Osteoclastogenesis Behavior of Zirconia for Dental Implant

Comprehensive Evaluation of Titanium, Zirconia, and Ceramic Dental Implant Materials: A Comparative Analysis of Mechanical and Esthetic Properties

BACKGROUND

Dental implant materials play a pivotal role in the success of restorative dentistry. This study comprehensively compares the mechanical and esthetic properties of three commonly used dental implant materials: titanium, zirconia, and ceramic.

OBJECTIVE

This study aimed to provide insights into the suitability of titanium, zirconia, and ceramic for various clinical applications within implant dentistry.

METHODS

Ninety dental implants, 30 for each material, were selected based on their well-established usage in dental implantology. Mechanical properties, including tensile strength, modulus of elasticity, and fatigue resistance, were assessed using state-of-the-art testing machines. Esthetic properties, such as color stability and translucency, were scrutinized through immersion in staining solutions and spectrophotometer measurements. Fracture properties and biocompatibility were also evaluated.

RESULTS

Mechanical testing revealed that titanium exhibited the highest tensile strength (810 ± 55 MPa), while zirconia demonstrated the highest modulus of elasticity (208 ± 8 GPa). Titanium also displayed the greatest fatigue resistance (1,010,000 ± 95,000 cycles), whereas zirconia had the highest hardness (1190 ± 45 Vickers hardness number (VHN)). Esthetically, zirconia showed superior color stability (ΔE: 1.7 ± 0.2), while ceramic exhibited the highest translucency (TP%: 15.3 ± 1.7). Zirconia presented the lowest surface roughness (0.28 ± 0.04 μm).

CONCLUSION

This study provides insights into potential dental implant material performance, with zirconia emerging as a promising alternative. Future research should validate these findings in clinical settings, considering a broader array of variables and long-term outcomes.

Effect of Non-Thermal Plasma Treatment of Contaminated Zirconia Surface on Porphyromonas gingivalis Adhesion and Osteoblast Viability

Plasma treatment on a zirconia surface prevents bacterial contamination and maintains osteoblast activity. To assess the degree of adhesion of Porphyromonas gingivalis on a zirconia surface after non-thermal plasma (NTP) treatment, specimens were treated with plasma for 60, 300, and 600 s, after which P. gingivalis was inoculated onto the surface and incubated for 48 h. To assess osteoblast activity after NTP treatment, osteoblasts (MC3T3-E1) were dispensed onto the specimens contaminated with P. gingivalis immediately after NTP for 60 and 120 s, followed by incubation for 48, 72, and 96 h. P. gingivalis was cultured after 60 s of NTP treatment of zirconia. The NTP and control groups showed no significant difference (p = 0.91), but adhesion was significantly increased following NTP treatment for 300 s or longer (300, 600 s groups) (p < 0.05). After NTP treatment of P. gingivalis-contaminated zirconia, osteoblast activity significantly increased at 72 and 96 h (I60 and I120 s group) in the groups treated with plasma (p < 0.017). Application of NTP to dental zirconia implants for 60 s not only inhibits the proliferation of P. gingivalis, which causes peri-implantitis but also increases osseointegration on zirconia surfaces contaminated with P. gingivalis.

Endosseous Dental Implant Materials and Clinical Outcomes of Different Alloys: A Systematic Review

In recent years, implantology has made significant progress, as it has now become a safe and predictable practice. The development of new geometries, primary and secondary, of new surfaces and alloys, has made this possible. The purpose of this review is to analyze the different alloys present on the market, such as that in zirconia, and evaluate their clinical differences with those most commonly used, such as those in grade IV titanium. The review, conducted on major scientific databases such as Scopus, PubMed, Web of Science and MDPI yielded a startling number of 305 results. After the application of the filters and the evaluation of the results in the review, only 10 Randomized Clinical Trials (RCTs) were included. Multiple outcomes were considered, such as Marginal Bone Level (MBL), Bleeding on Probing (BoP), Survival Rate, Success Rate and parameters related to aesthetic and prosthetic factors. There are currently no statistically significant differences between the use of zirconia implants and titanium implants, neither for fixed prosthetic restorations nor for overdenture restorations. Only the cases reported complain about the rigidity and, therefore, the possibility of fracture of the zirconium. Certainly the continuous improvement in these materials will ensure that they could be used safely while maintaining their high aesthetic performance.

Multi-objective design optimization of dental implant geometrical parameters

In-silico investigations are becoming an integral part of the development of novel biomedical devices, including dental implants. Using computer simulations can streamline the process by tuning different geometrical and structural features, emphasizing the osseointegration of the implant design a priori, leading to the optimal designs in preparation for in-vivo trails. This research aims to elucidate the interrelationship between 12 geometrical variables that holistically define the shape of the implant. The approach to achieve optimality hinged on coupling the finite element analysis results with the fractional factorial design method. The latter was used to determine the most influential variables during the screening process, followed by the parameter optimization process using the response surface method, regarding four different objectives, namely: bone-implant contact area, volume of trabecular bone dead cells, volume of cortical bone dead cells, and axial displacement. This resulted in reducing the number of virtual experiments and substantially decreasing the computational cost without compromising the accuracy of the solution. It was found that the optimized values improved the performance significantly. The validity of all models was verified by comparing optimized responses with simulation results. A sensitivity analysis was performed on all five optimized models to address the effect of friction coefficient on the implant-bone joint interaction. It was shown that the mechanical behavior of implant-bone would be independent in higher friction coefficients. The significance of this study is demonstrated in determining the most effective and optimized values of all possible geometrical parameters considering their singular or interactive effects.

New insights into bioactivity of ceria-stabilized zirconia: Direct bonding to bone-like hydroxyapatite at nanoscale

Osseointegration resulting from biomineralization means tight bone-implant attachment, which is clinically essential for successful dental implant treatment. The osseointegration ability of ceria-stabilized zirconia, a promising implant material, has been questionable and is unclear despite its clinical use due to zirconia's bioinert nature. The purpose of this research was to investigate the osseointegration ability of ceria-stabilized zirconia by clarifying its bioactivity. Here we show that ceria-stabilized zirconia is highly bioactive, contrary to the general consensus. Transmission electron microscopy observation revealed that the zirconia nanocrystals of a ceria-stabilized zirconia substrate directly bonded to osteoblastic cell-precipitated hydroxyapatite crystals at lattice fringe scale. This bonding was achieved without chemical treatment of the substrate surface before use. Hydroxyapatite crystals exhibited a morphology of flexible nanofibers less than 10 nm wide with nanometer-thick plates filling the spaces between nanofibers. Elemental analysis of the hydroxyapatites showed that they contained alkaline metal cations (Na, Mg, and K) as minor elements and that their average Ca/P atomic % ratio was ~1.40, similar to those of bone apatite. High bioactivity of ceria-stabilized zirconia resulted in direct bonding to bone-like hydroxyapatite, suggesting nanoscale direct osseointegration with bone in vivo that contributes to improving the success rate of dental implant treatment.

Multicenter clinical trial on dental implants survival rate: a FDS76® study

BACKGROUND

Implantology, thanks to its predictability in oral rehabilitations, has become a widespread method for rehabilitating edentulous patients, offering excellent patient satisfaction. Improving the quality of oral health, especially if rehabilitation involves minimal short and long-term complications, leads to an improvement in the quality of life of our patients.

METHODS

This clinical study was conducted to evaluate the short and long-term complications (up to 18 months) of implant-prosthetic rehabilitations performed with a new dental implant (FDS76^®, Italy).

RESULTS

The results showed a limited number of complications or implant failures.

CONCLUSIONS

Knowing the latter could certainly help improve both surgical and dental materials performance.

Multicenter clinical trial on dental implants survival rate: a FDS76® study

BACKGROUND

Implantology, thanks to its predictability in oral rehabilitations, has become a widespread method for rehabilitating edentulous patients, offering excellent patient satisfaction. Improving the quality of oral health, especially if rehabilitation involves minimal short and long-term complications, leads to an improvement in the quality of life of our patients.

METHODS

This clinical study was conducted to evaluate the short and long-term complications (up to 18 months) of implant-prosthetic rehabilitations performed with a new dental implant (FDS76^®, Italy).

RESULTS

The results showed a limited number of complications or implant failures.

CONCLUSIONS

Knowing the latter could certainly help improve both surgical and dental materials performance.

Effects of UV Treatment on Ceria-Stabilized Zirconia/Alumina Nanocomposite (NANOZR)

Nanostructured zirconia/alumina composite (NANOZR) has been explored as a suitable material for fabricating implants for patients with metal allergy. In this study, we examined the effect of UV treatment on the NANOZR surface. The experimental group was UV-treated NANOZR and the control group was untreated NANOZR. Observation of the surface of the UV-treated materials revealed no mechanical or structural change; however, the carbon content on the material surface was reduced, and the material surface displayed superhydrophilicity. Further, the effects of the UV-induced superhydrophilic properties of NANOZR plates on the adhesion behavior of various cells were investigated. Treatment of the NANOZR surface was found to facilitate protein adsorption onto it. An in vitro evaluation using rat bone marrow cells, human vascular endothelial cells, and rat periodontal ligament cells revealed high levels of adhesion in the experimental group. In addition, it was clarified that the NANOZR surface forms active oxygen and suppresses the generation of oxidative stress. Overall, the study results suggested that UV-treated NANOZR is useful as a new ceramic implant material.

New Implant Macrogeometry to Improve and Accelerate the Osseointegration: An In Vivo Experimental Study

A new implant design with healing chambers in the threads was analyzed and compared with a conventional implant macrogeometry, both implants models with and without surface treatment. Eighty conical implants were prepared using commercially pure titanium (grade IV) by the company Implacil De Bortoli (São Paulo, Brazil). Four groups were performed, as described below: Group 1 (G1), traditional conical implants with surface treatment; group 2 (G2), traditional conical implants without surface treatment (machined surface); group 3 (G3), new conical implant design with surface treatment; group 4 (G4), new conical implant design without surface treatment. The implants were placed in the two tibias (n = 2 implants per tibia) of twenty New Zealand rabbits determined by randomization. The animals were euthanized after 15 days (Time 1) and 30 days (Time 2). The parameters evaluated were the implant stability quotient (ISQ), removal torque values (RTv), and histomorphometric evaluation to determine the bone to implant contact (%BIC) and bone area fraction occupancy (BAFO%). The results showed that the implants with the macrogeometry modified with healing chambers in the threads produced a significant enhancement in the osseointegration, accelerating this process. The statistical analyses of ISQ and RTv showed a significative statistical difference between the groups in both time periods of evaluation (p ≤ 0.0001). Moreover, an important increase in the histological parameters were found for groups G3 and G4, with significant statistical differences to the BIC% (in the Time 1 p = 0.0406 and in the Time 2 p < 0.0001) and the BAFO% ((in the Time 1 p = 0.0002 and in the Time 2 p = 0.0045). In conclusion, the result data showed that the implants with the new macrogeometry, presenting the healing chambers in the threads, produced a significant enhancement in the osseointegration, accelerating the process.

Sandblasted and Acid Etched Titanium Dental Implant Surfaces Systematic Review and Confocal Microscopy Evaluation

The field of dental implantology has made progress in recent years, allowing safer and predictable oral rehabilitations. Surely the rehabilitation times have also been reduced, thanks to the advent of the new implant surfaces, which favour the osseointegration phases and allow the clinician to rehabilitate their patients earlier. To carry out this study, a search was conducted in the Pubmed, Embase and Elsevier databases; the articles initially obtained according to the keywords used numbered 283, and then subsequently reduced to 10 once the inclusion and exclusion criteria were applied. The review that has been carried out on this type of surface allows us to fully understand the features and above all to evaluate all the advantages or not related. The study materials also are supported by a manufacturing company, which provided all the indications regarding surface treatment and confocal microscopy scans. In conclusion, we can say that, thanks to these new surfaces, it has been possible to shorten the time necessary to obtain osseointegration and, therefore, secondary stability on the part of implants. The surfaces, therefore, guarantee an improved cellular adhesion and thanks to the excellent wettability all the biological processes that derive from it, such as increases in the exposed implant surface, resulting in an increase in bone-implant contact (BIC).