Monitoring the Changes of Material Properties at Bone-Implant Interface during the Healing Process In Vivo: A Viscoelastic Investigation

Antibiotic prophylaxis dysregulates dental implant placement surgery-induced osteoimmune wound healing and attenuates the alveolar bone-implant interface in mice

AIM

Antimicrobial-induced shifts in commensal oral microbiota can dysregulate helper T-cell oral immunity to affect osteoclast-osteoblast actions in alveolar bone. Antibiotic prophylaxis is commonly performed with dental implant placement surgery to prevent post-surgical complications. However, antibiotic prophylaxis effects on osteoimmune processes supporting dental implant osseointegration are unknown. The aim of the study was to discern the impact of antibiotic prophylaxis on dental implant placement surgery-induced osteoimmune wound healing and osseointegration.

MATERIALS AND METHODS

We performed SHAM or dental implant placement surgery in mice. Groups were administered prophylactic antibiotics (amoxicillin or clindamycin) or vehicle. Gingival bacteriome was assessed via 16S sequencing. Helper T-cell oral immunity was evaluated by flow cytometry. Osteoclasts and osteoblasts were assessed via histomorphometry. Implant osseointegration was evaluated by micro-computed tomography.

RESULTS

Dental implant placement surgery up-regulated TH 1, TH 2 and TREG cells in cervical lymph nodes (CLNs), which infers helper T-cell oral immunity contributes to dental implant placement osseous wound healing. Prophylactic antibiotics with dental implant placement surgery caused a bacterial dysbiosis, suppressed TH 1, TH 2 and TREG cells in CLNs, reduced osteoclasts and osteoblasts lining peri-implant alveolar bone, and attenuated the alveolar bone-implant interface.

CONCLUSIONS

Antibiotic prophylaxis dysregulates dental implant placement surgery-induced osteoimmune wound healing and attenuates the alveolar bone-implant interface in mice.

Integrating physicomechanical and biological strategies for BTE: biomaterials-induced osteogenic differentiation of MSCs

Large bone defects are a major global health concern. Bone tissue engineering (BTE) is the most promising alternative to avoid the drawbacks of autograft and allograft bone. Nevertheless, how to precisely control stem cell osteogenic differentiation has been a long-standing puzzle. Compared with biochemical cues, physicomechanical stimuli have been widely studied for their biosafety and stability. The mechanical properties of various biomaterials (polymers, bioceramics, metal and alloys) become the main source of physicomechanical stimuli. By altering the stiffness, viscoelasticity, and topography of materials, mechanical stimuli with different strengths transmit into precise signals that mediate osteogenic differentiation. In addition, externally mechanical forces also play a critical role in promoting osteogenesis, such as compression stress, tensile stress, fluid shear stress and vibration, etc. When exposed to mechanical forces, mesenchymal stem cells (MSCs) differentiate into osteogenic lineages by sensing mechanical stimuli through mechanical sensors, including integrin and focal adhesions (FAs), cytoskeleton, primary cilium, ions channels, gap junction, and activating osteogenic-related mechanotransduction pathways, such as yes associated proteins (YAP)/TAZ, MAPK, Rho-GTPases, Wnt/β-catenin, TGFβ superfamily, Notch signaling. This review summarizes various biomaterials that transmit mechanical signals, physicomechanical stimuli that directly regulate MSCs differentiation, and the mechanical transduction mechanisms of MSCs. This review provides a deep and broad understanding of mechanical transduction mechanisms and discusses the challenges that remained in clinical translocation as well as the outlook for the future improvements.

Evaluation of Correlation between Vitamin D Levels and Implant Stability in Indian Population: A Prospective Study in Bangalore

Purpose

Dental implants have become a definitive method for the esthetic and functional rehabilitation of both partially and completely edentulous arch. There is a significant role of vitamin D in bone metabolism and there are only few human studies that evaluate the effect of vitamin D deficiency on stability of dental implants. The study thus aims to evaluate the correlation of vitamin D deficiency and implant stability in delayed endosseous implant.

Methods

The study included 20 subjects of either gender in the age group of 20-50 years, who required implant placement for rehabilitation of partially edentulous condition. Vitamin D status was evaluated for all subjects preoperatively. Implant stability was checked postoperatively at three months and six months using Electronic Technology Resonance Frequency Analysis.

Results

The study found that for every 1 ng/ml increase in Vitamin D levels, the implant stability Quotient value (ISQ) significantly increased by 0.48 at 3 months and 0.62 units at 6 months, which was statistically significant at P = 0.01 and P = 0.002, respectively. Statistical analysis was done using Student Paired t test, Pearson Correlation test and Simple Linear regression analysis.

Conclusion

Albeit the smaller sample size, the results of the study showed the positive influence of vitamin D on stability of implant. The study thus emphasizes on the significance of screening the vitamin D status of subjects prior to implant placement.

Effect of Microimplant Neck Design with and without Microthread on Pullout Strength and Destruction Volume

The microthread neck concept has been applied to dental implants. This study investigated the pullout strength and destruction volume of orthodontic microimplants with and without the microthread neck design. Fifteen microimplants (diameter: 1.5 × 10 mm) of three types (Types A and B: without microimplant neck; Type C: with microimplant neck) were tested. The insertion torque (IT), Periotest value (PTV), horizontal pullout strength (HPS), and horizontal destruction volume (HDV) of each type were measured. Kruskal–Wallis H test and Dunn’s post-hoc comparison test were performed to compare the measured values of the three types of microimplants. The correlations of the measured values were used to perform the Spearman’s correlation coefficient analysis. The ITs of Types B (8.8 Ncm) and C (8.9 Ncm) were significantly higher than those of Type A (5.2 Ncm). Type B yielded the lowest PTV (4.1), and no statistical differences in PTV were observed among the three types. Type A had a significantly lower HPS (158.8 Ncm) than Types B (226.9 Ncm) and C (212.8 Ncm). The three types did not exhibit any significant differences in the HDV. The results of the Spearman’s correlation coefficient test revealed that HDV (ρ = 0.710) and IT (ρ = 0.813) were strongly correlated with HPS, whereas for PTV and HPS, it was not. HPS was strongly and significantly correlated with HDV. The orthodontic microimplant with a microimplant neck design did not perform better than that without a microthread in the mechanical strength test.

Effect of Different Surface Treatments on Titanium Dental Implant Micro-Morphology

Background: Titanium dental implants are today widely used with osseointegration mainly dependently on the implant surface properties. Different processing routes lead to different surface characteristics resulting, of course, in different in situ behaviors of the implants. Materials: The effect of different treatments, whether mechanical or chemical, on the surface morphology of titanium implants were investigated. To this aim, various experimental methods, including roughness analysis as well scanning electron microscope (SEM) observations, were applied. Results: The results showed that, in contrast to the mechanical treatments, the chemical ones gave rise to a more irregular surface. SEM observations suggested that where commercial pure titanium was used, the chemical treatments provided implant surfaces without contaminations. In contrast, sandblasted implants could cause potential risks of surface contamination because of the presence of blasting particles remnants. Conclusions: The examined implant surfaces showed different roughness levels in relation to the superficial treatment applied. The acid-etched surfaces were characterized by the presence of deeper valleys and higher peaks than the sandblasted surfaces. For this reason, acid-etched surfaces can be more easily damaged by the stress produced by the peri-implant bone during surgical implant placement.