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Dual aldehyde cross-linked hyaluronic acid hydrogels loaded with PRP and NGF biofunctionalized PEEK interfaces to enhance osteogenesis and vascularization. Mater Today Bio 2024; 24:100928. [PMID: 38179432 PMCID: PMC10765491 DOI: 10.1016/j.mtbio.2023.100928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
Polyetheretherketone (PEEK) material has become a potential bone replacement material due to its elastic modulus, which is close to that of human bone, and stable chemical properties. However, its biological inertness has hindered its clinical application. To improve the biological inertia of PEEK material, a hyaluronic acid (HA) hydrogel coating loaded with platelet-rich plasma (PRP) and nerve growth factor (NGF) was constructed on the surface of PEEK material in this study. After the hybrid hydrogel coating was constructed, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), Fourier transform infrared spectroscopy (FT-IR), degradation tests, and enzyme-linked immunosorbent assays (ELISAs) were used to evaluate its characteristics and biological properties. The osteogenic and angiogenic potentials were also investigated in vitro and in vivo. Our results showed that the HA hydrogel loaded with RPP and NGF on the PEEK surface degraded slowly and could sustainably release various growth factors, including NGF. The results of in vitro tests showed that the hybrid hydrogel on the surface of PEEK effectively promoted osteogenesis and angiogenesis. The in vivo experiment also confirmed that the PEEK surface hydrogel could promote osseointegration of the implant and the integration of new bone and neovascularization. Our results suggest that the cross-linked hyaluronic acid hydrogel loaded with PRP and NGF can significantly improve the biological inertia of PEEK material, endowing PEEK material with good osteogenic and angiogenic ability.
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Assessment of the intrasinusidal volume before and after maxillary sinus augmentation using mri - a pilot study of eight patients. BMC Oral Health 2024; 24:142. [PMID: 38287339 PMCID: PMC10823631 DOI: 10.1186/s12903-024-03858-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/04/2024] [Indexed: 01/31/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the suitability, accuracy, and reliability of a non-invasive 3-Tesla magnetic resonance imaging technique (3 T-MRI) for the visualization of maxillary sinus grafts in comparison to conventional, X-ray-based, established standard imaging techniques. METHODS A total of eight patients with alveolar bone atrophy who required surgical sinus floor augmentation in the course of dental implantation were included in this pilot study. Alongside pre-operative cone-beam computed tomography (CBCT), 3 T-MRI was performed before and 6 months after sinus floor augmentation. Two investigators measured the maxillary sinus volume preoperatively and after bone augmentation. RESULTS In all cases, MRI demonstrated accurately the volumes of the maxillary sinus grafts. Following surgery, the bony structures suitable for an implant placement increased at an average of 4.89 cm3, corresponding with the decrease of the intrasinusidal volumes. In general, interexaminer discrepancies were low and without statistical significance. CONCLUSION In this preliminary study, we could demonstrate the feasibility of MRI bone volume measurement as a radiation-free alternative with comparable accuracy to CT/CBCT before procedures like sinus floor augmentation. Nevertheless, costs and artifacts, also present in MRI, have to be taken into account. Larger studies will be necessary to justify the practicability of MRI bone volume evaluation.
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State-of-the-art polyetheretherketone three-dimensional printing and multifunctional modification for dental implants. Front Bioeng Biotechnol 2023; 11:1271629. [PMID: 37929192 PMCID: PMC10621213 DOI: 10.3389/fbioe.2023.1271629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Polyetheretherketone (PEEK) is a high-performance thermoplastic polymer with an elastic modulus close to that of the jawbone. PEEK has the potential to become a new dental implant material for special patients due to its radiolucency, chemical stability, color similarity to teeth, and low allergy rate. However, the aromatic main chain and lack of surface charge and chemical functional groups make PEEK hydrophobic and biologically inert, which hinders subsequent protein adsorption and osteoblast adhesion and differentiation. This will be detrimental to the deposition and mineralization of apatite on the surface of PEEK and limit its clinical application. Researchers have explored different modification methods to effectively improve the biomechanical, antibacterial, immunomodulatory, angiogenic, antioxidative, osteogenic and anti-osteoclastogenic, and soft tissue adhesion properties. This review comprehensively summarizes the latest research progress in material property advantages, three-dimensional printing synthesis, and functional modification of PEEK in the fields of implant dentistry and provides solutions for existing difficulties. We confirm the broad prospects of PEEK as a dental implant material to promote the clinical conversion of PEEK-based dental implants.
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Latest advances: Improving the anti-inflammatory and immunomodulatory properties of PEEK materials. Mater Today Bio 2023; 22:100748. [PMID: 37600350 PMCID: PMC10432209 DOI: 10.1016/j.mtbio.2023.100748] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Abstract
Excellent biocompatibility, mechanical properties, chemical stability, and elastic modulus close to bone tissue make polyetheretherketone (PEEK) a promising orthopedic implant material. However, biological inertness has hindered the clinical applications of PEEK. The immune responses and inflammatory reactions after implantation would interfere with the osteogenic process. Eventually, the proliferation of fibrous tissue and the formation of fibrous capsules would result in a loose connection between PEEK and bone, leading to implantation failure. Previous studies focused on improving the osteogenic properties and antibacterial ability of PEEK with various modification techniques. However, few studies have been conducted on the immunomodulatory capacity of PEEK. New clinical applications and advances in processing technology, research, and reports on the immunomodulatory capacity of PEEK have received increasing attention in recent years. Researchers have designed numerous modification techniques, including drug delivery systems, surface chemical modifications, and surface porous treatments, to modulate the post-implantation immune response to address the regulatory factors of the mechanism. These studies provide essential ideas and technical preconditions for the development and research of the next generation of PEEK biological implant materials. This paper summarizes the mechanism by which the immune response after PEEK implantation leads to fibrous capsule formation; it also focuses on modification techniques to improve the anti-inflammatory and immunomodulatory abilities of PEEK. We also discuss the limitations of the existing modification techniques and present the corresponding future perspectives.
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Preparation of Ta2O5/ polyetheretherketone samples with loading of PLGA/antibiotic agents for the tests of antibacterial performances and cell growth activities. J Taiwan Inst Chem Eng 2023. [DOI: 10.1016/j.jtice.2023.104783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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In vivo assessment of artefacts in MRI images caused by conventional twistflex and various fixed orthodontic CAD/CAM retainers. J Orofac Orthop 2023:10.1007/s00056-022-00445-z. [PMID: 36700953 DOI: 10.1007/s00056-022-00445-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/12/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess magnetic resonance imaging (MRI) artefacts caused by different computer-aided design/computer-aided manufacturing (CAD/CAM) retainers in comparison with conventional hand bent stainless steel twistflex retainers in vivo. MATERIALS AND METHODS MRI scans (3 Tesla) were performed on a male volunteer with different CAD/CAM retainers (cobalt-chromium, CoCr; nickel-titanium, NiTi; grade 5 titanium, Ti5) and twistflex retainers inserted. A total of 126 landmarks inside and outside the retainer area (RA; from canine to canine) were evaluated by two blinded radiologists using an established five-point visibility scoring (1: excellent, 2: good, 3: moderate, 4: poor, 5: not visible). Friedman and two-tailed Wilcoxon tests were used for statistical analysis (significance level: p < 0.05). RESULTS Twistflex retainers had the strongest impact on the visibility of all landmarks inside (4.0 ± 1.5) and outside the RA (1.7 ± 1.2). In contrast, artefacts caused by CAD/CAM retainers were limited to the dental area inside the RA (CoCr: 2.2 ± 1.2) or did not impair MRI-based diagnostics in a clinically relevant way (NiTi: 1.0 ± 0.1; Ti5: 1.4 ± 0.6). CONCLUSION The present study on a single test person demonstrates that conventional stainless steel twistflex retainers can severely impair the diagnostic value in head/neck and dental MRI. By contrast, CoCr CAD/CAM retainers can cause artefacts which only slightly impair dental MRI but not head/neck MRI, whereas NiTi and Ti5 CAD/CAM might be fully compatible with both head/neck and dental MRI.
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Fabrication and mechanical properties of different types of carbon fiber reinforced polyetheretherketone: A comparative study. J Mech Behav Biomed Mater 2022; 135:105472. [PMID: 36162163 DOI: 10.1016/j.jmbbm.2022.105472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To find alternative non-metallic materials as dental implants for clinical application, different types of carbon fiber reinforced polyetheretherketone were fabricated and investigated. METHODS Continuous carbon fiber reinforced polyetheretherketone fabrics were fabricated with polyetheretherketone fibers and carbon fibers. Different kinds of carbon fiber reinforced polyetheretherketone were synthesized by setting specific experiment parameters of injection or hot press molding. Various mechanical tests were performed to determine the mechanical properties of different carbon fiber reinforced polyetheretherketone, pure polyetheretherketone and pure titanium. RESULTS Polyetheretherketone composites presented outstanding mechanical and thermal properties after incorporating carbon fiber. The bending and tensile strength of short carbon fiber reinforced polyetheretherketone were close to human bone, and the bending strength of continuous carbon fiber reinforced polyetheretherketone reached 644 MPa, even higher than that of pure titanium. CONCLUSIONS The mechanical properties of polyetheretherketone composites are more similar to bone tissue than titanium, and the stress shielding phenomenon may be inhibited. They may become promising materials as substitutions for titanium and prospective materials in bone tissue engineering.
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Effect of combining different surface treatments on the surface characteristics of polyetheretherketone-based core materials and shear bond strength to a veneering composite resin. J Prosthet Dent 2022; 127:599.e1-599.e7. [DOI: 10.1016/j.prosdent.2022.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
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Pre-Clinical Models in Implant Dentistry: Past, Present, Future. Biomedicines 2021; 9:1538. [PMID: 34829765 PMCID: PMC8615291 DOI: 10.3390/biomedicines9111538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.
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Men who stare at bone: multimodal monitoring of bone healing. Biol Chem 2021; 402:1397-1413. [PMID: 34313084 DOI: 10.1515/hsz-2021-0170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/12/2021] [Indexed: 12/19/2022]
Abstract
Knowledge of the physiological and pathological processes, taking place in bone during fracture healing or defect regeneration, is essential in order to develop strategies to enhance bone healing under normal and critical conditions. Preclinical testing allows a wide range of imaging modalities that may be applied both simultaneously and longitudinally, which will in turn lower the number of animals needed to allow a comprehensive assessment of the healing process. This work provides an up-to-date review on morphological, functional, optical, biochemical, and biophysical imaging techniques including their advantages, disadvantages and potential for combining them in a multimodal and multiscale manner. The focus lies on preclinical testing of biomaterials modified with artificial extracellular matrices in various animal models to enhance bone remodeling and regeneration.
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Investigating the effect of water‐mixing nitrogen atmospheric pressure plasma jet on polyether‐ether‐ketone and time stability under different conditions. J Appl Polym Sci 2021. [DOI: 10.1002/app.50586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Implant-to-nasal floor dimensions projected by panoramic radiographs in the maxillary incisor-canine region: implications for dental implant treatment. Odontology 2021; 110:171-182. [PMID: 34191207 DOI: 10.1007/s10266-021-00632-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/20/2021] [Indexed: 10/21/2022]
Abstract
To make a comparison of panoramic radiography (PAN) and cone-beam computed tomography (CBCT) determinations of implant-to-nasal floor dimensions (INFD) in the anterior maxillary region, and to assist in determining in which tooth regions additional radiation exposure involved in CBCT scans is justifiable. Data related to INFD by PAN (PAN-D) at implant-to-nasal floor sites (central incisor, lateral incisor, canine) were gathered using 141 implant sites from 119 adult patients. INFD was estimated employing the CBCT technique as a reference method. PAN analysis equations were created for estimation of INFD by CBCT (CBCT-D) specific to implant sites. For assessment of the agreement between the PAN and CBCT methodologies, the Bland-Altman approach was employed. There were robust and significant odds ratios that implants in the canine region would fall into the underestimation groups of > 0 mm (4.5:1) (p = 0.003), > 0.5 mm (6.2:1) (p < 0.001), and > 1 mm (5.4:1) (p = 0.002). The root mean squared error (RMSE) and pure error (PE) were highest for the canine region (RMSE = 1.973 mm, PE = 2.20 mm). This research offers evidence of site-specific underestimations of available horizontal bone dimensions for implants when PAN is employed to assess the availability of vertical bone dimensions. The data suggest that it may be necessary to exclude canine regions when making assessment of INFD through PAN. Use of CBCT may, therefore, be recommended for all implant size and angulation estimations in this region.
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Estimating bone mineral density using MRI in medicine and dentistry: a literature review. Oral Radiol 2020; 37:366-375. [PMID: 32930913 DOI: 10.1007/s11282-020-00484-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Studies performed in the medical area have shown that an indirect diagnosis of bone mineral density (BMD) is feasible by assessing the amount of bone marrow fat with non-ionizing magnetic resonance imaging (MRI). In dentistry, radiographic methods are still the most used for alveolar bone diagnosis. The present literature review aimed at addressing the role of MRI in assessing BMD in medicine and dentistry. METHODS MEDLINE and EMBASE databases were searched for articles published up to 2019. RESULTS A total of 428 potentially eligible papers were screened. Of these, 397 were excluded after title, abstract and keyword assessment, yielding 31 papers that potentially met the inclusion criteria. Eleven studies were then excluded because their full texts did not discuss the role of MRI in the indirect diagnosis of BMD. As a result, a total of 20 studies were finally identified as eligible for inclusion in this literature review. Most studies found satisfactory accuracy of MRI for indirectly assessing BMD by quantifying bone mineral fat (BMF). However, only one of these studies was on dentistry. CONCLUSION Within the limitations of this study, the present findings suggest that MRI is accurate to indirectly estimate bone density by assessing BMF, and could be clinically relevant during dental treatment planning.
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Evaluation of magnetic resonance imaging artifacts caused by fixed orthodontic CAD/CAM retainers-an in vitro study. Clin Oral Investig 2020; 25:1423-1431. [PMID: 32785849 PMCID: PMC7878219 DOI: 10.1007/s00784-020-03450-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/07/2020] [Indexed: 12/27/2022]
Abstract
Objectives Magnetic resonance imaging (MRI) image quality can be severely impaired by artifacts caused by fixed orthodontic retainers. In clinical practice, there is a trend towards using computer-aided design/computer-aided manufacturing (CAD/CAM) retainers. This study aimed to quantify MRI artifacts produced by these novel CAD/CAM retainers. Material and methods Three CAD/CAM retainers and a stainless-steel retainer (“Twistflex”; clinical reference standard) were scanned in vitro at 3-T MRI using a high-resolution 3D sequence. The artifact diameters and three-dimensional artifact volumes (AV) were determined for all mandibular (AVmand) and maxillary (AVmax) retainers. Moreover, the corresponding ratio of artifact volume to retainer volume (AV/RVmand, AV/RVmax) was calculated. Results Twistflex caused large artifact volumes (AVmand: 13530 mm3; AVmax: 15642 mm3; AV/RVmand: 2602; AV/RVmax: 2235). By contrast, artifact volumes for CAD/CAM retainers were substantially smaller: whereas artifact volumes for cobalt–chromium retainers were moderate (381 mm3; 394 mm3; 39; 31), grade-5 titanium (110 mm3; 126 mm3; 12; 12) and nickel–titanium (54 mm3; 78 mm3; 12; 14) both produced very small artifact volumes. Conclusion All CAD/CAM retainers caused substantially smaller volumes of MRI artifacts compared to Twistflex. Grade-5 titanium and nickel–titanium CAD/CAM retainers showed the smallest artifact volumes. Clinical relevance CAD/CAM retainers made from titanium or nickel–titanium may not relevantly impair image quality in head/neck and dental MRI. Artifacts caused by cobalt–chromium CAD/CAM retainers may mask nearby dental/periodontal structures. In contrast, the large artifacts caused by Twistflex are likely to severely impair diagnosis of oral and adjacent pathologies.
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Enhanced bioactivity and osteogenic property of carbon fiber reinforced polyetheretherketone composites modified with amino groups. Colloids Surf B Biointerfaces 2020; 193:111098. [PMID: 32498001 DOI: 10.1016/j.colsurfb.2020.111098] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 11/19/2022]
Abstract
Polyetheretherketone (PEEK) is considered as a potential dental and orthopedic implant material owing to its favorable thermal and chemical stability, biocompatibility and mechanical properties. However, the inherent bio-inert and inferior osseointegration of PEEK have hampered its clinical application. In addition, carbon fiber is widely used as a filler to reinforce polymers for sturdy composites owing to its high strength, modulus, etc. In the study, carbon fiber reinforced PEEK (CPEEK) composites were fabricated and modified with amino groups by plasma-enhanced chemical vapor deposition surface modification technique. The surface characterization of composites was evaluated by FE-SEM, EDS, AFM, Water contact angle, XPS and FTIR, which revealed that amino groups were successfully incorporated on the modified CPEEK surface and significantly increased the hydrophilicity. In vitro study, cell adhesion, proliferation, ALP activity, ECM mineralization, real-time PCR analysis, and ELISA analysis showed the adhesion, proliferation and osteogenic differentiation of MG-63 cells on the amino group-modified CPEEK surface were higher than the CPEEK, equal to or better than pure titanium. Hence, the results indicated that the amino group-modified CPEEK possessed enhanced bioactivity and osteogenic property, which may be a potential candidate material for dental implants.
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Surface Modification Strategies to Improve the Osseointegration of Poly(etheretherketone) and Its Composites. Macromol Biosci 2019; 20:e1900271. [DOI: 10.1002/mabi.201900271] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 10/18/2019] [Indexed: 01/01/2023]
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Assessment of signal-to-noise ratio and contrast-to-noise ratio in 3 T magnetic resonance imaging in the presence of zirconium, titanium, and titanium-zirconium alloy implants. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:80-86. [PMID: 31628073 DOI: 10.1016/j.oooo.2019.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 08/09/2019] [Accepted: 08/31/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We quantitatively compared the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in T1 weighted imaging (WI) and T2 WI sequences in 3 Tesla (T) magnetic resonance imaging (MRI) using zirconium, titanium (grades 4 and 5), and titanium-zirconium alloy implants to evaluate the effect of implant type and imaging sequence. STUDY DESIGN MRI was acquired using a 3 T magnet with a 16-channel head coil. Implants of each type were mounted in gel and scanned in axial, coronal, and sagittal planes using fast spin echo sequences in T1 WI (TR = 600, TE = 12 milliseconds) and T2 WI (TR = 3000, TE = 80 milliseconds) sequences. Data were transferred to Synapse 3-D software, and images were measured twice by an oral and maxillofacial radiologist blinded to the type of implants. RESULTS Zirconium implants resulted in the lowest SNR and CNR values (P < .05). No significant differences were identified between titanium (grades 4 and 5) and titanium-zirconium implants. The T2 WI sequence had a significantly higher SNR and CNR than T1 WI. There was no difference in intraobserver agreement between T1 WI and T2 WI. CONCLUSIONS CNR and SNR at 3 T MRI are dependent on implant type and imaging sequence. Titanium (grades 4 and 5) and titanium-zirconium implants and the T2 WI sequence produced higher SNR and CNR values.
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Plasma treatment of polyether-ether-ketone: A means of obtaining desirable biomedical characteristics. Eur Polym J 2019. [DOI: 10.1016/j.eurpolymj.2019.06.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Surface phosphonation treatment shows dose-dependent enhancement of the bioactivity of polyetheretherketone. RSC Adv 2019; 9:30076-30086. [PMID: 35530193 PMCID: PMC9072086 DOI: 10.1039/c9ra05229a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 04/30/2020] [Accepted: 09/16/2019] [Indexed: 11/21/2022] Open
Abstract
Polyetheretherketone (PEEK) is a promising alternative for biomedical metallic implants in orthopedic and dental applications because its elastic modulus is similar to that of bone.
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PEEK materials as an alternative to titanium in dental implants: A systematic review. Clin Implant Dent Relat Res 2018; 21:208-222. [PMID: 30589497 DOI: 10.1111/cid.12706] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 11/17/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Evaluation of the available research on PEEK materials to find that whether PEEK material has favorable properties and can enhance osseointegration, so that they can be utilize as implants material. MATERIALS AND METHODS An electronic and structured systematic search was undertaken in May 2018, without any restrictions of time in the Medline/Pubmed, Sci-hub, Ebscohost, Cochrane, and Web of Science databases. To identify other related references further hand search was done. Articles related to PEEK and their applications in implants were only included. Articles not available in abstract form and article other than English language were excluded. RESULTS Initially, the search resulted in 153 papers. Independent screenings of the abstracts were done by the reviewers to identify the articles related to the question in focus. Sixty-two studies were selected out of which 10 were further excluded due to not in English language. Two additional papers were obtained after hand searching, and finally 54 articles were included in the review. CONCLUSIONS Surface modification of PEEK seems to enhance the cell adhesion, proliferation, biocompability, and osteogenic properties of PEEK implant materials. PEEK had also influence the biofilm structure and reduces the chances of periimplant inflammations. Further research and more number of controlled clinical trials on PEEK implant is required in near future so that it can replace titanium in future.
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Feasibility of Magnetic Resonance Imaging Monitoring of Postoperative Total Knee Arthroplasty without Metal Artifacts: A Preliminary Study of a Novel Implant Model. BIOMED RESEARCH INTERNATIONAL 2018; 2018:8194670. [PMID: 30426016 PMCID: PMC6218794 DOI: 10.1155/2018/8194670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 09/28/2018] [Accepted: 10/16/2018] [Indexed: 12/24/2022]
Abstract
Background Although magnetic resonance imaging (MRI) can provide superior detailed images of tissues without ionizing radiation, the imaging evaluation of total knee arthroplasty (TKA) complications and posttherapy changes can be limited because of abundant artifacts on MRI scans due to metallic implants and endoprosthesis in limb salvage and fracture fixation. This study aimed to develop a novel model of TKA using a polyetheretherketone- (PEEK-) on-highly cross-linked polyethylene (HXLPE) implant and to investigate its feasibility for MRI monitoring of peri-implant bone formation, the healing process, signs of infection, and tumor recurrence after TKA. Methods Three skeletally mature goats underwent TKA with the PEEK-on-HXLPE implant. Radiographic and MRI examinations were performed at 4 weeks postoperatively. Images were analyzed for the existence of artifact interruption and postoperative changes in the bone and peripheral soft tissue. Results The results showed that PEEK and HXLPE were invisible, but the metal wires were clearly visualized on X-rays. On MRI scans, PEEK and HXLPE materials showed a low signal intensity, fine metal wires generated no obvious metal artifacts on MRI scans, and the marrow and soft tissue showed a continuous signal intensity without artifact interruption. Conclusions This preliminary study introduced a novel model using PEEK-on-HXLPE knee implant for in vivo MRI monitoring of the region around the implant without metal artifacts. This novel model may be used to apply MRI to observe bone formation and the healing process around the prosthesis and the signs of infection and tumor recurrence after TKA. This model may be used to improve the diagnostic accuracy of postoperative complications of TKA clinically.
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Enhanced osteogenic activity of phosphorylated polyetheretherketone via surface-initiated grafting polymerization of vinylphosphonic acid. Colloids Surf B Biointerfaces 2018; 173:591-598. [PMID: 30352380 DOI: 10.1016/j.colsurfb.2018.10.031] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/27/2018] [Accepted: 10/12/2018] [Indexed: 11/22/2022]
Abstract
Polyetheretherketone (PEEK) is considered to be a prime candidate with the potential to replace biomedical metallic materials as an orthopedic and dental implant on account of its elastic modulus similar to that of human cortical bone. Unfortunately, its biomedical application is impeded by the bioinert surface property and inferior osteogenic activity. In this work, phosphate groups were incorporated onto the PEEK surface through a single-step UV-initiated graft polymerization of vinylphosphonic acid. Diffuse reflectance Fourier transform infrared spectroscopy (DRFTIR), X-ray photoelectron spectroscopy (XPS), and atomic force microscopy (AFM) revealed that phosphate groups were successfully introduced onto the PEEK surface without apparently altering its surface topographical feature and roughness. Water contact angle measurements diclosed the increasing hydrophilia after surface phosphonation. In vitro cell adhesion, spreading, proliferation, alkaline phosphatase activity, extracellular matrix mineralization, and real-time PCR analyses showed enhanced adhesion, spreading, proliferation and osteogenic differentiation of MC3T3-E1 osteoblast on the surface-phosphorylated PEEK. An in vivo biological evaluation in the rabbit tibiae proximal defect model by means of a histological analysis confirmed that the surface-phosphorylated PEEK had improved bone-implant contact. The obtained results indicate that enhanced osteogenic activity to surface-phosphorylated PEEK, which gives positive information of its potential applications in orthopedic and dental implants.
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Enhanced Osteoblasts Responses to Surface-Sulfonated Polyetheretherketone via a Single-Step Ultraviolet-Initiated Graft Polymerization. Ind Eng Chem Res 2018. [DOI: 10.1021/acs.iecr.8b02158] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000 2018; 73:51-72. [PMID: 28000270 DOI: 10.1111/prd.12161] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Diagnostic radiology is an essential component of treatment planning in the field of implant dentistry. This narrative review will present current concepts for the use of cone beam computed tomography imaging, before and after implant placement, in daily clinical practice and research. Guidelines for the selection of three-dimensional imaging will be discussed, and limitations will be highlighted. Current concepts of radiation dose optimization, including novel imaging modalities using low-dose protocols, will be presented. For preoperative cross-sectional imaging, data are still not available which demonstrate that cone beam computed tomography results in fewer intraoperative complications such as nerve damage or bleeding incidents, or that implants inserted using preoperative cone beam computed tomography data sets for planning purposes will exhibit higher survival or success rates. The use of cone beam computed tomography following the insertion of dental implants should be restricted to specific postoperative complications, such as damage of neurovascular structures or postoperative infections in relation to the maxillary sinus. Regarding peri-implantitis, the diagnosis and severity of the disease should be evaluated primarily based on clinical parameters and on radiological findings based on periapical radiographs (two dimensional). The use of cone beam computed tomography scans in clinical research might not yield any evident beneficial effect for the patient included. As many of the cone beam computed tomography scans performed for research have no direct therapeutic consequence, dose optimization measures should be implemented by using appropriate exposure parameters and by reducing the field of view to the actual region of interest.
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Early Stages of Biomineral Formation—A Solid-State NMR Investigation of the Mandibles of Minipigs. MAGNETOCHEMISTRY 2017. [DOI: 10.3390/magnetochemistry3040039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
The success of osseointegrated biomaterials often depends on the functional interface between the implant and mineralized bone tissue. Several parallels between natural and synthetic interfaces exist on various length scales from the microscale toward the cellular and the atomic scale structure. Interest lies in the development of more sophisticated methods to probe these hierarchical levels in tissues at both biomaterials interfaces and natural tissue interphases. This review will highlight new and emerging perspectives toward understanding mineralized tissues, particularly bone tissue, and interfaces between bone and engineered biomaterials at multilength scales and with multidimensionality. Emphasis will be placed on highlighting novel and correlative X-ray, ion, and electron beam imaging approaches, such as electron tomography, atom probe tomography, and in situ microscopies, as well as spectroscopic and mechanical characterizations. These less conventional approaches to imaging biomaterials are contributing to the evolution of the understanding of the structure and organization in bone and bone integrating materials.
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Solid-state 31P and 1H chemical MR micro-imaging of hard tissues and biomaterials with magic angle spinning at very high magnetic field. Sci Rep 2017; 7:8224. [PMID: 28811630 PMCID: PMC5557955 DOI: 10.1038/s41598-017-08458-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/10/2017] [Indexed: 11/09/2022] Open
Abstract
In this work, we show that it is possible to overcome the limitations of solid-state MRI for rigid tissues due to large line broadening and short dephasing times by combining Magic Angle Spinning (MAS) with rotating pulsed field gradients. This allows recording ex vivo 31P 3D and 2D slice-selected images of rigid tissues and related biomaterials at very high magnetic field, with greatly improved signal to noise ratio and spatial resolution when compared to static conditions. Cross-polarization is employed to enhance contrast and to further depict spatially localized chemical variations in reduced experimental time. In these materials, very high magnetic field and moderate MAS spinning rate directly provide high spectral resolution and enable the use of frequency selective excitation schemes for chemically selective imaging. These new possibilities are exemplified with experiments probing selectively the 3D spatial distribution of apatitic hydroxyl protons inside a mouse tooth with attached jaw bone with a nominal isotropic resolution nearing 100 µm.
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Assessing agreement between preclinical magnetic resonance imaging and histology: An evaluation of their image qualities and quantitative results. PLoS One 2017; 12:e0179249. [PMID: 28666026 PMCID: PMC5493293 DOI: 10.1371/journal.pone.0179249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/28/2017] [Indexed: 11/19/2022] Open
Abstract
One consequence of demographic change is the increasing demand for biocompatible materials for use in implants and prostheses. This is accompanied by a growing number of experimental animals because the interactions between new biomaterials and its host tissue have to be investigated. To evaluate novel materials and engineered tissues the use of non-destructive imaging modalities have been identified as a strategic priority. This provides the opportunity for studying interactions repeatedly with individual animals, along with the advantages of reduced biological variability and decreased number of laboratory animals. However, histological techniques are still the golden standard in preclinical biomaterial research. The present article demonstrates a detailed method comparison between histology and magnetic resonance imaging. This includes the presentation of their image qualities as well as the detailed statistical analysis for assessing agreement between quantitative measures. Exemplarily, the bony ingrowth of tissue engineered bone substitutes for treatment of a cleft-like maxillary bone defect has been evaluated. By using a graphical concordance analysis the mean difference between MRI results and histomorphometrical measures has been examined. The analysis revealed a slightly but significant bias in the case of the bone volume [Formula: see text] and a clearly significant deviation for the remaining defect width [Formula: see text] But the study although showed a considerable effect of the analyzed section position to the quantitative result. It could be proven, that the bias of the data sets was less originated due to the imaging modalities, but mainly on the evaluation of different slice positions. The article demonstrated that method comparisons not always need the use of an independent animal study, additionally.
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Use of High Performance Polymers as Dental Implant Abutments and Frameworks: A Case Series Report. J Prosthodont 2017; 28:365-372. [DOI: 10.1111/jopr.12639] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/30/2022] Open
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The applicability of PEEK-based abutment screws. J Mech Behav Biomed Mater 2016; 63:244-251. [PMID: 27434650 DOI: 10.1016/j.jmbbm.2016.06.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 06/20/2016] [Accepted: 06/26/2016] [Indexed: 11/19/2022]
Abstract
The high-performance polymer PEEK (poly-ether-ether-ketone) is more and more being used in the field of dentistry, mainly for removable and fixed prostheses. In cases of screw-retained implant-supported reconstructions of PEEK, an abutment screw made of PEEK might be advantageous over a conventional metal screw due to its similar elasticity. Also in case of abutment screw fracture, a screw of PEEK could be removed more easily. M1.6-abutment screws of four different PEEK compounds were subjected to tensile tests to set their maximum tensile strengths in relation to an equivalent stress of 186MPa, which is aused by a tightening torque of 15Ncm. Two screw types were manufactured via injection molding and contained 15% short carbon fibers (sCF-15) and 40% (sCF-40), respectively. Two screw types were manufactured via milling and contained 20% TiO2 powder (TiO2-20) and >50% parallel orientated, continuous carbon fibers (cCF-50). A conventional abutments screw of Ti6Al4V (Ti; CAMLOG(®) abutment screw, CAMLOG, Wimsheim, Germany) served as control. The maximum tensile strength was 76.08±5.50MPa for TiO2-20, 152.67±15.83MPa for sCF-15, 157.29±20.11MPa for sCF-40 and 191.69±36.33MPa for cCF-50. The maximum tensile strength of the Ti-screws amounted 1196.29±21.4MPa. The results of the TiO2-20 and the Ti screws were significantly different from the results of the other samples, respectively. For the manufacturing of PEEK abutment screws, PEEK reinforced by >50% continuous carbon fibers would be the material of choice.
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