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OBJECTIVE: To evaluate the clinical outcome of different designs of zirconia dental implants. DATA: This systematic review adhered to the PRISMA checklist and followed the PICO framework. The protocol is registered in PROSPERO (CRD42022337228). SOURCES: The search was conducted in March 2023 through four databases (PubMed, Web of Science, Cochrane Library, and Google Scholar) along with a search of references in the related reviews. Three authors reviewed on title, and abstract level and analysed the risk of bias, and all authors reviewed on a full-text level. STUDY SELECTION: Clinical studies excluding case reports for patients treated with different designs of zirconia dental implants were included. From a total of 2728 titles, 71 full-text studies were screened, and 27 studies were included to assess the risk of bias (ROBINS-I tool) and data extraction. After quality assessment, four studies were included, and the remaining 23 excluded studies were narratively described. RESULT: The included prospective studies with moderate risk of bias reported success and survival rates of one-piece implants that ranged between 95 and 98.4 % with no difference between different lengths and diameters. The acid-etched roughened surface showed higher clinical outcomes compared to other surface roughness designs. CONCLUSION: Promising 5-year clinical outcomes were found for one-piece zirconia implants with no difference between different diameters and lengths. Concerning surface roughness, better outcomes were found when using the acid-etched implant surface. However, due to the limited available studies, further high-quality clinical studies comparing zirconia one-piece and two-piece implants with different diameters, lengths, and surface roughness are needed. CLINICAL SIGNIFICANCE: Based on this systematic review, under suitable clinical situations, the one-piece zirconia implants with diameters of 4.0 mm, 4.5 mm, or 5.5 mm and lengths of 8 mm, 10 mm, 12 mm, or 14 mm have simila

CRUE-CSIC (Acuerdos Transformativos 2021), Objectives: The purpose of this experimental in vivo investigation was to evaluate the influence of modifying the implant surface by adding a monolayer of multiphosphonate molecules on the de novo bone formation and osseointegration. Material and Methods: The study was designed as an animal preclinical trial with intra-animal control and two healing periods, 2 and 8 weeks, to compare implants with an identical macro-design but with two different surfaces. Eight female Beagle dogs participated in the study. Control implants had a moderately rough surface combining sandblasting and acid etching; test implants had an additional monophosphonate layer covalently bonded to titanium. Histologic and radiographic (micro-CT) outcome variables were evaluated. Results: The first bone-to-implant contact (fBIC) was located more coronally for the test implants at the first (0.065 mm (95% CI = −0.82, 0.60)) and second healing milestones (0.17 mm (95% CI = −0.9, 0.55)). Most coronal BIC of the test implants displayed a higher percentage of osseointegration, +6.33% and +13.38% after 2 and 8 weeks, respectively; however, the differences were not statistically significant. The micro-CT examination did not show any BIC difference. Conclusions: The monophosphonate layer coating demonstrated clinical, histological, and radiographic results similar to the control surface., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub

In peri-implantitis, treatment lasers are effectively used to enhance implant surfaces’ decontamination of bacteria. The type of lasers commonly used and tested in dentistry are Nd:YAG, Er:YAG and diodes. The Er:YAG laser is considered to be effective in removing biofilm from implant surfaces. Photodynamic therapy (PDT), realized with low-level laser therapy (LLLT) and a photosensitizer, seems to have limited efficacy in peri-implantitis management, while diode lasers used with high frequency and power (Wiser, Doctor Smile), performed with hydrogen peroxide 10 vol. 3% (OHLLT), seems to lead to a deep sanitization of implant surfaces, without any thermal effect. The aim of our retrospective controlled study is to compare an oxygen high-level laser therapy (OHLLT) protocol with OHLLT with an Er:YAG laser (Pluser, Doctor Smile) in order to maximize bacterial removal and to evaluate if an Er:YAG laser could improve hard tissue regeneration with respect to OHLLT alone. Two hundred and ten implants affected by peri-implantitis were divided into two groups: 88 implants were treated with OHLLT alone (control group) while 122 underwent OHLLT and Er:YAG treatment (test group). Mean bone loss before (T0) and after treatment (T1) (with a follow-up of 5 years) was registered for all implants. The collected data were analyzed with the Statistical Package for Social Sciences (SPSS) version 11.5. No statistically significant differences were found. In the OHLLT group, we noticed a mean bone loss after treatment of 2.1 mm in the upper arch and 2.4 mm in the mandible. In the OHLLT + Er:YAG group, the results indicate a mean bone loss of 2.0 mm in the upper arch and 2.5 mm in the mandible. Both groups showed a mean bone loss after treatment of 2.3 mm. According to the Kolmogorov-Smirnov test, overall, data followed a normal distribution (value of the K-S test statistic = 0.0912; p = 0.36112). OHLLT plays a central role in enhancing clinical results in peri-implantitis treatment, leadi

Objectives: To answer the focused question, 'In animals or patients with dental implants, does implant surface characteristics and/or implant material have an effect on incidence and progression of peri-implantitis?' Material and methods: Pre-clinical in vivo experiments on experimental peri-implantitis and clinical trials with any aim and design, and ≥5 years follow-up, where the effect of ≥2 different type of implant material and/or surface characteristics on peri-implantitis incidence or severity, and/or progression, implant survival or losses due to peri-implantitis, and/or marginal bone levels/loss was assessed. Results: Meta-analyses based on data of pre-clinical experiments, using the ligature induced peri-implantitis model in the dog, indicated that after the spontaneous progression phase implants with a modified surface showed significantly greater radiographic bone loss (effect size 0.44 mm; 95%CI 0.10-0.79; p = .012; 8 publications) and area of infiltrated connective tissue (effect size 0.75 mm2 ; 95%CI 0.15-1.34; p = .014; 5 publications) compared to non-modified surfaces. However, in 9 out of the 18 included experiments, reported in 25 publications, no significant differences were shown among the different implant surface types assessed. Clinical and/or radiographic data from 7605 patients with 26,188 implants, reported in 31 publications (20 RCTs, 3 CTs, 4 prospective cohort, and 4 retrospective studies; 12 with follow-up ≥10 years), overall did not show significant differences in the incidence of peri-implantitis, when this was reported or could be inferred, among the various implant surfaces. In general, high survival rates (90-100%) up to 30 years and no clinically relevant differences in marginal bone loss/levels, merely compatible with crestal remodelling, were presented for the various implant types. Conclusion: Pre-clinical in vivo experiments indicate that surface characteristics of modified implants may have a significant negative impact on pe

Titanium surface is an important factor in achieving osseointegration during the early wound healing of dental implants in alveolar bone. The purpose of this study was to evaluate sandblasted-etched surface implants to investigate the osseointegration. In the present study, we used two different types of sandblasted-etched surface implants, an SLA™ surface and a Nanoblast Plus™ surface. Roughness and chemical composition were evaluated by a white light interferometer microscope and X-ray photoelectron spectroscopy, respectively. The SLA™ surface exhibited the higher values (Ra 3.05 µm) of rugosity compared to the Nanoblast Plus™ surface (Ra 1.78 µm). Both types of implants were inserted in the femoral condyles of ten New Zealand white rabbits. After 12 weeks, histological and histomorphometric analysis was performed. All the implants were osseointegrated and no signs of infection were observed. Histomorphometric analysis revealed that the bone–implant contact % (BIC) ratio was similar around the SLA™ implants (63.74 ± 13.61) than around the Nanoblast Plus™ implants (62.83 ± 9.91). Both implant surfaces demonstrated a favorable bone response, confirming the relevance of the sandblasted-etched surface on implant osseointegration.

Objectives: The purpose of this experimental in vivo investigation was to evaluate the influence of modifying the implant surface by adding a monolayer of multi-phosphonate molecules on the de novo bone formation and osseointegration. Material and Methods: The study was designed as an animal preclinical trial with intra-animal control and two healing periods, 2 and 8 weeks, to compare implants with an identical macro-design but with two different surfaces. Eight female Beagle dogs participated in the study. Control implants had a moderately rough surface combining sandblasting and acid etching; test implants had an additional monophosphonate layer covalently bonded to titanium. Histologic and radiographic (micro-CT) outcome variables were evaluated. Results: The first bone-to-implant contact (fBIC) was located more coronally for the test implants at the first (0.065 mm (95% CI = −0.82, 0.60)) and second healing milestones (0.17 mm (95% CI = −0.9, 0.55)). Most coronal BIC of the test implants displayed a higher percentage of osseointegration, +6.33% and +13.38% after 2 and 8 weeks, respectively; however, the differences were not statistically significant. The micro-CT examination did not show any BIC difference. Conclusions: The monophosphonate layer coating demonstrated clinical, histological, and radiographic results similar to the control surface.

Purpose: The objective of this study was to assess the influence of a novel surface of dental implants (ContacTi®) on the osseointegration process in a minipig model. The surface was compared with other existing surfaces on the market (SLA® and SLActive®) by employing bone implant contact analysis (BIC) and implant stability. Method: Twelve minipigs were used with prior authorisation from an ethics committee. Three types of surfaces were tested: SLA® (sand-blasted acid-etched titanium), SLActive® (same but hydrophilic, performed under a nitrogen atmosphere), and ContacTi® (alumina particle bombardment of titanium, bioactivated when treated thermochemically) in 4.1 mm × 8 mm implants with internal connection and a polished neck. Twelve implants of each surface type (N = 36) were placed, sacrificing 1/3 of the animals at 2 weeks of placement, 1/3 at 4 weeks and the remaining 1/3 at 8 weeks. Numerical variables were compared with Analysis of Variance, and the correlation between ISQ and BIC was established with the Spearman’s rank correlation coefficient. Results: SLActive® and ContacTi® surfaces showed elevated osteoconductivity at 4 weeks, maintaining a similar evolution at 8 weeks (large amount of mature lamellar tissue with high maturity and bone quality). The SLA® surface showed slower maturation. The ISQ values in surgery were elevated (above 65), higher at necropsy and higher at 4 and 8 weeks in the SLA® group than in the other two (SLActive® and ContacTi®). No significant correlation was found between ISQ and BIC for each implant surface and necropsy time. Conclusion: The three surfaces analysed showed high RFA and BIC values, which were more favourable for the SLActive® and ContacTi® surfaces. No statistical correlation was found between the RFA and BIC values in any of the three surfaces analysed.

The surface modifications of titanium dental implants play important roles in the enhancement of osseointegration. The objective of the present study was to test two different implant surface treatments on a rabbit model to investigate the osseointegration. The tested surfaces were: a) acid-etched surface with sandblasting treatment (SA) and b) an oxidized implant surface (OS). The roughness was measured by an interferometeric microscope with white light and the residual stress of the surfaces was measured with X-ray residual stress Bragg–Bentano diffraction. Six New Zealand white rabbits were used for the in vivo study. Implants with the two different surfaces (SA and OS) were inserted in the femoral bone. After 12 weeks of implantation, histological and histomorphometric analyses of the blocks containing the implants and the surrounding bone were performed. All the implants were correctly implanted and no signs of infection were observed. SA and OS surfaces were both surrounded by newly formed trabeculae. Histomorphometric analysis revealed that the bone–implant contact % (BIC) was higher around the SA implants (53.49 ± 8.46) than around the OS implants (50.94 ± 16.42), although there were no significant statistical differences among them. Both implant surfaces (SA and OS) demonstrated a good bone response with significant amounts of newly formed bone along the implant surface after 12 weeks of implantation. These results confirmed the importance of the topography and physico–chemical properties of dental implants in the osseointegration.

The surface modifications of titanium dental implants play important roles in the enhancement of osseointegration. The objective of the present study was to test two different implant surface treatments on a rabbit model to investigate the osseointegration. The tested surfaces were: a) acid-etched surface with sandblasting treatment (SA) and b) an oxidized implant surface (OS). The roughness was measured by an interferometeric microscope with white light and the residual stress of the surfaces was measured with X-ray residual stress Bragg–Bentano diffraction. Six New Zealand white rabbits were used for the in vivo study. Implants with the two different surfaces (SA and OS) were inserted in the femoral bone. After 12 weeks of implantation, histological and histomorphometric analyses of the blocks containing the implants and the surrounding bone were performed. All the implants were correctly implanted and no signs of infection were observed. SA and OS surfaces were both surrounded by newly formed trabeculae. Histomorphometric analysis revealed that the bone–implant contact % (BIC) was higher around the SA implants (53.49 ± 8.46) than around the OS implants (50.94 ± 16.42), although there were no significant statistical differences among them. Both implant surfaces (SA and OS) demonstrated a good bone response with significant amounts of newly formed bone along the implant surface after 12 weeks of implantation. These results confirmed the importance of the topography and physico–chemical properties of dental implants in the osseointegration.

Los fenómenos biológicos de la oseointegración comprenden un proceso de reabsorción y formación ósea que ha sido descrito en estudios histológicos en animales y humanos. La extracción de dientes seguida de la inserción de implantes inmediatos provoca alteraciones en las dimensiones del hueso alveolar con gaps horizontales y verticales entre las paredes del alveolo y el implante. La reabsorción de la pared vestibular parece ser más pronunciada. Esta deshicencia ósea despues de la inserción de implantes postextracción ha sido corroborada en experimentos con animales y confirmada en studios clínicos con pacientes. Diversos factores pueden afectar a la respuesta biológica de los tejidos periimplantarios y el contacto hueso-implante en los alveolos postextracción como la densidad de hueso, la superficie y el diseño del implante y la técnica quirúrgica. Conclusión. La investigación experimental y clínica indica que la inserción de implantes en alveolos frescos no perjudica la remodelación de los tejidos periimplantarios. Sin embargo, tiene lugar la reabsorción ósea tanto de la pared vestibular como lingual., The biology of osseointegration involve a process of healing with bone resorption and bone apposition, as described histologically in animal and human studies. The removal of teeth followed by immediate implant placement results in marked alterations to alveolar ridge dimensions as well as horizontal and vertical gaps between the bone walls and the implant. Resorption of the buccal plate was seen to be more pronounced; this bone dehiscence following implant placement corroborates findings reported in animal experiments and confirmed in clinical studies with patients. Several factors affecting the biologic response of peri-implant tissues and bone-implant contact in postextraction implants as original bone density, implant surfaces, implant design and surgical technique. Conclusions. Experimental and clinical research studies suggest that the insertion of implant in fresh sockets does not jeopardize remodeling of periimplant tissues. However, bone resorption can be expected on both the lingual and buccal aspects.

Titan i njegove legure se upotrebljavaju kao materijali za dentalne implantate zbog pokazane biokompatibilnosti titana i dobrih fizičkih i mehaničkih svojstva. Korozivna svojstva titana i njegovih legura u kiselim i baznim rastvorima, i u biološkim fluidima nisu zadovoljavajuća što je moguće prevazići modifikacijom njihove površine. Biofunkcionalnost modifikovanih površina titana zavisi od tehnika kojima se sprovode modifikacije. Postoje brojne metode modifikacije površine titana, kao hemijske metode koje zajedno sa naknadnim termičkim tretmanom obezbeđuju formiranje titan-oksidnog sloja ili fizičke metode nanošenja prevlaka hidroksiapatita (HAP). Dentalni implantati mogu dovesti do povećane produkcije citokina i hemokina sa proinflamacijskim delovanjem. Cilj istraživanja: Ispitivanje efekta modifikacije površine titanove legure (Ti6Al4V) hemijskom obradom i naknadnim termalnim tretmanom, i nanošenjem prevlake hidroksiapatita, na biokompatibilnost merenu pomoću određivanja citotoksičnosti in vitro, kao i na imunomodulacijsko delovanje titana in vitro. Materijal i metode: Citotoksičnost je ispitivana in vitro, primenom testova direktnog kontakta uzoraka titanovih legura sa L929 ćelijama ili indirektno, ispitivanjem metaboličke aktivnosti L929 ćelija u prisustvu različitih razblaženja kondicioniranog medijuma (KM). Korišćena je ćelijska linija mišijih fibroblasta (L929). Metabolička aktivnost je merena MTT testom, ćelijska proliferacija je merena testom ugradnje 3[H+]-timidina, dok je produkcija slobodnih radikala kiseonika (ROS) određivana protočnom citofluorimetrijom nakon obeležavanja sa dihloro-dihidro-fluorescin diacetatom (DCFH-DA). Nekroza i apoptoza su merene bojenjem ćelija sa propidijum jodidom, merenjem produkcije laktatdehidrogenaze (LDH), kao i analizom ekspresije gena za mišje kaspaze 3, 8 i 9 metodom lančane reakcije polimeraze u realnom vremenu (Real-Time PCR). Ćelijski rast i morfološka analiza L929 ćelija je procenjivana fazno kontrasno svetlosnom mi, Introduction: Titanium and its alloys are being used as dental implant materials due to its biocompatibility and solid physical and mechanical properties. Corrosion properties of titanium and its alloys in acid and alkaline solutions and biological fluids are not satisfying and can be surpassed by modifying its surface area. Biofunctionality of the modified surface depends on the techniques being used. There are many methods to modify titanium surface such as chemical methods that, together with subsequent thermal treatment, provide the formation of a titanium oxide layer, or physical methods, such as deposition of a hydroxyapatite coatings (HAP). Dental implants can increase production of cytokines and chemokines with proinflammatory properties. Aim: Investigation of the effect of the titanium alloy (Ti6Al4V) surface modification by chemical treatment and subsequent thermal treatment, and deposition of a hydroxyapatite coating, on biocompatibility, assesed by cytotoxicity evaluation in vitro, and on the immunomodulatory action of titanium in vitro. Material and methods: Cytotoxicity was determined by using in vitro test of direct contact of titanium alloy samples with L929 cells or indirectly, by determining metabolic activity of L929 cells in the presence of different solutions of conditioned medium (KM). Mouse fibroblast (L929) cell line was used. Metabolic activity was determined with MTT test, cell proliferation was measured with 3[H+]-thymidine test, while reactive oxygen species (ROS) production was determined by flow cytometry after labeling with dichloro-dihydro-fluorescein diacetate (DCFH-DA). Necrosis and apoptosis were measured with propidium iodide (PI) cell staining, measuring lactate dehydrogenase (LDH) production, and by analyzing gene expression of mice caspases 3, 8 and 9 with Real Time PCR method. Cell growth and morphological analysis of L929 cells were determined with phase contrast light microscopy, while viability was determined with Trypan Bl

Introduction: Titanium and its alloys are being used as dental implant materials due to its biocompatibility and solid physical and mechanical properties. Corrosion properties of titanium and its alloys in acid and alkaline solutions and biological fluids are not satisfying and can be surpassed by modifying its surface area. Biofunctionality of the modified surface depends on the techniques being used. There are many methods to modify titanium surface such as chemical methods that, together with subsequent thermal treatment, provide the formation of a titanium oxide layer, or physical methods, such as deposition of a hydroxyapatite coatings (HAP). Dental implants can increase production of cytokines and chemokines with proinflammatory properties. Aim: Investigation of the effect of the titanium alloy (Ti6Al4V) surface modification by chemical treatment and subsequent thermal treatment, and deposition of a hydroxyapatite coating, on biocompatibility, assesed by cytotoxicity evaluation in vitro, and on the immunomodulatory action of titanium in vitro. Material and methods: Cytotoxicity was determined by using in vitro test of direct contact of titanium alloy samples with L929 cells or indirectly, by determining metabolic activity of L929 cells in the presence of different solutions of conditioned medium (KM). Mouse fibroblast (L929) cell line was used. Metabolic activity was determined with MTT test, cell proliferation was measured with 3[H+]-thymidine test, while reactive oxygen species (ROS) production was determined by flow cytometry after labeling with dichloro-dihydro-fluorescein diacetate (DCFH-DA). Necrosis and apoptosis were measured with propidium iodide (PI) cell staining, measuring lactate dehydrogenase (LDH) production, and by analyzing gene expression of mice caspases 3, 8 and 9 with Real Time PCR method. Cell growth and morphological analysis of L929 cells were determined with phase contrast light microscopy, while viability was determined with Trypan Bl, Titan i njegove legure se upotrebljavaju kao materijali za dentalne implantate zbog pokazane biokompatibilnosti titana i dobrih fizičkih i mehaničkih svojstva. Korozivna svojstva titana i njegovih legura u kiselim i baznim rastvorima, i u biološkim fluidima nisu zadovoljavajuća što je moguće prevazići modifikacijom njihove površine. Biofunkcionalnost modifikovanih površina titana zavisi od tehnika kojima se sprovode modifikacije. Postoje brojne metode modifikacije površine titana, kao hemijske metode koje zajedno sa naknadnim termičkim tretmanom obezbeđuju formiranje titan-oksidnog sloja ili fizičke metode nanošenja prevlaka hidroksiapatita (HAP). Dentalni implantati mogu dovesti do povećane produkcije citokina i hemokina sa proinflamacijskim delovanjem. Cilj istraživanja: Ispitivanje efekta modifikacije površine titanove legure (Ti6Al4V) hemijskom obradom i naknadnim termalnim tretmanom, i nanošenjem prevlake hidroksiapatita, na biokompatibilnost merenu pomoću određivanja citotoksičnosti in vitro, kao i na imunomodulacijsko delovanje titana in vitro. Materijal i metode: Citotoksičnost je ispitivana in vitro, primenom testova direktnog kontakta uzoraka titanovih legura sa L929 ćelijama ili indirektno, ispitivanjem metaboličke aktivnosti L929 ćelija u prisustvu različitih razblaženja kondicioniranog medijuma (KM). Korišćena je ćelijska linija mišijih fibroblasta (L929). Metabolička aktivnost je merena MTT testom, ćelijska proliferacija je merena testom ugradnje 3[H+]-timidina, dok je produkcija slobodnih radikala kiseonika (ROS) određivana protočnom citofluorimetrijom nakon obeležavanja sa dihloro-dihidro-fluorescin diacetatom (DCFH-DA). Nekroza i apoptoza su merene bojenjem ćelija sa propidijum jodidom, merenjem produkcije laktatdehidrogenaze (LDH), kao i analizom ekspresije gena za mišje kaspaze 3, 8 i 9 metodom lančane reakcije polimeraze u realnom vremenu (Real-Time PCR). Ćelijski rast i morfološka analiza L929 ćelija je procenjivana fazno kontrasno svetlosnom mi

ObjectivesTo compare the peri-implant bone healing between TiZr implants with hydrophilic SLActive and hydrophobic SLA implant surface in patients receiving anticoagulants, to assess the implant survival and success rate, as well as to evaluate whether small-diameter TiZr implants could be used in patients on OAT in order to avoid augmentation procedures. Material and methodsA total of 80 small-diameter tissue-level TiZr implants with SLActive and SLA surfaces were placed in 20 anticoagulated patients, following the split-mouth study design. Implant stability was measured up to the third postoperative month by resonance frequency measurements (RFA). One-year implant survival and success rate were evaluated. ResultsAfter one year, 100% implant survival and success rate were observed. A significant decrease in ISQ comparing to baseline values was noted in the SLActive group from the first postoperative week, and in the SLA group, from the 3rdweek after the surgery. In both groups, a statistically significant decline in ISQ was observed between second and third postoperative week. No significant differences in ISQ values between SLActive and SLA implants were noted, at any time point. ConclusionsTitanium-zirconium small-diameter implants with SLActive and SLA surface predictably achieve and maintain adequate bone tissue integration in patients receiving anticoagulants. OAT appears to influence the bone healing events resulting in lower ISQ in the end of 3-month period in comparison with baseline values, although without compromising implant stability.

Magnesium has a key role in osteoporosis and could enhance implant osseointegration in osteoporotic patients. Titanium implants impregnated with Mg ions were installed in the tibia of ovariectomized rats. The release of Mg induced a significant increase of bone formation and the expression of anabolic markers in the peri-implant bone. The success of endosseous implants is highly predictable in patients possessing normal bone status, but it may be impaired in patients with osteoporosis. Thus, the application of strategies that adjuvate implant healing in compromized sites is of great interest. Magnesium has a key role in osteoporosis prevention and it is an interesting candidate for this purpose. In this study, the cellular and molecular effects of magnesium release from implants were investigated at the early healing stages of implant integration. Osteoporosis was induced in 24 female rats by means of ovariectomy and low-calcium diet. Titanium mini-screws were coated with mesoporous titania films and were loaded with magnesium (test group) or left as native (control group). The implants were inserted in the tibia and femur of the rats. One, 2 and 7 days after implantation, the implants were retrieved and histologically examined. In addition, expression of genes was evaluated in the peri-implant bone tissue at day 7 by means of quantitative polymerase chain reactions with pathway-oriented arrays. The histological evaluation revealed that new bone formation started already during the first week of healing for both groups. However, around the test implants, new bone was significantly more abundant and spread along a larger surface of the implants. In addition, the release of magnesium induced a significantly higher expression of BMP6. These results provide evidence that the release of magnesium promoted rapid bone formation and the activation of osteogenic signals in the vicinity of implants placed in osteoporotic bone., Correction available at https://doi.org/10.1007/s00198-018-4497-6 (ISI: 000441646600025)

Background: Smoking is a risk factor for dental implants. The mechanisms behind the impact of smoking on osseointegration are not fully understood. Purpose: To investigate the initial molecular and clinical course of osseointegration of different titanium implants in smokers and nonsmokers. Materials and Methods: Smoker (n = 16) and nonsmoker (n = 16) patients were included. Each patient received three implant types: machined, oxidized and laser-modified surfaces. After 1, 7, 14, and 28 days, the peri-implant crevicular fluid (PICF) was sampled for gene expression analysis of selected factors involved in early processes of osseointegration. Furthermore, pain-score (VAS), resonance frequency analysis (RFA) and baseline clinical assessments were performed. Results: Early failure of osseointegration, associated with a high and sustained perception of pain, was encountered in 3/32 patients. In general, high pain scores were reported during the first days after implantation, irrespective to smoking habit, which correlated to high levels of pro-inflammatory cytokines during the first days after implantation. Higher ISQ values were found in smokers compared to nonsmokers. In smokers exclusively, ISQ values correlated to harder and less atrophic bone quality and quantity, respectively. Smokers displayed a higher expression of osteocalcin (OC), but later peak and lower expression of bone morphogenetic protein (BMP-2) (at 7 days) compared to nonsmokers. In comparison to machined implants, surface-modified implants were associated with higher expression of alkaline phosphatase (ALP) and cathepsin K (CatK) at 28 days in nonsmokers. Conclusions: During the early phase of osseointegration, postoperative pain is linked to the inflammatory cell response and, may tentatively serve as an indicator of biological complication and implant loss. The present study suggests that smokers have an altered bone composition and (ultra)structure based on the observations that ISQ values are high

Background: A delayed approach is recommended for reconstruction of the jaws with autogenous bone grafts and dental implants. Experimental studies have shown stronger bone tissue responses to surface modified implants than to nonmodified ones. AimThe aim of the study was to evaluate bone integration and stability of surface modified and fluoridated implants when placed with fresh or healed autogenous bone grafts. Material and Methods: Six rabbits were used in this study. Each right rabbit tibia (control) received an autogenous bone graft, harvested from the calvarium. Eight weeks later, a second graft was harvested from the other side of the calvarium and placed on the left tibia (test) with an implant. Another implant was installed in the healed graft of the right tibia. TiO2-blasted and fluoridated OsseoSpeed(TM) implants (Astra Tech AB, Molndal, Sweden), 3.5mm in diameter and 9mm long, were used. After additional 8 weeks, the rabbits were sacrificed and the implants were removed en bloc for light-microscopic analysis. Bone-to-implant contact (BIC) was registered as well as the amount of bone filling a rectangle indicating a region of interest (ROI). Resonance frequency analysis (RFA) was conducted both at the time of surgery and at the end of the experiment. ResultsThere were no statistically significant differences either in BIC or ROI between the test and control sides. RFA showed higher implant stability for the control side at the time of the surgery, but the difference had leveled out at the time of the sacrifice. Conclusion: The present study showed similar bone tissue responses and stability for surface modified and fluoridated implants after 8 weeks of healing in fresh or healed autogenous bone grafts.

The drilling technique and the surface characteristics are known to influence the healing times of oral implants. The influence of osteotomy dimension on osseointegration of microroughned implant surfaces treated with resorbable blasting media was tested in an in vivo model.Ninety-six implants (ø4.5 mm, 8 mm in length) with resorbable blasting media-treated surfaces were placed in the ileum of six sheep. The final osteotomy diameters were 4.6mm (reamer), 4.1mm (loose), 3.7mm (medium), and 3.2mm (tight). After three and six weeks healing, the implants were biomechanically tested and histologically evaluated. Statistical analysis was performed using Page L trend test for ordered and paired sample and linear regression, with significance level at p < 0.05.An overall increase in all dependent variables was observed with the reduction of osteotomy diameter. In addition, all osseointegration scores increased over time. At three weeks, the retention was significantly higher for smaller osteo- tomies. The histological sections depicted intimate contact of bone with all the implant surfaces and osteoblast lines were visible in all sections.The resorbable blasting media microroughed surfaces achieved successful osseointegration for all the instrumentation procedures tested, with higher osseointegration scores for the high insertion torque group.

The effect of oxygen plasma treatment (t = 0.1-60 min, pO2 = 0.2 mbar, P = 50 W) of parylene C implant surface coating was investigated in order to check its influence on morphology (SEM, AFM observations), chemical composition (XPS analysis), hydrophilicity (contact angle measurements) and biocompatibility (MG-63 cell line and Staphylococcus aureus 24167 DSM adhesion screening). The modification procedure leads to oxygen insertion (up to 20 at.%) into the polymer matrix and together with surface topography changes has a dramatic impact on wettability (change of contact angle from θ = 78 ± 2 to θ = 33 ± 1.9 for unmodified and 60 min treated sample, respectively). As a result, the hydrophilic surface of modified parylene C promotes MG-63 cells growth and at the same time does not influence S. aureus adhesion. The obtained results clearly show that the plasma treatment of parylene C surface provides suitable polar groups (C = O, C-O, O-C = O, C-O-O and O-C(O)-O) for further development of the coating functionality., QC 20130819

Biofilms - communities of microorganisms attached to surfaces - are a constant threat for long-term success in modern implantology. The application of laser scanning microscopy (LSM) has increased the knowledge about microscopic properties of biofilms, whereas a 3D imaging technique for the large scale visualization of bacterial growth and migration on curved and non-transparent surfaces is not realized so far. Towards this goal, we built a scanning laser optical tomography (SLOT) setup detecting scattered laser light to image biofilm on dental implant surfaces. SLOT enables the visualization of living biofilms in 3D by detecting the wavelength-dependent absorption of non-fluorescent stains like e.g. reduced triphenyltetrazolium chloride (TTC) accumulated within metabolically active bacterial cells. Thus, the presented system allows the large scale investigation of vital biofilm structure and in vitro development on cylindrical and non-transparent objects without the need for fluorescent vital staining. We suggest SLOT to be a valuable tool for the structural and volumetric investigation of biofilm formation on implants with sizes up to several millimeters.