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Lackington WA, Bellon B, Guimond S, Schweizer P, Cancellieri C, Ambeza A, Chopard-Lallier AL, Pippenger B, Armutlulu A, Maeder X, Schmutz P, Rottmar M. Bio-Inspired Micro- and Nano-Scale Surface Features Produced by Femtosecond Laser-Texturing Enhance TiZr-Implant Osseointegration. Adv Healthc Mater 2024; 13:e2400810. [PMID: 38857489 DOI: 10.1002/adhm.202400810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/13/2024] [Indexed: 06/12/2024]
Abstract
Surface design plays a critical role in determining the integration of dental implants with bone tissue. Femtosecond laser-texturing has emerged as a breakthrough technology offering excellent uniformity and reproducibility in implant surface features. However, when compared to state-of-the-art sandblasted and acid-etched surfaces, laser-textured surface designs typically underperform in terms of osseointegration. This study investigates the capacity of a bio-inspired femtosecond laser-textured surface design to enhance osseointegration compared to state-of-the-art sandblasted & acid-etched surfaces. Laser-texturing facilitates the production of an organized trabeculae-like microarchitecture with superimposed nano-scale laser-induced periodic surface structures on both 2D and 3D samples of titanium-zirconium-alloy. Following a boiling treatment to modify the surface chemistry, improving wettability to a contact angle of 10°, laser-textured surfaces enhance fibrin network formation when in contact with human whole blood, comparable to state-of-the-art surfaces. In vitro experiments demonstrate that laser-textured surfaces significantly outperform state-of-the-art surfaces with a 2.5-fold higher level of mineralization by bone progenitor cells after 28 days of culture. Furthermore, in vivo evaluations reveal superior biomechanical integration of laser-textured surfaces after 28 days of implantation. Notably, during abiological pull-out tests, laser-textured surfaces exhibit comparable performance, suggesting that the observed enhanced osseointegration is primarily driven by the biological response to the surface.
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Affiliation(s)
- William Arthur Lackington
- Biointerfaces Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Benjamin Bellon
- Institut Straumann AG, Basel, 4052, Switzerland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, 33720, Finland
| | - Stefanie Guimond
- Biointerfaces Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Peter Schweizer
- Mechanics of Materials & Nanostructures Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Thun, 3603, Switzerland
| | - Claudia Cancellieri
- Joining Technologies & Corrosion Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, 8600, Switzerland
| | - Antoine Ambeza
- Laser TSE, GF Machining Solutions SA, Geneva, 1242, Switzerland
| | | | - Benjamin Pippenger
- Institut Straumann AG, Basel, 4052, Switzerland
- Department of Periodontology, University of Bern, Bern, 3010, Switzerland
| | | | - Xavier Maeder
- Mechanics of Materials & Nanostructures Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Thun, 3603, Switzerland
| | - Patrik Schmutz
- Joining Technologies & Corrosion Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, 8600, Switzerland
| | - Markus Rottmar
- Biointerfaces Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
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Tchinda A, Didelot A, Choquet P, Lerebours A, Kouitat-Njiwa R, Bravetti P. Innovative Bioactive Ca-SZ Coating on Titanium Dental Implants: A Multidimensional Structural and Elemental Analysis. J Funct Biomater 2024; 15:155. [PMID: 38921529 PMCID: PMC11205193 DOI: 10.3390/jfb15060155] [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: 04/22/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 06/27/2024] Open
Abstract
The design of new, biomimetic biomaterials is of great strategic interest and is converging for many applications, including in implantology. This study explores a novel approach to improving dental implants. Although endosseous TA6V alloy dental implants are widely used in oral implantology, this material presents significant challenges, notably the prevalence of peri-implantitis. Therefore, in this study, we investigate a new advance in the design of hybrid medical devices. This involves the design of a Ca-SZ coating deposited by PVD on a TA6V substrate. This approach aims to overcome the inherent limitations of each of these materials, namely TA6V's susceptibility to peri-implantitis on the one hand and zirconia's excessively high Young's modulus compared with bone on the other, while benefiting from their respective advantages, such as the ductility of TA6V and the excellent biocompatibility of zirconia, offering relevant prospects for the design of high-performance implantable medical devices. This study integrates characterisation techniques, focusing on the structural and elemental analysis of the Ca-SZ coating by XRD and TEM. The results suggest that this coating combines a tetragonal structure, a uniform morphology with no apparent defects, a clean interface highlighting good adhesion, and a homogeneous composition of calcium, predisposing it to optimal biocompatibility. All of these findings make this innovative coating a particularly suitable candidate for application in dental implantology.
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Affiliation(s)
- Alex Tchinda
- Department of Micro and Nanomechanics for Life, Jean Lamour Institute, University of Lorraine, UMR 7198, 54011 Nancy, France (R.K.-N.)
| | - Aurélien Didelot
- Department of Micro and Nanomechanics for Life, Jean Lamour Institute, University of Lorraine, UMR 7198, 54011 Nancy, France (R.K.-N.)
| | - Patrick Choquet
- Materials and Technology Department, Luxembourg Institute of Science and Technology, 41 Rue du Brill, L-4422 Belvaux, Luxembourg
| | - Augustin Lerebours
- Department of Micro and Nanomechanics for Life, Jean Lamour Institute, University of Lorraine, UMR 7198, 54011 Nancy, France (R.K.-N.)
| | - Richard Kouitat-Njiwa
- Department of Micro and Nanomechanics for Life, Jean Lamour Institute, University of Lorraine, UMR 7198, 54011 Nancy, France (R.K.-N.)
| | - Pierre Bravetti
- Department of Micro and Nanomechanics for Life, Jean Lamour Institute, University of Lorraine, UMR 7198, 54011 Nancy, France (R.K.-N.)
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Chopra D, Guo T, Gulati K, Ivanovski S. Load, unload and repeat: Understanding the mechanical characteristics of zirconia in dentistry. Dent Mater 2024; 40:e1-e17. [PMID: 37891132 DOI: 10.1016/j.dental.2023.10.007] [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: 01/25/2023] [Revised: 09/11/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVES Zirconia-based dental restorations and implants are gaining attention due to their bioactivity, corrosion resistance and mechanical stability. Further, surface modification of zirconia implants has been performed at the macro-, micro- and nanoscale to augment bioactivity. While zirconia's physical and chemical characteristics have been documented, its relation to mechanical performance still needs to be explored. This extensive review aims to address this knowledge gap. METHODS This review critically compares and contrasts the findings from articles published in the domain of 'mechanical stability of zirconia\ in dentistry' based on a literature survey (Web of Science, Medline/PubMed and Scopus databases) and a review of the relevant publications in international peer-reviewed journals. Reviewing the published data, the mechanical properties of zirconia, such as fracture resistance, stress/tension, flexural strength, fatigue, and wear are detailed and discussed to understand the biomechanical compatibility of zirconia with the mechanical performance of modified zirconia in dentistry also explored. RESULTS A comprehensive insight into dental zirconia's critical fundamental mechanical characteristics and performance is presented. Further, research challenges and future directions in this domain are recommended. SIGNIFICANCE This review extends existing knowledge of zirconia's biomechanical performance and it they can be modulated to design the next generation of zirconia dental restorations and implants to withstand long-term constant loading.
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Affiliation(s)
- Divya Chopra
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD 4006, Australia
| | - Tianqi Guo
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD 4006, Australia
| | - Karan Gulati
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD 4006, Australia.
| | - Sašo Ivanovski
- The University of Queensland, School of Dentistry, Herston, QLD 4006, Australia; Centre for Orofacial Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD 4006, Australia.
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Thu MK, Kang YS, Kwak JM, Jo YH, Han JS, Yeo ISL. Comparison between bone-implant interfaces of microtopographically modified zirconia and titanium implants. Sci Rep 2023; 13:11142. [PMID: 37429939 DOI: 10.1038/s41598-023-38432-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/07/2023] [Indexed: 07/12/2023] Open
Abstract
The aim of this study was to investigate the surface characteristics and evaluate the bone-implant interfaces of injection molded zirconia implants with or without surface treatment and compare them with those of conventional titanium implants. Four different zirconia and titanium implant groups (n = 14 for each group) were prepared: injection-molded zirconia implants without surface treatment (IM ZrO2); injection-molded zirconia implants with surface treatment via sandblasting (IM ZrO2-S); turned titanium implants (Ti-turned); and titanium implants with surface treatments via sandblasting with large-grit particles and acid-etching (Ti-SLA). Scanning electron microscopy, confocal laser scanning microscopy, and energy dispersive spectroscopy were used to assess the surface characteristics of the implant specimens. Eight rabbits were used, and four implants from each group were placed into the tibiae of each rabbit. Bone-to-implant contact (BIC) and bone area (BA) were measured to evaluate the bone response after 10-day and 28-day healing periods. One-way analysis of variance with Tukey's pairwise comparison was used to find any significant differences. The significance level was set at α = 0.05. Surface physical analysis showed that Ti-SLA had the highest surface roughness, followed by IM ZrO2-S, IM ZrO2, and Ti-turned. There were no statistically significant differences (p > 0.05) in BIC and BA among the different groups according to the histomorphometric analysis. This study suggests that injection-molded zirconia implants are reliable and predictable alternatives to titanium implants for future clinical applications.
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Affiliation(s)
- Myint Kyaw Thu
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - Young Suk Kang
- 618th Medical Company (Dental Area Support)/Dental Health Activity-Korea, Camp Humphreys, APO, AP, 96297, USA
| | - Jeong Min Kwak
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - Ye-Hyeon Jo
- Dental Research Institute, Seoul National University, Seoul, 03080, Korea
| | - Jung-Suk Han
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - 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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Hossain N, Mobarak MH, Hossain A, Khan F, Mim JJ, Chowdhury MA. Advances of plant and biomass extracted zirconium nanoparticles in dental implant application. Heliyon 2023; 9:e15973. [PMID: 37215906 PMCID: PMC10192772 DOI: 10.1016/j.heliyon.2023.e15973] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/24/2023] Open
Abstract
Nanoparticles are minimal materials with unique physicochemical features that set them apart from bulk materials of the same composition. These properties make nanoparticles highly desirable for use in commercial and medical research. The primary intention for the development of nanotechnology is to achieve overarching social objectives like bettering our understanding of nature, boosting productivity, improving healthcare, and extending the bounds of sustainable development and human potential. Keeping this as a motivation, Zirconia nanoparticles are becoming the preferred nanostructure for modern biomedical applications. This nanotechnology is exceptionally versatile and has several potential uses in dental research. This review paper concentrated on the various benefits of zirconium nanoparticles in dentistry and how they provide superior strength and flexibility compared to their counterparts. Moreover, the popularity of zirconium nanoparticles is also growing as it has strong biocompatibility potency. Zirconium nanoparticles can be used to develop or address the major difficulty in dentistry. Therefore, this review paper aims to provide a summary of the fundamental research and applications of zirconium nanoparticles in dental implants.
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Affiliation(s)
- Nayem Hossain
- Department of Mechanical Engineering, IUBAT-International University of Business Agriculture and Technology, Bangladesh
| | - Md Hosne Mobarak
- Department of Mechanical Engineering, IUBAT-International University of Business Agriculture and Technology, Bangladesh
| | - Amran Hossain
- Department of Mechanical Engineering, IUBAT-International University of Business Agriculture and Technology, Bangladesh
| | - Fardin Khan
- Department of Mechanical Engineering, IUBAT-International University of Business Agriculture and Technology, Bangladesh
| | - Juhi Jannat Mim
- Department of Mechanical Engineering, IUBAT-International University of Business Agriculture and Technology, Bangladesh
| | - Mohammad Asaduzzaman Chowdhury
- Department of Mechanical Engineering, Dhaka University of Engineering and Technology (DUET), Gazipur, Gazipur, 1707, Bangladesh
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Arlucea N, Brizuela-Velasco A, Dieguez-Pereira M, Punset M, Molmeneu M, Sánchez Lasheras F, deLlanos-Lanchares H, Álvarez-Arenal Á. Zirconia vs. Titanium Dental Implants: Primary Stability In-Vitro Analysis. MATERIALS 2021; 14:ma14247886. [PMID: 34947480 PMCID: PMC8705369 DOI: 10.3390/ma14247886] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022]
Abstract
The present experimental trial uses two types of dental implants, one made of titanium (Ti6Al4V) and the other one of zirconia (ZrO2), but both of identical design, to compare their stability and micro-movements values under load. One of each type of implant (n = 42) was placed into 21 cow ribs, recording the insertion torque and the resonance frequency using a specific transducer. Subsequently, a prosthetic crown made of PMMA was screwed onto each of the implants in the sample. They were then subjected to a static compression load on the vestibular cusp of the crown. The resulting micromovements were measured. The zirconia implants obtained a higher mean of both IT and RFA when compared with those of titanium, with statistically significant differences in both cases (p = 0.0483 and p = 0.0296). However, the micromovement values when load was applied were very similar for both types, with the differences between them (p = 0.3867) not found to be statistically significant. The results show that zirconia implants have higher implant stability values than titanium implants. However, the fact that there are no differences in micromobility values implies that caution should be exercised when applying clinical protocols for zirconia based on RFA, which only has evidence for titanium.
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Affiliation(s)
- Nerea Arlucea
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, c/Catedrático Serrano s/n, 33006 Oviedo, Spain; (N.A.); (A.B.-V.); (M.D.-P.); (H.d.-L.); (Á.Á.-A.)
| | - Aritza Brizuela-Velasco
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, c/Catedrático Serrano s/n, 33006 Oviedo, Spain; (N.A.); (A.B.-V.); (M.D.-P.); (H.d.-L.); (Á.Á.-A.)
| | - Markel Dieguez-Pereira
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, c/Catedrático Serrano s/n, 33006 Oviedo, Spain; (N.A.); (A.B.-V.); (M.D.-P.); (H.d.-L.); (Á.Á.-A.)
| | - Miquel Punset
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgy, EEBE, Technical University of Catalonia (UPC), 08034 Barcelona, Spain; (M.P.); (M.M.)
- UPC Innovation and Technology Center (CIT-UPC), Technical University of Catalonia (UPC), C. Jordi Girona 3-1, 08034 Barcelona, Spain
- Barcelona Research Centre in Multiscale Science and Engineering, Technical University of Catalonia (UPC), Av. Eduard Maristany, 10-14, 08019 Barcelona, Spain
| | - Meritxell Molmeneu
- Biomaterials, Biomechanics and Tissue Engineering Group, Department of Materials Science and Metallurgy, EEBE, Technical University of Catalonia (UPC), 08034 Barcelona, Spain; (M.P.); (M.M.)
- Barcelona Research Centre in Multiscale Science and Engineering, Technical University of Catalonia (UPC), Av. Eduard Maristany, 10-14, 08019 Barcelona, Spain
| | - Fernando Sánchez Lasheras
- Department of Mathematics c/Federico García Lorca 18, University of Oviedo, 33007 Oviedo, Spain
- Instituto Universitario de Ciencias y Tecnologías Espaciales de Asturias (ICTEA), c/Independencia 13, 33004 Oviedo, Spain
- Correspondence:
| | - Hector deLlanos-Lanchares
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, c/Catedrático Serrano s/n, 33006 Oviedo, Spain; (N.A.); (A.B.-V.); (M.D.-P.); (H.d.-L.); (Á.Á.-A.)
| | - Ángel Álvarez-Arenal
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, c/Catedrático Serrano s/n, 33006 Oviedo, Spain; (N.A.); (A.B.-V.); (M.D.-P.); (H.d.-L.); (Á.Á.-A.)
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Qu Y, Liu L. Zirconia Materials for Dental Implants: A Literature Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Titanium is currently the most commonly used material for manufacturing dental implants. However, its potential toxic effects and the gray color have resulted in increasing requests for metal-free treatment options. Zirconia is a type of ceramic materials that has been extensively used in medicine field, such as implant abutments and various joint replacement appliances. Amounts of clinical evaluations have indicated good biocompatibility for zirconia products. Besides, its toothlike color, low affinity for plaque and outstanding mechanical and chemical properties have made it an ideal candidate for dental implants. The aim of this study is to review the laboratory and clinical papers about several kinds of zirconia materials and zirconia surface modification techniques. Although there are plenty of literatures on these topics, most of the researches focused on the mechanical properties of the materials or based on cell and animal experiments. Randomized clinical trials on zirconia materials are still urgently needed to validate their application as dental implants.
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Lin H, Yin C, Mo A. Zirconia Based Dental Biomaterials: Structure, Mechanical Properties, Biocompatibility, Surface Modification, and Applications as Implant. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.689198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Zirconia, with its excellent mechanical properties, chemical stability, biocompatibility, and negligible thermal conductivity, is ideal for dental and orthopedic applications. In addition, the biocompatibility of zirconia has been studied in vivo, and no adverse reactions were observed when zirconia samples were inserted into bone. However, their use is controversial among dentists and researchers, especially when compared with mature implants made of titanium alloy. The advantages and limitations of zirconia as biomaterials, such as implant materials, need to be carefully studied, and the design, manufacture, and clinical operation guidelines are urgently required. In this review, the special components, microstructure, mechanical strength, biocompatibility, and the application of zirconia ceramics in biomaterials are detailly introduced. The review highlights discussions on how to implement innovative strategies to design the physical and chemical properties of zirconia so that the treated zirconia can provide better osteointegration after implantation.
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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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Majhi R, Majhi RK, Garhnayak L, Patro TK, Dhal A, Kumar S, Guha P, Goswami L, Goswami C. Comparative evaluation of surface-modified zirconia for the growth of bone cells and early osseointegration. J Prosthet Dent 2021; 126:92.e1-92.e8. [PMID: 34049698 DOI: 10.1016/j.prosdent.2021.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/04/2021] [Accepted: 04/05/2021] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM Rapid osseointegration between implant and bone tissue for early loading of a prosthesis with sufficient primary stability depends on the surface characteristics of the implant. The development and characterization of suitable surface coatings on dental implants is a major challenge. PURPOSE The purpose of this in vitro study was to evaluate and compare the osteogenic potential and cytotoxicity of unmodified zirconia, acid-etched zirconia, bioactive glass-coated zirconia, and tamarind kernel polysaccharide with hydrophilic acrylic acid (TKP-AA) hydrogel-coated zirconia. MATERIAL AND METHODS Thirty-six disks each of unmodified zirconia, acid-etched, 45S5 bioactive glass-coated, and TKP-AA hydrogel-coated zirconia were evaluated for osteogenic potential and cytotoxic effect by using human osteoblast Saos-2 cells. The surface topography of the disks and the morphology of the cells grown on these surfaces were examined by scanning electron microscopy (n=3). The cell attachment was evaluated by confocal imaging (n=3). The cytotoxic effect was evaluated by cell viability assay (n=9). Osteoblast maturation was assessed by alkaline phosphatase assay (n=9) and cell mineralization by alizarin red staining (n=9). ANOVA and Bonferroni multiple comparison post hoc tests were used to evaluate the statistical significance of the intergroup differences in these characteristics (α=.05). RESULTS The surface modifications resulted in distinct changes in the surface morphology of zirconia disks and the growth of Saos-2 cells. Zirconia disks coated with TKP-AA promoted higher proliferation of osteoblasts compared with unmodified disks (P<.001). Similarly, the surface modifications significantly increased the differentiation of mesenchymal stem cells to osteoblasts as compared with uncoated zirconia (P<.001). However, the rate of differentiation to osteoblasts was similar among the surface modifications. Acid-etched and TKP-AA-coated disks promoted mineralization of osteoblasts to the same extent, except bioactive glass coating, which significantly increased the rate of mineralization (P<.001). CONCLUSIONS Surface modification of zirconia by acid etching and coating with Bioglass or TKP-AA hydrogel resulted in the improved growth and differentiation of osteoblasts. TKP-AA hydrogel coating promoted the proliferation of osteoblasts, whereas Bioglass coating showed better mineralization. TKP-AA hydrogel coating is a promising candidate for improving the osseointegration of dental implants that warrants further investigation.
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Affiliation(s)
- Rashmita Majhi
- Master in Dental Surgery, Department of Prosthodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Rakesh Kumar Majhi
- Postdoctoral Researcher, School of Biological Sciences, National Institute of Science Education and Research, Jatni, Bhubaneswar, Odisha, India
| | - Lokanath Garhnayak
- Associate Professor, Department of Prosthodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Tapan Kumar Patro
- Professor and Head of Department, Department of Prosthodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Angurbala Dhal
- Associate Professor, Department of Prosthodontics, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Satish Kumar
- Research Fellow, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT), Bhubaneswar, Odisha, India
| | - Puspendu Guha
- Postdoctoral Researcher, Institute of Physics, Sachivalaya Marg, Bhubaneswar, India
| | - Luna Goswami
- Associate Professor, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT), Bhubaneswar, Odisha, India; Associate Professor, School of Chemical Technology, Kalinga Institute of Industrial Technology (KIIT), Bhubaneswar, Odisha, India
| | - Chandan Goswami
- Associate Professor, School of Biological Sciences, National Institute of Science Education and Research, Jatni, Bhubaneswar, Odisha, India; Associate Professor, Homi Bhabha National Institute, Training School Complex, Mumbai, India.
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Semisch-Dieter OK, Choi AH, Ben-Nissan B, Stewart MP. Modifying an Implant: A Mini-review of Dental Implant Biomaterials. BIO INTEGRATION 2021. [DOI: 10.15212/bioi-2020-0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Dental implants have been used as far back as 2000BC, and since then have developed into highly sophisticated solutions for tooth replacement. It is becoming increasingly important for the materials used in dental implants to exhibit and maintain favorable long-term mechanical, biological
and more recently, aesthetic properties. This review aims to assess the biomaterials used in modern dental implants, introducing their properties, and concentrating on modifications to improve these biomaterials. Focus is drawn to the prominent biomaterials, titanium (Ti) and zirconia due
to their prevalence in implant dentistry. Additionally, novel coatings and materials with potential use as viable improvements or alternatives are reviewed. An effective dental biomaterial should osseointegrate, maintain structural integrity, resist corrosion and infection, and not cause systemic
toxicity or cytotoxicity. Current materials such as bioactive glass offer protection against biofilm formation, and when combined with a titanium‐zirconium (TiZr) alloy, provide a reliable combination of properties to represent a competitive alternative. Further long-term clinical studies
are needed to inform the development of next-generation materials.Significance StatementBiomaterials have become essential for modern implants. A suitable implant biomaterial integrates into the body to perform a key function, whilst minimizing negative immune response. Focusing
on dentistry, the use of dental implants for tooth replacement requires a balance between bodily response, mechanical structure and performance, and aesthetics. This mini-review addresses the use of biomaterials in dental implants with significant comparisons drawn between Ti and zirconia.
Attention is drawn to optimizing surface modification processes and the additional use of coatings. Alternatives and novel developments are addressed, providing potential implications of combining biomaterials to form novel composites that combine and synergize the benefits of each material.
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Affiliation(s)
- Oliver K. Semisch-Dieter
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - Andy H. Choi
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - Besim Ben-Nissan
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - Martin P. Stewart
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Ultimo, NSW, Australia
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12
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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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13
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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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14
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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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15
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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: 129] [Impact Index Per Article: 25.8] [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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Çakırbay Tanış M, Akay C, Şen M. Effect of selective infiltration etching on the bond strength between zirconia and resin luting agents. J ESTHET RESTOR DENT 2018; 31:257-262. [PMID: 30565846 DOI: 10.1111/jerd.12441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 09/03/2018] [Accepted: 10/09/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the shear bond strength of resin cements to zirconia treated with the selective infiltration etching technique (SIE). MATERIALS AND METHODS Forty-seven zirconia specimens were prepared with a sequence of silicon carbide abrasives, cleaned in an ultrasonic bath. Three samples were separated for atomic force microscope (AFM) analyses (one nontreated for control, one sandblasted, and one selective infiltration etched) and the remaining were randomly distributed in four groups, according to the combination of surface treatment and resin cement: group 1a (sandblasting + Variolink II), group 1b (sandblasting + Panavia SA Plus), group 2a (SIE + Variolink II), group 2b (SIE + Panavia SA Plus). A composite resin cylinder (3 mm × 3 mm) was cemented to the zirconia surface, as per each group's specific protocol. After storing 24 hours in distilled water at 37°C, the specimens were tested for shear bond strength and the results were subjected to statistical analysis. RESULTS At 24 hours, the highest SBS values were observed in group 2b, where the SIE technique was used in conjunction with Panavia SA Plus. Lowest values were found in group 1a. Increased surface roughness was observed with SIE. CONCLUSIONS SIE significantly enhanced the resin bond strength to zirconia. However, cement selection was also an important factor, for both surface treatments tested. CLINICAL SIGNIFICANCE Use of SIE method combined with MDP monomer containing resin cement can provide clinically acceptable bond strength between zirconia and resin cement.
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Affiliation(s)
- Merve Çakırbay Tanış
- Faculty of Dentistry, Department of Prosthodontics, Gazi University, Ankara, Turkey
| | - Canan Akay
- Faculty of Dentistry, Department of Prosthodontics, University of Osmangazi, Eskişehir, Turkey
| | - Murat Şen
- Department of Chemistry, Polymer Chemistry Division, Hacettepe University, Ankara, Turkey
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17
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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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18
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Comparison of Resonance Frequency Analysis and of Quantitative Ultrasound to Assess Dental Implant Osseointegration. SENSORS 2018; 18:s18051397. [PMID: 29724028 PMCID: PMC5982662 DOI: 10.3390/s18051397] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/09/2018] [Accepted: 04/20/2018] [Indexed: 12/31/2022]
Abstract
Dental implants are widely used in the clinic. However, there remain risks of failure, which depend on the implant stability. The aim of this paper is to compare two methods based on resonance frequency analysis (RFA) and on quantitative ultrasound (QUS) and that aim at assessing implant stability. Eighty-one identical dental implants were inserted in the iliac crests of 11 sheep. The QUS and RFA measurements were realized after different healing times (0, 5, 7, and 15 weeks). The results obtained with the QUS (respectively RFA) method were significantly different when comparing two consecutive healing time for 97% (respectively, 18%) of the implants. The error made on the estimation of the healing time when analyzing the results obtained with the QUS technique was around 10 times lower than that made when using the RFA technique. The results corresponding to the dependence of the ISQ versus healing time were significantly different when comparing two directions of RFA measurement. The results show that the QUS method allows a more accurate determination of the evolution of dental implant stability when compared to the RFA method. This study paves the way towards the development of a medical device, thus providing a decision support system to dental surgeons.
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Huang Z, Wang Z, Li C, Yin K, Hao D, Lan J. Application of Plasma-Sprayed Zirconia Coating in Dental Implants: Study in Implants. J ORAL IMPLANTOL 2018; 44:37-45. [DOI: 10.1563/aaid-joi-d-17-00020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim was to investigate the osseointegration of a novel coating—plasma-sprayed nanostructured zirconia (NSZ)—for dental implants. Nanostructured zirconia coating on non-thread titanium implant was prepared by plasma spraying, and the implant surface morphology, surface roughness, and wettability were measured. In vivo, nanostructured zirconia-coated implants were inserted in rabbit tibia, and the animals were sacrificed at 2, 4, 8, and 12 weeks after implantation. The bond strength between implant and bone was measured with the removal torque (RTQ) test. Osseointegration was observed by scanning electron microscopy (SEM), microcomputerized tomography (micro CT), and histological analyses. Quantified parameters were calculated, including removal torque, bone volume to tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), trabecular separation/spacing (Tb.Sp), and bone-implant contact (BIC) percentage. The statistical differences were detected with a two-tail Mann-Whitney U test (SPSS 20.0). The surface roughness (1.58 μm) and wettability (54.61°) of a nanostructured zirconia-coated implant was more suitable than the titanium implant (0.598 μm, 74.38°) for osseointegration and hierarchical surface morphology seen on the zirconia coating. The histological analyses showed that a zirconia-coated implant induced earlier and had more condensed bone formation than did the titanium implant at 2 and 4 weeks. Quantified parameters showed the significant differences between these 2 groups at an early healing period, but the differences between the 2 groups decreased with an increased healing period. All these results demonstrated that plasma-sprayed zirconia coated implants induced better bone formation than did titanium implants at an early stage.
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Affiliation(s)
- Zhengfei Huang
- School of Stomatology, Shandong University, Jinan, China
- Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan, China
| | - Zhifeng Wang
- Department of Pediatric Dentistry, School of Stomatology, Shandong University, Jinan, China
| | - Chuanhua Li
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, China
| | - Kaifeng Yin
- Department of Orthodontics, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif
| | - Dan Hao
- Nantong Stomatological Hospital, Nantong, China
| | - Jing Lan
- Department of Prosthodontics, School of Stomatology, Shandong University, Jinan, China
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Khan ZA, Jhingran R, Bains VK, Madan R, Srivastava R, Rizvi I. Evaluation of peri-implant tissues around nanopore surface implants with or without platelet rich fibrin: a clinico-radiographic study. Biomed Mater 2018; 13:025002. [PMID: 28956535 DOI: 10.1088/1748-605x/aa8fa3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Pieralli S, Kohal RJ, Lopez Hernandez E, Doerken S, Spies BC. Osseointegration of zirconia dental implants in animal investigations: A systematic review and meta-analysis. Dent Mater 2017; 34:171-182. [PMID: 29122237 DOI: 10.1016/j.dental.2017.10.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/17/2017] [Accepted: 10/18/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the osseointegration rate of zirconium dioxide (ZrO2) dental implants in preclinical investigations. DATA Data on the osseointegration rate was extracted considering the bone to implant contact (BIC), removal torque analysis (RTQ) and push-in tests. Meta analyses were conducted using multilevel multivariable mixed-effects linear regression models. The Šidák method was used in case of multiple testing. SOURCES An electronic screening of the literature (MEDLINE/Pubmed, Cochrane Library and Embase) and a supplementary manual search were performed. Animal investigations with a minimum sample size of 3 units evaluating implants made of zirconia (ZrO2) or its composites (ZrO2>50vol.%) were included. STUDY SELECTION The search provided 4577 articles, and finally 54 investigations were included and analyzed. Fifty-two studies included implants made from zirconia, 4 zirconia composite implants and 37 titanium implants. In total, 3435 implants were installed in 954 animals. CONCLUSIONS No significant influence of the evaluated bulk materials on the outcomes of interest could be detected. When comparing different animal models, significant differences for the evaluated variables could be found. These results might be of interest for the design of further animal investigations.
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Affiliation(s)
- Stefano Pieralli
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Straße 4-6, 14197 Berlin, Germany.
| | - Ralf-Joachim Kohal
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Emilia Lopez Hernandez
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Sam Doerken
- Medical Center - University of Freiburg, Center for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Faculty of Medicine - University of Freiburg, Hebelstr. 11, 79104 Freiburg, Germany
| | - Benedikt Christopher Spies
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Straße 4-6, 14197 Berlin, Germany
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Sivaraman K, Chopra A, Narayan AI, Balakrishnan D. Is zirconia a viable alternative to titanium for oral implant? A critical review. J Prosthodont Res 2017; 62:121-133. [PMID: 28827030 DOI: 10.1016/j.jpor.2017.07.003] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/22/2017] [Accepted: 07/11/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE Titanium based implant systems, though considered as the gold standard for rehabilitation of edentulous spaces, have been criticized for many inherent flaws. The onset of hypersensitivity reactions, biocompatibility issues, and an unaesthetic gray hue have raised demands for more aesthetic and tissue compatible material for implant fabrication. Zirconia is emerging as a promising alternative to conventional Titanium based implant systems for oral rehabilitation with superior biological, aesthetics, mechanical and optical properties. This review aims to critically analyze and review the credibility of Zirconia implants as an alternative to Titanium for prosthetic rehabilitation. STUDY SELECTION The literature search for articles written in the English language in PubMed and Cochrane Library database from 1990 till December 2016. The following search terms were utilized for data search: "zirconia implants" NOT "abutment", "zirconia implants" AND "titanium implants" AND "osseointegration", "zirconia implants" AND compatibility. RESULTS The number of potential relevant articles selected were 47. All the human in vivo clinical, in vitro, animals' studies were included and discussed under the following subheadings: Chemical composition, structure and phases; Physical and mechanical properties; Aesthetic and optical properties; Osseointegration and biocompatibility; Surface modifications; Peri-implant tissue compatibility, inflammation and soft tissue healing, and long-term prognosis. CONCLUSIONS Zirconia implants are a promising alternative to titanium with a superior soft-tissue response, biocompatibility, and aesthetics with comparable osseointegration. However, further long-term longitudinal and comparative clinical trials are required to validate zirconia as a viable alternative to the titanium implant.
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Affiliation(s)
- Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Manipal, 576104, India.
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal University, Manipal, India
| | - Aparna I Narayan
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Manipal, 576104, India
| | - Dhanasekar Balakrishnan
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Manipal, 576104, India
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Choi HW, Park YS, Chung SH, Jung MH, Moon W, Rhee SH. Comparison of mechanical and biological properties of zirconia and titanium alloy orthodontic micro-implants. Korean J Orthod 2017; 47:229-237. [PMID: 28670564 PMCID: PMC5466905 DOI: 10.4041/kjod.2017.47.4.229] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/21/2017] [Accepted: 01/23/2017] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of this study was to compare the initial stability as insertion and removal torque and the clinical applicability of novel orthodontic zirconia micro-implants made using a powder injection molding (PIM) technique with those parameters in conventional titanium micro-implants. METHODS Sixty zirconia and 60 titanium micro-implants of similar design (diameter, 1.6 mm; length, 8.0 mm) were inserted perpendicularly in solid polyurethane foam with varying densities of 20 pounds per cubic foot (pcf), 30 pcf, and 40 pcf. Primary stability was measured as maximum insertion torque (MIT) and maximum removal torque (MRT). To investigate clinical applicability, compressive and tensile forces were recorded at 0.01, 0.02, and 0.03 mm displacement of the implants at angles of 0°, 10°, 20°, 30°, and 40°. The biocompatibility of zirconia micro-implants was assessed via an experimental animal study. RESULTS There were no statistically significant differences between zirconia micro-implants and titanium alloy implants with regard to MIT, MRT, or the amount of movement in the angulated lateral displacement test. As angulation increased, the mean compressive and tensile forces required to displace both types of micro-implants increased substantially at all distances. The average bone-to-implant contact ratio of prototype zirconia micro-implants was 56.88 ± 6.72%. CONCLUSIONS Zirconia micro-implants showed initial stability and clinical applicability for diverse orthodontic treatments comparable to that of titanium micro-implants under compressive and tensile forces.
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Affiliation(s)
- Hae Won Choi
- Department of Orthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Seok Park
- Department of Oral Anatomy, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| | - Shin Hye Chung
- Department of Dental Biomaterials Science, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| | - Min Ho Jung
- Department of Orthodontics, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea.,Private Practice, Seoul, Korea
| | - Won Moon
- Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, USA
| | - Sang Hoon Rhee
- Department of Dental Biomaterials Science, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
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Siddiqi A, Khan AS, Zafar S. Thirty Years of Translational Research in Zirconia Dental Implants: A Systematic Review of the Literature. J ORAL IMPLANTOL 2017; 43:314-325. [PMID: 28594591 DOI: 10.1563/aaid-joi-d-17-00016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Thirty years of transitional research in zirconia (Zr) ceramics has led to significant improvements in the biomedical field, especially in dental implantology. Oral implants made of yttria-tetragonal zirconia polycrystals (Y-TZP) because of their excellent mechanical properties, good biocompatibility, and esthetically acceptable color have emerged as an attractive metal-free alternative to titanium (Ti) implants. The aim of the review was to highlight the translation research in Zr dental implants that has been conducted over the past 3 decades using preclinical animal models. A computer search of electronic databases, primarily PubMed, was performed with the following key words: "zirconia ceramics AND animal trials," "ceramic implants AND animal trials," "zirconia AND animal trials," "zirconia AND in vivo animal trials," without any language restriction. However, the search was limited to animal trials discussing percentage bone-implant contact (%BIC) around zirconia implants/discs. This search resulted in 132 articles (reviews, in vivo studies, and animal studies) of potential interest. We restricted our search terms to "zirconia/ceramic," "bone-implant-contact," and "animal trials" and found 29 relevant publications, which were then selected for full-text reading. Reasons for exclusion included the article's not being an animal study, being a review article, and not discussing %BIC around Zr implants/discs. Most of the studies investigated BIC around Zr in rabbits (30%), pigs (approximately 20%), dogs, sheep, and rats. This review of the literature shows that preclinical animal models can be successfully used to investigate osseointegration around Zr ceramics. Results of the reviewed studies demonstrated excellent %BIC around Zr implants. It should be noted that most of the studies investigated %BIC/removal torque under nonloading conditions, and results would have been somewhat different in functional loading situations because of inherent limitations of Zr ceramics. Further trials are needed to evaluate the performance of Zr ceramics in clinical conditions using implants designed and manufactured via novel techniques that enhance their biomechanical properties.
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Affiliation(s)
- Allauddin Siddiqi
- 1 School of Dentistry and Health Sciences, Charles Sturt University, Orange, New South Wales, Australia
| | - Abdul Samad Khan
- 2 Department of Restorative Dental Sciences, College of Dentistry, University of Dammam, Saudi Arabia
| | - Sobia Zafar
- 3 Discipline of Paediatric Dentistry, UWA Dental School, Australia
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Aboushelib MN, Shawky R. Osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with nano-hydroxyapatite particles. Int J Implant Dent 2017; 3:21. [PMID: 28527036 PMCID: PMC5438327 DOI: 10.1186/s40729-017-0082-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/08/2017] [Indexed: 11/19/2022] Open
Abstract
Background The aim of this study was to evaluate osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with hydroxy apatite used to augment large boney defects in a dog model. Methods Surgical defects were made bilaterally on the lower jaw of 12 Beagle dogs. Cone beam CT images were used to create three dimensional images of the healed defects. Porous zirconia scaffolds were fabricated by milling custom made CAD/CAM blocks into the desired shape. After sintering, the pores of half of the scaffolds were filled with a nano-hydroxy apatite (HA) powder while the other half served as control. The scaffolds were inserted bilaterally in the healed mandibular jaw defects and were secured in position by resorbable fixation screws. After a healing time of 6 weeks, bone-scaffold interface was subjected to histomorphometric analysis to detect the amount of new bone formation. Stained histological sections were analyzed using a computer software (n=12, α=0.05). Mercury porosimetery was used to measure pore sizes, chemical composition was analyzed using energy dispersive x-ray analysis (EDX), and the crystal structure was identified using x-ray diffraction micro-analysis (XRD). Results HA enriched zirconia scaffolds revealed significantly higher volume of new bone formation (33% ± 14) compared to the controls (21% ± 11). New bone deposition started by coating the pore cavity walls and proceeded by filling the entire pore volume. Bone in-growth started from the surface of the scaffold and propagated towards the scaffold core. Islands of entrapped hydroxy apatite particles were observed in mineralized bone matrix. Conclusions Within the limitations of this study, hydroxy apatite enhanced osteogenesis ability of porous zirconia scaffolds.
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Affiliation(s)
- Moustafa N Aboushelib
- Dental Biomaterials Department, Faculty of Dentistry, Alexandria University, Champollion st, Azarita, Alexandria, Egypt.
| | - Rehab Shawky
- Oral Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Effect of Zirconia Dental Implant Surfaces on Bone Integration: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9246721. [PMID: 28299337 PMCID: PMC5337335 DOI: 10.1155/2017/9246721] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 01/11/2017] [Indexed: 11/18/2022]
Abstract
Background. The information available about osseointegration and the bone to implant interaction of zirconia implants with various surface modifications is still far from sufficient. Objective. The purpose of this systematic review and meta-analysis was to evaluate and compare zirconia dental implants with different surface topographies, with a focus on bone to implant contact and removal torque. Methods. The systematic review of the extracted publications was performed to compare the bone to implant contact (BIC) with removal torque (RT) values of titanium dental implants and machined and surfaced modified zirconia implants. Results. A total of fifteen articles on BIC and RT values were included in the quantitative analysis. No significant difference in the BIC values was observed between titanium and machined zirconia implants (p = 0.373; 95% CI: −0.166 to 0.443). However, a significantly better BIC values were observed for acid etched zirconia implants compared with those of titanium implants (p = 0.032; 95% CI: 0.068 to 1.461). Unmodified zirconia implants showed favorable BIC values compared to modified-surface zirconia implants (p = 0.021; 95% CI: −0.973 to −0.080). Conclusion. Acid etched zirconia implants may serve as a possible substitute for successful osseointegration.
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Kim HK, Woo KM, Shon WJ, Ahn JS, Cha S, Park YS. Comparison of peri-implant bone formation around injection-molded and machined surface zirconia implants in rabbit tibiae. Dent Mater J 2017; 34:508-15. [PMID: 26235717 DOI: 10.4012/dmj.2015-024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study was to compare osseointegration and surface characteristics of zirconia implants made by the powder injection molding (PIM) technique against those made by the conventional milling procedure in rabbit tibiae. Surface characteristics of 2 types of implants were evaluated. Sixteen rabbits received 2 types of external hex implants with similar geometry, either machined zirconia implants or PIM zirconia implants, in the tibiae. Removal torque tests and histomorphometric analyses were performed. The roughness of the PIM zirconia implants was higher than that of machined zirconia implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined zirconia implants (p<0.001). The osseointegration of the PIM zirconia implant is promising, and PIM, using the roughened mold etching technique, can produce substantially rougher surfaces on zirconia implants.
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Affiliation(s)
- Hong-Kyun Kim
- Department of Oral Anatomy, Dental Research Institute and School of Dentistry, Seoul National University
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Cionca N, Hashim D, Mombelli A. Zirconia dental implants: where are we now, and where are we heading? Periodontol 2000 2016; 73:241-258. [DOI: 10.1111/prd.12180] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Evaluation of alumina toughened zirconia implants with a sintered, moderately rough surface: An experiment in the rat. Dent Mater 2016; 32:65-72. [DOI: 10.1016/j.dental.2015.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 08/13/2015] [Accepted: 10/22/2015] [Indexed: 11/20/2022]
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Kohal RJ, Schwindling FS, Bächle M, Spies BC. Peri-implant bone response to retrieved human zirconia oral implants after a 4-year loading period: A histologic and histomorphometric evaluation of 22 cases. J Biomed Mater Res B Appl Biomater 2015; 104:1622-1631. [DOI: 10.1002/jbm.b.33512] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/30/2015] [Accepted: 08/14/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine, Medical Center-University of Freiburg; Freiburg Germany
| | | | - Maria Bächle
- Department of Prosthetic Dentistry; Center for Dental Medicine, Medical Center-University of Freiburg; Freiburg Germany
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry; Center for Dental Medicine, Medical Center-University of Freiburg; Freiburg Germany
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Song YG, Cho IH. Characteristics and osteogenic effect of zirconia porous scaffold coated with β-TCP/HA. J Adv Prosthodont 2014; 6:285-94. [PMID: 25177472 PMCID: PMC4146729 DOI: 10.4047/jap.2014.6.4.285] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 06/12/2014] [Accepted: 06/30/2014] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the properties of a porous zirconia scaffold coated with bioactive materials and compare the in vitro cellular behavior of MC3T3-E1 preosteoblastic cells to titanium and zirconia disks and porous zirconia scaffolds. MATERIALS AND METHODS Titanium and zirconia disks were prepared. A porous zirconia scaffold was fabricated with an open cell polyurethane disk foam template. The porous zirconia scaffolds were coated with β-TCP, HA and a compound of β-TCP and HA (BCP). The characteristics of the specimens were evaluated using scanning electron microscopy (SEM), energy dispersive x-ray spectrometer (EDX), and x-ray diffractometry (XRD). The dissolution tests were analyzed by an inductively coupled plasma spectrometer (ICP). The osteogenic effect of MC3T3-E1 cells was assessed via cell counting and reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS The EDX profiles showed the substrate of zirconia, which was surrounded by the Ca-P layer. In the dissolution test, dissolved Ca(2+) ions were observed in the following decreasing order; β-TCP > BCP > HA (P<.05). In the cellular experiments, the cell proliferation on titanium disks appeared significantly lower in comparison to the other groups after 5 days (P<.05). The zirconia scaffolds had greater values than the zirconia disks (P<.05). The mRNA level of osteocalcin was highest on the non-coated zirconia scaffolds after 7 days. CONCLUSION Zirconia had greater osteoblast cell activity than titanium. The interconnecting pores of the zirconia scaffolds showed enhanced proliferation and cell differentiation. The activity of osteoblast was more affected by microstructure than by coating materials.
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Affiliation(s)
- Young-Gyun Song
- Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan, Republic of Korea
| | - In-Ho Cho
- Department of Prosthodontics, College of Dentistry, Dankook University, Cheonan, Republic of Korea
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Ultrasonic evaluation of dental implant osseointegration. J Biomech 2014; 47:3562-8. [PMID: 25262877 DOI: 10.1016/j.jbiomech.2014.07.011] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 07/08/2014] [Accepted: 07/13/2014] [Indexed: 01/22/2023]
Abstract
Dental implants are widely used for oral rehabilitation. However, there remain risks of failure which are difficult to anticipate and depend on the implant osseointegration. The objective of this in vivo study is to determine the variation of the echographic ultrasonic response of a dental implant to bone healing around the implant interface. Twenty one dental implants were inserted in the femur of seven New Zealand white rabbits. Two animals were sacrificed after a healing duration of two weeks, three animals after six weeks and six animals after eleven weeks. The 10 MHz ultrasonic response of the implant was measured just after the implantation using a dedicated device positioned at the emerging surface of each dental implant. The measurements were realized again before the sacrifice with the same device. An indicator I˜ was derived based on the amplitude of the rf signal obtained for each configuration. The bone-Implant Contact (BIC) ratio was determined by histological analyses. The average value of the relative variation of the indicator I˜ obtained after initial surgery and after the corresponding healing period varies between 7% and 40%. A Kruskal-Wallis test (p<0.01) revealed a significant decrease of the value of the indicator I˜ as function of healing time. The indicator I˜ was significantly correlated (R(2)=0.45) with the BIC ratio. The results show that the ultrasonic response of a dental implant varies significantly as a function of healing time, which paves the way for the development of a new quantitative ultrasound (QUS) method in oral implantology.
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Kohal RJ, Patzelt SBM, Butz F, Sahlin H. One-piece zirconia oral implants: one-year results from a prospective case series. 2. Three-unit fixed dental prosthesis (FDP) reconstruction. J Clin Periodontol 2013; 40:553-62. [DOI: 10.1111/jcpe.12093] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthodontics; School of Dentistry; Albert-Ludwigs University; Freiburg Germany
| | - Sebastian B. M. Patzelt
- Department of Periodontics; School of Dentistry; University of Maryland; Baltimore USA
- Department of Prosthodontics; School of Dentistry; Albert-Ludwigs University; Freiburg Germany
| | - Frank Butz
- Department of Prosthodontics; School of Dentistry; Albert-Ludwigs University; Freiburg Germany
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Park YS, Chung SH, Shon WJ. Peri-implant bone formation and surface characteristics of rough surface zirconia implants manufactured by powder injection molding technique in rabbit tibiae. Clin Oral Implants Res 2012; 24:586-91. [PMID: 22471790 DOI: 10.1111/j.1600-0501.2012.02468.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate osseointegration in rabbit tibiae and to investigate surface characteristics of novel zirconia implants made by powder injection molding (PIM) technique, using molds with and without roughened inner surfaces. MATERIAL AND METHODS A total of 20 rabbits received three types of external hex implants with identical geometry on the tibiae: machined titanium implants, PIM zirconia implants without mold etching, and PIM zirconia implants with mold etching. Surface characteristics of the three types of implant were evaluated. Removal torque tests and histomorphometric analyses were performed. RESULTS The roughness of PIM zirconia implants was higher than that of machined titanium implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined titanium implants (P < 0.001). The PIM zirconia implants using roughened mold showed significantly higher removal torque values than PIM zirconia implants without using roughened mold (P < 0.001). CONCLUSIONS It is concluded that the osseointegration of PIM zirconia implant is promising and PIM using roughened mold etching technique can produce substantially rough surfaces on zirconia implants.
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Affiliation(s)
- Young-Seok Park
- Department of Oral Anatomy, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
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