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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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Musskopf ML, Finger Stadler A, Wikesjö UME, Susin C. The minipig intraoral dental implant model: A systematic review and meta-analysis. PLoS One 2022; 17:e0264475. [PMID: 35226690 PMCID: PMC8884544 DOI: 10.1371/journal.pone.0264475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/10/2022] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES The objective of this report was to provide a review of the minipig intraoral dental implant model including a meta-analysis to estimate osseointegration and crestal bone remodeling. METHODS A systematic review including PubMed and EMBASE databases through June 2021 was conducted. Two independent examiners screened titles/abstracts and selected full-text articles. Studies evaluating titanium dental implant osseointegration in native alveolar bone were included. A quality assessment of reporting was performed. Random-effects meta-analyses and meta-regressions were produced for bone-implant contact (BIC), first BIC, and crestal bone level. RESULTS 125 out of 249 full-text articles were reviewed, 55 original studies were included. Quality of reporting was generally low, omissions included animal characteristics, examiner masking/calibration, and sample size calculation. The typical minipig model protocol included surgical extraction of the mandibular premolars and first molar, 12±4 wks post-extraction healing, placement of three narrow regular length dental implants per jaw quadrant, submerged implant healing and 8 wks of osseointegration. Approximately 90% of studies reported undecalcified incandescent light microscopy histometrics. Overall, mean BIC was 59.88% (95%CI: 57.43-62.33). BIC increased significantly over time (p<0.001): 40.93 (95%CI: 34.95-46.90) at 2 wks, 58.37% (95%CI: 54.38-62.36) at 4 wks, and 66.33% (95%CI: 63.45-69.21) beyond 4 wks. Variability among studies was mainly explained by differences in observation interval post-extraction and post-implant placement, and implant surface. Heterogeneity was high for all studies (I2 > 90%, p<0.001). CONCLUSIONS The minipig intraoral dental implant model appears to effectively demonstrate osseointegration and alveolar bone remodeling similar to that observed in humans and canine models.
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Affiliation(s)
- Marta Liliana Musskopf
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Amanda Finger Stadler
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Ulf ME Wikesjö
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Cristiano Susin
- Division of Comprehensive Oral Health–Periodontology, Laboratory for Applied Periodontal & Craniofacial Research, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Ferrés-Amat E, Al Madhoun A, Ferrés-Amat E, Al Demour S, Ababneh MA, Ferrés-Padró E, Marti C, Carrio N, Barajas M, Atari M. Histologic and Histomorphometric Evaluation of a New Bioactive Liquid BBL on Implant Surface: A Preclinical Study in Foxhound Dogs. MATERIALS 2021; 14:ma14206217. [PMID: 34683810 PMCID: PMC8540508 DOI: 10.3390/ma14206217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/10/2021] [Accepted: 10/16/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bioactive chemical surface modifications improve the wettability and osseointegration properties of titanium implants in both animals and humans. The objective of this animal study was to investigate and compare the bioreactivity characteristics of titanium implants (BLT) pre-treated with a novel bone bioactive liquid (BBL) and the commercially available BLT-SLA active. METHODS Forty BLT-SLA titanium implants were placed in in four foxhound dogs. Animals were divided into two groups (n = 20): test (BLT-SLA pre-treated with BBL) and control (BLT-SLA active) implants. The implants were inserted in the post extraction sockets. After 8 and 12 weeks, the animals were sacrificed, and mandibles were extracted, containing the implants and the surrounding soft and hard tissues. Bone-to-implant contact (BIC), inter-thread bone area percentage (ITBA), soft tissue, and crestal bone loss were evaluated by histology and histomorphometry. RESULTS All animals were healthy with no implant loss or inflammation symptoms. All implants were clinically and histologically osseo-integrated. Relative to control groups, test implants demonstrated a significant 1.5- and 1.7-fold increase in BIC and ITBA values, respectively, at both assessment intervals. Crestal bone loss was also significantly reduced in the test group, as compared with controls, at week 8 in both the buccal crests (0.47 ± 0.32 vs 0.98 ± 0.51 mm, p < 0.05) and lingual crests (0.39* ± 0.3 vs. 0.89 ± 0.41 mm, p < 0.05). At week 12, a pronounced crestal bone loss improvement was observed in the test group (buccal, 0.41 ± 0.29 mm and lingual, 0.54 ± 0.23 mm). Tissue thickness showed comparable values at both the buccal and lingual regions and was significantly improved in the studied groups (0.82-0.92 mm vs. 33-48 mm in the control group). CONCLUSIONS Relative to the commercially available BLT-SLA active implants, BLT-SLA pre-treated with BBL showed improved histological and histomorphometric characteristics indicating a reduced titanium surface roughness and improved wettability, promoting healing and soft and hard tissue regeneration at the implant site.
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Affiliation(s)
- Eduard Ferrés-Amat
- Oral and Maxillofacial Surgery Service, Hospital HM Nens, HM Hospitales, 08009 Barcelona, Spain; (E.F.-A.); (E.F.-A.); (E.F.-P.)
| | - Ashraf Al Madhoun
- Department of Animal and Imaging Core Facilities, Dasman Diabetes Institute, Dasman 15462, Kuwait;
| | - Elvira Ferrés-Amat
- Oral and Maxillofacial Surgery Service, Hospital HM Nens, HM Hospitales, 08009 Barcelona, Spain; (E.F.-A.); (E.F.-A.); (E.F.-P.)
- Oral and Maxillofacial Surgery Department, Universitat Internacional de Catalunya, St Josep Trueta s/n, Sant Cugat del Vallès, 08195 Barcelona, Spain;
| | - Saddam Al Demour
- Department of Special Surgery/Division of Urology, School of Medicine, The University of Jordan, Amman 11942, Jordan;
| | - Mera A. Ababneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Eduard Ferrés-Padró
- Oral and Maxillofacial Surgery Service, Hospital HM Nens, HM Hospitales, 08009 Barcelona, Spain; (E.F.-A.); (E.F.-A.); (E.F.-P.)
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
| | - Carles Marti
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
- Oral and Maxillofacial Surgery Department, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
| | - Neus Carrio
- Oral and Maxillofacial Surgery Department, Universitat Internacional de Catalunya, St Josep Trueta s/n, Sant Cugat del Vallès, 08195 Barcelona, Spain;
| | - Miguel Barajas
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
- Biochemistry Area, Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
| | - Maher Atari
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
- Ziacom Medical SL, C. Buhos, 2, 28320 Madrid, Spain
- Correspondence:
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Shu T, Zhang Y, Sun G, Pan Y, He G, Cheng Y, Li A, Pei D. Enhanced Osseointegration by the Hierarchical Micro-Nano Topography on Selective Laser Melting Ti-6Al-4V Dental Implants. Front Bioeng Biotechnol 2021; 8:621601. [PMID: 33490056 PMCID: PMC7817818 DOI: 10.3389/fbioe.2020.621601] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022] Open
Abstract
Currently, selective laser melting (SLM) has been thriving in implant dentistry for on-demand fabricating dental implants. Based on the coarse microtopography of SLM titanium surfaces, constructing nanostructure to form the hierarchical micro-nano topography is effective in enhancing osseointegration. Given that current nanomodification techniques of SLM implants, such as anodization and hydrothermal treatment, are facing the inadequacy in costly specific apparatus and reagents, there has been no recognized nanomodified SLM dental implants. The present study aimed to construct hierarchical micro-nano topography on self-made SLM dental implants by a simple and safe inorganic chemical oxidation, and to evaluate its contribution on osteoblastic cells bioactivity and osseointegration. The surface chemical and physical parameters were characterized by FE-SEM, EDS, profilometer, AFM, and contact angle meter. The alteration on bioactivity of MG-63 human osteoblastic cells were detected by qRT-PCR. Then the osseointegration was assessed by implanting implants on the femur condyle of New Zealand Rabbits. The hierarchical micro-nano topography was constituted by the microrough surface of SLM implants and nanoneedles (diameter: 20∼50 nm, height: 150∼250 nm), after nanomodifying SLM implants in 30% hydrogen peroxide and 30% hydrochloride acid (volume ratio 1:2.5) at room temperature for 36 h. Low chemical impurities content and high hydrophilicity were observed in the nanomodified group. Cell experiments on the nanomodified group showed higher expression of mitophagy related gene (PINK1, PARKIN, LC3B, and LAMP1) at 5 days and higher expression of osteogenesis related gene (Runx2 and OCN) at 14 days. In the early stage of bone formation, the nanomodified SLM implants demonstrated higher bone-to-implant contact. Intriguingly, the initial bone-to-implant contact of nanomodified SLM implants consisted of more mineralized bone with less immature osteoid. After the cessation of bone formation, the bone-to-implant contact of nanomodified SLM implants was equal to untreated SLM implants and marketable TixOs implants. The overall findings indicated that the inorganic chemical oxidized hierarchical micro-nano topography could enhance the bioactivity of osteoblastic cells, and consequently promote the peri-implant bone formation and mineralization of SLM dental implants. This study sheds some light on improvements in additive manufactured dental implants.
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Affiliation(s)
- Tianyu Shu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,State Key Laboratory of Military Stomatology, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Yuchen Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Guo Sun
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yang Pan
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Gang He
- Frontier Institute of Science and Technology, Xi'an Jiaotong University, Xi'an, China
| | - Yilong Cheng
- School of Chemistry, Xi'an Jiaotong University, Xi'an, China
| | - Ang Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
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5
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Yang Y, Xiao Y. Biomaterials Regulating Bone Hematoma for Osteogenesis. Adv Healthc Mater 2020; 9:e2000726. [PMID: 32691989 DOI: 10.1002/adhm.202000726] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/18/2020] [Indexed: 12/11/2022]
Abstract
Blood coagulation in tissue healing not only prevents blood loss, but also forms a natural scaffold for tissue repair and regeneration. As blood clot formation is the initial and foremost phase upon bone injury, and the quality of blood clot (hematoma) orchestrates the following inflammatory and cellular processes as well as the subsequent callus formation and bone remodeling process. Inspired by the natural healing hematoma, tissue-engineered biomimic scaffold/hydrogels and blood prefabrication strategies attract significant interests in developing functional bone substitutes. The alteration of the fracture hematoma ca significantly accelerate or impair the overall bone healing process. This review summarizes the impact of biomaterials on blood coagulation and provides evidence on fibrin network structure, growth factors, and biomolecules that contribute to bone healing within the hematoma. The aim is to provide insights into the development of novel implant and bone biomaterials for enhanced osteogenesis. Advances in the understanding of biomaterial characteristics (e.g., morphology, chemistry, wettability, and protein adsorption) and their effect on hematoma properties are highlighted. Emphasizing the importance of the initial healing phase of the hematoma endows the design of advanced biomaterials with the desired regulatory properties for optimal coagulation and hematoma properties, thereby facilitating enhanced osteogenesis and ideal therapeutic effects.
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Affiliation(s)
- Ying Yang
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - Yin Xiao
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, 4059, Australia
- Australia-China Centre for Tissue Engineering and Regenerative Medicine, Queensland University of Technology, Brisbane, QLD, 4059, Australia
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Characterization and cytocompatibility of hierarchical porous TiO2 coatings incorporated with calcium and strontium by one-step micro-arc oxidation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 109:110610. [DOI: 10.1016/j.msec.2019.110610] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 12/18/2019] [Accepted: 12/26/2019] [Indexed: 12/22/2022]
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Kozlova MV, Mkrtumyan AM, Bazikyan EA, Belyakova AS, Dzikovitskaya LS. [Effect of dental implants with conditioned surface based on sodium hydroxide in patients with osteoporosis]. STOMATOLOGII︠A︡ 2019; 98:46-51. [PMID: 31322594 DOI: 10.17116/stomat20199803146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The problem of improving the efficiency of implantological treatment of patients with osteoporosis (OP) today remains relevant due to the high frequency of postoperative complications. Among the main factors affecting the success of dental implant treatment, the nature of the implant surface is essential. Patients with adentia and OP especially relevant in use of dental implants with optimized surface, air conditioned component influencing bone remodelling. OBJECTIVE Evaluation of the effectiveness of dental implants with a conditioned surface based on sodium hydroxide in men with osteoporosis. MATERIAL AND METHODS The study included 60 men 54-65 years of age in need of dental implants of which 40 were diagnosed with OP. Patients with OP were divided into groups: I - 20 men without antiresorptive therapy; II - 20 men taking ibandronate 150 mg monthly, calcium and vitamin D (1000 mg/800 IU daily). The control group consisted of 20 men 54-65 years without OP. Microarchitectonics of the mandible was studied using cone-beam computed tomography and histomorphometry. Implants with bioactive surface based on sodium hydroxide (NaOH) were used. RESULTS The results showed that the success of osseointegration is due to the qualitative parameters of the bone tissue of the perceived bed and the initial level of remodeling processes and does not depend on the conditioning of the implant surface NaOH. Comprehensive antiosteoporotic therapy with bisphosphonates and calcium supplementation with vitamin D leads to restoration of micro-alveolar part.
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Affiliation(s)
- M V Kozlova
- Central State Medical Academy of the Department of Presidential Affairs, Moscow, Russia
| | - A M Mkrtumyan
- Moscow State University of Medicine and Dentistry A.I. Yevdokimov, Moscow, Russia
| | - E A Bazikyan
- Moscow State University of Medicine and Dentistry A.I. Yevdokimov, Moscow, Russia
| | - A S Belyakova
- Moscow State University of Medicine and Dentistry A.I. Yevdokimov, Moscow, Russia
| | - L S Dzikovitskaya
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Makowiecki A, Hadzik J, Błaszczyszyn A, Gedrange T, Dominiak M. An evaluation of superhydrophilic surfaces of dental implants - a systematic review and meta-analysis. BMC Oral Health 2019; 19:79. [PMID: 31077190 PMCID: PMC6509828 DOI: 10.1186/s12903-019-0767-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/15/2019] [Indexed: 01/07/2023] Open
Abstract
Background The characteristics of a dental implant surface have a decisive influence on the process of osseointegration. According to the current state of knowledge, surface modification can not only affect the morphology of cells, and in this way have a positive impact on osseointegration. Methods The objective of this study was to compare survival rates and marginal bone loss as well as assess the degree of stability of Straumann SLAactive® and Thomenn Incell® implants with a superhydrophilic surface. Authors present review of data published between 01.01.2008 and 12.31.2016 that was found in PubMed/MEDLINE internet database, An Internet search of databases produced a total of 1230 studies, 20 publications were finally selected for the present study based on the established selection and exclusion criteria. Results The statistical analysis was performed. A Cumulative Implant Survival Rate (CSR%) was 98.5%, Marginal bone loss (MBL) after 6 months was M = 0.60 mm and 0.6 5 mm after 12 months and secondary stability in a group Thommen implants M = 71.3 ISQ and M = 75.2 ISQ in group of Straumann. Conclusion Despite certain differences in the values of the studied parameters, both of the systems, i.e. Thommen Inicell and Straumann SLActive, demonstrated a high survival rate, a high level of implant stability and low marginal bone loss.
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Affiliation(s)
| | - Jakub Hadzik
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland. .,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland.
| | - Artur Błaszczyszyn
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
| | - Tomasz Gedrange
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Orthodontics, Carl Gustav Carus Campus, Technische Universität Dresden, Germany, Fetscherstr. 74, 01307, Dresden, Germany
| | - Marzena Dominiak
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
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Lee J, Yoo JM, Amara HB, Lee YM, Lim YJ, Kim H, Koo KT. Bone healing dynamics associated with 3 implants with different surfaces: histologic and histomorphometric analyses in dogs. J Periodontal Implant Sci 2019; 49:25-38. [PMID: 30847254 PMCID: PMC6399089 DOI: 10.5051/jpis.2019.49.1.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 01/30/2019] [Indexed: 11/08/2022] Open
Abstract
Purpose This study evaluated differences in bone healing and remodeling among 3 implants with different surfaces: sandblasting and large-grit acid etching (SLA; IS-III Active®), SLA with hydroxyapatite nanocoating (IS-III Bioactive®), and SLA stored in sodium chloride solution (SLActive®). Methods The mandibular second, third, and fourth premolars of 9 dogs were extracted. After 4 weeks, 9 dogs with edentulous alveolar ridges underwent surgical placement of 3 implants bilaterally and were allowed to heal for 2, 4, or 12 weeks. Histologic and histomorphometric analyses were performed on 54 stained slides based on the following parameters: vertical marginal bone loss at the buccal and lingual aspects of the implant (b-MBL and l-MBL, respectively), mineralized bone-to-implant contact (mBIC), osteoid-to-implant contact (OIC), total bone-to-implant contact (tBIC), mineralized bone area fraction occupied (mBAFO), osteoid area fraction occupied (OAFO), and total bone area fraction occupied (tBAFO) in the threads of the region of interest. Two-way analysis of variance (3 types of implant surface×3 healing time periods) and additional analyses for simple effects were performed. Results Statistically significant differences were observed across the implant surfaces for OIC, mBIC, tBIC, OAFO, and tBAFO. Statistically significant differences were observed over time for l-MBL, mBIC, tBIC, mBAFO, and tBAFO. In addition, an interaction effect between the implant surface and the healing time period was observed for mBIC, tBIC, and mBAFO. Conclusions Our results suggest that implant surface wettability facilitates bone healing dynamics, which could be attributed to the improvement of early osseointegration. In addition, osteoblasts might become more activated with the use of HA-coated surface implants than with hydrophobic surface implants in the remodeling phase.
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Affiliation(s)
- Jungwon Lee
- Department of Periodontics, One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Korea
| | - Jung Min Yoo
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Heithem Ben Amara
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Young-Jun Lim
- Department of Prosthodontics, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Haeyoung Kim
- Department of Health Policy and Management, Korea University College of Health Science, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea.,Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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Li Y, Wang W, Liu H, Lei J, Zhang J, Zhou H, Qi M. Formation and in vitro/in vivo performance of “cortex-like” micro/nano-structured TiO 2 coatings on titanium by micro-arc oxidation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 87:90-103. [DOI: 10.1016/j.msec.2018.02.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/17/2017] [Accepted: 02/24/2018] [Indexed: 12/20/2022]
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Impact of Dental Implant Surface Modifications on Osseointegration. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6285620. [PMID: 27478833 PMCID: PMC4958483 DOI: 10.1155/2016/6285620] [Citation(s) in RCA: 297] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/22/2016] [Accepted: 06/06/2016] [Indexed: 11/18/2022]
Abstract
Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.
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Thukral R, Kumar A, Prasant MC, Punjabi KM, Paliwal A, Patel K. Assessment of Patients Referred to Specialty Dental Hospitals for Dental Implant Procedure: A Retrospective Cohort Analysis. J Contemp Dent Pract 2016; 17:470-5. [PMID: 27484600 DOI: 10.5005/jp-journals-10024-1874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION One of the most common and effective ways of replacing missing teeth is by dental implants. Both quality and quantity of bone along with the area of implant placement govern the prognosis of the implant procedure. Certain risk factors predispose the implant treatment to high failure rate. Hence, we assessed the implant patients who were referred from private practitioners to the specialty hospitals from 2010 to 2014. MATERIALS AND METHODS All the patients being referred from private clinics to the specialty dental hospital for the purpose of prosthetic rehabilitation by dental implants from June 2010 to July 2014 were included in the present study. Skilled oral and maxillofacial surgeons were appointed for performing the implant surgical procedures. Prosthetic rehabilitation was done after 6 to 8 weeks and after 10 to 14 weeks in implant cases without and with bone augmentation procedures respectively. Distribution of dental implants based on the indications, location, dimension of augmentation procedure, and complication of implants was analyzed and assessed for the level of significance. RESULTS Of the patients, 712 were females, while the remaining were males. Most of the patients were in the age group of 50 to 59 years. As compared with completely edentulous patients, most of the patients required rehabilitation by a single implant. Maximum dental implants were placed in maxillary premolar region and mandibular first molar region. Over 1,000 cases in this study required rehabilitation by augmentation procedure. CONCLUSION Partially edentulous patients are most commonly referred to specialized dental hospitals for prosthetic rehabilitation by dental implants, mostly with the purpose of implant placement. Failure rate can be minimized by following strict patient selection protocols along with following a standard surgical criterion. CLINICAL SIGNIFICANCE Following standard surgical protocols and strict treatment planning, prognosis of the dental implant procedures can be improved to a greater extent, thereby increasing its clinical success rate.
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Affiliation(s)
- Rishi Thukral
- Senior Resident, Department of Oral and Maxillofacial Surgery and Dentistry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India, Phone: +919414509596, e-mail:
| | - Anuj Kumar
- Department of Maxillofacial Surgery, Bhagwan Mahavir Medical Superspecialty Hospital, Ranchi, Jharkhand, India
| | - M C Prasant
- Department of Oral and Maxillofacial Surgery, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Krunal M Punjabi
- Department of Restorative Dentistry, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Aparna Paliwal
- Department of Oral Pathology and Microbiology, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Kunal Patel
- Department of Periodontics, Government Dental College and Hospital, Ahmedabad, Gujarat, India
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Synergistic interactions of blood-borne immune cells, fibroblasts and extracellular matrix drive repair in an in vitro peri-implant wound healing model. Sci Rep 2016; 6:21071. [PMID: 26883175 PMCID: PMC4756324 DOI: 10.1038/srep21071] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 01/18/2016] [Indexed: 01/18/2023] Open
Abstract
Low correlations of cell culture data with clinical outcomes pose major medical challenges with costly consequences. While the majority of biomaterials are tested using in vitro cell monocultures, the importance of synergistic interactions between different cell types on paracrine signalling has recently been highlighted. In this proof-of-concept study, we asked whether the first contact of surfaces with whole human blood could steer the tissue healing response. This hypothesis was tested using alkali-treatment of rough titanium (Ti) surfaces since they have clinically been shown to improve early implant integration and stability, yet blood-free in vitro cell cultures poorly correlated with in vivo tissue healing. We show that alkali-treatment, compared to native Ti surfaces, increased blood clot thickness, including platelet adhesion. Strikingly, blood clots with entrapped blood cells in synergistic interactions with fibroblasts, but not fibroblasts alone, upregulated the secretion of major factors associated with fast healing. This includes matrix metalloproteinases (MMPs) to break down extracellular matrix and the growth factor VEGF, known for its angiogenic potential. Consequently, in vitro test platforms, which consider whole blood-implant interactions, might be superior in predicting wound healing in response to biomaterial properties.
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Cuijpers VMJI, Alghamdi HS, Van Dijk NWM, Jaroszewicz J, Walboomers XF, Jansen JA. Osteogenesis around CaP-coated titanium implants visualized using 3D histology and micro-computed tomography. J Biomed Mater Res A 2015; 103:3463-73. [DOI: 10.1002/jbm.a.35485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/02/2015] [Accepted: 04/14/2015] [Indexed: 12/25/2022]
Affiliation(s)
| | - Hamdan S. Alghamdi
- Department of Biomaterials; Radboud University Medical Center; 6500 HB Nijmegen The Netherlands
- Department of Periodontics and Community Dentistry; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Natasja W. M. Van Dijk
- Department of Biomaterials; Radboud University Medical Center; 6500 HB Nijmegen The Netherlands
| | - Jakub Jaroszewicz
- Faculty of Materials Science and Engineering; Warsaw University of Technology; Warszawa 02-507 Poland
| | - X. Frank Walboomers
- Department of Biomaterials; Radboud University Medical Center; 6500 HB Nijmegen The Netherlands
| | - John A. Jansen
- Department of Biomaterials; Radboud University Medical Center; 6500 HB Nijmegen The Netherlands
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Six-Year Survival and Early Failure Rate of 2918 Implants with Hydrophobic and Hydrophilic Enossal Surfaces. Dent J (Basel) 2015; 3:15-23. [PMID: 29567922 PMCID: PMC5851166 DOI: 10.3390/dj3010015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 01/30/2015] [Accepted: 02/02/2015] [Indexed: 11/30/2022] Open
Abstract
The aim of this chart review was to obtain an objective, quantitative assessment of the clinical performance of an implant line used in an implantological office setting. Implants with hydrophilic (INICELL) and hydrophobic (TST; both: Thommen Medical AG, Grenchen, Switzerland) enossal surfaces were compared and the cumulative implant survival rate was calculated. The data of 1063 patients that received 2918 implants (1337 INICELL, 1581 TST) was included. The average follow up time was 2.1 (1.1–5.4) years for INICELL and 4.5 (1.3–5.9) years for TST implants (Thommen Medical AG, Switzerland). In the reported period 7 implants with INICELL (0.5%) and 23 TST implants (1.5%) failed. This difference was statistically significant. The analysis of cases treated and followed up in a single implantological office for 6 years confirmed the very good clinical outcome that was achieved with both used implant lines. Within the limitations of this retrospective analysis, the overall early failure rate of the hydrophilic implants was significantly lower than that of hydrophobic implants. The use of hydrophilic implants allows the clinician to obtain less early failures, hence the interest of an up-to-date surface for the daily work of an implant practice.
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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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17
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Stübinger S, Waser J, Hefti T, Drechsler A, Sidler M, Klein K, von Rechenberg B, Schlottig F. Evaluation of local cancellous bone amelioration by poly-L-DL-lactide copolymers to improve primary stability of dental implants: a biomechanical study in sheep. Clin Oral Implants Res 2014; 26:572-80. [PMID: 24989873 DOI: 10.1111/clr.12445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical performance of local cancellous bone amelioration by a 70:30 poly-(L-lactide-co-D,L-Lacide) copolymer with two different implant designs on primary stability and after 4 and 12 weeks of healing time. MATERIAL AND METHODS In six sheep, n = 36 implants (TH) with a conditioned, sandblasted, thermal acid-etched micro-rough surface and n = 36 implants (NB) with a highly crystalline and phosphate-enriched anodized titanium oxide surface were placed in the pelvic bone. Using an ultrasound-based process named Constant Amelioration Process (CAP), half of peri-implant trabecular bone structures were locally tested with 70:30 poly-(L-lactide-co-D,L-Lacide) copolymer in both implant groups, TH and NB. The CAP technology employs ultrasonic energy to liquefy 70:30 poly-(L-lactide-co-D,L-Lacide) which enters the inter-trabecular space, leading to local reinforcement of the cancellous bone structure after solidification of the copolymer. The CAP test group was compared with reference implants placed with the conventional site preparation according to the manufacturers' description. Primary stability was assessed by the measurement of torque-in values and implant stability quotient (ISQ; n = 18 per group). Secondary stability was analyzed by biomechanical removal torque testing after 4 and 12 weeks (n = 9 per group). RESULTS Insertion torque value (23.3 N cm ± 13.6) of reference TH implants demonstrated a statistically significant (P = 0.00) difference in comparison with test TH implants (41.9 N cm ± 19.5). Reference NB implants revealed a statistically significant (P = 0.03) lower insertion torque value (23.7 N cm ± 13.5) than test NB implants (39.7 N cm ± 18.6). ISQ values increased for all implants from initial implant placement until sacrifice at 12 weeks. Reference TH implants tended to result in an increase in torque values from 4 weeks (181.9 N cm ± 22.8) to 12 weeks (225.7 N cm ± 47.4). This trend could be also proven for implants of test sites (4 week: 176.8 N cm ± 24.1; 12 week: 201.5 N cm ± 53.4). For reference, NB implants a non-significant increase in removal torque values from 4 weeks (146. 7 N cm ± 18.0) to 12 weeks (170.2 N cm ± 40.4) was observed. Removal torque values of test NB implants did not increase from 4 weeks (153.3 N cm ± 21.5) to 12 weeks (146.1 N cm ± 37.5). CONCLUSION Biomechanical data proved significantly enhanced primary stability of dental implants after local amelioration without long-term sequelae and irrespective of implant design. After 4- and 12-week healing time, removal torque of locally test implants was as high as for control implants, and osseointegration was therefore not influenced by the CAP process. No correlation between ISQ values and torque values was found.
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Affiliation(s)
- Stefan Stübinger
- Musculoskeletal Research Unit, Equine Hospital, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland; Center of Applied Biotechnology and Molecular Medicine (CABMM), Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Botzenhart U, Kunert-Keil C, Heinemann F, Gredes T, Seiler J, Berniczei-Roykó Á, Gedrange T. Osseointegration of short titan implants: A pilot study in pigs. Ann Anat 2014; 199:16-22. [PMID: 24780612 DOI: 10.1016/j.aanat.2014.02.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 02/17/2014] [Accepted: 02/18/2014] [Indexed: 10/25/2022]
Abstract
Reduced vertical bone level in the implantation area is often considered one of the limiting factors before implant insertion. Inserting implants of reduced length might be useful in order to avoid vertical bone augmentation prior to implantation. To the present day, no official guidelines exist as to the optimal length for these implants. It is nevertheless well known that the stability of an implant depends primarily on its osseointegration, which could otherwise be influenced by modifying implant surface texture. The aim of our study was to evaluate osseointegration in correlation with implant length and surface texture. Three different variations of titan implants (n=5) were compared: two types, each with an acid-etched and ceramic blasted surface, were inserted in the upper jaw of adult female minipigs at different lengths (tioLogic ST Shorty, 5mm length; tioLogic ST, 9mm length) and were compared to a control group (tioLogic ST, 9mm length, ceramic blasted surface). Eight weeks after unloaded healing, bone tissue specimens containing the implants were processed, stained with Masson-Goldner-trichrome and analyzed histologically. Regardless of implant length and surface texture, new bone formation with no signs of inflammation could be detected in the area of the threads. Implants with a modified surface showed no statistically significant difference in bone-implant-contact (BIC) (tioLogic ST Shorty, 56.5%; tioLogic(©)ST; 77.2%), but a statistically significant difference could be found, when the 9mm implants were compared to the control group (BIC 48.9%). Surface modification could positively influence osseointegration as well as contribute to overcoming the adverse effects of length reduction.
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Affiliation(s)
- Ute Botzenhart
- Department of Orthodontics, University Medical Center, Technische Universität Dresden, 01307 Dresden, Germany.
| | - Christiane Kunert-Keil
- Department of Orthodontics, University Medical Center, Technische Universität Dresden, 01307 Dresden, Germany
| | - Friedhelm Heinemann
- Department of Prosthodontics, Gerodontology and Biomaterials, Medical University of Greifswald, 17489 Greifswald, Germany
| | - Tomasz Gredes
- Department of Orthodontics, University Medical Center, Technische Universität Dresden, 01307 Dresden, Germany
| | - Juliane Seiler
- Department of Orthodontics, University Medical Center, Technische Universität Dresden, 01307 Dresden, Germany
| | - Ádám Berniczei-Roykó
- Department of Orthodontics and Pediatric Dentistry, University of Szeged, 6720 Szeged, Hungary
| | - Tomasz Gedrange
- Department of Orthodontics, University Medical Center, Technische Universität Dresden, 01307 Dresden, Germany
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Held U, Rohner D, Rothamel D. Early loading of hydrophilic titanium implants inserted in low-mineralized (D3 and D4) bone: one year results of a prospective clinical trial. Head Face Med 2013; 9:37. [PMID: 24321192 PMCID: PMC3866303 DOI: 10.1186/1746-160x-9-37] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 11/26/2013] [Indexed: 01/10/2023] Open
Abstract
Introduction Pure titanium is the material of choice for contemporary dental implants. However, superficial reaction of the moderately rough titanium surface with atmospheric components decreases its hydrophilicity. INICELL® represents a chemical alteration and hydrophilization of a moderately rough i. e. sand-blasted and acid-etched titanium surface. The hydrophilicity leads to a more homogenous adsorption of proteins on the implant surface in-vitro, supporting the activation of a higher number of platelets and the generation of a homogenous, complete fibrin matrix in the early phases of osseointegration. This in turn helps to reduce the healing time and enhances the predictability of osseointegration in compromised bony situations. The objective of this case series trial was therefore to investigate if early loading (after 8 weeks) of hydrophilic INICELL implants is feasible in patients with reduced bone quality. Methods In 10 patients, 35 hydrophilic implants were placed in sites revealing bone quality class 3 and 4, and uncovered after 4 weeks. Eight weeks later implants were released for loading if the tactile resistance was ≥35 Ncm. Lower resistances resulted in 12 weeks initial healing period. Insertion torque, ISQ, tactile resistance and vertical bone level were evaluated at implant installation, after 4 weeks (uncovering), 8 or 12 weeks (loading), and 12 weeks and one year after loading. Results Mean implant insertion torque was 21 Ncm. 31 (88.6%) showed a tactile resistance of >35 Ncm after eight weeks and were released for prosthetic loading. Eight weeks after insertion, one implant (2.9%) had to be removed following a soft tissue complication. One implant had to be removed after 4 weeks due to a technical complication (fractured Osstell-abutment), it was therefore excluded from the analysis. 33 of 34 implants (97%) were loaded to occlusion and were in situ/functional one year after implantation. ISQs increased from 43 at baseline to 63 at eight weeks, and 72 at three months after loading. Then, ISQ remained constant until one year after loading. Conclusions Within the limitations of this prospective case series, hydrophilic implants may allow for shortening of the initial healing period even in bone with compromised density.
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Affiliation(s)
| | | | - Daniel Rothamel
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Cologne, 50924 Cologne, Germany.
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20
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Vasak C, Busenlechner D, Schwarze UY, Leitner HF, Munoz Guzon F, Hefti T, Schlottig F, Gruber R. Early bone apposition to hydrophilic and hydrophobic titanium implant surfaces: a histologic and histomorphometric study in minipigs. Clin Oral Implants Res 2013; 25:1378-85. [PMID: 24118429 DOI: 10.1111/clr.12277] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The first objective of this pilot study was to evaluate the impact of the hydrophilicity on the early phases of osseointegration. The second objective was to compare two hydrophilic implant surfaces with different geometries, surface roughness, and technologies achieving hydrophilicity. MATERIAL AND METHODS Twelve weeks after extraction, all four quadrants of nine minipigs received three dental implants, alternating between hydrophilic microrough surfaces (INICELL and SLActive) and a conventional hydrophobic microrough surface. After 5, 10, and 15 days of submerged healing, ground sections were prepared and subjected to histologic and histomorphometric analysis. RESULTS The histologic analysis revealed a similar healing pattern among the hydrophilic and hydrophobic implant surfaces, with extensive bone formation occurring between day 5 and day 10. With BIC values of greater than 50% after 10 days, all examined surfaces indicated favorable osseointegration at this very early point in healing. At day 15, the mean new bone-to-implant contact (newBIC) of one hydrophilic surface (INICELL; 55.8 ± 14.4%) was slightly greater than that of the hydrophobic microrough surface (40.6 ± 20.2%). At day 10 and day 15, an overall of 21% of the implants had to be excluded from analysis due to inflammations primarily caused by surgical complications. CONCLUSION Substantial bone apposition occurs between day 5 and day 10. The data suggest that the hydrophilic surface can provoke a slight tendency toward increased bone apposition in minipigs after 15 days. A direct comparison of two hydrophilic surfaces with varying geometries is of limited relevance.
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Affiliation(s)
- Christoph Vasak
- Department of Oral Surgery, Medical University of Vienna, Vienna, Austria; Department of Oral Surgery, Austrian Cluster for Tissue Regeneration, Vienna, Austria
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21
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Korn P, Schulz MC, Hintze V, Range U, Mai R, Eckelt U, Schnabelrauch M, Möller S, Becher J, Scharnweber D, Stadlinger B. Chondroitin sulfate and sulfated hyaluronan-containing collagen coatings of titanium implants influence peri-implant bone formation in a minipig model. J Biomed Mater Res A 2013; 102:2334-44. [PMID: 23946280 DOI: 10.1002/jbm.a.34913] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 07/10/2013] [Accepted: 08/05/2013] [Indexed: 01/21/2023]
Abstract
An improved osseous integration of dental implants in patients with lower bone quality is of particular interest. The aim of this study was to evaluate the effect of artificial extracellular matrix implant coatings on early bone formation. The coatings contained collagen (coll) in conjunction with either chondroitin sulfate (CS) or sulfated hyaluronan (sHya). Thirty-six screw-type, grit-blasted, and acid-etched titanium implants were inserted in the mandible of 6 minipigs. Three surface states were tested: (1) uncoated control (2) coll/CS (3) coll/sHya. After healing periods of 4 and 8 weeks, bone implant contact (BIC), bone volume density (BVD) as well as osteoid related parameters were measured. After 4 weeks, control implants showed a BIC of 44% which was comparable to coll/CS coated implants (48%) and significantly higher compared to coll/sHya coatings (37%, p = 0.012). This difference leveled out after 8 weeks. No significant differences could be detected for BVD values after 4 weeks and all surfaces showed reduced BVD values after 8 weeks. However, at that time, BVD around both, coll/CS (30%, p = 0.029), and coll/sHya (32%, p = 0.015), coatings was significantly higher compared to controls (22%). The osteoid implant contact (OIC) showed no significant differences after 4 weeks. After 8 weeks OIC for controls was comparable to coll/CS, the latter being significantly higher compared to coll/sHya (0.9% vs. 0.4%, p = 0.012). There were no significant differences in osteoid volume density. In summary, implant surface coatings by the chosen organic components of the extracellular matrix showed a certain potential to influence osseointegration in vivo.
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Affiliation(s)
- P Korn
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine "Carl Gustav Carus, " Technische Universität Dresden, Fetscherstr. 74, D-01307, Dresden, Germany
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Mardas N, Dereka X, Donos N, Dard M. Experimental Model for Bone Regeneration in Oral and Cranio-Maxillo-Facial Surgery. J INVEST SURG 2013; 27:32-49. [DOI: 10.3109/08941939.2013.817628] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zou D, Guo L, Lu J, Zhang X, Wei J, Liu C, Zhang Z, Jiang X. Engineering of bone using porous calcium phosphate cement and bone marrow stromal cells for maxillary sinus augmentation with simultaneous implant placement in goats. Tissue Eng Part A 2012; 18:1464-78. [PMID: 22452368 DOI: 10.1089/ten.tea.2011.0501] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to explore the effects of maxillary sinus floor elevation and simultaneous dental implantation with a tissue-engineered bone complex of calcium phosphate cement (CPC) scaffolds combined with bone marrow stromal cells (BMSCs). A large animal goat model is used with the tissue engineering method. Eighteen bilateral maxillary sinus of nine goats were randomly allocated into three groups; the CPC/BMSC complex (n=6) was used to elevate maxillary sinus floor with a simultaneous implant placement; the effects were compared with those treated with CPC alone (n=6) or autogenous bone (n=6). After a healing period of 3 months, sequential triad-color fluorescence labeling, micro-CT, as well as histological and histomorphometric analyses indicated that the tissue-engineered BMSC/CPC complex could promote earlier bone formation and mineralization, and maximally maintain the volume and height of the augmented maxillary sinus. By comparison, CPC-alone or autogenous bone achieved less bone formation and later mineralization. Besides, the average bone-implant contact value reflecting the osseointegration was 35.63%±9.42% in the BMSCs/CPC group, significantly higher than 22.47%±4.28% in the CPC-alone group or 28.26%±8.03% in the autogenous bone group. In conclusion, CPC serves as a potential substrate for BMSCs for the maxillary sinus floor augmentation and simultaneous implantation. The tissue-engineered bone might enhance the stability of implants and thus be of great significance to achieve improved quality to restore the oral function in clinic.
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Affiliation(s)
- Derong Zou
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, P. R. China
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Hamlet S, Alfarsi M, George R, Ivanovski S. The effect of hydrophilic titanium surface modification on macrophage inflammatory cytokine gene expression. Clin Oral Implants Res 2011; 23:584-90. [DOI: 10.1111/j.1600-0501.2011.02325.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2011] [Indexed: 01/26/2023]
Affiliation(s)
- Stephen Hamlet
- School of Dentistry and Oral Health; Centre for Medicine and Oral Health; Griffith University; Gold Coast Campus; Gold Coast; QLD; Australia
| | | | - Roy George
- School of Dentistry and Oral Health; Centre for Medicine and Oral Health; Griffith University; Gold Coast Campus; Gold Coast; QLD; Australia
| | - Saso Ivanovski
- School of Dentistry and Oral Health; Centre for Medicine and Oral Health; Griffith University; Gold Coast Campus; Gold Coast; QLD; Australia
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Hempel U, Hefti T, Dieter P, Schlottig F. Response of human bone marrow stromal cells, MG-63, and SaOS-2 to titanium-based dental implant surfaces with different topography and surface energy. Clin Oral Implants Res 2011; 24:174-82. [PMID: 22092368 DOI: 10.1111/j.1600-0501.2011.02328.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Revised: 08/26/2011] [Accepted: 08/28/2011] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Osseointegration is dependent on different parameters of the implant surface like surface roughness and physicochemical properties. In vitro studies using a wide variety of surface parameters and cell lines make it difficult to address the influence of a single parameter. With this study the influence of surface topography and energy on different osteoblast derived cell lines, namely MG-63 and SaOS-2 and of human mesenchymal stromal cells (hMSC) were investigated. MATERIAL AND METHODS Cells were cultured on polished (POL) and sandblasted/hot acid etched (SBA) titanium surfaces which were partly alkaline treated (SBA NaOH). Cell morphology, metabolic activity, tissue non-specific alkaline phosphatase (TNAP) activity and prostaglandin E(2) (PGE(2) ) formation were determined. RESULTS Impaired spreading was found on both SBA surfaces. Proliferation after 4 and 7 days increased on POL compared to both SBA surfaces. TNAP activity of hMSC and MG-63 was increased on POL compared to both SBA surfaces whereas SaOS-2 did not discriminate between the three surfaces. PGE(2) formation of hMSC and MG-63 was on both SBA surfaces after 2 days significantly higher than on POL. CONCLUSIONS The results of this study show that surface roughness has a distinct influence on proliferation and differentiation of osteoblasts. However, variations in physicochemical properties seem to have little influence under the used experimental conditions. It is suggested that more sever and long-lasting modifications of surface chemistry would have an influence on osteoblastic cells.
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Affiliation(s)
- Ute Hempel
- Institute of Physiological Chemistry, University of Technology, Dresden, Germany.
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Stadlinger B, Ferguson SJ, Eckelt U, Mai R, Lode AT, Loukota R, Schlottig F. Biomechanical evaluation of a titanium implant surface conditioned by a hydroxide ion solution. Br J Oral Maxillofac Surg 2010; 50:74-9. [PMID: 21177005 DOI: 10.1016/j.bjoms.2010.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Accepted: 11/20/2010] [Indexed: 10/18/2022]
Abstract
Two groups of titanium dental implants, identical in geometry but different in the treatment of their surfaces, were tested in an in vivo minipig model of the mandible. The surfaces that were tested were, first, sandblasted and acid-etched; and secondly, sandblasted, acid-etched, and conditioned. The removal torque was assessed at 2, 4, and 8 weeks after implantation (n=6 animals in each healing period). The interfacial stiffness was also evaluated. All dental implants were well-integrated at the time of death. Removal torque values increased significantly over the course of 8 weeks. Removal torque and interfacial stiffness were increased for conditioned surfaces after 2 weeks, but there were no significant differences between the two surfaces. The sandblasted and acid-etched implants are the standard, and conditioning of the surface showed a tendency to increase early peri-implant formation of bone.
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Affiliation(s)
- Bernd Stadlinger
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine Carl Gustav Carus, University of Technology Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
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Tugulu S, Löwe K, Scharnweber D, Schlottig F. Preparation of superhydrophilic microrough titanium implant surfaces by alkali treatment. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2010; 21:2751-2763. [PMID: 20725770 DOI: 10.1007/s10856-010-4138-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Accepted: 07/26/2010] [Indexed: 05/29/2023]
Abstract
A new strategy to render intrinsically hydrophobic microrough titanium implant surfaces superhydrophilic is reported, which is based on a rapid treatment with diluted aqueous sodium hydroxide solutions. The physicochemical characterization and protein interaction of the resulting superhydrophilic implant surfaces are presented. The superhydrophilicity of alkali treated microrough titanium substrates was mainly attributed to deprotonation and ion exchange processes in combination with a strong enhancement of wettability due to the roughness of the used substrates. Albeit these minor and mostly reversible chemical changes qualitative and quantitative differences between the protein adsorption on untreated and alkali treated microrough titanium substrates were detected. These differences in protein adsorption might account for the enhanced osseointegrative potential of superhydrophilic alkali treated microrough implant surfaces. The presented alkali treatment protocol represents a new clinically applicable route to superhydrophilic microrough titanium substrates by rendering the implant surface superhydrophilic "in situ of implantation".
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Affiliation(s)
- Stefano Tugulu
- Thommen Medical AG, Headquarters, Waldenburg, Switzerland.
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