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Kolokathis PD, Zouraris D, Voyiatzis E, Sidiropoulos NK, Tsoumanis A, Melagraki G, Tämm K, Lynch I, Afantitis A. NanoConstruct: A web application builder of ellipsoidal nanoparticles for the investigation of their crystal growth, stability, and the calculation of atomistic descriptors. Comput Struct Biotechnol J 2024; 25:81-90. [PMID: 38883847 PMCID: PMC11179235 DOI: 10.1016/j.csbj.2024.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/18/2024] Open
Abstract
NanoConstruct is a state-of-the-art computational tool that enables a) the digital construction of ellipsoidal neutral energy minimized nanoparticles (NPs) in vacuum through its graphical user-friendly interface, and b) the calculation of NPs atomistic descriptors. It allows the user to select NP's shape and size by inserting its ellipsoidal axes and rotation angle while the NP material is selected by uploading its Crystallography Information File (CIF). To investigate the stability of materials not yet synthesised, NanoConstruct allows the substitution of the chemical elements of an already synthesized material with chemical elements that belong into the same group and neighbouring rows of the periodic table. The process is divided into three stages: 1) digital construction of the unit cell, 2) digital construction of NP using geometry rules and keeping its stoichiometry and 3) energy minimization of the geometrically constructed NP and calculation of its atomistic descriptors. In this study, NanoConstruct was applied for the investigation of the crystal growth of Zirconia (ZrO2) NPs when in the rutile form. The most stable configuration and the crystal growth route were identified, showing a preferential direction for the crystal growth of ZrO2 in its rutile form. NanoConstruct is freely available through the Enalos Cloud Platform (https://enaloscloud.novamechanics.com/riskgone/nanoconstruct/).
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Affiliation(s)
| | - Dimitrios Zouraris
- NovaMechanics Ltd, Nicosia 1070, Cyprus
- Entelos Institute, Larnaca 6059, Cyprus
| | | | | | - Andreas Tsoumanis
- NovaMechanics MIKE, Piraeus 18545, Greece
- NovaMechanics Ltd, Nicosia 1070, Cyprus
| | - Georgia Melagraki
- Division of Physical Sciences and Applications, Hellenic Military Academy, Vari 16672, Greece
| | - Kaido Tämm
- Institute of Chemistry, University of Tartu, Tartu 50090, Estonia
| | - Iseult Lynch
- Entelos Institute, Larnaca 6059, Cyprus
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Antreas Afantitis
- NovaMechanics MIKE, Piraeus 18545, Greece
- NovaMechanics Ltd, Nicosia 1070, Cyprus
- Entelos Institute, Larnaca 6059, Cyprus
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Sun J, Ding Q, Chen Y, Li J, Wang Z, Wei Z, Ge X, Zhang L. Effects and underlying mechanism of micro-nano-structured zirconia surfaces on biological behaviors of human gingival fibroblasts under inflammatory conditions. Acta Biomater 2024:S1742-7061(24)00270-8. [PMID: 38768742 DOI: 10.1016/j.actbio.2024.05.031] [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: 12/29/2023] [Revised: 05/11/2024] [Accepted: 05/15/2024] [Indexed: 05/22/2024]
Abstract
Zirconia is one of the most commonly used materials for abutments of dental implants, especially in the anterior region. Soft tissue integration to the zirconia abutment surface remains a challenge. Peri-implant soft tissue integration serves as a physiological barrier, attenuating pathogen penetration and preventing peri‑implant disease. The surface microstructure of zirconia has significant effects on the biological behaviors of human gingival fibroblasts (HGFs), but the effects under inflammatory conditions are still unclear. In this study, we established two micro-nano structures on zirconia surfaces using a femtosecond laser, including microgrooves with widths of 30 µm (G3) and 60 µm (G6) and depths of 5 µm, and nanoparticles inside the microgrooves. Polished surfaces were used as controls. HGFs were seeded onto the three groups of zirconia specimens and stimulated with lipopolysaccharide. The HGFs on micro-nano-structured zirconia surfaces exhibited lower inflammatory responses and higher cell adhesion, proliferation, and migration under inflammatory conditions compared with the polished surfaces. Additionally, the G3 group exhibited lower inflammatory responses and higher cell adhesion and migration than the G6 group. The micro-nano-structured zirconia surface exhibited decreased neutrophil infiltration and increased M2-type macrophage polarization in vivo. To explore the molecular mechanism, RNA sequencing and gene silencing were utilized, which revealed two critical target genes regulated by the G3 group. Overall, we proposed an innovative micro-nano-structured zirconia surface that reduced the in vitro and in vivo inflammatory responses and promoted HGF adhesion, migration, and proliferation under inflammatory conditions, in which TRAFD1 and NLRC5 were the underlying key genes. STATEMENT OF SIGNIFICANCE: Zirconia is one of the most commonly used materials for abutments, especially in the anterior region. The surface microstructure of zirconia has significant effects on the biological behaviors of human gingival fibroblasts (HGFs), but few studies have investigated these effects under inflammatory conditions, and the mechanism remains unclear. In this study, we developed an innovative micro-nano-structured zirconia surface using a femtosecond laser, which reduces the in vitro and in vivo pro-inflammatory responses and promotes HGFs adhesion, migration, and proliferation under inflammatory conditions compared with the polished zirconia surface. The potential underlying mechanism was also investigated. This work has provided some theoretical basis for the micro-nano-structured zirconia surface in potentially reducing the inflammation and enhancing peri‑implant soft-tissue integration under inflammatory conditions.
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Affiliation(s)
- Jiao Sun
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - Qian Ding
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - Ying Chen
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
| | - Jiajun Li
- Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190, China; Department of Physics, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhaohua Wang
- Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190, China; Department of Physics, University of Chinese Academy of Sciences, Beijing 100049, China; Songshan Lake Materials Laboratory, Dongguan 523808, China
| | - Zhiyi Wei
- Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, Beijing 100190, China; Department of Physics, University of Chinese Academy of Sciences, Beijing 100049, China; Songshan Lake Materials Laboratory, Dongguan 523808, China
| | - Xiyuan Ge
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing 100081, China.
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing 100081, China.
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Rues S, Herpel C, Ilani A, Schmitt C, Rammelsberg P, Schwindling FS. Effect of firing time and wall thickness on the biaxial flexural strength of 3D-printed zirconia. Dent Mater 2024; 40:484-492. [PMID: 38155019 DOI: 10.1016/j.dental.2023.12.018] [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: 08/29/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES To evaluate the effect of accelerated firing on 3D-printed zirconia. METHODS To check if formulae provided by ISO 6872 can be extended to thin samples, finite element analyses were carried out in advance of fabricating 3-mol% yttria-stabilized tetragonal zirconia polycrystal discs by milling and by 3D-printing. Four groups (n = 38 each) of 3D-printed specimens were produced with two nominal thicknesses (0.6 mm and 1.2 mm) and two firing strategies (long: 51 h, accelerated: 14.5 h). In the milled group (thickness 1.2 mm, n = 30), a standard firing program (9.8 h) was selected. Biaxial flexural strength tests were applied and mean strength, characteristic strength, and Weibull modulus were calculated for each group. Differences were analyzed using Welch ANOVA and Dunnett-T3 post-hoc tests. RESULTS Maximum tensile stresses occurring during biaxial strength testing can be calculated according to ISO 6872 for thin samples with b > 0.3 mm. Variability of measured strengths values was smaller for milled zirconia compared with 3D-printed zirconia. The 1.2-mm-thick 3D-printed samples had significantly decreased strength after accelerated firing than after long firing. However, for the 0.6-mm-thick samples, comparable mean biaxial strength values of about 1000 MPa were measured for both firing protocols. SIGNIFICANCE At the moment, long fabrication time for zirconia restorations is a major drawback of 3D-printing when compared with milling technology. This investigation showed that the strength of 0.6-mm-thick zirconia discs fabricated by 3D-printing was not impaired by accelerated firing. Thus, overnight firing of thin-walled 3D-printed zirconia restorations could be possible.
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Affiliation(s)
- Stefan Rues
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany.
| | - Christopher Herpel
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Ilani
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Clemens Schmitt
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany; Department of Prosthetic Dentistry, Medical University Innsbruck, Innsbruck, Austria
| | - Peter Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Franz Sebastian Schwindling
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany; Department of Prosthetic Dentistry, Medical University Innsbruck, Innsbruck, Austria
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Fernandes BF, Silva N, Da Cruz MB, Garret G, Carvalho Ó, Silva F, Mata A, Francisco H, Marques JF. Cell Biological and Antibacterial Evaluation of a New Approach to Zirconia Implant Surfaces Modified with MTA. Biomimetics (Basel) 2024; 9:155. [PMID: 38534840 DOI: 10.3390/biomimetics9030155] [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: 01/18/2024] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Peri-implantitis continues to be one of the major reasons for implant failure. We propose a new approach to the incorporation of MTA into zirconia implant surfaces with Nd:YAG laser and investigate the biological and the microbiological responses of peri-implant cells. Discs of zirconia stabilized with yttria and titanium were produced according to the following four study groups: Nd:YAG laser-textured zirconia coated with MTA (Zr MTA), Nd:YAG laser-textured zirconia (Zr textured), polished zirconia discs, and polished titanium discs (Zr and Ti). Surface roughness was evaluated by contact profilometry. Human osteoblasts (hFOB), gingival fibroblasts (HGF hTERT) and S. oralis were cultured on discs. Cell adhesion and morphology, cell differentiation markers and bacterial growth were evaluated. Zr textured roughness was significantly higher than all other groups. SEM images reveal cellular adhesion at 1 day in all samples in both cell lines. Osteoblasts viability was lower in the Zr MTA group, unlike fibroblasts viability, which was shown to be higher in the Zr MTA group compared with the Zr textured group at 3 and 7 days. Osteocalcin and IL-8 secretion by osteoblasts were higher in Zr MTA. The Zr textured group showed higher IL-8 values released by fibroblasts. No differences in S. oralis CFUs were observed between groups. The present study suggests that zirconia implant surfaces coated with MTA induced fibroblast proliferation and osteoblast differentiation; however, they did not present antibacterial properties.
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Affiliation(s)
- Beatriz Ferreira Fernandes
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Neusa Silva
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Mariana Brito Da Cruz
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Gonçalo Garret
- Department of Mechanical Engineering, Center for Microelectromechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal
| | - Óscar Carvalho
- Department of Mechanical Engineering, Center for Microelectromechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal
| | - Filipe Silva
- Department of Mechanical Engineering, Center for Microelectromechanical Systems (CMEMS), University of Minho, 4800-058 Guimarães, Portugal
| | - António Mata
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), LIBPhys-FCT UIDB/04559/2020, Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
- CEMDBE-Cochrane Portugal, Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Helena Francisco
- Grupo de Investigação Implantologia e Regeneração Óssea (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
| | - Joana Faria Marques
- Oral Biology and Biochemistry Research Group-Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, 1600-277 Lisboa, Portugal
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Murphy B, Baez J, Morris MA. Characterising Hydroxyapatite Deposited from Solution onto Novel Substrates: Growth Mechanism and Physical Properties. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:2483. [PMID: 37686991 PMCID: PMC10489777 DOI: 10.3390/nano13172483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023]
Abstract
Whilst titanium, stainless steel, and cobalt-chrome alloys are the most common materials for use in orthopaedic implant devices, there are significant advantages in moving to alternative non-metallic substrates. Substrates such as polymers may have advantageous mechanical biological properties whilst other substrates may bring unique capability. A key challenge in the use of non-metal products is producing substrates which can be modified to allow the formation of well-adhered hydroxyapatite films which promote osteointegration and have other beneficial properties. In this work, we aim to develop methodology for the growth of hydroxyapatite films on surfaces other than bulk metallic parts using a wet chemical coating process, and we provide a detailed characterisation of the coatings. In this study, hydroxyapatite is grown from saturated solutions onto thin titanium films and silicon substrates and compared to results from titanium alloy substrates. The coating process efficacy is shown to be dependent on substrate roughness, hydrophilicity, and activation. The mechanism of the hydroxyapatite growth is investigated in terms of initial attachment and morphological development using SEM and XPS analysis. XPS analysis reveals the exact chemical state of the hydroxyapatite compositional elements of Ca, P, and O. The characterisation of grown hydroxyapatite layers by XRD reveals that the hydroxyapatite forms from amorphous phases, displaying preferential crystal growth along the [002] direction, with TEM imagery confirming polycrystalline pockets amid an amorphous matrix. SEM-EDX and FTIR confirmed the presence of hydroxyapatite phases through elemental atomic weight percentages and bond assignment. All data are collated and reviewed for the different substrates. The results demonstrate that once hydroxyapatite seeds, it crystallises in the same manner as bulk titanium whether that be on a titanium or silicon substrate. These data suggest that a range of substrates may be coated using this facile hydroxyapatite deposition technique, just broadening the choice of substrate for a particular function.
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Affiliation(s)
- Bríd Murphy
- Advanced Materials & Bioengineering Research Centre (AMBER), Trinity College Dublin, Dublin 2, D02 CP49 Dublin, Ireland;
- School of Chemistry, Trinity College Dublin, Dublin 2, D02 PN40 Dublin, Ireland
| | - Jhonattan Baez
- Advanced Materials & Bioengineering Research Centre (AMBER), Trinity College Dublin, Dublin 2, D02 CP49 Dublin, Ireland;
- School of Chemistry, Trinity College Dublin, Dublin 2, D02 PN40 Dublin, Ireland
| | - Mick A. Morris
- Advanced Materials & Bioengineering Research Centre (AMBER), Trinity College Dublin, Dublin 2, D02 CP49 Dublin, Ireland;
- School of Chemistry, Trinity College Dublin, Dublin 2, D02 PN40 Dublin, Ireland
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Kunrath MF, Gerhardt MDN. Trans-mucosal platforms for dental implants: Strategies to induce muco-integration and shield peri-implant diseases. Dent Mater 2023; 39:846-859. [PMID: 37537095 DOI: 10.1016/j.dental.2023.07.009] [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: 05/14/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Trans-mucosal platforms connecting the bone-anchored implants to the prosthetic teeth are essential for the success of oral rehabilitation in implant dentistry. This region promotes a challenging environment for the successfulness of dental components due to the transitional characteristics between soft and hard tissues, the presence of bacteria, and mechanical forces. This review explored the most current approaches to modify trans-mucosal components in terms of macro-design and surface properties. METHODS This critical review article revised intensely the literature until July 2023 to demonstrate, discuss, and summarize the current knowledge about marketable and innovative trans-mucosal components for dental implants. RESULTS A large number of dental implant brands have promoted the development of several implant-abutment designs in the clinical market. The progress of abutment designs shows an optimistic reduction of bacteria colonization underlying the implant-abutment gap, although, not completely inhibited. Fundamental and preclinical studies have demonstrated promising outcomes for altered-surface properties targeting antibacterial properties and soft tissue sealing. Nanotopographies, biomimetic coatings, and antibiotic-release properties have been shown to be able to modulate, align, orient soft tissue cells, and induce a reduction in biofilm formation, suggesting superior abilities compared to the current trans-mucosal platforms available on the market. SIGNIFICANCE Future clinical implant-abutments show the possibility to reduce peri-implant diseases and fortify soft tissue interaction with the implant-substrate, defending the implant system from bacteria invasion. However, the absence of technologies translated to commercial stages reveals the need for findings to "bridge the gap" between scientific evidences published and applied science in the industry.
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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; School of Health and Life Sciences, Post-Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil; School of Technology, Post-Graduate Program in Materials Technology and Engineering, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Maurício do N Gerhardt
- School of Health and Life Sciences, Post-Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Tang K, Luo ML, Zhou W, Niu LN, Chen JH, Wang F. The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies. Bioact Mater 2023; 27:348-361. [PMID: 37180640 PMCID: PMC10172871 DOI: 10.1016/j.bioactmat.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/23/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.
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Affiliation(s)
- Kai Tang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Meng-Lin Luo
- Institute of Stomatology & Oral Maxilla Facial Key Laboratory, The First Medical Center, Chinese PLA General Hospital & Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhou
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Li-Na Niu
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ji-Hua Chen
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
| | - Fu Wang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
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Kao CT, Liu SH, Kao CY, Huang TH. Clinical evaluation of 3D-printed zirconia crowns fabricated by selective laser melting (SLM) for posterior teeth restorations: Short-term pilot study. J Dent Sci 2022; 18:715-721. [PMID: 37021225 PMCID: PMC10068370 DOI: 10.1016/j.jds.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 11/14/2022] [Indexed: 11/28/2022] Open
Abstract
Background/purpose Zirconia crowns (ZrC) without veneering porcelain have become an effective alternative in clinical practice. Monolithic zirconia restorations fabricated by the dry milling method do not have acceptable clinical properties. This study evaluated the periodontal qualities of three-dimensional printed ZrC using the modified United States Public Health Service (USPHS) criteria. Materials and methods A total of 15 patients who required dental crowns were recruited, and all 15 teeth were restored with digital 3D-printed ZrC. All crowns were assessed at the time of crown placement and 2, 6, and 24 weeks post-placement. Clinical parameters, including plaque index, gingival index, probing depth, crown marginal integrity, and attrition of the antagonist's teeth, were evaluated and recorded. Results According to the Modified California Dental Association quality evaluation system, 100% of the crowns received satisfactory grades. Despite the significant increase in plaque index and gingival index at two weeks post-ZrC placement, there was no deterioration in probing depth. Moreover, there was discard usage of ZrC on the antagonist's teeth at 24 weeks posttreatment. Of the 15 crowns, one tooth had to be extracted due to a vertical root fracture. Overall, the digital 3D-printed crowns showed no adverse effects on periodontal tissues after 24 weeks of follow-up. Conclusion The 3D-printed ZrC showed no periodontal problems. It can serve as an alternative for patients, particularly those with high esthetic expectations.
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Thiem DGE, Stephan D, Kniha K, Kohal RJ, Röhling S, Spies BC, Stimmelmayr M, Grötz KA. German S3 guideline on the use of dental ceramic implants. Int J Implant Dent 2022; 8:43. [PMID: 36190587 PMCID: PMC9530079 DOI: 10.1186/s40729-022-00445-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/27/2022] [Indexed: 01/18/2023] Open
Abstract
PURPOSE Based on the excellent long-term data, dental implants made of titanium are considered the international implantological standard for replacing missing teeth. However, ceramic implants made of zirconia (ZrO2) have experienced a renaissance in the last 15 years due to constant innovations in materials and products, with material properties and soft tissue- and osseointegration behavior comparable to those of titanium. However, one limitation concerning ceramic implants is the lack of reliable long-term data, especially in the case of two-piece implant systems. As there is an increasing demand for ceramic implants from practitioners and patients, the German Society for Implantology (DGI) has decided to develop a guideline on the use of dental ceramic implants at the highest available evidence level with the involvement of experts in this field. METHODS Statements and recommendations were prepared after conducting a systematic literature search and an independent assessment process involving the relevant clinical literature from 2008 to 2021. The adopted recommendations and statements are summarized in this guideline. RESULTS AND CONCLUSIONS It confirms the feasible use of one-piece zirconia implants as an addendum/alternative to titanium implants. No final conclusion regarding the application of two-piece ceramic implant systems could be drawn on the basis of the existing data, thus its use can only be recommended after the patient has been informed in detail about the lack of long-term clinical data.
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Affiliation(s)
- D. G. E. Thiem
- grid.410607.4Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - D. Stephan
- grid.410607.4Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Centre Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - K. Kniha
- Private Practice for Oral Surgery and Implantology, Rosental 6, 80331 Munich, Germany
| | - R. J. Kohal
- grid.7708.80000 0000 9428 7911Department of Prosthetic Dentistry, University Medical Centre Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - S. Röhling
- Private Praxis for Oral Surgery, Oralchirurgie T1, im Schäfflerhaus Theaterstr. 1, 80333 Munich, Germany
| | - B. C. Spies
- grid.7708.80000 0000 9428 7911Department of Prosthetic Dentistry, University Medical Centre Freiburg, Hugstetter Straße 55, 79106 Freiburg, Germany
| | - M. Stimmelmayr
- Private Practice for Oral Surgery, Josef-Heilingbrunner-Straße 2, 93413 Cham, Germany
| | - K. A. Grötz
- grid.491861.3Helios Dr. Horst Schmidt Kliniken Wiesbaden, Ludwig-Erhard-Straße 100, 65199 Wiesbaden, Germany
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Tang S, Wang Y, Zong Z, Ding N, Zhang Z. Enhanced osteogenic activity of titania-modified zirconia implant by ultraviolet irradiation. Front Bioeng Biotechnol 2022; 10:945869. [PMID: 36003530 PMCID: PMC9393212 DOI: 10.3389/fbioe.2022.945869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Zirconia is a superior implant material owing to its high mechanical strength, durable corrosion resistance, superior aesthetic effect and excellent biocompatibility. However, the bioactivity of zirconia surfaces remains a great challenge for implant osseointegration. A titania (TiO2) coating was innovatively synthesized on the surface of zirconia by infiltration in a suspension of zirconium oxychloride and titania for dense sintering. Subsequently, the coating was subjected to ultraviolet (UV) light to enhance the biological inertness of zirconia. Scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD) and contact angle analysis were conducted to confirm the surface characteristics. Afterwards, in vitro assessments of cell adhesion, proliferation and osteogenic differentiation of MC3T3-E1 cells were performed. Zirconia samples were implanted into rat femurs to assess biocompatibility and host tissue response in vivo. Micro-CT evaluation and histological testing were conducted. After UV irradiation, the content of hydroxyl groups and hydrophilicity of TiO2-modified zirconia were significantly increased. The results of in vitro experiments showed that TiO2-modified zirconia subjected to UV light could promote cell proliferation and spreading, enhance ALP activity and the degree of mineralization, and upregulate osteogenesis-related genes. Furthermore, in vivo assessments confirmed that UV-irradiated TiO2-modified zirconia implants maximized the promotion of osseointegration. TiO2-modified zirconia after UV treatment will have broad clinical application prospects in improving the osseointegration of zirconia implants.
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Dental Implant Treatment in Patients Suffering from Oral Lichen Planus: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148397. [PMID: 35886246 PMCID: PMC9316128 DOI: 10.3390/ijerph19148397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/30/2022] [Accepted: 07/08/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND The aim of this study was to describe the complications and survival rates of dental implants placed in patients suffering from oral lichen planus (OLP) and to present recommendations for implant treatment in this group of patients through a narrative review of the published studies. METHODS A search of the literature was conducted using four databases: PubMed/Medline, Web of Science, Cochrane, and Scopus with a stop date of May 2022. RESULTS Eighteen studies were evaluated. The results showed that dental implant survival rates in patients with OLP were similar to those reported in the general population. Moreover, the existing literature seemed to imply that OLP is not a suspected risk factor for peri-implant diseases. However, patients suffering from erosive forms of OLP or desquamative gingivitis and poor oral hygiene were more susceptible to developing peri-implant diseases; in addition, oral squamous cell carcinoma was observed in a few cases of OLP. CONCLUSION With the limitations of this narrative review, dental implants may be regarded as a safe and feasible therapeutic approach to the treatment of patients with well-controlled OLP. These patients should be monitored carefully during follow-up care. Well-designed prospective trials are required to validate the present findings.
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The Impact of Early Saliva Interaction on Dental Implants and Biomaterials for Oral Regeneration: An Overview. Int J Mol Sci 2022; 23:ijms23042024. [PMID: 35216139 PMCID: PMC8875286 DOI: 10.3390/ijms23042024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/11/2022] Open
Abstract
The presence of saliva in the oral environment is relevant for several essential health processes. However, the noncontrolled early saliva interaction with biomaterials manufactured for oral rehabilitation may generate alterations in the superficial properties causing negative biological outcomes. Therefore, the present review aimed to provide a compilation of all possible physical-chemical-biological changes caused by the early saliva interaction in dental implants and materials for oral regeneration. Dental implants, bone substitutes and membranes in dentistry possess different properties focused on improving the healing process when in contact with oral tissues. The early saliva interaction was shown to impair some positive features present in biomaterials related to quick cellular adhesion and proliferation, such as surface hydrophilicity, cellular viability and antibacterial properties. Moreover, biomaterials that interacted with contaminated saliva containing specific bacteria demonstrated favorable conditions for increased bacterial metabolism. Additionally, the quantity of investigations associating biomaterials with early saliva interaction is still scarce in the current literature and requires clarification to prevent clinical failures. Therefore, clinically, controlling saliva exposure to sites involving the application of biomaterials must be prioritized in order to reduce impairment in important biomaterial properties developed for rapid healing.
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Kunrath MF, Muradás TC, Penha N, Campos MM. Innovative surfaces and alloys for dental implants: What about biointerface-safety concerns? Dent Mater 2021; 37:1447-1462. [PMID: 34426019 DOI: 10.1016/j.dental.2021.08.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The present review article aimed to discuss the recent technologies employed for the development of dental implants, mainly regarding innovative surface treatments and alternative alloys, emphasizing the bio-tribocorrosion processes. METHODS An electronic search applying specific MeSH terms was carried out in PubMed and Google Scholar databases to collect data until August 2021, considering basic, pre-clinical, clinical and review studies. The relevant articles (n=111), focused on innovative surface treatments for dental implants and their potential undesirable biological effects, were selected and explored. RESULTS Novel texturization methodologies for dental implants clearly provided superficial and structural atomic alterations in micro- and nanoscale, promoting different mechanical-chemical interactions when applied in the clinical set. Some particulate metals released from implant surfaces, their degradation products and/or contaminants exhibited local and systemic reactions after implant installation and osseointegration, contributing to unexpected treatment drawbacks and adverse effects. Therefore, there is an urgent need for development of pre-clinical and clinical platforms for screening dental implant devices, to predict the biointerface reactions as early as possible during the development phases. SIGNIFICANCE Modern surface treatments and innovative alloys developed for dental implants are not completely understood regarding their integrity during long-term clinical function, especially when considering the bio-tribocorrosion process. From this review, it is possible to assume that degradation and contamination of dental surfaces might be associated within peri-implant inflammation and cumulative long-lasting systemic toxicity. The in-depth comprehension of the biointerface modifications on these novel surface treatments might preclude unnecessary expenses and postoperative complications involving osseointegration failures.
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Affiliation(s)
- Marcel F Kunrath
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Thaís C Muradás
- Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Maria M Campos
- Programa de Pós-Graduação em Odontologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Centro de Pesquisa em Toxicologia e Farmacologia, Escola de Ciências da Saúde e da Vida, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil; Programa de Pós-Graduação em Medicina e Ciências da Saúde, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Abstract
This review aims to discuss the advantages and disadvantages of zirconia implants compared with titanium implants. Moreover, it intends to review the relevant available long-term literature of these two materials regarding osteointegration, soft-tissue, microbiota, and peri-implantitis, focusing on clinical results. Briefly, titanium implants are a reliable alternative for missing teeth; however, they are not incapable of failure. In an attempt to provide an alternative implant material, implants made from ceramic-derivate products were developed. Owing to its optimal osseointegration competence, biocompatibility, and esthetic proprieties, zirconium dioxide (ZrO2), also known as zirconia, has gained popularity among researchers and clinicians, being a metal-free alternative for titanium implants with its main use in the anterior esthetic zones. This type of implant may present similar osseointegration as those noted on titanium implants with a greater soft-tissue response. Furthermore, this material does not show corrosion as its titanium analog, and it is less susceptible to bacterial adhesion. Lastly, even presenting a similar inflammatory response to titanium, zirconia implants offer less biofilm formation, suggesting less susceptibility to peri-implantitis. However, it is a relatively new material that has been commercially available for a decade; consequently, the literature still lacks studies with long follow-up periods.
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