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Purpose: To test the antimicrobial properties, surface topography, reaction of surrounding tissue (biocompatibility) and osseointegration of ultrathin implant surfaces containing polysiloxane and nanoscaled silver particles. Materials and Methods: Implants with polysiloxane coating and nanoscaled silver particles (Ag/SiOxCy; HyProtect, Bio-Gate) were compared with implants with polysiloxane coating alone and with noncoated (grit-blasted and acid-etched) implants. A total of 72 implants were inserted into the calvaria of eight domestic pigs (nine implants each, three of each type). After 3 months, histologic sections were evaluated for inflammatory cell infiltration and bone implant contact. Results: Roughness parameters did not differ between all three implant types. The Ag/SiOxCy coating exhibited a good antimicrobial effect in vitro and no sign of inflammatory cell infiltration in vivo. The noncoated implants demonstrated 10.85% and 14.48% more bone contact than the polysiloxane-coated implants (P = .003) and the Ag/SiOxCy-coated implants (P ⩽ .001), respectively. Osseointegration was not significantly different between the Ag/SiOxCy-coated and polysiloxane-coated implants (P = .72). Conclusion: The osseointegration capability of the Ag/SiOxCy-coated implants was equal to that of the polysiloxane-coated implants but less than that of the grit-blasted and acid-etched implants. Because of the biocompatibility of the polysiloxane coating, further studies should be conducted in load-bearing models and in the oral cavity to investigate the antimicrobial effect of the embedded silver clusters. [ABSTRACT FROM AUTHOR]

The structural characteristics at the interface of bone implants can guide biological regulation. In this study, a dual-scale hierarchical microstructure is proposed and customized using hybrid machining to achieve temporal dependency osteogenic regulation. It is observed that osteoblasts induced by dual-scale hierarchical structure exhibit adequate protrusion development and rapid cell attachment through the modulation of mechanical forces in the cell growth environment, and further promot the upregulation of the cell membrane receptor PDGFR-α, which is related to cell proliferation. Afterward, transcriptomic analysis reveals that during the differentiation stage, the DSH structure regulates cellular signaling cascades primarily through integrin adhesion mechanisms and then accelerates osteogenic differentiation by activating the TGF-β pathway and cAMP signaling pathway. Furthermore, the calcium nodules are preferentially deposited within the lower honeycomb-like channels, thereby endowing the proposed dual-scale hierarchical structure with the potential to induce oriented deposition and improve the long-term stability of the implant., (© 2024 Wiley‐VCH GmbH.)

Background: The increased use of dental implants in oral rehabilitation has been followed by the development of new biomaterials as well as improvements in the performance of biomaterials already in use. This triggers the need for appropriate analytical approaches to assess the biological and, ultimately, clinical benefits of these approaches. Aims: To address the role of physical, chemical, mechanical, and biological characteristics in order to determine the critical parameters to improve biological responses and the long-term effectiveness of dental implant surfaces. Data sources and methods: Web of Science, MEDLINE and Lilacs databases were searched for the last 30 years in English, Spanish and Portuguese idioms. Results: Chemical composition, wettability, roughness, and topography of dental implant surfaces have all been linked to biological regulation in cell interactions, osseointegration, bone tissue and peri-implant mucosa preservation. Conclusion: Techniques involving subtractive and additive methods, especially those involving laser treatment or embedding of bioactive nanoparticles, have demonstrated promising results. However, the literature is heterogeneous regarding study design and methodology, which limits comparisons between studies and the definition of the critical determinants of optimal cell response. [ABSTRACT FROM AUTHOR]

Although capsular contracture represents one of the most important complications after breast augmentation, local inflammation and fibrosis can lead, to capsular calcification, an often-forgotten radiological sign of capsular contracture. In this article, the authors present a clinical case of breast implant calcification in an 81-year-old patient. Although this complication has been rarely described, the literature was reviewed to clarify the role of the local microenvironment in capsular contracture and calcification. At present, capsular contracture patients are classified using the conventional Baker score and the histological Wilflingseder classification. As it was not possible to consider capsular calcification when classifying our patient using the traditional scores, the authors propose an updated version of the current scale. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effect of surgical treatment of experimental peri‐implantitis at implants with different surface characteristics using mechanical and chemical decontamination methods. Materials and Methods: Following extraction of mandibular premolars, four implants with two different surface characteristics (A, moderately rough and B, smooth) were placed in each side of the mandible of six dogs. Experimental peri‐implantitis was induced. Surgical treatment of the peri‐implantitis sites was carried out using four implant surface decontamination protocols: (i) deposition of a citric acid gel, (ii) mechanical cleaning using a rotating titanium brush, (iii) a combination of the mechanical and chemical procedures, and (iv) saline (control). Clinical and radiographic examinations were performed. Block biopsies were obtained 6 months after therapy and prepared for histological analysis. Results: Irrespective of the treatment group, treatment resulted in 0.63 ± 0.92 and 0.65 ± 0.67 mm radiographic bone gain around implants A and B, respectively. Histological analyses revealed that persisting soft tissue inflammation as assessed using an infiltrated connective tissue (ICT) score was significantly lower at implant type B than at implant type A for all treatment groups. The test decontamination procedures did not demonstrate better results regarding resolution of peri‐implantitis lesions, as indicated by the ICT scores, than the control procedure. The control treatment resulted in significantly superior outcomes of resolution of peri‐implantitis lesions than the citric acid regimen. Conclusions: It is concluded that decontamination procedures including citric acid gel or rotating titanium brush did not improve outcomes following surgical treatment of experimental peri‐implantitis. Results were, however, influenced by the implant surface characteristics. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the most effective chemotherapeutic agent for decontamination of infected dental implants. Material and methods: A systematic electronic literature search in MEDLINE (PubMed) and Google scholar between January 2010 to December 2021 was carried out by using the PRISMA guidelines. A total of five studies related to chemical decontamination of the dental implant were evaluated. The search strategy was based on the PICOS framework. Randomized controlled trials (RCT's) and cohort studies evaluating the effectiveness of different chemotherapeutic agents for the decontamination of dental implants were included in the study. The outcome variable examined was the most effective chemotherapeutic agent(s) for dental implant surface decontamination after comparing the chemotherapeutic agents used in the qualifying studies. Result: Out of the basic database of 1564 records, 1380 articles were excluded due to irrelevance, unavailability, and repetition. Furthermore, 134 articles were excluded from 184 studies for various reasons. After further filtration, 13 studies were shortlisted. Two investigators (SSA and SA) appraised the quality of the selected studies using the risk of bias assessment tool. After excluding eight studies, five articles were finally included in the present systematic review. Conclusion: The data reported for the efficacy of chemotherapeutic agents in cleaning contaminated titanium surfaces are scarce, thus it is not possible to draw a definite conclusion. However, chlorhexidine (CHX) (0.2%, 0.12%), citric acid (40%) and sodium hypochlorite (1%) are the most commonly used chemotherapeutic agents; amongst them, citric acid showed the highest potential for biofilm removal from the contaminated implant surface. All three agents [CHX (0.2%, 0.12%), citric acid (40%), and sodium hypochlorite (1%)] can be recommended as therapeutic agents along with their curbs. [ABSTRACT FROM AUTHOR]

The objective of this in vitro study was to evaluate surface cleanness and cytocompatibility following mechanical instrumentation of biofilm‐contaminated titanium surfaces. Titanium discs (non‐modified [Ti(s)] and shot‐blasted surfaces [Ti(r)]) contaminated with Streptococcus gordonii were instrumented using four different techniques: (i) gauze soaked in saline (GS), (ii) ultra‐sonic device (US), (iii) rotating nickel‐titanium brush (TiB), or (iv) air‐polishing device (AP). Non‐contaminated, untreated titanium disks were used as controls (C). Residual deposits and cytocompatibility for osteoblast‐like cells were evaluated using scanning electron microscopy, immunofluorescence, and reverse transcriptase polymerase chain reaction. While the number of residual bacteria on Ti(s) discs was close to 0 in all treatment groups, significantly higher mean numbers of residual bacteria were observed on Ti(r) discs for GS (152.7 ± 75.7) and TiB (33.5 ± 22.2) than for US (0) and AP (0). Instrumentation with US resulted in deposition of foreign material (mean area% of foreign material: 3.0 ± 3.6% and 10.8 ± 9.6% for Ti(s) and Ti(r) discs, respectively). AP was the most effective decontamination procedure in reducing bacteria without depositing residual foreign material on Ti(r) discs. TiB and AP were superior methods in restoring cytocompatibility, although no method of mechanical decontamination resulted in pristine levels of cytocompatibility. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the in vitro cleaning effects of different decontamination methods and their impacts on surface characteristics using clinically failed TiUnite implants (Nobel Biocare, Kloten, Switzerland). Materials and methods: Thirty clinically failed TiUnite implants were treated using different decontamination methods. Group 1 (control group) received physiological saline irrigation; Group 2 underwent erythritol powder air polishing (AIRFLOW Master Piezon, EMS Dental, Nyon, Switzerland); Group 3 was treated with erythritol powder air polishing with ethylenediaminetetraacetic acid brushing (FileRite PRC, Pulpdent, Watertown, MA, USA); Group 4 received ultrasonic scaling with polyetheretherketone tips (EMS Dental); Group 5 underwent ultrasonic scaling with polyetheretherketone tips with ethylenediaminetetraacetic acid; and Group 6 was treated with a combination of ultrasonic scaling with polyetheretherketone tips, erythritol powder air polishing and ethylenediaminetetraacetic acid. Surface cleaning effects, quantified by relative contaminated area reduction and visual analogue scale score, as well as surface roughness and chemistry, were assessed after decontamination. The cleaning effects of each decontamination method were also compared between TiUnite and SLA (sandblasted, large-grit acid-etched; Straumann, Basel, Switzerland) implants. Results: Group 6 showed the highest relative contaminated area reduction (stereoscopic microscopy 83.92%, scanning electron microscopy 96.40%), visual analogue scale score (2.83) and reduction in surface roughness (thread bottom −0.78 μm, tip −1.35 μm), as well as an almost maximal decrease in the proportion of carbon (thread bottom −12.33%, tip −8.77%) and increase in that of titanium (thread bottom 13.71%, tip 10.73%). Polyetheretherketone remnants were observed in Groups 4 and 5 but appeared to be reduced in Group 6. When comparing the outcomes with those for SLA implants, no significant differences were found. Conclusion: Within the limitations of the present study, the combination of ultrasonic scaling with polyetheretherketone tips, erythritol powder air polishing and ethylenediaminetetraacetic brushing achieved reasonable cleaning effects. The original surface modification did not seem to have any impact on the decontamination results for any of the methods examined. [ABSTRACT FROM AUTHOR]

Purpose: A moderately rough anodized titanium implant surface (TiUnite) was introduced in 2000. This review and meta-analysis aimed to assess implant survival and marginal bone level (MBL) changes documented in the literature. Materials and Methods: Repeated literature searches on dental implants were conducted, with the final search on October 7, 2016. The inclusion criteria were: prospective study, minimum of 20 patients, at least 12 months follow-up postloading, and TiUnite implant survival reported. Regression analysis was performed on implant survival and MBL change from implant surgery. Peri-implantitis as defined by the primary authors was reported at the patient level. Results: One hundred six out of 32,519 publications on dental implants met the inclusion criteria. Implant survival rates at 1 year were 99.50% at the implant level and 99.12% at the patient level, and survival rates at 10 years were 95.14% at the implant level and 91.50% at the patient level. Mean MBL change at 1 year was -0.409 mm at the implant level and -0.413 mm at the patient level, and at 5 years, it was -0.886 mm at the implant level and -1.029 mm at the patient level. Nineteen studies (18%) specifically reported peri-implantitis in 64 out of 1,229 patients with a mean followup of 47.89 months, indicating a prevalence of 5.20% at the patient level. Conclusion: Based on a metaanalysis of prospective studies, implants with the TiUnite surface provide a predictable treatment modality in a variety of indications. [ABSTRACT FROM AUTHOR]

Purpose: Commercially pure titanium (CpTi) and its alloys possess favorable mechanical and biologic properties for use as implants in orthopedics and dentistry. However, failures in osseointegration still exist and are common in select individuals with risk factors such as smoking. Therefore, in this study, a proposal was made to enhance the potential for osseointegration of CpTi discs by coating their surfaces with nanoplexes comprising polyethylenimine (PEI) and plasmid DNA (pDNA) encoding bone morphogenetic protein-2 (pBMP- 2). Materials and Methods: The nanoplexes were characterized for size and surface charge with a range of N/P ratios (the molar ratio of amine groups of PEI to phosphate groups in pDNA backbone). CpTi discs were surface characterized for morphology and composition before and after nanoplex coating using scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and X-ray powder diffraction (XRD). The cytotoxicity and transfection ability of CpTi discs coated with nanoplexes of varying N/P ratios in human bone marrow-derived mesenchymal stem cells (BMSCs) was measured via MTS assays and flow cytometry, respectively. Results: The CpTi discs coated with nanoplexes prepared at an N/P ratio of 10 (N/P-10) were considered optimal, resulting in 75% cell viability and 14% transfection efficiency. Enzyme-linked immunosorbent assay results demonstrated a significant enhancement in BMP-2 protein secretion by BMSCs 7 days posttreatment with PEI/pBMP-2 nanoplexes (N/P-10) compared to the controls, and real-time PCR data demonstrated that the BMSCs treated with PEI/pBMP-2 nanoplex-coated CpTi discs resulted in an enhancement of Runx-2, alkaline phosphatase, and osteocalcin gene expressions on day 7 posttreatment. In addition, these BMSCs demonstrated enhanced calcium deposition on day 30 posttreatment as determined by qualitative (alizarin red staining) and quantitative (atomic absorption spectroscopy) assays. Conclusion: It can be concluded that PEI/pBMP-2 nanoplex (N/P-10)-coated CpTi discs have the potential to induce osteogenesis and enhance osseointegration. [ABSTRACT FROM AUTHOR]

Purpose: Osseointegration has been defined in many ways, from both basic science and clinical perspectives, but generally represents the restoration of bony homeostasis following implant placement and is usually judged by some form of bone/implant disruption test. In this study, bone anchorage to two different implant surfaces, in tensile and shear modes, was compared to investigate the relation between implant surface topography and osseointegration over time. The purpose was to determine if mathematical parameters could be derived that would reflect the biologic relevance of the implant surface design. Materials and Methods: Rectangular titanium implants (n = 244) were placed in the distal femora of 122 male Wistar rats proximal to the knee joint. Implants were either microsurfaced (MS) or nanosurfaced (NS). Animals were euthanized at one of six time points ranging from 5 days to 6 months, and the force required to disrupt the bone implant interface, in either shear or tension, was measured using an Instron machine. Data were analyzed by fitting the function F = C (1–e-x/τ), where F is the measured disruption force, C is the predicted average maximum disruption force, x is the time postimplantation, and τ is a time constant defined as the time required for F to reach 63.2% of C. Results: Analysis showed that shear testing resulted in significantly larger values of C than seen in tension, but no significant difference was observed when comparing the values of C for NS and MS implants in shear (P = .7). Thus, in accord with clinical reports, both implants performed equivalently at longer implantation periods. The differences in C were significant in tension (P < .05). Importantly, NS implants had a significantly smaller τ than the MS implants (P < .01, in shear), but no significant differences were observed in τ due to mechanical testing vector. The disruption force values reached a plateau with time, representing bony homeostasis as a result of osseointegration. With time, both implant surfaces reached the same maximum (C) values, in shear. However, the value of τ was smaller in NS compared to MS implants, which represented a higher rate of osseointegration. Conclusion: Thus, τ emerges as a measureable and biologically relevant parameter that can be employed to compare the osseointegration potential of putative implant surfaces. [ABSTRACT FROM AUTHOR]

The glucose fuel cells (GFCs) leverage the implant surface as an electrode, representing an optimal approach for miniaturizing implantable power sources. A conductive hydrogel electrode membrane is crafted through in situ reduction and electrochemical co-deposition techniques by employing bacterial cellulose as a scaffold. This process enables the seamless integration of the GFC directly onto the implant surface. The integrated GFC exhibits an impressive open-circuit voltage peak of 0.894 V and a peak power density of 94.7 μW cm−2. Additionally, the fuel cell demonstrates resistance to chloride ion toxicity under simulated interstitial fluid conditions. Although performance within horse serum is moderate, the methodology presents a viable strategy for developing GFCs on implant surfaces. • Cell's cathode and anode utilize bacterial cellulose and platinum nanoparticles. • Bacterial cellulose templating and electrochemical co-deposition are utilized. • The GFC exhibits a Voc of 0.894 V, along with a power density of 94.7 μW cm−2. • The anode membrane resists chloride ion poisoning, enhancing cell stability. [ABSTRACT FROM AUTHOR]

Background: The primary objective of this ex vivo study was to assess the influence of increasing insertion torques on three types of dental implants and possible alterations of their microgeometry after the application of three different torque intensities. Methods: 27 implants of 3 different implant brands (Groups A, B and C) were placed in cow ribs using 30 Ncm, 45 Ncm and 55 Ncm insertion torques. The implants were subsequently removed using trephine burs, and SEM analysis was carried out in order to detect implant surface and connection changes, as compared to the implant controls. Results: Surface deformations were predominantly observed on the third apical part of the implants. The alterations presented with increasing insertion torques, with 45 Ncm being the threshold value. Prosthetic connections were also compromised. Conclusions: The changes sustained by the implants were proportional to the insertion torque they were subjected to; 45 Ncm and greater insertion torques resulted in more consistent damage, both on the implant surface and the implant connection.

Background: Implant surface topography is a key element in achieving osseointegration. Nanostructured surfaces have shown promising results in accelerating and improving bone healing around dental implants. The main objective of the present clinical and histological study is to compare, at 4 and 6 weeks, (w) bone-to-implant contact in implants having either machined surface (MAC), sandblasted, large grit, acid-etched implant surface (SLA) medium roughness surface or a nanostructured calcium-incorporated surface (XPEED®). Methods: 35 mini-implants of 3.5 × 8.5 mm with three different surface treatments (XPEED® (n = 16)—SLA (n = 13)—MAC (n = 6), were placed in the posterior maxilla of 11 patients (6 females and 5 males) then, retrieved at either 4 or 6w in a randomized split-mouth study design. Results: The BIC rates measured at 4w and 6w respectively, were: 16.8% (±5.0) and 29.0% (±3.1) for MAC surface; 18.5% (±2.3) and 33.7% (±3.3) for SLA surface; 22.4% (±1.3) and 38.6% (±3.2) for XPEED® surface. In all types of investigated surfaces, the time factor appeared to significantly increase the bone to implant contact (BIC) rate (p < 0.05). XPEED® surface showed significantly higher BIC values when compared to both SLA and MAC values at 4w (p < 0.05). Also, at 6w, both roughened surfaces (SLA and XPEED®) showed significantly higher values (p < 0.05) than turned surface (MAC). Conclusions: Nanostructured Calcium titanate coating is able to enhance bone deposition around implants at early healing stages.

The characteristics such as microtopography, physical and chemical properties influence the behavior of an implant in a soft tissue. Anodization—as a potent method of titanium alloy surface modification—of the transgingival abutment or healing screw, has achieved some improvement. One of the possible surface treatment method is low-pressure radiofrequency oxygen plasma treatment. The aim of the study was to evaluate the chemical properties and cytocompatibility of the experimental surface. Titanium discs made of grade-23 titanium alloy (Ti-6Al-4V) anodized (A sample) with different voltage parameters (28, 67, 78, and 98 V) were included in the study. Half of the samples regarded as the “S” group were additionally treated with low-pressure radiofrequency oxygen plasma treatment. The surfaces were characterized using scanning electron microscopy, X-ray spectroscopy and Raman spectroscopy, and electrochemically investigated via a corrosion test. Furthermore, two cell lines were used, including the CHO-compatible reference line and a primary human fibroblast line for the MTT assay; direct (contact) cytotoxicity of the materials was tested with the cells, and the growth of fibroblasts on the surfaces of the different materials was tested. The morphology of the “S”-treated samples did not differ from the morphology of only-anodized samples. However, the oxygen concentration on the surface in that group slightly increased by about 1% as a result of post-trial treatment. The highest corrosion resistance was observed for both A-78 V and S-78 V samples. The cytotoxicity assay revealed no changes in cell morphology or vitality. The MTT test proved comparable culture viability among all groups; however, the “S” samples showed statistically significantly higher fibroblast proliferation and adhesion scores compared to the “A” samples. Through the in vitro study, the low-pressure radiofrequency oxygen plasma treatment of the anodized Ti-6Al-4V alloy presented itself as an auspicious option in the field of transgingival element surface modification of implants.

Background: The process of osteointegration, as key point has the activation of mesenchymal cells at implant-bone interspace, their differentiation into osteoblasts and connection between the implant surface and the surrounding bone. Main text: Implant surfaces composed by biocompatible, organism-friendly materials require changes in content and surface morphology; changes that may further stimulate mesenchymal cell activation. The way the implant surfaces are affected with advantages and disadvantages, that typically bring each methodology, is also the purpose of this study. The study is of review type, based on finding articles about implant surface modification, with the aim of promoting the mesenchymal cell activation, utilizing keyword combination. Conclusions: Implant success beyond the human element of the practicioner and the protocol element of implant treatment, also relies on the application of the right type of implant, at the right implant site, in accordance with oral and individual health status of the patient. Implant success does not depend on type of "coating" material of the implants. Based at this physiological process, the success or implant failure is not a process depending on the type of selected implant, because types of synthetic or natural materials that promote osteointegration are relatively in large number. [ABSTRACT FROM AUTHOR]

Background. The aim of this in vitro study was to evaluate the influence of implant length and diameter on the insertion torque and implant stability quotient (ISQ) in a porcine jaw bone. Materials and methods. Cylindrical implants were inserted into porcine jaw bone in vitro. Four groups of different implant length and diameters were investigated. The maximum insertion torque and ISQ value in mesio-distal and bucco-lingual direction were evaluated and analyzed statistically. Results and discussion. The mean insertion torque measured in the long implant groups was significantly higher than in the shorter ones. A similar tendency could be observed for the mean ISQ values, with significantly higher ISQ values of the longer implants compared to the values of groups 2 and 3. The highest ISQ values were observed in group 1. Conclusions. The insertion torque and ISQ value vary, depending on implant length and diameter. [ABSTRACT FROM AUTHOR]

The aim of the present systematic review was to analyse studies using inorganic implant coatings and, in a meta‐analysis, the effect of specifically tricalcium phosphate (TCP) and hydroxyapatite (HA) implant surface coatings on bone formation according to the PRISMA criteria. Inclusion criteria were the comparison to rough surfaced titanium implants in large animal studies at different time points of healing. Forty studies met the inclusion criteria for the systematic review. Fifteen of these analyzed the bone‐to‐implant contact (BIC) around the most investigated inorganic titanium implant coatings, namely TCP and HA, and were included in the meta‐analysis. The results of the TCP group show after 14 days a BIC being 3.48% points lower compared with the reference surface. This difference in BIC decreases to 0.85% points after 21–28 days. After 42–84 days, the difference in BIC of 13.79% points is in favor of the TCP‐coatings. However, the results are not statistically significant, in part due to the fact that the variability between the studies increased over time. The results of the HA group show a significant difference in mean BIC of 6.94% points after 14 days in favor of the reference surface. After 21–28 days and 42–84 days the difference in BIC is slightly in favor of the test group with 1.53% points and 1.57% points, respectively, lacking significance. In large animals, there does not seem to be much effect of TCP‐coated or HA‐coated implants over uncoated rough titanium implants in the short term. [ABSTRACT FROM AUTHOR]

Abstract Purpose To investigate the influence of implant surface decontaminated and uncontaminated on osteoblast-like cell adhesion and proliferation Materials and methods Commercially available implants of different brands and surface characteristics were selected: Biomet 3i® Nanotite (NT) and Osseotite (OT), Straumann® SLActive (SLA), and Neodent® Acqua Drive (ACQ) and Neoporos Drive CM (CM). Physical and chemical properties of the implants were investigated by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), and wettability analysis (WETT). Implants were previously contaminated with Aggregatibacter actinomycetemcomitans strains; after that, samples were decontaminated by different chemical methods. Decontaminated (test group; n = 15/type of implant) and uncontaminated (control group; n = 5/type of implant) samples were analyzed according to the number of human osteoblastic osteosarcoma cells (Saos-2) adhered on the implant surface after 24 h and 72 h in SEM images. Results ACQ was found to be highly hydrophilic, and NT was the most hydrophobic implant. Increased variation of Saos-2 cell adhesion and proliferation were observed on all test and control groups. Controversially, at the proliferation analysis in 72 h, CM implant was the only implant that showed no significant difference between test and group (p = 0.2833; Tukey’s multiple comparisons test). NT implants showed the greater value of cell proliferation when compared with all types of implant surface (p = 0.0002; Tukey’s multiple comparisons test). Conclusions These findings suggest that decontaminated surfaces were able to impair the counting of osteoblast-like cell adhesion and proliferation.

This retrospective comparative study aimed to evaluate the effect of implant surface in two cohorts of consecutive patients who underwent revision surgery following capsular contracture (Baker III-IV) after primary breast augmentation with textured implants. All patients underwent the same surgical procedure (capsulectomy – pocket plane change – implant exchange) and the only difference was that two different types of implants were used during the implant exchange: textured (Group A - biocell) or nanotextured (Group B - silksurface). A comparative analysis was performed using the following parameters: patients' demographics, age, the time between the primary breast augmentation and the revision surgery, the surgical and follow-up outcomes; and the incidence, timing, and capsular contracture recurrence. Eighty consecutive females were included, Group A(textured): age of 35(19–65) years and time between primary and secondary surgery of 59(6–209) months; and Group B(nanotextured): age of 39(26–58) years and time between primary and secondary surgery of 65(7–218) months. For both groups, at a mean follow-up of 25(21–36) months for Group A(textured), and at a mean follow-up of 24(21–34) months for Group B(nanotextured); capsular contracture reoccurred in 3 cases (7.5%), at 7, 10, and 14 months in Group A and in 3 cases (7,5%), at 9, 10, and 16 months in Group B, post revision surgery. Students' t-test demonstrated no statistically significant differences between the recurrences of the two implant surfaces (p-value>0.05). In capsular contracture revision surgery, the type of implant surface (textured or nanotextured) does not appear to influence recurrence rates. Further studies are required to identify the clinical impact on the implant surface in long-term outcomes of capsular contracture breast surgery. [ABSTRACT FROM AUTHOR]

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 peri‐implantitis progression, while clinical studies do not support the notion that there is a difference in peri‐implantitis incidence among the various types of implant surfaces. No assumptions can be made regarding the possible impact of implant material on incidence and/or peri‐implantitis progression due to limited information. [ABSTRACT FROM AUTHOR]

Abstract Background Blood is the first tissue contacting the implant surface and starting the biological interactions to enhance osseointegration and stimulate bone formation with the progenitor cytokines, chemokines, and growth factors. The coagulation cascade initiates the first step of osseointegration between implant and neighboring tissues. The wound healing may be inadequate unless the blood wets the implant surface properly. Wettability is one of the most important features of the implant surface while lipid level constitutes a milestone that may change the energy of blood, which determines its distribution on implant material. Thus, the aim of this study was to evaluate the effect of lipid component of blood as cholesterol and its treatment on their wetting behavior of titanium surfaces. Methods Five surface groups were formed including grade 4 titanium-machined, grade 4 titanium-SLA, grade 4 titanium-SLActive, Roxolid-SLA, and Roxolid-SLActive. In healthy, hyperlipidemic, and treatment situations, blood was taken from eight rabbits and dropped to the disc surfaces. Contact angles were measured between the blood samples and disc surfaces. Results A significant difference was found between both machined and SLActive surfaces, SLA and SLActive surfaces in the hyperlipidemic period, and only Roxolid-SLA and SLActive surfaces during the treatment period. When evaluated according to time, only grade 4-machined and Grade 4-SLA surfaces showed a significant difference. Conclusions Our findings indicated that each period has its own characteristics and showed the importance of cholesterol in blood structure on applicability of implant surfaces.

Abstract Purpose The aim of the present in vivo analysis was to evaluate the osseointegration process of titanium implants with three different surfaces (machined, sandblasted and acid-etched, and laser-treated) after 15 and 30 days of healing period. Materials and methods Thirty-six implants with different surfaces were placed in the iliac crest of four Bergamasca sheep. The implant surfaces tested were sandblasted and acid-etched (group A), laser-treated (group B), and fully machined (group C). Two animals were sacrificed after 15 days while the other two after 30 days. Histological and histomorphometric analyses were performed. Results After 30 days, the bone tissue layer onto implant groups A and B appeared almost continuous with small marrow spaces interruption, while on the machined surface (group C), larger spaces with marrow tissue alternated with the bony trabeculae onto the titanium surface. Implants in groups A and B showed significantly higher implant contact percentage (BIC%) value than group C (P < 0.05). Moreover, it was observed a BIC% increase in both groups A and B between 15 and 30 days while in the machined group (group C), the BIC% decreased. Conclusion Results from the present in vivo analysis revealed that both sandblasted/acid-etched and laser-treated titanium implants, compared to the machined ones, have higher values of osseointegration in less healing time.

Abstract Background Implantoplasty is an option in peri-implantitis treatment, but little is known about the effect on the soft tissue. The aim of the study was to characterize surface roughness following experimental implantoplasty and to examine its effect on human fibroblast growth and secretion of selected proteins. Methods Titanium grade IV coins were mechanically treated with six different rotating bur sequences; diamond burs or carbide burs alone, or followed by either Arkansas stone bur or silicone burs. Machined and rough-surface sandblasted, acid-etched (SLA) coins were used as control. The surface topography was characterized by scanning electron microscope and profilometer. Human gingival fibroblasts from two donors were cultured on the coins to quantify the effect on cell morphology, growth, and protein secretion by confocal microscopy and multiplex immunoassay. Results All surface roughness parameters were lower for the surfaces treated with experimental implantoplasty than for the SLA surface, and the sequence of carbide burs followed by silicone burs rendered the least rough surface of the test groups. The implantoplasty procedures changed the elemental composition of the titanium surface. High surface roughness showed a weak to moderate negative correlation to fibroblast growth, but induced a higher secretion of VEGF, IL-6 and MCP-3 to the cell medium compared to the least rough surfaces of the test groups. At day 30 fibronectin levels were higher in the SLA group. Conclusions The surface roughness following implantoplasty demonstrated a weak to moderate negative correlation with the growth of fibroblasts. The addition of Arkansas stone and silicon burs to the experimental implantoplasty bur protocol rendered an initial increase in fibroblast growth. Implantoplasty altered the elemental composition of the titanium surface, and had an effect on the fibroblast cytokine secretion and fibronectin levels.

Aim: The aim of this study was to comparatively evaluate stability changes in palatal implants during the early stages of bone healing with chemically modified sandblasted/acid-etched (modSLA) titanium surface compared with a standard sandblasted (SLA) titanium palatal implants. Materials and Methods: A statistically significant number (n = 40; 24 females and 16 males) of adult subjects who volunteered and have their informed consent for participating in the study were selected. These volunteers were randomly allocated to the experimental group (modSLA surface) and to the control group (SLA surface) with 20 subjects in each group. Documentation of implant stability was done by assessing resonance frequency analysis (RFA) at implant insertion, followed by subsequent assessments each week till 12th week from baseline (1–12 weeks). RFA values were expressed as an implant stability quotient (ISQ). Results: Immediately after installation of implant, the ISQ values for both surfaces tested were not significantly different and yielded mean values of 75.28 ± 5.23 for the control and 73.16 ± 4.81 for the test surface. In the first 2 weeks after implant installation, both groups presented only small changes and thereafter a reducing trend in the mean ISQ levels. In the test group, after 4 weeks a tendency toward increasing ISQ values was observed, and 6 weeks after surgery the ISQ values corresponded to those after implant insertion. For the SLA control group, the trend changed after fifth week and yielded ISQ values corresponding to the baseline after ninth week. After 12 weeks of observation, the test surface yielded significantly higher stability values of 78.68 ± 2.9 compared with the control implants of 75.5 ± 3.19, respectively. Conclusion: The results undoubtedly support and validate the potential for chemical modification of the SLA surface to positively influence the biologic process of osseointegration and also a faster healing.

The adhesion of zirconia and soft tissue is very important for the success of zirconia implants. The aim of this study was to characterize the effects of excimer laser treatment of zirconia on the adhesion of L929 fibroblasts. In this study, polished zirconia disks treated with an excimer laser were the experimental group and untreated zirconia disks were the control group. Surface roughness and contact angles of zirconia disks were measured. mRNA expression levels of integrin β1 and collagen type I α1 in L929 fibroblasts cultured on zirconia disks were measured using qRT-PCR. Cell morphology was evaluated using 3D laser microscopy and the expression of vinculin was characterized using confocal microscopy. There was no significant difference in the surface roughness of zirconia disks, but contact angles were significantly lower. mRNA expression of integrin β1 was significantly higher at 3, 6 and 24 h and of collagen type I α1 was significantly higher at 6 and 24 h. L929 fibroblasts tended to form elongated microspikes and vinculin colocalization in those microspikes. Furthermore, vinculin was strongly expressed in filopodia of L929 fibroblasts at 24 h. These results suggest that excimer laser treatment improves adhesion between zirconia disks and L929 fibroblasts.

In addition to transmitting and carrying genetic information, RNA plays an important abiotic role in the world of nanomaterials. RNA is a natural polyanionic biomacromolecule, and its ability to promote osteogenesis by binding with other inorganic materials as an osteogenic induction agent was discovered only recently. However, whether it can promote osseointegration on implants has not been reported. Here, we investigated the effect of the RNA-containing coating materials on peri-implant osseointegration. Total RNA extracted from rat muscle tissue was used as an osteogenic induction agent, and hyaluronic acid (HA) was used to maintain its negative charge. In simulated body fluids (SBF), in vitro studies demonstrated that the resulting material encouraged calcium salt deposition. Cytological experiments showed that the RNA-containing coating induced greater cell adhesion and osteogenic differentiation in comparison to the control. The results of animal experiments showed that the RNA-containing coating had osteoinductive and bone conduction activities, which are beneficial for bone formation and osseointegration. Therefore, the RNA-containing coatings are useful for the surface modification of titanium implants to promote osseointegration.

During an assessment of dental implant design effectiveness, most of the data are acquired from clinical or animal studies performed by researchers and clinicians. In order to represent scientific significance, those studies have to be properly designed, focusing on a precisely chosen aspect with inclusion and exclusion criteria. The last of these, especially, can create major limitations for the data collection. In order to create a reliable, complete overview of different implant suitability, the data from a single customer can also be a valuable input in dental science. The aim of the study was to compare if the type of implants returned corresponded with sales figures for this type of implant or if there were any differences in the number of complaints. Customer complaints regarding dental implants produced by the same manufacturer acquired from dental professionals from different countries were evaluated over a fixed period of time. After having compared the number of complaints regarding implants to the number of sold implants, it was evident that single-piece implants and those with a polished surface used for immediate loading were significantly less likely to generate customer complaints than conventional two-stage systems (p < 0.001) with rough surfaces and larger endosseous diameters.

Purpose: To compare the outcome of immediately loaded single implants with a machined or a roughened surface. Materials and methods: Fifty patients had two implant sites randomly allocated to receive flaplessplaced single Syra implants (Sweden & Martina), one with a machined and one with a roughened surface (sand-blasted with zirconia powder and acid etched), according to a split-mouth design. To be loaded immediately, implants had to be inserted with a torque superior to 50 Ncm. Implants were restored with definitive crowns in direct occlusal contact within 48 h. Patients were followed for 6 months after loading. Outcome measures were prosthetic and implant failures and complications. Results: Two machined implants and four roughened implants were not loaded immediately. Six months after loading no dropout occurred. One implant loaded late, which had a rough implant surface, failed 20 days after loading (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). Three crowns had to be remade on machined implants and four on roughened implants (P (McNemar test) = 1.000; difference in proportions = -0.02; 95% CI: -0.12 to 0.08). Three machined and five roughened implants experienced complications (P (McNemar test) = 0.625; difference in proportions = -0.04; 95% CI: -0.15 to 0.07). There were no statistically significant differences between groups for crown and implant losses as well as complications. Conclusions: Up to 6 months after loading both machined and roughened flapless-placed and immediately loaded single implants provided good and similar results, however, longer follow-ups are needed to evaluate the long-term prognosis of implants with different surfaces. [ABSTRACT FROM AUTHOR]

This study evaluated the effect of smoke exposure on the expression of genes related to bone metabolism in implants coated with nanohydroxyapatite (NHA). A total of 36 rats were exposed to cigarette smoke for 60 days. The animals were allocated into three groups: machined implants (MAC), dual acid-etched implants (DAE), and NHA-coated implants (NHA). Implants were installed in the left tibia of the rats after 30 days of smoke exposure. The implants were retrieved 7 and 30 days after implantation, and the adjacent bone analyzed using a real-time polymerase chain reaction for gene expression of alkaline phosphatase (ALP), osteopontin (OPN), receptor activator of the nuclear factor kappa ligand (RANKL), osteoprotegerin (OPG), the RANKL/OPG ratio, osteocalcin (OCN) and runt-related transcription factor 2 (Runx2). After 7 days, Runx2, OPN and OPG expression demonstrated significantly higher levels for the NHA surface treatment relative to DAE and MAC surfaces. NHA presented the lowest RANKL and RANKL/OPG levels. After 30 days, NHA-coated implants showed significantly higher levels of Runx2, ALP, OPN, OPG, OC, RANKL and RANKL/OPG relative to DAE and MAC implants. The results indicated a greater osteogenic and high osteoclastic activity around NHA implants, in comparison to DAE and MAC implants.

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 similar promising clinical outcomes. Additionally, the acid-etched roughened implant surface may be preferable., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Purpose: The objective of this randomized controlled clinical split-mouth trial was to compare anodized implant surfaces and implant surfaces modified by acid etching in terms of primary and secondary stability. Materials and Methods: Forty-six implants were placed bilaterally in the posterior mandibles of 23 patients. Each patient received one implant with a surface treated by acid (AC) and the other with an anodized implant surface (ANO). The selection of the side where the implant was placed was chosen randomly by lot. The implants were evaluated with respect to insertion torque within the surgical bed and primary and secondary stability by testing the implant stability quotient (ISQ) at five different times (immediate postoperative period and 21, 30, 60, and 180 days after surgery). The paired t test was used to compare the two groups, and ANOVA Repeated Measures complemented by the Tukey posttest were used for longitudinal analysis of the implants in each group. All tests were applied with a confidence level of 95% (P < .05). Results: No statistically significant difference was detected between the AC and ANO groups regarding insertion torque. ISQ analysis revealed that the AC group showed statistically higher values than the ANO group at the 21-day period (P < .05); however, no other statistically significant differences were detected at the other times. Conclusion: The different surfaces were similar in terms of primary and secondary stability of implants placed in the posterior mandible. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this case series study was to evaluate clinical and radiographic changes of soft and hard tissues around tapered, platform-switched, laser-microtextured implants 24 months after crown placement. Materials and Methods: Twenty tapered, platform-switched, laser-microtextured collar implants were placed in 20 patients. Full-mouth plaque score, full-mouth bleeding score, probing depth, and mucosal recession were recorded at the time of crown cementation and after 24 months follow-up. The marginal bone-level changes at the mesial and distal aspects of the implants were calculated by subtracting from baseline and 24-month implant marginal bone level. Results: In terms of the full-mouth plaque score and full-mouth bleeding score, tapered, platform-switched, laser-microtextured implants showed statistically significant improvements at 6 months when compared to baseline (P < .001). Statistically significantly deeper probing depths (P < .001) were found when comparing baseline and at 24 months at mesial, lingual, and distal sites. However, no statistically significant difference was found at the buccal aspects (P = .064). Radiographic marginal bone loss at 2-year follow-up for tapered, platform-switched, laser-microtextured implants was 0.72 ± 0.16 mm and 0.67 ± 0.15 mm at the mesial and distal sites, respectively. Conclusion: Within the limits of this study, tapered, platform-switched, laser-microtextured implants maintained marginal bone level (less than 1 mm radiographic bone loss) as well as limited mucosa recession over a 2-year period. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Although 5‐year clinical data exist for different zirconia implants, no analysis has yet been performed focusing on how the surface topography of the implant affects clinical parameters. Purpose: To analyze the influence of zirconia implant topography on first bone implant contact (fBIC). Materials and Methods: In a prospective two‐center cohort investigation 63 zirconia implants were evaluated at implant placement, prosthetic delivery, 1, 3, and 5 years. The distance (DIB) between implant shoulder and fBIC was measured at each time point in periapical radiographs at mesial and distal sites. Two‐way ANOVA/Bonferroni was used to analyze the effects of time and center (α < 0.05). Results: Between the centers, the mean DIB varied significantly at implant placement (Freiburg [FR]: 1.4 ± 0.6 mm; Zurich [ZH]: 0.8 ± 0.5 mm). Thereafter, no statistically significant difference in DIB was observed, neither between centers nor between time points (prosthetic delivery: FR: 1.9 ± 0.6 mm, ZH: 1.7 ± 0.8 mm; 1 year: FR: 1.8 ± 0.6 mm, ZH: 1.6 ± 0.8 mm; 3 years: FR: 1.9 ± 0.8 mm, ZH: 1.7 ± 0.8 mm; 5 years: FR: 1.9 ± 0.8 mm, ZH 1.8 ± 0.6 mm). The overall mean DIB at prosthetic delivery to 5 years of both centers (1.8 ± 0.7 mm) is located within the transition zone between the smooth neck and the moderately rough intraosseous part (1.6–2.0 mm from the implant shoulder). However, individual DIB values are ranging from 0.1 to 4.2 mm overlapping the transition zone. Conclusions: The standard deviation of the DIB indicates that the fBIC establishes on moderately rough and smooth surfaces. Consequently, soft tissue adapts to both topographies as well. [ABSTRACT FROM AUTHOR]

Abstract Bacterial colonization plays a key role on the pathogenesis of peri-implantitis and may be influenced by titanium surface topography. The aim of this in vitro study was to evaluate the influence of titanium topography after fluoride ions deposition in the bacterial colonization. Machined (M), double acid-etched (DE) and double acid-etched surface with fluoride ions deposition (Nano F-) were analyzed by scanning electron microscopy, contact angle and roughness (Ra). Streptococcus mutans viability was quantified by Live/Dead Baclight bacterial viability kit. The mean Ra/contact angle values were 0.20 μm/69.13°, 0.53 μm /92.82° and 0.56 μm/94.33° for M, DE and Nano F-, respectively. M surface presented significantly lower live bacterial counts when compared to the Nano F- surface (p=0.007). The dead bacteria count was higher on the Nano F- surface (p=0.001) than on the M and DE surfaces. Crystalline deposition of fluoride ions (Nano F-) promoted an increase in dead bacteria on the tested titanium surface.

(1) Background: Intrinsic characteristics of the implant surface and the possible presence of endotoxins may affect the bone–implant interface and cause an inflammatory response. This study aims to evaluate the possible inflammatory response induced in vitro in macrophages in contact with five different commercially available dental implants. (2) Methods: one zirconia implant NobelPearl® (Nobel Biocare) and four titanium implants, Syra® (Sweden & Martina), Prama® (Sweden & Martina), 3iT3® (Biomet 3i) and Shard® (Mech & Human), were evaluated. After 4 h of contact of murine macrophage cells J774a.1 with the implants, the total RNA was extracted, transcribed to cDNA and the gene expression of the macrophages was evaluated by quantitative PCR (qPCR) in relation to the following genes: GAPDH, YWHAZ, IL1β, IL6, TNFα, NOS2, MMP-9, MMP-8 and TIMP3. The results were statistically analyzed and compared with negative controls. (3) Results: No implant triggered a significant inflammatory response in macrophages, although 3iT3 exhibited a slight pro-inflammatory effect compared to other samples. (4) Conclusions: All the samples showed optimal outcomes without any inflammatory stimulus on the examined macrophagic cells. [ABSTRACT FROM AUTHOR]

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 development of experimental peri-implantitis. Material and methods: Eight beagle dogs received 5 tests and 5 control implants each following a split-mouth design 3 months after premolar and molar extraction. On the most mesial implant of each side, a 3-mm buccal dehiscence was artificially created. Experimental peri-implantitis was induced by silk ligatures over a 4-month period; after ligature removal, peri-implantitis was left to progress for another 4 months without plaque control. Clinical, histological, and radiographic outcomes were evaluated. Results: Radiographically, both implant groups showed a similar bone loss (BL) at the end of the induction and progression phases. BL measured on the histological sections of the test and control groups was 3.14 ± 0.42 mm and 3.26 ± 0.28 mm, respectively; the difference was not statistically significant (p > 0.05). The remaining buccal bone to implant contact (bBIC) percentage of the test and control groups was 59.38 ± 18.62 and 47.44 ± 20.46%, respectively; the difference, however, was not statistically significant (p > 0.05). Bone loss observed at dehiscent sites compared to non-dehiscent ones showed no statistically significant difference (p > 0.05). Conclusions: Addition of a monophosphonate layer to a moderately rough implant surface did not affect development of experimental peri-implantitis. Clinical relevance: Influence of implant surface on peri-implantitis may condition implant selection by the clinician, especially on patients with disease risk factors. In that sense, monophosphate layer implants do not show higher peri-implantitis risk than control implants. [ABSTRACT FROM AUTHOR]

Abstract Natural teeth are supported by connective tissue collagen fibers that insert perpendicularly in the tooth cementum. Perpendicular insertion plays an important role in the maintenance of the junction between the oral epithelium and the periodontal connective tissue. Most titanium dental implant surfaces have no micro or macro structure to support perpendicularly oriented collagen attachment. Without this tight biologic seal to resist bacterial invasion and epithelial downgrowth, progressive bone loss in peri-implantitis is seen around dental implants. The purpose of this study was to establish the perpendicularly oriented collagen attachment to titanium oxide nanotube (TNT), and to assess its binding stability. TNT was prepared on the titanium-surface by anodization. Scanning electron microscopy (SEM) showed a regularly aligned TNT with an average 67 nm-diameter when anodized at 30 V for 3 h. Subsequently, collagen type I (CoI) was electrophoretically fused to anodic TNT in native polyacrylamide gel system where negatively charged CoI-C term was perpendicularly navigated to TNT. SEM and atomic force microscopy (AFM) were used to analyze CoI on the TiO2 and TNT surface. Several tens of nanometers of CoI protrusion were recorded by AFM. These protrusions may be long enough to be priming sites for cell-secreted CoI. CoI laid parallel to the titanium surface when fused by a chemical linker. Binding resistance of CoI against drastic ultrasonication was measured by Fourier-transform infrared spectroscopy attenuated total reflection (FTIR-ATR). The electrophoretically fused CoI in the titanium nanotube (TNT–CoIEPF) showed the significantly greatest binding resistance than the other groups (P

Abstract Background To review the literature on the effect of dental implant surface roughness in patients with a history of periodontal disease. The present review addresses the following focus question: Is there a difference for implant survival, mean marginal bone loss, and the incidence of bleeding on probing in periodontally compromised patients receiving a machined dental implant or rough surface dental implant? Methods Electronic and manual literature searches were conducted on PubMed/MEDLINE and the Cochrane Library on studies published until May 2018 to collect information about the effect of machined, moderately rough, and rough dental implant surfaces in patients with a history of periodontal disease. The outcome variables implant survival, mean marginal bone level, and the incidence of peri-implantitis and bleeding on probing were evaluated. Meta-analysis was performed to obtain an accurate estimation of the overall, cumulative results. Results Out of 2411 articles, six studies were included in this systematic review. The meta-analysis of the implant survival and implant mean marginal bone loss revealed a risk ratio of 2.92 (CI 95% 0.45, 18.86) for implant failure and a total mean difference of − 0.09 (CI 95% − 0.31, 0.14) for implant mean marginal bone loss measured in a total group of 215 implants, both not statistically significant. Conclusions Due to lack of long-term data (> 5 years), the heterogeneity and variability in study designs and lack of reporting on confounding factors, definitive conclusions on differences in implant survival, and mean marginal bone loss between machined and moderate rough implants in periodontally compromised patients cannot be drawn. Future well-designed long-term randomized controlled trials are necessary to reveal that machined surfaces are superior to moderately rough and rough surfaces in patients with a history of periodontal disease.

Background: The issue of clinical importance in the development of periimplantitis in the presence of microscopic particles and contaminants on the surface of implants is to be studied. Objective: based on the study of the microstructure and the qualitative and quantitative elemental composition, the cleaning effectiveness for different types of surfaces of implants obtained from patients with periimplantitis was researched. Methods: surfaces of 12 implants were investigated: TiU-nite (Nobel BioSare, Sweden), SLA (XiVE, Dentsply Implants, Germany) and RBM (BioHorizons, USA), which were processed in three ways: with Er laser; Cr; YSGG (Waterlase MD, Biolase, USA), diamond burr, (Comet, Germany); brush (Neobiotech, Korea). Results: regardless of the type of surface, the gentlest cleaning method was laser: when the macrostructure was broken, the microroughness remained, and the composition of elements did not contain extraneous inclusions. Diamond burr was the most traumatic: macro and microstructure breakdowns, the presence of grooves and notches, the introduction of diamond particles into the implant structure have been detected; carbon has dominated in the elemental spectrum. The use of the brush also led to disturbances in the macroand microstructure of the surface; nickel (Ni) was detected in the microelement spectrum. Conclusion: practical implication: the results of this pilot study are the basis for further more detailed research.

Background: The increased use of dental implants in oral rehabilitation has been followed by the development of new biomaterials as well as improvements in the performance of biomaterials already in use. This triggers the need for appropriate analytical approaches to assess the biological and, ultimately, clinical benefits of these approaches. Aims: To address the role of physical, chemical, mechanical, and biological characteristics in order to determine the critical parameters to improve biological responses and the long-term effectiveness of dental implant surfaces. Data sources and methods: Web of Science, MEDLINE and Lilacs databases were searched for the last 30 years in English, Spanish and Portuguese idioms. Results: Chemical composition, wettability, roughness, and topography of dental implant surfaces have all been linked to biological regulation in cell interactions, osseointegration, bone tissue and peri-implant mucosa preservation. Conclusion: Techniques involving subtractive and additive methods, especially those involving laser treatment or embedding of bioactive nanoparticles, have demonstrated promising results. However, the literature is heterogeneous regarding study design and methodology, which limits comparisons between studies and the definition of the critical determinants of optimal cell response.

Soft tissue sealing around zirconia (ZrO2) abutment is critical for the long-term stability of dental implants. The goal of the study is to develop a strong basal lamina (BL)-mediated epithelial attachment to ZrO2 via a novel physicochemical immobilization method. An electrophoretic fusion (EPF) method was applied to fuse a phosphonic acid (PA) linker to ZrO2 discs. Bindings of the PA linker and the following protease activated receptor 4 (PAR4) were verified by Fourier-transform infrared spectroscopy (FITR). Then, ZrO2 discs were doped in platelet-rich plasma (PRP). Platelet-derived growth factor (PDGF) was measured to assess platelet activation. PRP-doped discs were subsequently co-cultured with human gingival epithelial cells (OBA9) to evaluate establishment of basal lamina-mediated epithelial attachment. The EPF method achieved robust immobilization of the PA linker and PAR4 onto the ZrO2 surface. The resultant PAR4-coupled ZrO2 successfully induced platelet aggregation and activation. Furthermore, a BL-mediated epithelial attachment was established. The results are significant for clinical application to minimize the risk of developing peri-implant diseases.

Aim: To evaluate the most effective chemotherapeutic agent for decontamination of infected dental implants. Material and methods: A systematic electronic literature search in MEDLINE (PubMed) and Google scholar between January 2010 to December 2021 was carried out by using the PRISMA guidelines. A total of five studies related to chemical decontamination of the dental implant were evaluated. The search strategy was based on the PICOS framework. Randomized controlled trials (RCT’s) and cohort studies evaluating the effectiveness of different chemotherapeutic agents for the decontamination of dental implants were included in the study. The outcome variable examined was the most effective chemotherapeutic agent(s) for dental implant surface decontamination after comparing the chemotherapeutic agents used in the qualifying studies. Result: Out of the basic database of 1564 records, 1380 articles were excluded due to irrelevance, unavailability, and repetition. Furthermore, 134 articles were excluded from 184 studies for various reasons. After further filtration, 13 studies were shortlisted. Two investigators (SSA and SA) appraised the quality of the selected studies using the risk of bias assessment tool. After excluding eight studies, five articles were finally included in the present systematic review. Conclusion: The data reported for the efficacy of chemotherapeutic agents in cleaning contaminated titanium surfaces are scarce, thus it is not possible to draw a definite conclusion. However, chlorhexidine (CHX) (0.2%, 0.12%), citric acid (40%) and sodium hypochlorite (1%) are the most commonly used chemotherapeutic agents; amongst them, citric acid showed the highest potential for biofilm removal from the contaminated implant surface. All three agents [CHX (0.2%, 0.12%), citric acid (40%), and sodium hypochlorite (1%)] can be recommended as therapeutic agents along with their curbs.

Background: The blood wettability of titanium implant surfaces favors primary osseointegration and tissue healing in peri-implantitis. The current study aims to evaluate this property on the main different kinds of surfaces, brand new and after treatments. Methods: grade IV titanium disks were used, five machined, five laser-treated, five sandblasted. The experiment was on four steps. Between each step, specimens were sterilized. At the end of each step, a 4 µL blood drop was put on the samples, and contact angles were calculated. The steps consisted of—1: no treatment; 2: surface instrumentation with an ultrasonic titanium tip; 3: platelet-rich fibrin (PRF) coating and drying with sterile gauze; 4: etching with phosphoric acid, rinse and saline solution and air-drying. At the end of each phase, a blood drop was placed on the surfaces. Blood for PRF preparation and for calculation of contact angles was collected from a single source. Results: average wettability decreased after instrumentation, and increased after the PRF application to a superior level both to the first and second steps. The highest wettability was obtained after etching. This trend is statistically significant for machined and sandblasted surfaces. Conclusions: In the clinical environment, PRF and phosphoric acid used for conditioning exposed implant surfaces can be used for the healing of peri-implant tissues. [ABSTRACT FROM AUTHOR]

Surface morphology plays a significant part in the longevity of the bio-implants. In this regard, the surface finishing of biomedical implants such as 316L stainless steel (SS 316L) requires intensive focus. A rotational magnetorheological abrasive flow finishing process (R-MRAFF) was engineered to ensure SS 316L surface uniformity within the nanometer range. Various process parameters such as pressure, revolution of the magnet, number of cycles, and distance between permanent magnet in rotating die and workpiece fixture have been taken into account. In this study, three different surface morphology samples A, B, and C with the surface roughness of 167, 173, and 184 nm, respectively, were compared to sample D which is pristine SS 316L with SR of 319 nm. The effect of biocompatibility achieved by using the R-MRAFF process was measured by comparing the finished sample with the pristine sample. Scanning electron microscopy images reveal the level of finishing obtained using the R-MRAFF process. From the surface wettability analysis, the finished surface exhibits hydrophilic nature (θ < 90°). X-ray photon spectroscopy study concludes that R-MRAFF promotes stable oxide formation in surface layers. Corrosion studies were carried out using potentiodynamic polarization (PDP) study and electron impedance spectroscopy (EIS) in artificial blood plasma (ABP). The corrosion rate was reduced from 4.3064 to 0.09236 µm/year in the finished samples with an improved protection efficiency of 97.85%. [ABSTRACT FROM AUTHOR]

Objectives: To compare the marginal bone level around implants with a thin multi‐phosphonate coated surface after either an early or conventional loading protocol. Material and methods: A randomized pilot clinical trial was conducted. Dental impressions were obtained after either 4 (test) or 8 weeks (control) and single crowns screwed‐in 2 weeks later. Several variables were evaluated including radiographical marginal bone level (MBL), patient's level variables, and those related to the restoration and surrounding tissues. These data were obtained at several time points up to a 1‐year follow‐up. Results: Thirty‐four patients were included in the study, 18 assigned to the test group. No differences at implant placement were detected for tissue thickness, keratinized mucosa, nor any other clinical or radiological variable. At the time of impressions, tissue was thinner in the test group (2.30 (0.46) versus 2.78 (0.66) mm, test versus control, respectively; p =.012) so shorter abutments were used in this group. Regardless, no significant changes in marginal bone level were detected neither within group along time nor between groups. The average MBL at the 1‐year follow‐up was −0.15 (0.32) versus −0.22 (0.37) (p =.443) (test versus control, respectively). None of the clinical or radiological variables evaluated had a determinant influence on the MBL at any visit nor group. Conclusion: The use of implants with a multi‐phosphonate coated surface for early loading offers successful radiographical outcomes 1 year after loading. MBL over time was not affected by taking the impressions 4 or 8 weeks after implant placement and loading them 2 weeks later. [ABSTRACT FROM AUTHOR]

This article describes the clinical and radiologic long-term results of a healthy, nonsmoker women aged 62 at the time of treatment, with severely resorbed edentulous jaws in which bar and clip supported complete dentures were delivered in both jaws and followed for 8 years after prosthesis delivery. The patient had been edentulous in both arches since she was 50 years old. Treatment included the placement of four mandibular implants with maximum spacing anterior to the mandibular nerve, and four maxillary implants anterior to sinus wall without tilting the posterior implants, because of the insufficient bone quantity necessary to angulate implants. Guided bone regeneration was required in the maxilla, due to a bone atrophy that limited the placement of conventional dental implants. After 4 months, a second-stage surgery was performed, and after 1 month of healing time the patient received definitive restorations. Implant survival rate, patient satisfaction, marginal bone maintenance, and soft tissue conditions at the modified titanium surface of the dental implants were evaluated after 8 years of function. A multifactorial approach, clinician-patient relationship, and vigilant maintenance of oral hygiene were needed in order to ensure an optimal treatment and a long-term successful result. Positive results regarding bone maintenance in the long-term perspective, also on regenerated bone, were observed using implants with implant-retained bar overdentures, when adequate levels of oral hygiene and prosthodontic adjustments are maintained. [ABSTRACT FROM AUTHOR]