Adhesion Behaviour of Primary Human Osteoblasts and Fibroblasts on Polyether Ether Ketone Compared with Titanium under In Vitro Lipopolysaccharide Incubation

On the material dependency of peri-implant morphology and stability in healing bone

The microstructural architecture of remodeled bone in the peri-implant region of screw implants plays a vital role in the distribution of strain energy and implant stability. We present a study in which screw implants made from titanium, polyetheretherketone and biodegradable magnesium-gadolinium alloys were implanted into rat tibia and subjected to a push-out test four, eight and twelve weeks after implantation. Screws were 4 mm in length and with an M2 thread. The loading experiment was accompanied by simultaneous three-dimensional imaging using synchrotron-radiation microcomputed tomography at 5 μm resolution. Bone deformation and strains were tracked by applying optical flow-based digital volume correlation to the recorded image sequences. Implant stabilities measured for screws of biodegradable alloys were comparable to pins whereas non-degradable biomaterials experienced additional mechanical stabilization. Peri-implant bone morphology and strain transfer from the loaded implant site depended heavily on the biomaterial utilized. Titanium implants stimulated rapid callus formation displaying a consistent monomodal strain profile whereas the bone volume fraction in the vicinity of magnesium-gadolinium alloys exhibited a minimum close to the interface of the implant and less ordered strain transfer. Correlations in our data suggest that implant stability benefits from disparate bone morphological properties depending on the biomaterial utilized. This leaves the choice of biomaterial as situational depending on local tissue properties.

Fabrication of bFGF/polydopamine-loaded PEEK implants for improving soft tissue integration by upregulating Wnt/β-catenin signaling

The difficulties associated with polyetheretherketone (PEEK) implants and soft tissue integration for craniomaxillofacial bone repair have led to a series of complications that limit the clinical benefits. In this study, 3D printed multi-stage microporous PEEK implants coated with bFGF via polydopamine were fabricated to enhance PEEK implant-soft tissue integration. Multistage microporous PEEK scaffolds prepared by sulfonation of concentrated sulfuric acid were coated with polydopamine, and then used as templates for electrophoretic deposition of bFGF bioactive factors. Achieving polydopamine and bFGF sustained release, the composite PEEK scaffolds possessed good mechanical properties, hydrophilicity, protein adhesion properties. The in vitro results indicated that bFGF/polydopamine-loaded PEEK exhibited good biocompatibility to rabbit embryonic fibroblasts (REF) by promoting cell proliferation, adhesion, and migration. Ribonucleic acid sequencing (RNA-seq) revealed that bFGF/polydopamine-loaded PEEK implants significantly upregulated the expression of genes and proteins associated with soft tissue integration and activated Wnt/β-catenin signaling in biological processes, but related expression of genes and proteins was significantly downregulated when the Wnt/β-catenin signaling was inhibited. Furthermore, in vivo bFGF/polydopamine-loaded PEEK implants exhibited excellent performance in improving the growth and adhesion of the surrounding soft tissue. In summary, bFGF/polydopamine-loaded PEEK implants possess soft tissue integration properties by activating the Wnt/β-catenin signaling, which have a potential translational clinical application in the future.

3D engineered human gingiva fabricated with electrospun collagen scaffolds provides a platform for in vitro analysis of gingival seal to abutment materials

In order to advance models of human oral mucosa towards routine use, these models must faithfully mimic the native tissue structure while also being scalable and cost efficient. The goal of this study was to develop a low-cost, keratinized human gingival model with high fidelity to human attached gingiva and demonstrate its utility for studying the implant-tissue interface. Primary human gingival fibroblasts (HGF) and keratinocytes (HGK) were isolated from clinically healthy gingival biopsies. Four matrices, electrospun collagen (ES), decellularized dermis (DD), type I collagen gels (Gel) and released type I collagen gels (Gel-R)) were tested to engineer lamina propria and gingiva. HGF viability was similar in all matrices except for Gel-R, which was significantly decreased. Cell penetration was largely limited to the top layers of all matrices. Histomorphometrically, engineered human gingiva was found to have similar appearance to the native normal human gingiva except absence of rete pegs. Immunohistochemical staining for cell phenotype, differentiation and extracellular matrix composition and organization within 3D engineered gingiva made with electrospun collagen was mostly in agreement with normal gingival tissue staining. Additionally, five types of dental material posts (5-mm diameter x 3-mm height) with different surface characteristics were used [machined titanium, SLA (sandblasted-acid etched) titanium, TiN-coated (titanium nitride-coated) titanium, ceramic, and PEEK (Polyetheretherketone) to investigate peri-implant soft tissue attachment studied by histology and SEM. Engineered epithelial and stromal tissue migration to the implant-gingival tissue interface was observed in machined, SLA, ceramic, and PEEK groups, while TiN was lacking attachment. Taken together, the results suggest that electrospun collagen scaffolds provide a scalable, reproducible and cost-effective lamina propria and 3D engineered gingiva that can be used to explore biomaterial-soft tissue interface.

In vitro assessment of polyetheretherketone for an attachment component for an implant-retained overdenture

STATEMENT OF PROBLEM

Frequent maintenance because of the limited lifetime of overdenture attachments with O-rings has led to the development of materials that might improve their functionality and longevity. However, testing of newly developed attachment materials is lacking.

PURPOSE

The purpose of this in vitro study was to evaluate a newly developed attachment made of polyetheretherketone (PEEK) for an implant-retained overdenture.

MATERIAL AND METHODS

Specimens of PEEK, polyacetal, and Teflon O-ring materials were prepared for analysis of roughness, surface hardness, and compressive strength. For the fatigue resistance test, new specimens based on acrylic resin were subjected to 2880 insertion and removal cycles. Compression and roughness data were compared with the Kruskal-Wallis and Dunn post hoc test; hardness data with ANOVA and t test; and fatigue and stereomicroscopy with ANOVA with repeated measures, t test, and Bonferroni adjustment (α=.05).

RESULTS

Polyacetal had the lowest surface roughness (P=.038). There was a significant difference in hardness among the materials (P<.05). PEEK presented the highest compressive strength among the materials (P<.001). For the fatigue resistance, only polyacetal showed a difference between the initial time-point (P<.05) and subsequent time-points. Polyacetal had a higher fatigue resistance than Teflon (P<.001) and PEEK (P<.05). Regarding the internal deformation of the attachments, a significant difference was observed among the materials (P<.05).

CONCLUSIONS

PEEK showed promising results regarding the physicomechanical properties necessary for use as an overdenture attachment when compared with other evaluated materials. In addition, the PEEK attachment showed results comparable to those in the control group (O-rings) in terms of retention.

In vitro effects of photobiomodulation applied to gingival fibroblasts cultured on titanium and zirconia surfaces and exposed to LPS from Escherichia coli

Photobiomodulation (PBM) therapy is used to stimulate cell proliferation and metabolism, as well as reduce inflammatory cytokine synthesis, which plays a main role in the long-term stability of implants. This study assessed the response of gingival fibroblasts cultured on titanium (Ti) and zirconia (ZrO₂), submitted to PBM and exposed to lipopolysaccharide (LPS). Cells seeded on Ti and ZrO₂ were irradiated (InGaAsP; 780 nm, 25 mW) 3 times, using 0.5, 1.5, and 3.0 J/cm² doses, and exposed to Escherichia coli LPS (1 μg/mL). After 24 h, cell viability (alamarBlue, n = 8), interleukin 6 (IL-6) and 8 (IL-8) synthesis (ELISA, n = 6), and IL-6 and vascular endothelial growth factor (VEGF) gene expression (qPCR, n = 5) were assessed and statistically analyzed (one-way ANOVA, α = 0.05). Cell morphology was evaluated by fluorescence microscopy. Increased cell viability occurred in all groups cultured on Ti compared with that of the control, except for cells exposed to LPS. Fibroblasts cultured on ZrO₂ and LPS-exposed exhibited reduced viability. PBM at 3.0 J/cm² and 1.5 J/cm² downregulated the IL-6 synthesis by fibroblasts seeded on Ti and ZrO₂, as well as IL-8 synthesis by cells seeded on ZrO₂. Fibroblasts seeded on both surfaces and LPS-exposed showed increased IL-6 gene expression; however, this activity was downregulated when fibroblasts were irradiated at 3.0 J/cm². Enhanced VEGF gene expression by cells seeded on Ti and laser-irradiated (3.0 J/cm²). Distinct patterns of cytoskeleton occurred in laser-irradiated cells exposed to LPS. Specific parameters of PBM can biomodulate the inflammatory response of fibroblasts seeded on Ti or ZrO₂ and exposed to LPS.