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ABSTRACT Objectives Material and Methods Results Conclusions Trial Registration This controlled preclinical study analyzed the effect of implant surface characteristics on osseointegration and crestal bone formation in a grafted dehiscence defect minipig model.A standardized 3 mm × 3 mm acute‐type buccal dehiscence minipig model grafted with deproteinized bovine bone mineral and covered with a porcine collagen membrane after 2 and 8 weeks of healing was utilized. Crestal bone formation was analyzed histologically and histomorphometrically to compare three implant groups: (1) a novel, commercially available, gradient anodized (NGA) implant, to two custom‐made geometric replicas of implant “1,” (2) a superhydrophilic micro‐rough large‐grit sandblasted and acid‐etched surface, and (3) a relatively hydrophobic micro‐rough large‐grit sandblasted and acid‐etched surface.At 2 and 8 weeks, there was no difference between the amount and height of newly formed bone (NBH, new bone height; BATA, bone area to total area) for any of the groups (p > 0.05). First bone‐to‐implant contact (fBIC) and vertical bone creep (VBC) at 2 and 8 weeks were significantly increased for Groups 2 and 3 compared to Group 1 (p < 0.05). At 8 weeks, osseointegration in the dehiscence (dehiscence bone‐implant‐contact; dBIC) was significantly higher for Groups 2 and 3 compared to Group 1 (p < 0.05).The amount of newly formed bone (BATA) and NBH was not influenced by surface type. However, moderately rough surfaces demonstrated significantly superior levels of osseointegration (dBIC) and coronal bone apposition (fBIC) in the dehiscence defect compared to the NGA surface at 2 and 8 weeks.For this type of study, clinical trial registration is not required. This study was conducted at the Biomedical Department of Lund University (Lund, Sweden) and approved by the local Ethics Committee of the University (M‐192‐14) [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions This study aimed to explore multiple effects of hyperbranched poly‐l‐lysine (HBPL) titanium (Ti) surfaces on osseointegration, bacteriostasis, and anti‐inflammation across three different animal models.Ti surfaces were covalently modified with HBPL, with uncoated surfaces as controls. Characterization included scanning electron microscopy (SEM) and surface chemistry and elemental analysis (EDX). Ti and Ti‐HBPL implants were placed in conventional canine edentulous sites, post‐operative infection canine edentulous sites, and diabetic rat tibias. Implants from canine edentulous models were analyzed using micro‐CT and histomorphometry to assess osseointegration at 8 weeks. Post‐operative infection beagles were used to evaluate antibacterial efficacy through clinical parameters and bacterial cultures at 1 week. In diabetic rats, micro‐CT and histomorphometry were performed at 8 weeks.HBPL was uniformly grafted on Ti‐HBPL surfaces. Ti‐HBPL surfaces showed higher bone volume/total volume (BV/TV, p < 0.001), bone‐implant contact (BIC%, p < 0.001), and trabecular number (Tb.N, p < 0.01) in beagles. Besides, it displayed higher BIC% (p < 0.001) and bone area fraction occupancy (BAFO%, p < 0.01) in hard tissue sections. In an infected model, Ti‐HBPL surfaces exhibited lower bleeding on probing (BOP, p < 0.001), and plaque index (DI, p < 0.01), with reduced bacterial colony formation (p < 0.001) compared to the control group. In diabetic rats, Ti‐HBPL surfaces showed an increase in BV/TV (p < 0.01) and Tb.N (p < 0.001), downregulated TNF‐α and IL‐1β (p < 0.01), and upregulated IL‐10 (p < 0.01) and osteocalcin (OCN) expression (p < 0.01).HBPL‐Ti surfaces demonstrated enhanced osseointegration, bacteriostasis, and anti‐inflammatory effects in vivo. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to compare a novel tapered, double‐threaded self‐tapping tissue‐Level design implant (TLC) to a well‐established parallel walled tissue‐level (TL) implant in terms of primary and secondary stability over time. Materials and Methods: Test TLC (n = 10/per timepoint) and control TL (n = 10/per timepoint) implants were placed in the mandible of minipigs and left for submerged healing for 3, 6, and 12 weeks. Maximum insertion torque and implant stability quotient (ISQ) were measured for each implant at placement. Osseointegration and cortical bone maintenance were histologically evaluated by measuring total bone‐to‐implant contact (BIC) and first bone‐to‐implant contact (fBIC). Results: A significantly higher maximum insertion torque was measured for the test implant TLC compared to the control TL implant (57.83 ± 24.73 Ncm and 22.62 ± 23.16 Ncm, respectively; p <.001). The mean ISQ values were comparable between the two implant types (75.00 ± 6.70 for TL compared to 75.40 ± 3.20 for TLC, p =.988). BIC was comparable between both implant types at each of the evaluated time points. The fBIC was found to be significantly more coronal at 12 weeks for the TLC implant compared to the TL implant (0.31 ± 0.83 mm for TLC compared to −0.22 ± 0.85 for TL, p =.027). Conclusion: The novel tapered tissue level design implant showed improved primary stability and an overall improved crestal bone height maintenance compared to the parallel walled design at 12 weeks. [ABSTRACT FROM AUTHOR]

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Bacterial overproliferation and virulence factors in plaque biofilms can cause inflammation of soft and hard tissues around the implant, resulting in peri-implantitis. If not well controlled, severe peri-implantitis can lead to failure of implant osseointegration and implant loosening and loss. Currently, peri-implantitis can be treated by surgical and non-surgical treatment such as mechanical debridement and chemotherapy, but there remain problems related to the unpredictable therapeutic effect and high recurrence rate. Therefore, gaining a comprehensive understanding of the relationship between plaque biofilm formation and peri-implantitis is crucial for the prevention and treatment of peri-implantitis. In this article, we comprehensively review current research on the specific composition and formation process of biofilms and the influence of implant material characteristics on biofilm formation. The results of the research review indicated that peri-implantitis biofilms are composed of extracellular matrix, with a predominant population of anaerobic Gram-negative bacteria embedded within. The formation process includes the acquisition of an acquired membrane, microbial adhesion, and biofilm detachment and dispersion. Biofilm formation is primarily influenced by the implant surface roughness, surface free energy (SFE), and material properties. Current strategies for biofilm removal around implants mainly involve implant surface coating techniques, mechanical debridement, chemical agents, laser therapy, and photodynamic therapy; however, the therapeutic outcomes remain uncertain. The future research direction will be based on the characteristics of the plaque biofilm around the implant, combined with cutting-edge methods, such as nanotechnology, immunotherapy, and gene therapy, to continuously prevent the formation of plaque biofilm on the surface of the implant to prevent and treat peri-implantitis.

This study aims to assess the impact of occlusal loadings on peri-implant bone loss by measuring the cantilever of each implant and evaluating the occlusal pattern using PRESCALE® and to examine the relationship between occlusal overload and peri-implant bone loss, including marginal bone loss (MBL) and biomechanical factors, in a sample of 41 patients with a total of 135 implants. In addition, this study examines the influence of occlusal overload among patient groups with no marginal bone loss, unilateral bone loss, and bilateral bone loss. The PRESCALE® quantifies the occlusal area and load along the dental arch. The analysis of variance (ANOVA) was used for comparing quantitative variables between groups and the Pearson correlation coefficient (r) was applied to analyze linear relationships between quantitative variables. The results of occlusal distribution and pressure range were presented using the PRESCALE®. It was found that the mesial cantilever was statistically significantly greater (p < 0.05) for the bilateral bone loss group. Additionally, MBL was significantly proportional to occlusal loading in the left anterior sector (r = 0.47; p < 0.01) and to follow-up time (r = 0.29; p < 0.01), though it was also proportional to implant diameter and length (r = 0.27 and r = 0.20). The presence of a wider cantilever and excess occlusal loading appears to be associated with increased bone loss. [ABSTRACT FROM AUTHOR]

Objectives: Bioactive surfaces were designed to increase the interaction between the surface and the cells. This may speed up the biological stability and loading protocols. Materials and methods: 36 patients with D3-D4 bone density were recruited and allocated into two groups. 30 bioactive (test group) and 30 traditional (control group) surfaced implants were placed. Insertion torque value (Ncm), insertion torque curve integral (cumulative torque, Ncm), torque density (Ncm/sec), implant stability quotient (ISQ) measured at three timepoints (baseline (T0), 30 (T30) and 45 (T45) days after surgery), and marginal bone loss (MBL) at 6 months of loading were assessed. Results: The mean ISQ and standard deviation at T0, T30, T45 were respectively 74.57 ± 7.85, 74.78 ± 7.31, 74.97 ± 6.34 in test group, and 77.12 ± 5.83, 73.33 ± 6.13, 73.44 ± 7.89 in control group, respectively. Data analysis showed significant differences between groups in ΔISQ at T0-T30 (p = 0.005) and T30-T45 (p = 0.012). Control group showed a significant decrease in ISQ at T30 (p = 0.01) and T45 (p = 0.03) compared to baseline, while no significant change was observed in test group. Due to the stability of the ISQ value ≥ 70, 26 test group and 23 control group implants were functionally loaded after 45 days. Conversely, due to the ISQ < 70 at T45, four test group implants and one control group implant were loaded after 90 days, and 6 control group implants were loaded after 180 days. Neither insertion torque nor ISQ at baseline were correlated with bone density (in Hounsfield units). There was no significant correlation between cumulative torque and ISQ at baseline. There was a significant positive slope in the correlation between torque density and ISQ at baseline, more accentuated in D3 than D4. This correlation remained significant for the test group in D3 bone at day 30 and 45 (p < 0.01 in both time frames), but not in D4 bone, and it was not significant in CG. Conclusions: The bioactive surface showed better behavior in terms of implant stability in D3-D4 bone quality in the early stages of bone healing. Clinical relevance This study demonstrated that the transition from primary to secondary stability is improved using bioactive surface, especially in cases of poor bone environment (D3/D4 bone). [ABSTRACT FROM AUTHOR]

Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. A microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p < 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration. [ABSTRACT FROM AUTHOR]

The use of dental implants for prosthetic rehabilitation in dentistry is based on the concept of osteointegration. This concept enables the clinical stability of the implants and a total absence of inflammatory tissue between the implant surface and the bone tissue. For this reason, it is essential to understand the role of the titanium surface in promoting and maintaining or not maintaining contact between the bone matrix and the surface of the titanium implant. Materials and Methods: Five types of titanium discs placed in contact with osteoblast cultures of osteosarcomas were studied. The materials had different roughness. Scanning electron microscopy (SEM) photos were taken before the in vitro culture to analyze the surfaces, and at the end of the culturing time, the different gene expressions of a broad pattern of proteins were evaluated to analyze the osteoblast response, as indicated in the scientific literature. Results: It was demonstrated that the responses of the osteoblasts were different in the five cultures in contact with the five titanium discs with different surfaces; in particular, the response in the production of some proteins was statistically significant. Discussion: The key role of titanium surfaces underlines how it is still possible to carry out increasingly accurate and targeted studies in the search for new surfaces capable of stimulating a better osteoblastic response and the long-term maintenance of osteointegration. [ABSTRACT FROM AUTHOR]

Background: Studies have shown positive effects of erbium lasers in removal of biofilms. A review article was required with quantitative data for confirmation of their effects, but there is still no a comprehensive study reviewing their effects based on the root canal and implant surface. This systematic review and meta-analysis was conducted to evaluate the efficiency of erbium lasers in removal of the root canal system and surface biofilms. Methods: Studies were searched with keywords in databases of PubMed, Scopus, Europe PMC, Cochrane Central, Embase, and Web of Science and screened by referees. Data were included based on mean - standard deviation and size of control and laser groups. Effect sizes were assessed as standardized mean differences and calculated for each study and for the root and dental surface. Laser characteristics and bacteria were considered as moderators. Results: Nineteen articles in the current study comprised 565 samples (283 control samples and 282 laser samples). The analyses showed the significant effects of erbium lasers on bacterial biofilms on the implant surface [-0.496, 95% confidence interval, CI (-0.720 to -0.273); I2 = 26.94; p = 0.029; Q= 13.28] and root canal [-0.551, 95% CI (-0.656 to -0.445); I2 = 23.89; p = 0.031; Q= 10.46]. Results showed that highest efficiency lasers were obtained at higher wavelengths of 2940 nm, 75-100 mJ energy, and 100-150 lsec and <50-Hz pulses. Conclusions: Erbium lasers can be used to remove biofilms on dental implant surfaces and root canal systems and are safe options for untouchable sites in the root canal. [ABSTRACT FROM AUTHOR]

Zirconia ceramic implants are commercially available from a rapidly growing number of manufacturers. Macroscopic and microscopic surface design and characteristics are considered to be key determining factors in the success of the osseointegration process. It is, therefore, crucial to assess which surface modification promotes the most favorable biological response. The purpose of this study was to conduct a comparison of modern surface modifications that are featured in the most common commercially available zirconia ceramic implant systems. A review of the currently available literature on zirconia implant surface topography and the associated bio-physical factors was conducted, with a focus on the osseointegration of zirconia surfaces. After a review of the selected articles for this study, commercially available zirconia implant surfaces were all modified using subtractive protocols. Commercially available ceramic implant surfaces were modified or enhanced using sandblasting, acid etching, laser etching, or combinations of the aforementioned. From our literature review, laser-modified surfaces emerged as the ones with the highest surface roughness and bone–implant contact (BIC). It was also found that surface roughness could be controlled to achieve optimal roughness by modifying the laser output power during manufacturing. Furthermore, laser surface modification induced a very low amount of preload microcracks in the zirconia. Osteopontin (OPN), an early–late osteogenic differentiation marker, was significantly upregulated in laser-treated surfaces. Moreover, surface wettability was highest in laser-treated surfaces, indicating favorable hydrophilicity and thus promoting early bone forming, cell adhesion, and subsequent maturation. Sandblasting followed by laser modification and sandblasting followed by acid etching and post-milling heat treatment (SE-H) surfaces featured comparable results, with favorable biological responses around zirconia implants. [ABSTRACT FROM AUTHOR]

Abstract Background One of the main factors for the osseointegration of dental implants is the development of an adequate soft tissue barrier, mainly composed by collagen, which protects the implant from bacterial development. The structural features of the peri-implant collagen are influenced by the implant components and, in particular, by the type of the surface. In the clinical practice, healing abutments are characterized by smooth surfaces, named machined. Recently, a new laser technique, Synthegra, has been developed to obtain a topography-controlled surface with micrometric regular pores that seems reducing the risk of peri-implantitis. Based on this background, this study aims investigating the structural organization and spatial distribution of collagen surrounding healing abutments characterized by laser-treated and machined surfaces. Methods Gingiva portions surrounding custom-made healing abutments (HA), characterized by alternated laser-treated and machined surfaces, were collected and analyzed by combining Fourier Transform InfraRed Imaging (FTIRI) spectroscopy, a non-invasive and high-resolution bidimensional analytical technique, with histological and multivariate analyses. Results Masson’s trichrome staining, specific for collagen, highlighted a massive presence of collagen in all the analyzed samples, evidencing a surface-related spatial distribution. The nature of collagen, investigated by the FTIRI spectroscopy, appeared more abundant close to the laser-treated surface, with a perpendicular disposition of the bundles respect to the HA; conversely, a parallel distribution was observed around the machined surface. A different secondary structure was also found, with a higher amount of triple helices and a lower quantity of random coils in collagen close to the laser treated surfaces. Conclusions FTIRI spectroscopy demonstrates that the use of a laser treated transmucosal surface can improve the morphological organization of the peri-implant collagen, which presents a distribution more similar to that of natural teeth. Trial registration: This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970). Registered 06/03/2023, retrospectively registered, https://clinicaltrials.gov/show/NCT05754970 .

The influence of implant surface roughness on implant treatment outcome is still under debate. A rougher implant surface improves osseointegration but yields greater plaque accumulation and biofilm formation. Hybrid implants have a minimally rough component coronally and a moderately rough implant body. The aim of this split-mouth study is to evaluate the long-term outcome of treatment with hybrid and moderately rough implants after 6 years. As a secondary aim, Oral Health Quality of Life (OHQoL) was assessed after one and six years. Fully edentulous patients received an overdenture supported by two implants. One implant had a hybrid surface (MSC) and one implant had a moderately rough surface (DCC). Radiographic crestal bone loss (CBL), plaque score, bleeding on probing (BoP) and periodontal probing depth (PPD) were determined at one and six years. OHQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14) questionnaire and a Visual Analogue Scale (VAS). Twenty-one patients with 42 implants were evaluated after 6 years. No implants failed and a mean CBL of 0.26 mm (SD: 0.42) for the MSC group and 0.17 mm (SD: 0.29) for the DCC group was observed, which was not statistically significant. Periodontal parameters were comparable after 6 years and a significant improvement in OHQoL was observed. This randomized controlled trial concludes that hybrid implants are a predictable treatment alternative for moderately rough implants in patients with an overdenture supported by two implants. [ABSTRACT FROM AUTHOR]

The aim of the current review is focused on compiling a comprehensive overview of the zirconia surface modification for implant interface osseointegration. Background: During the past few decades, the importance of osseointegration for patients has significantly increased, and this importance has been reflected in a sharp growth in the number of relevant items and treatments in that field of implant dentistry, as well as a parallel rise in publications on the subject. The search has been conducted through various databases including Cochrane, Web of Science databases, and Google Scholar, and Ovid Medline, on the given topic. The preferred method of zirconia surface treatment and its effect on osseointegration are briefly reviewed in this article in order to provide a concise summary of the current scientific and clinical viewpoints. Zirconia surface treatment is controversial topic in terms of surface treatment. Surface bio-inertness of zirconia implants result in limited osseointegration compared to titanium implants. [ABSTRACT FROM AUTHOR]

The limited osteointegration often leads to the failure of implant, which can be improved by fixing bioactive molecules onto the surface, such as arginyl-glycyl-aspartic acid (RGD): a cell adhesion motif. Metal-Phenolic Networks (MPNs) have garnered increasing attention from different disciplines in recent years due to their simple and rapid process for depositing on various substrates or particles with different shapes. However, the lack of cellular binding sites on MPNs greatly blocks its application in tissue engineering. In this study, we present a facile and efficient approach for producing PC/Fe@c(RGDfc) composite coatings through the conjugation of c(RGDfc) peptides onto the surface of PC/Fe-MPNs utilizing thiol-click reaction. By combined various techniques (ellipsometry, X-ray photoelectron spectroscopy, Liquid Chromatography-Mass Spectrometry, water contact angle, scanning electronic microscopy, atomic force microscopy) the physicochemical properties (composition, coating mechanism and process, modulus and hydrophilicity) of PC/Fe@c(RGDfc) surface were characterized in detail. In addition, the PC/Fe@c(RGDfc) coating exhibits the remarkable ability to positively modulate cellular attachment, proliferation, migration and promoted bone-implant integration in vivo, maintaining the inherent features of MPNs: anti-inflammatory, anti-oxidative properties, as well as multiple substrate deposition. This work contributes to engineering MPNs-based coatings with bioactive molecules by a facile and efficient thiol-click reaction, as an innovative perspective for future development of surface modification of implant materials.

Purpose: After some initial setbacks in the 1970s, ceramic implants seem to be a promising alternative to titanium implants. Since the surface of an implant system represents the interface to surrounding biologic structures, the study focuses on cleanliness and surface topography. Clinical documentation of the corresponding systems completes the picture and allows a better evaluation of zirconia implant systems. Materials and Methods: Five different ceramic implant systems were selected randomly and purchased via blind-shopping: Z5s (Z-Systems), ZiBone (COHO), W implant (TAVDental), ceramic. implant (vitaclinical), and BioWin!/Standard Zirkon Implantat (Champions-Implants/ZV3 system). Three samples of each implant system underwent scanning electron microscopy (SEM) imaging and elemental analysis (EDS). Where appropriate, subsequent Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS) was performed to identify the chemical nature of impurities. Surface topography was evaluated, and a search for clinical trials in the PubMed database, on the websites and by written request to each dental implant manufacturer, was performed. Results: Surfaces of Champions implants (ZV3) and Z-Systems implants were relatively clean, whereas the other investigated surfaces of vitaclinical, TAV Dental, and ZiBone implants all displayed organic contaminations on their surfaces. Four of the investigated ceramic implants showed a moderately rough implant surface. Only the vitaclinical ceramic. implant had minimal surface roughness. Three ceramic designs--vitaclinical, ZV3, and Z-Systems--had clinical trials documented with up to 3 years of follow-up and results varying between 82.5% and 100% survival. TAV Dental W and ZiBone implant systems lacked properly conducted clinical recording of results. Conclusion: The results of this study showed that it is technically possible to produce zirconia implants that are largely residue-free. On the other hand, the variety of significant residues found in this analysis raises concerns, as contamination may lead to undesirable biologic effects. The lack of clinical studies in peer-reviewed journals does not seem to be relevant for the approval of marketing, nor does the lack of surface cleanliness. In the authors' opinion, a critical analysis of these aspects should be included in a more stringent future analysis prior to the marketing of oral implant systems. [ABSTRACT FROM AUTHOR]

Surface treatment of implants facilitates osseointegration, with nanostructured surfaces exhibiting accelerated peri-implant bone regeneration. This study compared bone-to-implant contact (BIC) in implants with hydroxyapatite (HA), sand-blasted and acid-etched (SLA), and SLA with calcium (Ca)-coated (XPEED®) surfaces. Seventy-five disk-shaped grade 4 Ti specimens divided into three groups were prepared, with 16 implants per group tested in New Zealand white rabbits. Surface characterization was performed using X-ray diffraction (XRD), field emission scanning electron microscopy (FE-SEM), digital microscopy, and a contact angle analyzer. Cell viability, proliferation, and adhesion were assessed using MC3T3-E1 cells. Apatite formation was evaluated using modified simulated body fluid (m-SBF) incubation. After 4 weeks of healing, the outcomes reviewed were BIC, bone area (BA), removal torque tests, and histomorphometric evaluation. A microstructure analysis revealed irregular pores across all groups, with the XPEED group exhibiting a nanostructured Ca-coated surface. Surface characterization showed a crystalline CaTiO3 layer on XPEED surfaces, with evenly distributed Ca penetrating the implants. All surfaces provided excellent environments for cell growth. The XPEED and SLA groups showed significantly higher cell density and viability with superior osseointegration than HA (p < 0.05); XPEED exhibited the highest absorbance values. Thus, XPEED surface treatment improved implant performance, biocompatibility, stability, and osseointegration.

Purpose: The aim of this split-mouth randomized clinical trial was to evaluate the primary and secondary stability of implants with hydrophilic surfaces in comparison to implants with conventional surfaces in the posterior region of the maxilla. Materials and Methods: Twenty patients with a bilateral edentulous ridge in the posterior area of the maxilla randomly received implants with two types of surfaces: (1) implants with the surface modified by double acid-etching and sandblasting (DAS, n = 20); and (2) implants with the surface modified by double acid-etching and sandblasting, stored in 0.9% saline solution to confer highly hydrophilic properties (DAS-H, n = 20) on the surface. The implants presented the same macrostructure with a hybrid design. The resonance frequency analysis was performed in order to obtain the implant stability quotient (ISQ) using Osstell. The ISQ analyses were performed just after placement of the implant (primary stability) and at 28, 40, and 90 days after the surgical procedure (secondary stability). Results: There were no differences between the DAS and DAS-H surfaces in the primary stability or during the conversion of the primary to the secondary stability; however, there was a reduction in the stability of the implants at 28 days, which increased significantly at 40 and 90 days in both surfaces. Conclusion: It can be concluded that the surface wettability of implants with a hybrid macrostructure did not increase the primary and secondary implant stability in the posterior region of the maxilla. [ABSTRACT FROM AUTHOR]

Background: Dental implants have become the standard for replacing missing teeth. However, patients’ demands for shorter treatment times and the desire for aesthetics in their results can complicate the rehabilitation process, particularly when poor-quality bone is involved. In order to address these challenges, new methods of treating implant surfaces have been introduced. These methods aim to make the implants superhydrophilic and bioactive, enhancing their functionality and interactions with the surrounding tissues. Aim: The aim of the study was to retrospectively examine the efficacy of a superhydrophilic and bioactive implant for treatment of the edentulous maxillary anterior area. The study also aimed to evaluate whether this improved implant surface, by enhancing the osseointegration processes, could serve as a factor in speeding up the loading protocols. Materials and Methods: For this retrospective study, a total of 13 implants were included: 6 delayed restored implants and 7 immediately loaded implants placed in the anterior maxillary area. Clinical, radiographic, and esthetic outcomes were assessed. Baseline measurements of the insertion torque value (ITV) and stability implant quotient (ISQ) were recorded for all implants. In the early-loaded group, these measurements were also taken 30 days (t30) and 45 days (t45) after the placement of the implant to monitor their changes over time. Marginal bone loss (MBL) was calculated according to the changes in marginal bone level on intraoral X-rays taken at two different time points: at baseline and one year after loading. To evaluate the esthetic results, the pink esthetic score (PES) and the white esthetic score (WES) were assessed. For this evaluation, intraoral photographs were taken one year after implant loading. Results: A total of 7 implants were immediately restored, with a mean ITV of 32.29 ± 9.01 Ncm and a mean ISQ of 72.71 ± 2.81. These implants were placed in a bone environment with a mean density of 410.00 ± 194.42 HU. On the other hand, 6 implants with delayed loading had a mean ITV of 28.50 ± 3.27 Ncm, an ISQ of 67.92 ± 8.43, and a mean bone density of 607.50 ± 140.83 HU. The mean PES and WES after 1 year were, respectively, 8.71 ± 1.89 and 8.57 ± 0.79 for immediate and 8.33 ± 1.36 and 9.17 ± 1.33 for delayed-loaded implants. At 12 months after loading, the immediately loaded group had a MBL of 0.29 ± 0.29 mm, while the delayed-loaded group had a MBL of 0.33 ± 0.25. No statistically significant differences between the two treatment groups were found for any of the evaluated outcomes. Conclusions: Despite the limitations of this study, the obtained results may support the use of a superhydrophilic and bioactive implant surface for implant-prosthetic rehabilitation in critical loading protocols with satisfactory esthetic results.

Background: Dental implants have become the standard for replacing missing teeth. However, patients' demands for shorter treatment times and the desire for aesthetics in their results can complicate the rehabilitation process, particularly when poor-quality bone is involved. In order to address these challenges, new methods of treating implant surfaces have been introduced. These methods aim to make the implants superhydrophilic and bioactive, enhancing their functionality and interactions with the surrounding tissues. Aim: The aim of the study was to retrospectively examine the efficacy of a superhydrophilic and bioactive implant for treatment of the edentulous maxillary anterior area. The study also aimed to evaluate whether this improved implant surface, by enhancing the osseointegration processes, could serve as a factor in speeding up the loading protocols. Materials and Methods: For this retrospective study, a total of 13 implants were included: 6 delayed restored implants and 7 immediately loaded implants placed in the anterior maxillary area. Clinical, radiographic, and esthetic outcomes were assessed. Baseline measurements of the insertion torque value (ITV) and stability implant quotient (ISQ) were recorded for all implants. In the early-loaded group, these measurements were also taken 30 days (t30) and 45 days (t45) after the placement of the implant to monitor their changes over time. Marginal bone loss (MBL) was calculated according to the changes in marginal bone level on intraoral X-rays taken at two different time points: at baseline and one year after loading. To evaluate the esthetic results, the pink esthetic score (PES) and the white esthetic score (WES) were assessed. For this evaluation, intraoral photographs were taken one year after implant loading. Results: A total of 7 implants were immediately restored, with a mean ITV of 32.29 ± 9.01 Ncm and a mean ISQ of 72.71 ± 2.81. These implants were placed in a bone environment with a mean density of 410.00 ± 194.42 HU. On the other hand, 6 implants with delayed loading had a mean ITV of 28.50 ± 3.27 Ncm, an ISQ of 67.92 ± 8.43, and a mean bone density of 607.50 ± 140.83 HU. The mean PES and WES after 1 year were, respectively, 8.71 ± 1.89 and 8.57 ± 0.79 for immediate and 8.33 ± 1.36 and 9.17 ± 1.33 for delayed-loaded implants. At 12 months after loading, the immediately loaded group had a MBL of 0.29 ± 0.29 mm, while the delayed-loaded group had a MBL of 0.33 ± 0.25. No statistically significant differences between the two treatment groups were found for any of the evaluated outcomes. Conclusions: Despite the limitations of this study, the obtained results may support the use of a superhydrophilic and bioactive implant surface for implant-prosthetic rehabilitation in critical loading protocols with satisfactory esthetic results. [ABSTRACT FROM AUTHOR]

Purpose: To compare the onset of peri-implantitis, incidence of failure, and peri-implant marginal bone level changes between implants with a roughened surface and those with a machined/turned surface. Materials and Methods: All patients needing two dental implants of the same size on the left and right sides of the same arch, and not scheduled for immediate loading, were enrolled between October 2012 and February 2016. The patients were randomly allocated either to Nobel Biocare MkIII or Sweden & Martina Outlink2. Rough-surface implants and machined-surface implants were used from each company. After the preparation of two identical implant sites, each implant (rough or machined of the same group) was randomly allocated to the right and left sides of the same patient, following a split-mouth design. Outcome measures were peri-implantitis onset, incidence of failure, and peri-implant marginal bone level changes. Patients were followed up for 3 years after loading. Results: One hundred fourteen patients were enrolled and treated; nine patients dropped out. Following an intent-to-treat analysis to avoid overestimation, proportions are given related to the initial number of 114 patients. Peri-implantitis incidence was 4.39% for machined implants (5/114), 0.88% for rough implants (1/114), 1.75% in the Nobel Biocare group (2 cases), and 3.51% in the Sweden & Martina group (4 cases). The failure rate was 1.75% in machined implants (2/114), 0.88% in rough implants (1/114), 0.98% in the Nobel Biocare group (1/114), and 1.85% in the Sweden & Martina group (1/114). No statistically significant differences in marginal bone loss were found comparing different surfaces, while marginal bone loss was significantly lower in Nobel Biocare than in Sweden & Martina implants. Conclusion: Based on the results of this study, no significant differences can be demonstrated in either peri-implantitis or failure rate or in marginal bone loss between rough and machined implants. Marginal bone loss was significantly worse in machined-surface Sweden & Martina than in rough-surface Nobel Biocare implants. [ABSTRACT FROM AUTHOR]

The use of dental implants for prosthetic rehabilitation in dentistry is based on the concept of osteointegration. This concept enables the clinical stability of the implants and a total absence of inflammatory tissue between the implant surface and the bone tissue. For this reason, it is essential to understand the role of the titanium surface in promoting and maintaining or not maintaining contact between the bone matrix and the surface of the titanium implant. Materials and Methods: Five types of titanium discs placed in contact with osteoblast cultures of osteosarcomas were studied. The materials had different roughness. Scanning electron microscopy (SEM) photos were taken before the in vitro culture to analyze the surfaces, and at the end of the culturing time, the different gene expressions of a broad pattern of proteins were evaluated to analyze the osteoblast response, as indicated in the scientific literature. Results: It was demonstrated that the responses of the osteoblasts were different in the five cultures in contact with the five titanium discs with different surfaces; in particular, the response in the production of some proteins was statistically significant. Discussion: The key role of titanium surfaces underlines how it is still possible to carry out increasingly accurate and targeted studies in the search for new surfaces capable of stimulating a better osteoblastic response and the long-term maintenance of osteointegration.

Zirconia ceramic implants are commercially available from a rapidly growing number of manufacturers. Macroscopic and microscopic surface design and characteristics are considered to be key determining factors in the success of the osseointegration process. It is, therefore, crucial to assess which surface modification promotes the most favorable biological response. The purpose of this study was to conduct a comparison of modern surface modifications that are featured in the most common commercially available zirconia ceramic implant systems. A review of the currently available literature on zirconia implant surface topography and the associated bio-physical factors was conducted, with a focus on the osseointegration of zirconia surfaces. After a review of the selected articles for this study, commercially available zirconia implant surfaces were all modified using subtractive protocols. Commercially available ceramic implant surfaces were modified or enhanced using sandblasting, acid etching, laser etching, or combinations of the aforementioned. From our literature review, laser-modified surfaces emerged as the ones with the highest surface roughness and bone–implant contact (BIC). It was also found that surface roughness could be controlled to achieve optimal roughness by modifying the laser output power during manufacturing. Furthermore, laser surface modification induced a very low amount of preload microcracks in the zirconia. Osteopontin (OPN), an early–late osteogenic differentiation marker, was significantly upregulated in laser-treated surfaces. Moreover, surface wettability was highest in laser-treated surfaces, indicating favorable hydrophilicity and thus promoting early bone forming, cell adhesion, and subsequent maturation. Sandblasting followed by laser modification and sandblasting followed by acid etching and post-milling heat treatment (SE-H) surfaces featured comparable results, with favorable biological responses around zirconia implants.

Introduction: Marginal bone loss after implant placement is one of the most used criteria to assess the success of osseointegrated implants over time. The type of implant connection and implant surface type are reported to have an influence on bone remodeling around the placed implants. This study aimed to evaluate marginal bone loss around two implant systems with different connections and surfaces in horizontally augmented sites. Methods: This randomized control pilot study included 8 implants placed in 3 patients who needed implant placement in previously horizontally grafted sites. The placed implants were divided into two groups: group 1 consisting of implants with external connection and a hybrid design, and group 2 including implants with an internal connection and a fully etched surface. Clinical and radiographical measurements were taken at baseline, during the surgery, and up to one year after loading to evaluate marginal bone loss around the two different implants placed in grafted sites. Results: All implants were retained at all follow-up periods and healing was uneventful. There were similar Marginal Bone Loss (MBL) and soft tissue changes around both types of implants. Group 2 implants had higher MBL, however, the difference was not statistically significative. Conclusions: Preliminary analysis suggest that full surface etching does not seem to negatively influence marginal bone loss around implants placed in augmented bone. [ABSTRACT FROM AUTHOR]

The roughness of the dental implant surface will influence the behavior of osteoblastic cells regarding the spread, proliferation, differentiation and synthesis of proteins on the surface of titanium. Depending on its characteristics, roughness can be macro-, micro- and nano-roughness Material and method. We achieved the obtaining of thin layers of biomaterials by the pulsed laser deposition method (PLD, Pulsed Laser Deposition) on the titanium samples and the deposition has been made by Spin coating method of a thin film based on hydroxyapatite, respectively hydroxyapatite-maleic copolymer, only on one side of the sample. Results. From a microscopic point of view, the qualities of bio-glass are remarkable. Thus, bio-glasses are amorphous materials and are successfully used as covering material for metallic and polymeric implants, to significantly increase their biocompatibility. Discussion. The biological properties of the materials for implants are of fundamental importance for the success of the treatments and they are reflected along with other characteristics of the implants, in the tissue reaction they cause under the conditions of their insertion in biological systems. Conclusion. Osseointegration could be impaired in people with diabetes, osteoporosis, with bone metabolism disorder where therapeutic success depends on the biomimetic and functional topography of the dental implant.

Objectives: The objective of this study is to qualitatively and quantitatively evaluate biofilm formation on hybrid titanium implants (HS), with moderately rough and turned surface topographies. Materials and Methods: A validated dynamic in vitro multispecies biofilm model, based on bacterial growth under flow and shear conditions resembling the oral cavity, was used to evaluate biofilm formation on the tested implant surfaces. Scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) were used to compare the biofilm structure and microbial biomass deposited on either the moderately rough or the turned surface of HS. Quantitative polymerase chain reaction (qPCR) was used to evaluate the total bacterial counts and counts of each specific bacterium in biofilms formed on implants with either the moderately rough or the turned surfaces, as in the hybrid titanium implants, after 24, 48 and 72 h. A general linear model was applied to compare the CLSM and qPCR results between the tested implant surfaces. Results: A significantly higher bacterial biomass grew on the moderately rough implant surfaces, compared to the turned surface area of HS implants (p <.05), at all incubation times, as evidenced with both CLSM and SEM. qPCR analysis also demonstrated an important increase in the total and specific bacterial counts in moderately rough surface implants at the three incubation times. Conclusions: Implant surface topography (moderately rough versus turned) significantly influenced in vitro biofilm formation in terms of biofilm structure, bacterial biomass and quantity of the specific species selected for the model used. [ABSTRACT FROM AUTHOR]

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

The influence of implant surface roughness on implant treatment outcome is still under debate. A rougher implant surface improves osseointegration but yields greater plaque accumulation and biofilm formation. Hybrid implants have a minimally rough component coronally and a moderately rough implant body. The aim of this split-mouth study is to evaluate the long-term outcome of treatment with hybrid and moderately rough implants after 6 years. As a secondary aim, Oral Health Quality of Life (OHQoL) was assessed after one and six years. Fully edentulous patients received an overdenture supported by two implants. One implant had a hybrid surface (MSC) and one implant had a moderately rough surface (DCC). Radiographic crestal bone loss (CBL), plaque score, bleeding on probing (BoP) and periodontal probing depth (PPD) were determined at one and six years. OHQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14) questionnaire and a Visual Analogue Scale (VAS). Twenty-one patients with 42 implants were evaluated after 6 years. No implants failed and a mean CBL of 0.26 mm (SD: 0.42) for the MSC group and 0.17 mm (SD: 0.29) for the DCC group was observed, which was not statistically significant. Periodontal parameters were comparable after 6 years and a significant improvement in OHQoL was observed. This randomized controlled trial concludes that hybrid implants are a predictable treatment alternative for moderately rough implants in patients with an overdenture supported by two implants.

Purpose: To compare the influence of ultraviolet (UV) irradiation and cold atmospheric pressure plasma (CAP) treatment on surface structure, surface chemistry, cytocompatibility, and cell behavior on zirconia in vitro. Materials and Methods: Zirconia samples (TZ-3YSB-E) were treated by UV irradiation, oxygen plasma, or argon plasma for 12 minutes each and compared with the nontreated samples. Surface analysis was conducted using scanning electron microscopy, roughness analysis, and x-ray photoelectron spectroscopy. Cell proliferation, viability, and cell attachment as well as cytotoxicity were evaluated using MC3T3-E1 murine osteoblasts cultivated directly on the zirconia samples. Results: Surface structure and roughness were not affected by the surface treatments. CAP and UV irradiation significantly reduced organic material and increased the surface oxidation on the zirconia samples. Furthermore, CAP and UV treatment significantly decreased the contact angle on the zirconia samples, indicating superhydrophilicity. Cell attachment was significantly increased on oxygen plasma--treated zirconia samples compared with the nontreated samples at all times (P < .001). After 24 and 48 hours, cell proliferation and viability (P < .001) were significantly increased on oxygen plasma--treated samples in comparison with the nontreated, UV-treated, and argon plasma--treated samples. Neither UV nor CAP treatment led to cytotoxicity. Conclusion: In vitro, surface treatment by UV irradiation or CAP causes a significant reduction of organic material, increases the hydrophilicity of zirconia, and improves the conditions for osteoblasts. The results stipulate that treatment of zirconia surfaces with oxygen plasma may favor cell proliferation. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

• A facile and efficient strategy for engineering the implant surface was developed. • The implant surface can be endowed with customized biological functionalities. • This strategy was free toxic agents, mild condition, simplicity and universality. • Deposition of peptide improved the inferior modulus and stability of original coating. • This strategy exhibits enormous potentials in various biomedical fields. The interfacial property of implant is of paramount importance in determining the eventual therapeutic outcomes. However, the mutative shapes and substrates of biomedical materials present significant challenges in engineering the implant surface to meet the requirement of complicated in vivo biological events. Herein, a facile and efficient strategy based on supramolecular self-assembly was developed, in which the de novo designed peptide (hexalysine, K6) was linked with bio-functional units (short or long peptides, and the synthetic polymer) and deposited onto metal-polyphenol networks (MPNs) coating, to endow the interface with desired biological functionalities, independent on shapes and materials of implant. The coating thickness, mechanism, kinetics, binding force and mode between K6 and polyphenol were thoroughly investigated by various techniques (AFM, SEM, XPS, ellipsometry, UV–vis). We found that K6 was able to penetrate through the MPNs, thereby significantly enhancing the poor modulus and poor stability of original MPNs. It is of significant importance to note that the bio-functionalities of linked units could be exploited to enhance cellular adhesion, osteogenesis, antibacterial and antifouling properties of the implants. The strategy capitalised on the free toxic agents, mild condition, simplicity and universality of preparation, enabling the customisation of biomedical implants with desired biological functionalities, which exhibited enormous potential in various biomedical fields. [ABSTRACT FROM AUTHOR]

Abstract Aim Periprosthetic joint infections are a devastating complication after arthroplasty, leading to rejection of the prosthesis. The prevention of septic loosening may be possible by an antimicrobial coating of the implant surface. Poly (hexamethylene) biguanide hydrochloride [PHMB] seems to be a suitable antiseptic agent for this purpose since previous studies revealed a low cytotoxicity and a long-lasting microbicidal effect of Ti6Al4V alloy coated with PHMB. To preclude an excessive activation of the immune system, possible inflammatory effects on macrophages upon contact with PHMB-coated surfaces alone and after killing of S. epidermidis and P. aeruginosa are analyzed. Methods THP-1 monocytes were differentiated to M0 macrophages by phorbol 12-myristate 13-acetate and seeded onto Ti6Al4V surfaces coated with various amounts of PHMB. Next to microscopic immunofluorescence analysis of labeled macrophages after adhesion on the coated surface, measurement of intracellular reactive oxygen species and analysis of cytokine secretion at different time points without and with previous bacterial contamination were conducted. Results No influence on morphology of macrophages and only slight increases in iROS generation were detected. The cytokine secretion pattern depends on the surface treatment procedure and the amount of adsorbed PHMB. The PHMB coating resulted in a high reduction of viable bacteria, resulting in no significant differences in cytokine secretion as reaction to coated surfaces with and without bacterial burden. Conclusion Ti6Al4V specimens after alkaline treatment followed by coating with 5–7 μg PHMB and specimens treated with H2O2 before PHMB-coating (4 μg) had the smallest influence on the macrophage phienotype and thus are considered as the surface with the best cytocompatibility to macrophages tested in the present study.

Purpose: Decontamination of the rough surfaces of dental implants is a challenge in the treatment of peri-implantitis. An acceptable cleaning technique must be able to debride and detoxify the surface without traumatizing it. This study assessed the possible implant surface alterations following decontamination with laser, photodynamic therapy (PDT), and application of chlorhexidine (CHX). Materials and Methods: Of 16 dental implants with sandblasted, large-grit, acid-etched surfaces, Aggregatibacter actinomycetemcomitans was cultured on the surfaces of 15 implants for 48 hours. These 15 implants were divided into five groups of three and were subjected to erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation, 630 nm light-emitting diode and toluidine blue O photosensitizer, 810 nm diode laser, and indocyanine green-based photosensitizer, 2% CHX, and control group (no treatment). One implant remained intact. The morphology and element/phase identification of the implants were studied using scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS), respectively. Results: The SEM images and EDS maps revealed that the decontamination methods did not alter the surface quality of the implants. However, in photodynamic therapy, sodium chloride that remained from rinsing liquid can make an adhesive layer on the surface of the treated implants. Conclusion: Er:YAG laser irradiation and PDT did not alter the surfaces of sandblasted, large-grit, acid-etched implants. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of peri-implantitis has increased significantly, forcing clinicians to search for ways to prevent it. Laser-microtextured surfaces promote soft tissue attachment and provide a tight seal around implants. Hence, the aim of this study was to examine the clinical, radiographic, and histologic features of ligature-induced peri-implantitis, as well as the effect of surgical treatment of these induced peri-implantitis lesions on laser-microtextured implants in a controlled animal model. Materials and Methods: Six mini-pigs (three males/three females) received 6 implants each (3 resorbable blast textured [RBT] implants and 3 laser-microtextured [LM] implants) in mandibular premolar sites, for a total of 36 implants. Two groups were identified based on the time point of sample analysis. After osseointegration was achieved, metal wire ligatures were placed and left for 12 weeks. Group 1 samples were then obtained, and group 2 samples received rescue therapy following a guided bone regeneration (GBR) protocol. Sample collection in group 2 was completed 12 weeks after the samples were submerged and treated. All samples were analyzed histologically and measurements were taken. Results: Four implants (three RBT, one LM) were lost at early time points because of implant instability. Interimplant distances and soft tissue thicknesses varied subtly between groups. More notable was the mean (± standard error of the mean) crestal bone loss (group 1: 1.860 ± 1.618 mm [LM] and 2.440 ± 2.691 mm [RBT]; group 2: 2.04 ± 1.613 mm [LM] and 3.00 ± 2.196 mm [RBT]) (P < .05), as demonstrated by a paired t test. Histologic pocket depth was also greater at RBT sites than at LM sites (4.448 ± 2.839 mm and 4.121 ± 2.251 mm, respectively, in group 1; and 3.537 ± 2.719 mm and 2.339 ± 1.852 mm, respectively [P < .005] in group 2). Conclusion: LM implants had less crestal bone loss and shallower histologic pocket depth compared with their RBT counterparts. Also, LM implants had higher bone fill when a rescue therapy (GBR) was performed. [ABSTRACT FROM AUTHOR]

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

Objectives: Crestal bone formation represents a crucial aspect of the esthetic and biological success of dental implants. This controlled preclinical study analyzed the effect of implant surface and implant geometry on de novo crestal bone formation and osseointegration. Materials and methods: Histological and histomorphometrical analysis was performed to compare three implant groups, that is, (1) a novel, commercially available, gradient anodized implant, (2) a custom‐made geometric replica of implant "1," displaying a superhydrophilic micro‐rough large‐grit sandblasted and acid‐etched surface, and (3) a commercially available implant, having the same surface as "2" but a different implant geometry. The study applied a standardized buccal acute‐type dehiscence model in minipigs with observation periods of 2 and 8 weeks of healing. Results: The amount of newly formed crestal bone (BATA) around control groups (2) and (3) was significantly increased when compared to the test group (1) at the 8 weeks of healing time point. Similar results were obtained for all parameters related to osseointegration and direct bone apposition, to the implant surface (dBIC, VBC, and fBIC), demonstrating superior osseointegration of the moderately rough, compared to the gradient anodized functionalization. After 2 weeks, the osseointegration (nBIC) was found to be influenced by implant geometry with group (3) outperforming groups (1) and (2) on this parameter. At 8 weeks, nBIC was significantly higher for groups (2) and (3) compared to (1). Conclusions: The extent (BATA) of de novo crestal bone formation in the acute‐type dehiscence defects was primarily influenced by implant surface characteristics and their ability to promote osseointegration and direct bone apposition. Osseointegration (nBIC) of the apical part was found to be influenced by a combination of surface characteristics and implant geometry. For early healing, implant geometry may have a more pronounced effect on facilitating osseointegration, relative to the specific surface characteristics. [ABSTRACT FROM AUTHOR]

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

BACKGROUND: The regulation of cell function is the key to bone formation on the surface of dental implants. Understanding bone reconstruction from the perspective of cells and molecules is helpful to improve the success rate of dental implants. Studies have found that microRNA (miRNA), as a key factor controlling cell function, plays an important role in the regulation of cell differentiation of bone tissue around dental implants. OBJECTIVE: To review the regulation mechanism of miRNA in bone tissue repair around dental implants, the influence of dental implant surface morphology on miRNA expression, and the application of miRNA in bone tissue repair. METHODS: Articles were searched by the first author on PubMed, Medline, and Sciencedirect databases. Search terms were “microRNA, bone remodeling, dental implants, mesenchymal stem cells, titanium, osseointegration”. Preliminary screening was performed by reading the title and abstract. After excluding the research and experiment unrelated to the topic of the article, 61 articles were finally included for result analysis. RESULTS AND CONCLUSION: (1) miRNAs participate in osteoblast differentiation by directly targeting Runx2 and Osterix genes or influencing other genes that enhance or inhibit the expression level of Runx2 and Osterix, and interacting with bone morphogenetic protein/Smads, Wnt/β-catenin signaling pathway and integrin. (2) miRNAs regulate osteogenesis-angiogenesis coupling by stimulating the expression of osteoblast marker genes. (3) Many experiments have confirmed that the surface morphology of titanium implants affects the expression of miRNA, and micro/nano structure can promote the proliferation and differentiation of osteoblasts better. The surface with nano rough morphology can improve the response of bone tissue repair by expressing miRNA related to osteogenic genes. (4) Micro-arc oxidation coating of titanium implants can promote the osteogenic differentiation of mesenchymal stem cells by activating miRNAs. It is feasible to construct genetically modified tissue engineering implants by combining miRNAS with micro-arc titanium oxide implants. [ABSTRACT FROM AUTHOR]

Background: Inflammation triggered by bacterial biofilms in the surrounding tissue is a major etiological factor for peri‐implantitis and subsequent implant failure. However, little is known about the direct effects of bacterial corrosion and recolonization on implant failure Purpose: To investigate the influence of oral commensals on bacterial corrosion and recolonization of titanium surfaces. Materials and Methods: Streptococcus sanguinis (S. sanguinis) and Porphyromonas gingivalis (P. gingivalis), which are key bacteria in oral biofilm formation, were cultured on commercially pure titanium and titanium‐aluminum‐vanadium (Ti6Al4V) plates in artificial saliva/brain heart infusion medium under aerobic or anaerobic conditions. Biofilm formation was examined after 7 and 21 days by crystal violet and live/dead staining. Titanium ions released into culture supernatants were analyzed over a period of 21 days by atomic absorption spectrometry. Visual changes in surface morphology were investigated using scanning electron microscopy. Biofilm formation on sterilized, biocorroded, and recolonized implant surfaces was determined by crystal violet staining. Results: S. sanguinis and P. gingivalis formed stable biofilms on the titanium samples. Bacterial corrosion led to a significant increase in titanium ion release from these titanium plates (p < 0.01), which was significantly higher under aerobic conditions on pure titanium (p ≤ 0.001). No obvious morphological surface changes, such as pitting and discoloration, were detected in the titanium samples. During early biofilm formation, the addition of titanium ions significantly decreased the number of live cells. In contrast, a significant effect on biofilm mass was only detected with P. gingivalis. Bacterial corrosion had no influence on bacterial recolonization following sterilization of titanium and Ti6Al4V surfaces. Conclusion: Bacterial corrosion differs between oral commensal bacteria and leads to increased titanium ion release from titanium plates. The titanium ion release did not influence biofilm formation or bacterial recolonization under in vitro conditions [ABSTRACT FROM AUTHOR]

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Peri-implantitis is an inflammatory disease around dental implants that induces progressive bone resorption. Several procedures for decontaminating the implant surface and promoting bone growth have been established to treat this condition. The purpose of the present case report was to describe the decontamination method used to achieve peri-implant health in a 60-year-old man who had a single implant that had been in function in the mandibular left molar region for 10 years. The implant, in the region of the first molar, was osseointegrated and showed radiographic bone loss associated with a probing depth of 8 mm and bleeding on probing. The diagnosis was peri-implantitis, and a surgical treatment approach was selected to enable decontamination of the area with a combination of mechanical debridement, tetracycline hydrochloride (500 mg/mL), and photodynamic therapy. After the decontamination process, a sodium bicarbonate spray device was used, and a guided bone regeneration protocol with a xenogeneic graft and collagen membrane was performed to reestablish the peri-implant bone height. A connective tissue graft was placed to obtain a better biological seal and increase the peri-implant keratinized mucosa. Follow-up examinations performed 30 days, 5 months, 3 years, and 6 years after the surgical procedure revealed new bone formation and progressively reduced probing depths. The successful outcome in this case suggests that combining different decontamination procedures and a bone regeneration protocol could be an effective approach to inducing bone formation around dental implants in patients with peri-implantitis., Competing Interests: No conflicts of interest reported.