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Purpose: To evaluate the influence of immediate loading on the osseointegration and bone density of implants placed in a healed alveolar bone crest and supporting single crowns. Materials and Methods: Two solid titanium transmucosal mini-implants were placed in the distal regions of the mandible in 14 patients. One mini-implant was immediately functionally loaded, whereas the other was left unloaded. After 2 months of healing, biopsy samples were retrieved and the levels of new bone, old bone, and total bone (new + old) were assessed. Results: Histologic examination was performed on biopsies from 12 patients (n = 12). The new bone-to-implant contact percentage (BIC%) was 40.3% ± 16.8% and 55.1% ± 19.1% (P = .043) at the unloaded and loaded sites, respectively; in addition, the total BIC% was 44.9% ± 17.0% and 59.5% ± 18.8%, respectively (P = .034). The new bone density was 45.9% ± 11.6% for the unloaded implants and 45.9% ± 16.7% for the loaded implants (P = .622). Conclusions: Immediate loading had a positive effect on bone apposition at the implant surface, but no effect on bone density was observed after 2 months of healing. [ABSTRACT FROM AUTHOR]

Purpose: Marginal bone resorption (MBR) around dental implants may sometimes be a self-limiting condition due to balancing immunologic reactions against utilized materials rather than a progressive bacterial infection. Contrary to previous assumptions from ligature-induced experimental peri-implantitis studies, a recent 8-week experiment by the present authors showed that marginal ligatures trigger an inflammatory immune response, resulting in bone resorption around implants in the absence of plaque. The present study aimed to investigate whether this inflammatory/immunologic reaction attenuates or progresses toward implant failure after a longer healing time (12 weeks). Materials and Methods: Sterile silk ligatures were placed around the top of titanium (Ti) implants and compressed against the femoral cortical bone plate of six rabbits. A nonligated implant was used as a control. After 12 weeks of submerged healing, ground sections of implants and surrounding tissues were investigated with light microscopy. The marginal soft tissues were also analyzed using selected quantitative polymerase chain reaction (qPCR) markers. Results: Histologically, the ligatures were outlined by immune cells, including multinucleated giant cells (MNGCs), with adjacent fibrous encapsulation and resorbed peripheral bone that contrasted from the osseointegrated nonligated control implants. The difference in expression of qPCR markers was not significant, but > two-fold upregulation of markers CDIIb, IL1β, ARG1, NCF1, and CD4 and > twofold downregulation of CD8 indicated a mild, focal inflammatory/immune response against the ligatures compared to controls, with upregulation of M1 and M2 macrophages, neutrophils, and helper T-cells as well as downregulation of killer T cells. Further, the bone formation markers OC and ALPL were > two-fold downregulated (consistent with the lack of osseointegration of the ligatures) compared to control implants. Conclusions: Marginal silk ligatures trigger an inflammatory/immune response and aseptic bone resorption around implants. Compared to the previous 8-week study, the inflammatory reaction against the silk appears to attenuate with time, with only a mild persisting inflammation that may block osseointegration; instead, a fibrous tissue encapsulation-type reaction is maintained. This may explain why traditional ligature experiments have required regular exchange of ligatures for the bone resorption to progress. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the esthetic outcomes based on the color differences in zirconia (Zr) of varying thickness, resin cement color, and types of titanium (Ti) implant surface treatments. Materials and Methods: Overall, 28 high-translucency monolithic zirconia (HTMZ) specimens were arranged into four groups based on Zr thickness: 1.0, 1.5, 2.0, and 2.5 mm (n = 7 per thickness). Each group was tested using two resin cement colors (clear and opaque) in combination with six surface-treated Ti groups (n = 7), including untreated titanium (UT), anodization (AN), 50-µm alumina airborne-particle abrasion followed by AN (SBAN), AN followed by 50-µm alumina airborne-particle abrasion (ANSB), 9.5% hydrofluoric acid followed by AN (HFAN), and AN followed by 9.5% hydrofluoric acid (ANHF). This created a total of 48 experimental groups, including the use of composite resin (n = 7, shade A2D) for four control groups. All specimens were measured using a spectrophotometer and subsequently compared with composite resin (control) with the corresponding Zr thickness to establish color differences. A color difference of < 2.7 was considered clinically acceptable. The data obtained were statistically analyzed using ANOVA and post hoc test (P = .05). Results: Zr thickness, resin cement color, and type of Ti implant surface treatment significantly affected the observed color differences (P < .05). When using 2.5-mm HTMZ with clear resin cement on AN, UT, SBAN, HFAN, and ANSB, the mean color differences were below the clinically acceptable values, and the 95% CIs of color differences were below the clinically acceptable values for AN, UT, and SBAN groups. Conclusions: HTMZ with a minimum thickness of 2.5 mm and clear resin cement on AN, UT, and SBAN groups potentially result in acceptable color matching with 95% CIs. [ABSTRACT FROM AUTHOR]

Purpose: Dental implants are an established treatment option for varying edentulous conditions that has grown in popularity since the 1990s. This increased clinical application has shown a parallel increase in implant-related research. The objective of this paper was to perform a comprehensive bibliometric analysis of five dental implantology journals from 1991 to 2023. Materials and Methods: A search was done in the Web of Science database between 1991 and 2023 in five journals with a focus on dental implantology: Clinical Oral Implant Research, Clinical Implant Dentistry and Related Research, Implant Dentistry, The International Journal of Oral & Maxillofacial Implants, and International Journal of Oral Implantology. Results marked as a correction, retraction notice, retracted article, meeting abstract, or withdrawn publication were removed from the analysis. The time period analyzed was divided into four time periods, organized by decade: 1991 to 2000, 2001 to 2010, 2011 to 2020, and 2021 to 2023. Additionally, the top 100 cited papers were also exported separately. Authors and countries with most publications were tabulated from the Web of Science database. VOSviewer software was used to create network maps of keywords and title word occurrences for each of the time periods. HistCite software was used to analyze the number of publications and citation counts. Results: Network maps of keywords and title word occurrences suggested an early focus on osseointegration and titanium implants between 1991 and 2000. Publications between 2001 and 2010 saw a focus on in vivo studies, implant surface, and peri-implantitis. Publications from 2011 and later saw a focus on bone regeneration, complications, and zygomatic implants. The USA ranked highest in total number of publications in all analyzed time periods. Conclusions: Within the limitations of the present study, a comprehensive bibliometric analysis from 1990 to 2023 was reported. Trends in keywords and titles of implant publications were identified in these journals, which mirrored the trends seen in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: To propose and evaluate standardized polishing protocols for in vitro experiments using a custommade apparatus under controlled force to create consistent surface roughness on titanium and zirconia discs. Materials and Methods: A total of 160 discs were manufactured with a diameter of 10 mm, 80 titanium (Ti) and 80 zirconium oxide (Zr). Specimens were categorized into two groups: controlled force (CF) and without controlled force (WCF). Specimens in the CF group were polished with a custom apparatus incorporating a tension gauge on the Ti and Zr disc surfaces to achieve consistent roughness. The WCF group was polished without the use of a tension gauge. Each group had four subgroups (n = 10): control/machined with no polishing (C), rough (R), smooth (S), and very smooth (VS). The subgroups were processed using a sequence of diamond-impregnated polishing burs and polishing paste. Results: The CF group showed consistent surface roughness and a gradual decrease in surface roughness. Control in Ti (Ra = 6.5 ± 0.03 µm) and in Zr (Ra = 5.4 ± 0.04 µm); R in Ti (Ra = 3.5 ± 0.06 µm) and in Zr (Ra = 3.2 ± 0.07 µm); S in Ti (Ra = 1.5 ± 0.04 µm) and in Zr (Ra = 1.1 ± 0.06 µm); and VS in Ti (Ra = 0.05 ± 0.002 µm) and in Zr (Ra = 0.02 ± 0.005 µm). There were significant differences for R, S, and SV under CF and WCF in Ti and Zr surfaces. Conclusions: The specimens polished under control force produced significantly more uniform surface roughness than those polished without controlled force and were produced with a higher degree of consistency. [ABSTRACT FROM AUTHOR]

The article discusses studies which show that full-ceramic prosthetic restorations for single crowns (SCs) and fixed dental prostheses (FDPs) are high quality and have a satisfactory survival rate comparable to porcelain-fused-to-metal (PFM). These studies include the survival outcome and complications in a retrospective clinical study of complete-arch fixed implant-supported prostheses (CAFIPs), the prevalence of prosthetic complications, and clinical performance of implant-supported FDPs.

Purpose: To measure the surface temperature distribution after using a CO2 laser to heat titanium dental implants via different power settings, application intervals, and irradiation times. Materials and Methods: A total of 10 tissue-level titanium implants (Screw-Line Promote Plus, Camlog; 4.3 × 11 mm) were placed (EpoFix, Struers) and irradiated with a CO2 laser (Denta 2, Lutronic) with a wavelength of 10.6 µm at power levels of 4 watts (Group 1), 6 watts (Group 2), 8 watts (Group 3), and 10 watts (Group 4). A continuous beam mode (setting I) and noncontinuous beam modes with 5-second (setting II) and 10-second (setting III) pause intervals were used. For each setting, a total irradiation time of 50 seconds was used and repeated 10 times. The temperature was measured using external thermocouple (Testo) in contact with the implant surface at the implant shoulder, middle, and apex. A linear regression model was used to analyze the data (P = .05). Results: Setting I demonstrated the most rapid increase in implant surface temperature in all three test sites as well as the greatest total temperature at 50 seconds of irradiation time. The greater the pause interval (settings II and III) during the 50 seconds of irradiation, the lower the rate of temperature increase as well as the total temperature in all three test sites and with all power levels. The average temperature difference between the apex and shoulder site was significant for setting III for all groups, but not for any groups in settings I and II. Conclusions: Heating the internal aspect of an implant with a CO2 laser produces different temperature distribution profiles depending on the laser power level and the application interval. Laser-beam irradiation leads to a temperature gradient, which is greatest at the implant apex and smallest at the implant shoulder. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the screw loosening and fracture resistance of different hybrid abutment crown restorations after thermomechanical aging. Materials and Methods: Restorations were produced from zirconia, lithium disilicate, and hybrid ceramics with a CAD/CAM system (n = 10). Restorations and titanium bases (Ti-bases) were cemented, and the abutment screws were torqued to 30 Ncm. They were retorqued after 10 minutes, and then the removal torque values (RTVs) were measured. After 250,000 and 500,000 cycles of thermomechanical aging were completed, the RTVs were measured again, and removal torque loss (RTL) ratios were calculated. The specimens were subjected to a fracture resistance test after 750,000 cycles of thermomechanical aging, and the load at failure was recorded as the fracture resistance (N). The results were statistically analyzed (a = .05). Results: Aging was effective on the RTVs and RTL ratios (P < .001). The highest RTV was observed before aging; however, the RTVs significantly decreased and RTL ratios significantly increased after aging (P < .05). The fracture resistance values significantly differed among the ceramic materials. All lithium disilicate and hybrid ceramic specimens showed restoration fracture and most of the zirconia specimens showed Ti-base-related failure. Conclusions: Hybrid abutment crowns made of zirconia, lithium disilicate, and hybrid ceramics can withstand the average occlusal forces in the molar region; however, the ceramic type may affect the failure type. Retightening of the abutment screws after 10 minutes following the first tightening and annually may be beneficial to prevent the adverse effects of screw loosening on the integrity of the implant-abutment connection. [ABSTRACT FROM AUTHOR]

Following implant placement, a soft tissue barrier will form at the healing abutment connection called peri-implant mucosa. The dimension of this anatomical structure seems to play a key role in maintaining long-term peri-implant and marginal bone level stability. In its early stages, soft tissue healing is a process involving many cellular and molecular events. Enamel matrix derivative (EMD) may improve and accelerate soft tissue wound healing and inflammatory resolution. In the present split-mouth randomized clinical trial, EMD was used to influence the early phase of soft tissue healing around dental implants placed with a single-stage approach into a completely healed ridge. A total of 60 implants were placed in 30 patients (2 implants per patient, one in the test group and one in the control group). In the test sites, EMD was administered around the healing abutment before soft tissues were sutured. Soft tissue healing index (HI) and secondary endpoints (clinical, radiographic, and patientreported outcomes) were measured. Better outcomes were recorded in patients receiving EMD for all parameters. The present results support the use of EMD to improve and accelerate soft tissue wound healing around implants. [ABSTRACT FROM AUTHOR]

Solid solutions of ZryTi1−yS2 (y = 0.1, 0.2) compositions have been synthesized. The electrochemical introduction of lithium is carried out by the galvanostatic intermittent titration technique. An isothermal section of the phase diagram of the LixZryTi1−yS2 system at room temperature has been constructed. The limiting solubility of lithium in solid solutions decreases with an increasing amount of titanium substituted for zirconium. It was noted that at low lithium concentrations (x < 1), there is no change in the E(x) dependence when titanium is replaced by zirconium. This may indicate the formation of separate TiS2 and ZrS2 layers. [ABSTRACT FROM AUTHOR]

This pilot case series histologically and histometrically investigated the influence of implant surface hydrophilicity on early osseointegration and peri-implant bone formation around simultaneously grafted immediate implants. Hydrophilic test (SLAactive) or hydrophobic control (SLA) implants were immediately placed in maxillary molar extraction sites and simultaneously grafted with mineralized cancellous bone allograft (MCBA). Core biopsy samples were obtained at 3 weeks postplacement and histometrically compared for bone-to-implant contact, quantity of graft material, new bone formation, tissue reaction, and inflammatory scores. Test implants showed a more pronounced implant-bone apposition, peri-implant bone formation, and bone aggregate than control implants. Trabecular bone formation and maturation were also qualitatively advanced around test implants. These results indicate that the combination of implant surface and bone graft may affect periimplant bone formation. [ABSTRACT FROM AUTHOR]

Titanium has been proposed as a mesh material for guided bone regeneration (GBR) since the 1990s. To overcome difficulties in shaping and adapting meshes to the defect, digital techniques were introduced to digitally print meshes capable of fitting the bone perfectly, reproduced through the patient's CT scan. Five patients were included in this case series, and their CBCT data were acquired and sent to the producer of the titanium meshes. 3D regenerative surgery was performed with titanium meshes and a mix of demineralized bovine bone matrix (DBBM) and autogenous bone (1:1 ratio). Radiographic measures were evaluated on paraxial sections of the CBCT through a dedicated software. When possible, regenerated bone samples were obtained at implant insertion. Four out of five regenerated areas healed without local or systemic complications. One mesh was removed after 2 months and 2 weeks due to exposure. The mean vertical bone gain was 4.3 ± 1.5 mm (range: 2.5 to 7 mm). Two histologic samples were obtained. In sample 1, bone tissue area and graft material area were 44.4% and 12.5%, respectively; in sample 2, the same parameters were 15.6% and 16.9%, respectively. [ABSTRACT FROM AUTHOR]

Despite the various treatments proposed with barrier membranes, one of the main challenges for guided bone regeneration (GBR) is maintaining space for large defects and ensuring an adequate blood supply. The presented feasibility case series aims to introduce an original titanium frame (TF) design, customized for each defect, as a modification of well-known principles and materials for GBR to achieve an enhanced and more predictable horizontal and vertical bone augmentation. Three patients with significant horizontal defects were treated with pre-trimmed TFs to create needed space, and then a 50/50 mixture of autograft and bovine xenograft was placed and covered with a collagen membrane. After 8 months of healing, the sites were reopened, and the titanium screws were removed with the frame. An average of 8.0 ± 1.0 mm of horizontal and 3.0 ± 0.0 mm of vertical bone gain were achieved at the time of reentry and implant placement surgery. Bone core biopsy sample was obtained during the implant placement. Histomorphometric analysis revealed that 42.8% of the sample was new vital bone, 18.8% was residual bone graft particles, and 38.4% was bone marrow-like structures. After 3 to 4 months from implant placement, the implants were restored with provisional crowns and then finalized with zirconia screw-retained crowns. This case series suggests that GBR utilizing TFs with or without collagen membranes can be considered a suitable approach for horizontal and vertical bone augmentation. However, based on only three reported cases, the results should be carefully interpreted. [ABSTRACT FROM AUTHOR]

In recent years, the exploration of solar absorbers has grown in favor due to the scarcity of energy. Here, we propose an absorber with an array of a circular ring surrounding disk (RSD) for solar energy capture. The novel structure keeps above 93.5% absorption with an average absorption of 96.95% in wavelengths from 300 to 4000 nm. Meanwhile, the proposed absorber is advantageous in that the structure is generalizable to other metals and dielectric materials. Furthermore, the data results show that the absorber has polarization-independent properties as well as maintaining >90% absorption in the considered wavelength range up to an incidence angle of 52° and >95% absorption at large process tolerances. Finally, the excellent absorption under the AM1.5 solar spectrum demonstrates the RSD absorber's ability to capture solar energy. These results show the potential of the absorber for applications in electromagnetic invisibility cloaking, thermal emitters, and solar energy capture and conversion. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of continuous perioperative clopidogrel treatment on the osseointegration of titanium implants. Materials and Methods: A total of 32 New Zealand rabbits were randomly divided between two groups: a clopidogrel group (n = 16) and a control group (n = 16). For 1 week prior to the surgical placement of a titanium implant in their medial femoral condyle, rabbits in the clopidogrel group received 3 mg/kg of clopidogrel daily, and the control group received only the vehicle. This treatment was continued for another 6 weeks postoperatively. At 6 weeks, the rabbits were euthanized and postmortem histologic and histomorphometric evaluation of the implants was performed. Results: The surgical procedures and postoperative period were uneventful and well tolerated by all animals without any surgical wound dehiscence, signs of infection, or other complication. No implant failure was observed in any of the groups. Histomorphometric analysis showed that bone-to-implant contact (BIC) was 48.77% for the clopidogrel group and 34.65% for the control group, with statistically significant difference between them (P < .001). Moreover, clopidogrel group had significantly greater bone tissue density (40.52% vs 28.74%, respectively; P <.001) and mean trabecular thickness (284.7 μm vs 180.7 μm, respectively; P < .001) in proximity to the implant surface than the control group, while the mean trabecular number had no difference between groups (1.56 vs 1.60, respectively; P = .961). Conclusions: The present study showed that continuous clopidogrel treatment does not negatively affect osseointegration, but rather promotes it in terms of BIC and bone density around the titanium implants. Further studies on the effect of the P2Y12 receptor and its antagonists on peri-implant bone homeostasis may provide useful information or applications for long-term success of dental implant therapy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the difference in retention between implant-supported restorations with and without surface modification of the implant abutments. Materials and Methods: A total of 30 patients with singletooth implants were restored with cement-retained (Multilink N, Ivoclar) restorations using titanium base abutments (Variobase, Straumann) and randomly assigned surface modifications. Group 1 used nonmodified abutments, group 2 used sandblasted abutments, and group 3 used sandblasted abutments followed by an application of metal primer. All patients were recalled for a baseline examination 6 months after crown placement. The pull-out strength and intergroup distribution of mean pull-out strength were assessed. To assess differences between the three groups, intergroup statistical comparison of continuous variables was done using one-way ANOVA with Tukey correction for multiple group comparisons. Results: The results of the intergroup mean pull-out strength distribution revealed that the distribution of mean ± SD pull-out strength in group 1, group 2, and group 3 were 220.79 ± 94.23, 488.64 ± 84.12, and 705.46 ± 112.75 Ncm, respectively. Conclusions: Sandblasting followed by the application of metal primer produced the highest retention of porcelain-fused-to-metal (PFM) crowns to titanium base abutments, followed by sandblasting alone, with the least retention being observed with no surface treatment. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the effectiveness of coating of abutments with antimicrobial agents and their influence on the physicochemical and biologic properties of the coated materials. Materials and Methods: This work was registered in Open Science Framework (osf.io/6tkcp) and followed the PRISMA protocols. A search of two independent reviewers of articles published up to October 29, 2021, was performed in the Embase, PubMed, Science Direct, and Scopus databases. Results: The databases found a total of 1,474 references. After excluding the duplicates, 1,050 remained. After reading the titles and abstracts and applying the inclusion criteria, 13 articles remained and were read in full. A total of 8 articles were included in this systematic review. Different antimicrobial agents have been used to coat abutments, including graphene oxide, polydopamine, titanium and zirconium nitride, lactoferrin, tetracycline, silver, and doxycycline with varied release times. Titanium-coated silver showed a better antimicrobial agent release time of up to 28 days. Chemical analysis confirmed the presence of antimicrobials on the surface after coating. Different pathogenic microorganisms, such as Streptococcus sanguinis, Streptococcus oralis, and Staphylococcus aureus, were inhibited when in contact with the coated surface. Conclusions: This review showed that there is still no consensus on which is the better antimicrobial agent and which coated materials have the better performance. However, the association of surface coating of abutments with antimicrobials is feasible and can benefit many patients, which can support their clinical use to favor the healing process and prevent infections that can lead to treatment failure with dental implants. [ABSTRACT FROM AUTHOR]

With the anticipated foliar application of nanoparticles (NPs) as a potential strategy to improve crop production and ameliorate heavy metal toxicity, it is crucial to evaluate the role of NPs in improving the nutrient content of plants under Lead (Pb) stress for achieving higher agriculture productivity to ensure food security. Herein, Brassica napus L. grown under Pb contaminated soil (300 mg/kg) was sprayed with different rates (0, 25, 50, and 100 mg/L) of TiO2 and ZnO-NPs. The plants were evaluated for growth attributes, photosynthetic pigments, leaf exchange attributes, oxidant and antioxidant enzyme activities. The results revealed that 100 mg/L NPs foliar application significantly augmented plant growth, photosynthetic pigments, and leaf gas exchange attributes. Furthermore, 100 mg/L TiO2 and ZnO-NPs application showed a maximum increase in SPAD values (79.1%, 68.9%). NPs foliar application (100 mg/L TiO2 and ZnO-NPs) also substantially reduced malondialdehyde (44.3%, 38.3%), hydrogen peroxide (59.9%, 53.1%), electrolyte leakage (74.8%, 68.3%), and increased peroxidase (93.8%, 89.1%), catalase (91.3%, 84.1%), superoxide dismutase (81.8%, 73.5%) and ascorbate peroxidase (78.5%, 73.7%) thereby reducing Pb accumulation. NPs foliar application (100 mg/L) significantly reduced root Pb (45.7%, 42.3%) and shoot Pb (84.1%, 76.7%) concentration in TiO2 and ZnO-NPs respectively, as compared to control. Importantly, macro and micronutrient analysis showed that foliar application 100 mg/L TiO2 and ZnO-NPs increased shoot zinc (58.4%, 78.7%) iron (79.3%, 89.9%), manganese (62.8%, 68.6%), magnesium (72.1%, 93.7%), calcium (58.2%, 69.9%) and potassium (81.5%, 68.6%) when compared to control without NPs. The same trend was observed for root nutrient concentration. In conclusion, we found that the TiO2 and ZnO-NPs have the greatest efficiency at 100 mg/L concentration to alleviate Pb induced toxicity on growth, photosynthesis, and nutrient content of Brassica napus L. NPs foliar application is a promising strategy to ensure sustainable agriculture and food safety under metal contamination.

An approach for the crystallographic mapping of two-phase alloys on the nanoscale using a combination of scanned precession electron diffraction and open-source python libraries is introduced in this paper. This method is demonstrated using the example of a two-phase α/β titanium alloy. The data were recorded using a direct electron detector to collect the patterns, and recently developed algorithms to perform automated indexing and analyse the crystallography from the results. Very high-quality mapping is achieved at a 3 nm step size. The results show the expected Burgers orientation relationships between the α laths and β matrix, as well as the expected misorientations between α laths. A minor issue was found that one area was affected by 180° ambiguities in indexing occur due to this area being aligned too close to a zone axis of the α with twofold projection symmetry (not present in 3D) in the zero-order Laue Zone, and this should be avoided in data acquisition in the future. Nevertheless, this study demonstrates a good workflow for the analysis of nanocrystalline two- or multi-phase materials, which will be of widespread use in analysing two-phase titanium and other systems and how they evolve as a function of thermomechanical treatments.

Considering the biological activity of osteoblasts is crucial when devising new approaches to enhance the osseointegration of implant surfaces, as their behavior profoundly influences clinical outcomes. An established inverse correlation exists between osteoblast proliferation and their functional differentiation, which constrains the rapid generation of a significant amount of bone. Examining the surface morphology of implants reveals that roughened titanium surfaces facilitate rapid but thin bone formation, whereas smooth, machined surfaces promote greater volumes of bone formation albeit at a slower pace. Consequently, osteoblasts differentiate faster on roughened surfaces but at the expense of proliferation speed. Moreover, the attachment and initial spreading behavior of osteoblasts are notably compromised on microrough surfaces. This review delves into our current understanding and recent advances in nanonodular texturing, meso-scale texturing, and UV photofunctionalization as potential strategies to address the biological dilemma of osteoblast kinetics, aiming to improve the quality and quantity of osseointegration. We discuss how these topographical and physicochemical strategies effectively mitigate and even overcome the dichotomy of osteoblast behavior and the biological challenges posed by microrough surfaces. Indeed, surfaces modified with these strategies exhibit enhanced recruitment, attachment, spread, and proliferation of osteoblasts compared to smooth surfaces, while maintaining or amplifying the inherent advantage of cell differentiation. These technology platforms suggest promising avenues for the development of future implants.

Dental implant therapy, established as standard-of-care nearly three decades ago with the advent of microrough titanium surfaces, revolutionized clinical outcomes through enhanced osseointegration. However, despite this pivotal advancement, challenges persist, including prolonged healing times, restricted clinical indications, plateauing success rates, and a notable incidence of peri-implantitis. This review explores the biological merits and constraints of microrough surfaces and evaluates the current landscape of nanofeatured dental implant surfaces, aiming to illuminate strategies for addressing existing impediments in implant therapy. Currently available nanofeatured dental implants incorporated nano-structures onto their predecessor microrough surfaces. While nanofeature integration into microrough surfaces demonstrates potential for enhancing early-stage osseointegration, it falls short of surpassing its predecessors in terms of osseointegration capacity. This discrepancy may be attributed, in part, to the inherent dichotomy kinetics of osteoblasts, wherein increased surface roughness by nanofeatures enhances osteoblast differentiation but concomitantly impedes cell attachment and proliferation. We also showcase a controllable, hybrid micro-nano titanium model surface and contrast it with commercially-available nanofeatured surfaces. Unlike the commercial nanofeatured surfaces, the controllable micro-nano hybrid surface exhibits superior potential for enhancing both cell differentiation and proliferation. Hence, present nanofeatured dental implants represent an evolutionary step from conventional microrough implants, yet they presently lack transformative capacity to surmount existing limitations. Further research and development endeavors are imperative to devise optimized surfaces rooted in fundamental science, thereby propelling technological progress in the field.

Purpose: The present study describes a new presurgical soft tissue technique in oral/maxillary bone reconstructive surgery for reducing the risk of soft tissue dehiscence and its related complications. Materials and Methods: Ten consecutive patients with Cawood and Howell type V atrophy were scheduled for CAD/CAM titanium mesh bone reconstructive surgery after applying the vascular delay technique 21 days before regenerative surgery. The surgical and healing complications were clinically assessed at nine time points, ranging from the time of bone regenerative surgery to 9 months after surgery. Surgical complications included flap damage and neurologic and vascular complications. Healing complications were subdivided into four classes. These classes comprised Class I: small membrane exposure (= 3 mm) without purulent exudate; Class II: large membrane exposure (> 3 mm) without purulent exudate; Class III: membrane exposure with purulent exudate; and Class IV: abscess formation without membrane. Results: The study sample included seven men and three women (mean age: 48.2 ± 3.5 years) with seven mandibular cases and three maxillary cases. The defect length ranged from three to six teeth, with a mean mesiodistal distance of 29.9 ± 8.5 mm and a mean volume augmentation of 2.03 ± 0.9 cm3. There were no surgical complications. One patient presented a Class I healing complication that did not affect the regeneration outcome. Conclusions: The vascular delay technique appears to reduce the risk of soft tissue dehiscence and exposure in bone regenerative surgery, though randomized studies involving larger samples and longer follow-up periods are needed in order to draw firm conclusions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of supraphysiologic administration of testosterone in an early and late model of implant osseointegration in rat tibiae. Materials and Methods: A total of 40 rats were randomly allocated into four groups (n = 10/group), which were divided according to the type of experiment and time of osseointegration: (1) vehicle (14 days), (2) testosterone (14 days), (3) vehicle (42 days), and (4) testosterone (42 days). Testosterone cypionate (7.5 mg/kg) administration started 4 weeks before implant placement, and the injections were performed daily until euthanasia. Machined-surface titanium implants (2.2 mm in diameter and 4 mm high) were placed bilaterally in the tibia of animals 28 days after the first testosterone injection. At days 14 and 42 after implant placement, euthanasia was performed and the tibiae were harvested to perform biomechanical evaluation and histomorphometric analysis of bone-to-implant contact (BIC%) and bone between the threads (BBT%). Results: There was no statistical difference in the removal torque of the implants between the groups treated with the vehicle (control group) or testosterone (P > .05). At 14 days of osseointegration, the BIC% and BBT% did not differ between vehicle or testosterone groups (P > .05), while at 42 days, both the BIC% and BBT% were significantly reduced by testosterone compared to the vehicle group (P < .05). Conclusions: Testosterone cypionate in supraphysiologic dose impaired late-phase osseointegration in rat tibiae. [ABSTRACT FROM AUTHOR]

High-entropy alloys possess significant potential for material applications in demanding structural components subjected to extreme conditions. Through experimental investigations, we have validated that the CoCrFeNiAl0.1Ti0.05 high-entropy alloy, which was fabricated using a cold rolling and annealing process, exhibits an excellent balance of strength and ductility at 77 K. Specifically, it demonstrates a yield strength of 575 MPa, a tensile strength of 1145 MPa, and a ductility of 55%. This enhanced performance can be attributed to the altered deformation mechanism at low temperatures, leading to the multiplications of stacking faults and twins. Additionally, the introduction of small quantities of aluminum and titanium results in the formation of precipitated phases within the alloy matrix. The synergistic influence of these two factors contributes to the augmentation of cryogenic plasticity in the alloy. [ABSTRACT FROM AUTHOR]

This study evaluated the clinical efficacy of the coronally advanced lingual flap (CALF) technique in terms of the extent of lingual and buccal flap advancement, the maintenance of primary wound closure, and safety in comparison to buccal flap advancement alone during horizontal ridge augmentation in the posterior mandible. A total of 14 patients were randomly allocated to two different groups: buccal flap advancement without the CALF technique (control), referred to as the NO-CALF group, and buccal flap advancement with the CALF technique (test), referred to as the CALF group. Wound healing was monitored weekly for the first 4 weeks, then at 2, 4, 6, and 9 months postoperatively for any sod tissue dehiscence (titanium mesh [TM] exposure) along the incision line. The extent of lingual and buccal flap advancement was measured, and any intraoperative and postoperative CALF-related complications were reported. The difference between groups was statistically significant (P < .0001) in terms of (1) TM exposure: 83.3% of cases in the NO-CALF group showed early Class П exposures, whereas the CALF group showed no exposure; (2) mean lingual flap advancement: 3.9 ± 1.1 mm and 14.4 ± 3.8 mm for the NO-CALF and CALF groups, respectively; and (3) mean buccal flap advancement: 15.8 ± 2.1 mm and 10.5 ± 1.4 mm for the NO-CALF and CALF groups, respectively. There were no reported complications related to the CALF technique. Tension-free primary wound closure was facilitated and maintained during the healing period by applying the CALF technique, which is a reliable technique to safely advance the lingual flap coronally. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the process of early oral osseointegration of titanium (Ti) implants in diabetic 129/Sv mice through microCT and histologic and immunohistochemical analysis. Materials and Methods: A group of 30 male 129/Sv mice was equally subdivided into two groups: (1) nondiabetic (ND), in which mice did not undergo systemic alterations and received a standard diet, and (2) diabetic (D), in which mice were provided a high-fat diet from the age of 6 weeks until the conclusion of the study and received two intraperitoneal (IP) injections of streptozotocin (STZ) at a concentration of 100 mg/Kg each. Each mouse underwent extraction of a maxillary first molar, and customized Ti screws (0.50 mm diameter, 1.5 mm length) were placed in the residual alveolar sockets of the palatal roots. At 7 and 21 days after implant placement, the animals were euthanized for maxilla and pancreas collection. Maxillae containing Ti implants were analyzed with microCT, histology, and immunohistochemistry for cells that were positive for F4/80, CD146, runt-related transcription factor 2 (Runx2), and proliferating cell nuclear antigen (PCNA). Pancreata were histologically analyzed. Quantitative data were statistically analyzed with a significance level at 5% (P < .05). Results: ND mice presented successful healing and osseointegration, with a significantly higher fraction of bone volume compared to D mice, both at the alveolar sockets (53.39 ± 5.93 and 46.08 ± 3.18, respectively) and at the implant sites (68.88 ± 7.07 and 44.40 ± 6.98, respectively) 21 days after implant placement. Histologic evaluation revealed that the ND mice showed a significant decrease in inflammatory infiltrate and a significant increase in newly formed bone matrix at 21 days, whereas peri-implant sites in the D mice were predominantly encapsulated by fibrous tissue and chronic inflammatory infiltrate. Immunohistochemical characterization revealed higher Runx2 osteoblast differentiation and higher cell proliferation activity in the ND mice at 7 days, while higher amounts of macrophages were present in D mice at 7 and 21 days. Interestingly, no differences were found in CD146-positive cells when comparing ND and D mice. Conclusions: This study evaluated the effects of immediate dental implant placement in 129/Sv diabetic mice by using specific healing markers to identify changes in cellular events involved in early oral osseointegration. This approach may serve as tool to evaluate new materials and surface coatings to improve osseointegration in diabetic patients. [ABSTRACT FROM AUTHOR]

In situ temperature-dependent crystal structure of lead-free ferroelectric perovskite Ba0.798Ca0.202Zr0.006Ti0.994O3 single crystal was characterized using x-ray diffraction from 170 to 380 K. Three phases were identified at different temperatures of 170, 220, and 298 K, revealing rhombohedral (R3m), orthorhombic (Pmm2), and tetragonal (P4mm) crystal structures, respectively. The change in the bond length and its distortion are reported for both AO12 and BO6 polyhedrons, allowing for the estimation of the spontaneous polarization. The Debye–Waller factor is reported as a function of temperature for A and B-sites. Density-functional theory calculations on the tetragonal phase were performed to obtain information on the distribution of the Ca ions, the local atomic displacements, and the ideal value of the spontaneous polarization of a defect-free crystal at 0 K. We find that Ca prefers to arrange in columnar 2D plates oriented along the tetragonal axis. The Ca ions avoid being next neighbors of Zr; however, the specific arrangement of Ca has only a minor impact on the spontaneous polarization. [ABSTRACT FROM AUTHOR]

Purpose: To assess the influence of the bonding system and restora5ve material on the marginal integrity and pull-off forces of monolithic all-ceramic crowns bonded to 5tanium base (5-base) abutments. Materials and Methods: A total of 108 5-bases were sandblasted and divided into nine experimental groups (n = 12) according to the combina5on of crown material (polymer-infiltrated ceramic-network [PI], lithium-disilicate [LD], and zirconia [ZI]) and bonding system (Mul5link Hybrid-Abutment [MH], Panavia V5 [PV], RelyX Ul5mate [RU]) with the respec5ve primers. AXer bonding the crowns to the 5-base abutments, the restora5ons were screw-retained on implants and thermomechanically aged (1,200,000 cycles, 49 N, 1.67 Hz, 5 to 55°C). Marginal integrity and bonding failures were evaluated under a light microscope, and pull-off forces (N) were calculated. Chi-square tests for marginal integrity as well as one-way and two-way ANOVA sta5s5cal tests for pull-off forces were applied (α = .05). Results: PI presented higher marginal integrity than LD (P = .023). Bonding system PV revealed higher marginal integrity than MH (P =.005) and RU (P =.029). Differences in pull-off forces were found between restora5ve material and resin cements (P < .001), with the highest values for ZI + RU (598 ± 192 N), PI + PV (545 ± 114 N), LD + MH (532 ± 116 N), and PI + RU (528 ± 81 N). Specimens with marginal integrity revealed higher pull-off forces than those with altera5on (P = .006). Specimens presen5ng bonding failures (micromovements) showed lower pull-off forces than those without bonding failures (P < .001). Conclusions: The tested CAD/CAM materials show favorable bonding performances with different bonding systems, nevertheless for each restora5ve material a specific bonding system has to be recommended. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of ultraviolet-C light (UVC) photofunctionalization treatment time on the biologic activity of airborne particle-abraded and acid-etched (SLA) titanium surfaces and to analyze its physical and chemical mechanisms. Materials and Methods: SLA titanium was treated with UVC light for different lengths of time (10 minutes, 20 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, and 24 hours), and then changes to its surface characteristics were evaluated via electron microscope scanning, X-ray photoelectron spectroscopy (XPS), water contact angle measurement, and zeta potential measurement. The effect of UVC photofunctionalization on the biologic processes of SLA titanium surfaces was assessed by analyzing the bovine serum albumin adsorption, adhesion, proliferation, morphology, and alkaline phosphatase activity of MG-63 cells. Results: UVC irradiation did not change the topography of SLA titanium surfaces. As treatment times increased, the water contact angle decreased from 120 degrees to 0 degrees, and the hydrocarbon content decreased. Zeta potential testing showed increased surface potential of photofunctionalized titanium. In vitro testing showed that cell adhesion, proliferation, morphology, and alkaline phosphate (ALP) activity on titanium surfaces were significantly improved by UVC photofunctionalization. Conclusions: UVC photofunctionalization can improve the biologic activity of SLA titanium surfaces by removing hydrocarbons and increasing the surface potential of titanium. [ABSTRACT FROM AUTHOR]

Purpose: To compare the fit of 3D-printed titanium (Ti) and cobalt-chromium (Co-Cr) abutments with implants to computer numerical control (CNC)-milled, ready-made abutment-implant assemblies. Their clinical applicability was also evaluated by measuring removal torque values (RTVs) and percentage torque loss of abutment screws. Materials and Methods: A total of 138 abutments were included in the study: 92 abutments were fabricated with Ti and Co-Cr alloys using computerassisted design (CAD) through selective laser melting, and 46 ready-made abutments were prepared. The fit of interfaces between 90 abutments from the three groups (30 ready-made, 30 3D-printed Ti, and 30 3D-printed Co-Cr abutments) and implant assemblies was demonstrated by scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). After 30-Ncm torque tightening of Ti abutment screws twice within 10 minutes, the RTVs and percentage torque loss of screws of 48 abutments (16 ready-made, 16 3D-printed Ti, and 16 3D-printed Co-Cr) were evaluated after 10 minutes of thermocycling and cyclic loading. Results: The fits of 3D-printed Co-Cr abutments were not statistically different from those of ready-made abutments (P = .383), while the fit of 3D-printed Ti abutments was inadequate (P < .001). The RTVs of 3D-printed abutments after cyclic loading were significantly decreased compared with those of CNC-milled abutments (P < .001). Conclusion: The fit of interfaces between 3D-printed Co-Cr abutments and implants was adequate. The RTVs of 3D-printed Co-Cr abutments were not significantly different from those of CNC-milled abutments after 10 minutes of 30-Ncm torque tightening and thermocycling. [ABSTRACT FROM AUTHOR]

One of the main limitations to increasing productivity in machining processes is the emergence of self-excited vibrations. In the turning of titanium alloys, due to its mechanical properties, the material presents low machinability and is prone to the appearance of chatter during processing. Therefore, for this purpose, the material is machined using moderate machining parameters, aiming for parts with a better surface finish and avoiding the appearance of chatter. Therefore, this work seeks to evaluate the influence of machining parameters, cutting speed, feed rate, and cutting depth on vibration during the process and on the roughness of the parts. For this, experiments were carried out varying these parameters, and then the influence of each of them was analyzed using the Taguchi method for planning experiments and signal-to-noise for analyzing the variability of the collected data. It was found that the cutting depth and feed have an influence on the vibration during, where the greater the parameter, the greater the RMS of the signal. And the roughness of the parts is influenced by the cutting speed, in which the higher the speed, the lower the roughness of the parts. [ABSTRACT FROM AUTHOR]

Modern Total Hip Arthroplasty (THA) has evolved allowing orthopaedic surgeons for an exact reconstruction of hip biomechanical parameters thanks to modularity. Modular hip replacement represents, in fact, the best way to reconstruct the joint compared to conventional femoral stems. However, the modular implants are not massively used because of the high risk of breakage. One of the most common causes of their failure is the fretting corrosion at the neck-head interface combined with their relative micro-motion. Thus, the neck component undergoes major wear stresses leading to the implant failure. In order to avoid the risk of failure due to the corrosion fretting, it is necessary to improve the contact surfaces. Furthermore, available actual standards provide long testing procedure for verifying the overall modules fatigue performance thus discouraging researchers to search for possible solutions by changing the manufacturing process of the modules. This work presents a viable manufacturing technique for producing high performance neck components, proposing, at the same time, a faster and reliable testing procedure to predict the wear rate and its driving mechanism affecting the module. Thus, Ti6Al4V neck components have been manufactured by means of burnishing process at varying processing conditions which led to different surface characteristics. Different necks have been tested under real conditions for fretting fatigue simulating a walking loading cycle. Relative micromotions, together with information related to wearing path and operating conditions have been extracted online while testing, using the phase-based motion estimation method (PBME). The overall results demonstrate that burnishing process can tremendously improve the performance under service of the neck component and the proposed testing methodology is able to drastically reduce the testing time improving the reliability of the results. [ABSTRACT FROM AUTHOR]

An animal model was applied to develop erosive tooth wear (ETW) and to evaluate the efficacy and safety of titanium tetrafluoride (TiF4) in preventing ETW. Forty-eight male Wistar rats were divided into three groups (n = 16): TiF4 (2.45% F−), NaF (2.45% F−) and placebo varnishes. Eight from each group were subjected to erosive challenges (Sprite Zero) and the other received tap water, both ad libitum. After twenty-eight days, the mandibles were resected for histopathological gingival analysis, clinical and microscopic tooth evaluation by 3D confocal laser microscopy, scanning electron microscopy (SEM-EDX) and micro-Raman spectroscopy (MRS). Organs were evaluated with respect to fluoride content. No significant difference was found in F content in tissues. No histopathological damage was seen in gingiva. ETW was clinically more aggressive in rats from placebo group consuming Sprite compared to water (Q²=12.6, p < 0.01), in accordance with confocal images. TiF4 was superior in reducing cross-section area loss (0.036 ± 0.01µm2) compared to NaF and placebo, respectively (0.044 ± 0.01/0.063 ± 0.01µm2, ANOVA, p < 0.0001). Dentin exposure was detected by SEM in rats belonging to placebo consuming Sprite. Peaks compatible with typical apatite bands were visible. TiF4 reduces the progression of ETW without causing any relevant side-effect and the rats' model was able to simulate ETW in vivo. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Material and Methods Results Conclusion The objective of this study is to investigate the influence of metal artifact reduction (MAR) on two cone beam computed tomography (CBCT) units in the evaluation of bone graft loss adjacent to titanium (Ti) and zirconium (Zr) implants.Twelve Ti and twelve Zr implants were placed in the posterior region of dry human mandibles. Bone graft was applied to the level of the cover screw. Bone graft loss was simulated in half of the sample (6 Ti and 6 Zr) by removing the graft material up to the third implant thread on the buccal surface. CBCT images were acquired on two units, varying the application of MAR (OP300—off and on; Eagle 3D—standard, intermediate, and extreme). The images were assessed by five evaluators that scored the presence of graft loss according to a 5‐point scale. The diagnostic values were calculated and compared by non‐parametric tests with a significance level of 5%.Higher diagnostic values were achieved with MAR activated in the OP300 unit, for Ti and Zr (p < 0.05). On the Eagle 3D unit, MAR in extreme mode resulted in lower diagnostic values for both types of implants (p < 0.05). The diagnostic values of Ti implants were higher than Zr implants (p < 0.05).The application of MAR influences the diagnosis of bone graft loss adjacent to Ti and Zr dental implants. However, the extreme mode of MAR in the Eagle 3D unit can impair the diagnostic task in both types of implants and should be avoided. [ABSTRACT FROM AUTHOR]

Two routes leading to thiosemicarbazone-based complexes are reported with the view of developing ionic titanium complexes as cytotoxic metallodrugs. The reaction of bis(π-η5:σ-η1-pentafulvene)titanium complexes with most thiosemicarbazones gives κ2N,S thiosemicarbazonido complexes via deprotonation of the acidic N–H bond by the pentafulvene ligand. The use of an o-cresyl TSCN revealed a κ2N,O coordination mode by deprotonation of the O–H bond. The protonolysis of the remaining pentafulvene unit in these complexes with Brønsted acids and further functionalization with multiple bond substrates were attempted. The reaction of titanocene(III) triflate with TSCN reveals an unprecedented reactivity and leads to Ti(III) thiosemicarbazone complexes. The Ti(IV) complexes were characterized using NMR experiments and the nitrogen cores were identified via1H,15N HMBC experiments by coupling with the adjacent aldimine proton or the methyl group of the thiosemicarbazone. These are the first structural examples of thiosemicarbazone-based titanium complexes obtained from single-crystal X-ray diffraction. [ABSTRACT FROM AUTHOR]

We reported for the first time the generation of titanium (Ti) nanoparticles (NPs) in different liquids (deionized (DI) water and sodium dodecyl sulfate (SDS) solution) and at a range of temperatures (5 °C, 28 °C, 60 °C, and 80 °C) using continuous-wave high-power laser ablation in liquid (CWLAL). The CWLAL technique is a convenient and cost-effective way to generate NPs. The key outcomes of our investigation are the effects of temperature and the liquid mediums on the average size, generation rate, shape, surface charges, and crystallographic structure of the NPs. Generated NPs show consistent spherical shape regardless of liquid medium changes and temperature variation. SDS solution notably impacts NP size and generation rate with higher surface charges than DI water. For instance, at temperatures of 28 °C and 80 °C, the generation rates in SDS solution are 316 mg/hr and 309 mg/hr, with average NP sizes of 33 nm and 34 nm, respectively. In contrast, the generation rates in DI water are 96 mg/hr and 302 mg/hr, with NP sizes of 13 nm and 20 nm, respectively. The weaker crystallographic structure observed in NPs generated in SDS solution, compared to the more robust crystallographic structure of NPs synthesized in DI water. Liquid temperature plays a significant role in determining surface charges, average particle size, and molecular structure of NPs. The choice of the liquid medium and temperature can be critical for tailoring NP characteristics to specific applications. Ongoing work is being conducted to explore the possibilities of further progress in this area to generate efficient and customized NPs. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion Lamina‐implantation is gradually becoming the main surgical method for the treatment of intraspinal tumors. Traditional titanium (Ti) internal fixation not only produces artifacts, which affects the observation of tumors and dural sac closure, but also faces the problem of secondary surgical removal. In this study, absorbable material were used in lamina replantation for the first time and was evaluated for its efficacy and safety.We retrospectively enrolled patients who underwent short‐segment lamina replantation for intraspinal tumors in our center from February 2020 to November 2022. After condition matching of the number of fixation segment and fixation position, the baseline information, complications, neurological function, quality of life, spinal mobility and bone healing rate of the absorbable group and the Ti group were compared. Fisher exact, Chi‐square, or rank sum test were used for categorical variables, and t‐test was used for continuous variables to distinguish differences between groups.Cerebrospinal fluid leak was the most common complication, with no difference between the two groups (12.9% vs. 19.4%, p = 0.366). The bone healing rates of the two groups at 3 months after surgery were 77.4% and 87.1%, respectively, and there was no significant difference (p = 0.508). At 1 year after surgery, the resorbable group showedlower levels of anxiety/depression (1.20 ± 0.41 vs. 1.61 ± 0.61, p = 0.050), however, it did not affect the overall quality of life of the patients at 1 year.Both titanium and absorbable internal fixation have shown good clinical results in the treatment of intraspinal tumors by laminareplantation. Regardless of cost, absorbable screws and plates are also suitable options for patients undergoing lamina replantation, because it has no stress shielding effect and does not require secondary removal. In addition, there are no artifacts in the image, which is more conducive to observing the recurrence of the tumor and the closure of the dural sac. [ABSTRACT FROM AUTHOR]

Introduction: Clinical recognition of potential immune‐mediated allergic responses to implanted metal devices is increasing. For orthopaedic implants, while 'pure' compounds are used in specific circumstances, the majority of components are alloys – a combination of two or more distinct metals. Titanium is found commonly in many orthopaedic devices and is often championed as a 'hypoallergenic' option or inclusion. In the absence of a relevant previously published summary on the topic, this paper explores the current state‐of‐understanding of titanium allergy and proposes a patient management algorithm whereby such immune reactions are clinically‐suggested. Methods: A structured, systematic literature review was performed following PRISMA search principles to provide a contemporary summary‐of‐understanding in this area and to highlight clinical and knowledge deficiencies. Results: Thirty‐five topic‐related articles were identified, the majority reflecting small case series' or proof‐of‐concept studies. The general standard of scientific evidence available was poor. Justification for arthroplasty utilization of titanium as a 'hypoallergenic' option is largely extrapolated from non‐orthopaedic domains. Conclusions: Both ionic and conjugated titanium particles released from implant surfaces have the potential to trigger innate immune responses and true allergy. There exists no simple, high‐sensitivity, screening test for titanium allergy. Conventional skin‐patch testing is unreliable due to poor dermal penetration. Given established lymphocyte and macrophage activation pathways for allergy responses, in vitro methods using both cell‐types show diagnostic promise. Surgical biopsy analysis from host‐implant interfaces remains the contemporary 'gold‐standard', however this represents an invasive, costly and highly‐specialized approach not readily available in most settings. Further research to establish reliable/accessible diagnostic methods are indicated. [ABSTRACT FROM AUTHOR]

Graphene nanoplates (GNP) have been found to significantly enhance the strength of titanium and its alloys due to their unique structure and physical properties. However, the use of GNP-strengthened titanium matrix composites is often limited by a loss of ductility, which can hinder their practical application. This article categorizes two approaches to regulate ductility loss: controlling the distribution of GNP in the titanium matrix and optimizing the interface between GNP and titanium matrix. The critical factors in both approaches and the problems to be investigated in depth are also summarized by integrating published research results and related fundamental theories. Controlling the distribution of GNP is a challenging task, particularly in achieving a specific distribution that maintains the ductility of the titanium matrix. The boundary values of the preparation process parameters and the design of new methods are crucial in this regard. To regulate the interface, it is essential to control the degree of interfacial reaction and optimize the interfacial structure. This approach can effectively address the problems of ductility and strength imbalance. Finally, this section summarizes the challenges that must be overcome in order to apply graphene-reinforced titanium-based materials in practical settings. [ABSTRACT FROM AUTHOR]

Lithium disilicate (LS) ceramic emerges as a compelling option for customized implant abutments. However, ensuring its safety and reliability requires clarification on key aspects, notably its impact on inflammation and potential for cell adhesion. This study delves into these considerations, examining the influence of LS ceramic on cytokine release and the transcriptional profile of human gingival fibroblasts (hGFs) in direct contact with various LS surfaces. hGFs were cultured on LS disks featuring three distinct surfaces (unpolished, polished, and polished glaze), while titanium disks served as reference material and cells cultured directly on plates as controls. The surface of the disks was analyzed using a scanning electron microscope. The cell metabolism was analyzed by MTT test, cytokine release by MAGPIX and the expression of genes related to cell adhesion was evaluated by qPCR. The disks exhibited similar topography with smooth surfaces, except for the unpolished LS disks, which had an irregular surface. Contact with LS surfaces did not substantially reduce cell metabolism. Moreover, it generally decreased cytokine release compared to controls, particularly pro-inflammatory mediators like IL-1β, IL-6, and TNF-α. Significantly increased expression of genes related to cell adhesion to LS was observed, comparable to titanium, the gold standard material for implant abutments. Significance: This study unveils that LS ceramic not only fails to trigger pro-inflammatory cytokine release, but also significantly enhances gene expression associated with cell adhesion. These mechanisms are closely linked to gene pathways such as PTK2 , SRC , MAPK1 , and transcription factors ELK-1 and MYC. In summary, the findings underscore LS ceramic's potential as a biocompatible material for implant abutments, shedding light on its favorable inflammatory response and enhanced cell adhesion properties. [ABSTRACT FROM AUTHOR]

New materials have emerged in the dental field to replace the cobalt-chrome (CoCr) alloy used for the metal frameworks in removable partial denture (RPD) such as Titanium (Ti) and PolyEtherEtherKetone (PEEK). However, few studies have demonstrated their mechanical and biological performance. The purpose of this systematic review was to compare the performance of Ti and PEEK in RPD using CoCr metal framework as a reference. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three data bases were analyzed, including PubMed/MEDLINE, Embase and Web of Science before March 2024. Only studies assessing the mechanical and/or biological properties of RPD in Ti, PEEK and CoCr were included. The quality of the studies was assessed by using the software Rayyan. The risks of bias were assessed with the methodological index for nonrandomized studies (MINORS). The mechanical (retention force, fatigue life, deformation strength, machinability, rigidity, porosity and surface roughness) and biological (plaque indices, ion release and biocompatibility) aspects were assessed. Among 138 articles identified, only 18 studies were included in this review. Majority had a low to moderate risk of bias. Retention forces and fatigue were significantly lower for Ti and PEEK than for CoCr, and the same was true for Ti rigidity. PEEK showed less deformation. Both materials were suitable for machining. In terms of biological properties, both materials showed adequate biocompatibility for clinical use. Ti and PEEK seems to be promising as alternative materials to CoCr frameworks for RPD, in terms of both their mechanical and biological performance. However, additional studies are needed to better understand their clinical and long-term limitations to enable the best-informed clinical choice for the patients and the professionals. [ABSTRACT FROM AUTHOR]

The process of osteointegration depends significantly on the surface roughness, structure, chemical composition, and mechanical characteristics of the coating. In this regard, an important direction in the development of medical materials is the development of new techniques of surface modification and the creation of bioactive ceramic coatings. Calcium-phosphate materials based on hydroxyapatite have been proposed as bioactive ceramic coatings on titanium implants for the effective acceleration of bone tissue healing. To obtain bioactive ceramic coatings, pulse power sources are best suited, namely detonation spraying, in which the energy of the explosion of gas mixtures is used as a source of pulse action. The pulse mode of operation in the detonation spraying method is preferable for the formation of bioactive ceramic coatings. It provides a high velocity of hydroxyapatite particles, which promotes their effective fixation on the titanium substrate, while minimizing the heating of the material. This approach preserves the substrate structure and improves the coating adhesion. Four different types of coatings with varying O2/C2H2 molar ratios, ranging from 2.6 to 3.7, were obtained using detonation spraying. Powders and obtained coatings of hydroxyapatite were studied by Raman spectroscopy and XRD structural analysis. The results of XRD phase analysis showed the partial conversion of the hydroxyapatite phase to the α-tricalcium phosphate (α-TCP) phase during the detonation spraying process. The results obtained by Raman spectroscopy indicate that hydroxyapatite is the main phase in coatings. All hydroxyapatite-based coatings exhibited hydrophobic properties, which was confirmed by contact-angle values above 90° in wettability tests, characteristic of hydrophobic surfaces. The adhesive strength of the coatings was measured by the scratch test method. Tribological tests were conducted using the ball-on-disk method under both dry conditions and in Ringer's solution. This approach enabled the evaluation of wear resistance and friction coefficient of the coatings in different environments, simulating both lubrication-free conditions and those resembling physiological environments. [ABSTRACT FROM AUTHOR]

This study investigated the low-velocity impact response of titanium-based carbon-fibre/epoxy laminate (TI-CF FML). A comprehensive experimental study was carried out with impact energies ranging from 16.9 J to 91.9 J. Finite element analysis, performed using ABAQUS, was employed to elucidate the failure mechanisms of the laminate. Three distinct damage modes were identified based on the impact energy levels. The energy absorption characteristics of the TI-CF FML were analysed, revealing that maximum energy absorption is achieved and remains constant after penetration occurs. The relationship between impact force and displacement was also explored, showing that the laminate can withstand a peak force of 13.1 kN. The research on the impact resistance, damage mechanisms and energy absorption capacity of TI-CF FML provides an in-depth understanding of the impact behaviour of the laminate and its suitability for various industrial applications. [ABSTRACT FROM AUTHOR]

Legislative framework addresses the issues of alloy corrosion, demanding the restricted use of probable carcinogenic, mutagenic, and toxic-for-human-reproduction (CMG) metals like nickel, cobalt, and chromium and demanding the development of new biomaterials. The aim of this research was to evaluate and compare the ion release of standard dental alloys and their hypoallergenic equivalents. Six types of orthodontic alloy wires (nickel–titanium (NiTi), coated NiTi, stainless steel (SS), Ni-free SS, and cobalt–chromium (CoCr) and titanium–molybdenum (TMA) were immersed into artificial saliva of pH 5.5 and 6.6. Release of metal ions was measured by inductively coupled plasma–mass spectrometry after 3, 7, 14 and 28 days. The data were analyzed using analysis of variance, and results with p < 0.05 were considered significant. NiTi released more Ti and Ni ions compared to the coated NiTi; SS released more iron, chromium, and nickel compared to the nickel-free SS. CoCr released cobalt in a high concentration and low amounts of chromium, nickel, and molybdenum compared to the molybdenum and titanium released by TMA. Release of metals from dental orthodontic alloys in vitro was overall lower at pH 6.6 and for the hypoallergenic equivalents when compared to standard dental alloys. [ABSTRACT FROM AUTHOR]

This study investigates the effects of natural inhibitors (pomegranate, algae, and tomato extracts) on the corrosion resistance of titanium (grade 2). To deepen understanding the inhibition mechanism, Molecular Dynamic (MD) and Monte Carlo (MC) simulations were employed to analyze adsorption behaviors and identify optimal adsorption sites on titanium oxide (TiO2) surfaces for compounds within the inhibitors. Results indicate non-flat adsorption orientations, with pomegranate peel extract components showing superior inhibition capabilities, attributed to the formation of strong O-H chemical bonds with the TiO2 surface. In the experimental part of the study Electrochemical Impedance Spectroscopy (EIS) and Potentiodynamic Polarization (PDP) were conducted. Two electrolytes were tested: a solution 3.5% NaCl and a solution 0.5 M NaOH. All the tests were performed with 5% of inhibitor and with the reference solution. Also, inhibition efficiency was calculated on the base of PDP tests. The study found that pomegranate extract can act as a good corrosion inhibitor for titanium alloy in aqueous solutions 0.5 M NaOH. This was demonstrated by the increase in the corrosion potential and impedance modulus and decrease in the corrosion current density after the addition of pomegranate extract to the solution. However, in a 3.5% NaCl solution, the efficacy of pomegranate extract was less pronounced, probably due to the high aggressivity of the electrolyte. Tomato and algae extract have instead shown very low inhibition effects in all the tested conditions. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of titanium locking plate combined with suture anchor (SA) repair in the treatment of ankle fractures (AF). Methods: Retrospective analysis of clinical data of 170 patients with AF who underwent surgical treatment at the Department of Traumatology and Orthopedics of Wuhan Fourth Hospital, China from May 2020 to June 2023 was conducted. A total of 83 patients underwent conventional open reduction and internal fixation (control group); 87 patients received titanium locking plates combined with SA repair (observation group). Ankle joint functional recovery (measured using the Mazur Ankle Grading Scale), quality of life (measured using the Generic Quality of Life Inventory-74), and incidence of complications were compared between two groups. Active range of motion and muscle strength of the ankle joint in plantar flexion and dorsiflexion states, and medial clear space and talar tilt angle were also analyzed. Results: The rate of excellent recovery of ankle joint function in the observation group was significantly higher than that in the control group (P<0.05). Six months after surgery, active range of motion and muscle strength of the ankle joints in the plantar flexion and dorsiflexion states in the observation group was significantly higher than that in the control group (P<0.05). The medial clear space and talar tilt angle of the observation group was significantly smaller compared to the control group (P<0.05). The quality of life in the observation group was significantly higher than that in the control group, and the incidence of complications in the observation group was significantly lower than that in the control group (P<0.05). Conclusions: Titanium locking plates combined with SA repair for the treatment of AF can significantly improve ankle joint functional recovery, improve the quality of life of patients, and is associated with a lower incidence of complications. [ABSTRACT FROM AUTHOR]

Pure titanium due to its high corrosion resistance, low stiffness and good mechanical properties is commonly used in medicine for orthopaedic applications. However, its material properties (especially in the case of α -titanium) require a further enhancement to fulfil its role. The thermoplastic deformation in mid-temperature is proposed as a method for microstructure improvement. Titanium samples were compressed in different temperatures and strain rates to determine the best conditions for grain fragmentation—the main factor responsible for strength and hardness increase. The thermoplastic stress–strain curves were registered. Then microstructure observations and electron backscatter analysis were performed on the chosen samples. Finally, mechanical response of the previously deformed material was obtained in room temperature compression tests. A significant grain fragmentation was recorded for the material deformed in 400 ∘ C , at 0.1/s and 1/s strain rates. Desirable results were also noticed for the deformation performed at 500–600 ∘ C . However, high temperatures (700–800 ∘ C ) and strain rates (10/s) resulted in dynamic recrystallization, causing undesirable grain growth. An increase in hardness was observed in all cases, with higher values recorded in lower deformation temperatures. Room temperature compression tests revealed slight increase of ductility. [ABSTRACT FROM AUTHOR]

Introduction: In this study, the effects of adding titanium dioxide nanotubes (TiO2) to 3D‐printed denture base resin on the mechanical and physical properties of denture bases were examined for the first time. Methods: The specimens were digitally created using 3D builder software from Microsoft Corporation through computer‐aided design. In accordance with the test specifications for transverse strength, impact strength, hardness, surface roughness, and color stability, specimens were designed and printed with certain dimensions following relevant standards. TiO2 nanotubes (diameter: 15–30 nm and length: 2–3 μm) were added to the 3D‐printed denture base resin (DentaBase, Asiga, Australia) at 1.0% and 1.5% by weight. Flexural strength, impact strength (Charpy impact), hardness, surface roughness, and color stability were evaluated, and the collected data were analyzed with ANOVA followed by Tukey's post hoc test (α = 0.05). Field emission scanning electron microscopy (FESEM) and energy dispersive x‐ray spectroscopy (EDX) mapping were used to evaluate the dispersion of the nanotubes. Results: Compared with those of the control group (0.0 wt.% TiO2 nanotubes), the average flexural, impact, and hardness values of the 1.0 and 1.5 wt.% TiO2 nanotube reinforcement groups increased significantly. Both nanocomposite groups showed significant color changes compared to that of the pure resin, and there was a considerable reduction in the surface roughness of the nanocomposites compared to that of the control group. Conclusion: Adding TiO2 nanotubes to 3D‐printed denture base materials at 1.0 and 1.5 wt.% could enhance the mechanical and physical properties of the material, leading to better clinical performance. Clinical Significance: In terms of clinical applications, 3D‐printed denture base material has been shown to be a viable substitute for traditional heat‐cured materials. By combining this with nanotechnology, existing dentures could be significantly enhanced, promoting extended service life and patient satisfaction while addressing the shortcomings of the current standard materials. [ABSTRACT FROM AUTHOR]