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Saito MM, Onuma K, Yamakoshi Y. Nanoscale osseointegration of zirconia evaluated from the interfacial structure between ceria-stabilized tetragonal zirconia and cell-induced hydroxyapatite. J Oral Biosci 2024; 66:281-287. [PMID: 38723946 DOI: 10.1016/j.job.2024.05.003] [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: 04/02/2024] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The osseointegration of zirconia implants has been evaluated based on their implant fixture bonding with the alveolar bone at the optical microscopic level. Achieving nano-level bonding between zirconia and bone apatite is crucial for superior osseointegration; however, only a few studies have investigated nanoscale bonding. This review outlines zirconia osseointegration, including surface modification, and presents an evaluation of nanoscale zirconia-apatite bonding and its structure. HIGHLIGHT Assuming osseointegration, the cells produced calcium salts on a ceria-stabilized zirconia substrate. We analyzed the interface between calcium salts and zirconia substrates using transmission electron microscopy and found that 1) the cell-induced calcium salts were bone-like apatite and 2) direct nanoscale bonding was observed between the bone-like apatite and zirconia crystals without any special modifications of the zirconia surface. CONCLUSION Structural affinity exists between bone apatite and zirconia crystals. Apatite formation can be induced by the zirconia surface. Zirconia bonds directly with apatite, indicating superior osseointegration in vivo.
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Affiliation(s)
- Mari M Saito
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
| | - Kazuo Onuma
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Yasuo Yamakoshi
- Department of Biochemistry and Molecular Biology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
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Jin HW, Noumbissi S, Wiedemann TG. Comparison of Zirconia Implant Surface Modifications for Optimal Osseointegration. J Funct Biomater 2024; 15:91. [PMID: 38667548 PMCID: PMC11051113 DOI: 10.3390/jfb15040091] [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: 03/02/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Zirconia ceramic implants are commercially available from a rapidly growing number of manufacturers. Macroscopic and microscopic surface design and characteristics are considered to be key determining factors in the success of the osseointegration process. It is, therefore, crucial to assess which surface modification promotes the most favorable biological response. The purpose of this study was to conduct a comparison of modern surface modifications that are featured in the most common commercially available zirconia ceramic implant systems. A review of the currently available literature on zirconia implant surface topography and the associated bio-physical factors was conducted, with a focus on the osseointegration of zirconia surfaces. After a review of the selected articles for this study, commercially available zirconia implant surfaces were all modified using subtractive protocols. Commercially available ceramic implant surfaces were modified or enhanced using sandblasting, acid etching, laser etching, or combinations of the aforementioned. From our literature review, laser-modified surfaces emerged as the ones with the highest surface roughness and bone-implant contact (BIC). It was also found that surface roughness could be controlled to achieve optimal roughness by modifying the laser output power during manufacturing. Furthermore, laser surface modification induced a very low amount of preload microcracks in the zirconia. Osteopontin (OPN), an early-late osteogenic differentiation marker, was significantly upregulated in laser-treated surfaces. Moreover, surface wettability was highest in laser-treated surfaces, indicating favorable hydrophilicity and thus promoting early bone forming, cell adhesion, and subsequent maturation. Sandblasting followed by laser modification and sandblasting followed by acid etching and post-milling heat treatment (SE-H) surfaces featured comparable results, with favorable biological responses around zirconia implants.
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Affiliation(s)
- Hyun Woo Jin
- BA/DDS Joint Program, College of Dentistry, New York University, New York, NY 10010, USA
| | - Sammy Noumbissi
- Department of Oral and Maxillofacial Implantology, University of Milan, 20122 Milano, Italy
- Post-Graduate Program Oral Surgery, University of Chieti-Pescara, 65127 Pescara, Italy
- Department of Biomaterials INSA Lyon, 69100 Villeurbanne, France
- Private Practice, Silver Spring, MD 20910, USA
| | - Thomas G. Wiedemann
- Department of Oral and Maxillofacial Surgery, College of Dentistry, New York University, New York, NY 10010, USA
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Gul A, Papia E, Naimi-Akbar A, Ruud A, Vult von Steyern P. Zirconia dental implants; the relationship between design and clinical outcome: A systematic review. J Dent 2024; 143:104903. [PMID: 38437977 DOI: 10.1016/j.jdent.2024.104903] [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: 11/17/2023] [Revised: 02/09/2024] [Accepted: 02/26/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE To evaluate the clinical outcome of different designs of zirconia dental implants. DATA This systematic review adhered to the PRISMA checklist and followed the PICO framework. The protocol is registered in PROSPERO (CRD42022337228). SOURCES The search was conducted in March 2023 through four databases (PubMed, Web of Science, Cochrane Library, and Google Scholar) along with a search of references in the related reviews. Three authors reviewed on title, and abstract level and analysed the risk of bias, and all authors reviewed on a full-text level. STUDY SELECTION Clinical studies excluding case reports for patients treated with different designs of zirconia dental implants were included. From a total of 2728 titles, 71 full-text studies were screened, and 27 studies were included to assess the risk of bias (ROBINS-I tool) and data extraction. After quality assessment, four studies were included, and the remaining 23 excluded studies were narratively described. RESULT The included prospective studies with moderate risk of bias reported success and survival rates of one-piece implants that ranged between 95 and 98.4 % with no difference between different lengths and diameters. The acid-etched roughened surface showed higher clinical outcomes compared to other surface roughness designs. CONCLUSION Promising 5-year clinical outcomes were found for one-piece zirconia implants with no difference between different diameters and lengths. Concerning surface roughness, better outcomes were found when using the acid-etched implant surface. However, due to the limited available studies, further high-quality clinical studies comparing zirconia one-piece and two-piece implants with different diameters, lengths, and surface roughness are needed. CLINICAL SIGNIFICANCE Based on this systematic review, under suitable clinical situations, the one-piece zirconia implants with diameters of 4.0 mm, 4.5 mm, or 5.5 mm and lengths of 8 mm, 10 mm, 12 mm, or 14 mm have similar promising clinical outcomes. Additionally, the acid-etched roughened implant surface may be preferable.
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Affiliation(s)
- Abdulaziz Gul
- Department of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
| | - Evaggelia Papia
- Department of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aron Naimi-Akbar
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden; Department of Oral and Maxillofacial Surgery and Oral Medicine, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Amund Ruud
- Nordic Institute of Dental Materials, NIOM, Oslo, Norway
| | - Per Vult von Steyern
- Department of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden; Nordic Institute of Dental Materials, NIOM, Oslo, Norway
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Mourya D, Dubey K, Jha S, Maurya R, Pandey AK. In Vitro Effects of Zirconia Nanoparticles: Uptake, Genotoxicity, and Mutagenicity in V-79 cells. Biol Trace Elem Res 2024; 202:927-940. [PMID: 37440118 DOI: 10.1007/s12011-023-03739-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/18/2023] [Indexed: 07/14/2023]
Abstract
Zirconia nanoparticles are used in various industrial and biomedical applications such as dental implants, thermal barrier sprays, and fuel cells. The interaction of nanoparticles with the environment and humans is inevitable. Despite the enormous application potential of these nanoparticles, there are still some gaps in the literature regarding potential toxicological mechanisms and the genotoxicity of zirconia nanoparticles. The lung is one of the main exposure routes to nanomaterials; therefore, the present study was designed to determine the genotoxic and mutagenic effect of zirconia NPs in V-79 lung cells. Zirconia nanoparticles showed significant internalization in cells at 100 μg/mL and 150 μg/mL concentrations. Zirconia nanoparticles showed low cytotoxicity and were found to generate ROS in V-79 cells. In alkaline comet assay, zirconia nanoparticles (10 μg/mL, 50 μg/mL, and 100 μg/mL) exposed cells exhibited significant DNA strand breaks, while the neutral comet assay, which was used for double-strand break assessment, only revealed significant damage at 100 μg/mL. Chromosomal aberration induced by zirconia nanoparticles mainly resulted in the generation of gaps, few fragments, and breaks which signifies the low clastogenic activity of these nanoparticles in the V-79 cell line. In MN assay, zirconia nanoparticles resulted in no significant micronuclei induction at any given concentration. In the HPRT mutation assay, the particle shows a dose-dependent increase in the mutant frequency. It is evident from the result that zirconia nanoparticles cause dose-dependent cytotoxicity and genotoxicity, but still, more studies are needed to evaluate the clastogenic potential and the possible mechanism involved.
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Affiliation(s)
- Durgesh Mourya
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
- Nanomaterial Toxicology Laboratory, Drug and Chemical Toxicology Group (FEST), CSIR-Indian Institute of Toxicology Research, Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, P.O. Box 80, Lucknow-226001, India
| | - Kavita Dubey
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
- Nanomaterial Toxicology Laboratory, Drug and Chemical Toxicology Group (FEST), CSIR-Indian Institute of Toxicology Research, Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, P.O. Box 80, Lucknow-226001, India
| | - Shambhavi Jha
- Nanomaterial Toxicology Laboratory, Drug and Chemical Toxicology Group (FEST), CSIR-Indian Institute of Toxicology Research, Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, P.O. Box 80, Lucknow-226001, India
| | - Renuka Maurya
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
- Nanomaterial Toxicology Laboratory, Drug and Chemical Toxicology Group (FEST), CSIR-Indian Institute of Toxicology Research, Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, P.O. Box 80, Lucknow-226001, India
| | - Alok Kumar Pandey
- CSIR-Indian Institute of Toxicology Research, VishvigyanBhawan, 31, Mahatma Gandhi Marg, Lucknow, Uttar Pradesh, India.
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India.
- Nanomaterial Toxicology Laboratory, Drug and Chemical Toxicology Group (FEST), CSIR-Indian Institute of Toxicology Research, Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, P.O. Box 80, Lucknow-226001, India.
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Chaurasia A, Namachivayam A, Koca-Ünsal RB, Lee JH. Deep-learning performance in identifying and classifying dental implant systems from dental imaging: a systematic review and meta-analysis. J Periodontal Implant Sci 2024; 54:3-12. [PMID: 37154107 PMCID: PMC10901682 DOI: 10.5051/jpis.2300160008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 05/10/2023] Open
Abstract
Deep learning (DL) offers promising performance in computer vision tasks and is highly suitable for dental image recognition and analysis. We evaluated the accuracy of DL algorithms in identifying and classifying dental implant systems (DISs) using dental imaging. In this systematic review and meta-analysis, we explored the MEDLINE/PubMed, Scopus, Embase, and Google Scholar databases and identified studies published between January 2011 and March 2022. Studies conducted on DL approaches for DIS identification or classification were included, and the accuracy of the DL models was evaluated using panoramic and periapical radiographic images. The quality of the selected studies was assessed using QUADAS-2. This review was registered with PROSPERO (CRDCRD42022309624). From 1,293 identified records, 9 studies were included in this systematic review and meta-analysis. The DL-based implant classification accuracy was no less than 70.75% (95% confidence interval [CI], 65.6%-75.9%) and no higher than 98.19 (95% CI, 97.8%-98.5%). The weighted accuracy was calculated, and the pooled sample size was 46,645, with an overall accuracy of 92.16% (95% CI, 90.8%-93.5%). The risk of bias and applicability concerns were judged as high for most studies, mainly regarding data selection and reference standards. DL models showed high accuracy in identifying and classifying DISs using panoramic and periapical radiographic images. Therefore, DL models are promising prospects for use as decision aids and decision-making tools; however, there are limitations with respect to their application in actual clinical practice.
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Affiliation(s)
- Akhilanand Chaurasia
- Department of Oral Medicine & Radiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Arunkumar Namachivayam
- Department of Biostatistics, Bapuji Dental College & Hospital, Davengere, Karnataka, India
| | - Revan Birke Koca-Ünsal
- Department of Periodontology, Faculty of Dentistry, University of Kyrenia, Kyrenia, Cyprus
| | - Jae-Hong Lee
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
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Suzumura T, Matsuura T, Komatsu K, Sugita Y, Maeda H, Ogawa T. Vacuum Ultraviolet (VUV) Light Photofunctionalization to Induce Human Oral Fibroblast Transmigration on Zirconia. Cells 2023; 12:2542. [PMID: 37947620 PMCID: PMC10647316 DOI: 10.3390/cells12212542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
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.
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Affiliation(s)
- Toshikatsu Suzumura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Yoshihiko Sugita
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Hatsuhiko Maeda
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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7
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Poli PP, Manfredini M, Oliva N, Bettini S, Damiani G, Goldoni R, Strambini L, Casati S, Del Fabbro M, Tartaglia GM. Detection and sensing of oral xenobiotics in edentulous patients rehabilitated with titanium dental implants: Insights from a scoping review. J Prosthet Dent 2023:S0022-3913(23)00342-6. [PMID: 37423787 DOI: 10.1016/j.prosdent.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 07/11/2023]
Abstract
STATEMENT OF PROBLEM Titanium has been considered the standard element in implant manufacturing. Recent studies have evaluated the role of titanium as a biological modulator of oral health. However, evidence regarding the association between the release of metal particles and peri-implantitis is lacking. PURPOSE The purpose of this scoping review was to evaluate the literature regarding the release of metal particles in peri-implant tissues correlated with the methods of detection and the local and systemic implications. MATERIAL AND METHODS The study was performed in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was registered with the National Institute for Health Research PROSPERO (Submission No. 275576; ID: CRD42021275576). A systematic search was conducted in the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE via PubMed, Scopus, and Web of Science bibliographic databases, complemented by a manual evaluation. Only in vivo human studies written in the English language and published between January 2000 and June 2022 were included. RESULTS In total, 10 studies were included according to eligibility criteria. Different tissues and analytic techniques were reported: the characterization technique most used was inductively coupled plasma mass spectrometry. All 10 studies analyzed the release of metal particles in patients with dental implants, continuously detecting titanium. None of the studies reported a significant association between metal particles and biological effects. CONCLUSIONS Titanium is still considered the material of choice in implant dentistry, despite the detection of metal particles in peri-implant tissues. Further studies are necessary to evaluate the association between analytes and local health or inflammatory status.
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Affiliation(s)
- Pier Paolo Poli
- Research Fellow, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Research Fellow, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mattia Manfredini
- PhD Student, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; PhD Student, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Nadim Oliva
- Resident, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Sofia Bettini
- Resident, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Resident, Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Damiani
- Assistant Professor, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Assistant Professor, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy; Assistant Professor, Division of Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Riccardo Goldoni
- PhD Student, Department of Electronics, Information and Bioengineering (DEIB), Politecnico Di Milano, Milan, Italy; PhD Student, National Research Council, Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | - Lucanos Strambini
- Research Fellow, National Research Council, Department of Electronics, Computer and Telecommunication Engineering (CNR-IEIIT), Milan, Italy
| | - Sara Casati
- Research Fellow, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Massimo Del Fabbro
- Associate Professor, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Associate Professor, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca M Tartaglia
- Associate Professor, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Associate Professor, Maxillofacial Surgery and Odontostomatology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Hayashi T, Asakura M, Koie S, Hasegawa S, Mieki A, Aimu K, Kawai T. In Vitro Study of Zirconia Surface Modification for Dental Implants by Atomic Layer Deposition. Int J Mol Sci 2023; 24:10101. [PMID: 37373249 DOI: 10.3390/ijms241210101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Zirconia is a promising material for dental implants; however, an appropriate surface modification procedure has not yet been identified. Atomic layer deposition (ALD) is a nanotechnology that deposits thin films of metal oxides or metals on materials. The aim of this study was to deposit thin films of titanium dioxide (TiO2), aluminum oxide (Al2O3), silicon dioxide (SiO2), and zinc oxide (ZnO) on zirconia disks (ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn, respectively) using ALD and evaluate the cell proliferation abilities of mouse fibroblasts (L929) and mouse osteoblastic cells (MC3T3-E1) on each sample. Zirconia disks (ZR; diameter 10 mm) were fabricated using a computer-aided design/computer-aided manufacturing system. Following the ALD of TiO2, Al2O3, SiO2, or ZnO thin film, the thin-film thickness, elemental distribution, contact angle, adhesion strength, and elemental elution were determined. The L929 and MC3T3-E1 cell proliferation and morphologies on each sample were observed on days 1, 3, and 5 (L929) and days 1, 4, and 7 (MC3T3-E1). The ZR-Ti, ZR-Al, ZR-Si, and ZR-Zn thin-film thicknesses were 41.97, 42.36, 62.50, and 61.11 nm, respectively, and their average adhesion strengths were 163.5, 140.9, 157.3, and 161.6 mN, respectively. The contact angle on ZR-Si was significantly lower than that on all the other specimens. The eluted Zr, Ti, and Al amounts were below the detection limits, whereas the total Si and Zn elution amounts over two weeks were 0.019 and 0.695 ppm, respectively. For both L929 and MC3T3-E1, the cell numbers increased over time on ZR, ZR-Ti, ZR-Al, and ZR-Si. Particularly, cell proliferation in ZR-Ti exceeded that in the other samples. These results suggest that ALD application to zirconia, particularly for TiO2 deposition, could be a new surface modification procedure for zirconia dental implants.
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Affiliation(s)
- Tatsuhide Hayashi
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Masaki Asakura
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Shin Koie
- Department of Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Shogo Hasegawa
- Department of Maxillofacial Surgery, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Japan
| | - Akimichi Mieki
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Koki Aimu
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
| | - Tatsushi Kawai
- Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, 1-00 Kusumoto-cho, Chikusa-ku, Nagoya 464-8650, Japan
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Wang Z, Xiang Q, Tan X, Zhang Y, Zhu H, Pu J, Sun J, Sun M, Wang Y, Wei Q, Yu H. Functionalized Cortical Bone-Inspired Composites Adapt to the Mechanical and Biological Properties of the Edentulous Area to Resist Fretting Wear. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2207255. [PMID: 36775879 PMCID: PMC10104646 DOI: 10.1002/advs.202207255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Dental implants with long-term success of osseointegration have always been the goal, however, difficulties exist. The accumulation of fretting damage at the implant-bone interface often gets overlooked. Commonly used titanium is approximately 7-fold harder and stiffer than cortical bone. Stress shielding caused by the mismatching of the elastic modulus aggravates fretting at the interface, which is accompanied by the risk of the formation of proinflammatory metal debris and implant loosening. Thus, the authors explore functionalized cortical bone-inspired composites (FCBIC) with a hierarchical structure at multiple scales, that exhibit good mechanical and biological adaptivity with cortical bone. The design is inspired by nature, combining brittle minerals with organic molecules to maintain machinability, which helps to acquire excellent energy-dissipating capability. It therefore has the comparable hardness and elastic modulus, strength, and elastic-plastic deformation to cortical bone. Meanwhile, this cortical bone analogy exhibits excellent osteoinduction and osseointegration abilities. These two properties also facilitate each other to resist fretting wear, and therefore improve the success rate of implantation. Based on these results, the biological-mechanical co-operation coefficient is proposed to describe the coupling between these two factors for designing the optimized dental implants.
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Affiliation(s)
- ZhongYi Wang
- State Key Laboratory of Oral DiseasesNational Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduSichuan610041China
| | - QianRong Xiang
- State Key Laboratory of Oral DiseasesNational Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduSichuan610041China
| | - Xin Tan
- State Key Laboratory of Oral DiseasesNational Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduSichuan610041China
- Chongqing Key Laboratory of Oral Diseases and Biomedical SciencesCollege of StomatologyChongqing Medical UniversityChongqing400016China
| | - YaDong Zhang
- Research and Development DepartmentZhejiang PEKK‐X Advanced Materials Technology Co., Ltd.ShaoxingZhejiang312000China
| | - HaoQi Zhu
- Department of PhysicsCity University of Hong KongHong Kong Special Administrative Region of the People's Republic of ChinaKowloon999077China
| | - Jian Pu
- School of Mechanical EngineeringSouthwest Jiaotong UniversityChengduSichuan610031China
| | - JiKui Sun
- State Key Laboratory of Oral DiseasesNational Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduSichuan610041China
| | - ManLin Sun
- State Key Laboratory of Oral DiseasesNational Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduSichuan610041China
| | - YingKai Wang
- State Key Laboratory of Oral DiseasesNational Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduSichuan610041China
| | - Qiang Wei
- College of Polymer Science and Engineering State Key Laboratory of Polymer Materials and EngineeringSichuan UniversityChengduSichuan610065China
| | - HaiYang Yu
- State Key Laboratory of Oral DiseasesNational Clinical Research Center for Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduSichuan610041China
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Kohal RJ, Burkhardt F, Chevalier J, Patzelt SBM, Butz F. One-Piece Zirconia Oral Implants for Single Tooth Replacement: Five-Year Results from a Prospective Cohort Study. J Funct Biomater 2023; 14:jfb14020116. [PMID: 36826915 PMCID: PMC9964460 DOI: 10.3390/jfb14020116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
The intention of this 5-year prospective cohort investigation was to clinically and radiographically investigate the outcomes of a one-piece zirconia implant system for single tooth replacement. Sixty-five patients received a total of 66 single-tooth implants. All implants immediately received temporary restorations and were finally restored with all-ceramic crowns. Follow-ups were performed at the prosthetic delivery, after 1, 3, and 5 years. Peri-implant and dental soft-tissue parameters were evaluated and patient-reported outcomes recorded. To monitor peri-implant bone remodelling, standardised radiographs were taken at the implant insertion and at the 1-, 3-, and 5-year follow-ups. In the course of 5 years, 14 implants were lost, resulting in a cumulative implant survival rate of 78.2%. The mean marginal bone loss from the implant insertion to the 5-year follow-up amounted to 1.12 mm. Probing depth, clinical attachment level, bleeding, and plaque index increased over time. In 91.5% of the implants, the papilla index showed levels of 1 or 2, respectively. At the end of the study, the patient satisfaction was higher compared to the pre-treatment measurements. Due to the low survival rate after five years and the noticeably high frequency of advanced bone loss observed in this study, the implant has not met the launch criteria, as it would have not been recommended for routine clinical use.
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Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Felix Burkhardt
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Jerome Chevalier
- INSA-Lyon, MATEIS Laboratory, University of Lyon, UMR CNRS 5510, 20 Avenue Albert Einstein, CEDEX, 69621 Villeurbanne, France
| | - Sebastian Berthold Maximilian Patzelt
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
- Private Dental Clinic, Am Dorfplatz 3, 78658 Zimmern ob Rottweil, Germany
| | - Frank Butz
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
- Private Dental Clinic, Belchenstrasse 6a, 79189 Bad Krozingen, Germany
- Correspondence:
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11
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Brunello G, Rauch N, Becker K, Hakimi AR, Schwarz F, Becker J. Two-piece zirconia implants in the posterior mandible and maxilla: A cohort study with a follow-up period of 9 years. Clin Oral Implants Res 2022; 33:1233-1244. [PMID: 36184914 DOI: 10.1111/clr.14005] [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: 01/02/2022] [Revised: 08/12/2022] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Long-term follow-up observations of zirconia implants are rare. This study aimed at evaluating the clinical performance of two-piece zirconia implants in the posterior jaws over 9 years. MATERIALS AND METHODS Sixty partially edentulous patients were treated with two-piece zirconia implants. In eight no primary stability could be achieved. Fifty-two patients received the final restoration (i.e., cemented fibreglass abutments and all-ceramic crowns). After 2 years, 2 implants failed and 4 dropouts were recorded. The remaining 46 patients with one target implant each were recalled at 9 years. Besides implant survival, clinical parameters at the implant level (plaque index-PI, bleeding on probing-BOP, probing depth-PD, mucosal recession-MR) were recorded and compared with previously collected data. Mechanical and technical complications were assessed. RESULTS Thirty patients responded. The mean observation period was of 111.1 ± 2.2 months. One implant was lost. Data recorded from the remaining 29 implants were analysed. PI values increased overtime. Mean BOP and PD remained unchanged during follow-up. No additional cases of peri-implantitis were recorded over the 10 diagnosed during the first 2 years of follow-up. No significant changes in mean MR values were detected over time, with 65% of the all included implants exhibiting no recession at 9 years and all the others, but one, a maximum MR of 1 mm. Three technical and 6 mechanical complications occurred in 7 patients between 2- and 9-years (6.9% and 20.7%, respectively, at patient level). CONCLUSION Within the limitations of the present study, a high survival rate was registered. Albeit frequent mechanical and technical complications, two-piece zirconia implants could represent a valid solution for the replacement of single teeth in the posterior jaws.
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Affiliation(s)
- Giulia Brunello
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.,Department of Neurosciences, Dentistry Section, University of Padova, Padova, Italy
| | - Nicole Rauch
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Ahmad R Hakimi
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.,Private Practice, Berlin, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Jürgen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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12
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Grün P, Pfaffeneder-Mantai F, Schneider B, Bandura P, Grün AS, Turhani D. Are selective serotonin reuptake inhibitors responsible for the failure of osseointegrated titanium-zirconium and one-piece zirconia dental implants in a premenopausal Caucasian woman? - A case report. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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13
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Kumari N, Sareen S, Verma M, Sharma S, Sharma A, Sohal HS, Mehta SK, Park J, Mutreja V. Zirconia-based nanomaterials: recent developments in synthesis and applications. NANOSCALE ADVANCES 2022; 4:4210-4236. [PMID: 36321156 PMCID: PMC9552756 DOI: 10.1039/d2na00367h] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/19/2022] [Indexed: 05/30/2023]
Abstract
In the last decade, the whole scientific community has witnessed great advances and progress in the various fields of nanoscience. Among the different nanomaterials, zirconia nanomaterials have found numerous applications as nanocatalysts, nanosensors, adsorbents, etc. Additionally, their exceptional biomedical applications in dentistry and drug delivery, and interesting biological properties, viz. anti-microbial, antioxidant, and anti-cancer activity, have further motivated the researchers to explore their physico-chemical properties using different synthetic pathways. With such an interest in zirconia-based nanomaterials, the present review focuses systematically on different synthesis approaches and their impact on the structure, size, shape, and morphology of these nanomaterials. Broadly, there are two approaches, viz., chemical synthesis which includes hydrothermal, solvothermal, sol-gel, microwave, solution combustion, and co-precipitation methods, and a greener approach which employs bacteria, fungus, and plant parts for the preparation of zirconia nanoparticles. In this review article, the aforementioned methods have been critically analyzed for obtaining specific phases and shapes. The review also incorporates a detailed survey of the applications of zirconia-based nanomaterials. Furthermore, the influence of specific phases, morphology, and the comparison with their counterpart composites for different applications have also been included. Finally, the concluding remarks, prospects and possible scope are given in the last section.
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Affiliation(s)
- Nisha Kumari
- Department of Chemistry, University Institute of Science, Chandigarh University Mohali Punjab-140 413 India
| | - Shweta Sareen
- Department of Chemistry, Centre of Advanced Studies in Chemistry, Panjab University Chandigarh-160 014 India
| | - Meenakshi Verma
- Department of Chemistry, University Institute of Science, Chandigarh University Mohali Punjab-140 413 India
- Department of UCRD, Chandigarh University Gharuan Mohali Punjab-140 413 India
| | - Shelja Sharma
- Department of Chemistry, University Institute of Science, Chandigarh University Mohali Punjab-140 413 India
| | - Ajay Sharma
- Department of Chemistry, University Institute of Science, Chandigarh University Mohali Punjab-140 413 India
- Department of UCRD, Chandigarh University Gharuan Mohali Punjab-140 413 India
| | - Harvinder Singh Sohal
- Department of Chemistry, University Institute of Science, Chandigarh University Mohali Punjab-140 413 India
| | - S K Mehta
- Department of Chemistry, Centre of Advanced Studies in Chemistry, Panjab University Chandigarh-160 014 India
| | - Jeongwon Park
- Department of Electrical and Biomedical Engineering, University of Nevada Reno NV 89557 USA
| | - Vishal Mutreja
- Department of Chemistry, University Institute of Science, Chandigarh University Mohali Punjab-140 413 India
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14
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Abstract
Surface characteristics are an important factor for long-term clinical success of dental implants. Alterations of implant surface characteristics accelerate or improve osseointegration by interacting with the physiology of bone healing. Dental implant surfaces have been traditionally modified at the microlevel. Recently, researchers have actively investigated nano-modifications in dental implants. This review explores implant surface modifications that enhance biological response at the interface between a bone and the implant.
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Affiliation(s)
- In-Sung Luke Yeo
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101 Daehak-Ro, Jongro-Gu, Seoul 03080, Korea.
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15
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Lee SK, Ji MK, Jo YJ, Park C, Cho H, Lim HP. Effect of Non-Thermal Plasma Treatment of Contaminated Zirconia Surface on Porphyromonas gingivalis Adhesion and Osteoblast Viability. MATERIALS 2022; 15:ma15155348. [PMID: 35955282 PMCID: PMC9369701 DOI: 10.3390/ma15155348] [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: 06/22/2022] [Revised: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 02/05/2023]
Abstract
Plasma treatment on a zirconia surface prevents bacterial contamination and maintains osteoblast activity. To assess the degree of adhesion of Porphyromonas gingivalis on a zirconia surface after non-thermal plasma (NTP) treatment, specimens were treated with plasma for 60, 300, and 600 s, after which P. gingivalis was inoculated onto the surface and incubated for 48 h. To assess osteoblast activity after NTP treatment, osteoblasts (MC3T3-E1) were dispensed onto the specimens contaminated with P. gingivalis immediately after NTP for 60 and 120 s, followed by incubation for 48, 72, and 96 h. P. gingivalis was cultured after 60 s of NTP treatment of zirconia. The NTP and control groups showed no significant difference (p = 0.91), but adhesion was significantly increased following NTP treatment for 300 s or longer (300, 600 s groups) (p < 0.05). After NTP treatment of P. gingivalis-contaminated zirconia, osteoblast activity significantly increased at 72 and 96 h (I60 and I120 s group) in the groups treated with plasma (p < 0.017). Application of NTP to dental zirconia implants for 60 s not only inhibits the proliferation of P. gingivalis, which causes peri-implantitis but also increases osseointegration on zirconia surfaces contaminated with P. gingivalis.
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Affiliation(s)
- Seon-Ki Lee
- Department of Prosthodontics, Daejeon Dental Hospital, Wonkwang University, Daejeon 35233, Korea;
| | - Min-Kyung Ji
- Dental 4D Research Center, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Korea;
| | - Yu-Jin Jo
- Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Korea; (Y.-J.J.); (C.P.)
| | - Chan Park
- Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Korea; (Y.-J.J.); (C.P.)
| | - Hoonsung Cho
- School of Materials Science & Engineering, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Korea
- Correspondence: (H.C.); (H.-P.L.); Tel.: +82-62-530-1717 (H.C.); +82-62-530-5577 (H.-P.L.)
| | - Hyun-Pil Lim
- Department of Prosthodontics, School of Dentistry, Chonnam National University, 33 Yongbong-ro, Buk-gu, Gwangju 61186, Korea; (Y.-J.J.); (C.P.)
- Correspondence: (H.C.); (H.-P.L.); Tel.: +82-62-530-1717 (H.C.); +82-62-530-5577 (H.-P.L.)
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16
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Zirconia versus Titanium Implants: 8-Year Follow-Up in a Patient Cohort Contrasted with Histological Evidence from a Preclinical Animal Model. MATERIALS 2022; 15:ma15155322. [PMID: 35955254 PMCID: PMC9369473 DOI: 10.3390/ma15155322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
Abstract
Zirconia ceramic (ZC) implants are becoming more common, but comparisons between preclinical histology and long-term clinical trials are rare. This investigation comprised (1) 8-year clinical follow-up of one-piece ZC or titanium (Ti) implants supporting full overdentures and (2) histomorphometric analysis of the same implants in an animal model, comparing implants with various surface treatments. Methods: (1) Clinical trial: 24 completely edentulous participants (2 groups of N = 12) received 7 implants (one-piece ball-abutment ZC or Ti; maxilla N = 4, mandible N = 3) restored with implant overdentures. Outcomes after 8-years included survival, peri-implant bone levels, soft-tissue responses, and prosthodontic issues. (2) Preclinical trial: 10 New Zealand sheep received 4 implants bilaterally in the femoral condyle: Southern Implants ZC or Ti one-piece implants, identical to the clinical trial, and controls: Southern ITC® two-piece implants with the same surface or Nobel (NBC) anodised (TiUnite™) surface. %Bone-implant contact (%BIC) was measured after 12 weeks of unloaded healing. Results: 8 of 24 participants (33%) of an average age of 75 ± 8 years were recalled; 21% of original participants had died, and 46% could not be contacted. 80.4% of implants survived; excluding palatal sites, 87.5% of Ti and 79% of ZC implants survived. All failed implants were in the maxilla. Three ZC implants had fractured. Bone loss was similar for Ti vs. ZC; pocket depths (p = 0.04) and attachment levels (p = 0.02) were greater for Ti than ZC implants. (1.7 ± 1.6 mm vs. 1.6 ± 1.3 mm). All implants in sheep femurs survived. %BIC was not statistically different for one-piece blasted surface Ti (80 ± 19%) versus ZC (76 ± 20%) or ITC® (75 ± 16 mm); NBC had significantly higher %BIC than ITC (84 ± 17%, p = 0.4). Conclusion: Short-term preclinical results for ZC and Ti one-piece implants showed excellent bone-implant contact in unloaded femoral sites. This differed from the long-term clinical results in older-aged, edentulous participants. While ZC and Ti implants showed equivalent performance, the risks of peri-implantitis and implant loss in older, completely edentulous patients remain a significant factor.
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Tchinda A, Chézeau L, Pierson G, Kouitat-Njiwa R, Rihn BH, Bravetti P. Biocompatibility of ZrO2 vs. Y-TZP Alloys: Influence of Their Composition and Surface Topography. MATERIALS 2022; 15:ma15134655. [PMID: 35806779 PMCID: PMC9267226 DOI: 10.3390/ma15134655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/21/2022] [Accepted: 06/29/2022] [Indexed: 12/04/2022]
Abstract
The osseointegration of implants is defined as the direct anatomical and functional connection between neoformed living bone and the surface of a supporting implant. The biological compatibility of implants depends on various parameters, such as the nature of the material, chemical composition, surface topography, chemistry and loading, surface treatment, and physical and mechanical properties. In this context, the objective of this study is to evaluate the biocompatibility of rough (Ra = 1 µm) and smooth (Ra = 0 µm) surface conditions of yttria–zirconia (Y-TZP) discs compared to pure zirconia (ZrO2) discs by combining a classical toxicological test, morphological observations by SEM, and a transcriptomic analysis on an in vitro model of human Saos-2 bone cells. Similar cell proliferation rates were observed between ZrO2 and Y-TZP discs and control cells, regardless of the surface topography, at up to 96 h of exposure. Dense cell matting was similarly observed on the surfaces of both materials. Interestingly, only 110 transcripts were differentially expressed across the human transcriptome, consistent with the excellent biocompatibility of Y-TZP reported in the literature. These deregulated transcripts are mainly involved in two pathways, the first being related to “mineral uptake” and the second being the “immune response”. These observations suggest that Y-TZP is an interesting candidate for application in implantology.
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Cruz MB, Silva N, Marques JF, Mata A, Silva FS, Caramês J. Biomimetic Implant Surfaces and Their Role in Biological Integration-A Concise Review. Biomimetics (Basel) 2022; 7:74. [PMID: 35735590 PMCID: PMC9220941 DOI: 10.3390/biomimetics7020074] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The increased use of dental implants in oral rehabilitation has been followed by the development of new biomaterials as well as improvements in the performance of biomaterials already in use. This triggers the need for appropriate analytical approaches to assess the biological and, ultimately, clinical benefits of these approaches. AIMS To address the role of physical, chemical, mechanical, and biological characteristics in order to determine the critical parameters to improve biological responses and the long-term effectiveness of dental implant surfaces. DATA SOURCES AND METHODS Web of Science, MEDLINE and Lilacs databases were searched for the last 30 years in English, Spanish and Portuguese idioms. RESULTS Chemical composition, wettability, roughness, and topography of dental implant surfaces have all been linked to biological regulation in cell interactions, osseointegration, bone tissue and peri-implant mucosa preservation. CONCLUSION Techniques involving subtractive and additive methods, especially those involving laser treatment or embedding of bioactive nanoparticles, have demonstrated promising results. However, the literature is heterogeneous regarding study design and methodology, which limits comparisons between studies and the definition of the critical determinants of optimal cell response.
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Affiliation(s)
- Mariana Brito Cruz
- Universidade de Lisboa, Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; (J.F.M.); (A.M.)
| | - Neusa Silva
- Universidade de Lisboa, Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), LIBPhys-FTC UID/FIS/04559/2013, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal;
| | - Joana Faria Marques
- Universidade de Lisboa, Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; (J.F.M.); (A.M.)
| | - António Mata
- Universidade de Lisboa, Faculdade de Medicina Dentária, Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal; (J.F.M.); (A.M.)
- Cochrane Portugal, Instituto de Saúde Baseada na Evidência (ISBE), Faculdade de Medicina Dentária, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Felipe Samuel Silva
- Center for Microelectromechanical Systems (CMEMS), Department of Mechanical Engineering, University of Minho, 4800-058 Guimarães, Portugal;
| | - João Caramês
- Bone Physiology Research Group, Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Professora Teresa Ambrósio, 1600-277 Lisboa, Portugal;
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Modification of Zirconia Implant Surfaces by Nd:YAG Laser Grooves: Does It Change Cell Behavior? Biomimetics (Basel) 2022; 7:biomimetics7020049. [PMID: 35645176 PMCID: PMC9149890 DOI: 10.3390/biomimetics7020049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 12/10/2022] Open
Abstract
The aim of this study was to evaluate gingival fibroblasts and human osteoblasts’ response to textured Nd:YAG laser microgrooves, with different dimensions, on zirconia implant surfaces. A total of 60 zirconia disks (8 mm in diameter and 2 mm in thickness) were produced and divided between four study groups (N = 15): three laser-textured (widths between 125.07 ± 5.29 μm and 45.36 ± 2.37 μm and depth values from 50.54 ± 2.48 μm to 23.01 ± 3.79 μm) and a control group without laser treatment. Human osteoblasts and gingival fibroblasts were cultured on these surfaces for 14 days. FEG-SEM (Field Emission Gun–Scanning Electron Microscope) images showed cellular adhesion at 24 h, with comparable morphology in all samples for both cell types. A similar cell spreading within the grooves and in the space between them was observed. Cell viability increased over time in all study groups; however, no differences were found between them. Additionally, proliferation, ALP (Alkaline phosphatase) activity, collagen type I, osteopontin and interleukin levels were not significantly different between any of the study groups for any of the cell types. Analysis of variance to compare parameters effect did not reveal statistically significant differences when comparing all groups in the different tests performed. The results obtained revealed similar cell behavior based on cell viability and differentiation on different microtopographic laser grooves, compared to a microtopography only established by sandblasting and acid-etching protocol, the reference surface treatment on zirconia dental implants.
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Labis V, Bazikyan E, Zhigalina O, Sizova S, Oleinikov V, Khmelenin D, Dyachkova I, Zolotov D, Buzmakov A, Asadchikov V, Khaidukov S, Kozlov I. Assessment of dental implant surface stability at the nanoscale level. Dent Mater 2022; 38:924-934. [DOI: 10.1016/j.dental.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/03/2022]
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21
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Wang Z, Ding Q, Gao Y, Ma QQ, Zhang L, Ge XY, Sun YC, Xie QF. [Effect of porous zirconia ceramics on proliferation and differentiation of osteoblasts]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54. [PMID: 35165465 PMCID: PMC8860650 DOI: 10.19723/j.issn.1671-167x.2022.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
OBJECTIVE To investigate the effect of porous surface morphology of zirconia on the proliferation and differentiation of osteoblasts. METHODS According to different manufacturing and pore-forming methods, the zirconia specimens were divided into 4 groups, including milled sintering group (M-Ctrl), milled porous group (M-Porous), 3D printed sintering group (3D-Ctrl) and 3D printed porous group (3D-Porous). The surface micromorphology, surface roughness, contact angle and surface elements of specimens in each group were detected by scanning electron microscope (SEM), 3D laser microscope, contact angle measuring device and energy-dispersion X-ray analysis, respectively. MC3T3-E1 cells were cultured on 4 groups of zirconia discs. The cell morphology of MC3T3-E1 cells on zirconia discs was eva-luated on 1 and 7 days by SEM. The cell proliferation was detected on 1, 3 and 5 days by cell counting kit-8 (CCK-8). After osteogenic induction for 14 days, the relative mRNA expression of alkaline phosphatase (ALP), type Ⅰ collagen (Colla1), Runt-related transcription factor-2 (Runx2) and osteocalcin (OCN) in MC3T3-E1 cells were detected by real-time quantitative polymerase chain reaction. RESULTS The pore size [(419.72±6.99) μm] and pore depth [(560.38±8.55) μm] of 3D-Porous group were significantly larger than the pore size [(300.55±155.65) μm] and pore depth [(69.97±31.38) μm] of M-Porous group (P < 0.05). The surface of 3D-Porous group appeared with more regular round pores than that of M-Porous group. The contact angles of all the groups were less than 90°. The contact angles of 3D-Ctrl (73.83°±5.34°) and M-Porous group (72.7°±2.72°) were the largest, with no significant difference between them (P>0.05). Cells adhered inside the pores in M-Porous and 3D-Porous groups, and the proliferation activities of them were significantly higher than those of M-Ctrl and 3D-Ctrl groups after 3 and 5 days' culture (P < 0.05). After 14 days' incubation, ALP, Colla1, Runx2 and OCN mRNA expression in 3D-Porous groups were significantly lower than those of M-Ctrl and 3D-Ctrl groups (P < 0.05). Colla1, Runx2 and OCN mRNA expressions in M-Porous group were higher than those of 3D-Porous group (P < 0.05). CONCLUSION The porous surface morphology of zirconia can promote the proliferation and adhesion but inhibit the differentiation of MC3T3-E1 cells.
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Affiliation(s)
- Z Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - Q Ding
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China.,Foshan (Southern China) Institute for New Materials, Foshan 528000, Guangdong, China
| | - Y Gao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - Q Q Ma
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - L Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - X Y Ge
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Y C Sun
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China.,Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Q F Xie
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
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王 铮, 丁 茜, 高 远, 马 全, 张 磊, 葛 兮, 孙 玉, 谢 秋. [Effect of porous zirconia ceramics on proliferation and differentiation of osteoblasts]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2022; 54:31-39. [PMID: 35165465 PMCID: PMC8860650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Indexed: 11/06/2023]
Abstract
OBJECTIVE To investigate the effect of porous surface morphology of zirconia on the proliferation and differentiation of osteoblasts. METHODS According to different manufacturing and pore-forming methods, the zirconia specimens were divided into 4 groups, including milled sintering group (M-Ctrl), milled porous group (M-Porous), 3D printed sintering group (3D-Ctrl) and 3D printed porous group (3D-Porous). The surface micromorphology, surface roughness, contact angle and surface elements of specimens in each group were detected by scanning electron microscope (SEM), 3D laser microscope, contact angle measuring device and energy-dispersion X-ray analysis, respectively. MC3T3-E1 cells were cultured on 4 groups of zirconia discs. The cell morphology of MC3T3-E1 cells on zirconia discs was eva-luated on 1 and 7 days by SEM. The cell proliferation was detected on 1, 3 and 5 days by cell counting kit-8 (CCK-8). After osteogenic induction for 14 days, the relative mRNA expression of alkaline phosphatase (ALP), type Ⅰ collagen (Colla1), Runt-related transcription factor-2 (Runx2) and osteocalcin (OCN) in MC3T3-E1 cells were detected by real-time quantitative polymerase chain reaction. RESULTS The pore size [(419.72±6.99) μm] and pore depth [(560.38±8.55) μm] of 3D-Porous group were significantly larger than the pore size [(300.55±155.65) μm] and pore depth [(69.97±31.38) μm] of M-Porous group (P < 0.05). The surface of 3D-Porous group appeared with more regular round pores than that of M-Porous group. The contact angles of all the groups were less than 90°. The contact angles of 3D-Ctrl (73.83°±5.34°) and M-Porous group (72.7°±2.72°) were the largest, with no significant difference between them (P>0.05). Cells adhered inside the pores in M-Porous and 3D-Porous groups, and the proliferation activities of them were significantly higher than those of M-Ctrl and 3D-Ctrl groups after 3 and 5 days' culture (P < 0.05). After 14 days' incubation, ALP, Colla1, Runx2 and OCN mRNA expression in 3D-Porous groups were significantly lower than those of M-Ctrl and 3D-Ctrl groups (P < 0.05). Colla1, Runx2 and OCN mRNA expressions in M-Porous group were higher than those of 3D-Porous group (P < 0.05). CONCLUSION The porous surface morphology of zirconia can promote the proliferation and adhesion but inhibit the differentiation of MC3T3-E1 cells.
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Affiliation(s)
- 铮 王
- 北京大学口腔医学院·口腔医院修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 茜 丁
- 北京大学口腔医学院·口腔医院修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
- 佛山(华南)新材料研究院,广东佛山 528000Foshan (Southern China) Institute for New Materials, Foshan 528000, Guangdong, China
| | - 远 高
- 北京大学口腔医学院·口腔医院修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 全诠 马
- 北京大学口腔医学院·口腔医院修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 磊 张
- 北京大学口腔医学院·口腔医院修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - 兮源 葛
- 北京大学口腔医学院·口腔医院中心实验室,北京 100081Central Laboratory, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - 玉春 孙
- 北京大学口腔医学院·口腔医院修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
- 北京大学口腔医学院·口腔医院口腔医学数字化研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - 秋菲 谢
- 北京大学口腔医学院·口腔医院修复科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
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Fontenele RC, Nascimento EHL, Imbelloni-Vasconcelos AC, Martins LAC, Pontual ADA, Ramos-Perez FMM, Freitas DQ. Influence of kilovoltage-peak and the metal artifact reduction tool in cone-beam computed tomography on the detection of bone defects around titanium-zirconia and zirconia implants. Imaging Sci Dent 2022; 52:267-273. [PMID: 36238703 PMCID: PMC9530290 DOI: 10.5624/isd.20220040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/07/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The aim of this study was to assess the influence of kilovoltage-peak (kVp) and the metal artifact reduction (MAR) tool on the detection of buccal and lingual peri-implant dehiscence in the presence of titanium-zirconia (Ti-Zr) and zirconia (Zr) implants in cone-beam computed tomography (CBCT) images. Materials and Methods Twenty implant sites were created in the posterior region of human mandibles, including control sites (without dehiscence) and experimental sites (with dehiscence). Individually, a Ti-Zr or Zr implant was placed in each implant site. CBCT scans were performed using a Picasso Trio device, with variation in the kVp setting (70 or 90 kVp) and whether the MAR tool was used. Three oral radiologists scored the detection of dehiscence using a 5-point scale. The area under the receiver operating characteristic (ROC) curve, sensitivity, and specificity were calculated and compared by multi-way analysis of variance (α=0.05). Results The kVp, cortical plate involved (buccal or lingual cortices), and MAR did not influence any diagnostic values (P>0.05). The material of the implant did not influence the ROC curve values (P>0.05). In contrast, the sensitivity and specificity were statistically significantly influenced by the implant material (P<0.05) with Zr implants showing higher sensitivity values and lower specificity values than Ti-Zr implants. Conclusion The detection of peri-implant dehiscence was not influenced by kVp, use of the MAR tool, or the cortical plate. Greater sensitivity and lower specificity were shown for the detection of peri-implant dehiscence in the presence of a Zr implant.
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Affiliation(s)
- Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | | | - Luciano Augusto Cano Martins
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Andrea dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, Division of Oral Radiology, Federal University of Pernambuco, Recife, PE, Brazil
| | - Flávia Maria Moraes Ramos-Perez
- Department of Clinical and Preventive Dentistry, Division of Oral Radiology, Federal University of Pernambuco, Recife, PE, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Immediate Restoration of Single-Piece Zirconia Implants: A Prospective Case Series-Long-Term Results after 11 Years of Clinical Function. MATERIALS 2021; 14:ma14226738. [PMID: 34832139 PMCID: PMC8621133 DOI: 10.3390/ma14226738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this prospective case series was to evaluate single-piece zirconia implants restored with lithium disilicate CAD/CAM crowns through a long-term follow-up. METHODS In this trial, 20 one-piece zirconia implants were placed in 20 patients. Implants were restored (i) immediately with lithium disilicate CAD/CAM provisionals, and (ii) permanently four months after surgery. Patients were followed for 11 years. Clinical parameters and radiological measurements of the zirconia implants were assessed. For the statistical analysis, paired t-test was applied. RESULTS Four implants were counted as implant failure due to the loss of implant stability, resulting in a Kaplan-Meier survival rate of 80% up to 11 years. The mean bleeding on probing values were 19.1% (SD ± 13.1) and 18.2% (SD ± 17.6) 96 and 11 years after implant placement, respectively. The plaque index revealed a significant decrease over time (p < 0.001) with a value between 25.9% (SD ± 5.7) and 12.6% (SD ± 10.0) at baseline and 11-years follow-up respectively. The marginal bone level revealed a significant decrease 4, 8, and 11 years after implant insertion (p = 0.001, p = 0.019, and p = 0.027, respectively). CONCLUSIONS Immediately loaded zirconia single-piece implants showed a suitable success rate in clinical and radiographic outcomes.
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Sun L, Hong G. Surface Modifications for Zirconia Dental Implants: A Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.733242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Zirconia-based bioceramic is a potential material for dental implants developed and introduced in dentistry 30 years ago. However, some limitations still exist for zirconia implants caused by several factors, such as manufacturing difficulties, low-temperature degradation (LTD), long-term stability, and clinical experience. Several studies validated that some subtle changes on the zirconia surface might significantly impact its mechanical properties and osseointegration. Thus, attention was paid to the effect of surface modification of zirconia implants. This review generally summarizes the surface modifications of zirconia implants to date classified as physical treatment, chemical treatment, and surface coating, aiming to give an overall perspective based on the current situation. In conclusion, surface modification is an effective and essential method for zirconia implant application. However, before clinical use, we need more knowledge about these modification methods.
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Tan NCP, Miller CM, Antunes E, Sharma D. Impact of physical decontamination methods on zirconia implant surface and subsequent bacterial adhesion: An in-vitro study. Clin Exp Dent Res 2021; 8:313-321. [PMID: 34599862 PMCID: PMC8874065 DOI: 10.1002/cre2.486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate the effect of routinely used physical decontamination methods on the surface characteristics of zirconia implants and subsequent ability of bacteria to adhere in vitro. Background Physical decontamination methods commonly used in peri‐implantitis therapy and routine implant maintenance can potentially alter zirconia implant surfaces. Methods Acid‐etched zirconia discs were instrumented with titanium curette (TC), plastic curette, air abrasive device, ultrasonic scaler (US) with stainless steel tip. Following instrumentation, surface topography, and surface elemental composition was analyzed using 3D‐laser scanning microscopy and energy‐dispersive X‐ray spectroscopy, respectively. Subsequently, plaque biofilm was cultured on zirconia discs for 48 h and bacterial adhesion assessed using a turbidity test and scanning electron microscopy. Results A significant difference in surface roughness was observed between the US and control group (p < 0.05). The US and TC caused gray surface discolouration on zirconia discs due to deposition of metallic residue as confirmed by X‐ray spectroscopy. No significant difference in bacterial adhesion was noted among all treatment groups (p > 0.05). Conclusion TC and US with stainless steel tips should be used with caution due to deposition of metallic residue on the surface. Air abrasive devices and plastic curettes caused minimal surface alterations and are, therefore, safer for zirconia implant decontamination.
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Affiliation(s)
- Nathan Chiang Ping Tan
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, Australia
| | - Catherine M Miller
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Queensland, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Queensland, Australia
| | - Elsa Antunes
- College of Science and Engineering, James Cook University, Townsville, Queensland, Australia
| | - Dileep Sharma
- College of Medicine and Dentistry, James Cook University, Smithfield, Queensland, Australia.,Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Queensland, Australia
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Abstract
This review aims to discuss the advantages and disadvantages of zirconia implants compared with titanium implants. Moreover, it intends to review the relevant available long-term literature of these two materials regarding osteointegration, soft-tissue, microbiota, and peri-implantitis, focusing on clinical results. Briefly, titanium implants are a reliable alternative for missing teeth; however, they are not incapable of failure. In an attempt to provide an alternative implant material, implants made from ceramic-derivate products were developed. Owing to its optimal osseointegration competence, biocompatibility, and esthetic proprieties, zirconium dioxide (ZrO2), also known as zirconia, has gained popularity among researchers and clinicians, being a metal-free alternative for titanium implants with its main use in the anterior esthetic zones. This type of implant may present similar osseointegration as those noted on titanium implants with a greater soft-tissue response. Furthermore, this material does not show corrosion as its titanium analog, and it is less susceptible to bacterial adhesion. Lastly, even presenting a similar inflammatory response to titanium, zirconia implants offer less biofilm formation, suggesting less susceptibility to peri-implantitis. However, it is a relatively new material that has been commercially available for a decade; consequently, the literature still lacks studies with long follow-up periods.
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Rathee G, Bartwal G, Rathee J, Mishra YK, Kaushik A, Solanki PR. Emerging Multimodel Zirconia Nanosystems for High‐Performance Biomedical Applications. ADVANCED NANOBIOMED RESEARCH 2021. [DOI: 10.1002/anbr.202100039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Garima Rathee
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
| | - Gaurav Bartwal
- Hemwati Nandan Bahuguna Garhwal University Birla Campus, Pauri Garhwal Srinagar Uttarakhand 246174 India
| | - Jyotsna Rathee
- CSE Department Deenbandhu Chhoturam University of Science and Technology Murthal Haryana 131039 India
| | - Yogendra Kumar Mishra
- Mads Clausen Institute NanoSYD University of Southern Denmark Alison 2 6400 Sønderborg Denmark
| | - Ajeet Kaushik
- NanoBioTech Laboratory Department of Natural Sciences, Division of Sciences, Art, and Mathematics Florida Polytechnic University Lakeland FL 33805 USA
| | - Pratima R. Solanki
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
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Filiberto M, Daniele B, Franco B, Antonio S, Adriano P, Giovanna I, Raimondo Q. Histological and Histomorphometric Comparison of Innovative Dental Implants Laser Obtained: Animal Pilot Study. MATERIALS 2021; 14:ma14081830. [PMID: 33917152 PMCID: PMC8067823 DOI: 10.3390/ma14081830] [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: 02/14/2021] [Revised: 03/25/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Evaluation of the in vivo bone response of two innovative titanium surfaces ytterbium laser active fiber obtained (L1-L2) compared to a sandblasted and acid etched (SBAE) during early phase of osseointegration. MATERIAL AND METHODS Three implant groups with the same macroscopic features were obtained (L1-L2-SBAE) to promote specific surface characteristics. Scanning electron microscopy, profilometric evaluation, X-ray spectrometry, and diffraction analysis were performed. For each group, six implants were placed in the tibiae of three Peli Buey sheep, and histologic, histomorphometric analysis, bone to implant contact (BIC), and the Dynamic Osseointegration index (DOI) were performed. RESULTS During the early phases of osseointegration, the histological and histomorphometric results showed significant differences between L1-L2-SBAE implants. At 15 and 30 days, histological analysis detected a newly bone formation around all specimens with an higher vital bone in L2 compared to L1 and SBAE both in cortical and in poor-quality marrow bone. At same time, histomorphometric analysis showed significantly higher BIC values in L2 (42.1 ± 2.6 and 82.4 ± 2.2) compared to L1 (5.2 ± 3.1 and 56.2 ± 1.3) and SBAE (23.3 ± 3.9 and 77.3 ± 0.4). DOI medium value showed a higher rate in L2 (2.83) compared to SBAE (2.60) and L1 (1.91). CONCLUSIONS With the limitations of this pilot study, it is possible to assess that the titanium surface characteristics, and not the technologies used to obtain the modification, played a crucial role during the osseointegration process. Histological, histomorphometric, BIC, and DOI evaluation showed a significantly higher rate in L2 specimens compared to others, confirming that the implant surface could increase the bone response in cortical or marrow poor quality bone during the initial phases of osseointegration.
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Affiliation(s)
- Mastrangelo Filiberto
- Clinical and Experimental Medicine Department, School of Dentistry, University of Foggia, 77100 Foggia, Italy
- Correspondence:
| | - Botticelli Daniele
- ARDEC Academy, 47923 Rimini, Italy; (B.D.); (B.F.)
- Faculty of Dentistry, University of Medical Science, La Habana 10400, Cuba
| | - Bengazi Franco
- ARDEC Academy, 47923 Rimini, Italy; (B.D.); (B.F.)
- Faculty of Dentistry, University of Medical Science, La Habana 10400, Cuba
| | - Scarano Antonio
- Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, University of Chieti, 66100 Chieti, Italy; (S.A.); (P.A.); (I.G.)
| | - Piattelli Adriano
- Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, University of Chieti, 66100 Chieti, Italy; (S.A.); (P.A.); (I.G.)
| | - Iezzi Giovanna
- Department of Medical, Oral and Biotechnological Sciences, School of Dentistry, University of Chieti, 66100 Chieti, Italy; (S.A.); (P.A.); (I.G.)
| | - Quaresima Raimondo
- Department of Civil, Architecture and Environmental Engineering, University of L’Aquila, 67100 L’Aquila, Italy;
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The Anchorage of Bone Cells onto an Yttria-Stabilized Zirconia Surface with Mild Nano-Micro Curved Profiles. Dent J (Basel) 2020; 8:dj8040127. [PMID: 33182602 PMCID: PMC7712018 DOI: 10.3390/dj8040127] [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: 10/05/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 01/16/2023] Open
Abstract
The high biocompatibility, good mechanical properties, and perfect esthetics of ceramic dental materials motivate investigation into their suitability as an endosseous implant. Osseointegration at the interface between bone and implant surface, which is a criterion for dental implant success, is dependent on surface chemistry and topography. We found out earlier that osteoblasts on sharp-edged micro-topographies revealed an impaired cell phenotype and function and the cells attempted to phagocytize these spiky elevations in vitro. Therefore, micro-structured implants used in dental surgery should avoid any spiky topography on their surface. The sandblasted, acid-etched, and heat-treated yttria-stabilized zirconia (cer.face®14) surface was characterized by scanning electron microscopy and energy dispersive X-ray. In vitro studies with human MG-63 osteoblasts focused on cell attachment and intracellular stress level. The cer.face 14 surface featured a landscape with nano-micro hills that was most sinusoidal-shaped. The mildly curved profile proved to be a suitable material for cell anchorage. MG-63 cells on cer.face 14 showed a very low reactive oxygen species (ROS) generation similar to that on the extracellular matrix protein collagen I (Col). Intracellular adenosine triphosphate (ATP) levels were comparable to Col. Ceramic cer.face 14, with its sinusoidal-shaped surface structure, facilitates cell anchorage and prevents cell stress.
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Kyrylenko S, Warchoł F, Oleshko O, Husak Y, Kazek-Kęsik A, Korniienko V, Deineka V, Sowa M, Maciej A, Michalska J, Jakóbik-Kolon A, Matuła I, Basiaga M, Hulubnycha V, Stolarczyk A, Pisarek M, Mishchenko O, Pogorielov M, Simka W. Effects of the sources of calcium and phosphorus on the structural and functional properties of ceramic coatings on titanium dental implants produced by plasma electrolytic oxidation. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 119:111607. [PMID: 33321651 DOI: 10.1016/j.msec.2020.111607] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/18/2020] [Accepted: 10/06/2020] [Indexed: 12/12/2022]
Abstract
Plasma Electrolytic Oxidation (PEO) is as a promising technique to modify metal surfaces by application of oxide ceramic coatings with appropriate physical, chemical and biological characteristics. Therefore, objective of this research was to find the simplest settings, yet able to produce relevant bioactive implant surfaces layers on Ti implants by means of PEO. We show that an electrolyte containing potassium dihydrogen phosphate as a source of P and either calcium hydroxide or calcium formate as a source of Ca in combination with a chelating agent, ethylenediamine tetraacetic acid (EDTA), is suitable for PEO to deliver coatings with desired properties. We determined surface morphology, roughness, wettability, chemical and phase composition of titanium after the PEO process. To investigate biocompatibility and bacterial properties of the PEO oxide coatings we used microbial and cell culture tests. The electrolyte based on Ca(OH)2 and EDTA promotes active crystallization of apatites after PEO processing of the Ti implants. The PEO layers can increase electrochemical corrosion resistance. The PEO can be potentially used for development of bioactive surfaces with increased support of eukaryotic cells while inhibiting attachment and growth of bacteria without use of antibacterial agents.
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Affiliation(s)
| | - Fiona Warchoł
- Silesian University of Technology, Faculty of Chemistry, 44-100 Gliwice, Poland
| | | | - Yevheniia Husak
- Sumy State University, Medical Institute, 40018 Sumy, Ukraine
| | - Alicja Kazek-Kęsik
- Silesian University of Technology, Faculty of Chemistry, 44-100 Gliwice, Poland
| | | | | | - Maciej Sowa
- Silesian University of Technology, Faculty of Chemistry, 44-100 Gliwice, Poland
| | - Artur Maciej
- Silesian University of Technology, Faculty of Chemistry, 44-100 Gliwice, Poland
| | - Joanna Michalska
- Silesian University of Technology, Faculty of Chemistry, 44-100 Gliwice, Poland
| | - Agata Jakóbik-Kolon
- Silesian University of Technology, Faculty of Chemistry, 44-100 Gliwice, Poland
| | - Izabela Matuła
- University of Silesia, Institute of Materials Engineering, 41-500 Chorzów, Poland
| | - Marcin Basiaga
- Silesian University of Technology, Faculty of Biomedical Engineering, 41-800 Zabrze, Poland
| | | | | | - Marcin Pisarek
- Institute of Physical Chemistry PAS, 01-224 Warsaw, Poland
| | | | - Maksym Pogorielov
- Sumy State University, Medical Institute, 40018 Sumy, Ukraine; Nano Prime, 39-200 Dębica, Poland
| | - Wojciech Simka
- Silesian University of Technology, Faculty of Chemistry, 44-100 Gliwice, Poland; Nano Prime, 39-200 Dębica, Poland.
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Guo S, Liu N, Liu K, Li Y, Zhang W, Zhu B, Gu B, Wen N. Effects of carbon and nitrogen plasma immersion ion implantation on bioactivity of zirconia. RSC Adv 2020; 10:35917-35929. [PMID: 35517098 PMCID: PMC9056952 DOI: 10.1039/d0ra05853j] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/06/2020] [Indexed: 01/11/2023] Open
Abstract
Zirconia is considered the most promising alternative material to titanium implants. However, zirconia is a biologically inert material and its surface modification is essential to obtain efficient osseointegration. Plasma immersion ion implantation (PIII) is a controllable and flexible approach that constructs functional groups on the surface of biomaterials and enhances osteogenic ability of host osteoclast cells. Zirconia disks were randomly divided into 4 groups (n = 50/group): (1) Blank, (2) C60N0, (3) C60N6, and (4) C60N18. Carbon and nitrogen plasma immersion ion implantation on zirconia (C and N2-PIII) surface modification was completed with the corresponding parameters. When zirconia was modified by carbon and nitrogen plasma implantation, a new chemical structure was formed on the material surface while the surface roughness of the material remained unaltered. The nitrogen-containing functional groups with high potential were introduced but the bulk crystal structure of zirconia was not changed, indicating that the stability of zirconia was not affected. In vitro data showed that zirconia with high surface potential promoted adhesion, proliferation, and osteogenic differentiation of BMSCs. C60N6 was found to be superior to the other groups. Our results demonstrate that a zirconia surface modified by C and N2-PIII can introduce desirable nitrogen functional groups and create a suitable extracellular environment to promote BMSCs biological activity. Taken together, these results suggest that C and N2-PIII modified zirconia is a promising material for use in the field of medical implantation. Zirconia is considered the most promising alternative material to titanium implants.![]()
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Affiliation(s)
- Shuqin Guo
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947.,Department of Stomatology, Beijing Railway Construction Hospital, China Railway Construction Corporation 40 Fuxing Road, Haidian District Beijing 100855 China
| | - Na Liu
- Department of Stomatology, Hainan Hospital, Chinese PLA General Hospital Sanya 572013 Hainan Province China
| | - Ke Liu
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Beijing 100190 China
| | - Ying Li
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Wei Zhang
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences Beijing 100190 China
| | - Biao Zhu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Bin Gu
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
| | - Ning Wen
- Department of Stomatology, The First Medical Center, Chinese PLA General Hospital 28 Fuxing Road, Haidian District Beijing 100853 China + (86) 010 66937947
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Thomé G, Sandgren R, Bernardes S, Trojan L, Warfving N, Bellón B, Pippenger BE. Osseointegration of a novel injection molded 2-piece ceramic dental implant: a study in minipigs. Clin Oral Investig 2020; 25:603-615. [PMID: 32914271 DOI: 10.1007/s00784-020-03513-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/06/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study compared the osseointegrative potential of a novel injection molded zirconia dental implant (Neodent Zi ceramic implant, test) and a commercially available titanium implant (Neodent Alvim implant, control) in terms of histomorphometrically derived bone-to-implant contact (BIC), first bone-to-implant contact (fBIC), and the ratio of bone area to total area (BATA) around the implant. MATERIALS AND METHODS A total of 36 implants, 18 per individual test device, were implanted in a split-mouth arrangement in either side of the edentulous and fully healed mandible of 6 minipigs. Histomorphometric analysis of BIC, fBIC, and BATA were performed 8 weeks post implantation and subjected to statistical non-inferiority testing. Surface characteristics of both implant types were compared in terms of contact angle, surface topography, and elemental composition. RESULTS BIC, fBIC, and coronal BATA values of test and control implants were statistically comparable and non-inferior. BIC values of 77.8 ± 6.9% vs. 80.7 ± 6.9% (p = 0.095) were measured for the test and control groups. fBIC lingual values were - 238 ± 328 μm compared with - 414 ± 511 μm (p = 0.121) while buccal values were - 429 ± 648 μm and - 588 ± 550 μm (p = 0.230) for the test and control devices, respectively. BATA in the apical segment was significantly higher in the test group compared with the control group (67.2 ± 11.8% vs. 59.1 ± 11.4%) (p = 0.0103). Surface topographies of both implant types were comparable. Surface chemical analysis indicated the presence of carbonaceous adsorbates which correlated with a comparable and predominantly hydrophobic character of the implants. CONCLUSION The results demonstrate that the investigated zirconia implants, when compared with a commercially available titanium implant, show equivalent and non-inferior bone integration, bone formation, and alveolar bone level maintenance. This qualifies the investigated zirconia implant as a potential candidate for clinical development. CLINICAL RELEVANCE This study investigated the osseointegration of a novel zirconia 2-piece dental implant prototype intended for clinical development. With the aim of translating this prototype into clinical development preclinical models, procedures and materials within this study have been selected as close to clinical practice and human physiological conditions as possible.
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Affiliation(s)
| | - Rebecca Sandgren
- Biomedical Center, Faculty of Medicine, Lund University, Lund, Sweden
| | | | | | | | - Benjamin Bellón
- Department of Preclinical and Translational Research, Institut Straumann AG, Peter Merian-Weg 12, 4052, Basel, Switzerland.,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland
| | - Benjamin E Pippenger
- Department of Preclinical and Translational Research, Institut Straumann AG, Peter Merian-Weg 12, 4052, Basel, Switzerland. .,Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland.
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Cruz MBD, Marques JF, Fernandes BF, Costa M, Miranda G, Mata ADSPD, Carames JMM, Silva FS. Gingival fibroblasts behavior on bioactive zirconia and titanium dental implant surfaces produced by a functionally graded technique. J Appl Oral Sci 2020; 28:e20200100. [PMID: 32667382 PMCID: PMC7357876 DOI: 10.1590/1678-7757-2020-0100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/12/2020] [Indexed: 01/27/2023] Open
Abstract
Adding a biological apatite layer to the implant surface enhances bone healing around the implant.
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Affiliation(s)
| | - Joana Faria Marques
- LIBPhys, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisboa, Portugal
| | | | - Mafalda Costa
- Departamento de Engenharia Mecânica, Centro para Sistemas Micro Eletromecânicos, Universidade do Minho, Guimarães, Portugal
| | - Georgina Miranda
- Departamento de Engenharia Mecânica, Centro para Sistemas Micro Eletromecânicos, Universidade do Minho, Guimarães, Portugal
| | | | | | - Filipe Samuel Silva
- Departamento de Engenharia Mecânica, Centro para Sistemas Micro Eletromecânicos, Universidade do Minho, Guimarães, Portugal
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Fernandes BF, da Cruz MB, Marques JF, Madeira S, Carvalho Ó, Silva FS, da Mata ADSP, Caramês JMM. Laser Nd:YAG patterning enhance human osteoblast behavior on zirconia implants. Lasers Med Sci 2020; 35:2039-2048. [PMID: 32556830 DOI: 10.1007/s10103-020-03066-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/09/2020] [Indexed: 10/24/2022]
Abstract
Zirconia has been regarded as a promising material for dental implants, and Nd:YAG laser treatment has been proposed as a potential strategy to improve its bioactivity. The main aim of the present study was to evaluate the in vitro behavior of human fetal osteoblasts in contact with laser-textured zirconia implant surfaces assessing the effect of different texture patterns, spacing between laser passes and number of laser passes. Zirconia discs were produced and treated with Nd:YAG laser according to test group variables: texture (microgrooves and micropillar array), distance between surface features (25 μm, 30 μm and 35 μm), and laser passes [1, 2, 4, and 8]. Untextured sandblasted and acid-etched zirconia discs (SBAE) were used as controls. Human osteoblasts (hFOB 1.19) were cultured for 14 days on test and control samples. Morphology and cellular adhesion were observed using scanning electron microscopy (SEM). Cell viability and proliferation were evaluated at 1, 3, 7, and 14 days using a commercial resazurin-based method. Collagen type I was evaluated at 3 days using ELISA. Alkaline phosphatase (ALP) activity was evaluated at 7 days using a colorimetric enzymatic technique. Group comparisons were tested using ANOVA or Mann-Whitney test (Tukey's post hoc) using statistical software, and significance was set at p < 0.05. Cell viability and proliferation increased over time for all groups with statistically higher values for laser-textured groups when compared with control at 7 and 14 days in culture (p < 0.05). Collagen type I levels were higher for study groups (p < 0.05) when compared with control group. No statistically differences were detected for ALP activity levels between texture and control groups (p > 0.05). The results suggest that laser-machined zirconia implant surfaces may benefit biological osteoblast response. However, the type of texture, spacing at the range of 25-35 μm, and number of laser passes did not seem to be relevant variables.
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Affiliation(s)
- Beatriz Ferreira Fernandes
- Oral Biology and Biochemistry Research Group, LIBPhys, Faculty of Dental Medicine, Universidade de Lisboa, 1649-003, Lisboa, Portugal.
| | - Mariana Brito da Cruz
- Oral Biology and Biochemistry Research Group, LIBPhys, Faculty of Dental Medicine, Universidade de Lisboa, 1649-003, Lisboa, Portugal
| | - Joana Faria Marques
- Oral Biology and Biochemistry Research Group, LIBPhys, Faculty of Dental Medicine, Universidade de Lisboa, 1649-003, Lisboa, Portugal
| | - Sara Madeira
- Center for Microelectromechanical Systems (CMEMS), Dept. of Mechanical Engineering, University of Minho, 4800-058, Guimarães, Portugal
| | - Óscar Carvalho
- Center for Microelectromechanical Systems (CMEMS), Dept. of Mechanical Engineering, University of Minho, 4800-058, Guimarães, Portugal
| | - Filipe Samuel Silva
- Center for Microelectromechanical Systems (CMEMS), Dept. of Mechanical Engineering, University of Minho, 4800-058, Guimarães, Portugal
| | | | - João Manuel Mendez Caramês
- Bone Physiology Research Group, LIBPhys, Faculty of Dental Medicine, Universidade de Lisboa, 1649-003, Lisboa, Portugal
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Gupta S, Noumbissi S, Kunrath MF. Nano modified zirconia dental implants: Advances and the frontiers for rapid osseointegration. ACTA ACUST UNITED AC 2020. [DOI: 10.1002/mds3.10076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Saurabh Gupta
- Private Practise Dentistry Bangalore India
- International Academy of Ceramic Implantology Silver Spring MD USA
- Zirconia Implant Research Group (Z.I.R.G.) Silver Spring MD USA
| | - Sammy Noumbissi
- International Academy of Ceramic Implantology Silver Spring MD USA
- Zirconia Implant Research Group (Z.I.R.G.) Silver Spring MD USA
- Department of Oral Surgery University of Milan Milan Italy
| | - Marcel F. Kunrath
- Dentistry Department School of Health and Life Sciences Pontifical Catholic University of Rio Grande do Sul (PUCRS) Porto Alegre Brazil
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Iinuma Y, Hirota M, Hayakawa T, Ohkubo C. Surrounding Tissue Response to Surface-Treated Zirconia Implants. MATERIALS 2019; 13:ma13010030. [PMID: 31861679 PMCID: PMC6981750 DOI: 10.3390/ma13010030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022]
Abstract
Yttria-stabilized tetragonal zirconia polycrystals (Y-TZP), which are partially stabilized zirconia, have been used for fabricating dental implants. This study investigated the soft tissue attachment, the collagen fiber orientation to zirconia at different surface conditions, and the bone response using implantation experiments in animals. The zirconia implant surfaces were treated with ultraviolet irradiation (UV), a combination of large-grit sandblasting and hydrofluoric acid etching (blastedHF), and a combination of blastedHF and UV (blastedHF+UV). The surface treated with blastedHF and blastedHF+UV appeared rough and hydrophilic. The surface treated with blastedHF+UV appeared to be superhydrophilic. Subsequently, tapered cylindrical zirconia implants were placed in the alveolar sockets of the maxillary molars of rats. The bone-to-implant contact ratio of blastedHF and blastedHF+UV implants was significantly higher than that of the non-treated controls and UV-treated implants. The four different surface-treated zirconia implants demonstrated tight soft tissue attachments. Perpendicularly oriented collagen fibers towards zirconia implants were more prominent in blastedHF and blastedHF+UV implants compared to the controls and UV-treated implants. The area of the soft tissue attachment was the greatest with the perpendicularly oriented collagen fibers of blastedHF+UV-treated implants. In conclusion, blastedHF+UV treatment could be beneficial for ensuring greater soft-tissue attachment for zirconia implants.
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Affiliation(s)
- Yohei Iinuma
- Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan;
- Correspondence: ; Tel.: +81-45580-8421
| | - Masatsugu Hirota
- School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan; (M.H.); (T.H.)
| | - Tohru Hayakawa
- School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan; (M.H.); (T.H.)
| | - Chikahiro Ohkubo
- Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan;
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Clinical performance of zirconia implants: A meta-review. J Prosthet Dent 2019; 123:419-426. [PMID: 31451193 DOI: 10.1016/j.prosdent.2019.05.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 12/11/2022]
Abstract
STATEMENT OF PROBLEM The clinical effectiveness of zirconia implants as an alternative to titanium implants is still controversial. PURPOSE The purpose of this analysis was to identify and evaluate systematic reviews reporting on the clinical outcomes of zirconia implants for oral rehabilitation. MATERIAL AND METHODS An electronic search was undertaken on MEDLINE, Embase, and the Cochrane Oral Health Reviews databases up to December 24, 2018, without language restriction. Eligible reviews were screened and assessed. The eligibility criteria were systematic reviews or meta-analyses, implant survival rate, implant success, marginal bone loss, peri-implant soft tissue status, and biologic and functional complications of zirconia implants. Two review authors independently evaluated the quality assessment of the secondary studies by applying the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool. RESULTS Nine reviews fulfilled the inclusion criteria and were evaluated. Seven reviews were classified as moderate and 2 as high quality. The overall AMSTAR's quality of these reports was moderate. In the primary studies contained in these reviews, zirconia implant clinical outcomes were found to be similar or inferior to those for titanium implants. The few primary clinical studies contained in these reviews were not homogeneous among each other, presented poor methodology, and only offered promising short-term outcomes due to the lack of long-term follow-ups. CONCLUSIONS Based on this meta-review, in spite of short-term promising results of zirconia implants, evidence with long term is lacking.
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Marques A, Miranda G, Faria D, Pinto P, Silva F, Carvalho Ó. Novel design of low modulus high strength zirconia scaffolds for biomedical applications. J Mech Behav Biomed Mater 2019; 97:375-384. [PMID: 31170671 DOI: 10.1016/j.jmbbm.2019.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 11/30/2022]
Abstract
This study intends to develop a novel zirconia scaffold design with a significantly lower Young's Modulus than zirconia bulk material (210 GPa) aiming to match this elastic property with that of the host bone, for application as endosseous implants. This scaffold with a complex interconnected structure can allow bone ingrowth, vascularization and provide a good initial stability. This novel thin-walled zirconia scaffold was manufactured by green machining and afterwards furnace sintered. The obtained YM of this zirconia scaffold was found significantly lower than zirconia bulk material due a less stiff geometry with small (walls and floors) dimensions. Insertion replication tests were performed for evaluating the fixation at the initial moment of implantation, being experimentally verified a high static initial coefficient of friction. The capillarity of these scaffolds was also assessed, revealing a very high rising speed of water inside these structures. This study proved that this novel ceramic scaffold design can be fabricated for several dimensions for obtaining desired elastic properties. The proposed fabrication strategy allows the fabrication of thin-walled structures unachievable by conventional machining.
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Affiliation(s)
- Ana Marques
- Center for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal.
| | - Georgina Miranda
- Center for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Diana Faria
- Center for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Paulo Pinto
- Center for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Filipe Silva
- Center for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Óscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS-UMinho), University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
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Thoma DS, Lim HC, Paeng KW, Jung UW, Hämmerle CHF, Jung RE. Tissue integration of zirconia and titanium implants with and without buccal dehiscence defects-A histologic and radiographic preclinical study. Clin Oral Implants Res 2019; 30:660-669. [PMID: 31038788 DOI: 10.1111/clr.13451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 03/01/2019] [Accepted: 04/01/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To histologically and radiographically evaluate soft (primary outcome) and hard tissue integration of two-piece titanium and zirconia dental implants with/without buccal dehiscence defects. MATERIALS & METHODS In six dogs, five implants were randomly placed on both sides of the mandible: (a) Z1: a zirconia implant (modified surface) within the bony housing, (b) Z2: a zirconia implant (standard surface) within the bony housing, (c) T: a titanium implant within the bony housing, (d) Z1_D: a Z1 implant placed with a buccal bone dehiscence (3 mm in height, identical width to implant body), and (e) T_D: a titanium implant placed with a buccal bone dehiscence. Two weeks of healing and 6 months of loading were applied on each hemi-mandible, respectively. RESULTS The median level of the margo mucosae shifted more apically over time in all groups (borderline statistical significance in groups Z1_D: -0.52 mm and T_D: -1.26 mm). The median height of the peri-implant mucosa in groups Z1_D and T_D was greatest at 2 weeks and 6 months, but the linear change in the peri-implant mucosa was statistically significant only for group T_D over time (-1.45 mm). Z1 demonstrated a higher bone-to-implant contact compared to Z2 and T. Minimal change of radiographic marginal bone levels in all groups was observed (<1 mm). CONCLUSION When buccal dehiscence was presented, titanium implants presented significant loss of peri-implant mucosal height compared to zirconia implants with a modified surface, due to greater apical shift of the margo mucosae. A modified zirconia surface enhanced osseointegration.
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Affiliation(s)
- Daniel S Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Hyun-Chang Lim
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.,Department of Periodontology, School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Christoph H F Hämmerle
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Roehling S, Schlegel KA, Woelfler H, Gahlert M. Zirconia compared to titanium dental implants in preclinical studies—A systematic review and meta‐analysis. Clin Oral Implants Res 2019; 30:365-395. [DOI: 10.1111/clr.13425] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 02/27/2019] [Accepted: 03/12/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Stefan Roehling
- Clinic for Oral and Cranio‐Maxillofacial Surgery Hightech Research Center University Hospital Basel University of Basel Basel Switzerland
- Clinic for Oral and Cranio‐Maxillofacial Surgery Kantonsspital Aarau Aarau Switzerland
- Unit for Oral & Maxillofacial Surgery Medical Healthcare Center Lörrach Lörrach Germany
| | - Karl A. Schlegel
- Private Clinic for Oral and Maxillofacial Surgery Prof. Schlegel Munich Germany
- Maxillofacial Surgery Department University Hospital Erlangen University of Erlangen Erlangen Germany
| | | | - Michael Gahlert
- Clinic for Oral and Cranio‐Maxillofacial Surgery Hightech Research Center University Hospital Basel University of Basel Basel Switzerland
- Dental Clinic for Oral Surgery and Implant Dentistry Prof. Gahlert Munich Germany
- Department for Oral Surgery Faculty of Medicine Sigmund Freud University Vienna Vienna Austria
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Schünemann FH, Galárraga-Vinueza ME, Magini R, Fredel M, Silva F, Souza JCM, Zhang Y, Henriques B. Zirconia surface modifications for implant dentistry. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 98:1294-1305. [PMID: 30813009 DOI: 10.1016/j.msec.2019.01.062] [Citation(s) in RCA: 127] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Zirconia has emerged as a versatile dental material due to its excellent aesthetic outcomes such as color and opacity, unique mechanical properties that can mimic the appearance of natural teeth and decrease peri-implant inflammatory reactions. OBJECTIVE The aim of this review was to critically explore the state of art of zirconia surface treatment to enhance the biological and osseointegration behavior of zirconia in implant dentistry. MATERIALS AND METHODS An electronic search in PubMed database was carried out until May 2018 using the following combination of key words and MeSH terms without time periods: "zirconia surface treatment" or "zirconia surface modification" or "zirconia coating" and "osseointegration" or "biological properties" or "bioactivity" or "functionally graded properties". RESULTS Previous studies have reported the influence of zirconia-based implant surface on the adhesion, proliferation, and differentiation of osteoblast and fibroblasts at the implant to bone interface during the osseointegration process. A large number of physicochemical methods have been used to change the implant surfaces and therefore to improve the early and late bone-to-implant integration, namely: acid etching, gritblasting, laser treatment, UV light, CVD, and PVD. The development of coatings composed of silica, magnesium, graphene, dopamine, and bioactive molecules has been assessed although the development of a functionally graded material for implants has shown encouraging mechanical and biological behavior. CONCLUSION Modified zirconia surfaces clearly demonstrate faster osseointegration than that on untreated surfaces. However, there is no consensus regarding the surface treatment and consequent morphological aspects of the surfaces to enhance osseointegration.
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Affiliation(s)
- Fernanda H Schünemann
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - María E Galárraga-Vinueza
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - Ricardo Magini
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - Márcio Fredel
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil
| | - Filipe Silva
- CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal
| | - Júlio C M Souza
- CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal; Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra, Portugal
| | - Yu Zhang
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, NYU, New York, NY 10010, USA
| | - Bruno Henriques
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil; CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal.
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Maiborodin IV, Shevela AA, Toder MS, Shevela AI. [Current trends of the choice and processing of materials for dental implantation]. STOMATOLOGII︠A︡ 2018; 97:68-76. [PMID: 30199073 DOI: 10.17116/stomat20189704168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For assessment of the modern situation about the choice of materials for manufacture of dental implants and the processing of their surface the scientific literature for the last 2 years was study. On the basis of a large number of contradictory results of the researches devoted to each of dental implantation problems it is possible to draw a conclusion that any of primal problems of implantology is finally not solved. There is no unique opinion at the choice of optimum material for manufacture of dental implants, at the way of processing and modification of their surface. The problem of improvement of quality of dental implantation and fight against complications of this procedure cannot be solved simple drawing other substances on the implanted material surface, this task more easily and more successfully is solved via changes of product structure and various modification of implant surface. Up to the present the researches of an opportunity to influence on characteristics of the implanted materials, changing their structure and character of a surface, continue. And the publications reporting about the considerable positive effect of artificially created roughnesses on product surfaces, and the articles claiming that there are no big differences between the rough and polished implants are confirmed by objective measurements with statistical processing of the obtained data. It should be noted that among articles there are very many works of the doubtful plan or with insufficiently valid conclusions. This review leads to the conclusion that further clinical and experimental studies and about the choice of materials for manufacture of implants and at the ways of processing of their surface are necessary.
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Affiliation(s)
- I V Maiborodin
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
| | - A A Shevela
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - M S Toder
- International Center of Implantology of iDent, Novosibirsk, Russia
| | - A I Shevela
- Institute of Chemical Biology and Fundamental Medicine, Russian Academy of Science, Siberian Branch, Novosibirsk, Russia
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Current status of zirconia implants in dentistry: preclinical tests. J Prosthodont Res 2018; 63:1-14. [PMID: 30205949 DOI: 10.1016/j.jpor.2018.07.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/18/2018] [Accepted: 07/26/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE This systematic review aimed to provide an overview of zirconia implants as well as regarding the outcome of the implant-restorative complex in preclinical studies. STUDY SELECTION An electronic search of the literature prior to July 2017 was performed to identify all articles related to preclinical research on zirconia implants. The search was conducted using MEDLINE (National Library of Medicine) and PubMed without restrictions concerning the date of publication. The search terminology included: zirconia implant, osseointegration, bone-to-implant contact, soft tissue, histology, histomorphometry, surface modification, surface roughness, surface characteristics, and restoration (connecting multiple keywords with AND, OR). RESULTS Fifty-seven studies were finally selected from an initial yield of 654 titles, and the data were extracted. The identified preclinical studies focused on several aspects related to zirconia implants, namely biocompatibility, mechanical properties, implant design, osseointegration capacity, soft tissue response, and restorative options. Due to heterogeneity of the studies, a meta-analysis was not possible. The most frequently used zirconia material for the fabrication of implants is yttria-stabilized tetragonal zirconia polycrystal. The resistance-to-fracture for zirconia implants ranged between 516-2044N. The mostly investigated parameter was osseointegration, which is compared to that of titanium. A lack of evidence was found with other parameters. CONCLUSIONS Due to its good biocompatibility as well as favorable physical and mechanical properties, zirconia implants are a potential alternative to titanium implants. However, knowledge regarding the implant-restorative complex and related aspects is still immature to recommend its application for daily practice.
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Altay MA, Sindel A, Özalp Ö, Yildirimyan N, Kader D, Bilge U, Baur DA. Does the Intake of Selective Serotonin Reuptake Inhibitors Negatively Affect Dental Implant Osseointegration? A Retrospective Study. J ORAL IMPLANTOL 2018. [DOI: 10.1563/aaid-joi-d-17-00240] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The success of osseointegration is influenced by several factors that affect bone metabolism and by certain systemic medications. Selective serotonin reuptake inhibitors (SSRIs) have been previously suggested to be among these medications. This study aims to investigate the association between systemic intake of SSRIs and failure of osseointegration in patients rehabilitated with dental implants. A retrospective cohort study was conducted, including a total of 2055 osseointegrated dental implants in 631 patients (109 implants in 36 SSRI \users and 1946 in 595 nonusers). Predictor and outcome variables were SSRI intake and osseointegration failure, respectively. The data were analyzed with Mann–Whitney test or Fisher exact test accordingly. Both patient-level and implant-level models were implemented to evaluate the effect of SSRI exposure on the success of osseointegration of dental implants. Median duration of follow-up was 21.5 months (range = 4–56 months) for SSRI users and 23 months (range –60 months) for nonusers (P = .158). Two of 36 SSRI users had 1 failed implant each; thus, the failure rate was 5.6%. Eleven nonusers also had 1 failed implant each; thus, the failure rate was 1.85%. The difference between the 2 groups failed to reach statistical significance at patient and implant levels (P = .166, P = .149, respectively). The odds of implant failure were 3.123 times greater for SSRI users compared with nonusers. Patients using SSRIs were found to be 3.005 times more likely to experience early implant failure than nonusers. The results of this study suggest that SSRIs may lead to increase in the rate of osseointegration failure, although not reaching statistical significance.
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Affiliation(s)
- Mehmet Ali Altay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Sindel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Öznur Özalp
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Nelli Yildirimyan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Dinçer Kader
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Uğur Bilge
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Dale A. Baur
- Department of Oral and Maxillofacial Surgery, Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio
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da Costa Fernandes CJ, Ferreira MR, Bezerra FJB, Zambuzzi WF. Zirconia stimulates ECM-remodeling as a prerequisite to pre-osteoblast adhesion/proliferation by possible interference with cellular anchorage. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2018; 29:41. [PMID: 29582191 DOI: 10.1007/s10856-018-6041-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
The biological response to zirconia (ZrO2) is not completely understood, which prompted us to address its effect on pre-osteoblastic cells in both direct and indirect manner. Our results showed that zirconia triggers important intracellular signaling mainly by governing survival signals which leads to cell adhesion and proliferation by modulating signaling cascade responsible for dynamic cytoskeleton rearrangement, as observed by fluorescence microscopy. The phosphorylations of Focal Adhesion Kinase (FAK) and Rac1 decreased in response to ZrO2 enriched medium. This corroborates the result of the crystal violet assay, which indicated a significant decrease of pre-osteoblast adhesion in responding to ZrO2 enriched medium. However, we credit this decrease on pre-osteoblast adhesion to the need to govern intracellular repertory of intracellular pathways involved with cell cycle progression, because we found a significant up-phosphorylation of Mitogen-Activated Protein Kinase (MAPK)-p38 and Cyclin-dependent kinase 2 (CDK2), while p15 (a cell cycle suppressor) decreased. Importantly, Protein phosphatase 2 A (PP2A) activity decreased, guaranteeing the significant up-phosphorylation of MAPK -p38 in response to ZrO2 enriched medium. Complementarily, there was a regulation of Matrix Metalloproteinases (MMPs) in response to Zirconia and this remodeling could affect cell phenotype by interfering on cell anchorage. Altogether, our results show a repertory of signaling molecules, which suggests that ECM remodel as a pre-requisite to pre-osteoblast phenotype by affecting their anchoring in responding to zirconia.
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Affiliation(s)
- Celio J da Costa Fernandes
- Bioassays and Cell Dynamics Lab, Dept. of Chemistry and Biochemistry, Bioscience Institute, Universidade Estadual Paulista - UNESP, Botucatu, Sao Paulo, Brazil
| | - Marcel Rodrigues Ferreira
- Bioassays and Cell Dynamics Lab, Dept. of Chemistry and Biochemistry, Bioscience Institute, Universidade Estadual Paulista - UNESP, Botucatu, Sao Paulo, Brazil
| | - Fábio J B Bezerra
- Bioassays and Cell Dynamics Lab, Dept. of Chemistry and Biochemistry, Bioscience Institute, Universidade Estadual Paulista - UNESP, Botucatu, Sao Paulo, Brazil
| | - Willian F Zambuzzi
- Bioassays and Cell Dynamics Lab, Dept. of Chemistry and Biochemistry, Bioscience Institute, Universidade Estadual Paulista - UNESP, Botucatu, Sao Paulo, Brazil.
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Martins R, Cestari TM, Arantes RVN, Santos PS, Taga R, Carbonari MJ, Oliveira RC. Osseointegration of zirconia and titanium implants in a rabbit tibiae model evaluated by microtomography, histomorphometry and fluorochrome labeling analyses. J Periodontal Res 2017; 53:210-221. [PMID: 29044523 DOI: 10.1111/jre.12508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES This study compares the osseointegration of machined-zirconia implants containing yttria (M-Y-TZP) with machined (M-Ti) and resorbable blast media (RBM-Ti) titanium implants. MATERIAL AND METHODS M-Y-TZP, M-Ti and RBM-Ti implants were randomly placed in rabbit tibiae. Fluorochrome bone labels (tetracycline, alizarin and calcein) were administered at different time periods. After 8 weeks, osseointegration was evaluated in terms of bone-to-implant contact (BIC), new bone area (nBA), remaining cortical bone area (rBA) and temporal quantification of fluorochromes, using micro-CT and histomorphometric analyses. RESULTS RBM-Ti implants showed higher resorption of the remaining cortical bone and bone formation (rBA = 36.9% and nBA = 38.8%) than M-Y-TZP implants (rBA = 48% and nBA = 26.5%). The BIC values showed no differences among the groups in the cortical region (mean = 52.2%) but in the medullary region, they were 0.45-fold higher in the RBM-Ti group (51.2%) than in the M-Y-TZP group (35.2%). In all groups, high incorporation of tetracycline was observed (2nd to 4th weeks), followed by alizarin (4th to 6th weeks) and calcein (6th to 8th weeks). In the cortical region, incorporation of tetracycline was similar between RBM-Ti (49.8%) and M-Y-TZP (35.9%) implants, but higher than M-Ti (28.2%) implants. Subsequently, alizarin and calcein were 1.1-fold higher in RBM-Ti implants than in the other implants. In the medullary region, no significant differences were observed for all fluorochromes. CONCLUSION All implants favored bone formation and consequently promoted primary stability. Bone formation around the threads was faster in RBM-Ti and M-Y-TZP implants than in M-Ti implants, but limited bone remodeling with M-Y-TZP implants over time can have significant effects on secondary stability, suggesting caution for its use as an alternative substitute for titanium implants.
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Affiliation(s)
- R Martins
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - T M Cestari
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - R V N Arantes
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - P S Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - R Taga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - M J Carbonari
- Insper - Instituto de Ensino e Pesquisa, São Paulo, SP, Brazil
| | - R C Oliveira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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