The biologic tissue responses to uncoated and coated implanted biomaterials

Implications of graphene-based materials in dentistry: present and future

Since the advent of nanoscience, nanobiomaterials have been applied in the dental industry. Graphene and its derivatives have attracted the most interest of all of them due to their exceptional look, biocompatibility, multiplication differential, and antibacterial capabilities. We outlined the most recent developments about their applications to dentistry in our review. There is discussion of the synthesis processes, architectures, and characteristics of materials based on graphene. The implications of graphene and its counterparts are then meticulously gathered and described. Finally, in an effort to inspire more excellent research, this paper explores the obstacles and potential of graphene-based nanomaterials for dental aspects.

A Beginner’s Guide to the Characterization of Hydrogel Microarchitecture for Cellular Applications

The extracellular matrix (ECM) is a three-dimensional, acellular scaffold of living tissues. Incorporating the ECM into cell culture models is a goal of cell biology studies and requires biocompatible materials that can mimic the ECM. Among such materials are hydrogels: polymeric networks that derive most of their mass from water. With the tuning of their properties, these polymer networks can resemble living tissues. The microarchitectural properties of hydrogels, such as porosity, pore size, fiber length, and surface topology can determine cell plasticity. The adequate characterization of these parameters requires reliable and reproducible methods. However, most methods were historically standardized using other biological specimens, such as 2D cell cultures, biopsies, or even animal models. Therefore, their translation comes with technical limitations when applied to hydrogel-based cell culture systems. In our current work, we have reviewed the most common techniques employed in the characterization of hydrogel microarchitectures. Our review provides a concise description of the underlying principles of each method and summarizes the collective data obtained from cell-free and cell-loaded hydrogels. The advantages and limitations of each technique are discussed, and comparisons are made. The information presented in our current work will be of interest to researchers who employ hydrogels as platforms for cell culture, 3D bioprinting, and other fields within hydrogel-based research.

Graphene-Based Nanomaterials for Dental Applications: Principles, Current Advances, and Future Outlook

With the development of nanotechnology, nanomaterials have been used in dental fields over the past years. Among them, graphene and its derivatives have attracted great attentions, owing to their excellent physicochemical property, morphology, biocompatibility, multi-differentiation activity, and antimicrobial activity. In our review, we summarized the recent progress about their applications on the dentistry. The synthesis methods, structures, and properties of graphene-based materials are discussed. Then, the dental applications of graphene-based materials are emphatically collected and described. Finally, the challenges and outlooks of graphene-based nanomaterials on the dental applications are discussed in this paper, aiming at inspiring more excellent studies.

Influence of a novel scaffold composed of polyurethane, hydroxyapatite, and decellularized bone particles on the healing of fourth metacarpal defects in mares

OBJECTIVE

To determine the effect of a novel scaffold, designed for use in bone regeneration, on healing of splint bone segmental defects in mares.

STUDY DESIGN

In vivo experimental study.

SAMPLE POPULATION

Five adult mares (4-10 years old; mean weight, 437.7 kg ± 29 kg).

METHODS

Bilateral 2-cm full-thickness defects were created in the fourth metacarpal bones (MCIV) of each horse. Each defect was randomly assigned to either a novel scaffold treatment (n = 5) or an untreated control (n = 5). The scaffold was composed of polyurethane, hydroxyapatite, and decellularized bone particles. Bone healing was assessed for a period of 60 days by thermography, ultrasonography, radiography, and computed tomography (CT). Biopsies of each defect were performed 60 days after surgery for histological evaluation.

RESULTS

On the basis of radiographic analysis, scaffold-treated defects had greater filling (67.42% ± 26.7%) compared with untreated defects (35.88% ± 32.7%; P = .006). After 60 days, CT revealed that the density of the defects treated with the scaffolds (807.80 ± 129.6 Hounsfield units [HU]) was greater than density of the untreated defects (464.80 ± 81.3 HU; P = .004). Evaluation of histology slides provided evidence of bone formation within an average of 9.43% ± 3.7% of the cross-sectional area of scaffolds in contrast to unfilled defects in which connective tissue was predominant throughout the biopsy specimens.

CONCLUSION

The novel scaffold was biocompatible and supported bone formation within the MCIV segmental defects.

CLINICAL SIGNIFICANCE

This novel scaffold offers an effective option for filling bone voids in horses when support of bone healing is indicated.

Osseointegration and current interpretations of the bone-implant interface

Complex physical and chemical interactions take place in the interface between the implant surface and bone. Various descriptions of the ultrastructural arrangement to various implant design features, ranging from solid and macroporous geometries to surface modifications on the micron-, submicron-, and nano- levels, have been put forward. Here, the current knowledge regarding structural organisation of the bone-implant interface is reviewed with a focus on solid devices, mainly metal (or alloy) intended for permanent anchorage in bone. Certain biomaterials that undergo surface and bulk degradation are also considered. The bone-implant interface is a heterogeneous zone consisting of mineralised, partially mineralised, and unmineralised areas. Within the meso-micro-nano-continuum, mineralised collagen fibrils form the structural basis of the bone-implant interface, in addition to accumulation of non-collagenous macromolecules such as osteopontin, bone sialoprotein, and osteocalcin. In the published literature, as many as eight distinct arrangements of the bone-implant interface ultrastructure have been described. The interpretation is influenced by the in vivo model and species-specific characteristics, healing time point(s), physico-chemical properties of the implant surface, implant geometry, sample preparation route(s) and associated artefacts, analytical technique(s) and their limitations, and non-compromised vs compromised local tissue conditions. The understanding of the ultrastructure of the interface under experimental conditions is rapidly evolving due to the introduction of novel techniques for sample preparation and analysis. Nevertheless, the current understanding of the interface zone in humans in relation to clinical implant performance is still hampered by the shortcomings of clinical methods for resolving the finer details of the bone-implant interface. STATEMENT OF SIGNIFICANCE: Being a hierarchical material by design, the overall strength of bone is governed by composition and structure. Understanding the structure of the bone-implant interface is essential in the development of novel bone repair materials and strategies, and their long-term success. Here, the current knowledge regarding the eventual structural organisation of the bone-implant interface is reviewed, with a focus on solid devices intended for permanent anchorage in bone, and certain biomaterials that undergo surface and bulk degradation. The bone-implant interface is a heterogeneous zone consisting of mineralised, partially mineralised, and unmineralised areas. Within the meso-micro-nano-continuum, mineralised collagen fibrils form the structural basis of the bone-implant interface, in addition to accumulation of non-collagenous macromolecules such as osteopontin, bone sialoprotein, and osteocalcin.

Enhanced Osseointegration of Hierarchically Structured Ti Implant with Electrically Bioactive SnO2-TiO2 Bilayered Surface

The poor osseointegration of Ti implant significantly compromise its application in load-bearing bone repair and replacement. Electrically bioactive coating inspirited from heterojunction on Ti implant can benefit osseointegration but cannot avoid the stress shielding effect between bone and implant. To resolve this conflict, hierarchically structured Ti implant with electrically bioactive SnO₂-TiO₂ bilayered surface has been developed to enhance osseointegration. Benefiting from the electric cue offered by the built-in electrical field of SnO₂-TiO₂ heterojunction and the topographic cue provided by the hierarchical surface structure to bone regeneration, the osteoblastic function of basic multicellular units around the implant is significantly improved. Because the individual TiO₂ or SnO₂ coating with uniform surface exhibits no electrical bioactivity, the effects of electric and topographic cues to osseointegration have been decoupled via the analysis of in vivo performance for the placed Ti implant with different surfaces. The developed Ti implant shows significantly improved osseointegration with excellent bone-implant contact, improved mineralization of extracellular matrix, and increased push-out force. These results suggest that the synergistic strategy of combing electrical bioactivity with hierarchical surface structure provides a new platform for developing advanced endosseous implants.

Graphene as an Enabling Strategy for Dental Implant and Tissue Regeneration

Graphene-based approaches have been influential in the design and manipulation of dental implants and tissue regeneration to overcome the problems associated with traditional titanium-based dental implants, such as their low biological affinity. Here, we describe the current progress of graphene-based platforms, which have contributed to major advances for improving cellular functions in in vitro and in vivo applications of dental implants. We also present opinions on the principal challenges and future prospects for new graphene-based platforms for the development of advanced graphene dental implants and tissue regeneration.

Synergistic effects of surface chemistry and topologic structure from modified microarc oxidation coatings on Ti implants for improving osseointegration

Microarc oxidation (MAO) coating containing Ca, P, Si, and Na elements on a titanium (Ti) implant has been steam-hydrothermally treated and further mediated by post-heat treatment to overcome the compromised bone-implant integration. The bone regeneration, bone-implant contact, and biomechanical push-out force of the modified Ti implants are discussed thoroughly in this work. The best in vivo performances for the steam-hydrothermally treated one is attributed to the synergistic effects of surface chemistry and topologic structure. Through post-heat treatment, we can decouple the effects of surface chemistry and the nanoscale topologic structure easily. Attributed to the excellent in vivo performance of the surface-modified Ti implant, the steam-hydrothermal treatment could be a promising strategy to improve the osseointegration of the MAO coating covered Ti implant.

Resolving the CaP-bone interface: a review of discoveries with light and electron microscopy

It has long been known that the interfacial relationship between synthetic materials and tissue is influential in the success of implant materials. Instability at the implant interface has been shown, in some cases, to lead to complete implant failure. Bioceramics, and in particular calcium phosphates, form a large fraction of the implantable devices on the market today due to the biocompatibility they exhibit in contact with bone and tooth-like tissues. The characterization of such bioceramic-tissue interfaces has played a crucial role in understanding the behavior of bioceramics in vivo. In this review, we shed light on the preparation methods, technological approaches and key advances in resolving the interface between calcium phosphate bioceramics and bone, and share a future outlook on this field.

The effect of novel fluorapatite surfaces on osteoblast-like cell adhesion, growth, and mineralization

There is increasing demand for biomedical implants to correct skeletal defects caused by trauma, disease, or genetic disorder. In this study, the MG-63 cells were grown on metals coated with ordered and disordered fluorapatite (FA) crystal surfaces to study the biocompatibility, initial cellular response, and the underlying mechanisms during this process. The long-term growth and mineralization of the cells were also investigated. After 3 days, the cell numbers on etched metal surface are significantly higher than those on the ordered and disordered FA surfaces, but the initial adherence of a greater number of cells did not lead to earlier mineral formation at the cell-implant interface. Of the 84 cell adhesion and matrix-focused pathway genes, an up- or down-regulation of a total of 15 genes such as integrin molecules, integrin alpha M and integrin alpha 7 and 8 was noted, suggesting a modulating effect on these adhesion molecules by the ordered FA surface compared with the disordered. Osteocalcin expression and the mineral nodule formation are most evident on the FA surfaces after osteogenic induction (OI) for 7 weeks. The binding of the ordered FA surfaces to the metal, with and without OI, was significantly higher than that of the disordered FA surfaces with OI. Most significantly, even without the OI supplement, the MG-63 cells grown on FA crystal surfaces start to differentiate and mineralize, suggesting that the FA crystal could be a simple and bioactive implant coating material.

Soft tissue considerations in implant site development

Healthy soft tissue surrounding a dental implant is essential for health, function, and esthetics. The development of the tooth includes the formation of a biologic connection between the living tissues that has to be created during the healing process after placement of the implant. The success of dental implants is dependent on the establishment of a soft-tissue barrier that is able to shelter the underlying osseous structures and the osseointegration surrounding the implant body. The esthetics of a dental implant prosthesis depends on the health and stability of the peri-implant mucosa. Understanding of soft-tissue healing and maintenance around dental implants is paramount for implant success. This article discusses the soft-tissue interface, aspects of soft-tissue health, and esthetics during treatment planning and therapy.

Titanium oral implants: surface characteristics, interface biology and clinical outcome

Bone-anchored titanium implants have revolutionized oral healthcare. Surface properties of oral titanium implants play decisive roles for molecular interactions, cellular response and bone regeneration. Nevertheless, the role of specific surface properties, such as chemical and phase composition and nanoscale features, for the biological in vivo performance remains to be established. Partly, this is due to limited transfer of state-of-the-art preparation techniques to complex three-dimensional geometries, analytical tools and access to minute, intact interfacial layers. As judged by the available results of a few randomized clinical trials, there is no evidence that any particular type of oral implant has superior long-term success. Important insights into the recruitment of mesenchymal stem cells, cell-cell communication at the interface and high-resolution imaging of the interface between the surface oxide and the biological host are prerequisites for the understanding of the mechanisms of osseointegration. Strategies for development of the next generation of material surface modifications for compromised tissue are likely to include time and functionally programmed properties, pharmacological modulation and incorporation of cellular components.

Increased osteoblast functions on theta+delta nanofiber alumina

Nanophase materials, or materials with grain sizes less than 100 nm in at least one direction, are promising materials for various implant applications since our tissues are composed of nanometer components (i.e., proteins and/or inorganics). Specifically, bone is comprised of nanostructured hydroxyapatite and collagen fibers which continuously provide an extracellular matrix surface to bone-forming cells (osteoblasts) with a high degree of nanometer roughness. Despite this fact, materials currently utilized for orthopedic implants, whether metallic or ceramic, have constituent grain sizes in the non-biologically inspired micron regime. For this reason, the objective of the present in vitro study was to determine osteoblast functions on one classification of nanomaterials for orthopedic applications: nanofiber alumina. Various crystalline forms of nanofiber alumina were tested in this study. To obtained different crystalline structured nanofiber alumina, boehmite nanofiber alumina was sintered at either 400 degrees C, 600 degrees C, 800 degrees C, 1000 degrees C, or 1200 degrees C for 2 h in air. X-ray diffraction results provided evidence that boehmite nanofiber alumina remained boehmite when sintered at 400 degrees C but changed crystalline phases to gamma, gamma + delta, theta + delta, and alpha when sintered at 600 degrees C, 800 degrees C, 1000 degrees C, and 1200 degrees C, respectively. Moreover, compared to any other alumina formulation tested in this study, osteoblast functions (as measured by alkaline phosphatase activity and calcium deposition) were the greatest on theta + delta crystalline phase nanofiber alumina after 14 days of culture. Boehmite had the next greatest amount of calcium deposition by osteoblasts followed by gamma + delta. Gamma crystalline phase then followed and was greater than alpha crystalline phase nanofiber alumina which promoted osteoblast functions the least of all the compacts with the exception of borosilicate glass (reference substrate). For this reason, this study suggests that theta+delta nanofiber alumina should be further investigated in orthopedic applications.

Osteoblast function on nanophase alumina materials: Influence of chemistry, phase, and topography

Alumina is a material that has been used in both dental and orthopedic applications. It is with these uses in mind that osteoblast (bone-forming cell) function on alumina of varying particulate size, chemistry, and phase was tested in order to determine what formulation might be the most beneficial for bone regeneration. Specifically, in vitro osteoblast adhesion, proliferation, intracellular alkaline phosphatase activity, and calcium deposition was observed on delta-phase nanospherical, alpha-phase conventional spherical, and boehmite nanofiber alumina. Results showed for the first time increased osteoblast functions on the nanofiber alumina. Specifically, a 16% increase in osteoblast adhesion over nanophase spherical alumina and a 97% increase over conventional spherical alumina were found for nanofiber alumina after 2 h. A 29% increase in cell number after 5 days and up to a 57% greater amount of calcium was found on the surface of the nanofiber alumina compared with other alumina surfaces. Some of the possible explanations for such enhanced osteoblast behavior on nanofiber alumina may be attributed to chemistry, crystalline phase, and topography. Increased osteoblast function on nanofiber alumina suggests that it may be an ideal material for use in orthopedic and dental applications.