomaterials could circumvent concerns about tissue availability and immunogenicity. Moreover, employment of tissue engineering strategies may improve the equity of oral wound care by increasing global affordability and accessibility of materials.
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Affiliation(s)
- Brittany N Allen
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Qi Wang
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Yassine Filali
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Kristan S Worthington
- Roy J. Carver Department of Biomedical Engineering, College of Engineering, The University of Iowa, Iowa City, Iowa, USA
| | - Deborah S F Kacmarynski
- Department of Otolaryngology - Head and Neck Surgery, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA
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Integration of collagen fibers in connective tissue with dental implant in the transmucosal region. Int J Biol Macromol 2022; 208:833-843. [PMID: 35367473 DOI: 10.1016/j.ijbiomac.2022.03.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 12/26/2022]
Abstract
Dental implants have been widely accepted as an ideal therapy to replace the missing teeth for its good performance in aspects of mechanical properties and aesthetic outcomes. Its restorative success is contributed by not only the successful osseointegration of the implant but also the tight soft tissue integration, especially the collagen fibers, in the transmucosal region. Soft tissue attaching to the dental implant/abutment is overall similar, but in some aspects distinct with that seen around natural teeth and soft tissue integration can be enhanced via several surface modification methods. This review is going to focus on the current knowledge of the transmucosal zone around the dental implants (compared with natural teeth), and latest strategies in use to fine-tune the collagen fibers assembly in the connective tissue, in an attempt to enhance soft tissue integration.
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Van den Borre CE, Zigterman BGR, Mommaerts MY, Braem A. How surface coatings on titanium implants affect keratinized tissue: A systematic review. J Biomed Mater Res B Appl Biomater 2022; 110:1713-1723. [PMID: 35103386 PMCID: PMC9306745 DOI: 10.1002/jbm.b.35025] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 11/24/2021] [Accepted: 01/19/2022] [Indexed: 02/04/2023]
Abstract
Apart from osseointegration, the stability and long‐term survival of percutaneous titanium implants is also strongly dependent on a qualitative soft‐tissue integration in the transcutaneous region. A firm connective tissue seal is needed to minimize soft‐tissue dehiscence and epithelial downgrowth. It is well‐known that the implant surface plays a key role in controlling the biological response of the surrounding keratinized tissue and several coating systems have been suggested to enhance the soft‐tissue cell interactions. Although some promising results have been obtained in vitro, their clinical significance can be debated. Therefore, the purpose of this systematic review is to gain more insight into the effect of such coatings on the interface formed with keratinized soft‐tissue in vivo. A comprehensive search was undertaken in March 2021. Relevant electronic databases were consulted to identify appropriate studies using a set of search strings. In total, 12 out of 4971 publications were included in this review. The reported coating systems were assigned to several subgroups according to their characteristics: metallic, ceramic and composite. Notwithstanding the differences in study characteristics (animal model, implantation period, reported outcomes), it was noticed that several coatings improve the soft‐tissue integration as compared to pristine titanium. Porous titanium coatings having only limited pore sizes (<250 μm) do not support dermal fibroblast tissue attachment. Yet, larger pores (>700 μm) allow extensive vascularized soft‐tissue infiltration, thereby supporting cell attachment. Nanostructured ceramic coatings are found to reduce the inflammatory response in favor of the formation of cell adhesive structures, that is, hemidesmosomes. Biomolecule coatings seem of particular interest to stimulate the soft‐tissue behavior provided that a durable fixation to the implant surface can be ensured. In this respect, fibroblast growth factor‐2 entrapped in a biomimetic apatite coating instigates a close to natural soft‐tissue attachment with epidermal collagen fibers attaching almost perpendicular to the implant surface. However, several studies had limitations with respect to coating characterization and detailed soft‐tissue analysis, small sample size and short implantation periods. To date, robust and long‐term in vivo studies are still lacking. Further investigation is required before a clear consensus on the optimal coating system allowing enhancing the soft‐tissue seal around percutaneous titanium implants can be reached.
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Affiliation(s)
- Casper E Van den Borre
- Doctoral School of Life Sciences and Medicine, Vrije Universiteit Brussel, Brussels, Belgium.,European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Brandaan G R Zigterman
- European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Maurice Y Mommaerts
- European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Annabel Braem
- Department of Materials Engineering, Biomaterials and Tissue Engineering Research Group, KU Leuven, Leuven, Belgium
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Influence of abutment material and modifications on peri-implant soft-tissue attachment: A systematic review and meta-analysis of histological animal studies. J Prosthet Dent 2020; 125:426-436. [PMID: 32197823 DOI: 10.1016/j.prosdent.2020.01.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/14/2020] [Accepted: 01/14/2020] [Indexed: 11/23/2022]
Abstract
STATEMENT OF PROBLEM How the properties of the implant-abutment unit may affect the peri-implant soft-tissue seal, whose stability is considered key to safeguarding the implant from bacterial contamination and preserve peri-implant health conditions, is unclear. PURPOSE The purpose of this systematic review and meta-analysis of animal studies was to investigate whether material and surface properties of transmucosal implant components can influence the peri-implant soft-tissue adhesion at a histological level. MATERIAL AND METHODS An electronic and hand search was conducted until August 2019. Histological animal studies comparing soft-tissue response to abutment or transmucosal collar with different materials and/or surface characteristics were selected by 2 independent reviewers. Risk of bias in individual studies was evaluated. Histomorphometric data on the dimension of the peri-implant attachment were recorded, and a quantitative synthesis by a meta-analysis was performed. Risk of bias in individual studies was evaluated in accordance with the Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias tool. RESULTS Eighteen relevant studies out of 1187 were identified, none with a low risk of bias for all domains. Data from only 4 studies could be meta-analyzed. Comparable results in terms of peri-implant attachment dimensions between test and control groups were found, except for a significantly higher apical junctional epithelium to coronal bone to implant (ajE-CBI) distance for chemically modified acid-etched compared with titanium machined surfaces. Non-meta-analyzable and/or qualitative results highlighted some improved properties also for microgrooved and oxidized surfaces. CONCLUSIONS Limited data from animal studies suggest that some characteristics of the transmucosal implant components may affect peri-implant soft-tissue adhesion and stabilization but do not allow definitive conclusions. Future research should improve study design to increase the availability of comparable and suitable data on this topic.
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Abdallah MN, Badran Z, Ciobanu O, Hamdan N, Tamimi F. Strategies for Optimizing the Soft Tissue Seal around Osseointegrated Implants. Adv Healthc Mater 2017; 6. [PMID: 28960892 DOI: 10.1002/adhm.201700549] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 07/12/2017] [Indexed: 12/20/2022]
Abstract
Percutaneous and permucosal devices such as catheters, infusion pumps, orthopedic, and dental implants are commonly used in medical treatments. However, these useful devices breach the soft tissue barrier that protects the body from the outer environment, and thus increase bacterial infections resulting in morbidity and mortality. Such associated infections can be prevented if these devices are effectively integrated with the surrounding soft tissue, and thus creating a strong seal from the surrounding environment. However, so far, there are no percutaneous/permucosal medical devices able to prevent infection by achieving strong integration at the soft tissue-device interface. This review gives an insight into the current status of research into soft tissue-implant interface and the challenges associated with these interfaces. Biological soft/hard tissue interfaces may provide insights toward engineering better soft tissue interfaces around percutaneous devices. In this review, focus is put on the history and current findings as well as recent progress of the strategies aiming to develop a strong soft tissue seal around osseointegrated implants, such as orthopedic and dental implants.
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Affiliation(s)
- Mohamed-Nur Abdallah
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
- Division of Orthodontics; Faculty of Dentistry; Toronto University; Toronto M5G 1G6 ON Canada
| | - Zahi Badran
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
- Department of Periodontology (CHU/Rmes Inserm U1229/UIC11); Faculty of Dental Surgery; University of Nantes; Nantes 44042 France
| | - Ovidiu Ciobanu
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
| | - Nader Hamdan
- Department of Dental Clinical Sciences; Faculty of Dentistry; Dalhousie University; Halifax B3H 4R2 NS Canada
| | - Faleh Tamimi
- Division of Biomedical Sciences; Faculty of Dentistry; McGill University; Montreal H3A 1G1 QC Canada
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Soft and hard tissue changes around laser microtexture single tooth implants--a clinical and radiographic evaluation. IMPLANT DENT 2016; 23:570-5. [PMID: 25238269 DOI: 10.1097/id.0000000000000134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the periodontal parameters that affect the soft and hard tissues around Laser microtextured single tooth implants at 18 months after loading. METHODS Twenty Laser Lok implants were placed in 20 single missing tooth sites using a 2-stage protocol. Clinical Parameters included Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Bleeding on Probing (BOP), and Crestal Bone Loss (CBL). Clinical and radiographic evaluation was done at loading, 12 months and 18 months after loading. The data collected were analyzed statistically. RESULTS The PI and GI during the entire follow-up period were well controlled. Eighty-six percent of implant sites were free of BOP at loading and 87% of sites were free of BOP at 18 months. A significant increase in PPD was not observed. The mean CBL was 0.59 mm at the time of loading, 0.80 mm at 12 months, and 1.06 mm at 18 months. CONCLUSION The Laser Lok implants showed minimal CBL at 18 months than the commonly accepted 1.5 to 2.0 mm. The periimplant soft tissue stability was maintained throughout the study.
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Mas-Moruno C, Garrido B, Rodriguez D, Ruperez E, Gil FJ. Biofunctionalization strategies on tantalum-based materials for osseointegrative applications. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:109. [PMID: 25665847 PMCID: PMC4323513 DOI: 10.1007/s10856-015-5445-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 11/24/2014] [Indexed: 06/04/2023]
Abstract
The use of tantalum as biomaterial for orthopedic applications is gaining considerable attention in the clinical practice because it presents an excellent chemical stability, body fluid resistance, biocompatibility, and it is more osteoconductive than titanium or cobalt-chromium alloys. Nonetheless, metallic biomaterials are commonly bioinert and may not provide fast and long-lasting interactions with surrounding tissues. The use of short cell adhesive peptides derived from the extracellular matrix has shown to improve cell adhesion and accelerate the implant's biointegration in vivo. However, this strategy has been rarely applied to tantalum materials. In this work, we have studied two immobilization strategies (physical adsorption and covalent binding via silanization) to functionalize tantalum surfaces with a cell adhesive RGD peptide. Surfaces were used untreated or activated with either HNO3 or UV/ozone treatments. The process of biofunctionalization was characterized by means of physicochemical and biological methods. Physisorption of the RGD peptide on control and HNO3-treated tantalum surfaces significantly enhanced the attachment and spreading of osteoblast-like cells; however, no effect on cell adhesion was observed in ozone-treated samples. This effect was attributed to the inefficient binding of the peptide on these highly hydrophilic surfaces, as evidenced by contact angle measurements and X-ray photoelectron spectroscopy. In contrast, activation of tantalum with UV/ozone proved to be the most efficient method to support silanization and subsequent peptide attachment, displaying the highest values of cell adhesion. This study demonstrates that both physical adsorption and silanization are feasible methods to immobilize peptides onto tantalum-based materials, providing them with superior bioactivity.
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Affiliation(s)
- Carlos Mas-Moruno
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Technical University of Catalonia (UPC), ETSEIB, Av. Diagonal 647, 08028, Barcelona, Spain,
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Abdulmajeed AA, Willberg J, Syrjänen S, Vallittu PK, Närhi TO. In vitro assessment of the soft tissue/implant interface using porcine gingival explants. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:5385. [PMID: 25589208 DOI: 10.1007/s10856-015-5385-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 09/12/2014] [Indexed: 05/27/2023]
Abstract
The biologic seal of peri-implant soft tissue is crucial for long-term prognosis of oral implants. This in vitro study describes a novel tissue culture model using porcine gingival explants to evaluate the soft tissue/implant interface. Two different types of substrates were investigated: (a) plain polymer: BisGMA-TEGDMA (50-50 %) and (b) unidirectional fiber-reinforced composite (FRC). Porcine gingival explants were obtained from a local slaughterhouse. The experimental implants (n = 4) were inserted into the middle of freshly excised porcine gingival explants and cultured at the air/liquid interface up to 14 days. Porcine gingival explants with no implants served as baseline controls. The specimens were fixed and processed for the preparation of undecalcified samples. Histological analysis of the soft tissue/implant interface was carried out using a light-microscope. Microscopic evaluation suggests that the gingival explants established epithelial and connective tissue attachment to both implant types over the incubation period. FRC surfaces seemed to have a favorable tissue response with a sign of an outward epithelial migration. However, tissue degeneration was observed at the end of the experiment. In conclusion, this in vitro model maintains mucosal viability and ability to histologically evaluate soft tissue attachment to biomaterials rendering it a time efficient and cost effective model that may reduce the need for animal experiments.
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Affiliation(s)
- Aous A Abdulmajeed
- Department of Prosthetic Dentistry, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, 20520, Turku, Finland,
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12
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Mas-Moruno C, Fraioli R, Albericio F, Manero JM, Gil FJ. Novel peptide-based platform for the dual presentation of biologically active peptide motifs on biomaterials. ACS APPLIED MATERIALS & INTERFACES 2014; 6:6525-6536. [PMID: 24673628 DOI: 10.1021/am5001213] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Biofunctionalization of metallic materials with cell adhesive molecules derived from the extracellular matrix is a feasible approach to improve cell-material interactions and enhance the biointegration of implant materials (e.g., osseointegration of bone implants). However, classical biomimetic strategies may prove insufficient to elicit complex and multiple biological signals required in the processes of tissue regeneration. Thus, newer strategies are focusing on installing multifunctionality on biomaterials. In this work, we introduce a novel peptide-based divalent platform with the capacity to simultaneously present distinct bioactive peptide motifs in a chemically controlled fashion. As a proof of concept, the integrin-binding sequences RGD and PHSRN were selected and introduced in the platform. The biofunctionalization of titanium with this platform showed a positive trend towards increased numbers of cell attachment, and statistically higher values of spreading and proliferation of osteoblast-like cells compared to control noncoated samples. Moreover, it displayed statistically comparable or improved cell responses compared to samples coated with the single peptides or with an equimolar mixture of the two motifs. Osteoblast-like cells produced higher levels of alkaline phosphatase on surfaces functionalized with the platform than on control titanium; however, these values were not statistically significant. This study demonstrates that these peptidic structures are versatile tools to convey multiple biofunctionality to biomaterials in a chemically defined manner.
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Affiliation(s)
- Carlos Mas-Moruno
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgical Engineering, Technical University of Catalonia (UPC) , ETSEIB, Avenida Diagonal 647, 08028 Barcelona, Spain
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Liñares A, Domken O, Dard M, Blanco J. Peri-implant soft tissues around implants with a modified neck surface. Part 1. Clinical and histometric outcomes: a pilot study in minipigs. J Clin Periodontol 2013; 40:412-20. [DOI: 10.1111/jcpe.12068] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 10/02/2012] [Accepted: 12/27/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Antonio Liñares
- Periodontology Unit; School of Medicine and Dentistry, University of Santiago de Compostela; Santiago de Compostela Spain
| | - Olivier Domken
- Department of Periodontology; University of Liege; Liege Belgium
| | - Michel Dard
- Department of Periodontology and Implant Dentistry; College of Dentistry, New York University; NY USA
| | - Juan Blanco
- Periodontology Unit; School of Medicine and Dentistry, University of Santiago de Compostela; Santiago de Compostela Spain
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Sverzut AT, Crippa GE, Morra M, de Oliveira PT, Beloti MM, Rosa AL. Effects of type I collagen coating on titanium osseointegration: histomorphometric, cellular and molecular analyses. Biomed Mater 2012; 7:035007. [PMID: 22406648 DOI: 10.1088/1748-6041/7/3/035007] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The investigation of titanium (Ti) surface modifications aiming to increase implant osseointegration is one of the most active research areas in dental implantology. This study was carried out to evaluate the benefits of coating Ti with type I collagen on the osseointegration of dental implants. Acid etched Ti implants (AETi), either untreated or coated with type I collagen (ColTi), were placed in dog mandibles for three and eight weeks for histomorphometric, cellular and molecular evaluations of bone tissue response. While the histological aspects were essentially the same with both implants being surrounded by lamellar bone trabeculae, histomorphometric analysis showed more abundant bone formation in ColTi, mainly at three weeks. Cellular evaluation showed that cells harvested from bone fragments in close contact with ColTi display lower proliferative capacity and higher alkaline phosphatase activity, phenotypic features associated with more differentiated osteoblasts. Confirming these findings, molecular analyses showed that ColTi implants up-regulates the expression of a panel of genes well known as osteoblast markers. Our results present a set of evidences that coating AETi with collagen fastens the osseointegration by stimulating bone formation at the cellular and molecular levels, making this combination of morphological and biochemical modification a promising approach to treat Ti surfaces.
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Affiliation(s)
- Alexander Tadeu Sverzut
- Cell Culture Laboratory, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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15
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Abrahamsson I, Linder E, Larsson L, Berglundh T. Deposition of nanometer scaled calcium-phosphate crystals to implants with a dual acid-etched surface does not improve early tissue integration. Clin Oral Implants Res 2012; 24:57-62. [DOI: 10.1111/j.1600-0501.2012.02424.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Ingemar Abrahamsson
- Department of Periodontology; The Sahlgrenska Academy at Göteborg University; Göteborg; Sweden
| | - Elena Linder
- Department of Periodontology; The Sahlgrenska Academy at Göteborg University; Göteborg; Sweden
| | - Lena Larsson
- Department of Periodontology; The Sahlgrenska Academy at Göteborg University; Göteborg; Sweden
| | - Tord Berglundh
- Department of Periodontology; The Sahlgrenska Academy at Göteborg University; Göteborg; Sweden
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16
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Stadlinger B, Bierbaum S, Grimmer S, Schulz MC, Kuhlisch E, Scharnweber D, Eckelt U, Mai R. Increased bone formation around coated implants. J Clin Periodontol 2009; 36:698-704. [DOI: 10.1111/j.1600-051x.2009.01435.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Schwarz F, Wieland M, Schwartz Z, Zhao G, Rupp F, Geis-Gerstorfer J, Schedle A, Broggini N, Bornstein MM, Buser D, Ferguson SJ, Becker J, Boyan BD, Cochran DL. Potential of chemically modified hydrophilic surface characteristics to support tissue integration of titanium dental implants. J Biomed Mater Res B Appl Biomater 2009; 88:544-57. [PMID: 18837448 DOI: 10.1002/jbm.b.31233] [Citation(s) in RCA: 181] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In the past, several modifications of specific surface properties such as topography, structure, chemistry, surface charge, and wettability have been investigated to predictably improve the osseointegration of titanium implants. The aim of the present review was to evaluate, based on the currently available evidence, the impact of hydrophilic surface modifications of titanium for dental implants. A surface treatment was performed to produce hydroxylated/hydrated titanium surfaces with identical microstructure to either acid-etched, or sand-blasted, large grit and acid-etched substrates, but with hydrophilic character. Preliminary in vitro studies have indicated that the specific properties noted for hydrophilic titanium surfaces have a significant influence on cell differentiation and growth factor production. Animal experiments have pointed out that hydrophilic surfaces improve early stages of soft tissue and hard tissue integration of either nonsubmerged or submerged titanium implants. This data was also corroborated by the results from preliminary clinical studies. In conclusion, the present review has pointed to a potential of hydrophilic surface modifications to support tissue integration of titanium dental implants.
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Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany. . de
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18
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Quaranta A, Piattelli A, Scarano A, Quaranta M, Pompa G, Iezzi G. Light-Microscopic Evaluation of the Dimensions of Peri-Implant Mucosa Around Immediately Loaded and Submerged Titanium Implants in Monkeys. J Periodontol 2008; 79:1697-703. [DOI: 10.1902/jop.2008.070631] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Welander M, Abrahamsson I, Berglundh T. The mucosal barrier at implant abutments of different materials. Clin Oral Implants Res 2008. [DOI: 10.1111/j.1600-0501.2008.01543.x-i2] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Welander M, Abrahamsson I, Berglundh T. The mucosal barrier at implant abutments of different materials. Clin Oral Implants Res 2008; 19:635-41. [PMID: 18492075 DOI: 10.1111/j.1600-0501.2008.01543.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of the present study was to analyze the soft tissue barrier formed to implant abutments made of different materials. MATERIAL AND METHODS Six Labrador dogs, about 1 year old, were used. All mandibular premolars and the first, second and third maxillary premolars were extracted. Three months later four implants (OsseoSpeed, 4.5 x 9 mm, Astra Tech Dental, Mölndal, Sweden) were placed in the edentulous premolar region on one side of the mandible and healing abutments were connected. One month later, the healing abutments were disconnected and four new abutments were placed in a randomized order. Two of the abutments were made of titanium (Ti), while the remaining abutments were made of ZrO(2) or AuPt-alloy. A 5-months plaque control program was initiated. Three months after implant surgery, the implant installation procedure and the subsequent abutment shift were repeated in the contra-lateral mandibular region. Two months later, the dogs were euthanized and biopsies containing the implant and the surrounding soft and hard peri-implant tissues were collected and prepared for histological analysis. RESULTS It was demonstrated that the soft tissue dimensions at Ti- and ZrO(2) abutments remained stable between 2 and 5 months of healing. At Au/Pt-alloy abutment sites, however, an apical shift of the barrier epithelium and the marginal bone occurred between 2 and 5 months of healing. In addition, the 80-mum-wide connective tissue zone lateral to the Au/Pt-alloy abutments contained lower amounts of collagen and fibroblasts and larger fractions of leukocytes than the corresponding connective tissue zone of abutments made of Ti and ZrO(2). CONCLUSION It is suggested that the soft tissue healing to abutments made of titanium and ZrO(2) is different to that at abutments made of AuPt-alloy.
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Affiliation(s)
- Maria Welander
- Department of Periodontology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
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