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Ma Z, Zhao Y, Xu Z, Zhang Y, Han Y, Jiang H, Sun P, Feng W. 3D-printed porous titanium rods equipped with vancomycin-loaded hydrogels and polycaprolactone membranes for intelligent antibacterial drug release. Sci Rep 2024; 14:21749. [PMID: 39294268 PMCID: PMC11411058 DOI: 10.1038/s41598-024-72457-1] [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: 07/01/2024] [Accepted: 09/06/2024] [Indexed: 09/20/2024] Open
Abstract
Implant-related infections pose significant challenges to orthopedic surgeries due to the high risk of severe complications. The widespread use of bioactive prostheses in joint replacements, featuring roughened surfaces and tight integration with the bone marrow cavity, has facilitated bacterial proliferation and complicated treatment. Developing antibacterial coatings for orthopedic implants has been a key research focus in recent years to address this critical issue. Researchers have designed coatings using various materials and antibacterial strategies. In this study, we fabricated 3D-printed porous titanium rods, incorporated vancomycin-loaded mPEG750-b-PCL2500 gel, and coated them with a PCL layer. We then evaluated the antibacterial efficacy through both in vitro and in vivo experiments. Our coating passively inhibits bacterial biofilm formation and actively controls antibiotic release in response to bacterial growth, providing a practical solution for proactive and sustained infection control. This study utilized 3D printing technology to produce porous titanium rod implants simulating bioactive joint prostheses. The porous structure of the titanium rods was used to load a thermoresponsive gel, mPEG750-b-PCL2500 (PEG: polyethylene glycol; PCL: polycaprolactone), serving as a novel drug delivery system carrying vancomycin for controlled antibiotic release. The assembly was then covered with a PCL membrane that inhibits bacterial biofilm formation early in infection and degrades when exposed to lipase solutions, mimicking enzymatic activity during bacterial infections. This setup provides infection-responsive protection and promotes drug release. We investigated the coating's controlled release, antibacterial capability, and biocompatibility through in vitro experiments. We established a Staphylococcus aureus infection model in rabbits, implanting titanium rods in the femoral medullary cavity. We evaluated the efficacy and safety of the composite coating in preventing implant-related infections using imaging, hematology, and pathology. In vitro experiments demonstrated that the PCL membrane stably protects encapsulated vancomycin during PBS immersion. The PCL membrane rapidly degraded at a lipase concentration of 0.2 mg/mL. The mPEG750-b-PCL2500 gel ensured stable and sustained vancomycin release, inhibiting bacterial growth. We investigated the antibacterial effect of the 3D-printed titanium material, coated with PCL and loaded with mPEG750-b-PCL2500 hydrogel, using a rabbit Staphylococcus aureus infection model. Imaging, hematology, and histopathology confirmed that our composite antibacterial coating exhibited excellent antibacterial effects and infection prevention, with good safety in trials. Our results indicate that the composite antibacterial coating effectively protects vancomycin in the hydrogel from premature release in the absence of bacterial infection. The outer PCL membrane inhibits bacterial growth and prevents biofilm formation. Upon contact with bacterial lipase, the PCL membrane rapidly degrades, releasing vancomycin for antibacterial action. The mPEG750-b-PCL2500 gel provides stable and sustained vancomycin release, prolonging its antibacterial effects. Our composite antibacterial coating demonstrates promising potential for clinical application.
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Affiliation(s)
- Zheru Ma
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China
| | - Yao Zhao
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China
| | - Zhe Xu
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China
- Weifang Traditional Chinese Hospital, Weifang, China
| | - Yao Zhang
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China
- Affiliated Hospital of Yangzhou University, Yangzhou, China
| | - Yu Han
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China
| | - Haozhuo Jiang
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China
| | - Peng Sun
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China
| | - Wei Feng
- Department of Bone and Joint Surgery, Orthopedic Center, The First Hospital of Jilin University, 72 Xinmin Street, Changchun, 130021, Jilin, China.
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Schnurr E, Sperlich M, Sones A, Romanos GE, Rutkowski JL, Duddeck DU, Neugebauer J, Att W, Sperlich M, Volz KU, Ghanaati S. Ceramic Implant Rehabilitation: Consensus Statements from Joint Congress for Ceramic Implantology: Consensus Statements on Ceramic Implant. J ORAL IMPLANTOL 2024; 50:435-445. [PMID: 38867376 DOI: 10.1563/aaid-joi-d-23-00083] [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] [Indexed: 06/14/2024]
Abstract
The objectives of the study group focused on the following main topics related to the performance of 1- and 2-piece ceramic implants: defining bone-implant-contact percentages and its measurement methods, evaluating the pink esthetic score as an esthetic outcome parameter after immediate implantation, recognizing the different results of ceramic implant designs as redefined by the German Association of Oral Implantology, incorporating the patient report outcome measure to include satisfaction and improvement in oral health-related quality of life, and conducting preclinical studies to address existing gaps in ceramic implants. During the Joint Congress for Ceramic Implantology (2022), the study group evaluated 17 clinical trials published between 2015 and 2021. After extensive discussions and multiple closed sessions, consensus statements and recommendations were developed, incorporating all approved modifications. A 1-piece implant design features a coronal part that is fused to the implant body or interfaces with the postabutment restoration platform, undergoing transmucosal healing. Long-term evaluations of this implant design are supported by established favorable clinical evidence. Inaccuracies in the pink esthetic score and bone-implant-contact percentages were managed by establishing control groups for preclinical studies and randomizing clinical trials. The patient-reported outcome measures were adjusted to include an individual visual analog scale, collected from each clinical study, that quantified improved oral health and quality of life. Preclinical investigations should focus on examining the spread of ceramic debris and the impact of heat generation on tissue and cellular levels during drilling. Further technical advancements should prioritize wound management and developing safe drilling protocols.
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Affiliation(s)
- Etyene Schnurr
- Ceramic and Biological Dentistry Foundation, Kreuzlingen, Switzerland
- Basic Science Department, Health Institute of Nova Friburgo, Federal Fluminense University, Brazil
| | | | - Amerian Sones
- Board of Directors of the Academy of Osseointegration
| | - George E Romanos
- Department of Periodontology and Endodontics, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - J L Rutkowski
- Restorative Dentistry, School of Dental Medicine, State University of New York, Buffalo, New York
| | | | - Jörg Neugebauer
- Department of Oral and Maxillofacial Plastic Surgery, University of Cologne, Köln, Germany
| | - Wael Att
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | | | | | - Shahram Ghanaati
- Frankfurt Oral Regenerative Medicine, Clinic for Maxillofacial and Plastic Surgery, Johann Wolfgang Goethe University, Frankfurt Am Main, Germany
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3
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Matsuura T, Komatsu K, Cheng J, Park G, Ogawa T. Beyond microroughness: novel approaches to navigate osteoblast activity on implant surfaces. Int J Implant Dent 2024; 10:35. [PMID: 38967690 PMCID: PMC11226592 DOI: 10.1186/s40729-024-00554-x] [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: 04/04/2024] [Accepted: 06/15/2024] [Indexed: 07/06/2024] Open
Abstract
Considering the biological activity of osteoblasts is crucial when devising new approaches to enhance the osseointegration of implant surfaces, as their behavior profoundly influences clinical outcomes. An established inverse correlation exists between osteoblast proliferation and their functional differentiation, which constrains the rapid generation of a significant amount of bone. Examining the surface morphology of implants reveals that roughened titanium surfaces facilitate rapid but thin bone formation, whereas smooth, machined surfaces promote greater volumes of bone formation albeit at a slower pace. Consequently, osteoblasts differentiate faster on roughened surfaces but at the expense of proliferation speed. Moreover, the attachment and initial spreading behavior of osteoblasts are notably compromised on microrough surfaces. This review delves into our current understanding and recent advances in nanonodular texturing, meso-scale texturing, and UV photofunctionalization as potential strategies to address the "biological dilemma" of osteoblast kinetics, aiming to improve the quality and quantity of osseointegration. We discuss how these topographical and physicochemical strategies effectively mitigate and even overcome the dichotomy of osteoblast behavior and the biological challenges posed by microrough surfaces. Indeed, surfaces modified with these strategies exhibit enhanced recruitment, attachment, spread, and proliferation of osteoblasts compared to smooth surfaces, while maintaining or amplifying the inherent advantage of cell differentiation. These technology platforms suggest promising avenues for the development of future implants.
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Affiliation(s)
- Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - James Cheng
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
| | - Gunwoo Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA.
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA.
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Park G, Matsuura T, Komatsu K, Ogawa T. Optimizing implant osseointegration, soft tissue responses, and bacterial inhibition: A comprehensive narrative review on the multifaceted approach of the UV photofunctionalization of titanium. J Prosthodont Res 2024:JPR_D_24_00086. [PMID: 38853001 DOI: 10.2186/jpr.jpr_d_24_00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Titanium implants have revolutionized restorative and reconstructive therapy, yet achieving optimal osseointegration and ensuring long-term implant success remain persistent challenges. In this review, we explore a cutting-edge approach to enhancing implant properties: ultraviolet (UV) photofunctionalization. By harnessing UV energy, photofunctionalization rejuvenates aging implants, leveraging and often surpassing the intrinsic potential of titanium materials. The primary aim of this narrative review is to offer an updated perspective on the advancements made in the field, providing a comprehensive overview of recent findings and exploring the relationship between UV-induced physicochemical alterations and cellular responses. There is now compelling evidence of significant transformations in titanium surface chemistry induced by photofunctionalization, transitioning from hydrocarbon-rich to carbon pellicle-free surfaces, generating superhydrophilic surfaces, and modulating the electrostatic properties. These changes are closely associated with improved cellular attachment, spreading, proliferation, differentiation, and, ultimately, osseointegration. Additionally, we discuss clinical studies demonstrating the efficacy of UV photofunctionalization in accelerating and enhancing the osseointegration of dental implants. Furthermore, we delve into recent advancements, including the development of one-minute vacuum UV (VUV) photofunctionalization, which addresses the limitations of conventional UV methods as well as the newly discovered functions of photofunctionalization in modulating soft tissue and bacterial interfaces. By elucidating the intricate relationship between surface science and biology, this body of research lays the groundwork for innovative strategies aimed at enhancing the clinical performance of titanium implants, marking a new era in implantology.
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Affiliation(s)
- Gunwoo Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
- Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, USA
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5
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Barrak FN, Li S. From manufacturers to clinicians, the release of dental implant particles can no longer be ignored. Clin Implant Dent Relat Res 2024; 26:663-667. [PMID: 38369955 DOI: 10.1111/cid.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Fadi N Barrak
- School of Medicine and Dentistry, University of Central Lancashire, Preston, UK
- VSS Academy Training and Education Ltd., London, UK
| | - Siwei Li
- VSS Academy Training and Education Ltd., London, UK
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Martinez DC, Dobkowska A, Marek R, Ćwieka H, Jaroszewicz J, Płociński T, Donik Č, Helmholz H, Luthringer-Feyerabend B, Zeller-Plumhoff B, Willumeit-Römer R, Święszkowski W. In vitro and in vivo degradation behavior of Mg-0.45Zn-0.45Ca (ZX00) screws for orthopedic applications. Bioact Mater 2023; 28:132-154. [PMID: 37250863 PMCID: PMC10209338 DOI: 10.1016/j.bioactmat.2023.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/31/2023] Open
Abstract
Magnesium (Mg) alloys have become a potential material for orthopedic implants due to their unnecessary implant removal, biocompatibility, and mechanical integrity until fracture healing. This study examined the in vitro and in vivo degradation of an Mg fixation screw composed of Mg-0.45Zn-0.45Ca (ZX00, in wt.%). With ZX00 human-sized implants, in vitro immersion tests up to 28 days under physiological conditions, along with electrochemical measurements were performed for the first time. In addition, ZX00 screws were implanted in the diaphysis of sheep for 6, 12, and 24 weeks to assess the degradation and biocompatibility of the screws in vivo. Using scanning electron microscopy (SEM) coupled with energy dispersive X-ray spectroscopy (EDX), micro-computed tomography (μCT), X-ray photoelectron spectroscopy (XPS), and histology, the surface and cross-sectional morphologies of the corrosion layers formed, as well as the bone-corrosion-layer-implant interfaces, were analyzed. Our findings from in vivo testing demonstrated that ZX00 alloy promotes bone healing and the formation of new bone in direct contact with the corrosion products. In addition, the same elemental composition of corrosion products was observed for in vitro and in vivo experiments; however, their elemental distribution and thicknesses differ depending on the implant location. Our findings suggest that the corrosion resistance was microstructure-dependent. The head zone was the least corrosion-resistant, indicating that the production procedure could impact the corrosion performance of the implant. In spite of this, the formation of new bone and no adverse effects on the surrounding tissues demonstrated that the ZX00 is a suitable Mg-based alloy for temporary bone implants.
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Affiliation(s)
- Diana C. Martinez
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Anna Dobkowska
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Romy Marek
- Department of Orthopedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria
| | - Hanna Ćwieka
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | - Jakub Jaroszewicz
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Tomasz Płociński
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
| | - Črtomir Donik
- Department of Physics and Chemistry of Materials, Institute of Metals and Technology, University of Ljubljana, Lepi Pot 11, SI-1000, Ljubljana, Slovenia
| | - Heike Helmholz
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | | | - Berit Zeller-Plumhoff
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | - Regine Willumeit-Römer
- Institute of Metallic Biomaterials, Helmholtz-Zentrum Hereon GmbH, 21502, Geesthacht, Germany
| | - Wojciech Święszkowski
- Biomaterials Group, Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Wołoska 141, 02-507, Warsaw, Poland
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7
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Abdulla MA, Hasan RH, Al-Hyani OH. Impact of Er,Cr:YSGG Laser, Sandblast, and Acid Etching Surface Modification on Surface Topography of Biodental Titanium Implants. J Lasers Med Sci 2023; 14:e38. [PMID: 38028874 PMCID: PMC10658112 DOI: 10.34172/jlms.2023.38] [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: 07/01/2023] [Accepted: 08/14/2023] [Indexed: 12/01/2023]
Abstract
Introduction: Several techniques have been used to modify the surface of commercially pure titanium (CPTi) implants to improve osseointegration using lasers, sandblasts, sandblasts with acid etching, and other modalities. For implant-osseointegration, surface features like chemical composition of a surface, topography, and surface energy are essential. The present comparative study aimed to compare the impact of Er,Cr:YSGG laser, sandblasting, and acid etching implant surface modifications on the surface topography, roughness, and element chemical composition of the Ti dental implant. Methods: Thirty CPTi dental implants were divided into three groups according to the surface modification (n=10 for each group): Group A: Sandblasting with acid etching (SLActive), group B: Sandblasting, and group C: Er,Cr:YSGG laser surface modifications. The modified surfaces were analyzed using scanning electron microscopy (SEM), profilometer, and energy dispersive x-ray spectrometry (EDS). Results: One-way analysis of variance (ANOVA) showed that there were significant differences in the mean values of average roughness (Ra) of the three groups (P<0.05). Tukey's post hoc test showed that the average roughness (Ra) of laser-surface modification (group C) of the implant had the highest mean value (2.30 µm) among the different groups, while sandblasted surface modification (group B) of the implant had the lowest mean value (1.39 µm). The SLActive (group A) sandblast with acid etching had a mean value of 1.63 µm. SEM analysis showed that significantly modified surface topographies and different element concentrations were found within all modified groups. Conclusion: The Er,Cr:YSGG laser irradiation increased the implant surface roughness value after implant surface modification, compared to sandblasts and sandblasts with acid etching application. The observations for the SEM-EDS analysis revealed several elements with different concentrations, which were affected by the physical-chemical characteristics of the surface modification techniques. The SEM analysis showed a significant modification in implant surface topographies of the tested groups.
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Affiliation(s)
- Mohammed A Abdulla
- Department of Prosthetic Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| | - Radhwan H Hasan
- Department of Prosthetic Dentistry, College of Dentistry, University of Mosul, Mosul, Iraq
| | - Osama Hazim Al-Hyani
- Department of Surgery and Theriogenology, College of Veterinary Medicine, University of Mosul, Mosul, Iraq
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Hofmann P, Kunz A, Schmidt F, Beuer F, Duddeck D. Influence of exposure of customized dental implant abutments to different cleaning procedures: an in vitro study using AI-assisted SEM/EDS analysis. Int J Implant Dent 2023; 9:33. [PMID: 37730937 PMCID: PMC10511398 DOI: 10.1186/s40729-023-00498-8] [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: 03/13/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
PURPOSE Dental implant abutments are defined as medical devices by their intended use. Surfaces of custom-made CAD/CAM two-piece abutments may become contaminated during the manufacturing process in the dental lab. Inadequate reprocessing prior to patient care may contribute to implant-associated complications. Risk-adapted hygiene management is required to meet the requirements for medical devices. METHODS A total of 49 CAD/CAM-manufactured zirconia copings were bonded to prefabricated titanium bases. One group was bonded, polished, and cleaned separately in dental laboratories throughout Germany (LA). Another group was left untreated (NC). Five groups received the following hygiene regimen: three-stage ultrasonic cleaning (CP and FP), steam (SC), argon-oxygen plasma (PL), and simple ultrasonic cleaning (UD). Contaminants were detected using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) and segmented and quantified using interactive machine learning (ML) and thresholding (SW). The data were statistically analysed using non-parametric tests (Kruskal-Wallis test, Dunn's test). RESULTS Significant differences in contamination levels with the different cleaning procedures were found (p ≤ 0.01). The FP-NC/LA groups showed the most significant difference in contamination levels for both measurement methods (ML, SW), followed by CP-LA/NC and UD-LA/NC for SW and CP-LA/NC and PL-LA/NC for ML (p ≤ 0.05). EDS revealed organic contamination in all specimens; traces of aluminum, silicon, and calcium were detected. CONCLUSIONS Chemothermal cleaning methods based on ultrasound and argon-oxygen plasma effectively removed process-related contamination from zirconia surfaces. Machine learning is a promising assessment tool for quantifying and monitoring external contamination on zirconia abutments.
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Affiliation(s)
- Paul Hofmann
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Andreas Kunz
- Private Dental Laboratory, Schumannstraße 1, 10117, Berlin, Germany
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Dirk Duddeck
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
- Research Department, CleanImplant Foundation, Pariser Platz 4a, 10117, Berlin, Germany
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Mtanis T, Biadsee A, Ormianer Z. Assessing the Cleanliness of Dental Implants Using Scanning Electron Microscopy and Energy-Dispersive X-ray Spectroscopy Analysis-A SEM and EDS In Vitro Study. J Funct Biomater 2023; 14:jfb14030172. [PMID: 36976096 PMCID: PMC10058862 DOI: 10.3390/jfb14030172] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
A wide variety of titanium (Ti) alloy dental implant systems are available and as a result, choosing the correct system has become a challenge. Cleanliness of the dental implant surface affects osseointegration but surface cleanliness may be jeopardized during manufacturing. The purpose of this study was to assess the cleanliness of three implant systems. Fifteen implants per system were examined with scanning electron microscopy to identify and count foreign particles. Particle chemical composition analysis was performed with energy-dispersive X-ray spectroscopy. Particles were categorized according to size and location. Particles on the outer and inner threads were quantitatively compared. A second scan was performed after exposing the implants to room air for 10 min. Carbon, among other elements, was found on the surface of all implant groups. Zimmer Biomet dental implants had higher particle numbers than other brands. Cortex and Keystone dental implants showed similar distribution patterns. The outer surface had higher particle numbers. Cortex dental implants were the cleanest. The change in particle numbers after exposure was not significant (p > 0.05). Conclusion: Most of the implants studied were contaminated. Particle distribution patterns vary with the manufacturer. The wider and outer areas of the implant have a higher probability of contamination.
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Affiliation(s)
- Tarek Mtanis
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
| | - Ameer Biadsee
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
| | - Zeev Ormianer
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv 6997801, Israel
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10
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Draenert G, Mitov G. A new technology for the removal of corundum residues on dental implants. Br J Oral Maxillofac Surg 2023; 61:278-283. [PMID: 37024361 DOI: 10.1016/j.bjoms.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/12/2023] [Indexed: 03/14/2023]
Abstract
Surface modification is an important measure to improve dental implants. Corundum residues, which are part of current dental implant blasting, on Straumann dental implants, were found to have disappeared in recent publications. We further evaluated this new cleaning technology by evaluating the surface of four different Straumann implants using scanning electron microscopy (SEM) and energy-dispersive radiographic spectroscopy (EDX). The involved technology fits to a Straumann patent involving a dextran coating allowing easy corundum particle removal by aqueous solution.
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11
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Kunrath MF, Shah FA, Dahlin C. Bench-to-bedside: Feasibility of nano-engineered and drug-delivery biomaterials for bone-anchored implants and periodontal applications. Mater Today Bio 2023; 18:100540. [PMID: 36632628 PMCID: PMC9826856 DOI: 10.1016/j.mtbio.2022.100540] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/03/2022] [Accepted: 12/29/2022] [Indexed: 12/31/2022] Open
Abstract
Nanotechnology and drug-release biomaterials have been thoroughly explored in the last few years aiming to develop specialized clinical treatments. However, it is rare to find biomaterials associated with drug delivery properties in the current dental market for application in oral bone- and periodontal-related procedures. The gap between basic scientific evidence and translation to a commercial product remains wide. Several challenges have been reported regarding the clinical translation of biomaterials with drug-delivery systems (BDDS) and nanofeatures. Therefore, processes for BDDS development, application in preclinical models, drug delivery doses, sterilization processes, storage protocols and approval requirements were explored in this review, associated with tentative solutions for these issues. The diversity of techniques and compounds/molecules applied to develop BDDS demands a case-by-case approach to manufacturing and validating a commercial biomaterial. Promising outcomes such as accelerated tissue healing and higher antibacterial response have been shown through basic and preclinical studies using BDDS and nano-engineered biomaterials; however, the adequate process for sterilization, storage, cost-effectiveness and possible cytotoxic effects remains unclear for multifunctional biomaterials incorporated with different chemical compounds; then BDDSs are rarely translated into products. The future benefits of BDDS and nano-engineered biomaterials have been reported suggesting personalized clinical treatment and a promising reduction in the use of systemic antibiotics. Finally, the launch of these specialized biomaterials with solid data and controlled traceability onto the market will generate strong specificity for healthcare treatments.
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Affiliation(s)
- Marcel F. Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, P.O. Box 412, SE 405 30, Göteborg, Sweden
- Department of Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, Brazil
| | - Furqan A. Shah
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, P.O. Box 412, SE 405 30, Göteborg, Sweden
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, P.O. Box 412, SE 405 30, Göteborg, Sweden
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12
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Albrektsson T, Tengvall P, Amengual L, Coli P, Kotsakis GA, Cochran D. Osteoimmune regulation underlies oral implant osseointegration and its perturbation. Front Immunol 2023; 13:1056914. [PMID: 36761175 PMCID: PMC9902598 DOI: 10.3389/fimmu.2022.1056914] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
In the field of biomaterials, an endosseous implant is now recognized as an osteoimmunomodulatory but not bioinert biomaterial. Scientific advances in bone cell biology and in immunology have revealed a close relationship between the bone and immune systems resulting in a field of science called osteoimmunology. These discoveries have allowed for a novel interpretation of osseointegration as representing an osteoimmune reaction rather than a classic bone healing response, in which the activation state of macrophages ((M1-M2 polarization) appears to play a critical role. Through this viewpoint, the immune system is responsible for isolating the implant biomaterial foreign body by forming bone around the oral implant effectively shielding off the implant from the host bone system, i.e. osseointegration becomes a continuous and dynamic host defense reaction. At the same time, this has led to the proposal of a new model of osseointegration, the foreign body equilibrium (FBE). In addition, as an oral wound, the soft tissues are involved with all their innate immune characteristics. When implant integration is viewed as an osteoimmune reaction, this has implications for how marginal bone is regulated. For example, while bacteria are constitutive components of the soft tissue sulcus, if the inflammatory front and immune reaction is at some distance from the marginal bone, an equilibrium is established. If however, this inflammation approaches the marginal bone, an immune osteoclastic reaction occurs and marginal bone is removed. A number of clinical scenarios can be envisioned whereby the osteoimmune equilibrium is disturbed and marginal bone loss occurs, such as complications of aseptic nature and the synergistic activation of pro-inflammatory pathways (implant/wear debris, DAMPs, and PAMPs). Understanding that an implant is a foreign body and that the host reacts osteoimmunologically to shield off the implant allows for a distinction to be drawn between osteoimmunological conditions and peri-implant bone loss. This review will examine dental implant placement as an osteoimmune reaction and its implications for marginal bone loss.
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Affiliation(s)
- T. Albrektsson
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden
| | - P. Tengvall
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden,*Correspondence: P. Tengvall,
| | - L. Amengual
- Dental Implantology Unit, Hospital Leonardo Guzmán, Antofagasta, Chile
| | - P. Coli
- Edinburgh Dental Specialists, Edinburgh, United Kingdom,Department of Prosthetic Dentistry and Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden,Department of Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - G. A. Kotsakis
- Department of Periodontology, University of Texas, San Antonio, TX, United States
| | - D. Cochran
- Department of Periodontology, University of Texas, San Antonio, TX, United States
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13
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Veiko V, Karlagina Y, Zernitckaia E, Egorova E, Radaev M, Yaremenko A, Chernenko G, Romanov V, Shchedrina N, Ivanova E, Chichkov B, Odintsova G. Laser-Induced µ-Rooms for Osteocytes on Implant Surface: An In Vivo Study. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:4229. [PMID: 36500852 PMCID: PMC9737095 DOI: 10.3390/nano12234229] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
Laser processing of dental implant surfaces is becoming a more widespread replacement for classical techniques due to its undeniable advantages, including control of oxide formation and structure and surface relief at the microscale. Thus, using a laser, we created several biomimetic topographies of various shapes on the surface of titanium screw-shaped implants to research their success and survival rates. A distinctive feature of the topographies is the presence of "µ-rooms", which are special spaces created by the depressions and elevations and are analogous to the µ-sized room in which the osteocyte will potentially live. We conducted the comparable in vivo study using dental implants with continuous (G-topography with µ-canals), discrete (S-topography with μ-cavities), and irregular (I-topography) laser-induced topographies. A histological analysis performed with the statistical method (with p-value less than 0.05) was conducted, which showed that G-topography had the highest BIC parameter and contained the highest number of mature osteocytes, indicating the best secondary stability and osseointegration.
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Affiliation(s)
- Vadim Veiko
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Yuliya Karlagina
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Ekaterina Zernitckaia
- Department of Dental Surgery and Maxillofacial Surgery, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg 197022, Russia
| | - Elena Egorova
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Maxim Radaev
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Andrey Yaremenko
- Department of Dental Surgery and Maxillofacial Surgery, Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg 197022, Russia
| | - Gennadiy Chernenko
- Lenmiriot Dental Implant Prosthetics Manufacture, Saint-Petersburg 193079, Russia
| | - Valery Romanov
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Nadezhda Shchedrina
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
| | - Elena Ivanova
- STEM, School of Science, RMIT University, Melbourne 3000, Australia
| | - Boris Chichkov
- Institute of Quantum Optics, Leibniz University of Hanover, 30167 Hannover, Germany
| | - Galina Odintsova
- Institute of Laser Technologies, ITMO University, Saint-Petersburg 197101, Russia
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14
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Immediate Restoration of Single-Piece Zirconia Implants: A Prospective Case Series-Long-Term Results after 11 Years of Clinical Function. MATERIALS 2021; 14:ma14226738. [PMID: 34832139 PMCID: PMC8621133 DOI: 10.3390/ma14226738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this prospective case series was to evaluate single-piece zirconia implants restored with lithium disilicate CAD/CAM crowns through a long-term follow-up. METHODS In this trial, 20 one-piece zirconia implants were placed in 20 patients. Implants were restored (i) immediately with lithium disilicate CAD/CAM provisionals, and (ii) permanently four months after surgery. Patients were followed for 11 years. Clinical parameters and radiological measurements of the zirconia implants were assessed. For the statistical analysis, paired t-test was applied. RESULTS Four implants were counted as implant failure due to the loss of implant stability, resulting in a Kaplan-Meier survival rate of 80% up to 11 years. The mean bleeding on probing values were 19.1% (SD ± 13.1) and 18.2% (SD ± 17.6) 96 and 11 years after implant placement, respectively. The plaque index revealed a significant decrease over time (p < 0.001) with a value between 25.9% (SD ± 5.7) and 12.6% (SD ± 10.0) at baseline and 11-years follow-up respectively. The marginal bone level revealed a significant decrease 4, 8, and 11 years after implant insertion (p = 0.001, p = 0.019, and p = 0.027, respectively). CONCLUSIONS Immediately loaded zirconia single-piece implants showed a suitable success rate in clinical and radiographic outcomes.
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15
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Energy-Dispersive X-ray Spectroscopic Investigation of Failed Dental Implants Associated with Odontogenic Maxillary Sinusitis. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11083684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The failed dental implant associated with maxillary sinusitis is a multifactorial phenomenon and should be investigated thoroughly. The inflammatory process induced by accumulated biofilm and wear debris may increase mucous secretion and mucous thickening, which finally may lead to severe complications such as maxillary sinusitis. The inflammatory cytokines might compromise the long-term osseointegration of the related implant. In this study, implants retrieved from three patients who experienced implant failure relating to maxillary sinusitis were investigated using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy. SEM analysis of the implant apical region revealed a less-compact bone structure, indicating the high bone turnover due to an inflammatory process. The ratio of calcium (Ca) and phosphorus (P) was negligible in all specimens. Detection of fluorine (F), sodium (Na), silicon (Si), gold (Au), aluminum (Al), and magnesium (Mg) confirmed the contamination. The selected cases presented different biological aspects that might play the central role in the failed dental implants associated with maxillary sinusitis: the contamination of potentially toxic elements, microorganism infection, and long perforation of implant apex into the sinus. Each of the above phenomena needs to be confirmed with further clinical study with a larger number of failed implants and accompanying tissue samples.
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16
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Guler B, Uraz A, Hatipoğlu H, Yalım M. Chemical Evaluation of Energy Dispersive X-ray Spectroscopy Analysis of Different Failing Dental Implant Surfaces: A Comparative Clinical Trial. MATERIALS 2021; 14:ma14040986. [PMID: 33669886 PMCID: PMC7923284 DOI: 10.3390/ma14040986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 11/29/2022]
Abstract
The aim of the present study is to compare two different implant surface chemistries of failing dental implants. Sixteen patients (mean age: 52 ± 8.27 with eight females and eight males) and 34 implants were included in the study. Group-I implants consisted of a blasted/etched surface with a final process surface, while Group-II implants consisted of the sandblasted acid etching (SLA) method. The chemical surface analysis was performed by the energy dispersive X-ray spectroscopy (EDX) method from coronal, middle, and apical parts of each implant. Titanium (Ti) element values were found to be 20.22 ± 15.7 at.% in Group I and 33.96 ± 13.62 at.% in Group-II in the middle of the dental implants. Aluminum (Al) element values were found to be 0.01 ± 0.002 in Group-I and 0.17 ± 0.28 at.% in Group II in the middle of the dental implants, and statistically significant differences were found between the groups for the Al and Ti elements in the middle of the dental implants (p < 0.05). There was a statistically significant difference for the Ti, Al, O, Ca, Fe, P, and Mg elements in the coronal, middle, and apical parts of the implants in the intragroup evaluation (p < 0.05). It is reported that different parts of the implants affected by peri-implant inflammation show different surface chemistries, from coronal to apical, but there is no difference in the implants with different surfaces.
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Affiliation(s)
- Berceste Guler
- Department of Periodontology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya 43100, Turkey;
- Correspondence:
| | - Ahu Uraz
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara 06500, Turkey; (A.U.); (M.Y.)
| | - Hasan Hatipoğlu
- Department of Periodontology, Faculty of Dentistry, Kütahya Health Sciences University, Kütahya 43100, Turkey;
| | - Mehmet Yalım
- Department of Periodontology, Faculty of Dentistry, Gazi University, Ankara 06500, Turkey; (A.U.); (M.Y.)
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17
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Gao Y, Lin X, Zhao Y, Xu S, Lai C, Guo Z, Wu W, Ding X, Jia F, Zhou L, Liu Y. The Cleaning Effect of the Photocatalysis of TiO 2-B@anatase Nanowires on Biological Activity on a Titanium Surface. Int J Nanomedicine 2020; 15:9639-9655. [PMID: 33299309 PMCID: PMC7719464 DOI: 10.2147/ijn.s275373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022] Open
Abstract
Background Improvements in the early osseointegration of titanium implants require investigations on the bone-implant interface, which is a critical and complex challenge. The surface cleanliness of titanium implants plays an important role at this interface. However, the implant surface would inevitably absorb contamination such as organic hydrocarbons, which is not conductive to the establishment of early osseointegration. Herein, an optimized approach for removing contamination from titanium surfaces was studied. Methods The TiO2-B@anatase NWs (nanowires) were prepared on titanium substrates through a hydrothermal process. A methylene blue degradation experiment was performed to assess the photodegradation activity. The cleaning effect of the photocatalysis of TiO2-B@anatase NWs on a titanium surface and the cellular early response was determined by analyzing cell morphology, attachment, proliferation and differentiation. Results The results indicated that the photocatalysis of TiO2-B@anatase NWs could effectively remove hydrocarbons on titanium surfaces without sacrificing the favourable titanium surface morphology. The methylene blue degradation experiment revealed that the photocatalysis of TiO2-B@anatase NWs had powerful degradation activity, which is attributed to the presence of strong oxidants such as ·OH. In addition, compared to the merely ultraviolet-treated titanium surfaces, the titanium surfaces treated after the NWs photocatalytic cleaning process markedly enhanced cellular early response. Conclusion The photocatalysis of TiO2-B@anatase NWs for the removal of contamination from titanium surfaces has the potential to enable the rapid and complete establishment of early osseointegration.
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Affiliation(s)
- Yan Gao
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Xi Lin
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Yadong Zhao
- Department of Oral and Maxillofacial Surgery, Inner Mongolia People' Hospital, Huhhot, Inner Mongolia 010017, People's Republic of China
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Chunhua Lai
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Zehong Guo
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Wangxi Wu
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Xianglong Ding
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Fang Jia
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Lei Zhou
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
| | - Ying Liu
- Department of Endodontics, Stomatological Hospital, Southern Medical University, Guangzhou 510280, People's Republic of China
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18
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Dhaliwal JS, David SRN, Zulhilmi NR, Sodhi Dhaliwal SK, Knights J, de Albuquerque Junior RF. Contamination of titanium dental implants: a narrative review. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-2810-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
AbstractContamination of titanium dental implants may lead to implant failure. There are two major types of contaminants: the inorganic and organic contaminants. The inorganic contaminants mostly consist of elements such as calcium, phosphorus, chlorine, sulphur, sodium, silicon, fluorine and some organic carbons. Whereas organic contaminants consist of hydrocarbon, carboxylates, salts of organic acids, nitrogen from ammonium and bacterial cells/byproducts. Contaminants can alter the surface energy, chemical purity, thickness and composition of the oxide layer, however, we lack clinical evidence that contaminations have any effect at all. However, surface cleanliness seems to be essential for implant osseointegration.These contaminants may cause dental implants to fail in its function to restore missing teeth and also cause a financial burden to the patient and the health care services to invest in decontamination methods. Therefore, it is important to discuss the aetiology of dental implant failures. In this narrative review, we discuss two major types of contaminants: the inorganic and organic contaminants including bacterial contaminants. This review also aims to discuss the potential effect of contamination on Ti dental implants.
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Abstract
Dental implant treatment is a well-documented technology, but sadly with the passage of time, the vast majority of dental implants sold on the market today have little of their own documentation. All implants are not the same and the consequences of 'look-alike' implants relying on the documentation of others may be far-reaching. This opinion piece highlights concerns identified in the literature and exposes problems that are already occurring in reality.
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20
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Nicolas-Silvente AI, Velasco-Ortega E, Ortiz-Garcia I, Monsalve-Guil L, Gil J, Jimenez-Guerra A. Influence of the Titanium Implant Surface Treatment on the Surface Roughness and Chemical Composition. MATERIALS 2020; 13:ma13020314. [PMID: 31936686 PMCID: PMC7014346 DOI: 10.3390/ma13020314] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 12/25/2022]
Abstract
The implant surface features affect the osseointegration process. Different surface treatment methods have been applied to improve the surface topography and properties. Trace of different elements may appear on the implant surface, which can modify surface properties and may affect the body’s response. The aim was to evaluate the roughness based on the surface treatment received and the amount and type of trace elements found. Ninety implants (nine different surface treatment) were evaluated. Roughness parameters were measured using white-light-interferometry (WLI). The arithmetical mean for Ra, Rq, Rt, and Rz of each implant system was calculated, and Fisher’s exact test was applied, obtaining Ra values between 0.79 and 2.89 µm. Surface chemical composition was evaluated using X-ray photoelectron spectroscopy (XPS) at two times: as received by the manufacturer (AR) and after sputter-cleaning (SC). Traces of several elements were found in all groups, decreasing in favor of the Ti concentration after the sputter-cleaning. Within the limitations of this study, we can conclude that the surface treatment influences the roughness and the average percentage of the trace elements on the implant surface. The cleaning process at the implant surface should be improved by the manufacturer before assembling the implant.
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Affiliation(s)
- Ana Isabel Nicolas-Silvente
- Associate Professor of Restorative Dentistry, Professor of Master in Mucogingival, Periodontal and Implant Surgery, School of Dentistry, University of Murcia, 30008 Murcia, Spain;
| | - Eugenio Velasco-Ortega
- Professor of Comprehensive Dentistry for Adults, Director of Master in Implant Dentistry, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain
- Correspondence:
| | - Ivan Ortiz-Garcia
- Associate Professor of Comprehensive Dentistry for Adults, Professor of Master in Implant Dentistry, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (I.O.-G.); (L.M.-G.); (A.J.-G.)
| | - Loreto Monsalve-Guil
- Associate Professor of Comprehensive Dentistry for Adults, Professor of Master in Implant Dentistry, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (I.O.-G.); (L.M.-G.); (A.J.-G.)
| | - Javier Gil
- Chairman of Bioengineering Institute of Technology, Universitat Internacional de Catalunya, 08017 Barcelona, Spain;
| | - Alvaro Jimenez-Guerra
- Associate Professor of Comprehensive Dentistry for Adults, Professor of Master in Implant Dentistry, Faculty of Dentistry, University of Seville, 41009 Sevilla, Spain; (I.O.-G.); (L.M.-G.); (A.J.-G.)
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Asensio G, Vázquez-Lasa B, Rojo L. Achievements in the Topographic Design of Commercial Titanium Dental Implants: Towards Anti-Peri-Implantitis Surfaces. J Clin Med 2019; 8:E1982. [PMID: 31739615 PMCID: PMC6912779 DOI: 10.3390/jcm8111982] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/04/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
Titanium and its alloys constitute the gold standard materials for oral implantology in which their performance is mainly conditioned by their osseointegration capacity in the host's bone. We aim to provide an overview of the advances in surface modification of commercial dental implants analyzing and comparing the osseointegration capacity and the clinical outcome exhibited by different surfaces. Besides, the development of peri-implantitis constitutes one of the most common causes of implant loss due to bacteria colonization. Thus, a synergic response from industry and materials scientists is needed to provide reliable technical and commercial solutions to this issue. The second part of the review focuses on an update of the recent findings toward the development of new materials with osteogenic and antibacterial capacity that are most likely to be marketed, and their correlation with implant geometry, biomechanical behavior, biomaterials features, and clinical outcomes.
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Affiliation(s)
- Gerardo Asensio
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
| | - Blanca Vázquez-Lasa
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
- Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, 28029 Madrid, Spain
| | - Luis Rojo
- Instituto de Ciencia y Tecnología de Polímeros, Consejo Superior de Investigaciones Científicas, CSIC, 28006 Madrid, Spain; (G.A.); (B.V.-L.)
- Consorcio Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, 28029 Madrid, Spain
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