Professional Mechanical Tooth Cleaning Method for Dental Implant Surface by Agar Particle Blasting

Oral dysfunction due to peri-implantitis and shortened life of implants has become a major concern. Self-care and removal of oral biofilms by professional mechanical tooth cleaning (PMTC) are indispensable for its prevention. However, if the surface roughness of the implant is increased, it may result in the adhesion of biofilm in the oral cavity. Therefore, the PMTC method can serve for long-term implant management. Calcium carbonate (CaCO3) has been used as a cleaning method for implant surfaces; however, there is concern that the implant surface roughness could increase due to particle collision. Therefore, in this study, to establish a blasting cleaning method that does not adversely affect the implant surface, a new blasting cleaning method using agar particles was devised and its practical application examined. When the simulated stains were blasted with white alumina (WA) abrasive grains and CaCO3 particles, the simulated stains were almost removed, the surface roughness changed to a satin-finished surface—which was thought to be due to fine scratches—and the surface roughness increased. Most of the simulated stains were removed on the surface of the sample blasted with glycine particles and agar particles. Conversely, the gloss of the sample surface was maintained after cleaning, and the increase in surface roughness was slight.

Effect of Implant Surface Roughness and Macro- and Micro-Structural Composition on Wear and Metal Particles Released

Background: Considerations about implant surface wear and metal particles released during implant placement have been reported. However, little is known about implant surface macro- and microstructural components, which can influence these events. The aim of this research was to investigate accurately the surface morphology and chemical composition of commercially available dental implants, by means of multivariate and multidimensional statistical analysis, in order to predict their effect on wear onset and particle release during implant placement. Methods: The implant surface characterization (roughness, texture) was carried out through Confocal Microscopy and SEM-EDS analysis; the quantitative surface quality variables (amplitude and hybrid roughness parameters) were statistically analyzed through post hoc Bonferroni’s test for pair comparisons. Results: The parameters used by discriminant analysis evidenced several differences in terms of implant surface roughness between the examined fixtures. In relation to the observed surface quality, some of the investigated implants showed the presence of residuals due to the industrial surface treatments. Conclusions: Many structural components of the dental implant surface can influence the wear onset and particles released during the implant placement.

Effect of Magnesium-Based Coatings on Titanium or Zirconia Substrates on Bone Regeneration and Implant Osseointegration- A Systematic Review

Magnesium (Mg) is an essential trace element that has a significant role in the human body through its effects on bone metabolism. It has various applications in orthodpaedics and dentistry and the interest of this systematic review lies in its potential role as a dental implant surface coating. The dental implants can fail at different stages starting with its osseointegration phase to the restorative stage in the oral cavity. The biological loss of bone integration to the implant surface has been classified as one of the primary reasons for dental implant failure. There have been numerous strategies that have been shown to compensate this reason for implant failure, among which are the dental implant surface coatings. These coatings have been shown to improve the enhance the adhesion as well as the process of osseointegration. There are numerous studies in the existing literature that have analyzed the effects of Mg-based coatings on cellular as well as biological processes in bone-implant integration. A systematic search of various databases yielded 175 articles, of which 14 in vitro and experimental animal studies that analyzed the effect of Mg-based coatings and compared it to other coatings or no surface coatings were included in this systematic review. The main outcomes of this systematic review have been cellular behavior, osseointegration, and osteogenic markers and the effects of Mg-based coatings in these parameters have been highlighted in this review.

Critical Role of Etching Parameters in the Evolution of Nano Micro SLA Surface on the Ti6Al4V Alloy Dental Implants

The surface of dental implants plays a vital role in early and more predictable osseointegration. SLA (sandblasted large grit and acid-etched) represents the most widely accepted, long-term clinically proven surface. Primarily, dental implants are manufactured by either commercially pure titanium (CP-Ti) or Ti6Al4V ELI alloy. The acid etch behavior of CP-Ti is well known and its effects on the surface microstructure and physicochemical properties have been studied by various researchers in the past. However, there is a lack of studies showing the effect of acid etching parameters on the Ti6Al4V alloy surface. The requirement of the narrow diameter implants necessitates implant manufacturing from alloys due to their high mechanical properties. Hence, it is necessary to have an insight on the behavior of acid etching of the alloy surface as it might be different due to changed compositions and microstructure, which can further influence the osseointegration process. The present research was carried out to study the effect of acid etching parameters on Ti6Al4V ELI alloy surface properties and the optimization of process parameters to produce micro- and nanotopography on the dental implant surface. This study shows that the Ti6Al4V ELI alloy depicts an entirely different surface topography compared to CP-Ti. Moreover, the surface topography of the Ti6Al4V ELI alloy was also different when etching was done at room temperature compared to high temperature, which in turn affected the behavior of the cell on these surfaces. Both microns and nano-level topography were achieved through the optimized parameters of acid etching on Ti6Al4V ELI alloy dental implant surface along with improved roughness, hydrophilicity, and enhanced cytocompatibility.

Human Periodontal Ligament Stem Cells Response to Titanium Implant Surface: Extracellular Matrix Deposition

The major challenge for dentistry is to provide the patient an oral rehabilitation to maintain healthy bone conditions in order to reduce the time for loading protocols. Advancement in implant surface design is necessary to favour and promote the osseointegration process. The surface features of titanium dental implant can promote a relevant influence on the morphology and differentiation ability of mesenchymal stem cells, induction of the osteoblastic genes expression and the release of extracellular matrix (ECM) components. The present study aimed at evaluating the in vitro effects of two different dental implants with titanium surfaces, TEST and CTRL, to culture the human periodontal ligament stem cells (hPDLSCs). Expression of ECM components such as Vimentin, Fibronectin, N-cadherin, Laminin, Focal Adhesion Kinase (FAK) and Integrin beta-1 (ITGB1), and the osteogenic related markers, as runt related transcription factor 2 (RUNX2) and alkaline phosphatase (ALP), were investigated. Human PDLSCs cultured on the TEST implant surface demonstrated a better cell adhesion capability as observed by Scanning Electron Microscopy (SEM) and immunofluorescence analysis. Moreover, immunofluorescence and Western blot experiments showed an over expression of Fibronectin, Laminin, N-cadherin and RUNX2 in hPDLSCs seeded on TEST implant surface. The gene expression study by RT-PCR validated the results obtained in protein assays and exhibited the expression of RUNX2, ALP, Vimentin (VIM), Fibronectin (FN1), N-cadherin (CDH2), Laminin (LAMB1), FAK and ITGB1 in hPDLSCs seeded on TEST surface compared to the CTRL dental implant surface. Understanding the mechanisms of ECM components release and its regulation are essential for developing novel strategies in tissue engineering and regenerative medicine. Our results demonstrated that the impact of treated surfaces of titanium dental implants might increase and accelerate the ECM apposition and provide the starting point to initiate the osseointegration process.

QCM Analysis for Two-Step Adsorption of Albumin and Fibronectin on Zirconia Surface

The adsorption of proteins on the dental implant surface is the first step in the key role of osseointegration. Many types of proteins exist in the living body and compete for adsorption on the material surface. As an implant material, partially stabilized zirconia (ZrO2) is currently an attractive alternative to titanium to overcome the shortcomings of titanium implants. In this study, we investigated the two-step adsorption of fibronectin (Fn) and bovine serum albumin (Alb) on the ZrO2 surface using a 27-MHz quartz crystal microbalance (QCM) method. A ZrO2 sensor was employed for the QCM measurements. Two-step adsorptions were performed as follows. (1) Fn-Alb series: first, the Fn solution was injected into the phosphate-buffered saline (PBS) solution, followed by the Alb solution. (2) Alb-Fn series: first, the Alb solution was injected, followed by the Fn solution. The decrease in frequency was monitored for 60 minutes after each protein injection. The adsorbed amounts of Fn or Alb were calculated by observing the decrease in frequency, and the apparent reaction rate, kobs, was obtained through the curve fitting of frequency shift against the adsorption time. No significant difference was observed in the adsorbed amounts of Fn and Alb between the Fn-Alb and Alb-Fn series ( P > 0.05 ). The kobs, rate of protein adsorption, in the second step was significantly slower than that in the first step for both Fn and Alb adsorption ( P < 0.05 ). There was no clear correlation between the amount of protein adsorbed on the ZrO2 sensor and the surface topography. It was concluded that the amount of protein adsorbed on the ZrO2 surface was not influenced by the two-step adsorption series, but the adsorption rate of proteins in the second step was affected by the first-step protein adsorption.

Plant-Derived Nanobiomaterials as a Potential Next Generation Dental Implant Surface Modifier

Dental implants resemble synthetic materials, mainly designed as teeth-mimics to replace the damaged or irregular teeth. Specifically, they are demarcated as a surgical fixture of artificial implant materials, which are placed into the jawbone, and are allowed to be fused with the bone, similar to natural teeth. Dental implants may be categorized into endosteal, subperiosteal, and zygomatic classes, based on the placement of the implant “in the bone” or on top of the jawbone, under the gum tissue. In general, titanium and its alloys have found everyday applications as common, successful dental implant materials. However, these materials may also undergo corrosion and wear, which can lead to degradation into their ionic states, deposition in the surrounding tissues, as well as inflammation. Consequently, nanomaterials are recently introduced as a potential alternative to replace the conventional titanium-based dental implants. However, nanomaterials synthesized via physical and chemical approaches are either costly, non/less biocompatible, or toxic to the bone cells. Hence, biosynthesized nanomaterials, or bionanomaterials, are proposed in recent studies as potential non-toxic dental implant candidates. Further, nanobiomaterials with plant origins, such as nanocelluloses, nanometals, nanopolymers, and nanocarbon materials, are identified to possess enhanced biocompatibility, bioavailability and no/less cytotoxicity with antimicrobial efficacy at low costs and ease of fabrication. In this minireview, we present an outline of recent nanobiomaterials that are extensively investigated for dental implant applications. Additionally, we discuss their action mechanisms, applicability, and significance as dental implants, shortcomings, and future perspectives.

The Impact of Dental Implant Surface Modifications on Osseointegration and Biofilm Formation

Implant surface design has evolved to meet oral rehabilitation challenges in both healthy and compromised bone. For example, to conquer the most common dental implant-related complications, peri-implantitis, and subsequent implant loss, implant surfaces have been modified to introduce desired properties to a dental implant and thus increase the implant success rate and expand their indications. Until now, a diversity of implant surface modifications, including different physical, chemical, and biological techniques, have been applied to a broad range of materials, such as titanium, zirconia, and polyether ether ketone, to achieve these goals. Ideal modifications enhance the interaction between the implant’s surface and its surrounding bone which will facilitate osseointegration while minimizing the bacterial colonization to reduce the risk of biofilm formation. This review article aims to comprehensively discuss currently available implant surface modifications commonly used in implantology in terms of their impact on osseointegration and biofilm formation, which is critical for clinicians to choose the most suitable materials to improve the success and survival of implantation.