Evaluation of the effects of different sand particles that used in dental implant roughened for osseointegration

Osteoblast cell behavior on polyetheretherketone dental implant surfaces treated with different grit size aluminum oxide particles: An in vitro analysis

STATEMENT OF PROBLEM

The hydrophobic and bioinert nature of polyetheretherketone (PEEK) implants needs to be addressed for successful osseointegration.

PURPOSE

The purpose of this in vitro study was to evaluate the osteoblast cell behavior on PEEK implant surfaces treated with airborne-particle abrasion using different grit size aluminum oxide (Al2O3) particles.

MATERIAL AND METHODS

Disk-shaped specimens (n=96) were prepared from medical grade PEEK rods and were distributed into 4 groups (n=24) of untreated PEEK (PEEK 0), airborne-particle abrasion using 50-μm Al2O3 particles (PEEK 50), airborne-particle abrasion using 110-μm Al2O3 particles (PEEK 110), and airborne-particle abrasion using 150-μm Al2O3 particles (PEEK 150). The surface characteristics were assessed using water contact angle (WCA) measurements and scanning electron microscopy (SEM). MG-63 osteoblast cells were cultured, and the biocompatibility of PEEK was assessed using a CellTiter-blue cell viability assay and florescence staining at day 1, 3, and 7. The specimens were stained with Alizarin red to assess the osteoblast cell differentiation on day 10 and 14. The Levene test was used to test the homogeneity of variances. One-way and Welch ANOVA with post hoc corrections were used to assess the overall statistical significance of differences among the groups (α=.05).

RESULTS

The lowest mean WCA was demonstrated in PEEK 150 (49.25 ±5.51) and the highest in PEEK 0 (89.14 ±4.24) (P<.001). SEM images of PEEK 150 illustrated a more complex structure with a large area of globular outcroppings throughout the surface. PEEK 150 showed the highest cell metabolic activity at each time point with florescence staining showing a substantial cell confluence at day 3 and 7. Although PEEK 150 did not show a significant increase in cell proliferation, the number of cells attached was significantly higher than other groups (P<.05). PEEK 110 and 150 also showed a substantial increase in the extent of mineralization.

CONCLUSIONS

Airborne-particle abrasion using moderate Al2O3 grit size (110- or 150-μm) improved the hydrophilicity and osteoblast cell behavior on PEEK implants.

Clinical study with sandblasted dental implants: a 17-year retrospective follow up

Sandblasting is a standard procedure used for treating dental implant (DI) surfaces to enhance the osseointegration with known clinical success. This clinical study aimed to evaluate the long-term clinical outcomes of DIs with external hexagon connections and a surface sandblasted with calcium phosphate. Two hundred and seventy-five Mg-osseous™ (Mozo-Grau™) screw DIs were placed in 86 patients using a two-stage surgical technique and conventional loading protocol (at three months). Dental implants and prosthetic clinical findings were evaluated during a 17-year follow up. Four DIs were lost during the healing period, and 108 prostheses were placed over the 271 DIs left: 58 unitary implant-supported prosthesis (ISP), 31 partially ISP, 14 full-arch ISP, and five overdentures. Fourteen DIs were lost during the follow-up period. Clinical results indicated a DI survival rate of 93.50%. A total of 11.80% of DIs showed peri-implantitis as the primary biological complication. The mean (SD) marginal bone loss was 1.78 (0.40) mm, ranging from 0.90 to 2.80 mm. The most frequent complication was mechanical prosthodontic complications (24.40%). Sandblasted surface DIs inserted in both maxillary and mandibular areas produce favourable long-term (17-year follow up) outcomes and stable tissue conditions when a delayed loading protocol is followed.

Evaluation of bone apposition on surface modified titanium implant in experimental animal model: A systematic review and meta-analysis

Purpose

To evaluate the response of peri-implant bone to smooth (machined) surface and surface-modified dental implants in healthy experimental animal models.

Materials and Methods

Systematic electronic search was done for using PUBMED, SCOPUS, WEB OF SCIENCE, and EMBASE databases for potentially relevant records from the last 20 years. Duplicate screening and data extraction were performed to formulate the evidence tables and meta-analysis following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The outcome criteria were: 1. Bone Implant Contact (BIC) in percentage, 2. Removal Torque Values (RTV) in Ncm, 3. Implant stability Quotient (ISQ), Quality assessment was done using the ARRIVE (Animal Research: Reporting of In Vivo Experiments) guidelines and SYRCLE RoB (Systematic Review Centre for Laboratory Animal Experimentation Risk of Bias) tool.

Results

Results were expressed as pooled mean difference for the respective groups viz. sandblasted and acid etched, laser modified, acid etched and anodized surface. The surface modified implants revealed somewhat higher BIC over machined surface (P < 0.01). Forest plot were drawn for all the outcome variables.

Conclusions

Within the limitations of this study, the authors found a higher degree of osseointegration pertaining to bone to implant interface, RTV, and implant stability quotient (ISQ) with surface modified procedures which seemed to promote bone formation around peri-implant tissue during the early stages of healing. After analyzing all 37 included publications for the outcome of interest (BIC%, RTV, ISQ), a positive outcome was obtained for both subtractive and additive implant surface modifying procedures over machined implant surfaces when the data were pooled together. More advanced research work on healthy animal models needs to be investigated to review the impact of surface modifications on dental implant osseointegration.

Preparation and Characterization of a Polyetherketoneketone/Hydroxyapatite Hybrid for Dental Applications

Here, we developed a new synthetic method for the production of a new class of polymeric inorganic hybrid biomaterial that has potential for dental implant applications and, in general, other orthopedic applications owing to its excellent mechanical properties and biomechanical compatibility. The new hybrid biomaterial is a composite consisting of polyetherketoneketone (PEKK) and hydroxyapatite (HA). This hybrid material boasts several unique features, including its high HA loading (up to 50 wt%), which is close to that of natural human bone; the homogeneous HA distribution in the PEKK matrix without phase separation; and the fact that the addition of HA has no effect on the molecular weight of PEKK. Nanoindentation analysis was used to investigate the mechanical properties of the composite, and its nano/microstructure variations were investigated through a structural model developed here. Through nanoindentation technology, the newly developed PEKK/HA hybrid biomaterial has an indentation modulus of 12.1 ± 2.5 GPa and a hardness of 0.42 ± 0.09 GPa, which are comparable with those of human bone. Overall, the new PEKK/HA biomaterial exhibits excellent biomechanical compatibility and shows great promise for application to dental and orthopedic devices.

Advances in Barrier Membranes for Guided Bone Regeneration Techniques

Guided bone regeneration (GBR) is a widely used technique for alveolar bone augmentation. Among all the principal elements, barrier membrane is recognized as the key to the success of GBR. Ideal barrier membrane should have satisfactory biological and mechanical properties. According to their composition, barrier membranes can be divided into polymer membranes and non-polymer membranes. Polymer barrier membranes have become a research hotspot not only because they can control the physical and chemical characteristics of the membranes by regulating the synthesis conditions but also because their prices are relatively low. Still now the bone augment effect of barrier membrane used in clinical practice is more dependent on the body’s own growth potential and the osteogenic effect is difficult to predict. Therefore, scholars have carried out many researches to explore new barrier membranes in order to improve the success rate of bone enhancement. The aim of this study is to collect and compare recent studies on optimizing barrier membranes. The characteristics and research progress of different types of barrier membranes were also discussed in detail.

Latest Trends in Surface Modification for Dental Implantology: Innovative Developments and Analytical Applications

An increase in the world population and its life expectancy, as well as the ongoing concern about our physical appearance, have elevated the relevance of dental implantology in recent decades. Engineering strategies to improve the survival rate of dental implants have been widely investigated, focusing on implant material composition, geometry (usually guided to reduce stiffness), and interface surrounding tissues. Although efforts to develop different implant surface modifications are being applied in commercial dental prostheses today, the inclusion of surface coatings has gained special interest, as they can be tailored to efficiently enhance osseointegration, as well as to reduce bacterial-related infection, minimizing peri-implantitis appearance and its associated risks. The use of biomaterials to replace teeth has highlighted the need for the development of reliable analytical methods to assess the therapeutic benefits of implants. This literature review considers the state-of-the-art strategies for surface modification or coating and analytical methodologies for increasing the survival rate for teeth restoration.

Low Cycle Fatigue Performance of Additively Processed and Heat-Treated Ti-6Al-7Nb Alloy for Biomedical Applications

In biomedical engineering, laser powder bed fusion is an advanced manufacturing technology, which enables, for example, the production of patient-customized implants with complex geometries. Ti-6Al-7Nb shows promising improvements, especially regarding biocompatibility, compared with other titanium alloys. The biocompatible features are investigated employing cytocompatibility and antibacterial examinations on Al2O3-blasted and untreated surfaces. The mechanical properties of additively manufactured Ti-6Al-7Nb are evaluated in as-built and heat-treated conditions. Recrystallization annealing (925 °C for 4 h), β annealing (1050 °C for 2 h), as well as stress relieving (600 °C for 4 h) are applied. For microstructural investigation, scanning and transmission electron microscopy are performed. The different microstructures and the mechanical properties are compared. Mechanical behavior is determined based on quasi-static tensile tests and strain-controlled low cycle fatigue tests with total strain amplitudes εA of 0.35%, 0.5%, and 0.8%. The as-built and stress-relieved conditions meet the mechanical demands for the tensile properties of the international standard ISO 5832-11. Based on the Coffin–Manson–Basquin relation, fatigue strength and ductility coefficients, as well as exponents, are determined to examine fatigue life for the different conditions. The stress-relieved condition exhibits, overall, the best properties regarding monotonic tensile and cyclic fatigue behavior.

Effects of local application of the ankaferd blood stopper on osseointegration in three different surface titanium implants

Objective

Researchs of the effects of ankaferd blood stopper (ABS) on bone healing metabolism have revealed that it affects bone regeneration positively. The exact mechanism by which this positive effect on bone tissue metabolism is not known. The aim of this study is to biomechanic and biochemical analysis of the effects of the local ABS application on osseointegration of 3 different surfaced titanium implants.

Material & Methods

Spraque dawley rats were divided machined surfaced (MS) (n ​= ​10), sandblasted and large acid grid (SLA) (n ​= ​10) and resorbable blast material (RBM) (n ​= ​10) surfaced implants. ABS applied locally during the surgical application of the titanium implant before insertion in bone sockets. After 4 weeks experimental period the rats sacrificed and implants with surrounding bone tissues were removed to reverse torque analysis (Newton), blood samples collected to biochemical analysis (ALP, calcium, P).

Results

Biomechanic bone implant contact ratio detected higher in SLA surfaced implants compared with the RBM and controls (P ​< ​0,05). Phosphor levels detected lower in RBM implant group compared with the controls and SLA (P ​< ​0,05). Additionally; phosphor levels detected highly in controls compared with the RBM implants.

Conclusion

According the biomechanical parameters ABS may be more effective in SLA and RBM surfaced implants when locally applied.

The effects of titanium topography and chemical composition on human osteoblast cell

The objective of this study was to evaluate and compare titanium surfaces: machined (MA); sintered ceramic-blasted (HAS); sintered ceramic-blasted and acid-etched (HAS DE) and to determine the effects of surface topography, roughness and chemical composition on human osteoblast cell reaction. Titanium surface samples were analyzed with respect to surface chemical composition, topography, and roughness. The effects of material surface characteristics on osteoblasts was examined by analyzing osteoblast morphology, viability and differentiation. Osteoblasts cultured on these materials had attached, spread and proliferated on every sample. The viability of osteoblasts cultured on HAS and HAS DE samples increased more intensively in time comparing to MA sample. The viability of osteoblast cultured on HAS samples increased more intensively in the early phases of culture while for cells cultured on HAS DE the cells viability increased later in time. Alkaline phosphate activity was the highest for the cells cultured on HAS sample and statistically higher than for the MA sample. The least activity occurred on the smooth MA sample along with the rougher HAS DE samples. All the examined samples were found to be biocompatible, as indicated by cell attachment, proliferation, and differentiation. Titanium surfaces modification improved the dynamics of osteoblast viability increase. Osteoblast differentiation was found to be affected by the etching procedure and presence of Ca and P on the surface.

Surface Modified Techniques and Emerging Functional Coating of Dental Implants

Dental implants are widely used in the field of oral restoration, but there are still problems leading to implant failures in clinical application, such as failed osseointegration, marginal bone resorption, and peri-implantitis, which restrict the success rate of dental implants and patient satisfaction. Poor osseointegration and bacterial infection are the most essential reasons resulting in implant failure. To improve the clinical outcomes of implants, many scholars devoted to modifying the surface of implants, especially to preparing different physical and chemical modifications to improve the osseointegration between alveolar bone and implant surface. Besides, the bioactive-coatings to promote the adhesion and colonization of ossteointegration-related proteins and cells also aim to improve the osseointegration. Meanwhile, improving the anti-bacterial performance of the implant surface can obstruct the adhesion and activity of bacteria, avoiding the occurrence of inflammation related to implants. Therefore, this review comprehensively investigates and summarizes the modifying or coating methods of implant surfaces, and analyzes the ossteointegration ability and anti-bacterial characteristics of emerging functional coatings in published references.

Sandblasting improves the performance of electrodes of miniature electrical impedance tomography via double layer capacitance

Effect of sandblasting of the copper electrode structures before deposition of gold thin film for micro electrical impedance tomography (EIT) system has been studied experimentally. The comparison has been performed on the unmodified copper electrodes and the sandblasted electrodes before deposition of gold layer, using structural analysis while their performance in EIT system has been measured and analyzed. The results of scanning electron microscopy and atomic force microscopy show that the sandblasting of the electrodes results in the deposition of gold film with smaller grain size and uniformly, comparing to the unmodified structure. The measurement of impedance shows that the sandblasting will increase the double layer capacitance of electrode structure which improves the impedance measurement accordingly.

Biocompatibility and osseointegration of nanostructured titanium dental implants in minipigs

OBJECTIVES

It is well known that surface treatments of dental implants have a great impact on their rate of osseointegration. The aim of this study was to compare the biocompatibility and the bone-implant contact (BIC) of titanium dental implants with different surface treatments.

MATERIAL AND METHODS

Test implants (Biotech Dental) had a nanostructured surface and control implants (Anthogyr) were grit-blasted with biphasic calcium phosphate and acid-etched surface. Both titanium implants were inserted in mandible and maxillary bones of 6 Yucatan minipigs for 4 and 12 weeks (n = 10 implants/group). Biocompatibility and osseointegration were evaluated by non-decalcified histology and back-scattered electron microscopy images.

RESULTS

The reading of histology sections by an antomo-pathologist indicated that the test implants were considered non-irritating to the surrounding tissues and thus biocompatible compared with control implants. The BIC values were higher for test than for control dental implants at both 4 and 12 weeks.

CONCLUSIONS

In summary, the new nanostructured titanium dental implant is considered biocompatible and showed a better osseointegration than the control implant at both 4 and 12 weeks.

Achievements in the Topographic Design of Commercial Titanium Dental Implants: Towards Anti-Peri-Implantitis Surfaces

Titanium and its alloys constitute the gold standard materials for oral implantology in which their performance is mainly conditioned by their osseointegration capacity in the host's bone. We aim to provide an overview of the advances in surface modification of commercial dental implants analyzing and comparing the osseointegration capacity and the clinical outcome exhibited by different surfaces. Besides, the development of peri-implantitis constitutes one of the most common causes of implant loss due to bacteria colonization. Thus, a synergic response from industry and materials scientists is needed to provide reliable technical and commercial solutions to this issue. The second part of the review focuses on an update of the recent findings toward the development of new materials with osteogenic and antibacterial capacity that are most likely to be marketed, and their correlation with implant geometry, biomechanical behavior, biomaterials features, and clinical outcomes.

Influence of the Thermal Treatment to Address a Better Osseointegration of Ti6Al4V Dental Implants: Histological and Histomorphometrical Study in a Rabbit Model

Background

Pure titanium continues to be the first choice for dental implants and represents the gold standard for their biocompatibility and physical and mechanical characteristics, while the titanium alloy (Ti6Al4V) has good mechanical properties. The surface structure of the titanium oxide layer formation on the surface influences and improves the bone response around dental implants.

Purpose

The purpose of this study is to evaluate the influence of a thermal treatment of Ti6Al4V implant surfaces and the bone healing response in a rabbit model.

Methods

Altogether sixteen implants with same design were inserted into the distal femoral metaphysis. A screw (13 mm long, 4 mm in diameter) was inserted in an implant bed. Each rabbit received two implants, one in the left femur and one in the right femur. The samples were histologically and histomorphometrically evaluated at 8 weeks.

Results

A statistically significant difference (p = 0.000034) was present histologically in the percentages of bone-implant contact (BIC) between the test group (BIC = 69.25±4.49%.) and control group (BIC = 56.25 ± 4.8%) by one-way analysis of variance (ANOVA). Significance was set at p ≤ 0.05.

Conclusions

The outcome of the present study indicates a novel approach to improving bone healing around titanium implants.