Influence of Grit-Blasting and Hydrofluoric Acid Etching Treatment on Surface Characteristics and Biofilm Formation on Zirconia

A Comprehensive Review of the Contemporary Methods for Enhancing Osseointegration and the Antimicrobial Properties of Titanium Dental Implants

Titanium dental implants with various restorative options are popular for replacing missing teeth due to their comfortable fit, excellent stability, natural appearance, and impressive track record in clinical settings. However, challenges such as potential issues with osseointegration, peri-implant bone loss, and peri-implantitis might lead to implant failure, causing concern for patients and dental staff. Surface modification has the potential to significantly enhance the success rate of titanium implants and meet the needs of clinical applications. This involves the application of various physical, chemical, and bioactive coatings, as well as adjustments to implant surface topography, offering significant potential for enhancing implant outcomes in terms of osseointegration and antimicrobial properties. Many surface modification methods have been employed to improve titanium implants, showcasing the diversity of approaches in this field including sandblasting, acid etching, plasma spraying, plasma immersion ion implantation, physical vapor deposition, electrophoretic deposition, electrochemical deposition, anodization, microarc oxidation, laser treatments, sol-gel method, layer-by-layer self-assembly technology, and the adsorption of biomolecules. This article provides a comprehensive overview of the surface modification methods for titanium implants to address issues with insufficient osseointegration and implant-related infections. It encompasses the physical, chemical, and biological aspects of these methods to provide researchers and dental professionals with a robust resource to aid them in their study and practical use of dental implant materials, ensuring they are thoroughly knowledgeable and well-prepared for their endeavors.

Zirconia Dental Implant Designs and Surface Modifications: A Narrative Review

Titanium currently has a well-established position as the gold standard for manufacturing dental implants; however, it is not free of flaws. Mentions of possible soft-tissue discoloration, corrosion, and possible allergic reactions have led to the development of zirconia dental implants. Various techniques for the surface modification of titanium have been applied to increase titanium implants' ability to osseointegrate. Similarly, to achieve the best possible results, zirconia dental implants have also had their surface modified to promote proper healing and satisfactory long-term results. Despite zirconium oxide being a ceramic material, not simply a metal, there have been mentions of it being susceptible to corrosion too. In this article, we aim to review the literature available on zirconia implants, the available techniques for the surface modification of zirconia, and the effects of these techniques on zirconia's biological properties. Zirconia's biocompatibility and ability to osseointegrate appears unquestionably good. Despite some of its mechanical properties being, factually, inferior to those of titanium, the benefits seem to outweigh the drawbacks. Zirconia implants show very good success rates in clinical research. This is partially due to available methods of surface treatment, including nanotopography alterations, which allow for improved wettability, bone-to-implant contact, and osteointegration in general.

Surface modification of dental zirconia implants with a low infiltration temperature glass

The glass infiltration technique was employed for surface modification of zirconia implants in this study. The prepared glass-infiltrated zirconia with low infiltrating temperature showed excellent mechanical properties and enough infiltrating layer. The zirconia substrate was pre-sintered at 1,200°C and the glass infiltration depth reached 400 μm after infiltrating at 1,200°C for 10 h. The infiltrating glass has good wetting ability, thermal expansion match and good chemical compatibility with the zirconia substrate. Indentation fracture toughness and flexural strength of the dense sintered glass-infiltrated zirconia composite are respectively 5.37±0.45 MPa•m1/2 and 841.03±89.31 MPa. Its elasticity modulus is 163.99±7.6 GPa and has about 500 μm infiltrating layer. The glass-infiltrated zirconia can be acid etched to a medium roughness (1.29±0.09 μm) with a flexural strength of 823.65±87.46 MPa, which promotes cell proliferation and has potential for dental implants.

Overview of strategies to improve the antibacterial property of dental implants

The increasing number of peri-implant diseases and the unsatisfactory results of conventional treatment are causing great concern to patients and medical staff. The effective removal of plaque which is one of the key causes of peri-implant disease from the surface of implants has become one of the main problems to be solved urgently in the field of peri-implant disease prevention and treatment. In recent years, with the advancement of materials science and pharmacology, a lot of research has been conducted to enhance the implant antimicrobial properties, including the addition of antimicrobial coatings on the implant surface, the adjustment of implant surface topography, and the development of new implant materials, and significant progress has been made in various aspects. Antimicrobial materials have shown promising applications in the prevention of peri-implant diseases, but meanwhile, there are some shortcomings, which leads to the lack of clinical widespread use of antimicrobial materials. This paper summarizes the research on antimicrobial materials applied to implants in recent years and presents an outlook on the future development.

Role of Biofilms in Waste Water Treatment

Biofilm cells have a different physiology than planktonic cells, which has been the focus of most research. Biofilms are complex biostructures that form on any surface that comes into contact with water on a regular basis. They are dynamic, structurally complex systems having characteristics of multicellular animals and multiple ecosystems. The three themes covered in this review are biofilm ecology, biofilm reactor technology and design, and biofilm modeling. Membrane-supported biofilm reactors, moving bed biofilm reactors, granular sludge, and integrated fixed-film activated sludge processes are all examples of biofilm reactors used for water treatment. Biofilm control and/or beneficial application in membrane processes are improving. Biofilm models have become critical tools for biofilm foundational research as well as biofilm reactor architecture and design. At the same time, the differences between biofilm modeling and biofilm reactor modeling methods are acknowledged.

How Porphyromonas gingivalis Navigate the Map: The Effect of Surface Topography on the Adhesion of Porphyromonas gingivalis on Biomaterials

The main purpose of this study is to develop an understanding of how Porphyromonas gingivalis responds to subperiosteal implant surface topography. A literature review was drawn from various electronic databases from 2000 to 2021. The two main keywords used were "Porphyromonas gingivalis" and "Surface Topography". We excluded all reviews and or meta-analysis articles, articles not published in English, and articles with no surface characterization process or average surface roughness (Ra) value. A total of 26 selected publications were then included in this study. All research included showed the effect of topography on Porphyromonas gingivalis to various degrees. It was found that topography features such as size and shape affected Porphyromonas gingivalis adhesion to subperiosteal implant materials. In general, a smaller Ra value reduces Porphyromonas gingivalis regardless of the type of materials, with a threshold of 0.3 µm for titanium.

The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation

Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant's surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.

The application of novel mussel-inspired compounds in dentistry

OBJECTIVE

To give a current review of the mechanism of mussel adhesion, the application of mussel-inspired compounds in dentistry and the challenges associated with clinical application.

METHODS

Inspired by the wet adhesion property of 3,4-dihydroxyphenol-l-alanine (Dopa) in mussel plaques, various chemical compounds have been synthesized to mimic the mussel as an adhesion model for medical applications. Similar to mussels in the marine environment, dental materials in the oral environment have to endure long-term water hydrolysis, mechanical stress and other chemical challenges. These challenges have influenced an increasing number of studies that are exploring the translation of mussel-inspired adhesion to clinical applications. Therefore, this review discusses the mussel adhesion chemistry and its related application in dentistry.

RESULTS

Mussel-inspired compounds have achieved relatively acceptable performances in various dental fields, including surface coating, metal ions chelation, dentin bonding and mucosal adhesion. However, two practical problems remain to be comprehensively addressed, namely the protection of catechol groups from oxidation, and the feasibility for clinical application.

SIGNIFICANCE

The mussel's wet adhesion ability has attracted much research interest in the dental field because of its properties of moisture-resistant adhesion and surface coating. Despite the emergence of several mussel-inspired compounds in recent years, a comprehensive and timely review of their applications in dentistry is lacking. Therefore, the current review hopes to provide valuable information around the application of mussel-inspired compounds in dentistry with their pros and cons discussed.

The Effectiveness of Nafion-Coated Stainless Steel Surfaces for Inhibiting Bacillus Subtilis Biofilm Formation

Stainless steel is one of most commonly used materials in the world; however, biofilms on the surfaces of stainless steel cause many serious problems. In order to find effective methods of reducing bacterial adhesion to stainless steel, and to investigate the role of electrostatic effects during the formation of biofilms, this study used a stainless steel surface that was negatively charged by being coated with Nafion which was terminated by sulfonic groups. The results showed that the roughness of stainless steel discs coated with 1% Nafion was similar to an uncoated surface; however the hydrophobicity increased, and the Nafion-coated surface reduced the adhesion of Bacillus subtilis by 75% compared with uncoated surfaces. Therefore, a facile way to acquire antibacterial stainless steel was found, and it is proved that electrostatic effects have a significant influence on the formation of biofilms.

An introduction of biological performance of zirconia with different surface characteristics: A review

Zirconia (ZrO₂) ceramic is widely used in dentistry as a clinical dental biomaterial. In this review, we are focusing on and summarizing the biological performance of zirconia under different surface characteristics. We have included an initial tissue cell attachment study on zirconia and bacterial adhesion on zirconia. Our results suggest that surface modifications applied on zirconia may change the interfacial surface characteristics e.g. surface roughness, surface free energy, and chemistry of zirconia. The modifications also result in advanced biological performance of zirconia, including enhanced tissue cell attachment and reduction of bacterial adhesion. The recent laboratory research has provided many interesting modification methods and showed clinically interesting and promising outcomes. A few of the outcomes are validated and have been applied in clinical dentistry.

Prolonged UV-C Irradiation is a Double-Edged Sword on the Zirconia Surface

Zirconia has become an excellent choice of dental implants because of its excellent mechanical strength, aesthetic, and biocompatibility. Although some studies have shown ultraviolet (UV) irradiation is effective to photofunctionalize dental zirconia that can improve osteoblastic function, the scattered information has not identified the most effective exposure time and wavelength of UV. Herein, this study has investigated the effects of UV irradiation on zirconia after UV-A (365 nm) or UV-C (243 nm) photofunctionalization for different times (15 min, 3 and 24 h). After irradiation, the zirconia surface was analyzed by color spectrophotometry, scanned electron microscopy (SEM), energy-dispersive X-ray spectrometry, water contact angle (WCA) with goniometer, and X-ray diffraction. Osteoblastic (MC3T3-E1) cells were cultured on zirconia discs and evaluated with a CCK-8 test kit for cell proliferation (3 h and 1 day) and with alkaline phosphatase (ALP) activity (14 days). Significant color change (ΔE) was observed by irradiating with UV-C for 15 min (1.99), 3 h (1.92), and 24 h (3.35), whereas only minute changes were observed with UV-A (respectively, ΔE: 0.18, 0.14, 0.57). No surface textural changes were observed nor a monoclinic phase was detected on both the UV-A and UV-C irradiated samples. UV-C significantly decreased the C/Zr ratios and WCA, with irradiating for 24 h presenting the lowest values, and it was the only condition to give significantly higher ALP activity at 14 days (p < 0.05) and CCK-8 values for 1 day culture (p < 0.05). It is concluded that UV-C (but not UV-A) irradiation can significantly change the aesthetic in color, and only prolonged 24 h UV-C irradiation can enhance MC3T3-E1 cell adhesion on zirconia by photofunctionalization.

Evaluation of Zirconia Surfaces after Strong-Acid Etching and Its Effects on the Shear Bond Strength of Dental Resin Cement

The present study was intended to investigate changes in the microstructure and phase transformation of zirconia surfaces using etching and airborne-particle abrasion (AB) and the effects of these processes on the shear bond strength of dental resin cements to zirconia. Four groups were classified according to the surface treatment as follows: etching for 15 min (ET15), etching for 30 min (ET30), AB, and etching for 15 min following AB (ABET). These groups were then classified into two subgroups (a total of 8 groups with 11 specimens/group) according to the resin cement used for bonding, namely, Rely-X U200 (3M ESPE, St. Paul, MN, USA) or Panavia F 2.0 (Kuraray, Kurashiki, Okayama, Japan). Shear bond strength testing was performed using a universal testing device. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) were also performed. When using Rely-X U200, ET15 exhibited the highest mean shear bond strength; the strengths of ET15, ABET, and ET30 were significantly higher than that of AB. When using Panavia F 2.0, ABET demonstrated the highest mean shear bond strength; the strengths of ABET and ET15 were significantly higher than those of ET30 and AB. The etched surface of zirconia could be observed using SEM, and the phase transformations resulting from each surface treatment were detected by XRD. Strong-acid etching of zirconia induced significant surface changes that increased the shear bond strength of resin cement, and the resin adhesive strength was higher when zirconia was etched with strong acid vs. AB alone.

Current Status on Pulsed Laser Deposition of Coatings from Animal-Origin Calcium Phosphate Sources

The aim of this paper is to present the current status on animal-origin hydroxyapatite (HA) coatings synthesized by Pulsed Laser Deposition (PLD) technique for medical implant applications. PLD as a thin film synthesis method, although limited in terms of surface covered area, still gathers interest among researchers due to its advantages such as stoichiometric transfer, thickness control, film adherence, and relatively simple experimental set-up. While animal-origin HA synthesized by bacteria or extracted from animal bones, eggshells, and clams was tested in the form of thin films or scaffolds as a bioactive agent before, the reported results on PLD coatings from HA materials extracted from natural sources were not gathered and compared until the present study. Since natural apatite contains trace elements and new functional groups, such as CO32− and HPO42− in its complex molecules, physical-chemical results on the transfer of animal-origin HA by PLD are extremely interesting due to the stoichiometric transfer possibilities of this technique. The points of interest of this paper are the origin of HA from various sustainable resources, the extraction methods employed, the supplemental functional groups, and ions present in animal-origin HA targets and coatings as compared to synthetic HA, the coatings’ morphology function of the type of HA, and the structure and crystalline status after deposition (where properties were superior to synthetic HA), and the influence of various dopants on these properties. The most interesting studies published in the last decade in scientific literature were compared and morphological, elemental, structural, and mechanical data were compiled and interpreted. The biological response of different types of animal-origin apatites on a variety of cell types was qualitatively assessed by comparing MTS assay data of various studies, where the testing conditions were possible. Antibacterial and antifungal activity of some doped animal-origin HA coatings was also discussed.

Dental Resin-Zirconia Bonding Promotion Using High-Silica PVD Coating with High Ionization Sputtering Processing

Purpose: To evaluate the effect of high-silica coating deposited by high-silica physical vapor deposition (PVD) as a chemical bonding method on resin-zirconia bond strength under different aging conditions. Methods: Twelve Y-TZP blocks were used as the substrates. Four resin cement stubs were bonded on each Y-TZP block, with a total number of 48 resin cement stubs. Two test groups (n = 24) were evaluated: conventional Tribochemical silica-coating (TSC) and high-silica PVD with high ionization sputtering processing. Experimental silane primer (MPS) was brushed over the surface treated Y-TZP blocks, then a polyethylene mold was placed over the coated Y-TZP blocks and filled with the adhesive resin cement, then light-cured for 40 s. The shear bond strength (SBS) was then evaluated in dry condition and after thermo-cycling for 6000 cycles. Surface roughness, mode of failure, surface topography and elemental analysis were also evaluated. Results: In dry condition, PVD-coated zirconia specimens showed significantly higher mean SBS values (11.7 ± 1.3 MPa) compared to TSC (10.2 ± 1.1 MPa) (p = 0.027). The SBS values of TSC and PVD-coated samples after thermo-cycling were higher than in dry condition, but with no statistical significant difference (p > 0.05). Tetragonal-to-monoclinic phase transformation was detected in TSC, but not in PVD-coated zirconia. Significant decrease in surface roughness of PVD samples compared to TSC samples (p < 0.001). The silica content in PVD coating was 51% as detected by EDX. Conclusions: High-silica PVD coating on zirconia can give a reliable resin-zirconia chemical bond without any phase transformation and surface destruction by conventional grit-blasting.

Effects of different surface finishing protocols for zirconia on surface roughness and bacterial biofilm formation

PURPOSE

Surface finishing of a zirconia restoration is essential after clinical adjustment. Herein, we investigated the effects of a surface finishing protocol for monolithic zirconia on final roughness and bacterial adherence.

MATERIALS AND METHODS

Forty-eight disk-shaped monolithic zirconia specimens were fabricated and divided into four groups (n = 12) based on initial surface treatment, finishing, and polishing protocols: diamond bur+polishing bur (DP group), diamond bur+stone grinding bur+polishing bur (DSP group), no diamond bur+polishing bur (NP group), and no diamond bur+stone grinding bur+polishing bur (NSP group). Initial and final surface roughness was measured with a profilometer, and shown using scanning electron microscope. Bacterial adhesion was evaluated by quantifying Streptococcus mutans in the biofilm. Kruskal-Wallis and Mann-Whitney U tests were used to compare results among groups, and two-way analysis of variance was used to evaluate the effects of grinding burs on final roughness (α=.05).

RESULTS

The DP group had the highest final Ra value, followed by the DSP, NP, and NSP groups. Use of the stone grinding bur as a coarse-finishing step significantly decreased final Ra values when a diamond bur was used (P<.001). Omission of the stone grinding bur increased biofilm formation on specimen surfaces. Combining a stone grinding bur with silicone polishing burs produced the smallest final biofilm values, regardless of the use of a diamond bur in initial surface treatment.

CONCLUSION

Coarse finishing of monolithic zirconia with a stone grinding bur significantly decreased final Ra values and bacterial biofilm formation when surfaces had been roughened by a diamond bur.