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Background: Applying multifunctional coatings employing strontium (Sr) ions on titanium (Ti) surfaces is a useful and biocompatible method to improve osseointegration and prevent tissue infections through antimicrobial activity. Nonetheless, the effectiveness of Sr coating on the adhesion and viability of human gingival fibroblasts (HGFs) to Ti surfaces remains unclear. Purpose: The study aimed to evaluate the effect of Sr coating on the adhesion and viability of HGFs to Ti surfaces. Materials and Methods: The Ti wafers were divided into two groups based on Sr coating: uncoated Ti (control) and Sr-coated Ti. The Magnetron sputtering technique was used for Sr coating on Ti surfaces. The HGFs were seeded onto the surfaces and cultured for 48 and 96 hours before the cell adhesion and viability of the attached HGFs were assessed. The adhesion of HGFs was analyzed using the attached cell numbers at 48 h and 96 h, and the morphology at 24 h and 72 h. The cytotoxic effect on HGFs was assessed after 24 and 72 hours of incubation using cell viability assay. Student's t-test was used for statistical analysis. Results: The number of cells attached to Sr-coated surfaces was significantly greater than those attached to uncoated Ti surfaces after 48 hours (P< 0.0001) and 96 hours (P=0.0002). Sr-coated and uncoated Ti surfaces were not cytotoxic to HGFs, with the cell viability ranging from 92% to 105% of the untreated control HGFs. There were no significant differences in cell viability between Sr-coated and uncoated Ti surfaces at 24 hours (P=0.3675) and 72 hours (P=0.0982). Conclusion: Sr-coated Ti surfaces induce adhesion of HGFs compared to uncoated Ti surfaces. Further, Sr-coated and uncoated Ti surfaces show no cytotoxic effect on the attached HGFs. [ABSTRACT FROM AUTHOR]

This in vitro study assessed the efficacy of a solution containing 33% trichloroacetic acid (CCl3COOH; TCA) and hydrogen peroxide (H2O2) in decontaminating machined (MAC) and sand-blasted acid-etched (SBAE) titanium surfaces. A total of 80 titanium disks were prepared (40 MAC and 40 SBAE). Streptococcus sanguinis and Enterococcus faecalis strains were incubated on 36 samples, while the remaining 44 were kept as controls. Roughness analysis and scanning electron microscopy were used to evaluate the surface features before and after TCAH2O2 treatment. The viability of human adipose-derived mesenchymal stem cells (ASCs) after TCAH2O2 decontamination was assessed with a chemiluminescent assay along with cell morphology through fluorescent staining. TCAH2O2 preserved the surface topography of MAC and SBAE specimens. It also effectively eradicated bacteria on both types of specimens without altering the surface roughness (p > 0.05). Also, no significant differences in protein adsorption between the pristine and TCAH2O2-treated surfaces were found (p = 0.71 and p = 0.94). While ASC proliferation remained unchanged on MAC surfaces, a decrease was observed on the decontaminated SBAE specimens at 24 and 48 h (p < 0.05), with no difference at 72 h (p > 0.05). Cell morphology showed no significant changes after 72 h on both surface types even after decontamination. This study suggests TCAH2O2 as a promising decontamination agent for titanium surfaces, with potential implications for peri-implant health and treatment outcomes. [ABSTRACT FROM AUTHOR]

Objectives: The present study aimed to evaluate the potential of the salivary pellicle (SP) formed on titanium (Ti) surfaces to modulate the formation of a biofilm composed of Streptococcus gordonii, Actinomyces naeslundii, Fusobacterium nucleatum, and Porphyromonas gingivalis. Materials and methods: Ti substrates were incubated for 2 h with a pool of saliva samples obtained from 10 systemically and periodontally healthy subjects. Enamel substrates were included as a biological reference. Scanning electron microscopy (SEM) and Raman spectroscopy analysis were used to analyze the formation of the salivary pellicle. After the SP formation, the surfaces were incubated for 12 h with a mix of Streptococcus gordonii, Actinomyces naeslundii, Fusobacterium nucleatum, and Porphyromonas gingivalis. The number of bacterial cells attached to each surface was determined by the XTT assay while bacterial viability was analyzed by fluorescence microscopy using the LIVE/DEAD® BacLightTM kit. Results: The SEM and Raman spectroscopy analysis confirmed the presence of a salivary pellicle formed on the tested surfaces. Regarding the biofilm formation, the presence of the SP decreases the number of the bacterial cells detected in the test surfaces, compared with the uncover substrates. Even more, the SP-covered substrates showed similar bacterial counts in both Ti and enamel surfaces, meaning that the physicochemical differences of the substrates were less determinant than the presence of the SP. While on the SP-uncover substrates, differences in the bacterial adhesion patterns were directly related to the physicochemical nature of the substrates. Conclusions: The salivary pellicle was the main modulator in the development of the biofilm consisting of representative oral bacteria on the Ti substrates. Clinical relevance: The results of this study provide valuable information on the modulatory effect of the salivary pellicle on biofilm formation; such information allows us to understand better the events involved in the formation of oral biofilms on Ti dental implants. [ABSTRACT FROM AUTHOR]

This in vitro study assessed the efficacy of a solution containing 33% trichloroacetic acid (CCl3COOH; TCA) and hydrogen peroxide (H2O2) in decontaminating machined (MAC) and sand-blasted acid-etched (SBAE) titanium surfaces. A total of 80 titanium disks were prepared (40 MAC and 40 SBAE). Streptococcus sanguinis and Enterococcus faecalis strains were incubated on 36 samples, while the remaining 44 were kept as controls. Roughness analysis and scanning electron microscopy were used to evaluate the surface features before and after TCAH2O2 treatment. The viability of human adipose-derived mesenchymal stem cells (ASCs) after TCAH2O2 decontamination was assessed with a chemiluminescent assay along with cell morphology through fluorescent staining. TCAH2O2 preserved the surface topography of MAC and SBAE specimens. It also effectively eradicated bacteria on both types of specimens without altering the surface roughness (p > 0.05). Also, no significant differences in protein adsorption between the pristine and TCAH2O2-treated surfaces were found (p = 0.71 and p = 0.94). While ASC proliferation remained unchanged on MAC surfaces, a decrease was observed on the decontaminated SBAE specimens at 24 and 48 h (p < 0.05), with no difference at 72 h (p > 0.05). Cell morphology showed no significant changes after 72 h on both surface types even after decontamination. This study suggests TCAH2O2 as a promising decontamination agent for titanium surfaces, with potential implications for peri-implant health and treatment outcomes.

Featured Application: This study provides information about the effects of laser irradiation provided against peri-implant infection on titanium and supports the best choice of having lesser titanium implant damage. Over the past 10 years, the number of dental implants has grown significantly. This increase has consequently led to an elevation of the statistics related to cases of peri-implantitis. Laser therapy has conquered a place among the therapies of excellence to treat peri-implantitis. However, the laser device used could influence the therapy's success. The aim of this comparative experimental work was to highlight the differences in the work on grade 4 titanium surfaces of the most commonly used laser lights in this field, taking into consideration any structural damage that lasers could cause to implant surfaces. The lasers examined were a 980 nm diode laser; a 1064 nm Nd:YAG laser; and a new generation of 1064 nm Nd:YAG Q-switch nano pulsed laser. We evaluated the titanium temperature increase, the pre- and post-treatment two-dimensional surface appearance observed under the scanning electron microscope; finally, the three-dimensional pre- and post-treatment topographic analysis was assessed using atomic force microscopy. We showed that the 1064-nm Q-switch Nd:YAG nanosecond pulsed laser appears to be more suitable for the preservation of implant morphology because of the absence of the induction of metal damage. [ABSTRACT FROM AUTHOR]

Abstract Background Transdermal osseointegrated prosthesis have relatively high infection rates leading to implant revision or failure. A principle cause for this complication is the absence of a durable impervious biomechanical seal at the interface of the hard structure (implant) and adjacent soft tissues. This study explores the possibility of recapitulating an analogous cellular musculoskeletal-connective tissue interface, which is present at naturally occurring integumentary tissues where a hard structure exits the skin, such as the nail bed, hoof, and tooth. Methods Porcine mesenchymal stromal cells (pMSCs) were derived from nine different porcine integumentary and connective tissues: hoof-associated superficial flexor tendon, molar-associated periodontal ligament, Achilles tendon, adipose tissue and skin dermis from the hind limb and abdominal regions, bone marrow and muscle. For all nine pMSCs, the phenotype, multi-lineage differentiation potential and their adhesiveness to clinical grade titanium was characterized. Transcriptomic analysis of 11 common genes encoding cytoskeletal proteins VIM (Vimentin), cell–cell and cell–matrix adhesion genes (Vinculin, Integrin β1, Integrin β2, CD9, CD151), and for ECM genes (Collagen-1a1, Collagen-4a1, Fibronectin, Laminin-α5, Contactin-3) in early passaged cells was performed using qRT-PCR. Results All tissue-derived pMSCs were characterized as mesenchymal origin by adherence to plastic, expression of cell surface markers including CD29, CD44, CD90, and CD105, and lack of hematopoietic (CD11b) and endothelial (CD31) markers. All pMSCs differentiated into osteoblasts, adipocytes and chondrocytes, albeit at varying degrees, under specific culture conditions. Among the eleven adhesion genes evaluated, the cytoskeletal intermediate filament vimentin was found highly expressed in pMSC isolated from all tissues, followed by genes for the extracellular matrix proteins Fibronectin and Collagen-1a1. Expression of Vimentin was the highest in Achilles tendon, while Fibronectin and Col1agen-1a1 were highest in molar and hoof-associated superficial flexor tendon bone marrow, respectively. Achilles tendon ranked the highest in both multilineage differentiation and adhesion assessments to titanium metal. Conclusions These findings support further preclinical research of these tissue specific-derived MSCs in vivo in a transdermal osseointegration implant model.

Purpose: This study aimed to investigate the effects of titanium surface topography and simvastatin on growth and osteogenic differentiation of human bone marrow stromal cells (hBMSCs) in estrogen-deprived (ED) cell culture. Materials and Methods: Human BMSCs were seeded on cell culture plates, smooth-surface titanium (Ti) disks, and sandblasted with large grits and acid etched (SLA)–surface Ti disks; and subsequently cultured in regular (fetal bovine serum [FBS]), ED, and ED-with 100 nM simvastatin (ED-SIM) culture media for 14 to 21 days. Live/dead cell staining, scanning electron microscope examination, and cell viability assay were performed to determine cell attachment, morphology, and growth. Expression levels of osteoblast-associated genes, Runx2 and bone sialoprotein and levels of alkaline phosphatase (ALP) activity, calcium content, and osteocalcin in culture media were measured to determine osteoblastic differentiation. Expression levels of bone morphogenetic protein-2 (BMP-2) were investigated to examine stimulating effects of simvastatin (n = 4 to 5, mean ± SD). In vitro mineralization was verified by calcein staining. Results: Human BMSCs exhibited different attachment and shapes on smooth and SLA titanium surfaces. Estrogen-deprived cell culture decreased cell attachment and growth, particularly on the SLA titanium surface, but cells were able to grow to reach confluence on day 21 in the ED-osteogenic (OS) culture medium. Promoting effects of the SLA titanium surface in ED-OS were significantly decreased. Simvastatin significantly increased osteogenic differentiation of human BMSCs on the SLA titanium surface in the ED-OS medium, and the promoting effects of simvastatin corresponded with the increasing of BMP-2 gene expression on the SLA titanium surface in ED-OS-SIM culture medium. Conclusion: The ED cell culture model provided a well-defined platform for investigating the effects of hormones and growth factors on cells and titanium surface interaction. Titanium, the SLA surface, and simvastatin synergistically promoted osteoblastic differentiation of hBMSCs in ED condition and might be useful to promote osteointegration in osteoporotic bone. [ABSTRACT FROM AUTHOR]

Background: Transdermal osseointegrated prosthesis have relatively high infection rates leading to implant revision or failure. A principle cause for this complication is the absence of a durable impervious biomechanical seal at the interface of the hard structure (implant) and adjacent soft tissues. This study explores the possibility of recapitulating an analogous cellular musculoskeletal-connective tissue interface, which is present at naturally occurring integumentary tissues where a hard structure exits the skin, such as the nail bed, hoof, and tooth. Methods: Porcine mesenchymal stromal cells (pMSCs) were derived from nine different porcine integumentary and connective tissues: hoof-associated superficial flexor tendon, molar-associated periodontal ligament, Achilles tendon, adipose tissue and skin dermis from the hind limb and abdominal regions, bone marrow and muscle. For all nine pMSCs, the phenotype, multi-lineage differentiation potential and their adhesiveness to clinical grade titanium was characterized. Transcriptomic analysis of 11 common genes encoding cytoskeletal proteins VIM (Vimentin), cell–cell and cell–matrix adhesion genes (Vinculin, Integrin β1, Integrin β2, CD9, CD151), and for ECM genes (Collagen-1a1, Collagen-4a1, Fibronectin, Laminin-α5, Contactin-3) in early passaged cells was performed using qRT-PCR. Results: All tissue-derived pMSCs were characterized as mesenchymal origin by adherence to plastic, expression of cell surface markers including CD29, CD44, CD90, and CD105, and lack of hematopoietic (CD11b) and endothelial (CD31) markers. All pMSCs differentiated into osteoblasts, adipocytes and chondrocytes, albeit at varying degrees, under specific culture conditions. Among the eleven adhesion genes evaluated, the cytoskeletal intermediate filament vimentin was found highly expressed in pMSC isolated from all tissues, followed by genes for the extracellular matrix proteins Fibronectin and Collagen-1a1. Expression of Vimentin was the highest in Achilles tendon, while Fibronectin and Col1agen-1a1 were highest in molar and hoof-associated superficial flexor tendon bone marrow, respectively. Achilles tendon ranked the highest in both multilineage differentiation and adhesion assessments to titanium metal. Conclusions: These findings support further preclinical research of these tissue specific-derived MSCs in vivo in a transdermal osseointegration implant model. [ABSTRACT FROM AUTHOR]

Over the past 10 years, the number of dental implants has grown significantly. This increase has consequently led to an elevation of the statistics related to cases of peri-implantitis. Laser therapy has conquered a place among the therapies of excellence to treat peri-implantitis. However, the laser device used could influence the therapy’s success. The aim of this comparative experimental work was to highlight the differences in the work on grade 4 titanium surfaces of the most commonly used laser lights in this field, taking into consideration any structural damage that lasers could cause to implant surfaces. The lasers examined were a 980 nm diode laser; a 1064 nm Nd:YAG laser; and a new generation of 1064 nm Nd:YAG Q-switch nano pulsed laser. We evaluated the titanium temperature increase, the pre- and post-treatment two-dimensional surface appearance observed under the scanning electron microscope; finally, the three-dimensional pre- and post-treatment topographic analysis was assessed using atomic force microscopy. We showed that the 1064-nm Q-switch Nd:YAG nanosecond pulsed laser appears to be more suitable for the preservation of implant morphology because of the absence of the induction of metal damage.

Aim: Cold atmospheric plasma (CAP) is frequently used for the sterilization of biomaterials in the field of dentistry. The aim of this narrative review is to present the role of CAP in the control of biofilms on titanium surfaces. Materials and Methods: The PubMed, Scopus, and WOS databases were searched to identify scientific articles published between 2010 and 2020, with the keywords "biofilm," "cold atmospheric temperature," and "titanium," using the logical operators AND and OR. Results: We found 8 articles in PubMed, 11 in Scopus, and 10 in WOS, including review articles and original studies, among others. All the articles were selected by two independent reviewers according to the eligibility criteria. Conclusions: Despite the restrictions of this review, CAP seems to have an effect on titanium surfaces in the oral area. Studies have shown that bacterial biofilms become inactive after 3 min of plasma treatment. [ABSTRACT FROM AUTHOR]

Titanium surface modification is critical for dental implant success. Our aim was to determine surfaces influence on dental pulp stem cells (DPSCs) viability and differentiation. Implants were divided into sandblasted/acid-etched (control) and sandblasted/acid-etched coated with calcium and magnesium ions (CaMg), supplied as composite (test). Proliferation was evaluated by MTT, differentiation checking osteoblastic gene expression, PGE2 secretion and matrix formation, inflammation by Interleukin 6 (IL-6) detection. MTT and IL-6 do not modify on test. A PGE2 increase on test is recorded. BMP2 is higher on test at early experimental points, Osterix and RUNX2 augment later. Alizarin-red S reveals higher matrix production on test. These results suggest that test surface is more osteoinductive, representing a start point for in vivo studies aiming at the construction of more biocompatible dental implants, whose integration and clinical performance are improved and some undesired effects, such as implant stability loss and further surgical procedures, are reduced. [ABSTRACT FROM AUTHOR]

Objectives This split-mouth study evaluated mi RNA expression of tissues around implants with different surface treatments. Material and methods Each patient of the sample (five men and five women) received two implants (one control and one test) into an edentulous quadrant to support fixed partial dentures. The control implants (Osseotite) had a dual acid-etched ( DAE) surface in the apical portion and a machined coronal part, test implants (Full Osseotite, FOSS) were completely DAE. Machined healing abutments were placed on control implants and DAE abutments on test ones. All implants were assigned codes for blinding. Standardized periapical radiographs were taken at baseline, 2 and 6 months, and 1 year after surgery. Plaque index ( PI), bleeding on probing ( BOP), and probing depth ( PD) were recorded at 3 and 6 weeks, and 2, 3, 6, and 12 months post-implant placement. After 3 months, a mini-invasive sample of soft tissue was collected from seven patients (four women and three men) for miRNA microarray analysis. Results Control implants showed greater bone resorption (BR) and lower PI: this was not statistically significant. No statistically significant differences in BOP and PD appeared. mi RNA modulated by implant surfaces as well as by other clinical conditions has been identified. mi RNA microarray analysis revealed that: (i) implant sites with low PI and absence of BOP had a mi RNA expression profile similar to those with plaque and absence of BOP; sites with high PI and high BOP had a different profile. (ii) Implant sites with BOP presented similar profiles independently from implant surface. (iii) Implant sites with high PI and normal BR differed from others for mi RNA expression profile. (iv) Implant sites with normal BR despite high BOP differed from others. This profile resembled that of FOSS implants. (v) Implant surface affected BR; groups having similar BR clusterized differently according to the implant type. Conclusions DAE surfaces induced lower BR and more plaque accumulation: This did not affect the health of soft tissues. mi RNA analysis indicated that soft tissue inflammation is more related to gene expression profile than to plaque or to implant surface. Specific mi RNA profile can protect implant sites from bleeding and BR irrespective of plaque accumulation. [ABSTRACT FROM AUTHOR]

Background A number of studies revealed beneficial effects of low-level laser therapy ( LLLT) regarding cell proliferation and differentiation. Aim To investigate the effect of Nd: YAG (1.064 nm) laser radiation in the proliferation and differentiation potential of MG-63 osteoblast-like cells. Additionally, the effects of the surface configurations were to be evaluated. Material and methods MG-63 osteoblast cells were cultured on different surfaces: plastic tissue culture, smooth (polished) titanium- PT and rough titanium- SLA. The effects of both titanium surfaces and low-level laser therapy ( LLLT) on cell adhesion were evaluated by the gene expression of molecules involved in cell proliferation and differentiation. In addition, scanning electron microscopy ( SEM) and MTT proliferation assays were used to examine cell morphology and proliferation, respectively. Results Compared to smooth ( PT) surfaces, SLA surfaces favoured MG-63 cell differentiation. Following the application of Nd: YAG laser irradiation, cells yielded statistically significantly improved differentiation on both smooth and SLA surfaces compared with non-irradiated surfaces. Conclusions The findings of this present study suggest that both surface morphology and Nd: YAG laser irradiation influence the proliferation and differentiation potential of MG-63 cells. [ABSTRACT FROM AUTHOR]

Prevalence of bacterial species involved in biomineralization of manganese on titanium (Ti) surfaces in marine environment was revealed in this research work. This study involves one year sea water exposure of Ti and their periodical biofilm characterization was carried out to quantify the manganese oxidizing bacterial (MOB) presence in the biofilm formed on titanium surfaces. The total viable count study of Ti coupons exposed to sea water for one year resulted in 60% of the MOB in overall biofilm population. The biochemical characterization of MOB isolates were performed for the genus level identification of the seven bacterial isolates. Further, the seven strains were subjected to 16S rRNA gene sequencing. Evolutionary analysis was performed using MEGA 7 to obtain closely related strains within the groups. The manganese oxidizing ability of the bacterial isolates were determined with Leucoberbelin Blue Assay (LBB) and Atomic Absorption Spectroscopy studies (AAS). The results show that among the isolated marine MOB species, Bacillus sp. and Leptothrix sp. have the maximum Mn oxidizing property. The microtitre plate assay was performed to determine the biofilm forming ability of the isolated marine MOB species. All the results have confirmed the prevalence of Bacillus sp. among the biofilm colonizers on Ti surfaces when exposed in sea water. [ABSTRACT FROM AUTHOR]

• Ti implant surfaces allow the adsorption of salivary proteins. • Protein adsorption is less sensitive to physico-chemical Ti surface features. • Histatin 5 prevent the adhesion of P. gingivalis on Ti implant surfaces. • α-Amylase decrease the colonization of S. gordonii and F. nucleatum on titanium. This study aims to test the potential of histatin 5, cystatin S and α-amylase to reduce the colonization of three important oral species; Streptococcus gordonii , Fusobacterium nucleatum and Porphyromonas gingivalis on two titanium (Ti) implant surfaces with different roughness and wettability. Pre-treatment (TiPT) and sandblasted and acid-etched (TiSLA) Ti surfaces, were facilitated by the Institut Straumann. The Ti surfaces were coated for two hours with either each salivary protein and the levels of protein adsorption were quantified by ELISA. The pre-coated substrates were incubated during 24 h with each bacterial strain, then bacterial colonization was measured by the counting of colony forming units and by fluorescence microscopy. Results showed that histatin 5 had the highest adsorption on the Ti surfaces, regardless of their roughness and wettability. However, bacterial colonization of each strain was selectively influenced by the presence of the salivary proteins adsorbed on the Ti substrates. The surfaces coated with α-amylase, decreased the adhesion of S. gordonii and F. nucleatum , while the pre-incubation with histatin 5 significantly reduced the colonization of P. gingivalis. Our results showed that bacterial colonization of the three oral bacteria could be selectively reduced by salivary proteins like histatin 5, cystatin S or α-amylase. [ABSTRACT FROM AUTHOR]

In this paper, coatings of hydroxyapatite partially substituted with zinc (ZnHA) were produced on titanium substrates by a two-step hydrothermal process using a precursor solution rich in calcium, phosphate and zinc. Activation of titanium surfaces was performed by oxidation with an acidic HF/HNO 3 solution. The coated substrates were then converted into HA by immersion in an alkali 0.1 M NaOH solution. The ZnHA samples were characterized by several techniques and their in vitro behavior was studied in comparison to hydroxyapatite (HA) and titanium (Ti-control) samples. A uniform and homogeneous calcium-deficient carbonate apatite coating was obtained for all samples, both doped and undoped with zinc. The percentage of zinc incorporated in the coatings is 7 at%, and the Ca/P ratio is 1.61(±0.01) for both types of samples, suggesting that Zn is incorporated substitutionally, replacing Ca atoms into the HA structure. The incorporation of Zn in the HA structure changed the crystals morphology, reduced crystals sizes and decreased the deposition rate showing that zinc is an inhibitor of the growth of HA crystal. X-ray diffraction showed that HA is the single crystalline phase present after alkali treatment. The coating adhesion strength was evaluated in terms of the critical load (Lc) obtained from scratch tests and no significant difference was found between the two tested groups, indicating the good adhesion of ZnHA to Ti substrates. The in vitro response of human osteoblasts (HOB) exposed to the surfaces of HA and ZnHA coatings was evaluated. The results of Live/Dead tests showed cell viability for all samples surfaces, but the adhesion and proliferation tests showed that ZnHA samples presented better adhered and spread cells compared with HA. ZnHA coatings presented cells with elongated or polygonal shapes and clearly more spread than HA. Quantitative analysis showed that there was a significantly higher number of cells adhered to ZnHA coatings compared to HA, indicating the zinc incorporation stimulates osteoblast proliferation. [ABSTRACT FROM AUTHOR]

Objective The aim of this work was to evaluate the biofilm formation of Porphyromonas gingivalis on disks of titanium (Ti) grade 4 (G4) and Ti-6Al-4V alloy grade 5 (G5) with different surface topographies. Materials and methods Porphyromonas gingivalis ATCC 33277 was used to develop an in vitro mature biofilm on a total of 96 disk-shaped specimens of laser-treated (L), sandblasted (S), and machined (M) surfaces of Ti G4 and Ti G5. Surface roughness (Ra) and the wettability contact angle ( WCA) were measured to characterize the surface of the specimens. The bacterial biofilm was evaluated by biomass quantification, bacterial viability, visualization of the biofilm extracellular matrix, and bacterial cell count. Data were analyzed using one-way ANOVA and Holm-Sidak tests and expressed as mean ± standard deviation. Results The Ra for the L group was 0.10 (±0.07) μm inside the craters and 0.40 (±0.08) μm in the area surrounding the craters resulting the smoothest ( P < 0.05) in respect to the S group (1.30 ± 0.61 μm) and the M group (0.75 ± 0.23 μm). The L group showed a higher WCA than S and M groups for both G4 (109.9° ± 6.6) and G5 (104.2° ± 5.9) materials ( P < 0.05). The L group displayed both the less P. gingivalis bacterial biomass (0.38 ± 0.01 for G4; 0.62 ± 0.02 for G5) that was significant in respect to G4-S ( P < 0.001), G4-M ( P < 0.001), and G5-M ( P = 0.001) and the less total cell number (215 ± 18 for G4 and 244 ± 9 for G5) than S and M groups for both G4 and G5 materials ( P < 0.01). Conclusion Within the limits of the present study, the results showed that G4-L appears to be significantly efficient in the reduction of the P. gingivalis biofilm formation. [ABSTRACT FROM AUTHOR]

Background Dental implants will be exposed to a complex ecosystem once they are placed in the oral cavity. The bacterial colonization and biofilm formation on these devices will depend not only on the physicochemical surface implant properties but also on the periodontal health conditions of the patients, as these devices are exposed. Purpose The aim of this study was to correlate the subgingival microbial profile with the composition of initial biofilm formed on different microstructured titanium ( Ti) surfaces. Materials and Methods Ten periodontitis and 10 periodontally healthy subjects were included in this study. The subjects wore a removable acrylic device with four different fixed Ti surfaces for 48 hours. Microbial samples of subgingival plaque and the biofilm formed on each Ti surface were individually analyzed by the checkerboard DNA-DNA hybridization technique. Results Despite the roughness or hydrophilicity of the Ti surfaces, a characteristic pattern of bacterial adhesion was observed on each of the study groups. However, significant differences in the proportion of the species that colonized the Ti surfaces were found between the periodontitis and periodontally healthy groups. T reponema denticola, N eisseria mucosa, E ikenella corrodens, and T annerella forsythia were detected in higher proportions on the Ti disks placed in the periodontitis subjects, while significant higher proportions of C apnocytophaga sputigena, F usobacterium periodonticum, P revotella melaninogenica, and S treptococcus mitis were detected on the Ti disks placed in the periodontally healthy group. Conclusions The results obtained in this study shows that the composition and the proportion of the species that initially colonize Ti surfaces are highly influenced by the periodontal status more than the surface characteristics of the Ti implant. [ABSTRACT FROM AUTHOR]

Autophagy plays an important role in embryogenesis, for the maintenance of tissue homeostasis and the elimination of damaged subcellular structures. Furthermore, autophagy could be a mode of physiological cell death and also be implicated in cell differentiation. Thus, we hypothesized that autophagy may have an impact on the differentiation of osteoblast cells influenced by various titanium-based surfaces. Interactions between smooth, commercially available pure titanium (Ti cp), rough Ticer, acid-etched Ti cp (SS) and M1-M3 (comprised of the monoclinic phase of sodium-titanium oxides and rutile; M2 contains amorphous calcium phosphates) and human osteoblast cells were investigated. Immunofluorescent staining was used for detecting autophagy, cell cluster formation and collagen type I (Col-1) expression. Flow cytometry was employed to identify autophagy, the production of endogenous nitric oxide (NO) and the size and granularity of the cells. Rough surfaces caused osteoblast differentiation via the autophagic-dependent PI3/Akt signalling pathway. These surfaces induced the formation of discrete populations of large, granular cells, i.e. mature osteoblasts. In addition, M1-M3 provoked the development of a third population of small, granular cells, responsible for cell cluster formation, which are important for the formation of bone noduli and mineralisation. The same surfaces induced faster osteoblast maturation and enhanced NO production, a hallmark of the already mentioned processes. Neither the mature osteoblasts nor the small cells appeared after the inhibition of autophagy. Inhibition of autophagy also prevented cell cluster formation. We demonstrate that autophagy plays an essential role in the osteoblast differentiation on titanium-based surfaces with rough topography. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The erbium: yttrium-aluminum-garnet (Er: YAG) laser has been introduced as an effective method in the decontamination of implant surfaces. Data concerning the effects of the Er: YAG laser on the biological and surface properties of titanium are conflicting. Cellular behavior is greatly affected by surface properties, including composition, roughness, wettability, and morphology of the titanium surface. The aim of this study was to investigate the influence of the Er: YAG laser on the biocompatibility, surface roughness, and wettability of sandblasted and acid-etched (SLA) titanium surfaces. Twenty-one SLA titanium disks were irradiated by the Er: YAG laser at a pulse energy of 100 mJ, with a pulse frequency of 10 Hz under water irrigation for 1 min. Cell viability, surface roughness, and wettability alterations were evaluated. Thirteen nonirradiated SLA disks were used as the control groups. Human osteoblast-like SaOs-2 cells were seeded onto the disks in culture media. Cell viability was evaluated using the methylthiazol tetrazolium assay. The surface roughness and wettability of the test and control groups were measured using profilometer and tensiometer devices, respectively. A significantly higher cell viability rate was observed in the test group ( p = 0.032). The surface roughness was significantly reduced in the test group compared with the control group ( p = 0.008). The surface wettability was significantly higher in the test group ( p = 0.004). Within the limits of this study, the application of the Er: YAG laser with the previously described properties did not appear to have adverse effects on the biocompatibility of the SLA titanium surfaces. Application of this laser decreased the surface roughness and increased the wettability of the SLA titanium surfaces. [ABSTRACT FROM AUTHOR]

This in vitro study examined (a) the anti-bacterial efficacy of a pulsed erbium-doped yttrium aluminum garnet (Er:YAG) laser applied to Streptococcus sanguinis or Porphyromonas gingivalis adhered to either polished or microstructured titanium implant surfaces, (b) the response of osteoblast-like cells and (c) adhesion of oral bacteria to titanium surfaces after laser irradiation. Thereto, (a) bacteria adhered to titanium disks were irradiated with a pulsed Er:YAG laser ( λ = 2,940 nm) at two different power settings: a lower mode (12.74 J/cm calculated energy density) and a higher mode (63.69 J/cm). (b) After laser irradiation with both settings of sterile titanium, disks were seeded with 10 MG-63 cells/cm. Adhesion and proliferation were determined after 1, 4, and 24 h by fluorescence microscopy and scanning electron microscopy. (c) Bacterial adhesion was also studied on irradiated (test) and non-irradiated (control) surfaces. Adhered P. gingivalis were effectively killed, even at the lower laser setting, independent of the material's surface. S. sanguinis cells adhered were effectively killed only at the higher setting of 63.69 J/cm. Laser irradiation of titanium surfaces had no significant effects on (b) adhesion or proliferation of osteoblast-like MG-63 cells or (c) adhesion of both oral bacterial species in comparison to untreated surfaces. An effective decontamination of polished and rough titanium implant surfaces with a Er:YAG laser could only be achieved with a fluence of 63.69 J/cm. Even though this setting may lead to certain surface alterations, no significant adverse effect on subsequent colonization and proliferation of MG-63 cells or increased bacterial adhesion was found in comparison to untreated control surfaces. [ABSTRACT FROM AUTHOR]

Although titanium (Ti) is known to elicit a foreign body response when implanted into humans, Ti implant healing resembles normal wound healing in terms of inflammatory cell recruitment and inflammation persistence. Rough implant surfaces may present better conditions for protein adsorption and for the adhesion of platelets and inflammatory cells such as neutrophils. Implanted biomedical devices initially interact with coagulating blood; however, direct contact between the oxide layer of the implant and neutrophils has not been completely described. The aim of the present study is to compare the behaviours of neutrophils in direct contact with different Ti surfaces. Isolated human neutrophils were placed into contact with Ti discs, which had been rendered as 'smooth' or 'rough', following different surface treatments. Scanning electron microscopy and flow cytometry were used to measure cell adhesion to the surfaces and exposure of membrane proteins such as CD62L and CD11b. Topographic roughness was demonstrated as higher for SLA treated surfaces, measured by atomic force microscopy and elemental analysis was performed by energy dispersive X-ray, showing a similar composition for both surfaces. The adhesion of neutrophils to the 'rough' Ti surface was initially stronger than adhesion to the 'smooth' surface. The cell morphology and adhesion marker results revealed clear signs of neutrophil activation by either surface, with different neutrophil morphological characteristics being observed between the two surface types. Understanding the cellular mechanisms regulating cell-implant interactions should help researchers to improve the surface topography of biomedical implant devices. [ABSTRACT FROM AUTHOR]

Objectives: Fibronectin (FN), an extracellular matrix (ECM) glycoprotein, is a key factor in the compatibility of dental implant materials. Our objective was to determine the optimal dimensions of microgrooves in the transmucosal part of a dental implant, for optimal absorption of plasma FN and expression of cellular FN by human gingival fibroblasts (HGFs). Methods: Microgroove titanium surfaces were fabricated by photolithography with parallel grooves: 15 μm, 30 μm, or 60 μm in width and 5 μm or 10 μm in depth. Smooth titanium surfaces were used as controls. Surface hydrophilicity, plasma FN adsorption and cellular FN expression by HGFs were measured for both microgroove and control samples. Results: We found that narrower and deeper microgrooves amplified surface hydrophobic- ity. A 15-mm wide microgroove was the most hydrophobic surface and a 60-mm wide microgroove was the most hydrophilic. The latter had more expression of cellular FN than any other surface, but less absorption of plasma FN than 15-mm wide microgrooves. Variation in microgroove depth did not appear to effect FN absorption or expression unless the groove was narrow (~15 or 30 μm). In those instances, the shallower depths resulted in greater expression of cellular FN. Conclusions: Our microgrooves improved expression of cellular FN, which functionally compensated for plasma FN. A microgroove width of 60 μm and depth of 5 or 10 μm appears to be optimal for the transmucosal part of the dental implant. [ABSTRACT FROM AUTHOR]

Abstract: It is well established that nanosized surface topography significantly affects cell response at a biomaterial surface. Here we used a through-mask anodization technique to fabricate well-defined titania nanopillars with tunable feature sizes from 15 to 100nm on bulk titanium (Ti) substrates and studied their effects on initial attachment and spreading of osteoblast-like cells (MG63). An increase of titania pillar height from 15 to 100nm resulted in reduced spreading of MG63 osteoblast-like cells and the higher pillar structures also gave rise to heavily elongated cells. By using a FIB/SEM dual beam microscope the interface between MG63 cells and nanopatterned Ti surfaces could be studied in more detail. It was found that the higher pillar structures prevented the cells to conform to the surface topography leaving voids in between the cells and the substrates. The results found in this study agree with previous studies that cells response better to surfaces with smaller (<20nm) features. [Copyright &y& Elsevier]

Abstract: We discuss the effect of extreme grain refinement in the bulk of commercial purity titanium (CP, Grade-2) on bacterial attachment to the mechano-chemically polished surfaces of the material. The ultrafine crystallinity of the bulk was achieved by severe plastic deformation by means of equal channel angular pressing (ECAP). The chemical composition, wettability, surface topography and roughness of titanium surfaces were characterized using X-ray photoelectron spectroscopy (XPS) and water contact angle (WCA) measurements, as well as atomic force microscopy (AFM) with 3D interactive visualization of the titanium surface morphology. It was found that physico-chemical surface characteristics of the as-received and the ECAP-modified CP titanium did not differ in any significant way, while the surface roughness at the nano-scale did. Optical profilometry performed on large scanning areas of approximately 225 μm × 300 μm showed that there was no significant difference between the roughness parameters R a and R q for surfaces in the two conditions, the overall level of roughness being lower for the ECAP-processed one. By contrast, topographic profile analysis at the nano-scale by AFM did reveal a difference in these parameters. This difference was sensitive to the size of the scanned surface area. A further two surface roughness parameters, skewness (R skw) and kurtosis (R kur), were also used to describe the morphology of titanium surfaces. It was found that the bacterial strains used in this study as adsorbates, viz. Staphylococcus aureus CIP 65.8 and Pseudomonas aeruginosa ATCC 9025, showed preference for surfaces of ECAP-processed titanium. S. aureus cells were found to have a greater propensity for attachment to surfaces of ECAP-modified titanium, while the attachment of P. aeruginosa, while also showing some preference for the ECAP-processed material, was less sensitive to the ECAP processing. [Copyright &y& Elsevier]

Objectives: The purpose of this study was to examine in vitro the anti-bacterial efficacy of two different laser systems (CO2 and diode) applied to Streptococcus sanguinis or Porphyromonas gingivalis cells in suspensions or adhered to zirconia or titanium dental implant materials, with two different surfaces each. Materials and methods: Bacteria were irradiated at two different power settings with either a CO2 (λ=10,600 nm) or a diode laser (λ=810 nm). The lower mode is used clinically (for CO2 100 J/cm2, diode 50 J/cm2) and the higher may alter the materials' surface (for CO2 1200 J/cm2, diode 150 J/cm2). After irradiation, the number of viable bacteria was determined by culture. Results: Planktonic cells of both species were more resistant to the laser irradiations than bacteria that adhered to surfaces. Adhered P. gingivalis were effectively killed at both wavelengths λ=10,600 and 810 nm even at the lower settings, independent of the material. S. sanguinis cells that adhered to either zirconia surface were effectively killed by the CO2 laser at the lower setting of 100 J/cm2. However, the higher settings of both lasers were needed to reduce S. sanguinis that adhered to titanium surfaces. The CO2 laser at the lower setting and the diode laser at the higher setting effectively reduced the viability of S. sanguinis or P. gingivalis that adhered to zirconia surfaces. Conclusions: Under irradiation conditions known not to alter zirconia implant surfaces in vitro, both CO2 laser (100 J/cm2) and the diode laser (150 J/cm2) effectively reduced the viability of adhered S. sanguinis or P. gingivalis. To cite this article: Hauser-Gerspach I, Stübinger S, Meyer J. Bactericidal effects of different laser systems on bacteria adhered to dental implant surfaces: an in vitro study comparing zirconia to titanium. Clin. Oral Impl. Res. 21, 2010; 277–283. doi: 10.1111/j.1600-0501.2009.01835.x [ABSTRACT FROM AUTHOR]

The influence of the ultrafine crystallinity of commercial purity grade 2 (as-received) titanium and titanium modified by equal channel angular pressing (modified titanium) on bacterial attachment was studied. A topographic profile analysis of the surface of the modified titanium revealed a complex morphology of the surface. Its prominent micro- and nano-scale features were 100–200-nm-scale undulations with 10–15 μm spacing. The undulating surfaces were nano-smooth, with height variations not exceeding 5–10 nm. These surface topography characteristics were distinctly different from those of the as-received samples, where broad valleys (up to 40–60 μm) were detected, whose inner surfaces exhibited asperities approximately 100 nm in height spaced at 1–2 μm. It was found that each of the three bacteria strains used in this study as adsorbates, viz. Staphylococcus aureus CIP 68.5, Pseudomonas aeruginosa ATCC 9025 and Escherichia coli K12, responded differently to the two types of titanium surfaces. Extreme grain refinement by ECAP resulted in substantially increased numbers of cells attached to the surface compared to as-received titanium. This enhanced degree of attachment was accompanied with an increased level of extracellular polymeric substances (EPS) production by the bacteria. [ABSTRACT FROM AUTHOR]

Titanium is the standard material for dental and orthopaedical implants. The good biocompatibility has been proven in many experimental and clinical investigations. Different titanium topographies were testedin vitrousing different cell culture models. The aim of this systematic review was to evaluate and summarize the medical/dental literature to assess on which kind of titanium surface structure the osteoblast-like osteosarcoma cells MG63 show the best proliferation and differentiation rate, and the best protein synthesis.A systematic search was carried out using different on-line databases (PubMed, Web of Science, Cochrane Library, International Poster Journal), supplemented by handsearch in selected journals and by examination of the bibliographies of the identified articles. Inclusion and exclusion criterias were applied when considering relevant articles. Studies which met the inclusion criteria were included and data extraction was undertaken by one reviewer.The search yielded 348 references. Nine articles referring to nine different studies were relevant to our question. Additionally 8 less relevant articles were identified. It was found that regularly textured surfaces of pure titanium withRa values (average roughness) of around 4 μm are well-accepted by MG63 cells.The surfaces and culture conditions vary widely. Therefore it is still difficult to recommend one particular surface. It seems that there are no differences in cell proliferation and differentiation on surfaces treated by blasting and etching. Standardization in fabrication and size of the different test surfaces as well as homogeneity in culture times and plating densities should be aspects for future research.To cite this article:Bächle M, Kohal RJ. A systematic review of the influence of different titanium surfaces on proliferation, differentiation and protein synthesis of osteoblast-like MG63 cells.Clin. Oral Impl. Res.doi: 10.1111/j.1600-0501.2004.01054.x [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the effects of an Er : YAG laser (ERL) and the Vector® ultrasonic system (VS) on the biocompatibility of titanium implants in cultures of human osteoblast-like cells (SAOS-2). One hundred and sixty-eight titanium discs with four different surfaces (sand-blasted and acid-etched, titanium plasma-sprayed, machine-polished, and hydroxyapatite-coated) were used to evaluate cell attachment. The samples were equally and randomly assigned to the following groups: (1) an ERL at an energy level of 100 mJ/pulse and 10 Hz using a special application tip, (2) the VS using carbon fibre tips, or (3) untreated control (C). The discs were placed in culture plates, covered with a solution of SAOS-2 cells, and incubated for 7 days. The specimens were then washed with phosphate buffer to remove cells not attached to the surface, and the adherent cells were stained with hematoxilin–eosin. Cells were counted using a reflected light microscope and the cell density per mm2 was calculated. Additionally, cell morphology and surface alterations of the titanium discs after treatment were investigated using scanning electron microscopy (SEM). All titanium discs treated with ERL demonstrated nearly the same cell density per mm2 as the untreated C surfaces. There was a significant decrease in the number of cells that attached to the implant surfaces treated with VS. The SEM examination showed no visible differences between lased and C titanium surfaces. All surfaces treated with VS showed conspicuous surface damage and debris of the used carbon fibres. The results of the present study indicate that (i) ERL does not damage titanium surfaces and subsequently does not influence the attachment rate of SAOS-2 cells, and (ii) VS, used with this type of carbon fibre tip, does not seem to be suitable for the instrumentation of titanium surfaces. To cite this article: Schwarz F, Rothamel D, Sculean A, Georg T, Scherbaum W, Becker J. Effects of an Er : YAG laser and the Vector® ultrasonic system on the biocompatibility of titanium implants in cultures of human osteoblast-like cells. Clin. Oral Impl. Res. 14, 2003; 784–792 [ABSTRACT FROM AUTHOR]

Surface properties may affect the clinical outcome of titanium dental implants. The aim of the present study was to investigate the effects of 3 different titanium surfaces—smooth (S), sandblasted (SB), and titanium plasma-sprayed (TPS)—on proliferation, differentiation, and apoptosis of human osteoblast-like cells, SaOS-2. Cell proliferation was significantly (p < 0.05) higher on the S surface, and synthesis of extracellular matrix proteins was more abundant on TPS and SB than on S surfaces. Analysis of integrin receptors showed a higher expression of α2, α5, αVβ3, and ß1 on TPS as compared with SB and S surfaces. An increase in alkaline phosphatase activity was detected only on SB and TPS surfaces. Analysis of cell apoptosis did not demonstrate any significant difference among the 3 different surfaces. The results indicate that titanium surface topography affects proliferation and differentiation of osteoblast-like SaOS-2 cells, suggesting that surface properties might be important for bone response around dental implants in vivo. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate the adsorption of fibronectin on titanium (Ti) surfaces and the effect of pre-adsorbed fibronectin on osteoblast precursor cell attachment in vitro. Two different concentrations of bovine fibronectin were used in this study. Protein adsorption on Ti surfaces was analyzed using the micro bicinchoninic acid (BCA) protein assay. Cell concentration on Ti and fibronectin pre-adsorbed Ti surfaces after 3 h incubation was analyzed using the Vybrant™ cell adhesion assay. Cell morphology on Ti and fibronectin pre-adsorbed Ti surfaces was observed using scanning electron microscopy (SEM). After 180 min incubation, maximum adsorption of bovine fibronectin on Ti surfaces was observed. Fibronectin adsorption on Ti surfaces was observed to be significantly dependent on the initial concentration and the amount of incubation time. In the presence of 1 mg/ml fibronectin pre-adsorbed on Ti surfaces after 15 min, osteoblast precursor cell attachment on Ti surfaces was observed to be enhanced compared with control Ti surfaces, Ti surfaces pre-adsorbed with 1 mg/ml fibronectin for 180 min, and Ti surfaces pre-adsorbed with 0.1 mg/ml fibronectin for 15 and 180 min. No significant difference in cell attachment was observed between control Ti surfaces, Ti surfaces pre-adsorbed with fibronectin for 180 min, and Ti surfaces pre-adsorbed with 0.1 mg/ml fibronectin for 15 and 180 min. In addition, no differences in cell morphology of the attached osteoblast precursor cells on control Ti surfaces and Ti surfaces pre-adsorbed with fibronectin were observed in this study. It was concluded that an optimum concentration of adsorbed fibronectin on Ti surfaces plays an important role in governing cell attachment. [Copyright &y& Elsevier]

Chemical and topographical surface modifications on dental implants aim to increase the bone surface contact area of the implant and improve osseointegration. This study analyzed the cellular response of undifferentiated mesenchymal stem cells (MSC), derived from senile rats' femoral bone marrow, when cultured on a bioactive coating (by plasma electrolytic oxidation, PEO, with Ca2+ and P5+ ions), a sandblasting followed by acid-etching (SLA) surface, and a machined surface (MSU). A total of 102 Ti-6Al-4V discs were divided into three groups (n = 34). The surface chemistry was analyzed by energy dispersive spectroscopy (EDS). Cell viability assay, gene expression of osteoblastic markers, and mineralized matrix formation were investigated. The cell growth and viability results were higher for PEO vs. MSU surface (p = 0.001). An increase in cell proliferation from 3 to 7 days (p < 0.05) and from 7 to 10 days (p < 0.05) was noted for PEO and SLA surfaces. Gene expression for OSX, ALP, BSP, and OPN showed a statistical significance (p = 0.001) among groups. In addition, the PEO surface showed a higher mineralized matrix bone formation (p = 0.003). In conclusion, MSC from senile female rats cultured on SLA and PEO surfaces showed similar cellular responses and should be considered for future clinical investigations. [ABSTRACT FROM AUTHOR]

In this study, a surface modification strategy using natural biopolymers on titanium is proposed to improve bone healing and promote rapid and successful osseointegration of orthopedic implants. Titania nanotubes were fabricated via an anodization process and the surfaces were further modified with polyelectrolyte multilayers (PEMs) based on Tanfloc (a cationic tannin derivative) and glycosaminoglycans (heparin and hyaluronic acid). Scanning electron microscopy (SEM), water contact angle measurements, and X-ray photoelectron spectroscopy were used to characterize the surfaces. Adipose-derived stem cells (ADSCs) were seeded on the surfaces, and the cell viability, adhesion, and proliferation were investigated. Osteogenesis was induced and osteogenic differentiation of human ADSCs on the surfaces was evaluated via mineralization and protein expression assays, immunofluorescent staining, and SEM. The Tanfloc/heparin PEMs on titania nanotubes improved the rate of osteogenic differentiation of ADSCs as well as the bone mineral deposition, and is therefore a promising approach for use in orthopedic implants. [ABSTRACT FROM AUTHOR]

Aim: The purpose of the study was the evaluation of the esthetic and physical changes produced on colored titanium Grade 5 (Ti6Al4V) laser treated surfaces to be used in implant dentistry for esthetic success. Materials and methods: Colored titanium surfaces were obtained with laser treatment. The physical and topographic properties were evaluated by stereo, light, and electron microscopy and profilometric analyses. L*a*b* colorimetric coordinates were measured by spectrometry, and the superficial chemical characteristics were evaluated by energy dispersive X-ray analysis. Results: Within the complete palette of titanium colors, pinks (P1-P2), incarnadine (I), and white (W) obtained by laser were selected. The topography, texture, hues, saturation, roughness, and porosity of the samples were compared with those of machined (M) and sand-blasted and etched (SBAE) control surfaces. P1, P2, and I, similar in hue and roughness (Ra ≅ 0.5 μm), had a microgroove spacing of 56 μm and a decreasing porosity. The W sample with a "checkerboard" texture and a light color (L* 96.31) was similar to the M samples (Ra = 0.32 μm), but different from SBAE (Ra = 1.41 μm, L* 65.47). Discussion: The aspects of hard and soft tissue could result in an esthetic failure of the dental implant by showing the dark color of the fixture or abutment. The two different pinks and incarnadine surfaces showed favorable esthetic and physical features to promote dental implant success even in the maxillary anterior area with gingival recession, asymmetry, and deficiency. Conclusion: Titanium colored laser surfaces represent a valid alternative to those currently traditionally obtained and interesting and potential perspectives in the management of dental implants' esthetic failure. [ABSTRACT FROM AUTHOR]