Microscopic Study of Surface Microtopographic Characteristics of Dental Implants

A novel chlorhexidine-hexametaphosphate coating for titanium with antibiofilm efficacy and stem cell cytocompatibility

Dental implants are an increasingly popular way to replace missing teeth. Whilst implant survival rates are high, a small number fail soon after placement, with various factors, including bacterial contamination, capable of disrupting osseointegration. This work describes the development of chlorhexidine-hexametaphosphate coatings for titanium that hydrolyse to release the antiseptic agent chlorhexidine. The aim was to develop a coating for titanium that released sufficient chlorhexidine to prevent biofilm formation, whilst simultaneously maintaining cytocompatibility with cells involved in osseointegration. The coatings were characterised with respect to physical properties, after which antibiofilm efficacy was investigated using a multispecies biofilm model, and cytocompatibility determined using human mesenchymal stem cells. The coatings exhibited similar physicochemical properties to some implant surfaces in clinical use, and significantly reduced formation of multispecies biofilm biomass up to 72 h. One coating had superior cytocompatibility, with mesenchymal stem cells able to perform normal functions and commence osteoblastic differentiation, although at a slower rate than those grown on uncoated titanium. With further refinement, these coatings may have application in the prevention of bacterial contamination of dental implants at the time of surgery. This could aid a reduction in rates of early implant failure.

Bisphosphonate-based surface biofunctionalization improves titanium biocompatibility

Novel-biofunctionalized surfaces are required to improve the performance of endosseous implants, which are mainly related to the resistance against biocorrosion, as well as for the consideration of osteoinductive phenomena. Among different strategies, the use of bisphosphonate molecules as linkers between titanium dioxide (TiO₂) surfaces and proteins is a distinctive approach, one in which bisphosphonate could play a role in the osseointegration. Thus, to address this issue, we proposed a novel biofunctionalization of TiO₂ surfaces using sodium alendronate (ALN) as a linker and bovine serum albumin as the protein. Physicochemical analysis of the functionalized surfaces was performed using contact angle analyses and surface roughness measurements, which indicated an efficient functionalization. The biocompatibility of the functionalized surfaces was analyzed through the adhesion behavior of the pre-osteoblasts onto the samples. Overall, our data showed a significant improvement concerning the cell adhesion by modulating the adhesion cell-related set of genes. The obtained results show that for modified surfaces there is an increase of up to 100 times in the percentage of cells adhered when compared to the control, besides the extracellular matrix remodeling seemed to be an essential prerequisite for the early stages of cell adhesion on to the biomaterials, which was assayed by evaluating the matrix metalloproteinase activities as well as the gene activations. In the expressions of the Bsp and Bglap2 genes, for the group containing ALN (TiO₂ + ALN), it was observed an increase in expression (approximately sixfold change) when compared to the control. Altogether, our data clearly showed that the bisphosphonate-biofunctionalized surface enhanced the biocompatibility of titanium and claims to further progress preclinical in vivo experimentation.

Influence of Three Dental Implant Surfaces on Cell Viability and Bone Behavior. An In Vitro and a Histometric Study in a Rabbit Model

The chemical composition and the surface characteristics of dental implants are factors that have a decisive effect on the osseointegration process. The surface characterization at the compositional and topographic level of three dental implants available in the market was performed with different surface treatments: (1) sandblasted and acid etched surface (SLA), (2) hydroxyapatite (HA) and tricalcium phosphate (TCP) blasted surface (HA/TCP), and (3) HA-blasted and non-etching acid washed surface (HA + AW). In addition, an in vitro viability study of MG-63 osteoblast cells was performed with a JC-1 test. To complete the study, an in vivo study was conducted in New Zealand rabbits. The study analyzed the histometric characteristics of the bone formed around the implants at the level of area, volume, bone density, accumulated bone density, and bone–implant contact (BIC). The rabbits were sacrificed at 6 weeks after implants were placed in the tibial metaphysis. No statistically significant differences were observed at the level of cell viability or histometric parameters between the different study groups (p > 0.05). SLA and HA/TCP surfaces were the ones that obtained a higher BIC value. Taking into account the limitations of this study, it can be concluded that the different implant surfaces analyzed favor a good bone response.

Superficial Characteristics of Titanium after Treatment of Chorreated Surface, Passive Acid, and Decontamination with Argon Plasma

(1) Background. Titanium is characterized by its biocompatibility, resistance to maximum stress, and fatigue and non-toxicity. The composition, surface structure, and roughness of titanium have a key and direct influence on the osseointegration processes when it is used in the form of dental implants. The objective of the present study is to characterize, at chemical, superficial, and biological levels, the result of the application of the sandblasted with large-grit and acid-etched (SLA) treatment consisting of coarse-grained and double-passivated acid blasting with subsequent decontamination with argon plasma on the surface of titanium implants type IV. (2) Methods. Four Oxtein^® dental implants (Zaragoza, Spain) were investigated with the following coding: Code L63713T (titanium grade IV, 3.75 mm in diameter, and 13 mm in length). The surface of the implants was SLA type obtained from coarse-grained, double passivated acid, and decontaminated with argon plasma. The samples were in their sealed packages and were opened in our laboratory. The X-ray photoelectron spectroscopy (XPS) technique was used to characterize the chemical composition of the surface, and the scanning electronic microscope (SEM) technique was used to perform topographic surface evaluation. Cell cultures were also performed on both surfaces. (3) Results. The superficial chemical analysis of the studied samples presented the following components, approximately, expressed in atomic percentage: O: 39%; Ti: 18%; C: 39%; N: 2%; and Si: 1%. In the same way, the topographic analysis values were obtained in the evaluated roughness parameters: R_a: 1.5 μm ± 0.02%; R_q: 1.31 μm ± 0.33; R_z: 8.98 μm ± 0.73; R_p: 5.12 μm ± 0.48; R_v: 3.76 μm ± 0.51; and R_c: 4.92 μm ± 0.24. At a biological level, the expression of osteocalcin was higher (p < 0.05) on the micro-rough surface compared to that machined at 48 and 96 h of culture. (4) Conclusions. The data obtained in our study indicate that the total carbon content, the relative concentration of titanium, and the roughness of the treatment performed on the implants are in agreement with those found in the literature. Further, the roughness of the treatment performed on the implants throws a spongy, three-dimensional surface suitable for bone growth on it. The biological results found are compatible with the clinical use of the surface tested.

Titanium surface bio-functionalization using osteogenic peptides: Surface chemistry, biocompatibility, corrosion and tribocorrosion aspects

Titanium (Ti) is widely used in biomedical devices due to its recognized biocompatibility. However, implant failures and subsequent clinical side effects are still recurrent. In this context, improvements can be achieved by designing biomaterials where the bulk and the surface of Ti are independently tailored. The conjugation of biomolecules onto the Ti surface can improve its bioactivity, thus accelerating the osteointegration process. Ti was modified with TiO₂, two different spacers, 3-(4-aminophenyl) propionic acid (APPA) or 3-mercaptopropionic acid (MPA) and dentin matrix protein 1 (DMP1) peptides. X-ray photoelectron spectroscopy analysis revealed the presence of carbon and nitrogen for all samples, indicating a success in the functionalization process. Furthermore, DMP1 peptides showed an improved coverage area for the samples with APPA and MPA spacers. Biological tests indicated that the peptides could modulate cell affinity, proliferation, and differentiation. Enhanced results were observed in the presence of MPA. Moreover, the immobilization of DMP1 peptides through the spacers led to the formation of calcium phosphate minerals with a Ca/P ratio near to that of hydroxyapatite. Corrosion and tribocorrosion results indicated an increased resistance to corrosion and lower mass loss in the functionalized materials, showing that this new type of functional material has attractive properties for biomaterials application.