Surface treatments of titanium dental implants for rapid osseointegration

Immobilization of biofunctional molecule with potential osteoinductive efficacy on titanium implant for promoting early-stage osseointegration

In the present study, porcine-derived collagen type I was covalently immobilized on the surface of titanium (Ti) implants via carboxyl groups introduced by bonded p-vinylbenzoic acid to investigate its in vitro biocompatibility with gingival stem cells and in vivo bone regeneration behavior in the edentulous ridges of Lanyu small-ear pigs at weeks 2 and 6 (short-term effectiveness) through micro-computed tomography and histological analysis. Analytical results found that gingival stem cells showed effective adhesion and spreading on these collagen-immobilized implant surfaces. After 2 and 6 weeks of healing, significant differences in Hounsfield units were observed among the control (week 2 (674.2 ± 79.9) ∗∗p < 0.01 and week 6 (596.4 ± 49.6) ∗∗p < 0.01), buffer-coated implant (week 2 (768.1 ± 68.7) ∗p < 0.05 and week 6 (720.4 ± 62.6) ∗p < 0.05), and collagen-immobilized implant (week 2 (828.2 ± 69.4) and week 6 (907.4 ± 63.5)) groups. No significant differences in bone-to-implant contact ratios were discovered between the investigated groups. However, the bone surface area results demonstrated an enhanced bone apposition for the collagen-immobilized implants compared to the control and buffer-coated implants at weeks 2 and 6 post-implantation (∗p < 0.05). Therefore, this preclinical study underscores the advantageous impact of collagen immobilization on Ti implant surfaces for clinical application, substantiating its effectiveness through significant evidence of improved osseointegration at early-stages.

Clinical effectiveness of Zirconia versus titanium dental implants in anterior region: an overview of systematic reviews

BACKGROUND

Nowadays dental implants are commonly used and to fulfil esthetic demands, zirconia has been suggested as an implant material as an alternative to titanium. Many researchers and systematic reviews are documented on it, but the results have been often inconsistent. This overview of systematic reviews aimed to report on the factors that influence the clinical effectiveness of zirconia (Zi) versus titanium (Ti) dental implants in anterior region.

METHODS

This overview of systematic reviews (Registration Number CRD42023396206) is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. PubMed, Cochrane, Scopus, Embase and Google Scholar databases were sourced for systematic review and meta-analyses. Joanna Briggs Institute (JBI) criteria and Measurement Tool to Assess systematic Reviews" (AMSTAR-2), evaluated the quality. The PICO-focused question of this overview of systematic reviews was "What are the various factors influencing the clinical performance of Zi versus Ti implants in the anterior area?", Evaluations were assessed by two assessors. In case there was any uncertainty or dispute among the reviewers, the work was included for further screening. Using Cohen's kappa, the inter-reviewer reliability was evaluated.

RESULTS

Six reviews were chosen from 57 suitable reviews for this data analysis. Although the survival and effectiveness rates backed titanium implants, there was no conclusive proof of marginal bone loss. Zirconium implants performed better in terms of aesthetics.

CONCLUSION

Clinical performance of zirconia could be considered at par with titanium implants in the anterior area. Titanium has exhibited greater mechanical performance but no significant difference between two recorded. In future, studies with improved design are needed to identify biological and technical factors that affect implant's efficacy.

NOVELTY AND RELEVANCE

This is the first overview of systematic reviews focusing specifically on the anterior region, evaluates both aesthetic and biomechanical performance of Zi and Ti Implants, offers detailed insight into material-specific advantages and limitations. In the present clinical scenario it addresses a critical gap by comparing the performance of Zi and Ti implants and evaluates patient-centred priorities, particularly in the highly visible anterior region.

A Novel Porous Coating Method of Commercially Pure Titanium Using Silk Fibroin and UV Light for Biomedical Implant Applications

Surface coatings for titanium implants have been actively investigated using numerous materials to improve biocompatibility and osteointegration. This study developed a novel porous coating method for titanium implants; we coated commercially pure titanium (Cp-Ti) using the photocurable properties of methacrylated silk fibroin (SilMA). Surface morphologies and alloying chemistry after coating were investigated by scanning electron microscopy (SEM) and EDS, while the biocompatibility of the SilMA-coated Cp-Ti was evaluated by the CCK-8 and live/dead assays. With various SilMA concentrations, uniform and strong SilMA coatings were obtained by UV light for both thin and thick coating methods. A universal mechanical testing machine evaluated the mechanical properties of SilMA coating. The interface adhesive strength of the coating taken by advanced centrifugal measurement was enhanced as the SilMA concentration increased. Cell cytotoxicity test results for 1, 3, 5, and 7 days revealed no toxic behavior in human dermal fibroblast cells. Cells on the SilMA-coated Cp-Ti revealed a higher proliferation and survival rate than those on the titanium without coating. These results show that this versatile coating method offers a tightly adhered bioactive coating of silk fibroin on titanium implants, demonstrating the potential for a universal coating method for use in a wide range of biomedical applications.

Effect of mechanical instrumentation on titanium implant surface properties

OBJECTIVE

To assess the impact of mechanical decontamination using rotary brushes on the surface topography, elemental composition, roughness, and wettability of titanium implant surfaces.

METHODS

Four commercially available rotary brushes were used: Labrida BioClean Brush® (LB), i-Brush1 (IB), NiTiBrush Nano (NiTiB), and Peri-implantitis Brush (PIB). Seventy-five titanium discs with sandblasted, large-grit, acid-etched (SLA) surfaces were randomly assigned to five groups (n = 15): LB, IB, NiTiB, PIB, and a control group. Each disc was treated for 60 seconds with the respective rotary brush according to the manufacturer's instructions. Surface morphology was analysed using Scanning Electron Microscopy (SEM), surface elemental composition with Energy Dispersive X-ray (EDX), surface roughness via optical profilometry, and wettability with a droplet shape analyser.

RESULTS

SEI analysis revealed morphological changes, including scratches, flattening, and loose titanium particles in the IB, PIB, and NiTiB groups, whereas the LB group preserved the original surface morphology. SEM-EDX analysis showed that LB, PIB, and NiTiB groups closely match the control elemental composition. However, IB groups showed significantly different composition. Surface roughness values in the IB, PIB, and NiTiB groups differed significantly from the control (p < 0.05), whereas the LB group had comparable roughness values (p > 0.05). Contact angle measurements indicated enhanced wettability in IB, PIB, and NiTiB groups (p < 0.05), while the LB group exhibited values comparable to the control (p > 0.05).

SIGNIFICANCE

Mechanical decontamination of implant surfaces utilising rotary brushes can alter implant surface properties.

Sustained release of Sr and Ca from a micronanotopographic titanium surface improves osteoblast function

The surface chemistry and topographical features of dental implants play a crucial role in influencing the osseointegration process. Alkaline earth elements such as strontium (Sr) and calcium (Ca) exert beneficial effects in promoting bone formation. This study aimed to evaluate micronanotopographic cpTi substrates that doped these elements, Sr and Ca. The composition and morphology were analyzed by X-ray photoelectron spectroscopy, scanning electron microscopy (SEM), and atomic force microscopy (AFM). Wettability assays, Sr and Ca release tests, and electrochemical behavior were also conducted. Proliferation, adhesion, and differentiation of MC3T3-E1 cells on this surface were evaluated in vitro. Direct fluorescence assays and SEM, cell viability, alkaline phosphatase (ALP) activity, and mineralization nodule formation were performed. The biological results showed the absence of cytotoxicity after the treatments, increased cell spreading on the micronanotopographic substrates, and greater mineralization nodule formation on surfaces doped with Sr and Sr/Ca. Gene and protein expression of osteoblastic markers were assessed through PCR and ELISA, and some genes were regulated on the doped surfaces at three and seven days of cell culture, like Bglap, Ibsp, Spp, Col1a1, and Runx2. The micronanotopographic substrates modified the physicochemical properties and morphology of the pre-osteoblasts. The results indicate that the biological effect of implants treated with Sr and Sr/Ca was significantly superior to that of polished surfaces and undoped micronanotopographic implants. Furthermore, the addition of Sr alone was sufficient to improve events related to osseointegration.

Identification of a surface texture parameter panel characterizing surface micromorphologies of differently processed oral implant surfaces

OBJECTIVES

Inconsistent characterization of oral implant microtopography makes it difficult to compare and evaluate available data on microtopography and the biological response to topographical characteristics. The aim of this investigation was therefore to identify a surface texture parameter panel that enables a discriminative characterization of differently processed oral implant surfaces.

MATERIALS AND METHODS

Surface micromorphologies of titanium- and ceramic-based biomaterials processed by machining or by machining and subsequent post-processing, including blasting, etching, anodization or porous sintering, were analyzed by scanning electron microscopy and white light interferometry. It was then analyzed which of the parameters Sa, Sq, Sz, Ssk, Sku, Str, Sal, Spd, Spc, Sdq and Sdr best characterized morphological surface features and hence should be reported as minimum parameter panel for implant surface characterization.

RESULTS

SEM demonstrated that each surface processing resulted in a specific and biomaterial-dependent micromorphology. The data revealed that the micromorphology of machined surfaces was best characterized by Sa, Sdr, Str and Ssk, and that for post-processed surfaces Spd and Spc were additionally required. Based on these data, Sa, Sdr, Str, Ssk, Spd and Spc were identified as minimum parameter panel for discriminative description of the investigated implant microtopographies.

SIGNIFICANCE

The present investigation identified Sa, Sdr, Str, Ssk, Spd and Spc as minimum parameter panel for discriminative oral implant surface characterization. The widespread use of such a panel combined with biological data will help to identify cell-relevant implant surface structures, thus enabling the design of oral implants with predefined biological response.

Biocompatible and Antibacterial Chemical Coatings on TiZr Dental Implants

This research aims to study the antibacterial coatings of invasive surgical medical devices, including dental implants, to reduce superficial and deep local infections over the long term. To obtain the coating without altering the initial properties of the substrate (dental implant made of TiZr bioalloy), simple, cost-effective, and efficient methods were employed, such as chemical deposition of silver (Ag). The deposition characteristics were analyzed using scanning electron microscopy (SEM), EDX analysis, and FT-IR infrared analysis. The in vitro testing of antimicrobial activity was conducted using the diffusion method by cultivating the bacterial strains Escherichia coli (E. coli) ATCC25922 and Staphylococcus aureus (S. aureus) ATCC25923 and measuring the diameter of the bacterial inhibition zone. Investigations and biocompatibility evaluations were performed on both uncoated and silver-coated (Ag) samples by analyzing cell viability and morphology in the presence of human fetal osteoblasts (hFOB cell line) and human gingival fibroblasts (HFIB-G cells) after 8 days of incubation. The research results confirm the biocompatibility of the coating, demonstrated by the lack of significant differences in cell density between the Ag-coated samples and the control group, as well as by the fact that the silver-coated surface effectively supports actin cytoskeleton organization, adhesion, and migration of both human osteoblasts and gingival fibroblasts. The results regarding the antibacterial efficiency of the silver implant coating indicated that the E. coli bacterial strain is more resistant than S. aureus. The resistance difference between the two bacterial strains was attributed to differences in the structure of their cell envelopes.

Multiscale Hierarchical Micro- and Nano-Surface Induced by High-Repetition-Rate Femtosecond Laser Promote Peri-Implant Osseointegration

Micro- and nanomorphological modification and roughening of titanium implant surfaces can enhance osseointegration; however, the optimal morphology remains unclear. Laser processing of implant surfaces has demonstrated significant potential due to its precision, controllability, and environmental friendliness. Femtosecond lasers, through precise optimization of processing parameters, can modify the surface of any solid material to generate micro- and nanomorphologies of varying scales and roughness. Inspired by the multiscale micro- and nanostructures of natural bone tissue, this study employed a high-repetition-rate femtosecond laser to fabricate three distinct micro- and nanomorphologies on titanium implant surfaces, characterized by low (LTi), medium (MTi), and high (HTi) roughness, exhibiting multiscale coexistence. Comprehensive characterization of the modified surfaces included analysis of morphology, roughness, wettability, and elemental composition. Furthermore, in vitro and in vivo experiments were conducted to evaluate osteogenic differentiation and osseointegration capabilities. Results revealed that the HTi surface, exhibiting high roughness, presents a multiscale hierarchical micro- and nanostructure composed of micrometer-sized spheres, submicrometer-sized corrugations, and nanometer-sized particles. In vitro studies demonstrated that the HTi surface promoted earlier adhesion, spreading, and enhanced osteogenic differentiation of osteoblasts, while in vivo studies indicated improved bone formation and osseointegration. In conclusion, multiscale hierarchical micro- and nanosurfaces with high roughness generated by high-repetition-rate femtosecond laser processing hold considerable promise for titanium implant applications.

Advances in the application and research of biomaterials in promoting bone repair and regeneration through immune modulation

With the ongoing development of osteoimmunology, increasing evidence indicates that the local immune microenvironment plays a critical role in various stages of bone formation. Consequently, modulating the immune inflammatory response triggered by biomaterials to foster a more favorable immune microenvironment for bone regeneration has emerged as a novel strategy in bone tissue engineering. This review first examines the roles of various immune cells in bone tissue injury and repair. Then, the contributions of different biomaterials, including metals, bioceramics, and polymers, in promoting osteogenesis through immune regulation, as well as their future development directions, are discussed. Finally, various design strategies, such as modifying the physicochemical properties of biomaterials and integrating bioactive substances, to optimize material design and create an immune environment conducive to bone formation, are explored. In summary, this review comprehensively covers strategies and approaches for promoting bone tissue regeneration through immune modulation. It offers a thorough understanding of current research trends in biomaterial-based immune regulation, serving as a theoretical reference for the further development and clinical application of biomaterials in bone tissue engineering.

Is galvanic corrosion between implant abutments and roots a possible scenario? An experimental study under simulated healthy and inflammatory peri-implant conditions and F anions

PURPOSE

To assess the effect of healthy and inflammatory conditions and the presence of F anions on the galvanic coupling between the root surface and titanium abutments of commercially available titanium implants MATERIALS AND METHODS: Eight pairs of three dental root-abutment couples (BEGO, MIS, NOBEL) were exposed to a neutral (pH=7.4) (HE) and an acidic (pH=4.0) (IN) phosphate buffer solution (PBS) simulating healthy and inflammatory conditions respectively. In order to simulate the presence of F anions, which is commonly used in toothpastes, 3.12 gr of NaF was added in both solutions simulating healthy conditions (HEF) and inflammatoy conditions (INF) with the presence of F anions respectively. The galvanic potential difference was recorded for 48 h and averaged. Physical appearance of abutment and roots were tested under a stereomicroscope. Scanning electron microscopy and X-ray energy dispersive spectroscopy (SEM/EDX) was used to characterize the materials under reseach and compare the surfaces before and after galvanic testing.

RESULTS

All abutments are composed of Ti-6Al-4V alloy along with root of MIS system, while BEG and NOB are made of Ti according to the SEM/EDX analysis. No differences were identified in surface morphology before and after galvanic testing, while EDX analysis revealed only the presence of Na and F on the surface of MIS abutments after testing in INF conditions. All groups tested showed negligible potential difference and below the nominal threshold for triggering galvanic corrosion under HE, IN and HEF conditions. The same applies for BEG and MIS under INF conditions, while NOB presented an average potential difference value of -273 mV, which is above nominal thresshold for galvanic action. Only MIS abutment showed a color change from yellow to blue under INF conditions.

CONCLUSIONS AND CLINICAL IMPLICATIONS

BEG and MIS implant systems are not prone to galvanic corrosion in all conditions tested. NOB was found vulnerable to galvanic corrosion under inflammatory peri-implant conditions in the presence of F anions. Galvanic reactions is a possible scenario even between Ti base implant components.

Unlocking Osseointegration: Surface Engineering Strategies for Enhanced Dental Implant Integration

Tooth loss is a prevalent problem faced by individuals of all ages across the globe. Various biomaterials, such as metals, bioceramics, polymers, composites of ceramics and polymers, etc., have been used for the manufacturing of dental implants. The success of a dental implant primarily depends on its osseointegration rate. The current surface modification techniques fail to imbibe the basics of tooth development, which can impart better mineralization and osseointegration. This can be improved by developing an understanding of the developmental pathways of dental tissue. Stimulating the correct signaling pathways through inductive material systems can bring about a paradigm shift in dental implant materials. The current review focuses on the developmental pathway and mineralization process that happen during tooth formation and how surface modifications can help in biomimetic mineralization, thereby enhancing osseointegration. We further describe the effect of dental implant surface modifications on mineralization, osteoinduction, and osseointegration; both in vitro and in vivo. The review will help us to understand the natural process of teeth development and mineralization and how the surface properties of dental implants can be further improved to mimic teeth development, in turn increasing osseointegration.

Assessing the bond strength of short fiber composites to dentin using various air abrasion particles

PURPOSE

This study investigated the bond strength between short fiber-reinforced resin composite (SFC) and dentin following air abrasion with various types of abrasive particles.

METHODS

A total of 120 human molars were prepared for a shear bond strength (SBS) test of the resin composite. The teeth were divided into 12 groups (n = 10/group) based on the air abrasion particle used. Half of the groups underwent phosphoric acid etching (10 s) prior to air abrasion, while the other half received no pretreatment. Air abrasion was performed using five types of particles, after which a two-part adhesive (G2 Bond) and SFC were applied on the treated surfaces. The SBS test was performed using a universal testing machine at a crosshead speed of 1.0 mm/min until failure. Two additional specimens from each group were prepared to evaluate the air abraded surface using scanning electron microscopy after being stored in simulated body fluid (SBF) for two weeks. Statistical analysis was performed using two-way analysis of variance and the Tukey test (α = 0.05).

RESULTS

The highest SBS values were observed in the control group (18.9 MPa), which did not undergo air abrasion. The use of different air abrasion particles affected the SBS of SFC to dentin (P < 0.05), as air abrasion with jet sand in the absence of pre-etching differed significantly from the other Cojet group (P < 0.05).

CONCLUSIONS

Air abrasion with various particles did not improve the bond strength between the SFC and dentin.

Development of Zinc-Containing Chitosan/Gelatin Coatings with Immunomodulatory Effect for Soft Tissue Sealing around Dental Implants

BACKGROUND

Soft tissue integration (STI) around dental implant abutments is a prerequisite to prevent bacterial invasion and achieve successful dental implant rehabilitation. However, peri-implant STI is a major challenge after dental abutment placement due to alterations in the immune microenvironment upon surgical dental implant installation.

METHODS

Based on known immunomodulatory effects of zinc, we herein deposited zinc/chitosan/gelatin (Zn/CS/Gel) coatings onto titanium substrates to study their effect on macrophages. First, we exposed macrophages to cell culture media containing different zinc ion (Zn2+) concentrations. Next, we explored the immunomodulatory effect of Zn/CS/Gel coatings prepared via facile electrophoretic deposition (EPD).

RESULTS

We found that Zn2+ effectively altered the secretome by reducing the secretion of pro-inflammatory and enhancing pro-regenerative cytokine secretion, particularly at a Zn2+ supplementation of approximately 37.5 μM. Zn/CS/Gel coatings released Zn2+ in a concentration range which effectively stimulated pro-regenerative macrophage polarization as demonstrated by M2 macrophage polarization. Additionally, the impact of these Zn2+-exposed macrophages on gingival fibroblasts incubated in conditioned medium showed stimulated adhesion, proliferation, and collagen secretion.

CONCLUSION

Our promising results suggest that controlled release of Zn2+ from Zn/CS/Gel coatings could be applied to immunomodulate peri-implant STI, and to enhance dental implant survival.

Implant Surface Decontamination Methods That Can Impact Implant Wettability

This review addresses the effects of various decontamination methods on the wettability of titanium and zirconia dental implants. Despite extensive research on surface wettability, there is still a significant gap in understanding how different decontamination techniques impact the inherent wettability of these surfaces. Although the literature presents inconsistent findings on the efficacy of decontamination methods such as lasers, air-polishing, UV light, and chemical treatments, the reviewed studies suggest that decontamination alters in vitro hydrophilicity. Post-decontamination surface chemistry must be carefully considered when selecting optimal surface treatments for implant materials. Further in vitro investigations are essential to determine which approaches best enhance surface wettability, potentially leading to improved implant-tissue interactions in clinical settings.

Correlation between the size of released titanium particles and changes in the surface of dental implants during insertion into bone blocks: an in vitro study

PURPOSE

This study investigated the size and amount of titanium particles immediately released following dental implant insertion into bovine bone blocks and aimed to correlate them with the surface roughness of the implants.

METHODS

Twelve bone blocks were prepared from bovine mandibles. Six tapered (group A) and 6 cylindrical (group B) dental implants were inserted into the bone blocks under water irrigation, following the standard drilling protocol. After insertion, the implants were immediately removed from the bone. Scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and atomic force microscopy were performed to investigate the released titanium particles and implant surface roughness, respectively. The amount of titanium ions in the irrigation water was measured using inductively coupled plasma mass spectrometry. Dynamic light scattering (DLS) was used to determine the size range of the released titanium particles.

RESULTS

The percentages of titanium content on the surface of implants decreased in both groups after implantation into bone blocks. SEM-EDX analysis confirmed the presence of titanium particles embedded in the implanted bone bed. Group B implants showed significantly higher concentrations of titanium ions in the collected water than group A implants (0.868 and 0.565 µg/L, respectively). Group A implants demonstrated high pre-implantation surface roughness, which led to a much greater decrease in post-implantation surface roughness than was observed for group B implants. DLS analysis showed that the titanium particles released from group A implants were within the nano-size range, whereas those released from group B implants were within the micro-size range.

CONCLUSIONS

Dental implant placement leads to a decrease in implant surface roughness and the immediate release of titanium particles into the peri-implant bone. Variations in the size range and amount of released particles were correlated with implant surface roughness. This finding has clinical implications and warrants additional in vivo studies.

Platelet interaction and performance of antibacterial bioinspired nanostructures passivated with human plasma

The ever-increasing ageing of the world population is demanding superior orthopedic devices. Issues such as implant infection, poor osseointegration, or chronic inflammation remain problematic to the lifespan and long-term efficacy of implants. Fabrication of materials with bioinspired nanostructures is one emerging antibacterial strategy to prevent implant infection, however their interactions with blood components, and whether they retain their bactericidal properties in an environment displaying a complex protein corona, remains largely unexplored. In the present study, titanium alloy, commercially pure and plasma-sprayed titania were hydrothermally etched, passivated with human native plasma to develop a protein corona, and then incubated with either Staphylococcus aureus, Pseudomonas aeruginosa or human platelets. Surface analysis was first used to characterize the topography, chemical composition or crystallinity of each material. Fluorescence staining and SEM were performed to evaluate the nanostructure bactericidal properties, as well as to study platelet attachment and morphology. Composition of platelet supernatant was studied using ELISA and flow cytometry. Overall, our study showed that the bioinspired nanostructured surfaces displayed both impressive antibacterial properties in a complex environment, and a superior blood biocompatibility profile in terms of platelet activation (particularly for titanium alloy). Additionally, the amount of pro-inflammatory cytokines released by platelets was found to be no different to that found in native plasma (background levels) and, in some cases, presented a more pro-healing profile with an increased secretion of factors such as TGF-β, PDGF-BB or BMP-2. The nanostructured surfaces performed equally, or better, than hydroxyapatite-coated titanium which is one of the current gold standards in orthopedics. Although further in vivo studies are required to validate these results, such bioinspired nanostructured surfaces certainly show promise to be safely applied to medical device surfaces used in orthopedics and other areas.

Comparative Analysis of Surface Roughness and Design Features of Titanium Dental Implants on Primary Stability and Osseointegration

Objective

This study aimed to evaluate the impact of the surface roughness and design features of titanium dental implants on primary stability and osseointegration.

Methods

Sixty titanium dental implants were categorized into three groups based on their surface roughness: smooth (Subgroup A1), moderately rough (Subgroup A2), and highly rough (Subgroup A3). Each roughness category was further divided into three design subgroups: cylindrical (B1), tapered (B2), and hybrid (B3). Primary stability was assessed using insertion torque and resonance frequency analysis (RFA). Osseointegration was evaluated through histological and histomorphometric analyses, measuring bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) at 4, 8, and 12 weeks post-implantation in rabbit models.

Results

Highly rough-surface implants (Subgroup A3) demonstrated significantly higher insertion torque and ISQ values than smooth (Subgroup A1) and moderately rough (Subgroup A2) implants (P < 0.001). Among the design features, tapered implants (Subgroup B2) exhibited the highest insertion torque and ISQ values (P < 0.001). Histological and histomorphometric analyses revealed that highly rough-surface implants (Subgroup A3) and tapered implants (Subgroup B2) had the highest BIC and BAFO percentages at all time points (P < 0.001).

Conclusion

These findings indicate that both surface roughness and implant design significantly influence primary stability and osseointegration.

Comparison of osseointegration in commercial SLA-treated dental implants with different surface roughness: a pilot study in beagle dogs

PURPOSE

This pilot study investigated the effect of surface roughness on osseointegration by comparing two types of commercial SLA-treated dental implants with different surface roughness levels: moderately rough (Sa = 1 - 2 µm) and rough surfaces (Sa > 2 µm).

MATERIALS AND METHODS

Two implant groups were studied: TS (rough surface) and ADD (moderately rough surface) groups. Surface characteristics were analyzed using optical profilometry and SEM. In vitro studies using BRITER cells assessed cell adhesion, proliferation, and osteogenic differentiation through CCK-8 assay and qRT-PCR for osteopontin (OPN), osteocalcin (OCN), and alkaline phosphatase (ALP) expression. The in vivo study involved 12 implants (six per group) placed in mandibular defects of two beagle dogs. After 8 weeks, histomorphometric analysis evaluated bone to implant contact (BIC) and inter-thread bone density (ITBD). Statistical analysis used Student's t-test and two-way ANOVA for in vitro data, and Mann-Whitney U test for in vivo data.

RESULTS

Surface analysis revealed Sa values of 2.50 ± 0.27 µm for the TS group and 1.80 ± 0.06 µm for the ADD group. In vitro studies showed no significant differences in cell adhesion and proliferation between the groups (P > .05). However, gene expression patterns differed, with ADD group showing higher OPN expression (P < .001) and TS group showing higher ALP expression (P < .01). The in vivo study revealed no statistically significant differences in BIC and ITBD between the two groups (P > .05).

CONCLUSION

Surface roughness influenced osteoblast differentiation in vitro, but did not significantly affect osseointegration outcomes in vivo. Both moderately rough and rough surfaces appeared to support comparable levels of osseointegration. Larger studies are needed to confirm these findings and determine optimal implant surface characteristics.

Histomorphometric Analysis of Osseointegrated Intraosseous Dental Implants Using Undecalcified Specimens: A Scoping Review

Bone histology and histomorphometry are reliable diagnostic tools for the assessment of the bone-implant interface, material safety and biocompatibility, and tissue response. They allow for the qualitative and quantitative analysis of undecalcified bone specimens. This scoping review aims to identify the most common staining techniques, study models for in vivo experiments, and histomorphometric parameters used for quantitative bone evaluation of osseointegrated dental implants in the last decade. The Web of Science, PubMed, and Scopus databases were searched on 1 July 2024 for relevant articles in English, published in the last ten years, and the data were exported to an MS Excel spreadsheet. A total of 115 studies met the eligibility criteria and were included in the present review. The results indicate that the most common study models are dogs, rabbits, and pigs. Some of the most frequently used methods for the assessment of the bone-implant interface are the Toluidine blue, Stevenel's blue with Van Gieson, and Levai-Laczko stainings. The results from this study demonstrate that the most commonly used histomorphometric parameters in implant dentistry are the bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), bone area (BA), and bone density (BD). This review presents the recent trends in histomorphometric analysis of dental implants and identifies some research gaps that necessitate further research.

Biofunctionalization of dental abutments by a zinc/chitosan/gelatin coating to optimize fibroblast behavior and antibacterial properties

Tightly sealed peri-implant gingival tissue provides a barrier against oral bacterial invasion, protecting the alveolar bone and maintaining long-term implant survival. To investigate if zinc can enhance the integration between peri-implant gingival tissue and abutment surface, we herein present novel zinc/chitosan/gelatin (Zn/CS/Gel) coatings prepared using the electrophoretic deposition (EPD) technique. The effect of these coatings on human gingival fibroblasts (hGFs) was investigated by culturing these cells on top of the EPD coatings. Surface characterization demonstrated that Zn2+ were released in a sustained and pH-responsive manner. The preclinical cell culture evaluation of these coatings indicated that the zinc-containing coatings enhanced cell migration, adhesion and collagen secretion of hGFs. Moreover, the zinc-containing coatings exhibited antibacterial efficacy by inhibiting the growth of Porphyromonas gingivalis and reducing attachment of Staphylococcus aureus. Notably, zinc-free CS/Gel coatings prevented attachment of P. gingivalis as well. The coatings were also shown to be cytocompatible with epithelial cells and osteoblasts, which are other relevant cell types which surround dental implants after clinical placement. Based on our findings, it can be concluded that Zn-containing coatings hold promise to enhance the adhesion of gingival tissue to the implant surface, which may potentially contribute to the formation of a robust peri-implant soft sealing counteracting bacterial invasion.

Mussel-inspired bifunctional coating for long-term stability of oral implants

Peri-implantitis and osseointegration failure present considerable challenges to the prolonged stability of oral implants. To address these issues, there is an escalating demand for a resilient implant surface coating that seamlessly integrates antimicrobial features to combat bacteria-induced peri‑implantitis, and osteogenic properties to promote bone formation. In the present study, a bio-inspired poly(amidoamine) dendrimer (DA-PAMAM-NH2) is synthesized by utilizing a mussel protein (DA) known for its strong adherence to various materials. Conjugating DA with PAMAM-NH2, inherently endowed with antibacterial and osteogenic properties, results in a robust and multifunctional coating. Robust adhesion between DA-PAMAM-NH2 and the titanium alloy surface is identified using confocal laser scanning microscopy (CLSM) and attenuated total reflectance-infrared (ATR-IR) spectroscopy. Following a four-week immersion of the coated titanium alloy surface in simulated body fluid (SBF), the antimicrobial activity and superior osteogenesis of the DA-PAMAM-NH2-coated surface remain stable. In contrast, the bifunctional effects of the PAMAM-NH2-coated surface diminish after the same immersion period. In vivo animal experiments validate the enduring antimicrobial and osteogenic properties of DA-PAMAM-NH2-coated titanium alloy implants, significantly enhancing the long-term stability of the implants. This innovative coating holds promise for addressing the multifaceted challenges associated with peri‑implantitis and osseointegration failure in titanium-based implants. STATEMENT OF SIGNIFICANCE: Prolonged stability of oral implants remains a clinically-significant challenge. Peri-implantitis and osseointegration failure are two important contributors to the poor stability of oral implants. The present study developed a mussel-bioinspired poly(amidoamine) dendrimer (DA-PAMAM-NH2) for a resilient implant surface coating that seamlessly integrates antimicrobial features to combat bacteria-induced peri‑implantitis, and osteogenic properties to promote bone formation to extend the longevity of oral implants.

Biomechanical characteristics of maxillary anterior incisor, conventional immediate implantation and socket shield technique - A finite element analysis and case report

BACKGROUND

To prevent the absorption and collapse of the labial bone plate of the anterior teeth, immediate implantation and socket shield technique have been increasingly applied to anterior dental aesthetic implant restoration.

OBJECTIVE

To provide a biomechanical basis for implant restoration of maxillary anterior teeth, finite element analysis was used to investigate the stress peak and distribution in different anatomical sites of natural teeth, conventional immediate implantation and socket shield technique.

METHODS

Three maxillary finite element models were established, including a maxillary incisor as a natural tooth, a conventional immediate implantation and a socket shield technique. A mechanical load of 100 N was applied to simulate and analyze the biomechanical behavior of the root, periodontal ligament (PDL), implant and surrounding bone interface.

RESULTS

The stress distribution of the natural tooth was relatively uniform under load. The maximum von Mises stress of the root, periodontal ligament, cortical bone and cancellous bone were 20.14 MPa, 2.473 MPa, 19.48 MPa and 5.068 MPa, respectively. When the conventional immediate implantation was loaded, the stress was mainly concentrated around the neck of implant. Maximum stress on the surface of the implant was 102 MPa, the cortical bone was 16.13 MPa, and the cancellous bone was 18.29 MPa. When the implantation with socket shield technique was loaded, the stress distribution of the implant was similar to that of immediate implantation. Maximum stress on the surface of the implant was 100.5 MPa, the cortical bone was 23.11 MPa, the cancellous bone was 21.66 MPa, the remaining tooth fragment was 29.42 MPa and the periodontal ligament of the tooth fragment was 1.131 MPa.

CONCLUSIONS

1. Under static loading, both socket shield technology and conventional immediate implantation can support the esthetic restoration of anterior teeth biomechanically. 2.Under short-term follow-up, both immediate implant and socket shield technology achieved satisfactory clinical results, including bone healing and patient satisfaction. 3.The stress distribution is mainly located on the buccal bone surface of the implant and is associated with resorption of the buccal bone plate after implant replacement in both socket shield technology and conventional immediate implantation. 4.The presence of retained root fragment had an impact on the bone graft gap. In immediate implantation, the peak stress was located in the cortical bone near the implant position, while in socket shield technology, the peak stress was at the neck of the cortical bone corresponding to the retained root fragment.

Biomechanical Investigation of the Osseointegration of Titanium Implants With Different Surfaces Placed With Allogeneic Bone Transfer

Allogeneic grafts can be preferred to autogenous grafts in plastic and oral-maxillofacial surgery for vertical and horizontal bone deficiencies. Implant surface properties are an important factor in osseointegration. This study aims to evaluate the osseointegration levels of titanium implants with machined, sand-blasted, and acid-etched (SLA) and resorbable blast material (RBM) surfaces placed together with allogeneic bone tissue transplantations obtained from the tibia bone using biomechanical method. Twenty-five female Sprague-Dawley rats were included in the study. The rats were divided into groups in which machined (n=7), SLA (n=7), and RBM (n=7) surface implants were placed with the transplantation of bone taken from the tibia. Four rats (both left and right tibias) were used as donors. Grafts and implants were surgically placed in the corticocancellous part of the metaphyseal area of the tibia bones of rats. At the end of the 4-week experimental setup, all rats were killed, and the implants and surrounding bone tissue were subjected to biomechanical reverse torque analysis (N/cm). Sand-blasted acid-etched surface implants were observed to have higher biomechanical osseointegration levels than RBM and machined surface implants ( P <0.05). No statistical difference could be detected between the RBM and machined surface implants ( P >0.05). On the basis of the limited results of this study, it can be concluded that the osseointegration levels of SLA surface implants placed with allogeneic bone transplantation may be better than those of machined and RBM surface implants.

The impact of hyaluronic acid coating on polyether ether ketone dental implant surface: An in vitro analysis

Objective

Polyether ether ketone (PEEK), a biocompatible polymer, is being explored as an alternative to metallic alloys for dental implants due to its aesthetic and mechanical properties. This study aimed to enhance the surface biofunctionality through evaluating human MG-63 osteoblastic cell survival, proliferation, differentiation, and mineralization.

Method

Following the sandblasting and plasma treatment of the 3D-printed PEEK discs, a layer of hyaluronic acid (Hya) was coated onto the PEEK surface. Osteoblast cells were seeded onto the discs. The groups consisted of Hya-coated PEEK, uncoated PEEK, and a control group. Cell viability, proliferation, differentiation, and mineralization potential were examined after seven and twenty-one days of cell seeding using the MTT test, DAPI staining technique, alkaline phosphatase activity (ALP), and alizarin red staining.

Results

Hya-coated PEEK increased cell viability (1.48 ± 0.13, 1.49 ± 0.09) compared to the uncoated group (1.19 ± 0.06, 1.26 ± 0.07) and control group (0.98 ± 0.04, 1.00 ± 0.07) after 7 and 21 days. Proliferation rates of coated group (60.50 ± 3.08) were greater than the uncoated (50.33 ± 2.58) and control group (38.33 ± 4.88) at 21 days, respectively. Additionally, the ALP activity on Hya-coated PEEK disks (5.55 ± 0.65, 7.54 ± 0.64) was notably higher than that of the uncoated group (1.08 ± 0.49, 2.59 ± 0.68), and control group (0.16 ± 0.09, 0.34 ± 0.18) at both time periods. Alizarin red staining in the Hya-coated PEEK group (1.81 ± 0.23, 1.97 ± 0.20) was significantly greater in comparison with uncoated group (1.12 ± 0.17, 1.14 ± 0.19) and control group (0.99 ± 0.10, 0.98 ± 0.05) at both time intervals.

Conclusion

Hya's surface coating has enhanced the biofunctional properties of PEEK implant material, as demonstrated by improved cell survival, proliferation, differentiation, and mineralization potential.

Prospective Randomized Controlled Clinical Trial to Evaluate the Safety and Efficacy of ACTLINK Plasma Treatment for Promoting Osseointegration and Bone Regeneration in Dental Implants

Recent studies have explored surface treatments, such as increasing the hydrophilicity of implant fixtures, to enhance the osseointegration of implants. This prospective clinical study aimed to assess the clinical stability and efficacy of plasma treatment applied to implants with sandblast-acid etching (SLA) surfaces before placement. Twenty-eight patients requiring implant placement provided consent and were assigned randomly to either the SLA group without plasma treatment or the SLA/plasma group with plasma treatment. Recall checks were conducted one and three months after the first-stage surgery, followed by a second surgery at four months. Although no significant differences in buccal bone defects or implant stability were observed between the groups, the SLA/plasma group showed significant increases in marginal bone changes on the mesial and distal sides, as assessed using periapical radiographs. This study underscores the potential of pre-implantation plasma treatment to enhance bone regeneration around implants.

Suspension-Sprayed Calcium Phosphate Coatings with Antibacterial Properties

Prosthesis loosening due to lack of osteointegration between an implant and surrounding bone tissue is one of the most common causes of implant failure. Further, bacterial contamination and biofilm formation onto implants represent a serious complication after surgery. The enhancement of osteointegration can be achieved by using bioconductive materials that promote biological responses in the body, stimulating bone growth and thus bonding to tissue. Through the incorporation of antibacterial substances in bioconductive, biodegradable calcium phosphate (CaP) coatings, faster osteointegration and bactericidal properties can be achieved. In this study, Cu-doped CaP supraparticles are spray-dried and suspension-sprayed CaP ceramic coatings with antibacterial properties are prepared using high-velocity suspension flame spraying (HVSFS). The objective was to increase the coatings' porosity and investigate which Cu-doped supraparticles have the strongest antibacterial properties when introduced into the coating layers. Biocompatibility was tested on human Osteosarcoma cells MG63. A porosity of at least 13% was achieved and the supraparticles could be implemented, enhancing it up to 16%. The results showed that the addition of Cu-doped supraparticles did not significantly reduce the number of viable cells compared to the Cu-free sample, demonstrating good biocompatibility. The antimicrobial activity was assessed against the bacterial strains Escherichia coli and Staphylococcus aureus, with Safe Airborne Antibacterial testing showing a significant reduction in both Gram-positive and Gram-negative strains on the Cu-doped coatings.

The past forty-three years of dental implantology literature. A global mapping and scientometric analysis

PURPOSE

The aim of this research is to make a scientometric analysis of the dental implantology literature and to present the results in a more understandable way to the reader by visualizing them with maps.

METHODS

The dental implantology literature was accessed through the Web of Science database. Scientometric data was obtained with Citespace 6.1 software, co-citation, clustering analysis, citation burst, and mapping analyzes were performed. Scimago Graphica software was used for additional visualizations.

RESULTS

A total of 35,704 articles were included in the analysis. There were 88,616 authors, 72,333 institutes, 142 countries/regions, and 3,265 journals contributing to the dental implantology literature. The United States was first with 7,334 publications and 225,868 citations. The literature between 1980 and 2023 was divided into 19 different clusters, and the literature between 2000 and 2023 was divided into 16 different clusters.

CONCLUSIONS

Key themes in the field include the use of autogenous bone, advancements in implant surface technology, and the use of platform switching and intraoral scanners. Emerging topics of interest include esthetic considerations in the treatment of the anterior region, stress distribution, the use of zirconia, and the impact of implant treatment on oral health-related quality of life. With similar scientometric analysis studies to be done in the future, the progress of the literature can be followed on the basis of evidence.

Epoxy resin bioactive dental implant capped with hydroxyapatite and curcumin nanoparticles: a novel approach

OBJECTIVE

In this study, the developed bioactive dental implant (BDI) from epoxy resin (ER), hydroxyapatite (HA), and curcumin nanoparticles (CUNPs).

MATERIALS AND METHODS

The prepared BDI were characterized using their physicochemical, mechanical, antimicrobial, bioactive, and biocompatibility study. The scanning electron microscopy (SEM) morphology of the BDI was observed HA mineralized crystal layer after being immersed in the stimulated body fluids (SBF) solution.

RESULTS

The mechanical properties of the BDI exhibited tensile strength (250.61 ± 0.43 MPa), elongation at break (215.66 ± 0.87%), flexural modulus (03.90 ± 0.12 GPa), water absorption (05.68 ± 0.15%), and water desorption (06.42 ± 0.14%). The antimicrobial activity of BDI was observed in excellent zone of inhibition against the gram-negative (15.33 ± 0.04%) and gram- positive (15.98 ± 0.07%) bacteria. The biocompatibility study of BDI on osteoblasts cell line (MG-63) was analyzed using MTT (3-[4, 5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay. The results were observed 85% viable cells present in the BDI compared to the control (only ER) samples.

CONCLUSIONS

Based on the research outcome, the BDI could be used for biomaterials application, particularly tooth dental implantation.

Mandibular biomechanics rehabilitated with different prosthetic restorations under normal and impact loading scenarios

BACKGROUND

Restorative treatment options for edentulous patients range from traditional dentures to fixed restorations. The proper selection of materials greatly influences the longevity and stability of fixed restorations. Most prosthetic parts are frequently fabricated from titanium. Ceramics (e.g. zirconia) and polymers (e.g. PEEK and BIOHPP) have recently been included in these fabrications. The mandibular movement produces complex patterns of stress and strain. Mandibular fractures may result from these stresses and strains exceeding the critical limits because of the impact force from falls or accidents. Therefore, it is necessary to evaluate the biomechanical behavior of the edentulous mandible with different restorations under different loading situations.

OBJECTIVE

This study analyzes the biomechanical behavior of mandibles after four prosthetic restorations for rehabilitation under normal and impact loading scenarios.

MATERIAL AND METHODS

The mandibular model was constructed with a fixed restoration, which was simulated using various materials (e.g. Titanium, Zirconia & BIOHPP), under frontal bite force, maximum intercuspation, and chin impact force. From the extraction of tensile and compressive stresses and strains, as well as the total deformation of mandible segments, the biomechanical behavior and clinical situations were studied.

RESULTS

Under frontal bite, the anterior body exhibited the highest tensile (60.34 MPa) and compressive (108.81 MPa) stresses using restoration 4, while the condyles and angles had the lowest tensile (7.12 MPa) and compressive (12.67 MPa) stresses using restoration 3. Under maximum intercuspation, the highest tensile (40.02 MPa) and compressive (98.87 MPa) stresses were generated on the anterior body of the cortical bone using restoration 4. Additionally, the lowest tensile (7.7 MPa) and compressive (10.08 MPa) stresses were generated on the condyles and angles, respectively, using restoration 3. Under chin impact, the highest tensile (374.57 MPa) and compressive (387.3 MPa) stresses were generated on the anterior body using restoration 4. Additionally, the lowest tensile (0.65 MPa) and compressive (0.57 MPa) stresses were generated on the coronoid processes using restoration 3. For all loading scenarios, the anterior body of the mandible had the highest stress and strain values compared with the other segments. Compared to the traditional titanium restoration.2, restoration.1(zirconia) increases the tensile and compressive stresses and strains on the mandibular segments, in contrast to restoration.3 (BIOHPP). In addition, zirconia implants exhibited higher displacements than the other implants.

CONCLUSION

In the normal loading scenario, the tensile and compressive stresses and strains on the mandible were within the allowable limits when all restorations were used. Under the chin impact loading scenario, the anterior body of the mandible was damaged by restorations 1 and 4.

Laminin 332 functionalized surface improve implant roughness and oral keratinocyte bioactivity

Objective

The biological seal (BS) at the implant-tissue interface is essential for the success of dental implants (DIs), and the absence of a proper BS can lead to peri-implantitis. The basement membrane (BM) and junctional epithelium are critical for sealing the peri-implant mucosa, and laminin 332 is an important protein in binding the epithelium to the implant surface. The aim of this study was to evaluate the response of oral keratinocytes to titanium dental implant surfaces biofunctionalized with laminin 332.

Design

The dental implant surface was treated with a piranha solution to create hydroxyl (OH) groups, facilitating biofunctionalization with laminin 332. The modified surface underwent scanning electron microscopy, surface roughness evaluation, and chemical composition analysis. Human keratinocytes from the Cal-27 line were then cultured on the modified implants for 24 and 48 h to assess viability, morphology, cytokine secretion, and mRNA expression of tissue repair-associated genes.

Results

The results showed that laminin 332 biofunctionalization of the implant surface resulted in lower values of Ra, Rq and positive surface roughness parameters Rsk, Rku and Rv. The elemental composition showed an increase in nitrogen and carbon content corresponding to protein binding. The biofunctionalized surfaces did not affect cell viability and promoted cytokine secretion (IL-1a and IL-8) and a significant increase (p < 0.05) in MCP-1, EGF, FGF, TGF and VEGF gene expression compared to the control.

Conclusion

In conclusion, laminin 332 coating Ti implants was shown to be effective in promoting keratinocyte adhesion, spreading, and viability. This approach could be an alternative way to improve biocompatibility.

Osseointegrative and antimicrobial properties of graphene oxide nano coated dental implants: A systematic review

Introduction

Osseointegration stands as a pivotal concept within the realm of dental implants, signifying the intricate process through which a dental implant integrates with the adjoining bone tissue. Graphene oxide (GO) has been shown to promote osseointegration, the process by which the implant fuses with the surrounding bone. The objective of this study was to assess the osseointegrative and antimicrobial properties of GO nano coated dental implants.

Methods

A systematic search was conducted using electronic databases (e.g., PubMed, Scopus, Web of Science) to identify relevant studies published. Inclusion criteria encompassed studies that evaluated the effects of GO nano coating on osseointegrative and antimicrobial characteristics of dental implants. Studies not written in English and published before 2012 were excluded.

Results

The initial search yielded a total of 127 potential studies, of which six met the inclusion criteria and five were included in the review. These studies provided data on GO nano coated dental implants and their osseointegrative and antimicrobial properties. All the included studies showed moderate risk of bias. None of the studies provided information related to sample size calculation or sampling technique.

Discussion

The findings from the included studies demonstrated that GO nano coating had a positive impact on osseointegrative properties of dental implants. Enhanced bone-implant contact and increased bone density were observed in animals and humans receiving GO nano coated implants. Furthermore, the antimicrobial properties of GO nano coating were found to inhibit bacterial colonization and biofilm formation on the implant surface, reducing the risk of implant-associated infections.

Conclusion

The findings indicate that GO nano coating holds promise in enhancing the success rate and longevity of dental implants. However, more studies with larger sample sizes, are needed to further strengthen the evidence and determine the long-term effects of GO nano coated dental implants.

Workflow for Maxilla/Mandible Individual [Mai®] Implant by Integra Implants-How Individual Implants Are Manufactured

The newest technology allows the medical industry to manufacture innovative products such as milled titanium prosthodontic parts in an implant for a screw-retained suprastructure. In the literature, there are some articles on the clinical usage of subperiosteal implants, but none of these publications, either in PubMed or Google Scholar, thoroughly describe the workflow for the design and manufacture of individual implants for maxillofacial surgery with milled threads for a screw-retained prosthodontic bridge. The aim of the article is to present a step-by-step method of producing personalized implants, from the first steps of production to the implantation of the final product. The article includes information on patient qualification for surgery, computational preparation and skull printing, planning of Mai Implants®, meshing, 3D printing and milling, cleaning, rinsing, anodizing, and laser marking, as well as the cleaning and sterilization process in a hospital or dental clinic. A detailed description of implant production allows for the analysis of each step and the development of technology. The production of implants is an expensive procedure, but considering all the advantages of the Mai Implants® treatment and the disadvantages of alternatives, the product is worth the price.

Surface Topography Has Less Influence on Peri-Implantitis than Patient Factors: A Comparative Clinical Study of Two Dental Implant Systems

OBJECTIVES

This study aims to assess the risk of peri-implantitis (PI) onset among different implant systems and evaluate the severity of the disease from a population of patients treated in a university clinic. Furthermore, this study intends to thoroughly examine the surface properties of the implant systems that have been identified and investigated.

MATERIAL AND METHODS

Data from a total of six hundred and 14 patients were extracted from the Institute of Clinical Dentistry, Dental Faculty, University of Oslo. Subject- and implant-based variables were collected, including the type of implant, date of implant installation, medical records, recall appointments up to 2022, periodontal measurements, information on diabetes, smoking status, sex, and age. The outcome of interest was the diagnosis of PI, defined as the occurrence of bleeding on probing (BoP), peri-implant probing depth (PD) ≥ 5 mm, and bone loss (BL). Data were analyzed using multivariate linear and logistic regression. Scanning electron microscopy, light laser profilometer, and X-ray photoelectron spectroscopy were utilized for surface and chemical analyses.

RESULTS

Among the patients evaluated, 6.8% were diagnosed with PI. A comparison was made between two different implant systems: Dentsply Sirona, OsseospeedTM and Straumann SLActive, with mean follow-up times of 3.84 years (SE: 0.15) and 3.34 years (SE: 0.15), respectively. The surfaces have different topographies and surface chemistry. However, no significant association was found between PI and implant surface/system, including no difference in the onset or severity of the disease. Nonetheless, plaque control was associated with an increased risk of developing PI, along with the gender of the patient. Furthermore, patients suffering from PI exhibited increased BL in the anterior region.

CONCLUSION

No differences were observed among the evaluated implant systems, although the surfaces have different topography and chemistry. Factors that affected the risk of developing PI were plaque index and male gender. The severity of BL in patients with PI was more pronounced in the anterior region. Consequently, our findings show that success in implantology is less contingent on selecting implant systems and more on a better understanding of patient-specific risk factors, as well as on implementing biomaterials that can more effectively debride dental implants.

Influence of surface texture on osteogenic differentiation of dental pulp stem cells: An in vitro study

Background

In comparison with perfectly machined surface implants, surface topographic modifications like roughness accelerate the osteogenesis of dental pulpal stem cells (DPSC). This greatly enhances bone-implant contact and osteogenic potential of the stem cells. Hence, the aim of the current study was to evaluate and compare the differentiation and proliferation potential of stem cells obtained from dental pulp on sand-blasted and acid etched implant discs surfaces.

Materials and Methods

Stem cells from dental pulp were extracted from the premolar region of oral cavity. Titanium discs that measured one centimeter in diameter and three millimetres in thickness were used as investigation surfaces. Titanium surface disc were acid etched and sandblasted. Investigation had three group: acid etched (Group A), sandblasted (Group B), and standard control group, i.e., cells treated with osteogenic induction media only (Group C). In Group C, mesenchymal stem cells (MSCs) were treated with osteogenic induction medium without any titanium disc and these cells were used as standard controls. To identify which modified implant surface had greater potential for proliferation, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed using the explant culture. MTT assay assessed the viability of the cells as a function of its redox potential. This was followed by recognition of the stem cells for CD90, CD73, and CD 105 markers using flow cytometry with RUNX2 antibody on days 7 and 21 of incubation. The isolated cells were stained using 1% alizarin red stain to identify the number of stem cells per square centimeter area under the light microscope.

Results

The osteogenic differentiation of both the materials was compared with standard control (MSCs treated with osteogenic differentiation media only). The osteoblastic cells on the acid-etched and sand-blasted implant surface disc had an almost identical capacity for proliferation till the MTT assay but according to the results of the alizarin red staining there was a slightly higher proliferation potential on acid etched surfaces compared to the sand blasted surfaces. Therefore, acid etched surfaces showed higher potential of osteogenic differentiation of DPSCs compared with sand-blasted surfaces.

Conclusion

In comparison with perfectly machined surface implants, topographic surface modifications such as roughness can accelerate the osteogenesis of DPSC in vitro.

Retrospective Study of Maxillary Sinus Augmentation Using Demineralized Tooth Block Bone for Dental Implant

(1) Background: When placing implants in the maxillary posterior region with insufficient alveolar bone, a maxillary sinus elevation is necessary. Autogenous bone, though biologically ideal, poses risks and discomfort due to donor site harvesting. Block-type autogenous tooth bone graft material, made from the patient's own extracted tooth, offers similar biological stability without these drawbacks. (2) Methods: This study observed the progress of 19 implant patients who were treated with maxillary sinus elevation procedures using block-type autogenous tooth bone graft material at the Daegu Catholic University Medical Center. Extracted teeth were processed into demineralized tooth block bone. After elevating the sinus membrane, implants and the tooth bone graft material were placed in the space, and the bony window was repositioned. Postoperative evaluations through clinical observation and radiographic imaging assessed sinus membrane elevation, alveolar bone height increase, and implant osseointegration. (3) Results: Results showed proportional increases in alveolar bone height to the graft material size, with long-term stability. No postoperative complications occurred, even with sinus membrane perforation, and implants remained stable. (4) Conclusions: The study concludes that maxillary sinus lifts using block-type autogenous tooth bone graft material provide excellent bone induction and biocompatibility, making this a highly beneficial method for both dentists and patients.

Efficacy of plasma treatment for surface cleansing and osseointegration of sandblasted and acid-etched titanium implants

PURPOSE

This study was conducted to evaluate the effects of plasma treatment of sandblasted and acid-etched (SLA) titanium implants on surface cleansing and osseointegration in a beagle model.

MATERIALS AND METHODS

For morphological analysis and XPS analysis, scanning electron microscope and x-ray photoelectron spectroscopy were used to analyze the surface topography and chemical compositions of implant before and after plasma treatment. For this animal experiment, twelve SLA titanium implants were divided into two groups: a control group (untreated implants) and a plasma group (implants treated with plasma). Each group was randomly located in the mandibular bone of the beagle dog (n = 6). After 8 weeks, the beagle dogs were sacrificed, and volumetric analysis and histometric analysis were performed within the region of interest.

RESULTS

In morphological analysis, plasma treatment did not alter the implant surface topography or cause any physical damage. In XPS analysis, the atomic percentage of carbon at the inspection point before the plasma treatment was 34.09%. After the plasma treatment, it was reduced to 18.74%, indicating a 45% reduction in carbon. In volumetric analysis and histometric analysis, the plasma group exhibited relatively higher mean values for new bone volume (NBV), bone to implant contact (BIC), and inter-thread bone density (ITBD) compared to the control group. However, there was no significant difference between the two groups (P > .05).

CONCLUSION

Within the limits of this study, plasma treatment effectively eliminated hydrocarbons without changing the implant surface.

Tribocorrosion of 3D printed dental implants: An overview

With the advancements in dental science and the growing need for improved dental health, it has become imperative to develop new implant materials which possess better geometrical, mechanical, and physical properties. The oral environment is a corrosive environment and the relative motion between the teeth also makes the environment more hostile. Therefore, the combined corrosion and tribology commonly known as tribocorrosion of implants needs to be studied. The complex shapes of the dental implants and the high-performance requirements of these implants make manufacturing difficult by conventional manufacturing processes. With the advent of additive manufacturing or 3D-printing, the development of implants has become easy. However, the various requirements such as surface roughness, mechanical strength, and corrosion resistance further make the manufacturing of implants difficult. The current paper reviews the various studies related to3D-printed implants. Also, the paper tries to highlight the role of 3D-Printing can play in the area of dental implants. Further studies both experimental and numerical are needed to devise optimized conditions for 3D-printing implants to develop implants with improved mechanical, corrosion, and biological properties.

Preparation of Ag@3D-TiO2 Scaffolds and Determination of its Antimicrobial Properties and Osteogenesis-promoting Ability

OBJECTIVES

The micro-nano structure of 3D-printed porous titanium (Ti) alloy with excellent performance in avoiding stress shielding and promoting bone tissue differentiation provides a new opportunity for the development of bone implants, but it necessitates higher requirements for bone tissue differentiation and the antibacterial properties of bone implants in clinical practice.

METHODS

This study investigated the preparation, antimicrobial properties, and osteogenesis-promoting ability of the 3D printed porous Ti alloy anodic oxidized Ag-carrying (Ag@3D-TiO2) scaffolds. The 3D printed porous Ti alloy (3D-Ti), anodized 3D printed porous Ti alloy (3D-TiO2), and Ag@3D-TiO2 scaffolds were synthesized using electron beam melting. The antimicrobial properties of the scaffolds were examined using antibacterial tests and their cytocompatibility was assessed using a cell proliferation assay and acridine orange/ethidium bromide (AO/EB) staining. In vitro cellular assays were used to investigate the effects of the scaffold microstructural features on cell activity, proliferation, and osteogenesis-related genes and proteins. In vivo animal experiments were used to evaluate the anti-inflammatory and osteogenesis-promoting abilities of the scaffolds.

RESULTS

The Ag@3D-TiO2 scaffolds exhibited sustained anti-microbial activity over time, enhanced cell proliferation, facilitated osteogenic differentiation, and increased extracellular matrix mineralization. In addition, alkaline phosphatase (ALP), collagen type I (COL-I), and osteocalcin (OCN)-related genes and proteins were upregulated. In vivo animal implantation experiments, the anti-inflammatory effect of the Ag@3D-TiO2 scaffolds were observed using histology, and a large amount of fibrous connective tissue was present around it; the Ag@3D-TiO2 scaffolds were more bio-compatible with the surrounding tissues compared with 3D-Ti and 3D-TiO2; a large amount of uniformly distributed neoplastic bone tissue existed in their pores, and the chronic systemic toxicity test showed that the 3D-Ti, 3D-TiO2, and Ag@3D-TiO2 scaffolds are biologically safe.

CONCLUSION

The goal of this study was to create a scaffold that exhibits antimicrobial properties and can aid bone growth, making it highly suitable for use in bone tissue engineering.

Atomic Layer Deposition of Zirconia on Titanium Implants Improves Osseointegration in Rabbit Bones

Purpose

Atomic layer deposition (ALD) is a method that can deposit zirconia uniformly on an atomic basis. The effect of deposited zirconia on titanium implants using ALD was evaluated in vivo.

Methods

Machined titanium implants (MTIs) were used as the Control. MTIs treated by sandblasting with large grit and acid etching (SA) and MTIs deposited with zirconia using ALD are referred to as Groups S and Z, respectively. Twelve implants were prepared for each group. Six rabbits were used as experimental animals. To evaluate the osteogenesis and osteocyte aspects around the implants, radiological and histological analyses were performed. The bone-to-implant contact (BIC) ratio was measured and statistically analyzed to evaluate the osseointegration capabilities.

Results

In the micro-CT analysis, more radiopaque bone tissues were observed around the implants in Groups S and Z. Histological observation found that Groups S and Z had more and denser mature bone tissues around the implants in the cortical bone area. Many new and mature bone tissues were also observed in the medullary cavity area. For the BIC ratio, Groups S and Z were significantly higher than the Control in the cortical bone area (P < 0.017), but there was no significant difference between Groups S and Z.

Conclusion

MTIs deposited with zirconia using ALD (Group Z) radiologically and histologically showed more mature bone formation and activated osteocytes compared with MTIs (Control). Group Z also had a significantly higher BIC ratio than the Control. Within the limitations of this study, depositing zirconia on the surface of MTIs using ALD can improve osseointegration in vivo.

Biomaterials science and surface engineering strategies for dental peri-implantitis management

Peri-implantitis is a bacterial infection that causes soft tissue inflammatory lesions and alveolar bone resorption, ultimately resulting in implant failure. Dental implants for clinical use barely have antibacterial properties, and bacterial colonization and biofilm formation on the dental implants are major causes of peri-implantitis. Treatment strategies such as mechanical debridement and antibiotic therapy have been used to remove dental plaque. However, it is particularly important to prevent the occurrence of peri-implantitis rather than treatment. Therefore, the current research spot has focused on improving the antibacterial properties of dental implants, such as the construction of specific micro-nano surface texture, the introduction of diverse functional coatings, or the application of materials with intrinsic antibacterial properties. The aforementioned antibacterial surfaces can be incorporated with bioactive molecules, metallic nanoparticles, or other functional components to further enhance the osteogenic properties and accelerate the healing process. In this review, we summarize the recent developments in biomaterial science and the modification strategies applied to dental implants to inhibit biofilm formation and facilitate bone-implant integration. Furthermore, we summarized the obstacles existing in the process of laboratory research to reach the clinic products, and propose corresponding directions for future developments and research perspectives, so that to provide insights into the rational design and construction of dental implants with the aim to balance antibacterial efficacy, biological safety, and osteogenic property.

An Innovative Design to Enhance Osteoinductive Efficacy and Biomechanical Behavior of a Titanium Dental Implant

The present study investigated the in vivo bone-forming efficacy of an innovative titanium (Ti) dental implant combined with a collagen sponge containing recombinant human bone morphogenetic protein-2 (BMP-2) in a pig model. Two different concentrations of BMP-2 (20 and 40 µg/mL) were incorporated into collagen sponges and placed at the bottom of Ti dental implants. The investigated implants were inserted into the edentulous ridge at the canine-premolar regions of Lanyu small-ear pigs, which were then euthanized at weeks 1, 2, 4, 8, and 12 post-implantation. Specimens containing the implants and surrounding bone tissue were collected for histological evaluation of their bone-to-implant contact (BIC) ratios and calculation of maximum torques using removal torque measurement. Analytical results showed that the control and BMP-2-loaded implants presented good implant stability and bone healing for all testing durations. After 1 week of healing, the BMP-2-loaded implants with a concentration of 20 µg/mL exhibited the highest BIC ratios, ranging from 58% to 76%, among all groups (p = 0.034). Additionally, they also possessed the highest removal torque values (50.1 ± 1.3 N-cm) throughout the 8-week healing period. The BMP-2-loaded implants not only displayed excellent in vivo biocompatibility but also presented superior osteoinductive performance. Therefore, these findings demonstrate that BMP-2 delivered through a collagen sponge can potentially enhance the early-stage osseointegration of Ti dental implants.

Assessing the Impact of Various Decontamination Instruments on Titanium and Zirconia Dental Implants: An In Vitro Study

This study investigates the impact of various instrumentation techniques on material removal and surface changes in titanium (Ti)- and zirconia (Zr) implant discs. Ti- and Zr discs were subjected to standardized experiments using various instruments including airflow, ultrasound, carbide, and diamond burs. Instrumentation was performed for 60 s with continuous automatic motion. Abrasion and changes in surface roughness were assessed using profilometry, while scanning electron microscopy was used to examine morphological changes and particle size. Carbide burs predominantly caused abrasion on Ti discs, while diamond burs caused more abrasion on Zr discs. The Ti discs were more susceptible to surface changes. However, among the materials tested, machined Zr discs treated with diamond burs produced the largest particle. In certain cases, a statistical significance (p < 0.05) was observed between the groups, while in others, there was no considerable difference among the means (p > 0.05). These results highlighted the statistical significance of our findings. These results found diverse alterations in surface characteristics of Ti- and Zr discs due to different instruments, with carbide and diamond burs causing notable effects. The findings highlight the need for a careful balance between promoting healing and minimizing harm during implantoplasty.

Effect of polydimethylsiloxane surface morphology on osteogenic differentiation of mesenchymal stem cells through SIRT1 signalling pathway

Constructing surface topography with a certain roughness is a widely used, non-toxic, cost-effective and effective method for improving the microenvironment of cells, promoting the proliferation and osteogenic differentiation of mesenchymal stem cells (MSCs), and promoting the osseointegration of grafts and further improving their biocompatibility under clinical environmental conditions. SIRT1 plays an important regulatory role in the osteogenic differentiation of bone marrow-derived MSCs (BM-MSCs). However, it remains unknown whether SIRT1 plays an important regulatory role in the osteogenic differentiation of BM-MSCs with regard to surface morphology. Polydimethylsiloxane (PDMS) with different surface morphologies were prepared using different grits of sandpaper. The value for BMSCs added on different surfaces was detected by cell proliferation assays. RT-qPCR and Western blotting were performed to detect SIRT1 activation and osteogenic differentiation of MSCs. Osteogenesis of MSCs was detected by alkaline phosphatase (ALP) and alizarin red S staining. SIRT1 inhibition experiments were performed to investigate the role of SIRT1 in the osteogenic differentiation of MSCs induced by surface morphology. We found that BM-MSCs have better value and osteogenic differentiation ability on a surface with roughness of PDMS-1000M. SIRT1 showed higher gene and protein expression on a PDMS-1000M surface with a roughness of 13.741 ± 1.388 µm. The promotion of the osteogenic differentiation of MSCs on the PDMS-1000M surface was significantly decreased after inhibiting SIRT1 expression. Our study demonstrated that a surface morphology with certain roughness can activate the SIRT1 pathway of MSCs and promote the osteogenic differentiation of BMSCs via the SIRT1 pathway.

Role of Polyetheretherketone in Prosthodontics: A Literature Review

Implant prostheses and other fixed and removable metal prostheses have led to an increase in demand for the development of new and efficient materials such as high-performance polymers polyetheretherketone (PEEK) over titanium and other metals because of their further complications in the human body. PEEK is a polymer that is nontoxic and has a modulus of elasticity that is comparable to that of human bone. PEEK implants provide benefits over metal implants, such as reducing the stress shielding effect, simple processing, and color resemblance to natural teeth. And it is a fantastic alternative to titanium for dental and orthopedic implants. The current review is undertaken to understand the properties of this PEEK material to weigh its benefits and drawbacks for potential use in dental implants and other prostheses.

An introduction to dental implants

The use of implants to replace missing teeth is now commonplace and practised by clinicians worldwide in both general and specialist practice. There is an abundance of evidence on the general success of implant treatment. As well as reviewing the history of dental implants, this narrative review will discuss the merits and successful placement of tissue-level verses bone-level implants. Furthermore, the article will evaluate the concept and benefits of platform switching for implant treatment. Finally, with the increased placement of implants, this narrative paper will review how different titanium surfaces impact on the risk of peri-implantitis.

Assessment of a novel electrochemically deposited smart bioactive trabecular coating (SBTC®): a randomized controlled clinical trial

OBJECTIVES

A randomized controlled clinical trial of dental implants was conducted to compare the clinical properties of a novel electrochemically deposited calcium phosphate coating to those of a common marketed surface treatment.

MATERIAL AND METHODS

Forty implants of the same brand and type were placed in 20 fully edentulous participants requiring mandibular implantation. The two study groups were defined by the surface treatment of the implants. 20 implants in the control group were coated via a commercial electrochemical surface treatment that forms a mixture of brushite and hydroxyapatite, while the remaining 20 in the test group were coated with a novel electrochemical Smart Bioactive Trabecular Coating (SBTC®). A split-mouth design was employed, with each participants receiving one control implant in one mandibular side and a test implant in the other. To mitigate potential operator-handedness bias, control and test implants were randomly assigned to mandibular sides. All cases underwent digital planning, implant placement with a static surgical guide, and participants received locator-anchored full-arch dentures. The primary outcome was implant stability (measured using Osstell ISQ) assessed at insertion, loading, and then 3 months, 9 months, and 2 years post-insertion. The secondary outcome was bone level change (in millimeters) over the 2-year observation period. Oral health-related quality of life (OHRQL) was monitored using the OHIP-14 questionnaire. Complications and adverse events were recorded.

RESULTS

Successful osseointegration and implant stability were achieved in all cases, allowing loading. ISQ values steadily increased throughout the observation period. While no significant differences were observed between the SBTC® and control coatings, the test group exhibited a higher ISQ gain. Bone resorption was somewhat lower in the SBTC® but not significantly so. Patients' OHRQL significantly improved after denture delivery and remained stable throughout the follow-up. No complications or adverse events were observed.

CONCLUSIONS

Based on the study results, we conclude that the new surface treatment is a safe alternative to the widely used control surface, demonstrating similar osseointegrative properties and time-dependent bone level changes. Further research may explore the broader implications of these findings.

TRIAL REGISTRATION

The study is registered on clinicaltrials.gov under the identifier ID: NCT06034171.

Evaluation of the Impact of Different Surface Treatments on Implant Surface: An In Vitro Study

Aim

The current study was conducted to assess the effects of various surface treatments on the implant surface.

Materials and Methods

A total of 45 dental implants measuring 16 mm in length and 5 mm in diameter were used, along with the appropriate abutments. Depending on the surface treatment used, the samples were randomly split into three groups, with 15 implants in each group: Group 1: Control, Group 2: UV light-treated, Group 3: Sandblasted and acid-etched (SLA)-treated. After surface treatment, a scanning electron microscope (SEM) was used to assess the test samples' surface properties. All sample images were captured using a 3000× magnification. After all three groups' surfaces were treated, the surface roughness was measured using a digital optical profilometer with a stylus speed of 0.5 mm/s that was connected to computer software.

Results

The maximum surface roughness was found in the group treated with SLA (0.714 ± 0.12), followed by the group treated with UV light (0.692 ± 0.09) and the control group (0.516 ± 0.12). There was a significant difference found between different surface treatment methods.

Conclusion

The present study concluded that the group that received the SLA treatment had the highest surface roughness when compared to the UV light and control groups.

Novel Ti surface coated with PVA hydrogel and chitosan nanoparticles with antibacterial drug release: An experimental in vitro study

OBJECTIVES

The aims of this study were to design a novel titanium surface coated with a PVA hydrogel matrix and chitosan-based nanoparticles and to investigate the antibiotic release and its ability to inhibit microbial activity.

METHODS

Two drug delivery systems were developed and mixed. Chitosan-based nanoparticles (NP) and a polyvinyl alcohol film (PVA). The size, ζ-potential, stability, adhesive properties, and encapsulation profile of NP, as well as the release kinetics of drug delivery systems and their antimicrobial ability of PVA and PVANP films, were studied on Ti surfaces. The systems were loaded with doxycycline, vancomycin, and doxepin hydrochloride.

RESULTS

Nanoparticles presented a ζ-potential greater than 30 mV for 45 days and the efficiency drug encapsulation was 26.88% ± 1.51% for doxycycline, 16.09% ± 10.24% for vancomycin and 17.57% ± 11.08% for doxepin. In addition, PVA films were loaded with 125 μg/mL of doxycycline, 125 μg/mL of vancomycin, and 100 μg/mL of doxepin. PVANP-doxycycline achieved the antibacterial effect at 4 h while PVA-doxycycline maintained its effect at 24 h.

Effect of micro-arc oxidation coatings with graphene oxide and graphite on osseointegration of titanium implants-an in vivo study

Background

This in vivo study evaluated the effect of graphene oxide and graphite coatings, coupled with the micro-arc oxidation (MAO) surface roughening technique, known for their mechanical strength, chemical stability, and antibacterial properties. The main objective was to assess the degree of improvement in osseointegration of titanium implants resulting from these interventions.

Materials and methods

In this study, 32 female rats were utilized and randomly allocated into four groups (n = 8 each): machined surface titanium implants (control), those roughened by the MAO method, those coated with graphene oxide-doped MAO, and those with a graphite-doped MAO coating. Titanium implants were surgically placed in the right tibia of the rats. Rats undergoing no additional procedures during the 4-week experimental period were sacrificed at the end. Then, the implants and surrounding bone tissues were separated and embedded in acrylic blocks for reverse torque analysis. Using a digital torque device, the rotational force was applied to all samples using a hex driver and racquet until implant separation from the bone occurred, with the corresponding values recorded on the digital display. Then, statistical analysis was performed to analyze the data.

Results

No statistically significant difference between the groups was observed in the biomechanical bone-implant connection levels (N/cm) (P = 0.268). Post-hoc tests were not required because no discernible differences were identified between the groups.

Conclusion

Within the scope of this study, implants treated with the MAO method, along with those coated with graphene oxide- and graphite-doped MAO method, did not exhibit significant superiority in terms of osseointegration compared to machined surface titanium implants.

Comparative analysis of the physical, chemical, and microbiological properties of Ti-6Al-4V disks produced by different methods and subjected to surface treatments

STATEMENT OF PROBLEM

To improve the osseointegration of dental implants and reduce microbiological growth, different micro- and nanoscale surface topographies can be used.

PURPOSE

The purpose of this in vitro study was to evaluate the influence of Ti-6Al-4V with 4 surfaces, machined (DU), machined+hydroxyapatite (DUHAp), machined+acid-alkali treatment (DUAA), and additive manufacturing (DMA), on the physical, chemical, and microbiological properties.

MATERIAL AND METHODS

The topography of Ti-6Al-4V disks with the 4 surfaces was evaluated by scanning electron microscopy (SEM), the chemical composition by energy dispersive X-ray spectroscopy (EDS), and the crystalline structure by X-ray diffraction (XRD). Physical and chemical properties were analyzed by using wettability and surface free energy, roughness, and microbial adhesion against Staphylococcus aureus by colony forming units (CFU). One-way ANOVA analysis of variance and the Tukey multiple comparisons test were applied to evaluate the data, except CFU, which was submitted to the Kruskal-Wallis nonparametric test (α=.05).

RESULTS

DU photomicrographs showed a topography characteristic of a polished machined surface, DUHAp and DUAA exhibited patterns corresponding to the surface modifications performed, and in DMA the presence of partially fused spherical particles was observed. The EDS identified chemical elements inherent in the Ti-6Al-4V, and the DUHAp and DUAA disks also had the ions from the treatments applied. XRD patterns revealed similarities between DU and DMA, as well as characteristic peaks of hydroxyapatite (HA) in the DUHAp disk and the DUAA. Compared with DU and DMA the DUHAp and DUAA groups showed hydrophilic behavior with smaller contact angles and higher surface free energy (P<.05). DMA showed a higher mean value of roughness, different from the others (P<.05), and a higher CFU for S. aureus (P=.006).

CONCLUSIONS

DUHAp and DUAA showed similar behaviors regarding wettability, surface free energy, and bacterial adhesion. Among the untreated groups, DMA exhibited higher roughness, bacterial adhesion, and lower wettability and surface free energy.