Hard and soft tissue responses to implant made of three different materials with microgrooved collar in a dog model

Pre-Clinical Models in Implant Dentistry: Past, Present, Future

Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.

The Early Adhesion Effects of Human Gingival Fibroblasts on Bovine Serum Albumin Loaded Hydrogenated Titanium Nanotube Surface

The soft tissue sealing at the transmucal portion of implants is vital for the long-term stability of implants. Hydrogenated titanium nanotubes (H₂-TNTs) as implant surface treatments were proved to promote the adhesion of human gingival fibroblasts (HGFs) and have broad usage as drug delivery systems. Bovine serum albumin (BSA) as the most abundant albumin in body fluid was crucial for cell adhesion and was demonstrated as a normal loading protein. As the first protein arriving on the surface of the implant, albumin plays an important role in initial adhesion of soft tissue cells, it is also a common carrier, transferring and loading different endogenous and exogenous substances, ions, drugs, and other small molecules. The aim of the present work was to investigate whether BSA-loaded H₂-TNTs could promote the early adhesion of HGFs; H₂-TNTs were obtained by hydrogenated anodized titanium dioxide nanotubes (TNTs) in thermal treatment, and BSA was loaded in the nanotubes by vacuum drying; our results showed that the superhydrophilicity of H₂-TNTs is conducive to the loading of BSA. In both hydrogenated titanium nanotubes and non-hydrogenated titanium nanotubes, a high rate of release was observed over the first hour, followed by a period of slow and sustained release; however, BSA-loading inhibits the early adhesion of human gingival fibroblasts, and H₂-TNTs has the best promoting effect on cell adhesion. With the release of BSA after 4 h, the inhibitory effect of BSA on cell adhesion was weakened.

Histologic and histomorphometric evaluation of new zirconia-based ceramic dental implants: A preclinical study in dogs

OBJECTIVE

Healing of soft tissues and improvement of aesthetics have become major research objectives in implantology and renewed the interest for ceramics implants. The aim of this study was to evaluate the pre-clinical performance of screw-shaped sandblasted-etched implants processed from an innovative zirconia-based ceramic composite, in comparison to titanium.

METHODS

Twenty-four ceramic and twenty-four titanium screw-shaped sandblasted-etched dental implants were tested in a split-mouth design in six Beagle dogs. Surface topographies were investigated by confocal microscopy. Local tissue effects were evaluated at 4 and 13 weeks after implantation through histology. An ANOVA statistical analysis (5% risk; p < 0.05) was performed to compare peri-implant quantitative histomorphometric parameters on buccal and lingual sides, including Bone to Implant Contact (BIC) among test groups and time-periods.

RESULTS

Titanium and ceramic implants presented respectively moderate and minimal roughness. After 4 and 13 weeks, ceramic implants showed an inflammatory tissue response close to titanium implants. At both period of time there was no significant difference between the titanium and ceramic groups in terms of BIC values (mean ± SD) at the lingual or buccal sides or when combining buccal + lingual BIC values (respectively for titanium and ceramic, 68.4 ± 14.7 % and 75.0 ± 13.5 % at 4 weeks, and 92.0 ± 8.6 % and 86.1 ± 13.8 % at 13 weeks).

SIGNIFICANCE

Within the limits of the present study, it can be concluded that newly developed zirconia-based ceramic composite dental implants have similar biocompatibility and osseointegration to those observed in titanium implants. These pre-clinical results corroborate the potential for the use of these new zirconia-based ceramics in oral implantology.

Oral Tissue Interactions and Cellular Response to Zirconia Implant-Prosthetic Components: A Critical Review

Background: Dental components manufactured with zirconia (ZrO₂) represent a significant percentage of the implant prosthetic market in dentistry. However, during the last few years, we have observed robust clinical and pre-clinical scientific investigations on zirconia both as a prosthetic and an implantable material. At the same time, we have witnessed consistent technical and manufacturing updates with regards to the applications of zirconia which appear to gradually clarify points which until recently were not well understood. Methods: This critical review evaluated the “state of the art” in relation to applications of this biomaterial in dental components and its interactions with oral tissues. Results: The physico-chemical and structural properties as well as the current surface treatment methodologies for ZrO₂ were explored. A critical investigation of the cellular response to this biomaterial was completed and the clinical implications discussed. Finally, surface treatments of ZrO₂ demonstrate that excellent osseointegration is possible and provide encouraging prospects for rapid bone adhesion. Furthermore, sophisticated surface treatment techniques and technologies are providing impressive oral soft tissue cell responses thus leading to superior biological seal. Conclusions: Dental devices manufactured from ZrO₂ are structurally and chemically stable with biocompatibility levels allowing for safe and long-term function in the oral environment.

Responses of human gingival fibroblasts to superhydrophilic hydrogenated titanium dioxide nanotubes

Soft tissue integration is critical for the long-term retention of dental implants. The surface properties including topography and wettability can impact soft tissue sealing. In our work, a thermal hydrogenation technique was applied to modify anodized titanium dioxide nanotubes (TNTs). However, the effects of the hydrogenated surface on soft-tissue cells remain unclear. The aim of the present study was to investigate the bioactivities of human gingival fibroblasts (HGFs) on structured surfaces, which determine the early formation of soft tissue sealing. Three groups were examined: commercially pure titanium (Ti), anodized TNTs (air-TNTs) and hydrogenated TNTs (H₂-TNTs). Scanning electron microscopy showed the nanotubular topography on the titanium surfaces after anodization. Then, hydrogenation ensured that the H₂-TNTs were superhydrophilic with a contact angle of 3.5 ± 0.8°. In vitro studies such as cell adhesion assays, cell morphology, immunocytochemistry, wound healing assays, real-time PCR and enzyme-linked immunosorbent assays displayed enhanced adhesion, migration, relative gene expression levels, and extracellular matrix synthesis of the HGFs on H₂-TNTs. Interestingly, focal adhesion kinase activation and integrin-mediated adhesion seemed to be induced by the H₂-TNT surface. Our results revealed that a superhydrophilic nanostructure modified by anodization and hydrogenation can improve the bioactivity of HGFs and connective tissue regeneration, which will further promote and expand the application of titanium dioxide nanotubes in dental implants.

Proliferation of Saos-2 and Ca9-22 cells on grooved and pillared titanium surfaces

BACKGROUND

Surface nanostructures in titanium (Ti) oral implants are critical for rapid osseointegration.

OBJECTIVE

The purpose of this study was to evaluate the growth of osteoblast-like (Saos-2) and epithelial-like (Ca9-22) cells on nanopatterned Ti films.

METHODS

Ti films with 500 nm grooves and pillars were fabricated by nanoimprinting, and seeded with Saos-2 and Ca9-22 cells. Cell viability and morphology were assessed by cell proliferation assay and scanning electron microscopy, respectively.

RESULTS

As assessed after 1 hour, proliferation of Saos-2 cells was most robust on grooved films than on pillared and smooth films, in this order. These cells approximately doubled on grooved and pillared substrates in 24 hours and after 5 days, but not on smooth surfaces. In contrast, Ca9-22 cells favored smooth surfaces, followed by grooved and pillared films. Indeed, cells sparsely adhered to pillared films over 5 days of incubation (p < 0.05).

CONCLUSIONS

The data show that Saos-2 and Ca9-22 cells respond differently to different nanostructures, and highlight the potential use of nanopatterns to promote bone regeneration or to prevent epithelial downgrowth at the implant-bone interface.