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Cheers GM, Weimer LP, Neuerburg C, Arnholdt J, Gilbert F, Thorwächter C, Holzapfel BM, Mayer-Wagner S, Laubach M. Advances in implants and bone graft types for lumbar spinal fusion surgery. Biomater Sci 2024; 12:4875-4902. [PMID: 39190323 DOI: 10.1039/d4bm00848k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
The increasing prevalence of spinal disorders worldwide necessitates advanced treatments, particularly interbody fusion for severe cases that are unresponsive to non-surgical interventions. This procedure, especially 360° lumbar interbody fusion, employs an interbody cage, pedicle screw-and-rod instrumentation, and autologous bone graft (ABG) to enhance spinal stability and promote fusion. Despite significant advancements, a persistent 10% incidence of non-union continues to result in compromised patient outcomes and escalated healthcare costs. Innovations in lumbar stabilisation seek to mimic the properties of natural bone, with evolving implant materials like titanium (Ti) and polyetheretherketone (PEEK) and their composites offering new prospects. Additionally, biomimetic cages featuring precisely engineered porosities and interconnectivity have gained traction, as they enhance osteogenic differentiation, support osteogenesis, and alleviate stress-shielding. However, the limitations of ABG, such as harvesting morbidities and limited fusion capacity, have spurred the exploration of sophisticated solutions involving advanced bone graft substitutes. Currently, demineralised bone matrix and ceramics are in clinical use, forming the basis for future investigations into novel bone graft substitutes. Bioglass, a promising newcomer, is under investigation despite its observed rapid absorption and the potential for foreign body reactions in preclinical studies. Its clinical applicability remains under scrutiny, with ongoing research addressing challenges related to burst release and appropriate dosing. Conversely, the well-documented favourable osteogenic potential of growth factors remains encouraging, with current efforts focused on modulating their release dynamics to minimise complications. In this evidence-based narrative review, we provide a comprehensive overview of the evolving landscape of non-degradable spinal implants and bone graft substitutes, emphasising their applications in lumbar spinal fusion surgery. We highlight the necessity for continued research to improve clinical outcomes and enhance patient well-being.
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Affiliation(s)
- Giles Michael Cheers
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Lucas Philipp Weimer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Carl Neuerburg
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Jörg Arnholdt
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Fabian Gilbert
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Christoph Thorwächter
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Boris Michael Holzapfel
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Susanne Mayer-Wagner
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
| | - Markus Laubach
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, Marchioninistraße 15, 81377 Munich, Germany.
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
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Domingo MG, Kurtz M, Maglione G, Martin M, Brites F, Tasat DR, Olmedo DG. Chronic exposure to TiO 2 micro- and nano particles: A biochemical and histopathological experimental study. J Biomed Mater Res B Appl Biomater 2024; 112:e35443. [PMID: 38968028 DOI: 10.1002/jbm.b.35443] [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: 04/17/2023] [Revised: 04/08/2024] [Accepted: 06/09/2024] [Indexed: 07/07/2024]
Abstract
The aim of this work was to analyze the effects of long-term exposure to titanium dioxide (TiO2) micro- (MPs) and nanoparticles (NPs) (six and 12 months) on the biochemical and histopathological response of target organs using a murine model. Male Wistar rats were intraperitoneally injected with a suspension of TiO2 NPs (5 nm; TiO2-NP5 group) or MPs (45 μm; TiO2-NP5 group); the control group was injected with saline solution. Six and 12 months post-injection, titanium (Ti) concentration in plasma and target organs was determined spectrometrically (ICP-MS). Blood smears and organ tissue samples were evaluated by light microscopy. Liver and kidney function was evaluated using serum biochemical parameters. Oxidative metabolism was assessed 6 months post-injection (determination of superoxide anion by nitroblue tetrazolium (NBT) test, superoxide dismutase (SOD) and catalase (CAT), lipid peroxidation, and paraoxonase 1). Titanium (Ti) concentration in target organs and plasma was significantly higher in the TiO2-exposed groups than in the control group. Histological evaluation showed the presence of titanium-based particles in the target organs, which displayed no structural alterations, and in blood monocytes. Oxidative metabolism analysis showed that TiO2 NPs were more reactive over time than MPs (p < .05) and mobilization of antioxidant enzymes and membrane damage varied among the studied organs. Clearance of TiO2 micro and nanoparticles differed among the target organs, and lung clearance was more rapid than clearance from the lungs and kidneys (p < .05). Conversely, Ti concentration in plasma increased with time (p < .05). In conclusion, neither serum biochemical parameters nor oxidative metabolism markers appear to be useful as biomarkers of tissue damage in response to TiO2 micro- and nanoparticle deposits at chronic time points.
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Affiliation(s)
- Mariela Gisele Domingo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina
- Becario de Investigación de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Melisa Kurtz
- CONICET, Buenos Aires, Argentina
- Instituto de Tecnologías Emergentes y Ciencias Aplicadas (ITECA), Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín-CONICET, Buenos Aires, Argentina
| | - Guillermo Maglione
- Instituto de Tecnologías Emergentes y Ciencias Aplicadas (ITECA), Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín-CONICET, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Histología y Embriología, Buenos Aires, Argentina
| | | | - Fernando Brites
- CONICET, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Departamento de Bioquímica Clínica, Laboratorio de Lípidos y Lipoproteínas, Buenos Aires, Argentina
| | - Deborah Ruth Tasat
- Instituto de Tecnologías Emergentes y Ciencias Aplicadas (ITECA), Escuela de Ciencia y Tecnología, Universidad Nacional de San Martín-CONICET, Buenos Aires, Argentina
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Histología y Embriología, Buenos Aires, Argentina
| | - Daniel Gustavo Olmedo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina
- CONICET, Buenos Aires, Argentina
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Lin X, Yang Y, Huang Y, Li E, Zhuang X, Zhang Z, Xu R, Yu X, Deng F. Mettl3‑mediated m 6A RNA methylation regulates osteolysis induced by titanium particles. Mol Med Rep 2024; 29:36. [PMID: 38214327 PMCID: PMC10823336 DOI: 10.3892/mmr.2024.13160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/24/2023] [Indexed: 01/13/2024] Open
Abstract
Peri‑prosthetic osteolysis (PPO) induced by wear particles is considered the primary cause of titanium prosthesis failure and revision surgery. The specific molecular mechanisms involve titanium particles inducing multiple intracellular pathways, which impact disease prevention and the targeted therapy of PPO. Notably, N6‑methyladenosine (m6A) serves critical roles in epigenetic regulation, particularly in bone metabolism and inflammatory responses. Thus, the present study aimed to determine the role of RNA methylation in titanium particle‑induced osteolysis. Results of reverse transcription‑quantitative PCR (RT‑qPCR), western blotting, ELISA and RNA dot blot assays revealed that titanium particles induced osteogenic inhibition and proinflammatory responses, accompanied by the reduced expression of methyltransferase‑like (Mettl) 3, a key component of m6A methyltransferase. Specific lentiviruses vectors were employed for Mettl3 knockdown and overexpression experiments. RT‑qPCR, western blotting and ELISA revealed that the knockdown of Mettl3 induced osteogenic inhibition and proinflammatory responses comparable with that induced by titanium particle, while Mettl3 overexpression attenuated titanium particle‑induced cellular reactions. Methylated RNA immunoprecipitation‑qPCR results revealed that titanium particles mediated the methylation of two inhibitory molecules, namely Smad7 and SMAD specific E3 ubiquitin protein ligase 1, via Mettl3 in bone morphogenetic protein signaling, leading to osteogenic inhibition. Furthermore, titanium particles induced activation of the nucleotide binding oligomerization domain 1 signaling pathway through methylation regulation, and the subsequent activation of the MAPK and NF‑κB pathways. Collectively, the results of the present study indicated that titanium particles utilized Mettl3 as an upstream regulatory molecule to induce osteogenic inhibition and inflammatory responses. Thus, the present study may provide novel insights into potential therapeutic targets for aseptic loosening in titanium prostheses.
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Affiliation(s)
- Xiaoxuan Lin
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Yang Yang
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Yaohong Huang
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - E Li
- Department of Stomatology, Zhuhai Center for Maternal and Child Healthcare, Zhuhai Women and Children's Hospital, Zhuhai, Guangdong 519000, P.R. China
| | - Xiumei Zhuang
- Department of Stomatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510000, P.R. China
| | - Zhengchuan Zhang
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Ruogu Xu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Xiaolin Yu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
| | - Feilong Deng
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong 510055, P.R. China
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Seo MH, Eo MY, Park MW, Myoung H, Lee JH, Kim SM. Clinical retrospective analysis of peri-implant oral malignancies. Int J Implant Dent 2024; 10:5. [PMID: 38321262 PMCID: PMC10847072 DOI: 10.1186/s40729-024-00527-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 01/30/2024] [Indexed: 02/08/2024] Open
Abstract
PURPOSE Complications of implant prostheses have direct correlation with the increased use of implants for dental rehabilitation. In this study, we present cases of peri-implant oral malignancies (PIOM) around dental implants and a retrospective analysis of patients treated for PIOM. METHODS The retrospective analysis was performed with patients treated for PIOM at the Department of Oral and Maxillofacial Surgery of the Seoul National University Dental Hospital between 2006 and 2014. The patient records were thoroughly screened for previous medical issues, human papilloma virus infections, and other clinical data with a focus on relevant information such as localization, time from implant insertion to the development of the carcinoma, implant type and prosthetic rehabilitation. RESULTS Twenty-one patients were diagnosed with PIOM. The male-to-female ratio was 1.625. The mean age of the patients was 60.42 ± 9.35 years old. Three patients reported ongoing alcohol/tobacco consumption. Five patients had a history of previous oral cancer surgery or exhibited mucosal lesions. The time from implant placement until carcinoma diagnosis was 49.13 ± 33.63 months on average. Most PIOM patients (95.2%) were diagnosed with SCC. All patients had previously been treated for peri-implantitis. In 85.7% of the patients, prostheses were observed on the opposing teeth where PIOM occurred. CONCLUSION Based on the review of these cases, it can be deduced that there is a possibility that implant treatment and galvanic currents between prosthesis may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of malignant tumors. Patients at potential risk may benefit from individualized recall intervals and careful evaluations.
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Affiliation(s)
- Mi Hyun Seo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, South Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, South Korea
| | - Min Woo Park
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, South Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, South Korea
| | - Jong Ho Lee
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, South Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 110-768, South Korea.
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Xu T, Liu P, Yang Y, Duan W, Zhang X, Huang D. Near-infrared Ⅱ light-assisted Cu-containing porous TiO 2 coating for combating implant-associated infection. Colloids Surf B Biointerfaces 2024; 234:113744. [PMID: 38183871 DOI: 10.1016/j.colsurfb.2024.113744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/02/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
Treatment implant-associated infections remains a severe challenge in the clinical practice. This work focuses on the fabrication of Cu-containing porous TiO2 coatings on titanium (Ti) by a combination of magnetron sputtering and dealloying techniques. Additionally, photothermal therapy is employed to enhance the effect of Cu ions in preventing bacterial infection. After the dealloying, most of Cu element was removed from the magnetron sputtered Cu-containing films, and porous TiO2 coatings were prepared on Ti. The formation of porous nanostructures significantly enhanced the photothermal conversion performance under NIR-II light irradiation. The combined effect of hyperthermia and Cu ions demonstrated enhanced antibacterial activity in both in vitro and in vivo experiments, and the antibacterial efficiency can reach 99% against Streptococcus mutans. Moreover, the porous TiO2 coatings also exhibited excellent biocompatibility. This modification of the titanium surface structure through dealloying changes may offer a novel approach to enhance the antimicrobial properties of titanium implants.
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Affiliation(s)
- Tao Xu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Panyue Liu
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China
| | - Yongqiang Yang
- National Graphene Products Quality Inspection and Testing Center (Jiangsu), Special Equipment Safety Supervision Inspection Institute of Jiangsu Province, Wuxi 214174, China
| | - Wangping Duan
- Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, China.
| | - Xiangyu Zhang
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China; Shanxi Key Laboratory of Bone and Soft Tissue Injury Repair, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030001, China; Shanxi-Zheda Institute of Advanced Materials and Chemical Engineering, Taiyuan 030032, China.
| | - Di Huang
- Department of Biomedical Engineering, Research Center for Nano-biomaterials & Regenerative Medicine, College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan 030024, China; Shanxi Key Laboratory of Biomedical Metal Materials, College of Materials Science and Engineering, Taiyuan University of Technology, Taiyuan 030024, China.
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6
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Pozhitkov A, Lindahl E, Chan DC. Toward Elimination of Electrochemical Corrosion in Dental Implants: A Zirconia-Titanium Composite Prototype. Cureus 2023; 15:e49907. [PMID: 38174166 PMCID: PMC10763590 DOI: 10.7759/cureus.49907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
Background Titanium dental implants (e.g., Nobel Biocare, Switzerland) are routinely used as support for dental restoration. Titanium has been the material of choice due to its corrosion resistance and ability to integrate with bone. Nevertheless, corrosion and titanium dissolution do occur. Compared to control, peri-implantitis tissue biopsies have been shown to contain high concentrations of dissolved titanium as well as metal particles. Dissolved titanium species have been found to be associated with the structure/diversity of the subgingival plaque microbiome and the extent of global methylation. Of note, peri-implantitis and peri-implant mucositis are common biological complications of implant therapy. Microorganisms and local inflammation together with a gradient of oxygen have been proven to form an electrochemical fuel cell, which generates the current that flows through the body of the titanium implant. Effectively, the fuel cell reduces oxygen and oxidizes titanium that turns into a soluble form. We are proposing a new zirconia-titanium composite implant design whereby the electrical current is disrupted while other properties are still conducive to osseointegration. Methodology Biocompatible zirconia bolts were treated with hydrofluoric acid (HF) and coated with titanium in a vacuum evaporator. The coating was masked with nail polish, and unmasked areas were etched with HF followed by mask removal with a solvent. Microbial challenges were conducted with a volunteer's plaque. Regular implant (control) and the prototype were inserted into simulated peri-implant environments implemented as a fiberglass sleeve immersed into a growth medium. After a five-day growth, samples were taken and HNO3 digested. Dissolved titanium was evaluated by inductively coupled plasma mass spectrometry. Results Proof-of-concept implant prototypes were successfully created. Vacuum deposition results in reproducible stable titanium coating. The thickness of the titanium coating was estimated using atomic force microscopy. A microbial challenge revealed that compared to the commercial titanium implant, the new implant prototype showed decreased amounts of corrosion-leached titanium. Conclusions We demonstrate a path forward toward a new design of a dental implant, whereby corrosion-induced electrical currents are interrupted resulting in a decreased amount of dissolved titanium.
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Affiliation(s)
- Alex Pozhitkov
- Division of Research Informatics, City of Hope National Medical Center, Duarte, USA
- Restorative Dentistry, University of Washington School of Dentistry, Seattle, USA
| | | | - Daniel C Chan
- Restorative Dentistry, University of Washington School of Dentistry, Seattle, USA
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Chen L, Tong Z, Luo H, Qu Y, Gu X, Si M. Titanium particles in peri-implantitis: distribution, pathogenesis and prospects. Int J Oral Sci 2023; 15:49. [PMID: 37996420 PMCID: PMC10667540 DOI: 10.1038/s41368-023-00256-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Peri-implantitis is one of the most important biological complications in the field of oral implantology. Identifying the causative factors of peri-implant inflammation and osteolysis is crucial for the disease's prevention and treatment. The underlying risk factors and detailed pathogenesis of peri-implantitis remain to be elucidated. Titanium-based implants as the most widely used implant inevitably release titanium particles into the surrounding tissue. Notably, the concentration of titanium particles increases significantly at peri-implantitis sites, suggesting titanium particles as a potential risk factor for the condition. Previous studies have indicated that titanium particles can induce peripheral osteolysis and foster the development of aseptic osteoarthritis in orthopedic joint replacement. However, it remains unconfirmed whether this phenomenon also triggers inflammation and bone resorption in peri-implant tissues. This review summarizes the distribution of titanium particles around the implant, the potential roles in peri-implantitis and the prevalent prevention strategies, which expects to provide new directions for the study of the pathogenesis and treatment of peri-implantitis.
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Affiliation(s)
- Long Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zian Tong
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Hongke Luo
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yuan Qu
- Zhejiang University-University of Edinburgh Institute, International Campus, Zhejiang University, Haining, China
| | - Xinhua Gu
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Misi Si
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
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Gulati K, Chopra D, Kocak-Oztug NA, Verron E. Fit and forget: The future of dental implant therapy via nanotechnology. Adv Drug Deliv Rev 2023; 199:114900. [PMID: 37263543 DOI: 10.1016/j.addr.2023.114900] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/11/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.
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Affiliation(s)
- Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia.
| | - Divya Chopra
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia
| | - Necla Asli Kocak-Oztug
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Istanbul University, Faculty of Dentistry, Department of Periodontology, 34116 Istanbul, Turkey
| | - Elise Verron
- Nantes Université, CNRS, CEISAM, UMR 6230, 44000 Nantes, France
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Chen IC, Su CY, Tu JJ, Kao DW, Fang HW. In vitro studies of factors affecting debridement of dental implants by tricalcium phosphate powder abrasive treatment. Sci Rep 2023; 13:8271. [PMID: 37217571 DOI: 10.1038/s41598-023-35053-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023] Open
Abstract
Peri-implantitis is a common complication characterized by inflammation in tissues surrounding dental implants due to plaque accumulation, which can lead to implant failure. While air flow abrasive treatment has been found to be effective for debriding implant surfaces, little is known about the factors that affect its cleaning capacity. This study systematically examined the cleaning capacity of air powder abrasive (APA) treatment with β-tricalcium phosphate (β-TCP) powder, using various powder jetting strengths and different particle sizes. Three sizes of β-TCP powder (S, M, and L) were prepared, and different powder settings (low, medium, and high) were tested. The cleaning capacity was determined by quantifying ink removal, which simulated biofilm removal from the implant surfaces at different time points. The results of the systematic comparisons showed that the most efficient cleaning of implant surfaces was achieved using size M particles with medium setting. Additionally, the amount of powder consumed was found to be critical to cleaning efficiency, and the implant surfaces were altered in all tested groups. These systematically analyzed outcomes may provide insights into the development of potential non-surgical strategies for treating peri-implant diseases.
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Affiliation(s)
- I-Cheng Chen
- Accelerator for Happiness and Health Industry, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
- High-value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., 10608, Taipei, Taiwan
| | - Chen-Ying Su
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
- High-value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., 10608, Taipei, Taiwan
| | - Jia-Jun Tu
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan
| | - Daniel Wenkai Kao
- Washington Dental Group, No. 111, Sec. 3, Heping E. Rd., Da-an Dist., Taipei City, 10675, Taiwan.
- Department of Dentistry, National Yang Ming University, No. 155, Yixin Rd., Beitou Dist., Taipei City, 11221, Taiwan.
- Harvard School of Dental Medicine, Boston, 188 Longwood Ave, Boston, MA, 02115, USA.
| | - Hsu-Wei Fang
- Accelerator for Happiness and Health Industry, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan.
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan.
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town, Miaoli County, 35053, Taiwan.
- High-value Biomaterials Research and Commercialization Center, National Taipei University of Technology, No. 1, Sec. 3, Zhongxiao E. Rd., 10608, Taipei, Taiwan.
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10
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Mtanis T, Biadsee A, Ormianer Z. Assessing the Cleanliness of Dental Implants Using Scanning Electron Microscopy and Energy-Dispersive X-ray Spectroscopy Analysis-A SEM and EDS In Vitro Study. J Funct Biomater 2023; 14:jfb14030172. [PMID: 36976096 PMCID: PMC10058862 DOI: 10.3390/jfb14030172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
A wide variety of titanium (Ti) alloy dental implant systems are available and as a result, choosing the correct system has become a challenge. Cleanliness of the dental implant surface affects osseointegration but surface cleanliness may be jeopardized during manufacturing. The purpose of this study was to assess the cleanliness of three implant systems. Fifteen implants per system were examined with scanning electron microscopy to identify and count foreign particles. Particle chemical composition analysis was performed with energy-dispersive X-ray spectroscopy. Particles were categorized according to size and location. Particles on the outer and inner threads were quantitatively compared. A second scan was performed after exposing the implants to room air for 10 min. Carbon, among other elements, was found on the surface of all implant groups. Zimmer Biomet dental implants had higher particle numbers than other brands. Cortex and Keystone dental implants showed similar distribution patterns. The outer surface had higher particle numbers. Cortex dental implants were the cleanest. The change in particle numbers after exposure was not significant (p > 0.05). Conclusion: Most of the implants studied were contaminated. Particle distribution patterns vary with the manufacturer. The wider and outer areas of the implant have a higher probability of contamination.
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Affiliation(s)
- Tarek Mtanis
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
| | - Ameer Biadsee
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
| | - Zeev Ormianer
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
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11
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Wagner C, Herberg S, Bourauel C, Stark H, Dörsam I. Biomechanical analysis of different fixed dental restorations on short implants: a finite element study. BIOMED ENG-BIOMED TE 2023:bmt-2022-0414. [PMID: 36795430 DOI: 10.1515/bmt-2022-0414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES Although the use of short implants is becoming more common for patients with atrophic alveolar ridges, their use is still quite limited. This is due to the lack of data of long-term survival compared to standard-length implants. The aim of this study was to determine the load in the bone and implant system with different superstructures. METHODS Three kinds of prosthetic restorations were created on short implants based on CT-Data. Two short implants with different macro-geometries were used. The implants were inserted in idealised posterior lower mandibular segments and afterwards restored with a crown, a double splinted crown, and a bridge. RESULTS The analysis was performed under load of 300 N either divided between a mesial and distal point or as a point load on the pontic/mesial crown. The different design of the implant systems had a noticeable influence on the stress in the cortical bone, in the implant system, and the displacement of the superstructure as well. CONCLUSIONS Compared with implants of standard length, higher stresses were observed, which can lead early failure of the implant during the healing period or a late cervical bone resorption. Precise indications are essential for short implants to avoid the failure of short implants.
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Affiliation(s)
- Christian Wagner
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn Bonn, Germany
| | - Samira Herberg
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn Bonn, Germany
| | | | - Helmut Stark
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn Bonn, Germany
| | - Istabrak Dörsam
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn Bonn, Germany.,Oral Technology, University of Bonn Bonn, Germany
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12
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Lopes DP, Freitas SRM, Tanaka CB, Delechiave G, Kikuchi LNT, Braga RR, Kruzic JJ, Moreira MS, Boaro LCC, Catalani LH, Gonçalves F. Synthesis of Submicrometric Chitosan Particles Loaded with Calcium Phosphate for Biomedical Applications. AAPS PharmSciTech 2023; 24:56. [PMID: 36759364 DOI: 10.1208/s12249-023-02517-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/16/2023] [Indexed: 02/11/2023] Open
Abstract
Chitosan particles loaded with dibasic calcium phosphate anhydrous (DCPA) is a promising strategy for combining antimicrobial and osteoconduction properties in regenerative medicine. However, mostly micrometer-sized particles have been reported in the literature, limiting their use and reducing their effect in the biomedical field. We have recently overcome this limitation by developing submicrometer-sized particles with electrospray technique. The objective of this study was to understand how the process parameters control the size and properties of submicrometer chitosan particles loaded with DCPA. Solutions of 10 mg/mL chitosan and 2.5 mg/mL DCPA in a 90% acetic acid were electrosprayed under three distinct flow rate conditions: 0.2, 0.5, and 1.0 mL/h. The particles were crosslinked in a glutaraldehyde atmosphere and characterized in terms of their morphology, inorganic content, zeta potential, and minimum inhibitory concentration (MIC) against S. mutans. All conditions showed particles with two similar morphologies: one small-sized with a spherical shape and another larger-sized with a bi-concave shape. All generated a broad particle size distribution, with a similar mean size of ~ 235 nm. The addition of DCPA decreased the zeta potential for all the samples, but it was above 30 mV, indicating a low aggregation potential. The lower flow rate showed the worst efficacy for DCPA incorporation. Antimicrobial activity was greater in chitosan/DCPA particles with flow rate of 0.5 mL/h. It can be concluded that the flow rate of 0.5 mL/h presents the best compromise solution in terms of morphology, zeta potential, MIC, and inorganic content.
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Affiliation(s)
- Diana Pereira Lopes
- Departamento de Odontologia, Universidade Ibirapuera, Av. Interlagos 1329 - 4° andar, São Paulo, SP, 04661-100, Brazil
| | - Selma Regina Muniz Freitas
- Faculdade de Odontologia, Universidade Santo Amaro, Av. Prof. Eneas de Siqueira Neto, 340, São Paulo, SP, 04829-900, Brazil
| | - Carina Baptiston Tanaka
- Centre for Rural Dentistry & Oral Health, Charles Sturt University, Orange, NSW, 2800, Australia
| | - Giovanne Delechiave
- Departamento de Química Fundamental, Instituto de Química da Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, São Paulo, SP, 05508-000, Brazil
| | - Lucia Nobuco Takamori Kikuchi
- Departamento de Odontologia, Universidade Ibirapuera, Av. Interlagos 1329 - 4° andar, São Paulo, SP, 04661-100, Brazil
| | - Roberto R Braga
- Faculdade de Odontologia da Universidade de São Paulo, Departamento de Biomateriais e Biologia Oral, Av. Prof. Lineu Prestes, 2222, São Paulo, SP, 05508-000, Brazil
| | - Jamie J Kruzic
- School of Mechanical and Manufacturing Engineering, University of New South Wales (UNSW Sydney), Sydney, NSW, 2052, Australia
| | - Maria Stella Moreira
- Departamento de Odontologia, Universidade Ibirapuera, Av. Interlagos 1329 - 4° andar, São Paulo, SP, 04661-100, Brazil
| | - Leticia Cristina Cidreira Boaro
- Faculdade de Odontologia, Universidade Santo Amaro, Av. Prof. Eneas de Siqueira Neto, 340, São Paulo, SP, 04829-900, Brazil.
| | - Luiz Henrique Catalani
- Departamento de Química Fundamental, Instituto de Química da Universidade de São Paulo, Av. Prof. Lineu Prestes, 748, São Paulo, SP, 05508-000, Brazil
| | - Flávia Gonçalves
- Faculdade de Odontologia, Universidade Santo Amaro, Av. Prof. Eneas de Siqueira Neto, 340, São Paulo, SP, 04829-900, Brazil
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13
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Albrektsson T, Tengvall P, Amengual L, Coli P, Kotsakis GA, Cochran D. Osteoimmune regulation underlies oral implant osseointegration and its perturbation. Front Immunol 2023; 13:1056914. [PMID: 36761175 PMCID: PMC9902598 DOI: 10.3389/fimmu.2022.1056914] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
In the field of biomaterials, an endosseous implant is now recognized as an osteoimmunomodulatory but not bioinert biomaterial. Scientific advances in bone cell biology and in immunology have revealed a close relationship between the bone and immune systems resulting in a field of science called osteoimmunology. These discoveries have allowed for a novel interpretation of osseointegration as representing an osteoimmune reaction rather than a classic bone healing response, in which the activation state of macrophages ((M1-M2 polarization) appears to play a critical role. Through this viewpoint, the immune system is responsible for isolating the implant biomaterial foreign body by forming bone around the oral implant effectively shielding off the implant from the host bone system, i.e. osseointegration becomes a continuous and dynamic host defense reaction. At the same time, this has led to the proposal of a new model of osseointegration, the foreign body equilibrium (FBE). In addition, as an oral wound, the soft tissues are involved with all their innate immune characteristics. When implant integration is viewed as an osteoimmune reaction, this has implications for how marginal bone is regulated. For example, while bacteria are constitutive components of the soft tissue sulcus, if the inflammatory front and immune reaction is at some distance from the marginal bone, an equilibrium is established. If however, this inflammation approaches the marginal bone, an immune osteoclastic reaction occurs and marginal bone is removed. A number of clinical scenarios can be envisioned whereby the osteoimmune equilibrium is disturbed and marginal bone loss occurs, such as complications of aseptic nature and the synergistic activation of pro-inflammatory pathways (implant/wear debris, DAMPs, and PAMPs). Understanding that an implant is a foreign body and that the host reacts osteoimmunologically to shield off the implant allows for a distinction to be drawn between osteoimmunological conditions and peri-implant bone loss. This review will examine dental implant placement as an osteoimmune reaction and its implications for marginal bone loss.
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Affiliation(s)
- T. Albrektsson
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden
| | - P. Tengvall
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden,*Correspondence: P. Tengvall,
| | - L. Amengual
- Dental Implantology Unit, Hospital Leonardo Guzmán, Antofagasta, Chile
| | - P. Coli
- Edinburgh Dental Specialists, Edinburgh, United Kingdom,Department of Prosthetic Dentistry and Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden,Department of Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - G. A. Kotsakis
- Department of Periodontology, University of Texas, San Antonio, TX, United States
| | - D. Cochran
- Department of Periodontology, University of Texas, San Antonio, TX, United States
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14
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Enhanced Corrosion Resistance and Local Therapy from Nano-Engineered Titanium Dental Implants. Pharmaceutics 2023; 15:pharmaceutics15020315. [PMID: 36839638 PMCID: PMC9963924 DOI: 10.3390/pharmaceutics15020315] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Titanium is the ideal material for fabricating dental implants with favorable biocompatibility and biomechanics. However, the chemical corrosions arising from interaction with the surrounding tissues and fluids in oral cavity can challenge the integrity of Ti implants and leach Ti ions/nanoparticles, thereby causing cytotoxicity. Various nanoscale surface modifications have been performed to augment the chemical and electrochemical stability of Ti-based dental implants, and this review discusses and details these advances. For instance, depositing nanowires/nanoparticles via alkali-heat treatment and plasma spraying results in the fabrication of a nanostructured layer to reduce chemical corrosion. Further, refining the grain size to nanoscale could enhance Ti implants' mechanical and chemical stability by alleviating the internal strain and establishing a uniform TiO2 layer. More recently, electrochemical anodization (EA) has emerged as a promising method to fabricate controlled TiO2 nanostructures on Ti dental implants. These anodized implants enhance Ti implants' corrosion resistance and bioactivity. A particular focus of this review is to highlight critical advances in anodized Ti implants with nanotubes/nanopores for local drug delivery of potent therapeutics to augment osseo- and soft-tissue integration. This review aims to improve the understanding of novel nano-engineered Ti dental implant modifications, focusing on anodized nanostructures to fabricate the next generation of therapeutic and corrosion-resistant dental implants. The review explores the latest developments, clinical translation challenges, and future directions to assist in developing the next generation of dental implants that will survive long-term in the complex corrosive oral microenvironment.
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15
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Doolan JA, Williams GT, Hilton KLF, Chaudhari R, Fossey JS, Goult BT, Hiscock JR. Advancements in antimicrobial nanoscale materials and self-assembling systems. Chem Soc Rev 2022; 51:8696-8755. [PMID: 36190355 PMCID: PMC9575517 DOI: 10.1039/d1cs00915j] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Indexed: 11/21/2022]
Abstract
Antimicrobial resistance is directly responsible for more deaths per year than either HIV/AIDS or malaria and is predicted to incur a cumulative societal financial burden of at least $100 trillion between 2014 and 2050. Already heralded as one of the greatest threats to human health, the onset of the coronavirus pandemic has accelerated the prevalence of antimicrobial resistant bacterial infections due to factors including increased global antibiotic/antimicrobial use. Thus an urgent need for novel therapeutics to combat what some have termed the 'silent pandemic' is evident. This review acts as a repository of research and an overview of the novel therapeutic strategies being developed to overcome antimicrobial resistance, with a focus on self-assembling systems and nanoscale materials. The fundamental mechanisms of action, as well as the key advantages and disadvantages of each system are discussed, and attention is drawn to key examples within each field. As a result, this review provides a guide to the further design and development of antimicrobial systems, and outlines the interdisciplinary techniques required to translate this fundamental research towards the clinic.
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Affiliation(s)
- Jack A Doolan
- School of Chemistry and Forensic Science, University of Kent, Canterbury, Kent CT2 7NH, UK.
- School of Biosciences, University of Kent, Canterbury, Kent CT2 7NJ, UK.
| | - George T Williams
- School of Chemistry, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Kira L F Hilton
- School of Chemistry and Forensic Science, University of Kent, Canterbury, Kent CT2 7NH, UK.
| | - Rajas Chaudhari
- School of Chemistry and Forensic Science, University of Kent, Canterbury, Kent CT2 7NH, UK.
| | - John S Fossey
- School of Chemistry, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Benjamin T Goult
- School of Biosciences, University of Kent, Canterbury, Kent CT2 7NJ, UK.
| | - Jennifer R Hiscock
- School of Chemistry and Forensic Science, University of Kent, Canterbury, Kent CT2 7NH, UK.
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16
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Silver Nanoparticles Produced by Laser Ablation and Re-Irradiation Are Effective Preventing Peri-Implantitis Multispecies Biofilm Formation. Int J Mol Sci 2022; 23:ijms231912027. [PMID: 36233328 PMCID: PMC9570054 DOI: 10.3390/ijms231912027] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022] Open
Abstract
Implant-associated infection due to biofilm formation is a growing problem. Given that silver nanoparticles (Ag-NPs) have shown antibacterial effects, our goal is to study their effect against multispecies biofilm involved in the development of peri-implantitis. To this purpose, Ag-NPs were synthesized by laser ablation in de-ionized water using two different lasers, leading to the production of colloidal suspensions. Subsequently, part of each suspension was subjected to irradiation one and three times with the same laser source with which it was obtained. Ag-NPs were immobilized on the surface of titanium discs and the resultant materials were compared with unmodified titanium coupons. Nanoparticles were physico-chemically analysed to determine their shape, crystallinity, chemical composition, and mean diameter. The materials were incubated for 90 min or 48 h, to evaluate bacterial adhesion or biofilm formation respectively with Staphylococcus aureus or oral mixed bacterial flora composed of Streptococcus oralis, Actinomyces naeslundii, Veionella dispar, and Porphyromonas gingivalis. Ag-NPs help prevent the formation of biofilms both by S. aureus and by mixed oral bacterial flora. Nanoparticles re-irradiated three times showed the biggest antimicrobial effects. Modifying dental implants in this way could prevent the development of peri-implantitis.
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17
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Li R, Wan L, Zhang X, Liu W, Rong M, Li X, Lu H. Effect of a neodymium-doped yttrium aluminium garnet laser on the physicochemical properties of contaminated titanium surfaces and macrophage polarization. J Periodontal Res 2022; 57:533-544. [PMID: 35266182 DOI: 10.1111/jre.12982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/10/2021] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Abstract
AIM(S) The objective of this study was to evaluate the changes in the physical and chemical properties of titanium surfaces contaminated by a Nd:YAG laser with different levels of energy and the regulation of macrophage polarization. MATERIALS AND METHODS The titanium specimens were divided into four groups. The blank control group consisted of the above-mentioned contaminated titanium specimens, and the conditioned control group consisted of sandblasted and acid-etched (SLA) titanium surfaces. The blank control and condition control groups were sealed and preserved in a sterile dark box. There were two experimental groups treated with the Nd:YAG laser-one with 0.5 W and the second with 1.0 W. Surface characteristics were evaluated using scanning electron microscopy, surface profilometry, and contact angle assays. The macrophage viability and proliferation of mouse RAW246.7 were analysed, and the macrophage surface markers, macrophage cytokines, and inflammatory and anti-inflammatory genes were expressed. RESULTS The Nd:YAG laser increased the hydrophilicity and roughness of the titanium surface after decontamination. Fewer RAW264.7 cells were observed on the titanium surface after Nd:YAG decontamination than on the contaminated titanium surface expressing the M1-type macrophage marker CCR7, whereas more cells were observed after decontamination than on the contaminated titanium surface expressing the M2-type macrophage marker CD206. Following Nd:YAG laser treatment, the secretion of the inflammatory cytokines IL-1β and TNF-α by RAW264.7 cells on the titanium surface was decreased, whereas the secretion of the anti-inflammatory cytokines IL-4 and IL-10 was increased. RAW264.7 cells cultured for 3 days on the titanium surface after Nd:YAG decontamination treatment expressed significantly reduced levels of the inflammation-related genes IL-1β, TNF-α, IL-6 and iNOS. The expression of the anti-inflammatory genes Arg-1, IL-4, IL-10 and TGF-β by RAW264.7 cells was significantly up-regulated after 3 days of incubation on the titanium surface after Nd:YAG decontamination treatment. CONCLUSION(S) The Nd:YAG laser increased the hydrophilicity and roughness of the titanium surface after decontamination, and this change inhibited M1-type macrophage polarization and promoted M2-type macrophage polarization.
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Affiliation(s)
- Ruiqi Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Lei Wan
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xueyang Zhang
- Stomatological Hospital, Southern Medical University, Guangzhou, China.,Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China
| | - Wenjing Liu
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Mingdeng Rong
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoling Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Haibin Lu
- Stomatological Hospital, Southern Medical University, Guangzhou, China.,Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde), Foshan, China
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18
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Accioni F, Vázquez J, Merinero M, Begines B, Alcudia A. Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications. Pharmaceutics 2022; 14:455. [PMID: 35214186 PMCID: PMC8876580 DOI: 10.3390/pharmaceutics14020455] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 12/27/2022] Open
Abstract
An increase in the world population and its life expectancy, as well as the ongoing concern about our physical appearance, have elevated the relevance of dental implantology in recent decades. Engineering strategies to improve the survival rate of dental implants have been widely investigated, focusing on implant material composition, geometry (usually guided to reduce stiffness), and interface surrounding tissues. Although efforts to develop different implant surface modifications are being applied in commercial dental prostheses today, the inclusion of surface coatings has gained special interest, as they can be tailored to efficiently enhance osseointegration, as well as to reduce bacterial-related infection, minimizing peri-implantitis appearance and its associated risks. The use of biomaterials to replace teeth has highlighted the need for the development of reliable analytical methods to assess the therapeutic benefits of implants. This literature review considers the state-of-the-art strategies for surface modification or coating and analytical methodologies for increasing the survival rate for teeth restoration.
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Affiliation(s)
- Francesca Accioni
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
| | - Juan Vázquez
- Departamento de Química Orgánica, Universidad de Sevilla, 41012 Seville, Spain;
| | - Manuel Merinero
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
- Departamento de Citología e Histología Normal y Patológica, Universidad de Sevilla, 41012 Seville, Spain
| | - Belén Begines
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
| | - Ana Alcudia
- Departamento de Química Orgánica y Farmacéutica, Universidad de Sevilla, 41012 Seville, Spain; (F.A.); (M.M.)
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19
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Di Trani N, Pons-Faudoa FP, Sizovs A, Shelton KA, Marzinke MA, Nehete PN, Grattoni A. Extending drug release from implants via transcutaneous refilling with solid therapeutics. ADVANCED THERAPEUTICS 2022; 5:2100214. [PMID: 35815229 PMCID: PMC9268610 DOI: 10.1002/adtp.202100214] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Long-acting (LA) implantable drug delivery systems (IDDS) offer an effective approach for the management or prevention of chronic conditions by sustained parenteral therapeutic administration. LA IDDS can and improve adherence to treatment regimens by minimizing dosing frequency. However, their clinical deployment is challenged by factors such as poor drug loading capacity, which limit their lifespan and require repeated surgical replacement for continued therapy. To address these challenges, and by leveraging previous work on nanofluidic systems, a reservoir-based IDDS that enables transcutaneous refilling of solid drug formulations through minimally invasive needle injection is presented. With thousand-fold higher drug loading efficiency, the implant affords minimal volume and aspect ratio suitable for discrete subcutaneous deployment. Key parameters for clinical acceptability, namely implant safety, access port robustness, and refilling method were systematically evaluated. The implant and refilling procedure are studied in rats and nonhuman primates with therapeutics used clinically for type 2 diabetes and human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP). The ability to extend drug release and maintain equivalent pharmacokinetics (PK) profiles pre- and post-drug refilling is demonstrated. This technology presents a clinically viable LA approach to prolong drug release for lifelong prevention or management of chronic conditions.
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Affiliation(s)
| | | | - Antons Sizovs
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA; Latvian Institute of Organic Synthesis, Riga, Latvia; Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
| | - Kathryn A. Shelton
- Department of Comparative Medicine, Michael E. Keeling Center for Comparative Medicine and Research, MD Anderson Cancer Center, Bastrop, TX 78602, USA
| | - Mark A. Marzinke
- Departments of Pathology and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Pramod N. Nehete
- Department of Comparative Medicine, Michael E. Keeling Center for Comparative Medicine and Research, MD Anderson Cancer Center, Bastrop, TX 78602, USA; The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX 77030, USA
| | - Alessandro Grattoni
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA; Department of Surgery, Houston Methodist Research Institute, Houston, TX 77030, USA; Department of Radiation Oncology, Houston Methodist Research Institute, Houston, TX 77030, USA
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20
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Zhou P, Manoil D, Belibasakis GN, Kotsakis GA. Veillonellae: Beyond Bridging Species in Oral Biofilm Ecology. FRONTIERS IN ORAL HEALTH 2022; 2:774115. [PMID: 35048073 PMCID: PMC8757872 DOI: 10.3389/froh.2021.774115] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/05/2021] [Indexed: 12/28/2022] Open
Abstract
The genus Veillonella comprises 16 characterized species, among which eight are commonly found in the human oral cavity. The high abundance of Veillonella species in the microbiome of both supra- and sub-gingival biofilms, and their interdependent relationship with a multitude of other bacterial species, suggest veillonellae to play an important role in oral biofilm ecology. Development of oral biofilms relies on an incremental coaggregation process between early, bridging and later bacterial colonizers, ultimately forming multispecies communities. As early colonizer and bridging species, veillonellae are critical in guiding the development of multispecies communities in the human oral microenvironment. Their ability to establish mutualistic relationships with other members of the oral microbiome has emerged as a crucial factor that may contribute to health equilibrium. Here, we review the general characteristics, taxonomy, physiology, genomic and genetics of veillonellae, as well as their bridging role in the development of oral biofilms. We further discuss the role of Veillonella spp. as potential “accessory pathogens” in the human oral cavity, capable of supporting colonization by other, more pathogenic species. The relationship between Veillonella spp. and dental caries, periodontitis, and peri-implantitis is also recapitulated in this review. We finally highlight areas of future research required to better understand the intergeneric signaling employed by veillonellae during their bridging activities and interspecies mutualism. With the recent discoveries of large species and strain-specific variation within the genus in biological and virulence characteristics, the study of Veillonella as an example of highly adaptive microorganisms that indirectly participates in dysbiosis holds great promise for broadening our understanding of polymicrobial disease pathogenesis.
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Affiliation(s)
- Peng Zhou
- Translational Periodontal Research Lab, Department of Periodontics, School of Dentistry, UT Health San Antonio, San Antonio, TX, United States
| | - Daniel Manoil
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
| | - Georgios A Kotsakis
- Translational Periodontal Research Lab, Department of Periodontics, School of Dentistry, UT Health San Antonio, San Antonio, TX, United States
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He Y, Li Y, Zuo E, Chai S, Ren X, Fei T, Ma G, Wang X, Liu H. A Novel Antibacterial Titanium Modification with a Sustained Release of Pac-525. NANOMATERIALS 2021; 11:nano11123306. [PMID: 34947655 PMCID: PMC8704243 DOI: 10.3390/nano11123306] [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: 10/13/2021] [Revised: 11/26/2021] [Accepted: 11/26/2021] [Indexed: 12/12/2022]
Abstract
For the benefit of antibacterial Ti on orthopedic and dental implants, a bioactive coating (Pac@PLGA MS/HA coated Ti) was deposited on the surface of pure titanium (Ti), which included two layers: an acid-alkali heat pretreated biomimetic mineralization layer and an electrosprayed Poly (D,L-lactide-co- glycolic acid) (PLGA) microsphere layer as a sustained-release system. Hydroxyapatite (HA) in mineralization layer was primarily prepared on the Ti followed by the antibacterial coating of Pac-525 loaded by PLGA microspheres. After observing the antimicrobial peptides distributed uniformly on the titanium surface, the release assay showed that the release of Pac-525 from Pac@PLGA MS/HA coated Ti provided a large initial burst followed by a slow release at a flat rate. Pac@PLGA MS/HA coated Ti exhibited a strong cytotoxicity to both Gram-negative bacteria (Escherichia coli) and Gram-positive bacteria (Staphylococcus aureus). In addition, Pac@PLGA MS/HA coated Ti did not affect the growth and adhesion of the osteoblast-like cell line, MC3T3-E1. These data suggested that a bionic mineralized composite coating with long-term antimicrobial activity was successfully prepared.
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Affiliation(s)
- Yuzhu He
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Yuanyuan Li
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Enjun Zuo
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
| | - Songling Chai
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
| | - Xiang Ren
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
| | - Tao Fei
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
| | - Guowu Ma
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
- Correspondence: (G.M.); (X.W.); (H.L.); Tel.: +86-8611-0401 (G.M.); +86-1062-782-966 (X.W.); +86-8611-0404 (H.L.)
| | - Xiumei Wang
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
- Correspondence: (G.M.); (X.W.); (H.L.); Tel.: +86-8611-0401 (G.M.); +86-1062-782-966 (X.W.); +86-8611-0404 (H.L.)
| | - Huiying Liu
- School of Stomatology, Dalian Medical University, Dalian 116044, China; (Y.H.); (Y.L.); (E.Z.); (S.C.); (X.R.); (T.F.)
- Correspondence: (G.M.); (X.W.); (H.L.); Tel.: +86-8611-0401 (G.M.); +86-1062-782-966 (X.W.); +86-8611-0404 (H.L.)
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22
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Seloto CB, Strazzi-Sahyon HB, Dos Santos PH, Assunção WG. Performance of different abutment/implant joints as a result of a sealing agent. J Prosthodont Res 2021; 65:489-494. [PMID: 34470982 DOI: 10.2186/jpr.jpr_d_20_00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose This in vitro study aimed to evaluate the effectiveness of a sealing agent in sealing the abutment/implant interface and the preload maintenance of retaining screws after mechanical cycling.Methods Six groups (n = 12) were evaluated according to the abutment/implant system (external-hexagon implant and UCLA abutments, EHU; Morse taper implant and UCLA abutments, MTU; and Morse taper implant and flexcone abutments, MTF) and the presence of an anaerobic gel sealing agent (control group, no sealing agent; experimental group, sealing agent). Toluidine blue (0.7 μL) was inserted into each implant and the abutments were attached to the implants using a digital torque wrench to evaluate the sealing of the abutment/implant interface. The specimens were tested through mechanical cycling (1 × 106 cycles, 2 Hz, and 130 N). Dye release from the abutment/implant interface was analyzed using a spectrophotometer, and the reverse torque values were obtained using a digital wrench. Reverse torque and dye release data were measured after mechanical cycling and analyzed using ANOVA and Tukey's test (α =.05).Results All experimental groups showed higher reverse torque values than the control groups (P <.05). In general, the MTU and MTF experimental groups, as well as the MTF control group, showed no significant dye release at different periods (P >.05).Conclusions The use of a sealing agent improved the preload maintenance of screw-retained implant-supported prostheses. The sealing agent was effective in sealing the Morse taper connection.
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Affiliation(s)
- Camila Berbel Seloto
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University, São Paulo, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University, São Paulo, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University, São Paulo, Brazil
| | - Wirley Gonçalves Assunção
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University, São Paulo, Brazil
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Toledano M, Osorio MT, Vallecillo-Rivas M, Toledano-Osorio M, Rodríguez-Archilla A, Toledano R, Osorio R. Efficacy of local antibiotic therapy in the treatment of peri-implantitis: A systematic review and meta-analysis. J Dent 2021; 113:103790. [PMID: 34455016 DOI: 10.1016/j.jdent.2021.103790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/01/2021] [Accepted: 08/20/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to state the efficacy of local administration of antibiotics in the treatment of peri-implantitis in terms of peri-implant probing depth (PPD) and bleeding on probing (BoP) reduction. DATA, SOURCES AND STUDY SELECTION Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). Due to the encountered heterogeneity between the studies being combined, random-effects models were applied in order to analyze effect sizes. Twelve studies (365 patients and 463 implants) were included in the systematic review. After peri-implantitis treatment with local antibiotics, PPD was reduced 1.40 mm (95% confidence interval: 0.82-1.98). When local antibiotics were applied, a 0.30 mm higher reduction of PPD was obtained than in the control group (95% confidence interval: 0.07-0.53). BoP attained an odds ratio value of 1.82 (95% confidence interval: 1.09-3.04), indicating that the likehood of bleeding is almost two-fold when antibiotics are not locally administrated. Adverse effects were not found after applying local antibiotics. CONCLUSIONS The local antibiotic administration does reduce, without adverse effects, both peri-implant probing depths and bleeding on probing in patients affected by peri-implantitis, if compared to control groups without local antibiotic application. CLINICAL SIGNIFICANCE Patients with dental implants frequently suffer from peri-implantitis. Clinical features of peri-implantitis lesions include the presence of bleeding on probing and increased peri-implant probing depths. Both BoP and PPD have become reduced after local administration of antibiotics.
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Affiliation(s)
- Manuel Toledano
- University of Granada, Faculty of Dentistry, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | | | - Marta Vallecillo-Rivas
- University of Granada, Faculty of Dentistry, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | - Manuel Toledano-Osorio
- University of Granada, Faculty of Dentistry, Colegio Máximo de Cartuja s/n, Granada 18071, Spain.
| | | | | | - Raquel Osorio
- University of Granada, Faculty of Dentistry, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
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24
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Rasul J, Thakur MK, Maheshwari B, Aga N, Kumar H, Mahajani M. Assessment of Titanium Level in Submucosal Plaque Around Healthy Implants and Implants with Peri-implantitis: A Clinical Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S383-S386. [PMID: 34447115 PMCID: PMC8375966 DOI: 10.4103/jpbs.jpbs_815_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/04/2022] Open
Abstract
Background The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants. Methodology Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry. Results The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 μg and in Group II was 0.91 ± 0.04 μg. A highly significant difference between both groups was found (P < 0.05). Conclusion There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.
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Affiliation(s)
- Juzer Rasul
- Reader and HOD of Public Health Dentistry, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India
| | - Manoj Kumar Thakur
- Department of Prosthodontics and Crown and Bridge, Vananchal Dental College and Hospital, Garhwa, Jharkhand, India
| | - Barkha Maheshwari
- Dental Surgeon, Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India
| | - Nausheen Aga
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, Sharjah, United Arab Emirates
| | - Harsh Kumar
- Department of Dentistry, Patna Medical College and Hospital, Patna, Bihar, India
| | - Monica Mahajani
- Department of Periodontology, Dr. HSRSM Dental College and Hospital, Hingoli, Maharashtra, India
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25
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Tamayo JA, Riascos M, Vargas CA, Baena LM. Additive manufacturing of Ti6Al4V alloy via electron beam melting for the development of implants for the biomedical industry. Heliyon 2021; 7:e06892. [PMID: 34027149 PMCID: PMC8120950 DOI: 10.1016/j.heliyon.2021.e06892] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/27/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Additive Manufacturing (AM) or rapid prototyping technologies are presented as one of the best options to produce customized prostheses and implants with high-level requirements in terms of complex geometries, mechanical properties, and short production times. The AM method that has been more investigated to obtain metallic implants for medical and biomedical use is Electron Beam Melting (EBM), which is based on the powder bed fusion technique. One of the most common metals employed to manufacture medical implants is titanium. Although discovered in 1790, titanium and its alloys only started to be used as engineering materials for biomedical prostheses after the 1950s. In the biomedical field, these materials have been mainly employed to facilitate bone adhesion and fixation, as well as for joint replacement surgeries, thanks to their good chemical, mechanical, and biocompatibility properties. Therefore, this study aims to collect relevant and up-to-date information from an exhaustive literature review on EBM and its applications in the medical and biomedical fields. This AM method has become increasingly popular in the manufacturing sector due to its great versatility and geometry control.
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Affiliation(s)
- José A. Tamayo
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Mateo Riascos
- Grupo Calidad, Metrología y Producción, Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Carlos A. Vargas
- Grupo Materiales Avanzados y Energía (Matyer), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
| | - Libia M. Baena
- Grupo de Química Básica, Aplicada y Ambiente (Alquimia), Instituto Tecnológico Metropolitano (ITM), Medellín, Colombia
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26
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López-Valverde N, Macedo-de-Sousa B, López-Valverde A, Ramírez JM. Effectiveness of Antibacterial Surfaces in Osseointegration of Titanium Dental Implants: A Systematic Review. Antibiotics (Basel) 2021; 10:antibiotics10040360. [PMID: 33800702 PMCID: PMC8066819 DOI: 10.3390/antibiotics10040360] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/15/2022] Open
Abstract
Titanium (Ti) dental implant failure as a result of infection has been established at 40%, being regarded as one of the most habitual and untreatable problems. Current research is focused on the design of new surfaces that can generate long-lasting, infection-free osseointegration. The purpose of our study was to assess studies on Ti implants coated with different antibacterial surfaces, assessing their osseointegration. The PubMed, Web of Science and Scopus databases were electronically searched for in vivo studies up to December 2020, selecting six studies that met the inclusion criteria. The quality of the selected studies was assessed using the ARRIVE (Animal Research: Reporting of In Vivo Experiments) criteria and Systematic Review Center for Laboratory animal Experimentation's (SYRCLE's) risk of bias tool. Although all the included studies, proved greater osseointegration capacity of the different antibacterial surfaces studied, the methodological quality and experimental models used in some of them make it difficult to draw predictable conclusions. Because of the foregoing, we recommend caution when interpreting the results obtained.
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Affiliation(s)
- Nansi López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain;
| | - Bruno Macedo-de-Sousa
- Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, Polo I-Edifício Central Rua Larga, 3004-504 Coimbra, Portugal;
| | - Antonio López-Valverde
- Department of Surgery, Instituto de Investigación Biomédica de Salamanca (IBSAL), University of Salamanca, 37007 Salamanca, Spain;
- Correspondence:
| | - Juan Manuel Ramírez
- Department of Morphological Sciences, University of Cordoba, Avenida Menéndez Pidal S/N, 14071 Cordoba, Spain;
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27
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Kotsakis GA, Olmedo DG. Peri-implantitis is not periodontitis: Scientific discoveries shed light on microbiome-biomaterial interactions that may determine disease phenotype. Periodontol 2000 2021; 86:231-240. [PMID: 33690947 DOI: 10.1111/prd.12372] [Citation(s) in RCA: 93] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Peri-implantitis is an immune-mediated biological complication that is attributed to bacterial biofilms on the implant surface. As both periodontitis and peri-implantitis have similar inflammatory phenotypes when assessed cross-sectionally, treatment protocols for peri-implantitis were modeled according to those used for periodontitis. However, lack of efficacy of antimicrobial treatments targeting periodontal pathogens coupled with recent discoveries from open-ended microbial investigation studies create a heightened need to revisit the pathogenesis of peri-implantitis compared with that of periodontitis. The tale of biofilm formation on intraoral solid surfaces begins with pellicle formation, which supports initial bacterial adhesion. The differences between implant- and tooth-bound biofilms appear as early as bacterial adhesion commences. The electrostatic forces and ionic bonding that drive initial bacterial adhesion are fundamentally different in the presence of titanium dioxide or other implant alloys vs mineralized organic hydroxyapatite, respectively. Moreover, the interaction between metal surfaces and the oral environment leads to the release of implant degradation products into the peri-implant sulcus, which exposes the microbiota to increased environmental stress and may alter immune responses to bacteria. Clinically, biofilms found in peri-implantitis are resistant to beta-lactam antibiotics, which are effective against periodontal communities even as monotherapies and demonstrate a composition different from that of biofilms found in periodontitis; these facts strongly suggest that a new model of peri-implant infection is required.
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Affiliation(s)
- Georgios A Kotsakis
- Department of Periodontics, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Daniel G Olmedo
- Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Anatomía Patológica, Buenos Aires, Argentina & CONICET, Buenos Aires, Argentina
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Zhou Z, Shi Q, Wang J, Chen X, Hao Y, Zhang Y, Wang X. The unfavorable role of titanium particles released from dental implants. Nanotheranostics 2021; 5:321-332. [PMID: 33732603 PMCID: PMC7961127 DOI: 10.7150/ntno.56401] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/10/2021] [Indexed: 12/17/2022] Open
Abstract
Titanium is considered to be a metal material with the best biological safety. Studies have proved that the titanium implanted in the bone continuously releases titanium particles (Ti particles), significantly increasing the total titanium content in human body. Generally, Ti particles are released slowly without causing a systemic immune response. However, the continuous increased local concentration may result in damage to the intraepithelial homeostasis, aggravation of inflammatory reaction in the surrounding tissues, bone resorption and implant detachment. They also migrate with blood flow and aggregate in the distal organ. The release of Ti particles is affected by the score of the implant surface structure, microenvironment wear and corrosion, medical operation wear, and so on, but the specific mechanism is not clear. Thus, it difficult to prevent the release completely. This paper reviews the causes of the Ti particles formation, the damage to the surrounding tissue, and its mechanism, in particular, methods for reducing the release and toxicity of the Ti particles.
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Affiliation(s)
- Zilan Zhou
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Quan Shi
- Institute of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jie Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Xiaohang Chen
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Yujia Hao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan 030001, China
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Guler B, Uraz A, Hatipoğlu H, Yalım M. Chemical Evaluation of Energy Dispersive X-ray Spectroscopy Analysis of Different Failing Dental Implant Surfaces: A Comparative Clinical Trial. MATERIALS 2021; 14:ma14040986. [PMID: 33669886 PMCID: PMC7923284 DOI: 10.3390/ma14040986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022]
Abstract
The aim of the present study is to compare two different implant surface chemistries of failing dental implants. Sixteen patients (mean age: 52 ± 8.27 with eight females and eight males) and 34 implants were included in the study. Group-I implants consisted of a blasted/etched surface with a final process surface, while Group-II implants consisted of the sandblasted acid etching (SLA) method. The chemical surface analysis was performed by the energy dispersive X-ray spectroscopy (EDX) method from coronal, middle, and apical parts of each implant. Titanium (Ti) element values were found to be 20.22 ± 15.7 at.% in Group I and 33.96 ± 13.62 at.% in Group-II in the middle of the dental implants. Aluminum (Al) element values were found to be 0.01 ± 0.002 in Group-I and 0.17 ± 0.28 at.% in Group II in the middle of the dental implants, and statistically significant differences were found between the groups for the Al and Ti elements in the middle of the dental implants (p < 0.05). There was a statistically significant difference for the Ti, Al, O, Ca, Fe, P, and Mg elements in the coronal, middle, and apical parts of the implants in the intragroup evaluation (p < 0.05). It is reported that different parts of the implants affected by peri-implant inflammation show different surface chemistries, from coronal to apical, but there is no difference in the implants with different surfaces.
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Affiliation(s)
- Berceste Guler
- Department of Periodontology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya 43100, Turkey;
- Correspondence:
| | - Ahu Uraz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara 06500, Turkey; (A.U.); (M.Y.)
| | - Hasan Hatipoğlu
- Department of Periodontology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya 43100, Turkey;
| | - Mehmet Yalım
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara 06500, Turkey; (A.U.); (M.Y.)
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Effect of Cu and Ti electrodes on surface and electrochemical properties of Electro Discharge Machined (EDMed) structures made of Co-Cr and Ti dental alloys. Dent Mater 2021; 37:588-596. [PMID: 33581911 DOI: 10.1016/j.dental.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/08/2021] [Accepted: 01/18/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Previous studies have shown that the use of Cu electrodes compromises the electrochemical properties of Co-Cr and Ti alloys used for the fabrication of implant retained superstructures by Electro Discharge Machining (EDM). A possible solution is the use of Ti instead of Cu electrodes and thus the aim of this study was to evaluate the effect of Cu and Ti electrodes on surface and electrochemical properties of two types of dental alloys used for fabrication of implant retained superstructures after EDM. METHODS Three full arch frameworks were prepared from a Co-Cr and three from Ti6Al7Nb alloy. One framework from each alloy was used as control, one was subjected to EDM with Cu electrodes and the last one with Ti electrodes. Morphological and elemental characterization was studied by SEM/EDX. The electrochemical properties of the alloys were evaluated by Open Circuit Potential (OCP) and Linear Sweep Voltammetry (LSV) in Ringer's solution. Electrochemical data were analyzed statistically by one way ANOVA and SNK multiple comparison tests at a = 0.05 RESULTS: All groups demonstrate the typical surface after EDM treatment with almost circular valleys and an increase in C and O content compared to control groups. Both alloys demonstrated an uptake of C and Cu by Cu electrodes and C and Ti after treatment with Ti electrodes. The use of Cu electrodes had a detrimental effect on corrosion resistance of Ti alloy. SIGNIFICANCE The use of Ti electrodes mitigates the degradation of electrochemical properties compared to Cu electrodes and from this standpoint is safer for the EDM of implant retained superstructures made of Co-Cr and Ti alloys.
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31
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Paparella ML, Domingo MG, Puia SA, Jacobi-Gresser E, Olmedo DG. Titanium dental implant-related pathologies: A retrospective histopathological study. Oral Dis 2021; 28:503-512. [PMID: 33544935 DOI: 10.1111/odi.13794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To perform a retrospective, descriptive, histopathological study of peri-implant tissue pathologies associated with titanium dental implants (TDI), and to evaluate the presence of metallic particles in samples from a single diagnostic center. METHODS Sixty-eight cases of TDI-associated lesions were retrieved from the Surgical Pathology Laboratory archives, School of Dentistry, University of Buenos Aires (UBA) (1990-2018). The study included re-examining the histopathological features of the biopsy samples, analyzing the inflammatory infiltrate, and examining the samples to detect metallic particles whose chemical composition was determined spectrophotometrically (EDS). Available clinical and radiographic data were also reviewed. RESULTS The retrieved cases ranged from lesions of inflammatory origin to neoplastic lesions. Metallic particles were observed in 36 cases (52.9%), all of which showed inflammation. Particle length ranged from 2 to 85µm. EDS analysis of the particles/deposits observed in the tissues showed the presence of aluminum, titanium, iron, and nickel, among other elements. CONCLUSIONS A significant number of TDI-associated lesions, including cases not reported to date and diagnosed at a single diagnostic center, are shown here. Cases showing particles exhibited an inflammatory response, irrespective of the histopathological diagnosis. The role of metallic particles in the development of TDI-associated lesion is yet to be established.
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Affiliation(s)
- María Luisa Paparella
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina
| | - Mariela Gisele Domingo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina.,Research Fellow of the University of Buenos Aires, Buenos Aires, Argentina
| | - Sebastián Ariel Puia
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Cirugía I, Buenos Aires, Argentina
| | | | - Daniel Gustavo Olmedo
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Anatomía Patológica, Buenos Aires, Argentina.,National Council of Scientific and Technical Research (CONICET), Buenos Aires, Argentina
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Guarnieri R, Di Nardo D, Di Giorgio G, Miccoli G, Testarelli L. Evaluation of peri-implant tissues condition after 10-15 years of loading in treated chronic periodontitis patients attending a private practice setting: A retrospective study. Clin Oral Implants Res 2021; 32:422-436. [PMID: 33452830 DOI: 10.1111/clr.13712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 09/22/2020] [Accepted: 01/07/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To retrospectively evaluate the conditions of the peri-implant tissues in treated patients with chronic periodontitis (CP) and in patients without chronic periodontitis (noCP). MATERIALS AND METHODS A chart review was used to evaluate 267 implants, 134 placed in 42 CP treated patients and 133 placed in 46 noCP patients. The primary outcome was to evaluate the condition of the peri-implant tissues (health, peri-mucositis, and peri-implantitis). The secondary outcome was to evaluate the possible association of some variables, such as, Plaque Index (PI), Bleeding Index (BI), probing pocket depth (PD), bleeding on probing (BoP), bone level (BL), loading time, type of implant placement and loading protocol, type of prosthesis, type of bone, implant manufacturer, and implant diameter and length, with the implant health condition. RESULTS The analysis of patient files revealed that after 10-15 years of loading (mean loading time 13.4 ± 2.07 years), six noCP patients (13%) experienced implant loss with a total of nine implants (6.7%) lost. The remaining 124 implants were classified: 54 (43.5%) as healthy, 45 (36.3%) with peri-implant mucositis, and 25 (20.2%) with peri-implantitis. Twelve CP subjects (28.5%) experienced implant loss with a total of 19 implants (14.1%) lost. The remaining 115 implants were classified: 34 (29.5%) as healthy, 40 (34.7%) with peri-implant mucositis and 41 (35.6%) with peri-implantitis. Compared with noCP subjects, only treated CP subjects with recurrent periodontal disease (RPD) showed differences statistically significant (p < .05). CONCLUSIONS After 10-15 years of loading, in CP patients treated in a private practice setting, most implants (70.1%) were classified with some type of peri-implant inflammation. In patients with RPD, a higher tendency for implant loss and peri-implant biologic complications was found.
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Affiliation(s)
- Renzo Guarnieri
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Dario Di Nardo
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gianni Di Giorgio
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gabriele Miccoli
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Luca Testarelli
- Department of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
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One-Step Liquid Phase Polymerization of HEMA by Atmospheric-Pressure Plasma Discharges for Ti Dental Implants. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11020662] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dental implants can fail due to various factors, in which bad tissue integration is believed to have a significant role. Specific properties of the implant surface, such as its chemistry and roughness, are of paramount importance to address specific cell responses, such as the adsorption of proteins, as well as the adhesion and differentiation of cells, which are suitable for biomaterial and tissue engineering. In this study, an acrylate-containing coating was produced on titanium surfaces through the atmospheric pressure plasma treatment of a liquid precursor, 2-hydroxyethyl methacrylate. A hydrophilic coating was obtained, showing retention of the monomer chemistry as assessed by FTIR analysis and XPS. Enhanced fibroblast adhesion and decreased Staphylococcus aureus and Escherichia coli adhesion were recorded, showing that this is a suitable method to produce biocompatible coatings with a reduced bacterial adhesion.
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Gaur V, Doshi AG, Gandhi S. Immediate Prosthetic Rehabilitation of Marginal Mandibulectomy Post Radiation Case by Single-Piece Implant - A Case Report. Ann Maxillofac Surg 2020; 10:501-506. [PMID: 33708605 PMCID: PMC7943986 DOI: 10.4103/ams.ams_260_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 01/23/2023] Open
Abstract
Prosthetic rehabilitation post resection and radiotherapy demand a thorough understanding of the biomechanics of the jaw, its associated structures, and their post radiation changes at the bone level. Restoring lost structures can often pose a challenge, especially with regard to the dentition. Due to inadequate hard- and soft-tissue structures as well as their demand for “biologic osseointegration,” it is difficult to conduct immediate loading as a treatment option on conventional implants. Alternatives are today available. Since piece smooth surface cortical implants transmit occlusal forces at cortical bone/buttress by engaging them, with or without reliance on the alveolar bone, it can be considered as an option. Here, we report a case of immediate loading with single-piece smooth surface implants in a male patient who had undergone a marginal mandibulectomy 3 years back for the removal of an oral squamous cell carcinoma of the retromolar trigone area that was closed by an anastomosed radial forearm flap, followed by radiation therapy. The dentition was restored successfully using a single piece smooth surface cortically anchored implant and reported favorable success and survival rate with high patient acceptance. Single piece corticobasal implant technology is one of the most predictable methods for the functional and sociopsychological correction, with minimal invasive immediate functional loading protocol restoring function and post resection surgical deformation of the jaw, thus improving lifestyle and survival.
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Affiliation(s)
- Vivek Gaur
- Department of Oromaxillofacial Surgery, Jaipur Dental College, Jaipur, Rajasthan, India
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35
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Le PH, Nguyen DHK, Aburto-Medina A, Linklater DP, Crawford RJ, MacLaughlin S, Ivanova EP. Nanoscale Surface Roughness Influences Candida albicans Biofilm Formation. ACS APPLIED BIO MATERIALS 2020; 3:8581-8591. [PMID: 35019629 DOI: 10.1021/acsabm.0c00985] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The microbial contamination of surfaces presents a significant challenge due to the adverse effects associated with biofilm formation, particularly on implantable devices. Here, the attachment and biofilm formation of the opportunistic human pathogen, Candida albicans ATCC 10231, were studied on surfaces with decreasing magnitudes of nanoscale roughness. The nanoscale surface roughness of nonpolished titanium, polished titanium, and glass was characterized according to average surface roughness, skewness, and kurtosis. Nonpolished titanium, polished titanium, and glass possessed average surface roughness (Sa) values of 350, 20, and 2.5 nm; skewness (Sskw) values of 1.0, 4.0, and 1.0; and (Skur) values of 3.5, 16, and 4, respectively. These unique characteristics of the surface nanoarchitecture were found to play a key role in limiting C. albicans attachment and modulating the functional phenotypic changes associated with biofilm formation. Our results suggest that surfaces with a specific combination of surface topographical parameters could prevent the attachment and biofilm formation of C. albicans. After 7 days, the density of attached C. albicans cells was recorded to be 230, 70, and 220 cells mm-2 on nonpolished titanium, polished titanium, and glass surfaces, respectively. Despite achieving a very low attachment density, C. albicanscells were only observed to produce hyphae associated with biofilm formation on nonpolished titanium surfaces, possessing the highest degree of surface roughness (Sa = 350 nm). This study provides a more comprehensive picture of the impact of surface architectures on C. albicans attachment, which is beneficial for the design of antifungal surfaces.
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Affiliation(s)
- Phuc H Le
- School of Science, College of Science, Engineering and Health, RMIT University, Melbourne, Victoria 3000, Australia.,Australian Research Council Research Hub for Australian Steel Manufacturing, Wollongong, New South Wales 2500, Australia
| | - Duy H K Nguyen
- School of Science, College of Science, Engineering and Health, RMIT University, Melbourne, Victoria 3000, Australia
| | - Arturo Aburto-Medina
- School of Science, College of Science, Engineering and Health, RMIT University, Melbourne, Victoria 3000, Australia.,Australian Research Council Research Hub for Australian Steel Manufacturing, Wollongong, New South Wales 2500, Australia
| | - Denver P Linklater
- School of Science, College of Science, Engineering and Health, RMIT University, Melbourne, Victoria 3000, Australia
| | - Russell J Crawford
- School of Science, College of Science, Engineering and Health, RMIT University, Melbourne, Victoria 3000, Australia
| | | | - Elena P Ivanova
- School of Science, College of Science, Engineering and Health, RMIT University, Melbourne, Victoria 3000, Australia
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Osteoclast-mediated biocorrosion of pure titanium in an inflammatory microenvironment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 119:111610. [PMID: 33321654 DOI: 10.1016/j.msec.2020.111610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 01/15/2023]
Abstract
Titanium (Ti) and alloys thereof are commonly utilized in biomedical settings owing to their desirable mechanical properties and good biocompatibility. However, when exposed to biological systems for extended periods of time, Ti still undergoes corrosion. In the present study, we therefore explore the impact of osteoclasts (OC) on the surface characteristics and corrosion of commercially pure Titanium (cpTi) in the context of lipopolysaccharide (LPS)-induced inflammation. We utilized tartrate resistant acidic phosphatase (TRAP) and fluorescence staining to assess OC properties, while scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), optical profilometer, electrochemical impedance spectroscopy (EIS), potentiodynamic polarization tests, and inductively coupled plasma atomic emission spectrometry (ICP-AES) were used to evaluate metal microstructure, surface composition and roughness, electrochemical corrosion properties, and metal ion release. SEM findings demonstrated that the surface of cpTi exhibited micro-pitting as well as the presence of viable OCs. Correspondingly, cpTi that had been exposed to OCs exhibited reduced levels of Ti, oxygen, and oxides within the corroded regions relative to smooth Ti as measured via EDS and XPS. OC exposure was also associated with significant changes in cpTi surface roughness, a significant decrease in corrosion resistance, and a significant increase in the release of Ti ions into the surrounding medium. In summary, these findings indicate that OC culture on the surface of cpTi can directly corrode titanium and lead to the release of Ti ions.
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Titanium Corrosion in Peri-Implantitis. MATERIALS 2020; 13:ma13235488. [PMID: 33276474 PMCID: PMC7730765 DOI: 10.3390/ma13235488] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/10/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022]
Abstract
Titanium (Ti) corrodes clinically in the presence of bacteria. We investigated this phenomenon as a function of Ti particles found in biopsied tissues around peri-implantitis sites and surface roughness of failed Ti implants. Tissue biopsies were surgically collected from peri-implantitis sites, processed, and embedded in resin. The resin-embedded samples were hand trimmed to the region of interest and semi-thick (500 nm) sections were collected onto coverslips. One section was toluidine blue post-stained as a reference. The remainder sections were left unstained for energy-dispersive X-ray spectroscopy (EDX) analysis. Processed samples were examined under scanning electron microscopy (SEM) and EDX. Corresponding failed implants were also removed and examined under SEM and EDX. Five out of eight biopsied samples demonstrated the presence of Ti particles in the soft tissue, suggesting the true rate among all failures was between 24.5% and 91.5% (the lower bound of a 95% confidence interval for the true rate of Ti presence). SEM analysis of failed implant bodies also indicated changes in surface morphology and appeared less detailed with decreased weight percent of Ti on the surface of the failed implants. In conclusion, Ti particles were noted in 5/8 biopsied samples. Surface morphologies were smoother in failed implants compared with the reference implant.
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38
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Qiaoxia L, Yujie Z, Meng Y, Yizhu C, Yan W, Yinchun H, Xiaojie L, Weiyi C, Di H. Hydroxyapatite/tannic acid composite coating formation based on Ti modified by TiO2 nanotubes. Colloids Surf B Biointerfaces 2020; 196:111304. [DOI: 10.1016/j.colsurfb.2020.111304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/11/2022]
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Abstract
Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence. Therefore, it is sensible to consider and control all potential factors that may predispose an implant to peri-implant tissue inflammation in an attempt to avoid the disease. This paper reviews recent evidence on factors that may predispose implants to peri-implantitis and measures that can be taken to prevent it.
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Affiliation(s)
- Jia-Hui Fu
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, USA
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40
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A Comprehensive Review on the Corrosion Pathways of Titanium Dental Implants and Their Biological Adverse Effects. METALS 2020. [DOI: 10.3390/met10091272] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The main aim of this work was to perform a comprehensive review of findings reported by previous studies on the corrosion of titanium dental implants and consequent clinical detrimental effects to the patients. Most studies were performed by in vitro electrochemical tests and complemented with microscopic techniques to evaluate the corrosion behavior of the protective passive oxide film layer, namely TiO2. Results revealed that bacterial accumulation, dietary, inflammation, infection, and therapeutic solutions decrease the pH of the oral environment leading to the corrosion of titanium. Some therapeutic products used as mouthwash negatively affect the corrosion behavior of the titanium oxide film and promote changes on the implant surface. In addition, toothpaste and bleaching agents, can amplify the chemical reactivity of titanium since fluor ions interacting with the titanium oxide film. Furthermore, the number of in vivo studies is limited although corrosion signs have been found in retrieved implants. Histological evaluation revealed titanium macro- and micro-scale particles on the peri-implant tissues. As a consequence, progressive damage of the dental implants and the evolution of inflammatory reactions depend on the size, chemical composition, and concentration of submicron- and nanoparticles in the surrounding tissues and internalized by the cells. In fact, the damage of the implant surfaces results in the loss of material that compromises the implant surfaces, implant-abutment connections, and the interaction with soft tissues. The corrosion can be an initial trigger point for the development of biological or mechanical failures in dental implants.
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41
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Gaur V, Doshi AG, Palka LR. Mandibular reconstruction using single piece zygomatic implant in conjunction with a reinforcing Fibular Graft Union: A case report. Int J Surg Case Rep 2020; 73:347-354. [PMID: 32745726 PMCID: PMC7398898 DOI: 10.1016/j.ijscr.2020.07.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/29/2022] Open
Abstract
Presenting to our knowledge, for the first time in literature, a case report on the long term follow-up of an implant retained fixed prosthesis on free fibular reconstruction with a single piece zygomatic implant and single piece bicortical implant via a flapless approach and immediate functional rehabilitation. The technique involved the concept of "Remote Bone Anchorage" in conjunction with the union of grafted free fibula flap with the native mandible. It was facilitated with a single piece zygomatic implant engaged in the mandible and splinted with single piece implants on the grafted fibula as needed for prosthetic functional reconstruction. The author has reported a unique concept of immediate functional rehabilitation in the fibular graft therefore providing additional splinting of the vascularized free fibula to the mandible by splinting them with single piece zygomatic cortical implant.
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Affiliation(s)
- Vivek Gaur
- Jaipur Dental College, Maharaj Vinayak Global University, Jaipur, India.
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42
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Gonzalez-Gonzalez I, deLlanos-Lanchares H, Brizuela-Velasco A, Alvarez-Riesgo JA, Llorente-Pendas S, Herrero-Climent M, Alvarez-Arenal A. Complications of Fixed Full-Arch Implant-Supported Metal-Ceramic Prostheses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124250. [PMID: 32545913 PMCID: PMC7345239 DOI: 10.3390/ijerph17124250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/19/2022]
Abstract
We aimed to assess the biological and mechanical-technical complications and survival rate of implants of full-arch metal-ceramic prostheses, during five years of follow-up. 558 implants (of three different brands) retaining 80 full-arch metal-ceramic prostheses were placed in 65 patients, all of whom were examined annually for biological and mechanical-technical complications during the five years of follow-up. Descriptive statistics and univariate logistic regression were calculated. The cumulative survival rate of the implants was 99.8%, and 98.8% prosthesis-based. Mucositis was the most frequent of the biological complications and peri-implantitis was recorded as 13.8% at restoration-level, 16.9% at patient level and 2.0% at implant level. An implant length greater than 10 mm was shown to be a protective factor against biological complications. The mechanical-technical complications were associated with implant diameter, abutment/implant connection and retention system. Loss of screw access filling was the most frequent prosthetic complication, followed by the fracture of the porcelain. Full-arch metal-ceramic prostheses show a high prevalence of implant and prosthesis survival, with few biological and mechanical-technical complications.
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Affiliation(s)
- Ignacio Gonzalez-Gonzalez
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | - Hector deLlanos-Lanchares
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | - Aritza Brizuela-Velasco
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
- Correspondence: ; Tel.: +34-661-842-026
| | - Jose-Antonio Alvarez-Riesgo
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | | | | | - Angel Alvarez-Arenal
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
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Choi SH, Jang YS, Jang JH, Bae TS, Lee SJ, Lee MH. Enhanced antibacterial activity of titanium by surface modification with polydopamine and silver for dental implant application. J Appl Biomater Funct Mater 2020; 17:2280800019847067. [PMID: 31530071 DOI: 10.1177/2280800019847067] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Biofilm formation and microbial colonization on the surface of implant devices may cause dental caries and peri-implantitis. Therefore, various surface treatments have been developed to improve the antibacterial activity of titanium implant. METHODS Silver-loaded polydopamine coating was formed by immersing pure titanium in dopamine hydrochloride/HCl buffer solution for 24 h in 50 mL silver nitrate solutions with different concentrations for 30 min. Microbial growth inhibition and microbial growth curve analyses for bacterial solutions of Streptococcus mutans and Porphyromonas gingivalis incubated with the specimens were respectively conducted by counting the numbers of colonies on agar solid medium and by measuring absorbance using enzyme-linked immunosorbent assay reader. RESULTS Silver nanoparticles were uniformly distributed over the whole surface of the polydopamine and silver-coated titanium specimens. The numbers of microbial colonies for both bacteria cultured with surface-modified titanium were significantly lower than those cultured with uncoated titanium. When Streptococcus mutans and Porphyromonas gingivalis were cultured with surface-modified titanium, the lag phase of the growth curves for both bacteria was continually maintained, whereas the lag phase for Streptococcus mutans and Porphyromonas gingivalis changed to exponential phase after 9 and 15 h, respectively, when both bacteria were cultured with uncoated titanium. CONCLUSION It was confirmed that the coating of polydopamine and silver on the surface of titanium effectively retards the microbial growth, which can cause the formation of biofilm and pathogenesis of gum disease in the mouth.
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Affiliation(s)
- Soo-Hyoen Choi
- Department of Dental Biomaterials and Institute of Biodegradable Material, Chonbuk National University, Jeollabuk-do, South Korea
| | - Yong-Seok Jang
- Department of Dental Biomaterials and Institute of Biodegradable Material, Chonbuk National University, Jeollabuk-do, South Korea
| | - Jong-Hwa Jang
- Department of Dental Hygiene, Dankook University, Jeollabuk-do, South Korea
| | - Tae-Sung Bae
- Department of Dental Biomaterials and Institute of Biodegradable Material, Chonbuk National University, Jeollabuk-do, South Korea
| | - Sook-Jeong Lee
- Department of Bioactive Material Science, Chonbuk National University, Jeonju, South Korea
| | - Min-Ho Lee
- Department of Dental Biomaterials and Institute of Biodegradable Material, Chonbuk National University, Jeollabuk-do, South Korea
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Wheelis SE, Biguetti CC, Natarajan S, Guida L, Hedden B, Garlet GP, Rodrigues DC. Investigation of the early healing response to dicationic imidazolium-based ionic liquids: a biocompatible coating for titanium implants. ACS Biomater Sci Eng 2020; 6:984-994. [PMID: 32656316 DOI: 10.1021/acsbiomaterials.9b01884] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dicationic Imidazolum-based ionic liquids with amino acid anions (IonL) have been proposed as a multifunctional coating for titanium dental implants, as their properties have been shown to address multiple early complicating factors while maintaining host cell compatibility. This study aims to evaluate effects of this coating on host response in the absence of complicating oral factors during the early healing period using a subcutaneous implantation model in the rat. IonLs with the best cytocompatibility and antimicrobial properties (IonL-Phe, IonL-Met) were chosen as coatings. Three different doses were applied to cpTi disks and subcutaneously implanted into 36 male Lewis rats. Rats received 2 implants: 1 coated implant on one side and an uncoated implant on the contralateral sides (n=3 per formulation, per dose). Peri-implant tissue was evaluated 2 and 14 days after implantation with H&E staining and IHC markers associated with macrophage polarization as well as molecular analysis (qPCR) for inflammatory and healing markers. H&E stains revealed the presence of the coating, blood clots and inflammatory infiltrate at 2 days around all implants. At 14 days, inflammation had receded with more developed connective tissue with fibroblasts, blood vessels in certain doses of coated and uncoated samples with no foreign body giant cells. This study demonstrated that IonL at the appropriate concentration does not significantly interfere with and healing and Ti foreign body response. Results regarding optimal dose and formulation from this study will be applied in future studies using an oral osseointegration model.
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Affiliation(s)
| | - Claudia C Biguetti
- Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil.,Bauru School of Dentistry, Department of Biological Sciences, University of São Paulo São Paulo, Brazil
| | - Shruti Natarajan
- Department of Biological Sciences, University of Texas at Dallas
| | - Lidia Guida
- Deparment of Bioengineering, University of Texas at Dallas
| | - Brian Hedden
- Deparment of Bioengineering, University of Texas at Dallas
| | - Gustavo P Garlet
- Bauru School of Dentistry, Department of Biological Sciences, University of São Paulo São Paulo, Brazil
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45
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Antibacterial Activity and Impact of Different Antiseptics on Biofilm-Contaminated Implant Surfaces. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9245467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Several antiseptic agents have been proposed for the treatment of peri-implantitis as a complementary therapeutic strategy in addition to mechanical devices. The aim of this study was to compare six different antiseptics, as well as alternative formulations of the same chemical agent, with respect to their decontamination efficacy and impact on chemical properties of the implant surface. Titanium disks with a micro-rough surface, previously contaminated with Porphyromonas gingivalis and Streptococcus mutans biofilms, were treated for 2 min with different antiseptics (liquid sodium hypochlorite 5.25%, gel sodium hypochlorite 5.25%, liquid chlorhexidine 0.2%, gel chlorhexidine 1%, gel citric acid 40%, and gel orthophosphoric acid 37%) or sterile saline solution (control) and their antibacterial activity as well as their ability to remove biofilm were assessed by viable bacterial count and scanning electron microscopy, respectively. Spectroscopic analysis was also performed on non-contaminated disks after exposure to the antiseptics, in order to detect any change in the elemental composition of the titanium surface. All the antimicrobial formulations examined were effective against P. gingivalis and S. mutans biofilms. SEM analysis revealed however that liquid sodium hypochlorite 5.25% was more effective in dissolving biofilm residues. Spectroscopic analysis detected traces of the antiseptics, probably due to insufficient rinsing of the titanium surfaces. In conclusion, since gel formulations of these antiseptic agents possessed a similar antibacterial activity to the liquid formulations, these may be proposed as alternative treatments given their properties to avoid overflows and increase contact time without significant side effects on the bone.
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46
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Abstract
This article summarizes the microbiological findings at dental implants, drawing distinctions between the peri-implant microbiome and the periodontal microbiome, and summarizes what is known regarding biofilm as a risk factor for specific stages of implant treatment. Targeted microbial analysis is reviewed as well as the latest results from open-ended sequencing of the peri-implant flora. At this time there remains a lack of consensus for a specific microbial profile that is associated with peri-implantitis, suggesting that there may be other factors which influence the microbiome such as titanium surface dissolution. Therapeutic interventions to address the biofilm are presented at the preoperative, perioperative, and postoperative stages. Evidence supports that perioperative chlorhexidine reduces biofilm-related implant complications and failure. Regular maintenance for dental implants is also shown to reduce peri-implant mucositis and implant failure. Maintenance procedures should aim to disrupt the biofilm without damaging the titanium dioxide surface layer in an effort to prevent further oxidation. Evidence supports the use of glycine powder air polishing as a valuable adjunct to conventional therapies for use at implant maintenance visits. For the treatment of peri-implantitis, nonsurgical therapy has not been shown to be effective, and while surgical intervention is not always predictable, it has been shown to be superior to nonsurgical treatment for decontamination of the implant surface that is not covered by bone.
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Affiliation(s)
- Diane M Daubert
- Department of Periodontics, University of Washington, Seattle, Washington, USA
| | - Bradley F Weinstein
- Department of Periodontics, University of Washington, Seattle, Washington, USA
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47
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Mouhyi J, Salama MA, Mangano FG, Mangano C, Margiani B, Admakin O. A novel guided surgery system with a sleeveless open frame structure: a retrospective clinical study on 38 partially edentulous patients with 1 year of follow-up. BMC Oral Health 2019; 19:253. [PMID: 31752811 PMCID: PMC6873693 DOI: 10.1186/s12903-019-0940-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/28/2019] [Indexed: 01/23/2023] Open
Abstract
Background This retrospective clinical study aims to present results of experience with a novel guided surgery system with a sleeveless, open-frame structure, in which the surgical handpiece (not the drills used for preparation) is guided. Methods This study was based on an evaluation of the records of partially edentulous patients who had been treated with a sleeveless open-frame guided surgery system (TWIN-Guide®, 2Ingis, Brussels, Belgium), between January 2015 and December 2017. Inclusion criteria were patients with good systemic/oral health and a minimum follow-up of 1 year. Exclusion criteria were patients who had been treated without a guide, or with a guide with sleeves, patients with systemic/oral diseases and who did not have a follow-up of 1 year. The main outcomes were surgical (fit and stability of the surgical guide, duration of the intervention, implant stability, and any intra-operative or immediate post-operative complication), biologic, and prosthetic. Results Thirty-eight patients (24 males, 14 females; mean age 56.5 ± 14.0 years) were included in the study. These patients had been treated with 110 implants inserted by means of 40 sleeveless, open-frame guides. With regard to fit and stability, 34 guides were excellent, 4 acceptable, and 2 inadequate for use. The mean duration of the intervention was 23.7 (± 6.7) minutes. Immediately after placement, 2 fixtures were not stable and had to be removed. Two patients experienced pain/swelling after surgery. The 108 surviving implants were restored with 36 single crowns and 32 fixed partial prostheses (24 two-unit and 8 three-unit bridges); these restorations survived until the 1-year follow-up, with a low incidence of biologic and prosthetic complications. Conclusions Within the limits of this study, this novel guided surgery system with sleeveless, open frame–structure guides seems to be clinically reliable; further studies on a larger sample of patients are needed to confirm these outcomes.
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Affiliation(s)
- Jaafar Mouhyi
- Casablanca Oral Rehabilitation Training & Education Center (CORTEC), Casablanca, Morocco. .,Biomaterials Research Department, International University of Agadir (Universiapolis), 8143, Agadir, Morocco.
| | - Maurice Albert Salama
- Department of Periodontics, University of Pennsylvania, Philadelphia, PA, USA.,Department of Periodontics, Medical College of Georgia, Atlanta, GE, USA
| | - Francesco Guido Mangano
- Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119992, Moscow, Russia
| | - Carlo Mangano
- Department of Dental Sciences, Vita and Salute University, San Raffaele, Milan, Italy
| | - Bidzina Margiani
- Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119992, Moscow, Russia
| | - Oleg Admakin
- Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119992, Moscow, Russia
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Al Otaibi A, Sherif ESM, Al-Rifaiy MQ, Zinelis S, Al Jabbari YS. Corrosion resistance of coupled sandblasted, large-grit, acid-etched (SLA) and anodized Ti implant surfaces in synthetic saliva. Clin Exp Dent Res 2019; 5:452-459. [PMID: 31687177 PMCID: PMC6820584 DOI: 10.1002/cre2.198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/16/2019] [Accepted: 02/18/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose The purpose of this study was to investigate the corrosion resistance of galvanically coupled SLA and anodized implant surfaces with a Co‐Cr alloy. Materials and Methods Three groups were included in this study. The first (SLA) was composed of SLA implants (Institut Straumann, Basel, Switzerland), the second (ANO) of NobelReplace® (Nobel Biocare, Göteborg, Sweden), and the third (MIX) of both implant systems combined. All groups were assembled with a single Co‐Cr superstructure. Electrochemical testing included open‐circuit potential, electrochemical impedance spectroscopy, cyclic potentiodynamic polarization, and chronoamperometric current‐time measurements. The quantitative results (EOCP, ECORR, ICORR, EPROT, RP, and ICA) were statistically analyzed by one‐way ANOVA and Tukey's post‐hoc multiple comparison test (α = 0.05) Results All the aforementioned parameters showed statistically significant differences apart from ECORR and EPROT. The evaluation of qualitative and quantitative results showed that although SLA had higher corrosion resistance compared with ANO, it had less resistance to pitting corrosion. This means that SLA showed increased resistance to uniform corrosion but less resistance if pitting corrosion was initiated. In all cases, MIX showed intermediate behavior. Conclusion The corrosion resistance of implant‐retained superstructures is dependent on the electrochemical properties of the implants involved, and thus different degrees of intraoral corrosion resistance among different implant systems are anticipated.
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Affiliation(s)
- Ala'a Al Otaibi
- Dental Biomaterials Research and Development Chair, College of Dentistry King Saud University Riyadh Saudi Arabia.,Department of Prosthetic Dental Science, College of Dentistry King Saud University Riyadh Saudi Arabia
| | - El-Sayed M Sherif
- Dental Biomaterials Research and Development Chair, College of Dentistry King Saud University Riyadh Saudi Arabia.,Center of Excellence for Research in Engineering Materials (CEREM) King Saud University Riyadh Saudi Arabia.,Electrochemistry and Corrosion Laboratory, Department of Physical Chemistry National Research Centre (NRC) Cairo Egypt
| | - Mohammed Q Al-Rifaiy
- Dental Biomaterials Research and Development Chair, College of Dentistry King Saud University Riyadh Saudi Arabia.,Department of Prosthetic Dental Science, College of Dentistry King Saud University Riyadh Saudi Arabia
| | - Spiros Zinelis
- Department of Biomaterials, School of Dentistry National and Kapodistrian University of Athens Athens Greece.,Dental Biomaterials Research and Development Chair, College of Dentistry King Saud University Riyadh Saudi Arabia
| | - Youssef S Al Jabbari
- Dental Biomaterials Research and Development Chair, College of Dentistry King Saud University Riyadh Saudi Arabia.,Department of Prosthetic Dental Science, College of Dentistry King Saud University Riyadh Saudi Arabia
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Demirturk Kocasarac H, Kursun-Cakmak ES, Ustaoglu G, Bayrak S, Orhan K, Noujeim M. Assessment of signal-to-noise ratio and contrast-to-noise ratio in 3 T magnetic resonance imaging in the presence of zirconium, titanium, and titanium-zirconium alloy implants. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:80-86. [PMID: 31628073 DOI: 10.1016/j.oooo.2019.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 08/09/2019] [Accepted: 08/31/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We quantitatively compared the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in T1 weighted imaging (WI) and T2 WI sequences in 3 Tesla (T) magnetic resonance imaging (MRI) using zirconium, titanium (grades 4 and 5), and titanium-zirconium alloy implants to evaluate the effect of implant type and imaging sequence. STUDY DESIGN MRI was acquired using a 3 T magnet with a 16-channel head coil. Implants of each type were mounted in gel and scanned in axial, coronal, and sagittal planes using fast spin echo sequences in T1 WI (TR = 600, TE = 12 milliseconds) and T2 WI (TR = 3000, TE = 80 milliseconds) sequences. Data were transferred to Synapse 3-D software, and images were measured twice by an oral and maxillofacial radiologist blinded to the type of implants. RESULTS Zirconium implants resulted in the lowest SNR and CNR values (P < .05). No significant differences were identified between titanium (grades 4 and 5) and titanium-zirconium implants. The T2 WI sequence had a significantly higher SNR and CNR than T1 WI. There was no difference in intraobserver agreement between T1 WI and T2 WI. CONCLUSIONS CNR and SNR at 3 T MRI are dependent on implant type and imaging sequence. Titanium (grades 4 and 5) and titanium-zirconium implants and the T2 WI sequence produced higher SNR and CNR values.
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Affiliation(s)
| | | | - Gulbahar Ustaoglu
- Department of Periodontology, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Seval Bayrak
- Department of Oral and Maxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Kaan Orhan
- Professor, Department of Oral and Maxillofacial Radiology, Ankara University, Ankara, Turkey; OMFS-IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Marcel Noujeim
- Professor, Oral and Maxillofacial Radiology, Private practice, San Antonio, Texas, USA
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Littuma GJS, Sordi MB, Borges Curtarelli R, Aragonês Á, da Cruz ACC, Magini RS. Titanium coated with poly(lactic-co-glycolic) acid incorporating simvastatin: Biofunctionalization of dental prosthetic abutments. J Periodontal Res 2019; 55:116-124. [PMID: 31493346 DOI: 10.1111/jre.12695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 07/19/2019] [Accepted: 08/13/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To propose a biofunctionalized prosthetic abutment by analyzing physico-chemical and morphological properties, simvastatin (SIM) release, and biocompatibility of titanium (Ti) disks coated with poly(lactic-co-glycolic) acid (PLGA) incorporating SIM. METHODS Titanium disks (8 × 3 mm) were distributed into four groups: Ti: pure Ti; Ti + PLGA: Ti coated with PLGA; Ti + PLGA + SIM6%: Ti + PLGA with 6% SIM; and Ti + PLGA + SIM0.6%: Ti + PLGA incorporating 0.6% SIM. PLGA was prepared through chloroform evaporation technique. After complete dissolution of PLGA, SIM was diluted in the solution. Ti + PLGA, Ti + PLGA + SIM6%, and Ti + PLGA + SIM0.6% were dip coated with PLGA and PLGA + SIM, respectively. Samples were sterilized by ethylene oxide. For SIM release assay, disks were submerged in PBS, pH 7.4, 37°C, 30 rpm up to 600 hours. At different time intervals, SIM was quantified by spectrophotometry (238 nm). For characterization of the biomaterial components, it was performed Fourier-transform infrared spectroscopy, differential scanning calorimetry, scanning electron microscopy (SEM), optical profilometry, and atomic force microscopy. Biocompatibility analyses were performed by MTS colorimetric assay on murine fibroblasts L929, human gingival fibroblasts (HGFs), and stem cells from human exfoliated deciduous teeth (SHEDs). Absorbance was measured at 490 nm, and percentages of viable cells were calculated in relation to positive control (Ti). SEM images were obtained to verify cell adhesion and morphology. One-way ANOVA followed by Tukey's post hoc test was applied (P < 0.05) for statistical analyses. RESULTS SIM release was slow and continuous, reaching about 21% of the incorporated SIM after 600 hours. Topographical analyses revealed success in coating Ti disks with PLGA incorporating SIM. Regarding biocompatibility test, Ti + PLGA + SIM0.6% showed the highest percentage of L929 viability at days 3 and 7. There was no significant difference for Ti, Ti + PLGA, and Ti + PLGA + SIM0.6% groups on cell viability of both SHEDs and HGFs at days 3 and 7. SEM corroborates that SHEDs and HGFs were able to adhere and proliferate on Ti, Ti + PLGA, and Ti + PLGA + SIM0.6% surfaces. CONCLUSION A slow and controlled release of SIM was achieved, attributed to a diffusional mass transfer mechanism. Moreover, a homogenous coating topography was obtained. Additionally, 0.6% SIM incorporated into PLGA coating improved fibroblasts L929 viability compared to titanium or PLGA. Also, 0.6% SIM incorporated into PLGA promoted cell viability of about 100% for HGFs and approximately 150% for human mesenchymal stem cells. Therefore, this study allows to consider the use of PLGA-coated titanium incorporating SIM as a biofunctionalized abutment for dental implants.
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Affiliation(s)
- Gustavo J S Littuma
- Dentistry Post Graduation, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Mariane B Sordi
- Dentistry Post Graduation, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | - Ariadne C C da Cruz
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ricardo S Magini
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
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