Stability of smooth and rough mini-implants: clinical and biomechanical evaluation - an in vivostudy

Advancing of 3D-Printed Titanium Implants with Combined Antibacterial Protection Using Ultrasharp Nanostructured Surface and Gallium-Releasing Agents

This paper presents the development of advanced Ti implants with enhanced antibacterial activity. The implants were engineered using additive manufacturing three-dimensional (3D) printing technology followed by surface modification with electrochemical anodization and hydrothermal etching, to create unique hierarchical micro/nanosurface topographies of microspheres covered with sharp nanopillars that can mechanically kill bacteria in contact with the surface. To achieve enhanced antibacterial performance, fabricated Ti implant models were loaded with gallium nitrate as an antibacterial agent. The antibacterial efficacy of the fabricated substrates with the combined action of sharp nanopillars and locally releasing gallium ions (Ga³⁺) was evaluated toward Staphylococcus aureus and Pseudomonas aeruginosa. Results confirm the significant antibacterial performance of Ga³⁺-loaded substrates with a 100% eradication of bacteria. The nanopillars significantly reduced bacterial attachment and prevented biofilm formation while also killing any bacteria remaining on the surface. Furthermore, 3D-printed surfaces with microspheres of diameter 5-30 μm and interspaces of 12-35 μm favored the attachment of osteoblast-like MG-63 cells, as confirmed via the assessment of their attachment, proliferation, and viability. This study provides important progress toward engineering of next-generation 3D-printed implants, that combine surface chemistry and structure to achieve a highly efficacious antibacterial surface with dual cytocompatibility to overcome the limitations of conventional Ti implants.

Effect of surface treatment on the mechanical stability of orthodontic miniscrews

OBJECTIVES

To provide collective quantitative evidence about the effect of surface treatments on the mechanical stability of orthodontic miniscrews (MSs).

MATERIALS AND METHODS

The study was registered in PROSPERO (No. CRD42020209652). The research question was defined according to the PICO (population, intervention, control, and outcomes) format. Various research databases were searched for animal and human studies on effects of surface treatment on the mechanical stability of MSs. Both prospective and retrospective in vivo clinical studies published in English were included. The risk of bias was assessed using SYRCLE's risk of bias tool for animal studies. The meta-analysis was conducted using RevMan 5.4.

RESULTS

A total of 109 articles were identified; 14 were included in the systematic review, and seven studies with sandblasting, acid etching (SLA) methods of surface treatment were included for meta-analysis. The number of study participants ranged from 6 to 24 (total n = 185), with a mean of 13.2. A total of 949 MSs were used with a mean of 67.8. The overall success rate for surface-treated MSs ranged from 47.9% to 100%. Forest plot of removal torque values showed significantly higher values for SLA surface-treated MSs compared with controls with a standard mean difference of 2.61 (95% confidence interval = 1.49-3.72, I2 = 85%). Forest plot of insertion torque showed a standard mean difference of -6.19 (95% confidence interval = -13.63-1.25, I2 = 98%, P = .10).

CONCLUSIONS

Surface treatment of MSs improved primary and secondary stability with good osseointegration at the bone-implant surface. However, significant heterogeneity across the studies included in the meta-analysis made it difficult to draw conclusions.