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Residual alveolar ridge resorption often occurs after tooth extraction, which causes issues requiring further prothesis rehabilitation. A treatment concept referred to as all-on-four, involving fixed dentures supported with four implants, was recently developed. The current study aimed to determine the effect of changing bone atrophy and implant length in all-on-four treatments on stress and strain in the surrounding bone of the implant. A three-dimensional finite element method was used in this research. The stress analysis was conducted with von Mises stress values. Two types of synthetic jawbone models with mild and moderate atrophy were used. Furthermore, two different implant lengths with a similar implant design and diameter were selected, and they were classified into eight models. Then, the bone model was assessed via a computed tomography (CT) scan and was transformed into a virtual model in Geomagic and SolidWorks with implant rebuilding. After modifying bone atrophy, the von Mises stresses in the surrounding bone of the implant were as follows: mild type 2 < mild type 3 < moderate type 3 < moderate type 4. The bone quantity change rate increased more than when bone conditions were limited. Compared with changes in implant lengths, the stresses in the peri-implant surrounding bone were generally higher in the 9 mm implant length group than in the 11.5 mm group. However, the results did not significantly differ. In conclusion, the von Mises stress and strain increased in the models with moderate atrophy and low-density trabecular bone. Hence, bone atrophy and its presurgical diagnosis in long-term implant prognosis are crucial. [ABSTRACT FROM AUTHOR]

Titanium (Ti) and Ti alloys possess extensive applications in the medical field due to their non-toxic, biocompatible, and antibacterial properties. This study investigates the biocompatibility enhancement of a Ti-based alloy, Ti-6Al-4V, through a multi-step process involving cathodic arc ion plating of a TiZrTa thin film and subsequent laser-textured oxidation (LTO). LTO treatment produced a structured microtopography with regular groove patterns, including straight lines (L-s), circles (L-c), and checkboards (L-ch), resulting in surface oxidation and the formation of various oxides on the TiZrTa coating. Microstructure analyses revealed substantial alterations in surface topography induced by laser texturing. Antibacterial assessments against Staphylococcus aureus (S. aureus) showed that the films with LTO treatment did not exhibit significant advantages after 12 or 24 h of coculture because the laser-textured portions consisted of a combination of the film and the substrate, and the antibacterial effect was not obvious. Coatings with LTO treatment significantly improved L-929 mouse fibroblasts cell viability at 48 h, particularly for samples with a 50 μm spacing of straight and circular patterns (L-s and L-c). After two weeks of MG-63 human osteosarcoma cell culture, the viability of all samples reached similar levels. It suggested that the TiZrTa-coated Ti-6Al-4V exhibited good biocompatibility with both cells. This study contributed to the understanding of surface modification techniques for enhancing the biocompatibility of Ti-based alloys in biomedical applications. • A TiZrTa thin film with LTO treatment was applied onto Ti-6Al-4V alloys. • LTO produced regular groove patterns and resulted in superior hydrophilicity. • LTO-treated thin films did not have obvious antibacterial improvement of S. aureus. • LTO-treated thin films improved the cell viability of both L-929 and MG-63 cells. [ABSTRACT FROM AUTHOR]

Objective: The study objective was to investigate four common occlusal modes by using the finite element (FE) method and to conduct a biomechanical analysis of the periodontal ligament (PDL) and surrounding bone when orthodontic force is applied. Materials and methods: A complete mandibular FE model including teeth and the PDL was established on the basis of cone-beam computed tomography images of an artificial mandible. In the FE model, the left and right mandibular first premolars were not modeled because both canines required distal movement. In addition, four occlusal modes were simulated: incisal clench (INC), intercuspal position (ICP), right unilateral molar clench (RMOL), and right group function (RGF). The effects of these four occlusal modes on the von Mises stress and strain of the canine PDLs and bone were analyzed. Results: Occlusal mode strongly influenced the distribution and value of von Mises strain in the canine PDLs. The maximum von Mises strain values on the canine PDLs were 0.396, 1.811, 0.398, and 1.121 for INC, ICP, RMOL, and RGF, respectively. The four occlusal modes had smaller effects on strain distribution in the cortical bone, cancellous bone, and miniscrews. Conclusion: Occlusal mode strongly influenced von Mises strain on the canine PDLs when orthodontic force was applied. Clinical relevance: When an FE model is used to analyze the biomechanical behavior of orthodontic treatments, the effect of muscle forces caused by occlusion must be considered. [ABSTRACT FROM AUTHOR]

Titanium and titanium alloy materials are often made as medical implants. Surface properties of titanium medical implants play decisive roles for antibacterial and biological response and tissue biocompatibility. In this study, cathode arc evaporation (CAE) technology was used to deposit TiNb–Zr–Ta and nitrogen-doped TiNb–Zr–Ta coatings with nanostructures on the Ti–6Al–4V dental abutment screws. The deposited coatings were then oxidized at high temperature to produce different oxides on the surface of the coatings. The mechanical properties, antibacterial properties and biocompatibilities of the coatings were analyzed. The effect of coatings on the abutment screw loosening and removal torque between the abutment screw and the pure titanium implant fixture was studied by removal torque measurement. In addition, Staphylococcus aureus (S. aureus) was used for evaluating the antibacterial properties of coatings, and mouse fibroblasts (L929) were used for ISO 10993-5 cytotoxicity analyses to determine whether it had good biocompatibility. Nanolayered structures and multiphases of polycrystalline TiNb–Zr–Ta were obtained by co-deposition of Ta, Zr and TiNb. When small content of N was introduced, the TiNb–Zr–Ta(N) showed a polycrystalline TiNb–Zr–Ta where N atoms entered the metallic lattice at interstitial sites. After oxidation, oxide phases of Ta 2 O 5 , TiO 2 , Nb 2 O 5 and ZrO 2 were formed on the surface of TiNb–Zr–Ta and TiNb–Zr–Ta(N). Ta 2 O 5 was obtained on the surface of the coating prior to other oxides such as TiO 2 , Nb 2 O 5 and ZrO 2. The deposited TiNb–Zr–Ta and TiNb–Zr–Ta(N) coatings had high contact angle and exhibited a hydrophobic feature, while the annealed TiNb–Zr–Ta–O and TiNb–Zr–Ta(N)–O showed hydrophilicity. The deposited TiNb–Zr–Ta had similar hardness and Young's modulus values to that of the uncoated Ti–6Al–4V. When N was doped, the TiNb–Zr–Ta(N) had the highest hardness and Young's modulus. The hardness of the annealed TiNb–Zr–Ta(N) coating only decreased slightly due to the small oxide layer of ∼140 nm. Compared with the uncoated Ti–6Al–4V, TiNb–Zr–Ta serial coatings deposited on abutment screws had higher removal torques, which prevented the abutment screw of dental implant from loosening after long-term use. The biocompatibility of TiNb–Zr–Ta serial coatings was similar to that of the uncoated Ti–6Al–4V. In addition, the oxidized TiNb–Zr–Ta and TiNb–Zr–Ta(N) coatings had excellent antibacterial properties. It is speculated that the resulting Ta 2 O 5 of both coatings may inhibit bacterial growth and improve the antibacterial effect. Based on the above advantages, the TiNb–Zr–Ta serial coatings are expected to have the potential to be applied to biomedical implants. • TiNb–Zr–Ta and nitrogen-doped TiNb–Zr–Ta coatings were obtained by co-deposition of Ta, Zr and TiNb targets. • After annealing, oxide phases were formed on the surface of TiNb–Zr–Ta and nitrogen-doped TiNb–Zr–Ta. • All coatings fabricated provided good biocompatibility similar to Ti–6Al–4V alloy. • Annealed coatings with Ta 2 O 5 on the surface possessed good antibacterial effect. • The highest removal torque was obtained for the abutment screw coated with TiNbZrTa. [ABSTRACT FROM AUTHOR]

Background: Dental cone beam computed tomography (CBCT) is commonly used to evaluate cancellous bone density before dental implant surgery. However, to our knowledge, no measurement approach has been standardized yet. This study aimed to evaluate the relationship between three different regions of interest (ROI) methods on cancellous bone density at the dental implant site using dental CBCT images. Methods: Patients' dental CBCT images (n = 300) obtained before dental implant surgery were processed using Mimics (Materialise, Leuven, Belgium). At the potential implant sites, the rectangle, cylinder, and surrounding cylinder ROI methods were used to measure bone density. Repeated measures one-way analysis of variance was performed to compare the three ROI methods in terms of measurement results. Pearson correlation analysis was performed to identify the likely pair-wise correlations between the three ROI methods. Results: The density value obtained using the surrounding cylinder approach (grayscale value [GV],523.56 ± 228.03) was significantly higher than the values obtained using the rectangle (GV, 497.04 ± 236.69) and cylinder (GV,493 ± 231.19) ROI methods in terms of results. Furthermore, significant correlations were noted between the ROI methods (r > 0.965; p < 0.001). Conclusions: The density measured using the surrounding cylinder method was the highest. The choice of method may not influence the trends of measurement results. Trial registration: This study was approved by the Institutional Review Board of China Medical University Hospital, No. CMUH111-REC3-205. Informed consent was waived by the Institutional Review Board of China Medical University Hospital, CMUH111-REC3-205, owing to the retrospective nature of the study. [ABSTRACT FROM AUTHOR]

The objective of this study was to evaluate the effect of bone–miniscrew contact percentage (BMC%) and bone quality and quantity on orthodontic miniscrew stability and the maximum insertion torque value (ITV). Orthodontic miniscrews of five different dimensions and several bovine iliac bone specimens were used in the evaluation. Miniscrews of each dimension group were inserted into 20 positions in bovine iliac bone specimens. The experiment was divided into three parts: (1) Bone quality and quantity were evaluated using cone-beam computed tomography (CBCT) and microcomputed tomography. (2) The 3D BMC% was calculated. (3) The ITVs during miniscrew insertion were recorded to evaluate the stability of the orthodontic miniscrews. The results indicated that longer and thicker miniscrews enabled higher ITVs. CBCT was used to accurately measure cortical bone thickness (r = 0.939, P < 0.05) and to predict the bone volume fraction of cancellous bone (r = 0.752, P < 0.05). BMC% was significantly influenced by miniscrew length. The contribution of cortical bone thickness to the ITV is greater than that of cancellous bone structure, and the contribution of cortical bone thickness to BMC% is greater than that of cancellous bone structure. Finally, the higher is BMC%, the greater is the ITV. This study concludes that use of CBCT may predict the mechanical stability of orthodontic miniscrews. [ABSTRACT FROM AUTHOR]

Background: the clinical application of orthopedic or dental implants improves the quality of the lives of patients. However, the long-term use of implants may lead to implant loosening and related complications. The purpose of this study is to deposit titanium (Ti)-niobium (Nb)-zirconium (Zr)-tantalum (Ta) alloys on the surface of Ti-6Al-4V to increase structural strength and biocompatibility for the possible future application of implants. Materials and methods: Ti, Nb, Zr, and Ta served as the materials for the surface modification of the titanium alloy. TiNbZr and TiNbZrTa coatings were produced using cathodic arc evaporation, and a small amount of nitrogen was added to produce TiNbZrTa(N) film. Annealing and oxidation were then conducted to produce TiNbZrTa-O and TiNbZrTa(N)-O coatings. In this study, biological tests and finite element analyses of those five alloy films, as well as uncoated Ti-6Al-4V, were performed. Human osteosarcoma cells (MG-63) and mouse fibroblast cells (L-929) were used to analyze cytotoxicity, cell viability, and cell morphology, and the bone differentiation of MG-63 was evaluated in an alkaline phosphatase experiment. Furthermore, for measuring the gene expression level of L-929, reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was conducted. The three-dimensional (3D) computational models of the coated and uncoated sample films were constructed using images of transmission electron microscopy and computer-aided design software and, then, the stress distributions of all models were evaluated by finite element analysis. Result: the cytotoxicity test revealed that the surface treatment had no significant cytotoxic effects on MG-63 and L-929 cells. According to the results of the cell viability of L-929, more cell activity was observed in the surface-treated experimental group than in the control group; for MG-63, the cell viability of the coated samples was similar to that of the uncoated samples. In the cell morphology analysis, both MG-63 and L-929 exhibited attached filopodia and lamellipodia, verifying that the cells were well attached. The alkaline phosphatase experiment demonstrated that the surface treatment did not affect the characteristics of early osteogenic differentiation, whereas RT-qPCR analysis showed that surface treatment can promote better performance of L-929 cells in collagen, type I, α1, and fibronectin 1. Finally, the results of the finite element analysis revealed that the coated TiNb interlayer can effectively reduce the stress concentration inside the layered coatings. Conclusions: TiNbZrTa series films deposited using cathodic arc evaporation had excellent biocompatibility with titanium alloys, particularly in regard to soft tissue cells, which exhibited an active performance. The finite element analysis verified that the TiNb interlayer can reduce the stress concentration inside TiNbZrTa series films, increasing their suitability for application in biomedical implants in the future. [ABSTRACT FROM AUTHOR]