A comparison of epithelial cells, fibroblasts, and osteoblasts in dental implant titanium topographies

Correlation between tooth decay and insulin resistance in normal weight males prompts a role for myo-inositol as a regenerative factor in dentistry and oral surgery: a feasibility study

Background

In an era of precision and stratified medicine, homogeneity in population-based cohorts, stringent causative entry, and pattern analysis of datasets are key elements to investigate medical treatments. Adhering to these principles, we collected in vivo and in vitro data pointing to an insulin-sensitizing/insulin-mimetic effect of myo-inositol (MYO) relevant to cell regeneration in dentistry and oral surgery. Confirmation of this possibility was obtained by in silico analysis of the relation between in vivo and in vitro results (the so-called bed-to-benchside reverse translational approach).

Results

Fourteen subjects over the 266 screened were young adult, normal weight, euglycemic, sedentary males having normal appetite, free diet, with a regular three-times-a-day eating schedule, standard dental hygiene, and negligible malocclusion/enamel defects. Occlusal caries were detected by fluorescence videoscanning, whereas body composition and energy balance were estimated with plicometry, predictive equations, and handgrip. Statistically significant correlations (Pearson r coefficient) were found between the number of occlusal caries and anthropometric indexes predicting insulin resistance (IR) in relation to the abdominal/visceral fat mass, fat-free mass, muscular strength, and energy expenditure adjusted to the fat and muscle stores. This indicated a role for IR in affecting dentin reparative processes. Consistently, in vitro administration of MYO to HUVEC and Swiss NIH3T3 cells in concentrations corresponding to those administered in vivo to reduce IR resulted in statistically significant cell replication (ANOVA/Turkey tests), suggesting that MYO has the potential to counteract inhibitory effects of IR on dental vascular and stromal cells turnover. Finally, in in silico experiments, quantitative evaluation (WOE and information value) of a bioinformatic Clinical Outcome Pathway confirmed that in vitro trophic effects of MYO could be transferred in vivo with high predictability, providing robust credence of its efficacy for oral health.

Conclusion

Our reverse bed-to-benchside data indicate that MYO might antagonize the detrimental effects of IR on tooth decay. This provides feasibility for clinical studies on MYO as a regenerative factor in dentistry and oral surgery, including dysmetabolic/aging conditions, bone reconstruction in oral destructive/necrotic disorders, dental implants, and for empowering the efficacy of a number of tissue engineering methodologies in dentistry and oral surgery.

Vacuum Ultraviolet (VUV) Light Photofunctionalization to Induce Human Oral Fibroblast Transmigration on Zirconia

Soft tissue adhesion and sealing around dental and maxillofacial implants, related prosthetic components, and crowns are a clinical imperative to prevent adverse outcomes of periodontitis and periimplantitis. Zirconia is often used to fabricate implant components and crowns. Here, we hypothesized that UV treatment of zirconia would induce unique behaviors in fibroblasts that favor the establishment of a soft tissue seal. Human oral fibroblasts were cultured on zirconia specimens to confluency before placing a second zirconia specimen (either untreated or treated with one minute of 172 nm vacuum UV (VUV) light) next to the first specimen separated by a gap of 150 µm. After seven days of culture, fibroblasts only transmigrated onto VUV-treated zirconia, forming a 2.36 mm volume zone and 5.30 mm leading edge. Cells migrating on VUV-treated zirconia were enlarged, with robust formation of multidirectional cytoplastic projections, even on day seven. Fibroblasts were also cultured on horizontally placed and 45° and 60° tilted zirconia specimens, with the latter configurations compromising initial attachment and proliferation. However, VUV treatment of zirconia mitigated the negative impact of tilting, with higher tilt angles increasing the difference in cellular behavior between control and VUV-treated specimens. Fibroblast size, perimeter, and diameter on day seven were greater than on day one exclusively on VUV-treated zirconia. VUV treatment reduced surface elemental carbon and induced superhydrophilicity, confirming the removal of the hydrocarbon pellicle. Similar effects of VUV treatment were observed on glazed zirconia specimens with silica surfaces. One-minute VUV photofunctionalization of zirconia and silica therefore promotes human oral fibroblast attachment and proliferation, especially under challenging culture conditions, and induces specimen-to-specimen transmigration and sustainable photofunctionalization for at least seven days.

Effect of gingival height of a titanium base on the biomechanical behavior of 2-piece custom implant abutments: A 3-dimensional nonlinear finite element study

STATEMENT OF PROBLEM

Titanium base (TiBase) abutments to restore an implant-supported single crown are available in different gingival heights, but information on the biomechanical effects of the gingival heights is lacking.

PURPOSE

The purpose of this nonlinear finite element analysis study was to evaluate the effects of TiBase gingival heights on the biomechanical behavior of custom zirconia (CustomZir) abutments and TiBase, including von Mises stress and maximum and minimum principal stress.

MATERIAL AND METHODS

TiBases with different gingival heights (0.5 mm, 1 mm, 1.5 mm, and 2 mm) with internal hexagon Morse taper connections were simulated in 3-dimensional models. The simulations (ANSYS Workbench 2020; ANSYS Inc) included the OsseoSpeed EV implant (Ø5.4 mm) (AstraTech; Dentsply Sirona), restoration, and surrounding bone in the mandibular first molar region. An occlusal force of 200 N was applied with a 2-mm horizontal offset toward the buccal side and a 30-degree inclination from the vertical axis.

RESULTS

High-stress concentration was observed in the uppermost internal connection area on the buccal side and the antirotational part of the titanium abutment on the lingual side in all models. CustomZir abutments with a shorter gingival height exhibited larger concentrated areas of volume average stress von Mises stress and higher magnitude of maximum and minimum principal stress compared with a taller gingival height.

CONCLUSIONS

A TiBase abutment with a taller gingival height reduced the fracture risk of a CustomZir abutment without increasing any mechanical risk.

Laser microgrooving and resorbable blast texturing for enhanced surface function of titanium alloy for dental implant applications

Long-term dental implant success is dependent on biocompatibility and osseointegration between the bone and the implant. Surface modifications such as laser-induced microgrooving which increase contact area can enhance osseointegration by establishing and directing a stable attachment between the implant surface and peri-implant bone. The objective of this study was to evaluate pre-osteoblast proliferation, morphology, and differentiation on titanium alloy (Ti64) surfaces-Laser-Lok^© (LL), resorbable blast textured (RBT), and machined (M)-compared to tissue culture plastic (TCP) control. We hypothesized the LL surfaces would facilitate increased cellular alignment compared to all other groups, and LL and RBT surfaces would demonstrate enhanced proliferation and differentiation compared to M and TCP surfaces. Surface roughness was quantified using a surface profilometer, and water contact angle was measured to evaluate the hydrophilicity of the surfaces. Cellular function was assessed using quantitative viability and differentiation assays and image analyses, along with qualitative fluorescent (viability and cytoskeletal) imaging and scanning electron microscopy. No differences in surface roughness were observed between groups. Water contact angle indicated LL was the least hydrophilic surface, with RBT and M surfaces exhibiting greater hydrophilicity. Cell proliferation on day 2 was enhanced on both LL and RBT surfaces compared to M, and all three groups had higher cell numbers on day 2 compared to day 1. Cell orientation was driven by the geometry of the surface modification, as cells were more highly aligned on LL surfaces compared to TCP (on day 2) and RBT (on day 3). At day 21, cell proliferation was greater on LL, RBT, and TCP surfaces compared to M, though no differences in osteogenic differentiation were observed. Collectively, our results highlight the efficacy of laser microgrooved and resorbable blast textured surface modifications of Ti64 for enhancing cellular functions, which may facilitate improved osseointegration of dental implants.

Peri-implant cell differentiation in delayed and immediately-loaded dental implant: A mechanobiological simulation

OBJECTIVE

This study aimed to investigate the effect of immediate versus delayed dental implant placement strategies on cell differentiation in a dental callus.

DESIGN

The implant was placed in the mandible with two nearby teeth using an idealized two-dimensional finite element model. Eight weeks after surgery, the mechanobiological modeling of healing was used to estimate cell differentiation. It was assumed that the callus was initially filled by mesenchymal cells. The model then transformed mechanical stimuli received by the callus from loadings in terms of distortional and dilatational strains into predictions of the cellular phenotypes, including fibroblasts, chondrocytes, and osteoblasts, or whether they would remain unchanged or die.

RESULTS

The results demonstrated that delayed loading led to greater bone formation than immediate loading. Osteoblast colonies were observed in the base of threads in the immediately-loaded implant, whereas the delayed loading caused distant bone formation from the surrounding bone side towards the implant. The osteoblasts were differentiated from both intramembranous and endochondral mechanisms of ossification. After eight weeks, approximately 61 % of the callus was ossified in the delayed placement model compared to 35 % in the immediate placement model, resulting in a greater amount of fibrocartilaginous tissue on the bone side of the callus.

CONCLUSIONS

Immediate and delayed loading models generated different results. In the delayed strategy, bone cells were supplied appropriately during the first few weeks following surgery, whereas the immediate loading caused fibrocartilaginous tissue differentiation. In the form of distant osseointegration, the secondary stability of the dental implant was higher and faster due to the delayed placement.

Clinical and immunological evaluation of peri-implant tissues around ultra-polished and conventionally-polished zirconia abutments. A 1-year follow-up randomized clinical trial

PURPOSE

This is a randomized clinical trial to compare the clinical and immunological performance of ultrasmooth versus conventionally-smooth zirconia abutments placed subgingivally after a period of 1 year.

MATERIALS AND METHODS

Sixty-two bone level platform-switched implants (NobelParallel CC) were placed epicrestally in the mandibular molar or premolar region in 62 patients. After osseointegration, implants were restored with auto polymerizing acrylic resin crowns and subsequently randomly allocated to two groups according to the type of screw-retained zirconia crown prescribed. The control group received custom zirconia restoration with the subgingival zirconia part conventionally polished, whereas the test group implants were restored with ultra-polished zirconia abutments. Periodontal parameters (PD, PI, and BOP) and marginal bone level changes (MBLC) were recorded for each implant 2 months after insertion (T0), 1 month after final delivery of the crown (T2), and at the 1-year follow-up (T3). Immunological mediators from gingival crevicular fluid (IL-1α, IL-1ra, and TNF-α) were inspected at 1 month after provisional (T1) and accordingly at T2 and T3. Data was analyzed statistically, and significance level was set to α = 0.05.

RESULTS

After 1 year, there were no significant changes in PD control-2.18 ± 0.89 mm and test-2.5 ± 0.72 mm (p = 0.073). PD between T2 and T3 dropped significantly in the test group (p = 0.037) and remained stable in the control group. PI was not different in both groups at T0 (p = 0.518) and T2 (p = 0.817). At T3, the test group (0.9 ± 1.01) had a significantly lower PI than the control group (1.55 ± 1.23) (p = 0.035). There was no difference in BOP positive cases between groups after 1 year (control-61.3%, test-51.7%, and p = 0.455). The amount of IL-1ra decreased significantly in the test group (41.75 ± 57.58) (p = 0.001) but not in the control group (59.59 ± 70.43) (p = 0.177). MBLC for the control and test groups after 1 year were 0.68 ± 0.7 and 0.94 ± 0.65 mm (p = 0.061).

CONCLUSIONS

PD dynamics, PI, BOP, and IL-1ra revealed better outcomes around ultra-polished zirconia abutments than around conventionally polished zirconia abutments.

Biomaterials and Clinical Applications of Customized Healing Abutment-A Narrative Review

Customized healing abutments have been introduced in clinical practice along with implant surgery to preserve or create natural-appearing hard and soft tissue around the implant. This provides the benefits of reducing the overall treatment time by eliminating the second stage and reducing the elapsed time of the fabrication of the final prostheses. This article aims to review the types and properties of materials used for the fabrication of customized healing abutments and their clinical applications. Articles published in English on customized healing abutments were searched in Google Scholar, PubMed/MEDLINE, ScienceDirect, and the Scopus databases up to August 2022. The relevant articles were selected and included in this literature review. Customized healing abutments can be fabricated from materials available for dental implants, including PEEK, PMMA, zirconia, resin composite, and titanium. All the materials can be used following both immediate and delayed implant placement. Each material provides different mechanical and biological properties that influence the peri-implant tissues. In conclusion, the studies have demonstrated promising outcomes for all the materials. However, further investigation comparing the effects of each material on peri-implant soft and hard tissues is required.

Physical and biological implications of accelerated aging on stereolithographic additive-manufactured zirconia for dental implant abutment

PURPOSE

This study aimed to comparatively investigate the effects of accelerated aging on the physical and biological features of zirconia manufactured by digital light processing (DLP) and conventional subtractive manufacturing (SM) with similar composition.

METHODS

Both the DLP- and SM-fabricated zirconia samples (7 mm × 7.5 mm × 1.5 mm) were grouped according to aging (134 °C, 0.2 MPa, 100% humidity) times, including 0 h, 5 h, and 10 h. Phase assemblage and surface topography of zirconia manufactured by different technologies were evaluated before and after aging. The biological effects of zirconia on human gingival fibroblast (HGF) cell events, including cell viability, proliferation, morphology and adhesion, were also evaluated by live/dead viability assay, cck-8 assay, scanning electron microscopy and confocal laser scanning microscopy respectively.

RESULTS

The DLP-fabricated zirconia showed a higher initial cubic phase content and rate of phase transformation than the SM-fabricated zirconia. Among the different aging time-based groups, the 5 h-aged group exhibited significantly lower sub-micron scale surface roughness compared with the other groups. Aging did not significantly alter cellular behavior in any zirconia type, except for minor changes in adhesive cell numbers recorded in an aging time/culturing time-dependent manner. In addition to small differences in cell alignment patterns and overall cell morphology, the two zirconia types presented comparable biological performance before and after aging.

CONCLUSION

Although the microstructure and surface characteristics of DLP-fabricated zirconia can be affected by autoclave aging, this newly manufactured zirconia is likely to maintain desirable long-term biocompatibility as an implant abutment material.

The effect of surface modification of TiMg composite on the in-vitro degradation response, cell survival, adhesion, and proliferation

This study is aimed to evaluate the influence of mechanical surface treatment on the degradation response, cell survival, adhesion, and proliferation of a TiMg composite material. Two sets of the TiMg samples with different surface characteristics were studied: i) as-machined samples (TiMg-T) and ii) samples with a mechanically modified surface (TiMg-P). Surface roughness was determined using a confocal microscope. Degradation rates (DR) were evaluated in artificial Plasma, HBSS, and NaCl 0.9%. The cell viability was evaluated using an MTT assay. The initial cell adhesion and spreading were investigated using the direct contact assay. An xCELLigence system was employed to provide real-time cell proliferation. The focal adhesion and cell morphological changes were also examined. The DR of TiMg-P decreased by ⁓5 times compared with that of TiMg-T. Surface of the TiMg-P specimens after 72 h exposure to either HBSS or Plasma was passivated by a layer enriched with bioactive Ca/P species. The cell viability of L929 and Saos-2 after 72 h incubation for TiMg-P was 94.6% and 94.8% compared with 73.8% and 74.3% obtained for TiMg-T, respectively. The direct contact assay showed that the initial adhesion and spreading of the L929 cells incubated with TiMg-P was more pronounced compared with that of TiMg-T. The proliferation rate of Saos-2 cells incubated with TiMg-P was higher when compared with that of TiMg-T, and was almost comparable to that of the DMEM-blank between the 24 and 72 h interval. TiMg-P had a pronounced difference in the number and area of Focal Adhesions (FA) compared with that of TiMg-T. The morphology of cells incubated with TiMg-P was not altered. The results confirmed that the smooth and less strained surface of the TiMg-P samples effectively improved the in-vitro degradation response, cell survival, adhesion, and proliferation.

Correlation between Surface Properties of Polystyrene and Polylactide Materials and Fibroblast and Osteoblast Cell Line Behavior: A Critical Overview of the Literature

Bone reconstruction remains an important challenge today in several clinical situations, notably regarding the control of the competition occurring during proliferation of osteoblasts and fibroblasts. Polystyrene and polylactide are reference materials in the biomedical field. Therefore, it could be expected from the literature that clear correlations have been already established between the behavior of fibroblasts or osteoblasts and the surface characteristics of these materials. After an extensive analysis of the literature, although general trends could be established, our critical review has highlighted the need to develop a more in-depth analysis of the surface properties of these materials. Moreover, the large variation noticed in the experimental conditions used for in vitro animal cell studies impairs comparison between studies. From our comprehensive review on this topic, we have suggested several parameters that would be valuable to standardize to integrate the data from the literature and improve our knowledge on the cell-material interactions.

Improved Multicellular Response, Biomimetic Mineralization, Angiogenesis, and Reduced Foreign Body Response of Modified Polydioxanone Scaffolds for Skeletal Tissue Regeneration

The potential of electrospun polydioxanone (PDX) mats as scaffolds for skeletal tissue regeneration was significantly enhanced through improvement of the cell-mediated biomimetic mineralization and multicellular response. This was achieved by blending PDX ( i) with poly(hydroxybutyrate- co-valerate) (PHBV) in the presence of hydroxyapatite (HA) and ( ii) with aloe vera (AV) extract containing a mixture of acemannan/glucomannan. In an exhaustive study, the behavior of the most relevant cell lines involved in the skeletal tissue healing cascade, i.e. fibroblasts, macrophages, endothelial cells and preosteoblasts, on the scaffolds was investigated. The scaffolds were shown to be nontoxic, to exhibit insignificant inflammatory responses in macrophages, and to be degradable by macrophage-secreted enzymes. As a result of different phase separation in PDX/PHBV/HA and PDX/AV blend mats, cells interacted differentially. Presumably due to varying tension states of cell-matrix interactions, thinner microtubules and significantly more cell adhesion sites and filopodia were formed on PDX/AV compared to PDX/PHBV/HA. While PDX/PHBV/HA supported micrometer-sized spherical particles, nanosized rod-like HA was observed to nucleate and grow on PDX/AV fibers, allowing the mineralized PDX/AV scaffold to retain its porosity over a longer time for cellular infiltration. Finally, PDX/AV exhibited better in vivo biocompatibility compared to PDX/PHBV/HA, as indicated by the reduced fibrous capsule thickness and enhanced blood vessel formation. Overall, PDX/AV blend mats showed a significantly enhanced potential for skeletal tissue regeneration compared to the already promising PDX/PHBV/HA blends.

Micro-/nano-topography of selective laser melting titanium enhances adhesion and proliferation and regulates adhesion-related gene expressions of human gingival fibroblasts and human gingival epithelial cells

Background

Selective laser melting (SLM) titanium is an ideal option to manufacture customized implants with suitable surface modification to improve its bioactivity. The peri-implant soft tissues form a protective tissue barrier for the underlying osseointegration. Therefore, original microrough SLM surfaces should be treated for favorable attachment of surrounding soft tissues.

Material and methods

In this study, anodic oxidation (AO) was applied on the microrough SLM titanium substrate to form TiO₂ nanotube arrays. After that, calcium phosphate (CaP) nanoparticles were embedded into the nanotubes or the interval of nanotubes by electrochemical deposition (AOC). These two samples were compared to untreated (SLM) samples and accepted mechanically polished (MP) SLM titanium samples. Scanning electron microscopy, energy dispersive spectrometry, X-ray diffraction, surface roughness, and water contact angle measurements were used for surface characterization. The primary human gingival epithelial cells (HGECs) and human gingival fibroblasts (HGFs) were cultured for cell assays to determine adhesion, proliferation, and adhesion-related gene expressions.

Results

For HGECs, AOC samples showed significantly higher adhesion, proliferation, and adhesion-related gene expressions than AO and SLM samples (P<0.05) and similar exceptional ability in above aspects to MP samples. At the same time, AOC samples showed the highest adhesion, proliferation, and adhesion-related gene expressions for HGFs (P<0.05).

Conclusion

By comparison between each sample, we could confirm that both anodic oxidation and CaP nanoparticles had improved bioactivity, and their combined utilization may likely be superior to mechanical polishing, which is most commonly used and widely accepted. Our results indicated that creating appropriate micro-/nano-topographies can be an effective method to affect cell behavior and increase the stability of the peri-implant mucosal barrier on SLM titanium surfaces, which contributes to its application in dental and other biomedical implants.

Bone Response to Two Dental Implants with Different Sandblasted/Acid-Etched Implant Surfaces: A Histological and Histomorphometrical Study in Rabbits

Background

Scientific evidence in the field of implant dentistry of the past 20 years established that titanium rough surfaces have shown improved osseointegration rates. In a majority of dental implants, the surface microroughness was obtained by grit blasting and/or acid etching. The aim of the study was to evaluate in vivo two different highly hydrophilic surfaces at different experimental times.

Methods

Calcium-modified (CA) and SLActive surfaces were evaluated and a total of 18 implants for each type of surface were positioned into the rabbit articular femoral knee-joint in a split model experiment, and they were evaluated histologically and histomorphometrically at 15, 30, and 60 days of healing.

Results

Bone-implant contact (BIC) at the two-implant surfaces was significantly different in favor of the CA surface at 15 days (p = 0.027), while SLActive displayed not significantly higher values at 30 (p = 0.51) and 60 days (p = 0.061).

Conclusion

Both implant surfaces show an intimate interaction with newly formed bone.

Engineering of Micro- to Nanostructured 3D-Printed Drug-Releasing Titanium Implants for Enhanced Osseointegration and Localized Delivery of Anticancer Drugs

Primary and secondary bone cancers are major causes of pathological bone fractures which are usually treated through implant fixation and chemotherapy. However, both approaches face many limitations. On one hand, implants may suffer from poor osseointegration, and their rejection results in repeated surgery, patient's suffering, and extensive expenses. On the other hand, there are severe systemic adverse effects of toxic chemotherapeutics which are administrated systemically. In this paper, in order to address these two problems, we present a new type of localized drug-releasing titanium implants with enhanced implants' biointegration and drug release capabilities that could provide a high concentration of anticancer drugs locally to treat bone cancers. The implants are fabricated by 3D printing of Ti alloy followed by an anodization process featuring unique micro- (particles) and nanosurface (tubular arrays) topography. We successfully demonstrate their enhanced bone osseointegration and drug loading capabilities using two types of anticancer drugs, doxorubicin (DOX) and apoptosis-inducing ligand (Apo2L/TRAIL). In vitro study showed strong anticancer efficacy against cancer cells (MDA-MB-231-TXSA), confirming that these drug-releasing implants can be used for localized chemotherapy for treatment of primary and secondary bone cancers together with fracture support.

Effect of different implant abutment surfaces on OBA-09 epithelial cell adhesion

For the long-term success of implants, it is necessary to achieve a direct contact between the implant and the subjacent bone. To avoid bacterial penetration that could adversely affect the initial wound healing as well as the long-term behavior of the implants, an early tissue barrier must form that is able to protect the biological peri-implant structures. Given the need of an effective tissue early barrier around dental implants, the present study evaluated, in vitro, the influence of physical and chemical characteristics of two implant abutment surfaces on gingival epithelial cells (OBA-9) adhesion. To this end, titanium (Ti) and zirconia (ZrO₂ ) disk-shaped specimens were used mimicking the abutment components surfaces, while bovine enamel (BE) and glass cover slips (GCS) disks served as positive and negative controls, respectively. Roughness and surface free energy (SFE) of all materials were evaluated previously to cellular adhesion step. In sequence, the effect of each material on cells morphology and viability was analyzed after 1 and 24 hr. The results showed that roughness and SFE had no effect on the cell viability data or on their interaction (p = .559), independent of a post-contact analysis of 1 or 24 hr. However, cells attachment and spreading increased after 24 hr on Ti and ZrO₂ than BE, corresponding to the highest SFE values. SFE appears to be an important property interfering on the quality of the soft tissue surrounding dental implants. These data can be considered a trigger point for developing new material surfaces.

Cellular Homeostasis and Antioxidant Response in Epithelial HT29 Cells on Titania Nanotube Arrays Surface

Cell growth and proliferative activities on titania nanotube arrays (TNA) have raised alerts on genotoxicity risk. Present toxicogenomic approach focused on epithelial HT29 cells with TNA surface. Fledgling cell-TNA interaction has triggered G0/G1 cell cycle arrests and initiates DNA damage surveillance checkpoint, which possibly indicated the cellular stress stimuli. A profound gene regulation was observed to be involved in cellular growth and survival signals such as p53 and AKT expressions. Interestingly, the activation of redox regulator pathways (antioxidant defense) was observed through the cascade interactions of GADD45, MYC, CHECK1, and ATR genes. These mechanisms furnish to protect DNA during cellular division from an oxidative challenge, set in motion with XRRC5 and RAD50 genes for DNA damage and repair activities. The cell fate decision on TNA-nanoenvironment has been reported to possibly regulate proliferative activities via expression of p27 and BCL2 tumor suppressor proteins, cogent with SKP2 and BCL2 oncogenic proteins suppression. Findings suggested that epithelial HT29 cells on the surface of TNA may have a positive regulation via cell-homeostasis mechanisms: a careful circadian orchestration between cell proliferation, survival, and death. This nanomolecular knowledge could be beneficial for advanced medical applications such as in nanomedicine and nanotherapeutics.

Effects of Osseointegration by Bone Morphogenetic Protein-2 on Titanium Implants In Vitro and In Vivo

This study designed a biomimetic implant for reducing healing time and achieving early osseointegration to create an active surface. Bone morphogenetic protein-2 (BMP-2) is a strong regulator protein in osteogenic pathways. Due to hardly maintaining BMP-2 biological function and specificity, BMP-2 efficient delivery on implant surfaces is the main challenge for the clinic application. In this study, a novel method for synthesizing functionalized silane film for superior modification with BMP-2 on titanium surfaces is proposed. Three groups were compared with and without BMP-2 on modified titanium surfaces in vitro and in vivo: mechanical grinding; electrochemical modification through potentiostatic anodization (ECH); and sandblasting, alkali heating, and etching (SMART). Cell tests indicated that the ECH and SMART groups with BMP-2 markedly promoted D1 cell activity and differentiation compared with the groups without BMP-2. Moreover, the SMART group with a BMP-2 surface markedly promoted early alkaline phosphatase expression in the D1 cells compared with the other surface groups. Compared with these groups in vivo, SMART silaning with BMP-2 showed superior bone quality and created contact areas between implant and surrounding bones. The SMART group with BMP-2 could promote cell mineralization in vitro and osseointegration in vivo, indicating potential clinical use.

Evaluation of mammalian and bacterial cell activity on titanium surface coated with dicationic imidazolium-based ionic liquids

This work presents a new strategy to protect titanium surfaces against bacterial colonization and biofilm formation using dicationic imidazolium-based ionic liquid coatings.

Antibacterial titanium nano-patterned arrays inspired by dragonfly wings

Titanium and its alloys remain the most popular choice as a medical implant material because of its desirable properties. The successful osseointegration of titanium implants is, however, adversely affected by the presence of bacterial biofilms that can form on the surface, and hence methods for preventing the formation of surface biofilms have been the subject of intensive research over the past few years. In this study, we report the response of bacteria and primary human fibroblasts to the antibacterial nanoarrays fabricated on titanium surfaces using a simple hydrothermal etching process. These fabricated titanium surfaces were shown to possess selective bactericidal activity, eliminating almost 50% of Pseudomonas aeruginosa cells and about 20% of the Staphylococcus aureus cells coming into contact with the surface. These nano-patterned surfaces were also shown to enhance the aligned attachment behavior and proliferation of primary human fibroblasts over 10 days of growth. These antibacterial surfaces, which are capable of exhibiting differential responses to bacterial and eukaryotic cells, represent surfaces that have excellent prospects for biomedical applications.

Effect of laser-dimpled titanium surfaces on attachment of epithelial-like cells and fibroblasts

PURPOSE

The objective of this study was to conduct an in vitro comparative evaluation of polished and laserdimpled titanium (Ti) surfaces to determine whether either surface has an advantage in promoting the attachment of epithelial-like cells and fibroblast to Ti.

MATERIALS AND METHODS

Forty-eight coin-shaped samples of commercially pure, grade 4 Ti plates were used in this study. These discs were cleaned to a surface roughness (Ra: roughness centerline average) of 180 nm by polishing and were divided into three groups: SM (n=16) had no dimples and served as the control, SM15 (n=16) had 5-µm dimples at 10-µm intervals, and SM30 (n=16) had 5-µm dimples at 25-µm intervals in a 2 × 4 mm(2) area at the center of the disc. Human gingival squamous cell carcinoma cells (YD-38) and human lung fibroblasts (MRC-5) were cultured and used in cell proliferation assays, adhesion assays, immunofluorescent staining of adhesion proteins, and morphological analysis by SEM. The data were analyzed statistically to determine the significance of differences.

RESULTS

The adhesion strength of epithelial cells was higher on Ti surfaces with 5-µm laser dimples than on polished Ti surfaces, while the adhesion of fibroblasts was not significantly changed by laser treatment of implant surfaces. However, epithelial cells and fibroblasts around the laser dimples appeared larger and showed increased expression of adhesion proteins.

CONCLUSION

These findings demonstrate that laser dimpling may contribute to improving the periimplant soft tissue barrier. This study provided helpful information for developing the transmucosal surface of the abutment.

Viability of Titanium-Titanium Boride Composite as a Biomaterial

The use of reinforcements to enhance mechanical properties of titanium such as hardness has been adopted by many researchers. Of these reinforcements, titanium boride has emerged as one of the most suitable reinforcements for titanium which is both chemically and mechanically compatible with the titanium matrix. Despite the extensive work conducted on these types of composites, very little is known about their biocompatibility which has so far precluded their use in bioapplications. The present paper investigates, for the first time, the biocompatibility of powder-processed titanium-titanium boride () composites for use in medical and dental implants and basic studies on fibroblast attachment conducted to assess for this application. The work is intended to serve as an initial step towards understanding the bioresponse of these composites by evaluating cytotoxicity, cellular attachment and morphology, and hemolytic potential. Results indicate that fibroblasts attach, proliferate, and achieve confluency when in contact with the composites, exhibiting normal morphology. Furthermore, the cells show a favorable growth rate when cultured with the composite for 48 hours. The composite demonstrated excellent blood biocompatibility, with a low hemolysis level (0.12% ) when compared with CP Ti (0.17%) and Ti-6Al-4V (0.36%). These findings suggest that composite is biocompatible and further investigation into its suitability as a biomaterial should be considered.