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Komatsu K, Matsuura T, Cheng J, Kido D, Park W, Ogawa T. Nanofeatured surfaces in dental implants: contemporary insights and impending challenges. Int J Implant Dent 2024; 10:34. [PMID: 38963524 PMCID: PMC11224214 DOI: 10.1186/s40729-024-00550-1] [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: 05/13/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Dental implant therapy, established as standard-of-care nearly three decades ago with the advent of microrough titanium surfaces, revolutionized clinical outcomes through enhanced osseointegration. However, despite this pivotal advancement, challenges persist, including prolonged healing times, restricted clinical indications, plateauing success rates, and a notable incidence of peri-implantitis. This review explores the biological merits and constraints of microrough surfaces and evaluates the current landscape of nanofeatured dental implant surfaces, aiming to illuminate strategies for addressing existing impediments in implant therapy. Currently available nanofeatured dental implants incorporated nano-structures onto their predecessor microrough surfaces. While nanofeature integration into microrough surfaces demonstrates potential for enhancing early-stage osseointegration, it falls short of surpassing its predecessors in terms of osseointegration capacity. This discrepancy may be attributed, in part, to the inherent "dichotomy kinetics" of osteoblasts, wherein increased surface roughness by nanofeatures enhances osteoblast differentiation but concomitantly impedes cell attachment and proliferation. We also showcase a controllable, hybrid micro-nano titanium model surface and contrast it with commercially-available nanofeatured surfaces. Unlike the commercial nanofeatured surfaces, the controllable micro-nano hybrid surface exhibits superior potential for enhancing both cell differentiation and proliferation. Hence, present nanofeatured dental implants represent an evolutionary step from conventional microrough implants, yet they presently lack transformative capacity to surmount existing limitations. Further research and development endeavors are imperative to devise optimized surfaces rooted in fundamental science, thereby propelling technological progress in the field.
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Affiliation(s)
- Keiji Komatsu
- 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
| | - James Cheng
- 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
- Section of Periodontics, UCLA School of Dentistry, Los Angeles, USA
| | - Daisuke Kido
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
| | - Wonhee Park
- Weintraub Center for Reconstructive Biotechnology, UCLA School of Dentistry, Los Angeles, USA
- Department of Dentistry, College of Medicine, Hanyang University, Seoul, Korea
| | - 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.
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, 10833 Le Conte Avenue B3-087, Box951668, Los Angeles, CA, 90095-1668, USA.
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Lackington WA, Bellon B, Guimond S, Schweizer P, Cancellieri C, Ambeza A, Chopard-Lallier AL, Pippenger B, Armutlulu A, Maeder X, Schmutz P, Rottmar M. Bio-Inspired Micro- and Nano-Scale Surface Features Produced by Femtosecond Laser-Texturing Enhance TiZr-Implant Osseointegration. Adv Healthc Mater 2024:e2400810. [PMID: 38857489 DOI: 10.1002/adhm.202400810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/13/2024] [Indexed: 06/12/2024]
Abstract
Surface design plays a critical role in determining the integration of dental implants with bone tissue. Femtosecond laser-texturing has emerged as a breakthrough technology offering excellent uniformity and reproducibility in implant surface features. However, when compared to state-of-the-art sandblasted and acid-etched surfaces, laser-textured surface designs typically underperform in terms of osseointegration. This study investigates the capacity of a bio-inspired femtosecond laser-textured surface design to enhance osseointegration compared to state-of-the-art sandblasted & acid-etched surfaces. Laser-texturing facilitates the production of an organized trabeculae-like microarchitecture with superimposed nano-scale laser-induced periodic surface structures on both 2D and 3D samples of titanium-zirconium-alloy. Following a boiling treatment to modify the surface chemistry, improving wettability to a contact angle of 10°, laser-textured surfaces enhance fibrin network formation when in contact with human whole blood, comparable to state-of-the-art surfaces. In vitro experiments demonstrate that laser-textured surfaces significantly outperform state-of-the-art surfaces with a 2.5-fold higher level of mineralization by bone progenitor cells after 28 days of culture. Furthermore, in vivo evaluations reveal superior biomechanical integration of laser-textured surfaces after 28 days of implantation. Notably, during abiological pull-out tests, laser-textured surfaces exhibit comparable performance, suggesting that the observed enhanced osseointegration is primarily driven by the biological response to the surface.
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Affiliation(s)
- William Arthur Lackington
- Biointerfaces Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Benjamin Bellon
- Institut Straumann AG, Basel, 4052, Switzerland
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, 33720, Finland
| | - Stefanie Guimond
- Biointerfaces Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
| | - Peter Schweizer
- Mechanics of Materials & Nanostructures Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Thun, 3603, Switzerland
| | - Claudia Cancellieri
- Joining Technologies & Corrosion Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, 8600, Switzerland
| | - Antoine Ambeza
- Laser TSE, GF Machining Solutions SA, Geneva, 1242, Switzerland
| | | | - Benjamin Pippenger
- Institut Straumann AG, Basel, 4052, Switzerland
- Department of Periodontology, University of Bern, Bern, 3010, Switzerland
| | | | - Xavier Maeder
- Mechanics of Materials & Nanostructures Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Thun, 3603, Switzerland
| | - Patrik Schmutz
- Joining Technologies & Corrosion Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, 8600, Switzerland
| | - Markus Rottmar
- Biointerfaces Lab, Empa, Swiss Federal Laboratories for Materials Science and Technology, St. Gallen, 9014, Switzerland
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Bellon B, Pippenger B, Stähli A, Degen M, Parisi L. Cementum and enamel surface mimicry influences soft tissue cell behavior. J Periodontal Res 2024. [PMID: 38828886 DOI: 10.1111/jre.13295] [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: 04/03/2024] [Revised: 05/06/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
AIMS To test whether titanium surface roughness disparity might be used to specifically guide the behavior of gingiva fibroblasts and keratinocytes, thereby improving the quality of soft tissue (ST) integration around abutments. METHODS Titanium discs resembling the roughness of enamel (M) or cementum (MA) were created with normal or increased hydrophilicity and used as substrates for human fibroblasts and keratinocytes. Adhesion and proliferation assays were performed to assess cell-type specific responses upon encountering the different surfaces. Additionally, immunofluorescence and qPCR analyses were performed to study more in depth the behavior of fibroblasts and keratinocytes on MA and M surfaces, respectively. RESULTS While enamel-like M surfaces supported adhesion, growth and a normal differentiation potential of keratinocytes, cementum-emulating MA surfaces specifically impaired the growth of keratinocytes. Vice versa, MA surfaces sustained regular adhesion and proliferation of fibroblasts. Yet, a more intimate adhesion between fibroblasts and titanium was achieved by an increased hydrophilicity of MA surfaces, which was associated with an increased expression of elastin. CONCLUSION The optimal titanium implant abutment might be achieved by a bimodal roughness design, mimicking the roughness of enamel (M) and cementum with increased hydrophilicity (hMA), respectively. These surfaces can selectively elicit cell responses favoring proper ST barrier by impairing epithelial downgrowth and promoting firm adhesion of fibroblasts.
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Affiliation(s)
- Benjamin Bellon
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland
- Clinic of Conservative and Preventive Dentistry, University of Zurich, Zürich, Switzerland
| | - Benjamin Pippenger
- Preclinical and Translational Research, Institut Straumann AG, Basel, Switzerland
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Martin Degen
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
| | - Ludovica Parisi
- Laboratory for Oral Molecular Biology, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland
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Isler SC, Bellon B, Foss M, Pippenger B, Stavropoulos A, Andersen OZ. Assessing the osseointegration potential of a strontium releasing nanostructured titanium oxide surface: A biomechanical study in the rabbit tibia plateau model. Clin Exp Dent Res 2024; 10:e812. [PMID: 38044566 PMCID: PMC10860460 DOI: 10.1002/cre2.812] [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: 08/12/2023] [Revised: 10/19/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
OBJECTIVES To investigate the impact of a Ti-Sr-O technology, applied to either a turned surface or an SLA surface, on the mechanical robustness of osseointegration, benchmarked against the SLActive surface. MATERIAL AND METHODS Ti discs (6.25-mm-diameter and 2-mm-thick) with three different surfaces were inserted on the proximal-anterior part of the tibial plateau of adult Swedish loop rabbits: (I) turned surface modified with Ti-Sr-O (turned + Ti-Sr-O), (II) SLA surface modified with Ti-Sr-O (SLA + Ti-Sr-O), and (III) SLActive surface (SLActive). Following a healing period of 2 weeks and 4 weeks, the pull-out (PO) force needed to detach the discs from the bone was assessed, as a surrogate of osseointegration. RESULTS The SLActive surface exhibited statistically significant higher median PO forces, compared with the SLA + Ti-Sr-O surfaces at both 2- and 4 weeks post-op (p > .05). In this study, no single turned + Ti-Sr-O surface disk was integrated. CONCLUSIONS The tested Ti-Sr-O technology failed to enhance osseointegration; however, this finding may be related to the inappropriateness of the rabbit tibia plateau model for assessing third-generation implant surface technologies, due to the limited diffusion and clearance at the disk-bone interface.
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Affiliation(s)
- Sila Cagri Isler
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Department of Periodontology, Faculty of DentistryGazi UniversityAnkaraTurkey
| | - Benjamin Bellon
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
- Department of Periodontology, Faculty of DentistryUniversity of ZurichZurichSwitzerland
| | - Morten Foss
- iNANO and Department of Physics and AstronomyScience and TechnologyAarhusDenmark
| | - Benjamin Pippenger
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
| | - Andreas Stavropoulos
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Department of Periodontology, Faculty of OdontologyMalmö UniversityMalmöSweden
- Division of Conservative Dentistry and Periodontology, University Clinic of DentistryMedical University of ViennaViennaAustria
| | - Ole Zoffmann Andersen
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
- Preclinical & Translational ResearchInstitut Straumann AGBaselSwitzerland
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