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Zhao D, Leng Y, Liu Y, Zhou X. Effect of calcium hydrothermal treatment of zirconia abutments on human gingival fibroblasts. J Biomed Mater Res B Appl Biomater 2023; 111:1883-1889. [PMID: 37289176 DOI: 10.1002/jbm.b.35291] [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: 03/01/2023] [Revised: 05/07/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
Zirconia materials have been increasingly used in implant rehabilitation due to their excellent physical and esthetic properties. Stable peri-implant epithelial tissue adhesion to the transmucosal implant abutment may significantly enhance the efficacy of implant long-term stability. However, it is difficult to form stable chemical or biological bindings with peri-implant epithelial tissue due to the strong biological inertia of zirconia materials. In the present study, we investigated whether calcium hydrothermal treatment of zirconia promotes sealing of peri-implant epithelial tissue. In vitro experiments were performed to analyze the effects of calcium hydrothermal treatment on zirconia surface morphology and composition by scanning electron microscopy and energy dispersive spectrometry. Immunofluorescence staining of adherent proteins, namely, F-actin and integrin β1, in human gingival fibroblast line (HGF-l) cells was performed. In the calcium hydrothermal treatment group, there was higher expression of these adherent proteins and increased HGF-l cell proliferation. An in vivo study was conducted by extracting the maxillary right first molars of rats and replacing them with mini-zirconia abutment implants. The calcium hydrothermal treatment group showed better attachment at the zirconia abutment surface, which inhibited horseradish peroxidase penetration at 2 weeks post-implantation. These results demonstrated that calcium hydrothermal treatment of zirconia improves the seal between the implant abutment and surrounding epithelial tissues, potentially increasing the long-term stability of the implant.
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Affiliation(s)
- Dan Zhao
- Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Yanjun Leng
- School of Stomatology, Central South University, Changsha, China
| | - Yishu Liu
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xudiyang Zhou
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Rohr N, Schönenberger AJ, Fischer J. Influence of Surface Treatment and Accelerated Ageing on Biaxial Flexural Strength and Hardness of Zirconia. MATERIALS (BASEL, SWITZERLAND) 2023; 16:910. [PMID: 36769917 PMCID: PMC9917567 DOI: 10.3390/ma16030910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/10/2023] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
The aim was to investigate how the surface treatment and the process of accelerated ageing of zirconia for dental implants affect the biaxial flexural strength and hardness. Zirconia discs with a diameter of 12.6 mm were subjected to either one of the following treatments: polishing (Zp); polishing and heat treatment at 1250 °C for 1 h (Zpt); machining (Zm); machining and heat treatment (Zmt); or sandblasting, acid-etching, and heat treatment (Z14) (n = 45 per group). Biaxial flexural strength and Martens hardness (HM) were measured without further treatment and after accelerated ageing for 5 h or 5 × 5 h according to ISO 13356 (n = 15 per group). Two-way ANOVA was applied to test the effect of surface treatment and ageing (α = 0.05). The reliability of the specimens was described with Weibull two-parameter distribution of biaxial flexural strength data. Overall, the surface treatment (p < 0.001) and ageing (p = 0.012) revealed a significant effect on biaxial flexural strength values, while HM was only affected by the surface treatment (p < 0.001) but not ageing (p = 0.160). Surface treatment significantly affected HM (p < 0.001) but not ageing (p = 0.160). The applied surface treatments affected the biaxial flexural strength and HM of zirconia. For accelerated ageing, a duration of both 5 h and 5 × 5 h is recommended to evaluate the effect of surface treatments. Zm was the most reliable surface as it was least affected by ageing and provided low standard deviations of biaxial flexural strength values.
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Zhang F, Spies BC, Willems E, Inokoshi M, Wesemann C, Cokic SM, Hache B, Kohal RJ, Altmann B, Vleugels J, Van Meerbeek B, Rabel K. 3D printed zirconia dental implants with integrated directional surface pores combine mechanical strength with favorable osteoblast response. Acta Biomater 2022; 150:427-441. [PMID: 35902036 DOI: 10.1016/j.actbio.2022.07.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/25/2022] [Accepted: 07/19/2022] [Indexed: 11/01/2022]
Abstract
Dental implants need to combine mechanical strength with promoted osseointegration. Currently used subtractive manufacturing techniques require a multi-step process to obtain a rough surface topography that stimulates osseointegration. Advantageously, additive manufacturing (AM) enables direct implant shaping with unique geometries and surface topographies. In this study, zirconia implants with integrated lamellar surface topography were additively manufactured by nano-particle ink-jetting. The ISO-14801 fracture load of as-sintered implants (516±39 N) resisted fatigue in 5-55°C water thermo-cycling (631±134 N). Remarkably, simultaneous mechanical fatigue and hydrothermal aging at 90°C significantly increased the implant strength to 909±280 N due to compressive stress generated at the seamless transition of the 30-40 µm thick, rough and porous surface layer to the dense implant core. This unique surface structure induced an elongated osteoblast morphology with uniform cell orientation and allowed for osteoblast proliferation, long-term attachment and matrix mineralization. In conclusion, the developed AM zirconia implants not only provided high long-term mechanical resistance thanks to the dense core along with compressive stress induced at the transition zone, but also generated a favorable osteoblast response owing to the integrated directional surface pores. STATEMENT OF SIGNIFICANCE: : Zirconia ceramics are becoming the material of choice for metal-free dental implants, however significant efforts are required to obtain a rough/porous surface for enhanced osseointegration, along with the risk of surface delamination and/or microstructure variation. In this study, we addressed the challenge by additively manufacturing implants that seamlessly combine dense core with a porous surface layer. For the first time, a unique surface with a directional lamellar pore morphology was additively obtained. This AM implant also provided strength as strong as conventionally manufactured zirconia implants before and after long-term fatigue. Favorable osteoblast response was proved by in-vitro cell investigation. This work demonstrated the opportunity to AM fabricate novel ceramic implants that can simultaneously meet the mechanical and biological functionality requirements.
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Affiliation(s)
- Fei Zhang
- KU Leuven (University of Leuven), Department of Materials Engineering, Leuven, Belgium; KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium.
| | - Benedikt C Spies
- University of Freiburg, Faculty of Medicine, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany
| | - Evita Willems
- KU Leuven (University of Leuven), Department of Materials Engineering, Leuven, Belgium; KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Masanao Inokoshi
- Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Department of Gerodontology and Oral Rehabilitation, Tokyo, Japan
| | - Christian Wesemann
- University of Freiburg, Faculty of Medicine, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Stevan M Cokic
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Benedikt Hache
- University of Freiburg, Faculty of Medicine, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany; University of Freiburg, Faculty of Medicine, Research Center for Tissue Replacement, Regeneration and Neogenesis, Section of Cell biology-inspired Bone Regeneration, G.E.R.N. Freiburg, Germany
| | - Ralf J Kohal
- University of Freiburg, Faculty of Medicine, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany
| | - Brigitte Altmann
- University of Freiburg, Faculty of Medicine, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany; University of Freiburg, Faculty of Medicine, Research Center for Tissue Replacement, Regeneration and Neogenesis, Section of Cell biology-inspired Bone Regeneration, G.E.R.N. Freiburg, Germany
| | - Jef Vleugels
- KU Leuven (University of Leuven), Department of Materials Engineering, Leuven, Belgium
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Leuven, Belgium
| | - Kerstin Rabel
- University of Freiburg, Faculty of Medicine, Center for Dental Medicine, Department of Prosthetic Dentistry, Freiburg, Germany
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