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This review of literature paper was done in order to conduct a review of the literature and an assessment of the effects of titanium implant corrosion on peri-implant health and success in the oral environment. This paper evaluates and critically reviews the findings of the multiple in-depth in vivo and in vitro studies that are related to corrosion aspects of the titanium and its alloys. A literature survey was conducted by electronic search in Medline and studies that were published between 1940 and August 2018 were selected. The search terms used were types of corrosion, corrosion of titanium implants, titanium corrosion, metal ion release from the titanium implants, fretting and pitting corrosion, implant corrosion, peri implantitis, and corrosion. Both in vivo and in vitro studies were also included in the review. The search and selection resulted in 64 articles. These articles were divided on the basis of their context to different kinds of corrosion related to titanium dental implants. It is evident that metal ions are released from titanium and titanium alloy dental implants as a result of corrosion. Corrosion of implants is multifactorial, including electrical, chemical, and mechanical factors, which have an effect on the peri-implant tissues and microbiota. The literature surveyed showed that corrosion related to titanium and its alloys has an effect on the health of peri-implant soft and hard tissue and the long term survival of metal dental implants. It can be concluded that presence of the long-term corrosion reaction along with continuous corrosion leads to the release of ions into the peri-implant tissue but also to a disintegration of the implant that contribute to material fatigue and even fracture of the abutments and implant body or both. This combined impact of the corrosion, bacterial activity, chemical reactions, and functional stresses are to be looked at as important factors of implant failure. The findings can be used to explore the possible strategies of research to investigate the biological impact of implant materials.

Background: Piezosurgery is a surgical procedure that is able to perform osteotomies by a micrometric and selective cut of the bone tissue. The objective of this investigation was to evaluate two different techniques; an ultrasonic device, and a drill approach for implant site preparation. Methods: A total of fifty patients were recruited for the randomized clinical trial to receive dental implants for fixed prosthetic restoration in the posterior mandible and were allotted to two groups. In Group A the implant site was prepared following a drilling technique, while in Group B the implant site was prepared using an ultrasonic device; moreover, the operative duration was recorded. Postoperative pain and swelling were evaluated at 1, 2, 4, and 6 days. The crestal bone resorption was measured at 3 months from implant placement by a three-dimensional tomography evaluation. Results: The findings suggest that osteotomies performed by an ultrasonic device cause less pain and swelling. On the other hand, the piezoelectric preparation was characterized by a significative increase in the operative time. No statistical differences in crestal bone resorption were evident in the two different approaches. Conclusions: According to the outcome of the study, ultrasonic implant bed preparation can be used with success in implantology and could be considered a suitable alternative to traditional drilling techniques for dental fixture placement.

Background/purpose: A bacterial adhesion to implant surfaces is a first stage of peri-implant mucositis and peri-implantitis. The aim of this longitudinal study was to examine the quantitative and qualitative biofilm formation on healing screws and the presence of periodontal pathogens in peri-implant crevicular fluid (PCF). In each of the 30 participants, one healing screw was adapted to every single implant. Materials and methods: Thirty patients, 18 females and 12 males, were selected. Thirty healing abutments were left in situ for 20, 30 and 90 days. At regular times, the presence/absence of bleeding on probing (BOP) was determined. The specific periodontal pathogens were determined in PCF, by polymerase chain reaction (PCR). After 20, 30 and 90 days, the healing screws were removed and analyzed to establish the total bacterial count by a culture method. Results: BOP+ increased significantly after 90 days. Biofilm was detected on all healing abutments and the number of cultivable oral flora showed a significant increase from 20 days to 30 days and to 90 days. At 90 days, the anaerobic counts constituted the bulk of plaque examined and Veillonella spp. were present in higher percentages levels (19.82%) among the Gram-negative bacteria. No significant differences among the experimental groups were detected in the frequencies of detection of each monitored bacteria in PCF. Conclusion: The healing screws left in situ for a period of 90 days caused a peri-implant inflammation and the presence of periodontal pathogenic bacteria in the peri-implant sulcus, due to the plaque accumulation on screw surfaces.

Aim Bacterial adherence to implants is considered to be an important event in the pathogenesis of bacterial infections. In fact, this infection process is a first stage of peri-implant mucositis and peri-implantitis, and a positive correlation has been found between oral hygiene and marginal bone loss around implants in the edentulous mandible. Surface properties of transgingival implant components are important determinants in bacterial adhesion. The purpose of this study was to characterize the biofilm formation, in vivo, on healing screws made of titanium alloy or coated with a combination of anatase and Bactercline® product. Materials and methods Twenty-five patients, between 21- 37 years, in excellent systemic health, participated in this study. In each of the 25 participants, one anatase-Bactercline® coated healing screw (Test) and one titanium alloy (TI6Al4V) healing screw (Control) were adapted to two different implants. Quantitative and qualitative biofilm formation on healing abutments was analyzed by culture method.Results Bacterial adherence to the two different healing screws used in this study were compared. Statistically significant differences were found between the Control and the Test group for both aerobic and anaerobic bacterial counts (p

Nanostructures are structures, mainly synthetic (nanosurfaces, cylindrical nanotubes, and nanospheres), which range between 1–100 nm in at least one dimension and can be engineered to a wide range of physical properties. This paper aims to explore the bacteriostatic and cytotoxic characteristics of nano-TiO2 coated specimens of glass, stainless steel and ceramic with different thickness and roughness. The results show that stainless steel and glass specimens with a nano-TiO2 coating thickness of 200 nm have a bacteriostatic effect of 97% and 100%, respectively after 30 minutes of UV exposure. Glass specimens with a nano-TiO2 coating thickness of 750, 200 and 50 nm have a bacteriostatic effect of 86%, 93% and 100% after 60 minutes. Nano-TiO2 coatings show a great bacteriostatic but not a cytotoxic effect, thus representing a valuable alternative for biomedical applications.

Aim: Although the presence of mineralized tissues at the interface with blade implants has been reported, the view that blade implants cannot integrate still persists. Blades are the immediately loaded implants with the longest clinical history, so their histological evaluation may give results applicable to root-form implants. The aim of the present retrospective study was a histological evaluation of the peri-implant tissues in immediately loaded human blade implants retrieved after a long loading history. Materials and methods: Thirty-one implants were included in the present report, after a loading history varying from 2 to 23 years, with a mean of 15 years. The implants were processed for histological examination. Results: Histologically, the bone was in close and tight contact with the implants surface and no gaps or connective fibrous tissues were present at the implant-bone interface. The peri-implant bone was compact, mature, with the presence of small marrow spaces and Haversian canals. Many osteons were in contact with the implan surface. Most Haversian systems ran perpendicular to the major axis of the blades. In some fields it was possible to observe the presence of a few osteoblasts. Remodelling areas were present. Mean bone to implant contact percentage was, for all 31 implants, 43±5.2%. Conclusion: The present report showed that immediately loaded blade implants can achieve and maintain osseointegration under long-term function (more than 20 years).

Background: Titanium dioxide exists in three different crystal lattices, anatase, rutile, and brookite. Anatase coating releases, under ultraviolet (UV) irradiation, free radicals such as ·OH, O 2 - , HO 2 - , and H2 O2 . This potent oxidizing power characteristically results in the lysis of bacteria and other organic substances. The purpose of this study was to evaluate the bone response to implants made of titanium alloy or coated with a new combination of anatase and Bactercline® product. Materials and Methods: In the period between July 2009 and June 2010, 26 patients (10 females and 16 males; median age 51 ± 11 years, min. 27 years, max. 72 years) were operated and 62 implants were inserted. Lost fixtures and peri-implant bone resorption were considered as predictors of clinical outcomes. Pearson χ2 -test was used. Prosthesis and implant failures, any complications after loading, and peri-implant marginal bone-level changes were assessed by a masked assessor. All patients were followed up to 1 year after loading. Results: No implant was lost. Average bone resorption around implant was 0.33 mm (both for 25 standard and 37 Bactercline-coated implants), and thus no statistical difference was detected. Conclusion: These results shown that no adverse effects on osseo-integration were present.

The use of chemical devices for periodontitis treatment has led to new strategies aiming primarily to control infections. Over the last few years, new chemical devices have been subjected to many scientific and medical studies. The purpose of the present study was to assess the effect of a new silver based chemical devices gel named “Hydrosilver Plus Gel”, abbreviated here as Hydrosilver, on the pathogenic microorganisms, using Polymerase Chain Reaction (PCR) for microbiological analysis. Materials and methods: Ten patients with a diagnosis of chronic periodontitis in the age group >25 years were selected. None of these patients had received any surgical or non-surgical periodontal therapy, and demonstrated radiographic evidence of moderate bone loss. After scaling and root planning, patients received Hydrosilver to be used at home. Four non-adjacent sites in separate quadrants were selected in each patient for monitoring, based on criteria that the sites localise chronic periodontitis. Microbial analysis was analysed at baseline and at Day 15. SPSS program was used for statistical purposes and a paired samples correlation was performed at the end of the observation period. Results: Mean amounts of bacterial loading before and after Hydrosilver treatment reduced statistically significantly (p = 0.002). Conclusions: The present study demonstrated that Hydrosilver has a good impact on oral biofilm. Additional studies are needed to detect the efficacy of this chemical device.

Background: The aim of this randomized controlled clinical trial was to compare the efficacy of two different techniques for maxillary sinus augmentation using a lateral window approach: Heterologous cortical lamina without any grafting material versus 100% collagenated granular collagen porcine bone. Methods: Twenty-three healthy patients with not relevant past medical history (14 women and 9 men, non-smokers, mean age 52 years, range 48–65 years) were included. In Group I, the sinus was filled with collagen porcine bone (Geno-os, OsteoBiol, Turin, Italy) and a collagen membrane (Evolution, OsteoBiol, Turin, Italy) was used to close the lateral window of the sinus. In Group II, the sinus was treated with heterologous cortical lamina only (Lamina, OsteoBiol, Turin, Italy). Results: There was a statistically significant difference in the surgical time required to complete the augmentation procedures: 18.3 ± 2.1 min for lamina treated sites versus 12.5 ± 3.1 min for porcine bone treated sites. In Group I, the mean volume of the graft was 3101 ± 321 mm3 in the immediate postoperative examination (5–7 days), while after a six-month healing period it was 2716.7 ± 432 mm3. Conclusion: This study demonstrates that the use of heterologous cortical lamina is a valid technique for the mechanical support of sinus membranes resulting in only bone tissue formation and not mixed with the graft. The graft material was biocompatible and not completely resorbed after six months, although the remains were integrated into the bone.

Aim: Studies have shown that mandibular implant overdentures significantly increase satisfaction and quality of life of edentulous elders. Improved chewing ability appears to have a positive impact on nutritional state. Materials and methods: Forty edentulous subjects received four permucosal mini-implants for overdentures in the interforamina region of the mandible. Almost all participants were still satisfied with their overdentures. Participant satisfaction concerning retention and stability of the mandibular overdenture was assessed. A micro invasive technique was adopted, without open flap and performed in one chirurgical step; this technique can be used also in the so-called “highrisk” patients (anticoagulant terapy, diabetes, etc). Results and conclusion: Results and conclusion The results suggest that a mandibular overdenture retained by 4 mini-implants may be the best treatment strategy for edentulous people with atrophic ridges. The use of mini-implants is in many cases a good clinical alternative to the use of larger diameter implants, in that they enable to reduce surgical time, bleeding, postoperative discomfort and healing time.

Background: Mucositis and peri-implantitis are pathologies that may be encountered during dental implant rehabilitation. Therapeutic strategies for their resolution range from non-surgical to surgical treatments and aimed at eliminating the biofilm from the implant’s surface, through mechanical, chemical or photodynamic agents. Aim: The aim was to evaluate the effect of the electric field generated by the Ximplant machine on the bacterial load and on the biofilm grown on dental implants. Materials and Methods: Ten dental implants were brought into contact with a donor’s saliva, then five implants were treated with the electric field and four were not treated. Bacterial biofilm was then measured by resazurin assay, both on treated and untreated implants. Results: The study showed the preliminary success of the electrofield in reducing the microbial population and destroying the clinical biofilm, compared with a sterile implant as control.