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Kandaswamy E, Harsha M, Joshi VM. Titanium corrosion products from dental implants and their effect on cells and cytokine release: A review. J Trace Elem Med Biol 2024; 84:127464. [PMID: 38703537 DOI: 10.1016/j.jtemb.2024.127464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Titanium is considered to be an inert material owing to the ability of the material to form a passive titanium oxide layer. However, once the titanium oxide layer is lost, it can lead to exposure of the underlying titanium substructure and can undergo corrosion. SUMMARY The article explores the role of titanium ions and particles from dental implants on cells, cytokine release, and on the systemic redistribution of these particles as well as theories proposed to elucidate the effects of these particles on peri-implant inflammation based on evidence from in-vitro, human, and animal studies. Titanium particles and ions have a pro-inflammatory and cytotoxic effect on cells and promote the release of pro-inflammatory mediators like cytokines. Three theories to explain etiopathogenesis have been proposed, one based on microbial dysbiosis, the second based on titanium particles and ions and the third based on a synergistic effect between microbiome and titanium particles on the host. CONCLUSION There is clear evidence from in-vitro and limited human and animal studies that titanium particles released from dental implants have a detrimental effect on cells directly and through the release of pro-inflammatory cytokines. Future clinical and translational studies are required to clarify the role of titanium particles and ions in peri-implant inflammation and the etiopathogenesis of peri-implantitis.
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Affiliation(s)
- Eswar Kandaswamy
- Department of Periodontics, LSUHSC, School of Dentistry, 100 Florida Avenue, New Orleans, LA 70119, USA
| | - M Harsha
- Department of Oral Pathology & Microbiology, Yogita Dental College & Hospital, Naringi Riverside, At Post Tal Dist. SH104, Khed, Maharashtra 415709, India
| | - Vinayak M Joshi
- Department of Periodontics, LSUHSC, School of Dentistry, 100 Florida Avenue, New Orleans, LA 70119, USA.
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Vierling L, Liu CC, Wiedemeier D, Gubler A, Schmidlin PR. Assessing the Impact of Various Decontamination Instruments on Titanium and Zirconia Dental Implants: An In Vitro Study. Dent J (Basel) 2024; 12:136. [PMID: 38786534 PMCID: PMC11119916 DOI: 10.3390/dj12050136] [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: 03/18/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
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.
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Affiliation(s)
- Louisa Vierling
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (L.V.); (C.C.L.); (A.G.)
| | - Chun Ching Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (L.V.); (C.C.L.); (A.G.)
| | - Daniel Wiedemeier
- Statistics Group, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
| | - Andrea Gubler
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (L.V.); (C.C.L.); (A.G.)
| | - Patrick R. Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (L.V.); (C.C.L.); (A.G.)
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Sellin ML, Hansmann D, Bader R, Jonitz-Heincke A. Influence of metallic particles and TNF on the transcriptional regulation of NLRP3 inflammasome-associated genes in human osteoblasts. Front Immunol 2024; 15:1397432. [PMID: 38751427 PMCID: PMC11094288 DOI: 10.3389/fimmu.2024.1397432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction The release of mature interleukin (IL-) 1β from osteoblasts in response to danger signals is tightly regulated by the nucleotide-binding oligomerization domain leucine-rich repeat and pyrin-containing protein 3 (NLRP3) inflammasome. These danger signals include wear products resulting from aseptic loosening of joint arthroplasty. However, inflammasome activation requires two different signals: a nuclear factor-kappa B (NF-κB)-activating priming signal and an actual inflammasome-activating signal. Since human osteoblasts react to wear particles via Toll-like receptors (TLR), particles may represent an inflammasome activator that can induce both signals. Methods Temporal gene expression profiles of TLRs and associated intracellular signaling pathways were determined to investigate the period when human osteoblasts take up metallic wear particles after initial contact and initiate a molecular response. For this purpose, human osteoblasts were treated with metallic particles derived from cobalt-chromium alloy (CoCr), lipopolysaccharides (LPS), and tumor necrosis factor-alpha (TNF) alone or in combination for incubation times ranging from one hour to three days. Shortly after adding the particles, their uptake was observed by the change in cell morphology and spectral data. Results Exposure of osteoblasts to particles alone increased NLRP3 inflammasome-associated genes. The response was not significantly enhanced when cells were treated with CoCr + LPS or CoCr + TNF, whereas inflammation markers were induced. Despite an increase in genes related to the NLRP3 inflammasome, the release of IL-1β was unaffected after contact with CoCr particles. Discussion Although CoCr particles affect the expression of NLRP3 inflammasome-associated genes, a single stimulus was not sufficient to prime and activate the inflammasome. TNF was able to prime the NLRP3 inflammasome of human osteoblasts.
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Affiliation(s)
- Marie-Luise Sellin
- Biomechanics and Implant Technology Research Laboratory, Department of Orthopedics, Rostock University Medical Center, Rostock, Germany
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Kao A, Tawse-Smith A, Ma S, Duncan WJ, Reid M, Atieh MA. Quantity and Size of Titanium Particles Released from Different Mechanical Decontamination Procedures on Titanium Discs: An In Vitro Study. Dent J (Basel) 2024; 12:123. [PMID: 38786521 PMCID: PMC11119952 DOI: 10.3390/dj12050123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/11/2024] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
Complications such as peri-implantitis could ultimately affect the survival of a dental implant. The prevention and treatment of peri-implant diseases require managing bacterial biofilm and controlling environmental risks, including the presence of pro-inflammatory titanium (Ti) particles in the peri-implant niche. Objectives included the evaluation of the size and quantity of Ti particles released from moderately roughened Ti surfaces during common mechanical surface decontamination methods. One hundred and forty moderately roughened Ti discs were divided into seven groups (n = 20 per group); six groups received mechanical decontamination procedures (ultrasonic scaling (US) with a metal tip and poly-ether-ketone (PEEK) under low and medium power settings, air-polishing with erythritol powder, and Ti brush), and the control group underwent air-water spray using a dental triplex. The rinsing solution was collected for Ti mass analysis using inductively coupled plasma mass spectrometry (ICPMS), as well as for Ti particle size and count analysis under scanning electron microscopy (SEM) with energy-dispersive spectroscopy (EDS). US metal tip instrumentation generated 34.00 ± 12.54 μg and 34.44 ± 6.08 μg of Ti under low and medium power settings, respectively. This amount of Ti generation was significantly higher than other instrumentation methods. The mean Ti particle size of the US groups ranged from 0.89 ± 0.27 μm to 1.25 ± 0.24 μm. No statistically significant difference was found in the particle size among US groups and Ti brush group (1.05 ± 0.11 μm), except for US with the PEEK tip, where a significantly smaller mean particle diameter was found at the low power setting (0.89 ± 0.27 μm). Mechanical instrumentation can produce Ti particulates and modify the implant surfaces. US using a metal tip generated the highest amount of Ti with smaller Ti size particles compared to all other commonly used mechanical surface instrumentations. The EDS analysis confirmed Ti in PEEK US tips. It can be suggested that deterioration from the PEEK US tip and Ti brush, as observed under SEM, is an additional source of Ti release during Ti surface decontamination.
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Affiliation(s)
- Anthony Kao
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Andrew Tawse-Smith
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Sunyoung Ma
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Warwick J. Duncan
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
| | - Malcolm Reid
- Department of Chemistry and Centre for Trace Element Analysis, Department of Geology, Dunedin 9054, New Zealand;
| | - Momen A. Atieh
- Sir John Walsh Research Institute, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand; (A.K.); (S.M.); (W.J.D.); (M.A.A.)
- Department of Oral Diagnostics and Surgical Sciences, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
- School of Dentistry, University of Jordan, Amman 11942, Jordan
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Piatnitskaia S, Rafikova G, Bilyalov A, Chugunov S, Akhatov I, Pavlov V, Kzhyshkowska J. Modelling of macrophage responses to biomaterials in vitro: state-of-the-art and the need for the improvement. Front Immunol 2024; 15:1349461. [PMID: 38596667 PMCID: PMC11002093 DOI: 10.3389/fimmu.2024.1349461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/21/2024] [Indexed: 04/11/2024] Open
Abstract
The increasing use of medical implants in various areas of medicine, particularly in orthopedic surgery, oncology, cardiology and dentistry, displayed the limitations in long-term integration of available biomaterials. The effective functioning and successful integration of implants requires not only technical excellence of materials but also consideration of the dynamics of biomaterial interaction with the immune system throughout the entire duration of implant use. The acute as well as long-term decisions about the efficiency of implant integration are done by local resident tissue macrophages and monocyte-derived macrophages that start to be recruited during tissue damage, when implant is installed, and are continuously recruited during the healing phase. Our review summarized the knowledge about the currently used macrophages-based in vitro cells system that include murine and human cells lines and primary ex vivo differentiated macrophages. We provided the information about most frequently examined biomarkers for acute inflammation, chronic inflammation, foreign body response and fibrosis, indicating the benefits and limitations of the model systems. Particular attention is given to the scavenging function of macrophages that controls dynamic composition of peri-implant microenvironment and ensures timely clearance of microorganisms, cytokines, metabolites, extracellular matrix components, dying cells as well as implant debris. We outline the perspective for the application of 3D systems for modelling implant interaction with the immune system in human tissue-specific microenvironment avoiding animal experimentation.
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Affiliation(s)
- Svetlana Piatnitskaia
- Cell Technology Laboratory, Institute of Fundamental Medicine, Bashkir State Medical University, Ufa, Russia
| | - Guzel Rafikova
- Additive Technology Laboratory, Institute of Fundamental Medicine, Bashkir State Medical University, Ufa, Russia
- Laboratory of Immunology, Institute of Urology and Clinical Oncology, Bashkir State Medical University, Ufa, Russia
| | - Azat Bilyalov
- Additive Technology Laboratory, Institute of Fundamental Medicine, Bashkir State Medical University, Ufa, Russia
| | - Svyatoslav Chugunov
- Additive Technology Laboratory, Institute of Fundamental Medicine, Bashkir State Medical University, Ufa, Russia
| | - Iskander Akhatov
- Laboratory of Mathematical modeling, Institute of Fundamental Medicine, Bashkir State Medical University, Ufa, Russia
| | - Valentin Pavlov
- Institute of Urology and Clinical Oncology, Department of Urology, Bashkir State Medical University, Ufa, Russia
| | - Julia Kzhyshkowska
- Laboratory for Translational Cellular and Molecular Biomedicine, Tomsk State University, Tomsk, Russia
- Institute of Transfusion Medicine and Immunology, Mannheim Institute of Innate Immunosciences (MI3), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- German Red Cross Blood Service Baden-Württemberg—Hessen, Mannheim, Germany
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6
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Lammi MJ, Qu C. Regulation of Oxygen Tension as a Strategy to Control Chondrocytic Phenotype for Cartilage Tissue Engineering and Regeneration. Bioengineering (Basel) 2024; 11:211. [PMID: 38534484 DOI: 10.3390/bioengineering11030211] [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: 02/12/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/28/2024] Open
Abstract
Cartilage defects and osteoarthritis are health problems which are major burdens on health care systems globally, especially in aging populations. Cartilage is a vulnerable tissue, which generally faces a progressive degenerative process when injured. This makes it the 11th most common cause of global disability. Conservative methods are used to treat the initial phases of the illness, while orthopedic management is the method used for more progressed phases. These include, for instance, arthroscopic shaving, microfracturing and mosaicplasty, and joint replacement as the final treatment. Cell-based implantation methods have also been developed. Despite reports of successful treatments, they often suffer from the non-optimal nature of chondrocyte phenotype in the repair tissue. Thus, improved strategies to control the phenotype of the regenerating cells are needed. Avascular tissue cartilage relies on diffusion for nutrients acquisition and the removal of metabolic waste products. A low oxygen content is also present in cartilage, and the chondrocytes are, in fact, well adapted to it. Therefore, this raises an idea that the regulation of oxygen tension could be a strategy to control the chondrocyte phenotype expression, important in cartilage tissue for regenerative purposes. This narrative review discusses the aspects related to oxygen tension in the metabolism and regulation of articular and growth plate chondrocytes and progenitor cell phenotypes, and the role of some microenvironmental factors as regulators of chondrocytes.
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Affiliation(s)
- Mikko J Lammi
- Department of Medical and Translational Biology, Umeå University, SE-90187 Umeå, Sweden
| | - Chengjuan Qu
- Department of Odontology, Umeå University, SE-90187 Umeå, Sweden
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Barrak FN, Li S. From manufacturers to clinicians, the release of dental implant particles can no longer be ignored. Clin Implant Dent Relat Res 2024. [PMID: 38369955 DOI: 10.1111/cid.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/03/2024] [Accepted: 01/19/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Fadi N Barrak
- School of Medicine and Dentistry, University of Central Lancashire, Preston, UK
- VSS Academy Training and Education Ltd., London, UK
| | - Siwei Li
- VSS Academy Training and Education Ltd., London, UK
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Ng E, Tay JRH, Mattheos N, Bostanci N, Belibasakis GN, Seneviratne CJ. A Mapping Review of the Pathogenesis of Peri-Implantitis: The Biofilm-Mediated Inflammation and Bone Dysregulation (BIND) Hypothesis. Cells 2024; 13:315. [PMID: 38391928 PMCID: PMC10886485 DOI: 10.3390/cells13040315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
This mapping review highlights the need for a new paradigm in the understanding of peri-implantitis pathogenesis. The biofilm-mediated inflammation and bone dysregulation (BIND) hypothesis is proposed, focusing on the relationship between biofilm, inflammation, and bone biology. The close interactions between immune and bone cells are discussed, with multiple stable states likely existing between clinically observable definitions of peri-implant health and peri-implantitis. The framework presented aims to explain the transition from health to disease as a staged and incremental process, where multiple factors contribute to distinct steps towards a tipping point where disease is manifested clinically. These steps might be reached in different ways in different patients and may constitute highly individualised paths. Notably, factors affecting the underlying biology are identified in the pathogenesis of peri-implantitis, highlighting that disruptions to the host-microbe homeostasis at the implant-mucosa interface may not be the sole factor. An improved understanding of disease pathogenesis will allow for intervention on multiple levels and a personalised treatment approach. Further research areas are identified, such as the use of novel biomarkers to detect changes in macrophage polarisation and activation status, and bone turnover.
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Affiliation(s)
- Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore 168938, Singapore;
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand;
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Nagihan Bostanci
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Georgios N. Belibasakis
- Division of Oral Health and Periodontology, Department of Dental Medicine, Karolinska Institute, 14152 Stockholm, Sweden; (N.B.); (G.N.B.)
| | - Chaminda Jayampath Seneviratne
- School of Dentistry, The University of Queensland, Brisbane, QLD 4006, Australia
- School of Dentistry, Center for Oral-Facial Regeneration, Rehabilitation and Reconstruction (COR3), The University of Queensland, Brisbane, QLD 4072, Australia
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore 168938, Singapore
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Insua A, Galindo-Moreno P, Miron RJ, Wang HL, Monje A. Emerging factors affecting peri-implant bone metabolism. Periodontol 2000 2024; 94:27-78. [PMID: 37904311 DOI: 10.1111/prd.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/05/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023]
Abstract
Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.
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Affiliation(s)
- Angel Insua
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pablo Galindo-Moreno
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Li Y, Li X, Guo D, Meng L, Feng X, Zhang Y, Pan S. Immune dysregulation and macrophage polarization in peri-implantitis. Front Bioeng Biotechnol 2024; 12:1291880. [PMID: 38347915 PMCID: PMC10859439 DOI: 10.3389/fbioe.2024.1291880] [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: 09/10/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024] Open
Abstract
The term "peri-implantitis" (peri-implantitis) refers to an inflammatory lesion of the mucosa surrounding an endosseous implant and a progressive loss of the peri-implant bone that supports the implant. Recently, it has been suggested that the increased sensitivity of implants to infection and the quick elimination of supporting tissue after infection may be caused by a dysregulated peri-implant mucosal immune response. Macrophages are polarized in response to environmental signals and play multiple roles in peri-implantitis. In peri-implantitis lesion samples, recent investigations have discovered a considerable increase in M1 type macrophages, with M1 type macrophages contributing to the pro-inflammatory response brought on by bacteria, whereas M2 type macrophages contribute to inflammation remission and tissue repair. In an effort to better understand the pathogenesis of peri-implantitis and suggest potential immunomodulatory treatments for peri-implantitis in the direction of macrophage polarization patterns, this review summarizes the research findings related to macrophage polarization in peri-implantitis and compares them with periodontitis.
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Affiliation(s)
- Yue Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xue Li
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing, China
| | - Danni Guo
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Lingwei Meng
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xianghui Feng
- Department of Periodontology, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yi Zhang
- Stem Cell and Regenerative Medicine Lab, Beijing Institute of Radiation Medicine, Beijing, China
| | - Shaoxia Pan
- Department of Prosthodontics, Peking University School and Hospital of Stomatology and National Center for Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Research Center of Oral Biomaterials and Digital Medical Devices and Beijing Key Laboratory of Digital Stomatology and Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health and NMPA Key Laboratory for Dental Materials, Beijing, China
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Padial-Molina M, Montalvo-Acosta S, Martín-Morales N, Pérez-Carrasco V, Magan-Fernandez A, Mesa F, O’Valle F, Garcia-Salcedo JA, Galindo-Moreno P. Correlation between Inflammasomes and Microbiota in Peri-Implantitis. Int J Mol Sci 2024; 25:961. [PMID: 38256037 PMCID: PMC10815557 DOI: 10.3390/ijms25020961] [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: 12/07/2023] [Revised: 01/05/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The activation of inflammasomes is thought to induce the inflammatory process around dental implants. No information is available on the correlation between microbiota and inflammasomes in clinical samples from patients suffering peri-implantitis. For this cross-sectional study, 30 biofilm samples were obtained from 19 patients undergoing surgical treatment for peri-implantitis because of the presence of bleeding on probing, probing depth higher than 6 mm, and radiographic bone loss higher than 3 mm. Then, soft tissue samples from around the implant were also collected. The relative abundance of bacteria and alpha-diversity indexes were calculated after analyzing the 16S rRNA gene using next-generation sequencing. The soft-tissue samples were processed for evaluation of the inflammasomes NLRP3 and AIM2 as well as caspase-1 and IL-1β. The relative abundance (mean (SD)) of specific species indicated that the most abundant species were Porphyromonas gingivalis (10.95 (14.17)%), Fusobacterium vincentii (10.93 (13.18)%), Porphyromonas endodontalis (5.89 (7.23)%), Prevotella oris (3.88 (4.94)%), Treponema denticola (2.91 (3.19)%), and Tannerella forsythia (2.84 (4.15)%). Several correlations were found between the species and the immunohistochemical detection of the inflammasomes NLRP3 and AIM2 as well as caspase-1 and IL-1β, both in the epithelium and the lamina propria. A network analysis found an important cluster of variables formed by NLRP3 in the lamina propria and AIM2, caspase-1, and IL-1β in the lamina propria and the epithelium with Prevotella dentalis, Prevotella tannerae, Tannerella forsythia, or Selenomonas timonae. Thus, it could be concluded that inflammasomes NLRP3 and AIM2 and their downstream effectors caspase-1 and interleukin-1β can be significantly associated with specific bacteria.
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Affiliation(s)
- Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Saray Montalvo-Acosta
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18071 Granada, Spain
| | - Natividad Martín-Morales
- PhD Program in Biomedicine, University of Granada, 18071 Granada, Spain
- Department of Pathology, School of Medicine, University of Granada, 18071 Granada, Spain
| | - Virginia Pérez-Carrasco
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centre for Genomics and Oncological Research, Pfizer–University of Granada–Andalusian Regional Government (GENYO), PTS Granada, 18016 Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain
| | - Antonio Magan-Fernandez
- Department of Periodontics, School of Dentistry, University of Granada, 18071 Granada, Spain (F.M.)
| | - Francisco Mesa
- Department of Periodontics, School of Dentistry, University of Granada, 18071 Granada, Spain (F.M.)
| | - Francisco O’Valle
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER, CIBM), University of Granada, 18071 Granada, Spain
| | - Jose Antonio Garcia-Salcedo
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Centre for Genomics and Oncological Research, Pfizer–University of Granada–Andalusian Regional Government (GENYO), PTS Granada, 18016 Granada, Spain
- Microbiology Unit, University Hospital Virgen de las Nieves, 18014 Granada, Spain
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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12
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Rakic M, Canullo L, Radovanovic S, Tatic Z, Radunovic M, Souedain A, Weiss P, Struillou X, Vojvodic D. Diagnostic value of VEGF in peri-implantitis and its correlation with titanium particles: A controlled clinical study. Dent Mater 2024; 40:28-36. [PMID: 37865576 DOI: 10.1016/j.dental.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/29/2023] [Accepted: 10/05/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES VEGF is prototypic marker of neovascularization, repeatedly proposed as intrinsic characteristic of peri-implantitis. This study aimed to assess pattern of VEGF in peri-implantitis, its correlation with titanium particles (TPs) and capacity as respective biomarker. MATERIAL AND METHODS Pathological specificity of VEGF was assessed in peri-implant granulations using immunohistochemistry, periodontal granulations represented Ti-free positive controls. VEGF was correlated to TPs, identified using scanning electron microscopy coupled with dispersive x-ray spectrometry. Diagnostic accuracy, sensitivity and specificity of VEGF were estimated in PICF specimens from peri-implantitis, peri-implant mucositis (PIM) and healthy peri-implant tissues (HI) using machine learning algorithms. RESULTS Peri-implantitis exhibited rich neovascular network with expressed density in contact zones toward neutrophil infiltrates without specific pattern variations around TPs, identified in all peri-implantitis specimens (mean particle size 8.9 ± 24.8 µm2; Ti-mass (%) 0.380 ± 0.163). VEGF was significantly more expressed in peri-implantitis (47,065 ± 24.2) compared to periodontitis (31,14 ± 9.15), and positively correlated with its soluble concentrations in PICF (p = 0.01). VEGF was positively correlated to all clinical endpoints and significantly increased in peri-implantitis compared to both PIM and HI, but despite high specificity (96%), its overall diagnostic capacity was average. Two patient clusters were identified in peri-implantitis, one with 8-fold higher VEGF values compared to HI, and second with lower values comparable to PIM. SIGNIFICANCE VEGF accurately reflects neovascularization in peri-implantitis that was expressed in contact zones toward implant surface without specific histopathological patter variation around TPs. VEGF answered requests for biomarker of peri-implantitis but further research is necessary to decrypt its exact underlying cause.
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Affiliation(s)
- Mia Rakic
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Genova, Italy; Department of Periodontology, University of Bern, Switzerland
| | - Sandro Radovanovic
- Faculty of Organizational Sciences, University of Belgrade, Belgrade, Serbia; Department for Oral Implantology, Military Medical Academy, Belgrade, Serbia
| | - Zoran Tatic
- Department for Oral Implantology, Military Medical Academy, Belgrade, Serbia
| | - Milena Radunovic
- Department of Oral Microbiology, Faculty of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Assem Souedain
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes, Department of Periodontology, Faculty of Dental Surgery, France
| | - Pierre Weiss
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes, France
| | - Xavier Struillou
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes, France; Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes, France
| | - Danilo Vojvodic
- Institute for Experimental Medicine, Military Medical Academy, Belgrade, Serbia
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Chato-Astrain J, Toledano-Osorio M, Alaminos M, Toledano M, Sanz M, Osorio R. Effect of functionalized titanium particles with dexamethasone-loaded nanospheres on macrophage polarization and activity. Dent Mater 2024; 40:66-79. [PMID: 37914549 DOI: 10.1016/j.dental.2023.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE The aim of this study was to determine the effect of titanium micro particles (TiP) previously functionalized with nanoparticles doped with dexamethasone (Dex) and doxycycline (Dox), on macrophage polarization and activity. METHODS Macrophages RAW264.7 were cultured in the presence TiP loaded with dexamethasone -NPs (Dex)- and doxycycline -NPs (Dox)-, and as control, TiP with or without doped NPs. Cells were tested with and without previous bacterial lipopolysaccharide endotoxin (LPS) stimulation. Their morphology, proliferation, cytotoxicity, phenotypic change, and cytokines release were assessed by LIVE/DEAD, DNA release, metabolic activity, brightfield and scanning electron microscopy. The test Kruskall-Wallis was used for comparisons, while the cytokine expression profiles were examined by hierarchical clustering (p < 0.05). RESULTS Upon exposure with TiP macrophages were activated and polarized to M1, but without depicting cytotoxic effects. The particles were phagocytised, and vacuolized. When exposed to functionalised TiP with NPs(Dex) and NPs(Dox), the ratio M1/M2 was up to forty times lower compared to TiP alone. When exposed to LPS, TiP reduced cell viability in half. Functionalised TiP with NPs(Dex) inhibited the cytokine release exerted by TiP on macrophages. When macrophages were exposed to functionalised TiPs with NPs(Dex) with and without LPS, the effect of TiP on cytokine secretion was inhibited. SIGNIFICANCE Functionalised TiPs with NPs(Dex) and NPs(Dox) may potentially have beneficial effects on modulating titanium and LPS-related inflammatory reactions.
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Affiliation(s)
- Jesús Chato-Astrain
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria IBS. Granada, Granada, Spain
| | - Manuel Toledano-Osorio
- Dental School, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, Granada 18071, Spain..
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Instituto de Investigación Biosanitaria IBS. Granada, Granada, Spain
| | - Manuel Toledano
- Instituto de Investigación Biosanitaria IBS. Granada, Granada, Spain; Dental School, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
| | - Mariano Sanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group. University Complutense of Madrid, Madrid, Spain
| | - Raquel Osorio
- Instituto de Investigación Biosanitaria IBS. Granada, Granada, Spain; Dental School, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, Granada 18071, Spain
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14
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Galindo-Moreno P, Montalvo-Acosta S, Martín-Morales N, Carrillo-Gálvez AB, González-Rey E, O'Valle F, Padial-Molina M. Inflammasomes NLRP3 and AIM2 in peri-implantitis: A cross-sectional study. Clin Oral Implants Res 2023; 34:1342-1353. [PMID: 37642257 DOI: 10.1111/clr.14174] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 07/18/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Inflammasome components NLRP3 and AIM2 contribute to inflammation development by the activation of caspase-1 and IL-1β. They have not been yet evaluated in samples from patients with active peri-implantitis. Thus, the aim of the present study is to analyze the expression of inflammasomes NLRP3 and AIM2 and subsequent caspase 1 and IL-1β assessing the microenvironment of leukocyte subsets in samples from patients with active peri-implantitis. METHODS Biopsies were collected from 33 implants in 21 patients being treated for peri-implantitis. Biopsies from gingival tissues from 15 patients with healthy periodontium were also collected for control. These tissues were evaluated through conventional histological stainings. Then, immunohistochemical detection was performed to analyze NLRP3, AIM2, caspase-1, and IL-1β and markers of different leukocyte subsets. PCR for inflammasomes and related genes was also done. RESULTS This manuscript reveals a high immunohistochemical and mRNA expression of NLRP3 and AIM2 inflammasomes, caspase-1, and IL-1β in biopsies collected from human peri-implantitis. The expression of the tested markers was significantly correlated with the increase in inflammatory infiltrate, probing depth, presence of biofilm, and bleeding on probing. In these peri-implantitis lesions, the area of biopsy tissue occupied by inflammatory infiltrate was intense while the area occupied by collagen was significantly lower. In comparison with periodontal healthy tissues, the inflammatory infiltrate was statistically significantly higher in the peri-implantitis biopsies and was mainly composed of plasma cells, followed by T and B lymphocytes. CONCLUSION In human peri-implantitis, chronic inflammation can be explained in part by the action of IL-1β/caspase 1 induced through NLRP3 and AIM2 inflammasome activation.
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Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - Saray Montalvo-Acosta
- PhD Program in Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Natividad Martín-Morales
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- PhD Program in Biomedicine, University of Granada, Granada, Spain
- Department of Pathology, School of Medicine, University of Granada, Granada, Spain
| | | | - Elena González-Rey
- Institute of Parasitology and Biomedicine Lopez-Neyra, IPBLN-CSIC, Parque Tecnologico de la Salud, Granada, Spain
| | - Francisco O'Valle
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- Department of Pathology, School of Medicine, University of Granada, Granada, Spain
- Institute of Biopathology and Regenerative Medicine (IBIMER, CIBM), University of Granada, Granada, Spain
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
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15
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Spinell T, Kröger A, Freitag L, Würfl G, Lauseker M, Hickel R, Kebschull M. Dental implant material related changes in molecular signatures in peri-implantitis - A systematic review of omics in-vivo studies. Dent Mater 2023; 39:1150-1158. [PMID: 37839998 DOI: 10.1016/j.dental.2023.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/22/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE Titanium particles have been shown in in-vitro studies to lead to the activation of specific pathways, this work aims to systematically review in- vivo studies examining peri-implant and periodontal tissues at the transcriptome, proteome, epigenome and genome level to reveal implant material-related processes favoring peri-implantitis development investigated in animal and human trials. METHODS Inquiring three literature databases (Medline, Embase, Cochrane) a systematic search based on a priori defined PICOs was conducted: '-omics' studies comparing molecular signatures in healthy and infected peri-implant sites and/or healthy and periodontitis-affected teeth in animals/humans. After risk of bias assessments, lists of differentially expressed genes and results of functional enrichment analyses were compiled whenever possible. RESULTS Out of 2187 screened articles 9 publications were deemed eligible. Both healthy and inflamed peri-implant tissues showed distinct gene expression patterns compared to healthy/diseased periodontal tissues in animal (n = 4) or human studies (n = 5), with immune response, bone metabolism and oxidative stress being affected the most. Due to the lack of available re-analyzable data and inconsistency in methodology of the eligible studies, integrative analyses on differential gene expression were not applicable CONCLUSION: The differences of transcriptomic signatures in between peri-implant lesions compared to periodontal tissue might be related to titanium particles arising from dental implants and are in line with the in-vitro data recently published by our group. Nevertheless, limitations emerge from small sample sizes of included studies and insufficient publication of re-analyzable data.
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Affiliation(s)
- Thomas Spinell
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany.
| | - Annika Kröger
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK; NIHR Birmingham Biomedical Research Centre, Birmingham, UK
| | - Lena Freitag
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | | | - Michael Lauseker
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | - Moritz Kebschull
- Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University Collegeof Dental Medicine, New York, NY, United States
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16
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Chen L, Tong Z, Luo H, Qu Y, Gu X, Si M. Titanium particles in peri-implantitis: distribution, pathogenesis and prospects. Int J Oral Sci 2023; 15:49. [PMID: 37996420 PMCID: PMC10667540 DOI: 10.1038/s41368-023-00256-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: 08/24/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
Peri-implantitis is one of the most important biological complications in the field of oral implantology. Identifying the causative factors of peri-implant inflammation and osteolysis is crucial for the disease's prevention and treatment. The underlying risk factors and detailed pathogenesis of peri-implantitis remain to be elucidated. Titanium-based implants as the most widely used implant inevitably release titanium particles into the surrounding tissue. Notably, the concentration of titanium particles increases significantly at peri-implantitis sites, suggesting titanium particles as a potential risk factor for the condition. Previous studies have indicated that titanium particles can induce peripheral osteolysis and foster the development of aseptic osteoarthritis in orthopedic joint replacement. However, it remains unconfirmed whether this phenomenon also triggers inflammation and bone resorption in peri-implant tissues. This review summarizes the distribution of titanium particles around the implant, the potential roles in peri-implantitis and the prevalent prevention strategies, which expects to provide new directions for the study of the pathogenesis and treatment of peri-implantitis.
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Affiliation(s)
- Long Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zian Tong
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Hongke Luo
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China
| | - Yuan Qu
- Zhejiang University-University of Edinburgh Institute, International Campus, Zhejiang University, Haining, China
| | - Xinhua Gu
- Department of Stomatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Misi Si
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
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17
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Qiu W, Li Z, Su Z, Cao L, Li L, Chen X, Zhang W, Li Y. Kaempferol prevents aseptic loosening via enhance the Wnt/β-catenin signaling pathway in vitro and in vivo. Eur J Med Res 2023; 28:505. [PMID: 37946300 PMCID: PMC10634165 DOI: 10.1186/s40001-023-01469-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023] Open
Abstract
Kaempferol has demonstrated notable positive effects on the osteogenic differentiation of mesenchymal stem cells (MSC) and osteoblasts. A substantial body of research has emphasized the role of dislodged titanium particles in aseptic loosening following joint replacement surgery. This study predominantly investigates the suppressive influence of Kaempferol on osteolysis induced by titanium (Ti) alloy particles. In vitro investigations disclosed that Kaempferol effectively enhanced mineralization and alkaline phosphatase (ALP) activity in bone-marrow mesenchymal stem cells exposed to Ti particles. In addition, we conducted a comprehensive analysis of osteogenic differentiation microarray data_sets (GSE37676, GSE79814, and GSE114474) to identify differentially expressed genes. Significantly, Kaempferol upregulated the expression of critical osteogenic markers, including Runt-related transcription factor 2 (Runx2), osteocalcin (OCN), osterix/Sp-7, and β-catenin. In vivo experiments, including H&E staining and Immunohistochemistry, provided compelling evidence that Kaempferol exerted a robust inhibitory effect on periprosthetic osteolysis in mice, with particularly pronounced results at higher doses. Moreover, it elevated the expression levels of osteogenic factors and Wnt/β-catenin signaling components. These findings collectively indicate that Kaempferol mitigates the hindrance to osteogenesis posed by titanium particles by activating the Runx2 and Wnt/β-catenin signaling pathways. This research lays a solid foundation for the prospective utilization of Kaempferol in the management of aseptic loosening following arthroplasty, offering promising therapeutic potential.
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Affiliation(s)
- Wenkui Qiu
- Department of Orthopedics, Kaifeng Central Hospital, Kaifeng, 475000, Henan, People's Republic of China
| | - Zhenghui Li
- Department of Neurosurgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
| | - Zhenyan Su
- Department of Orthopedics, Kaifeng Central Hospital, Kaifeng, 475000, Henan, People's Republic of China
| | - Lichao Cao
- Department of Orthopedics, Kaifeng Central Hospital, Kaifeng, 475000, Henan, People's Republic of China
| | - Lei Li
- Department of Orthopedics, Kaifeng Central Hospital, Kaifeng, 475000, Henan, People's Republic of China
| | - Xi Chen
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - Wanhong Zhang
- Department of Neurosurgery, Kaifeng Central Hospital, Kaifeng, 475000, Henan, People's Republic of China
| | - Yanqing Li
- Department of Orthopedics, Kaifeng Central Hospital, Kaifeng, 475000, Henan, People's Republic of China.
- School of Life Sciences, Henan University, Kaifeng, 475000, Henan, People's Republic of China.
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Schnurr E, Volz KU, Mosetter K, Ghanaati S, Hueber R, Preussler C. Interaction of Telomere Length and Inflammatory Biomarkers Following Zirconia Implant Placement: A Case Series. J ORAL IMPLANTOL 2023; 49:524-531. [PMID: 38349660 DOI: 10.1563/aaid-joi-d-22-00236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Zirconia implants have gained popularity for their aesthetic appeal and biocompatibility, making them a preferred choice for anterior teeth replacement. This study explores the interaction between telomere length and inflammatory biomarkers in seven cases of zirconia implant placement to gain insights into postoperative cellular aging, inflammatory responses, and long-term outcomes. Zirconia implants offer advantages over titanium implants, as they do not corrode or release metal ions, leading to potential inflammation and implant failure. Monitoring immune and inflammatory biomarkers is essential to assess inflammation initiation, severity, and progression. C-reactive protein (CRP) and pro-inflammatory cytokines, like interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), play crucial roles in host immune responses, while anti-inflammatory cytokines, including interleukin-10 (IL-10), regulate and dampen immune responses. Achieving a delicate balance between pro- and anti-inflammatory cytokines is vital for maintaining a healthy immune response and preventing chronic inflammatory conditions. Telomeres, protective structures present at chromosome ends, influence cellular aging and mitochondrial function. Shorter telomeres are associated with impaired mitochondrial function, increased oxidative stress, and cellular senescence, while longer telomeres are linked to reduced inflammation and improved immune function. Understanding these mechanisms is essential for addressing age-related conditions and promoting overall well-being. In this case series, we investigated the interaction between telomere length and inflammatory biomarkers in patients who received zirconia dental implants. The study aims to improve our understanding of postoperative cellular aging, inflammatory responses, and the biocompatibility of zirconia implants, potentially leading to improved treatment protocols and patient outcomes. This innovative assessment of telomere length and inflammatory biomarkers in the context of zirconia implants provides novel insights into the field of dental implantology. By exploring the effects of zirconia implants on cellular health and inflammation, this study contributes to advancements in implant technology and patient care.
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Affiliation(s)
| | | | - Kurt Mosetter
- SDS: Swiss Dental Solutions, Kreuzlingen, Switzerland
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19
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Platt A, Liu CC, Gubler A, Naenni N, Thoma D, Schmidlin PR. In vitro evaluation of different protective techniques to reduce titanium particle contamination during implantoplasty. Clin Oral Investig 2023; 27:4205-4213. [PMID: 37140763 PMCID: PMC10415425 DOI: 10.1007/s00784-023-05037-8] [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: 02/22/2023] [Accepted: 04/21/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Our aim is to study titanium remains in a bone model during standardized implantoplasty under different isolation and protective modalities. MATERIAL AND METHODS Forty implants were placed in artificial spongy bone blocks mimicking a horizontal bone loss and implant neck protrusion of 5 mm. Samples were randomly divided into four groups (n = 10), which were treated as follows: rubber dam (A), a dental adhesive paste (B), bone wax (C), and an unprotected positive control (D). Implantoplasty was performed using carbide and diamond burs under strict water cooling and standardized suction. After removal of the respective isolation materials, the bone blocks were thoroughly rinsed with tap water for 3 min and titanium chips were collected using a filter integrated in the model. The filter paper was removed and dissolved in 37% hydrochloric acid for 2 h at 120 °C and the titanium remnants were quantified using atomic absorption spectrometry. RESULTS None of the test groups were able to completely prevent titanium particle contamination. Rubber dam (691 ± 249 µg) and bone wax (516 ± 157 µg) were found to be significantly more protective than the positive control (2313 ± 747 µg) (p < 0.001) with respect to the amount of titanium particles that remained in the bone model after implantoplasty. The adhesive paste group (1863.5 ± 538 µg) was not significantly different from the positive control (p = 0.19). CONCLUSIONS Despite some limitations of the present study, titanium particles resulting from a standardized implantoplasty can be assumed to be significantly reduced when the tissues/bone were protected with rubber dam and bone wax, or a combination, depending on individual accessibility. CLINICAL RELEVANCE Tissue protective measures to reduce or avoid particle contamination during implantoplasty is possible and should be considered and further clinically assessed to avoid iatrogenic inflammatory reactions.
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Affiliation(s)
- A Platt
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - C C Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - A Gubler
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - N Naenni
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - D Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - P R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland.
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20
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Cionca N, Meyer J, Michalet S, Varesio E, Hashim D. Quantification of titanium and zirconium elements in oral mucosa around healthy dental implants: a case-control pilot study. Clin Oral Investig 2023; 27:4715-4726. [PMID: 37270723 PMCID: PMC10415439 DOI: 10.1007/s00784-023-05099-8] [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: 05/18/2022] [Accepted: 05/29/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Metallic particles are detected in different sites of the oral cavity, mainly in patients with peri-implantitis lesions. The aim of this pilot study was to analyze the levels of titanium and zirconium elements in the oral mucosa around healthy implants and to investigate the impact of titanium exogenous contamination on the measurements. MATERIALS AND METHODS Forty-one participants were included in this three-phase study. Two groups of subjects were defined according to presence of titanium or zirconia implants (n: 20) or without any implants nor metallic restorations (n:21). Thirteen patients (n: 5 with zirconia implant; n: 3 with titanium implants; n: 5 control group) took part to the first part designed to optimize and validate the method of detecting titanium (Ti) and zirconium (Zr) elements in the oral mucosa and gingival tissues by the Inductively Coupled Plasma Mass Spectrometry (ICPMS). The second phase compared the levels of Ti and Zr concentrations in patients with implants (n: 12) and without implants (n: 6) who were controlled for their intake of titanium dioxide (TiO2). The last step included ten control subjects without any metallic devices to measure the concentration of Ti and Zr before and after having candies containing TiO2. RESULTS In the first phase, concentrations of Ti and Zr were below the limit of detection (LOD) in most cases, 0.18 μg/L and 0.07 μg/L respectively. In the titanium group, two out of three subjects displayed concentrations above the LOD, 0.21 μg/L and 0.66 μg/L. Zr element was only found in patients with zirconia implants. After controlling the intake of TiO2, all concentrations of Ti and Zr were below the limit of quantification (LOQ). Moreover, in patients with no implants, the Ti concentration in gingiva cells was superior for 75% of the samples after having a TiO2 diet. CONCLUSIONS Zirconium was only found in patients with zirconia implants, whereas titanium was detected in all groups even in subjects with no titanium implants. Zirconium and titanium elements were not detected in patients who were controlled for their intake of food and their use of toothpaste irrespective of the presence of implants or not. For 70% of the patients, the titanium detection was directly influenced by the intake of TiO2 contained candies. CLINICAL RELEVANCE When analyzing titanium particles, it is necessary to pay attention to the risk of contamination bias brought by external products. When this parameter was controlled, no titanium particles were detected around clinically healthy implants.
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Affiliation(s)
- Norbert Cionca
- Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Julien Meyer
- Mass Spectrometry Core Facility (MZ 2.0), Faculty of Sciences, University of Geneva, Geneva, Switzerland
| | - Sophie Michalet
- Mass Spectrometry Core Facility (MZ 2.0), Faculty of Sciences, University of Geneva, Geneva, Switzerland
| | - Emmanuel Varesio
- Mass Spectrometry Core Facility (MZ 2.0), Faculty of Sciences, University of Geneva, Geneva, Switzerland
| | - Dena Hashim
- Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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21
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Olander J, Barkarmo S, Hammarström Johansson P, Wennerberg A, Stenport VF. Inflammatory Gene Profile and Particle Presence in Peri-Implant Mucosa: a Pilot Study on 9 Patients. J Oral Maxillofac Res 2023; 14:e2. [PMID: 37969950 PMCID: PMC10645473 DOI: 10.5037/jomr.2023.14302] [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: 08/22/2023] [Accepted: 09/27/2023] [Indexed: 11/17/2023]
Abstract
Objectives The purpose of this pilot study is to compare gene expression in mucosa around dental implants with zirconia abutment to titanium and investigate presence of particles in mucosa samples and on implant heads. Material and Methods Ten patients with a single implant supported prosthesis connected to zirconia or titanium abutments were invited at the five-year control. A clinical examination and a survey on experience of function and appearance were conducted. A mucosa biopsy taken in close vicinity to the implant were analysed by real-time polymerase chain reaction (qPCR) and presence of particles in a scanning electron microscope/energy-dispersive X-ray spectroscope (SEM/EDX). Cytological smear samples were collected and analysed through inductively coupled plasma mass spectrometry (ICP-MS) to investigate presence of particles on implant heads. Results In total, 9 patients participated in the study, five with titanium abutments and four with zirconia abutments. All patients were satisfied with function and aesthetics. Titanium and iron particles were detected in mucosa biopsies. The ICP - MS analysis demonstrated presence of zirconia and titanium. Several proinflammatory genes were upregulated in the zirconia abutment group. Conclusions Around zirconia abutments a slight increase in proinflammatory response and amount of wear particles was seen as compared to titanium. Wear particles of titanium were present in all soft tissue samples, however zirconia particles only in the samples from implants heads/mucosa with zirconia abutments.
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Affiliation(s)
- Julia Olander
- Department of Prosthodontics and Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, GothenburgSweden.
| | - Sargon Barkarmo
- Department of Prosthodontics and Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, GothenburgSweden.
| | - Petra Hammarström Johansson
- Department of Prosthodontics and Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, GothenburgSweden.
| | - Ann Wennerberg
- Department of Prosthodontics and Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, GothenburgSweden.
| | - Victoria Franke Stenport
- Department of Prosthodontics and Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, GothenburgSweden.
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22
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Malheiros SS, Nagay BE, Bertolini MM, de Avila ED, Shibli JA, Souza JGS, Barão VAR. Biomaterial engineering surface to control polymicrobial dental implant-related infections: focusing on disease modulating factors and coatings development. Expert Rev Med Devices 2023:1-17. [PMID: 37228179 DOI: 10.1080/17434440.2023.2218547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/29/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Peri-implantitis is the leading cause of dental implant loss and is initiated by a polymicrobial dysbiotic biofilm formation on the implant surface. The destruction of peri-implant tissue by the host immune response and the low effectiveness of surgical or non-surgical treatments highlight the need for new strategies to prevent, modulate and/or eliminate biofilm formation on the implant surface. Currently, several surface modifications have been proposed using biomolecules, ions, antimicrobial agents, and topography alterations. AREAS COVERED Initially, this review provides an overview of the etiopathogenesis and host- and material-dependent modulating factors of peri-implant disease. In addition, a critical discussion about the antimicrobial surface modification mechanisms and techniques employed to modify the titanium implant material is provided. Finally, we also considered the future perspectives on the development of antimicrobial surfaces to narrow the bridge between idea and product and favor the clinical application possibility. EXPERT OPINION Antimicrobial surface modifications have demonstrated effective results; however, there is no consensus about the best modification strategy and in-depth information on the safety and longevity of the antimicrobial effect. Modified surfaces display recurring challenges such as short-term effectiveness, the burst release of drugs, cytotoxicity, and lack of reusability. Stimulus-responsive surfaces seem to be a promising strategy for a controlled and precise antimicrobial effect, and future research should focus on this technology and study it from models that better mimic clinical conditions.
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Affiliation(s)
- Samuel S Malheiros
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Bruna E Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
| | - Martinna M Bertolini
- Department of Periodontics and Preventive Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15106, USA
| | - Erica D de Avila
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araçatuba, São Paulo State University (UNESP), Araçatuba, Sao Paulo 16015-050, Brazil
| | - Jamil A Shibli
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo 07023-070, Brazil
| | - João Gabriel S Souza
- Dental Research Division, Guarulhos University, Guarulhos, São Paulo 07023-070, Brazil
- Dental Science School (Faculdade de Ciências Odontológicas - FCO), Montes Claros, Minas Gerais39401-303, Brazil
| | - Valentim A R Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo 13414-903, Brazil
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23
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Robles D, Brizuela A, Fernández-Domínguez M, Gil J. Corrosion Resistance and Titanium Ion Release of Hybrid Dental Implants. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16103650. [PMID: 37241275 DOI: 10.3390/ma16103650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
One of the strategies for the fight against peri-implantitis is the fabrication of titanium dental implants with the part close to the neck without roughness. It is well known that roughness favors osseointegration but hinders the formation of biofilm. Implants with this type of structure are called hybrid dental implants, which sacrifice better coronal osseointegration for a smooth surface that hinders bacterial colonization. In this contribution, we have studied the corrosion resistance and the release of titanium ions to the medium of smooth (L), hybrid (H), and rough (R) dental implants. All implants were identical in design. Roughness was determined with an optical interferometer and residual stresses were determined for each surface by X-ray diffraction using the Bragg-Bentano technique. Corrosion studies were carried out with a Voltalab PGZ301 potentiostat, using Hank's solution as an electrolyte at a temperature of 37 °C. Open-circuit potentials (Eocp), corrosion potential (Ecorr), and current density (icorr) were determined. Implant surfaces were observed by JEOL 5410 scanning electron microscopy. Finally, for each of the different dental implants, the release of ions into Hank's solution at 37 °C at 1, 7, 14, and 30 days of immersion was determined by ICP-MS. The results, as expected, show a higher roughness of R with respect to L and compressive residual stresses of -201.2 MPa and -20.2 MPa, respectively. These differences in residual stresses create a potential difference in the H implant corresponding to Eocp of -186.4 mV higher than for the L and R of -200.9 and -192.2 mV, respectively. The corrosion potentials and current intensity are also higher for the H implants (-223 mV and 0.069 μA/mm2) with respect to the L (-280 mV and 0.014 μA/mm2 and R (-273 mV and 0.019 μA/mm2). Scanning electron microscopy revealed pitting in the interface zone of the H implants and no pitting in the L and R dental implants. The titanium ion release values to the medium are higher in the R implants due to their higher specific surface area compared to the H and L implants. The maximum values obtained are low, not exceeding 6 ppb in 30 days.
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Affiliation(s)
- Daniel Robles
- Department of Translational Medicine CEU, San Pablo University, Urbanización Montepríncipe, Alcorcón, 28925 Madrid, Spain
- Facultad de Odontología, Universidad Europea Miguel de Cervantes, C/del Padre Julio Chevalier 2, 47012 Valladolid, Spain
| | - Aritza Brizuela
- Facultad de Odontología, Universidad Europea Miguel de Cervantes, C/del Padre Julio Chevalier 2, 47012 Valladolid, Spain
| | - Manuel Fernández-Domínguez
- Department of Oral and Maxillofacial Surgery, Hospital Monteprincipe, University CEU San Pablo, Av. de Montepríncipe s/n, Alcorcón, 28668 Madrid, Spain
| | - Javier Gil
- Bioengineering Institute of Technology, Facultad de Medicina y Ciencias de la Salud, Universidad Internacional de Catalunya, Josep Trueta s/n, Sant Cugat del Vallés, 08195 Barcelona, Spain
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Brunken F, Senft T, Herbster M, Relja B, Bertrand J, Lohmann CH. CoNiCrMo Particles, but Not TiAlV Particles, Activate the NLRP3 Inflammasome in Periprosthetic Cells. Int J Mol Sci 2023; 24:ijms24065108. [PMID: 36982177 PMCID: PMC10048784 DOI: 10.3390/ijms24065108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/22/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
Aseptic loosening is the main reason for arthroplasty failure. The wear particles generated at the tribological bearings are thought to induce an inflammatory tissue response, leading to bone loss and the subsequent loosening of the implant. Different wear particles have been shown to activate the inflammasome, thereby contributing to an inflammatory milieu in the direct vicinity of the implant. The aim of this study was to investigate whether the NLRP3 inflammasome is activated by different metal particles in vitro and in vivo. Three different cell lines representing periprosthetic cell subsets (MM6, MG63 and Jurkat) were incubated with different amounts of TiAlV or CoNiCrMo particles. The activation of the NLRP3 inflammasome was determined through the detection of the caspase 1 cleavage product p20 in a Western blot. The formation of the inflammasome was also investigated in vivo using immunohistological staining for ASC in primary synovial tissues as well as tissues containing TiAlV and CoCrMo particles and in vitro after the stimulation of the cells. The results show that the CoCrMo particles induced ASC more markedly, as a readout for inflammasome formation in vivo, compared to TiAlV particular wear. The CoNiCrMo particles also induced ASC-speck formation in all the tested cell lines, which was not induced by the TiAlV particles. The Western blot shows that NRLP3 inflammasome activation, measured through caspase 1 cleavage, was increased only by the CoNiCrMo particles in the MG63 cells. We conclude from our data that the activation of the inflammasome is mainly driven by CoNiCrMo particles and less by TiAlV particles, indicating that different inflammatory pathways are activated by the different alloys.
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Affiliation(s)
- Fenna Brunken
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, 39120 Magdeburg, Germany
| | - Tristan Senft
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, 39120 Magdeburg, Germany
| | - Maria Herbster
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, 39120 Magdeburg, Germany
- Institute of Materials and Joining Technology, Otto-von-Guericke-University, 39120 Magdeburg, Germany
| | - Borna Relja
- Department of Experimental Radiology, Otto-von-Guericke-University, 39120 Magdeburg, Germany
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, 39120 Magdeburg, Germany
- Correspondence: ; Tel.: +49-391-67-15804
| | - Christoph H. Lohmann
- Department of Orthopaedic Surgery, Otto-von-Guericke-University, 39120 Magdeburg, Germany
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25
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Chen Z, Gu X. Effects of NLRP3 on implants placement. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:126-133. [PMID: 37283126 DOI: 10.3724/zdxbyxb-2022-0614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Bone stability is precisely controlled by osteoclast-mediated bone resorption and osteoblast-mediated bone formation. When the balance is broken, the integrity of the bone structure will be destroyed. Inflammasomes are important protein complexes in response to pathogen-related molecular models or injury-related molecular models, which can promote the activation and secretion of proinflammatory cytokines and activate a local inflammatory response. NOD-like receptor thermal protein domain associated protein (NLRP) 3 inflammasome can promote bone resorption through the activation of the proinflammatory cytokines interleukin (IL)-1β, IL-18 and the induction of caspase-1-mediated pyroptosis. Inhibiting the production of NLRP3 inflammasome may be beneficial to improve comfort and bone stability. The presence of metal particles and microorganisms around implants can activate NLRP3 and promote bone absorption. NLRP3 inflammasome plays an important role in the maintenance of bone stability around implants, however, most studies focus on orthopedic implants and periodontitis. This article reviews the effects of NLRP3 inflammasome on bone formation, resorption and pain induced by implants, and the possibility of NLRP3 as a target for preventing peri-implantitis is discussed.
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Affiliation(s)
- Ziyun Chen
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
| | - Xinhua Gu
- Department of Stomatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
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26
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Huang W, Zhang Z, Qiu Y, Gao Y, Fan Y, Wang Q, Zhou Q. NLRP3 inflammasome activation in response to metals. Front Immunol 2023; 14:1055788. [PMID: 36845085 PMCID: PMC9950627 DOI: 10.3389/fimmu.2023.1055788] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Implant surgery is followed by a series of inflammatory reactions that directly affect its postoperative results. The inflammasome plays a vital role in the inflammatory response by inducing pyroptosis and producing interleukin-1β, which plays a critical role in inflammation and tissue damage. Therefore, it is essential to study the activation of the inflammasome in the bone healing process after implant surgery. As metals are the primary implant materials, metal-induced local inflammatory reactions have received significant attention, and there has been more and more research on the activation of the NLRP3 (NOD-like receptor protein-3) inflammasome caused by these metals. In this review, we consolidate the basic knowledge on the NLRP3 inflammasome structures, the present knowledge on the mechanisms of NLRP3 inflammasome activation, and the studies of metal-induced NLRP3 inflammasome activation.
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Affiliation(s)
- Wanyi Huang
- School and Hospital of Stomatology, China Medical University, Shenyang, China,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Ziqi Zhang
- School and Hospital of Stomatology, China Medical University, Shenyang, China,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Yueyang Qiu
- School and Hospital of Stomatology, China Medical University, Shenyang, China,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China
| | - Yuan Gao
- School and Hospital of Stomatology, China Medical University, Shenyang, China,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China,Department of Orthodontics, Shenyang Stomatological Hospital, Shenyang, China
| | - Yongqiang Fan
- College of Life and Health Sciences, Northeastern University, Shenyang, China,Shenyang National Laboratory for Materials Science, Northeastern University, Shenyang, China
| | - Qiang Wang
- School and Hospital of Stomatology, China Medical University, Shenyang, China,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China,*Correspondence: Qing Zhou, ; Qiang Wang,
| | - Qing Zhou
- School and Hospital of Stomatology, China Medical University, Shenyang, China,Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China,*Correspondence: Qing Zhou, ; Qiang Wang,
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27
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Li Q, Wang H, Liu L, Weng Y, Xu S, Li L, Wang Z. Suppression of the NLRP3 Inflammasome through Activation of the Transient Receptor Potential Channel Melastatin 2 Promotes Osteogenesis in Tooth Extraction Sockets of Periodontitis. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:213-232. [PMID: 36410421 DOI: 10.1016/j.ajpath.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/29/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022]
Abstract
This study explored the role of transient receptor potential channel melastatin 2 (TRPM2)-mediated activation of NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome in osteogenesis during healing of tooth extraction sockets. Tooth extraction socket tissue samples were collected from patients with or without periodontitis. In a TRPM2 knockout mouse model of socket healing, mice with or without periodontitis and their wild-type littermates were used for comparing the socket healing phenotypes. Micro-computed tomography imaging, three-dimensional reconstruction of the sockets, and hematoxylin and eosin staining for histopathologic analysis were performed. Immunofluorescence, immunohistochemistry, and Western blot analysis were used for evaluation of protein expression; the mRNA levels were evaluated by quantitative RT-PCR. Osteogenic, chondrogenic, and adipogenic differentiation potential of human bone marrow mesenchymal stem cells (BMMSCs) was evaluated. Calcium deposition was evaluated using Alizarin Red S staining. NLRP3 and CASP1 were up-regulated in tooth sockets of periodontitis patients. NLRP3 knockdown promoted the osteogenic differentiation of maxillary BMMSCs under inflammatory conditions. TRPM2 was up-regulated in the tooth extraction socket tissue of periodontitis. Inhibiting TRPM2 expression mitigated the NLRP3 inflammasome and its deleterious effect on osteogenesis. Activation of the TRPM2 ion channel regulated osteogenesis of BMMSCs under inflammatory conditions via Ca2+ influx, the mitochondrial dynamics, and pyroptosis. Targeting the TRPM2/Ca2+/NLRP3 axis could be beneficial in the healing process of the tooth extraction sockets of patients with periodontitis.
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Affiliation(s)
- Qin Li
- Department of Implantology, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Haicheng Wang
- Department of Implantology, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Liwei Liu
- Department of Implantology, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yuteng Weng
- Department of Implantology, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Shuyu Xu
- Department of Implantology, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Lin Li
- Department of Implantology, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Zuolin Wang
- Department of Oral and Maxillofacial Surgery and Department of Oral Implantology, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China.
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28
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Albrektsson T, Tengvall P, Amengual L, Coli P, Kotsakis GA, Cochran D. Osteoimmune regulation underlies oral implant osseointegration and its perturbation. Front Immunol 2023; 13:1056914. [PMID: 36761175 PMCID: PMC9902598 DOI: 10.3389/fimmu.2022.1056914] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/20/2022] [Indexed: 01/26/2023] Open
Abstract
In the field of biomaterials, an endosseous implant is now recognized as an osteoimmunomodulatory but not bioinert biomaterial. Scientific advances in bone cell biology and in immunology have revealed a close relationship between the bone and immune systems resulting in a field of science called osteoimmunology. These discoveries have allowed for a novel interpretation of osseointegration as representing an osteoimmune reaction rather than a classic bone healing response, in which the activation state of macrophages ((M1-M2 polarization) appears to play a critical role. Through this viewpoint, the immune system is responsible for isolating the implant biomaterial foreign body by forming bone around the oral implant effectively shielding off the implant from the host bone system, i.e. osseointegration becomes a continuous and dynamic host defense reaction. At the same time, this has led to the proposal of a new model of osseointegration, the foreign body equilibrium (FBE). In addition, as an oral wound, the soft tissues are involved with all their innate immune characteristics. When implant integration is viewed as an osteoimmune reaction, this has implications for how marginal bone is regulated. For example, while bacteria are constitutive components of the soft tissue sulcus, if the inflammatory front and immune reaction is at some distance from the marginal bone, an equilibrium is established. If however, this inflammation approaches the marginal bone, an immune osteoclastic reaction occurs and marginal bone is removed. A number of clinical scenarios can be envisioned whereby the osteoimmune equilibrium is disturbed and marginal bone loss occurs, such as complications of aseptic nature and the synergistic activation of pro-inflammatory pathways (implant/wear debris, DAMPs, and PAMPs). Understanding that an implant is a foreign body and that the host reacts osteoimmunologically to shield off the implant allows for a distinction to be drawn between osteoimmunological conditions and peri-implant bone loss. This review will examine dental implant placement as an osteoimmune reaction and its implications for marginal bone loss.
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Affiliation(s)
- T. Albrektsson
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden
| | - P. Tengvall
- Department of Biomaterials, University of Gothenburg, Gothenburg, Sweden,*Correspondence: P. Tengvall,
| | - L. Amengual
- Dental Implantology Unit, Hospital Leonardo Guzmán, Antofagasta, Chile
| | - P. Coli
- Edinburgh Dental Specialists, Edinburgh, United Kingdom,Department of Prosthetic Dentistry and Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden,Department of Dental Material Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - G. A. Kotsakis
- Department of Periodontology, University of Texas, San Antonio, TX, United States
| | - D. Cochran
- Department of Periodontology, University of Texas, San Antonio, TX, United States
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29
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Enhanced Corrosion Resistance and Local Therapy from Nano-Engineered Titanium Dental Implants. Pharmaceutics 2023; 15:pharmaceutics15020315. [PMID: 36839638 PMCID: PMC9963924 DOI: 10.3390/pharmaceutics15020315] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Titanium is the ideal material for fabricating dental implants with favorable biocompatibility and biomechanics. However, the chemical corrosions arising from interaction with the surrounding tissues and fluids in oral cavity can challenge the integrity of Ti implants and leach Ti ions/nanoparticles, thereby causing cytotoxicity. Various nanoscale surface modifications have been performed to augment the chemical and electrochemical stability of Ti-based dental implants, and this review discusses and details these advances. For instance, depositing nanowires/nanoparticles via alkali-heat treatment and plasma spraying results in the fabrication of a nanostructured layer to reduce chemical corrosion. Further, refining the grain size to nanoscale could enhance Ti implants' mechanical and chemical stability by alleviating the internal strain and establishing a uniform TiO2 layer. More recently, electrochemical anodization (EA) has emerged as a promising method to fabricate controlled TiO2 nanostructures on Ti dental implants. These anodized implants enhance Ti implants' corrosion resistance and bioactivity. A particular focus of this review is to highlight critical advances in anodized Ti implants with nanotubes/nanopores for local drug delivery of potent therapeutics to augment osseo- and soft-tissue integration. This review aims to improve the understanding of novel nano-engineered Ti dental implant modifications, focusing on anodized nanostructures to fabricate the next generation of therapeutic and corrosion-resistant dental implants. The review explores the latest developments, clinical translation challenges, and future directions to assist in developing the next generation of dental implants that will survive long-term in the complex corrosive oral microenvironment.
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30
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Freitag L, Spinell T, Kröger A, Würfl G, Lauseker M, Hickel R, Kebschull M. Dental implant material related changes in molecular signatures in peri-implantitis - A systematic review and integrative analysis of omics in-vitro studies. Dent Mater 2023; 39:101-113. [PMID: 36526446 DOI: 10.1016/j.dental.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Since peri-implantitis differs clinically and histopathologically from periodontitis, implant wear debris is considered to play a role in the destructive processes. This work aims to systematically review if titanium particles affect oral-related cells through changes in molecular signatures (e.g., transcriptome, proteome, epigenome), thereby promoting peri-implantitis. METHODS Leveraging three literature databases (Medline, Embase, Cochrane) a systematic search based on a priori defined PICOs was conducted: '-omics' studies examining titanium exposure in oral-related cells. After risk of bias assessments, lists of differentially expressed genes, proteins, and results of functional enrichment analyses were compiled. The significance of overlapping genes across multiple studies was assessed via Monte Carlo simulation and their ranking was verified using rank aggregation. RESULTS Out of 2104 screened articles we found 12 eligible publications. A significant overlap of gene expression in oral-related cells exposed to titanium particles was found in four studies. Furthermore, changes in biological processes like immune/inflammatory or stress response as well as toll-like receptor (TLR) and mitogen-activated protein kinase (MAPK) signaling pathways were linked to titanium in transcriptome and proteome studies. Epigenetic changes caused by titanium were detected but inconsistent. CONCLUSION An influence of titanium implant wear debris on the development and progression of peri-implantitis is plausible but needs to be proven in further studies. Limitations arise from small sample sizes of included studies and insufficient publication of re-analyzable data.
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Affiliation(s)
- Lena Freitag
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | - Thomas Spinell
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany.
| | - Annika Kröger
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | | | - Michael Lauseker
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University, Goethestr. 70, D-80336 Munich, Germany
| | - Moritz Kebschull
- School of Dentistry, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, NY, USA
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31
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Yang J, Liu C, Sun H, Liu Y, Liu Z, Zhang D, Zhao G, Wang Q, Yang D. The progress in titanium alloys used as biomedical implants: From the view of reactive oxygen species. Front Bioeng Biotechnol 2022; 10:1092916. [PMID: 36601391 PMCID: PMC9806234 DOI: 10.3389/fbioe.2022.1092916] [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: 11/10/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Titanium and Titanium alloys are widely used as biomedical implants in oral and maxillofacial surgery, due to superior mechanical properties and biocompatibility. In specific clinical populations such as the elderly, diabetics and patients with metabolic diseases, the failure rate of medical metal implants is increased significantly, putting them at increased risk of revision surgery. Many studies show that the content of reactive oxygen species (ROS) in the microenvironment of bone tissue surrounding implant materials is increased in patients undergoing revision surgery. In addition, the size and shape of materials, the morphology, wettability, mechanical properties, and other properties play significant roles in the production of ROS. The accumulated ROS break the original balance of oxidation and anti-oxidation, resulting in host oxidative stress. It may accelerate implant degradation mainly by activating inflammatory cells. Peri-implantitis usually leads to a loss of bone mass around the implant, which tends to affect the long-term stability and longevity of implant. Therefore, a great deal of research is urgently needed to focus on developing antibacterial technologies. The addition of active elements to biomedical titanium and titanium alloys greatly reduce the risk of postoperative infection in patients. Besides, innovative technologies are developing new biomaterials surfaces conferring anti-infective properties that rely on the production of ROS. It can be considered that ROS may act as a messenger substance for the communication between the host and the implanted material, which run through the entire wound repair process and play a role that cannot be ignored. It is necessary to understand the interaction between oxidative stress and materials, the effects of oxidative stress products on osseointegration and implant life as well as ROS-induced bactericidal activity. This helps to facilitate the development of a new generation of well-biocompatible implant materials with ROS responsiveness, and ultimately prolong the lifespan of implants.
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Affiliation(s)
- Jun Yang
- School of Stomatology, Jiamusi University, Jiamusi, China,Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Chang Liu
- School of Stomatology, Jiamusi University, Jiamusi, China,Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Hui Sun
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Ying Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
| | - Zhaogang Liu
- The Affiliated Taian City Central Hospital of Qingdao University, Taian, China
| | - Dan Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China,*Correspondence: Donghong Yang, ; Dan Zhang,
| | - Gang Zhao
- School of Stomatology, Jiamusi University, Jiamusi, China
| | - Qiang Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Donghong Yang
- School of Stomatology, Jiamusi University, Jiamusi, China,*Correspondence: Donghong Yang, ; Dan Zhang,
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Immunopathological Inflammation in the Evolution of Mucositis and Peri-Implantitis. Int J Mol Sci 2022; 23:ijms232415797. [PMID: 36555457 PMCID: PMC9779511 DOI: 10.3390/ijms232415797] [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: 10/21/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
The purpose of this study was to provide an immuno-mediated substantiation of the etiopathogenesis of mucositis and peri-implantitis based on the results of experimental, laboratory and clinical studies. The biopsy material was studied to identify impregnated nanoscale and microscale particles in the structure of pathological tissues by using X-ray microtomography and X-ray fluorescence analyses. Electron microscopy with energy-dispersive analysis identified the composition of supernatants containing nanoscale metal particles obtained from the surfaces of dental implants. The parameters of the nanoscale particles were determined by dynamic light scattering. Flow cytometry was used to study the effect of nanoscale particles on the ability to induce the activation and apoptosis of immunocompetent cells depending on the particles' concentrations during cultivation with the monocytic cell line THP-1 with the addition of inductors. An analysis of the laboratory results suggested the presence of dose-dependent activation, as well as early and late apoptosis of the immunocompetent cells. Activation and early and late apoptosis of a monocytic cell line when THP-1 was co-cultured with nanoscale metal particles in supernatants were shown for the first time. When human venous blood plasma was added, both activation and early and late apoptosis had a dose-dependent effect and differed from those of the control groups.
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Shirazi S, Ravindran S, Cooper LF. Topography-mediated immunomodulation in osseointegration; Ally or Enemy. Biomaterials 2022; 291:121903. [PMID: 36410109 PMCID: PMC10148651 DOI: 10.1016/j.biomaterials.2022.121903] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022]
Abstract
Osteoimmunology is at full display during endosseous implant osseointegration. Bone formation, maintenance and resorption at the implant surface is a result of bidirectional and dynamic reciprocal communication between the bone and immune cells that extends beyond the well-defined osteoblast-osteoclast signaling. Implant surface topography informs adherent progenitor and immune cell function and their cross-talk to modulate the process of bone accrual. Integrating titanium surface engineering with the principles of immunology is utilized to harness the power of immune system to improve osseointegration in healthy and diseased microenvironments. This review summarizes current information regarding immune cell-titanium implant surface interactions and places these events in the context of surface-mediated immunomodulation and bone regeneration. A mechanistic approach is directed in demonstrating the central role of osteoimmunology in the process of osseointegration and exploring how regulation of immune cell function at the implant-bone interface may be used in future control of clinical therapies. The process of peri-implant bone loss is also informed by immunomodulation at the implant surface. How surface topography is exploited to prevent osteoclastogenesis is considered herein with respect to peri-implant inflammation, osteoclastic precursor-surface interactions, and the upstream/downstream effects of surface topography on immune and progenitor cell function.
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Affiliation(s)
- Sajjad Shirazi
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | - Sriram Ravindran
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Lyndon F Cooper
- School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA.
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AjitSankardas P, Stein SH, Tipton D, Abhyankar V, Morrow BR. Impact of Metal Particles Released during Ultrasonic Scaling of Titanium Surfaces on Human Gingival Fibroblasts. J Long Term Eff Med Implants 2022; 33:9-22. [PMID: 36382700 DOI: 10.1615/jlongtermeffmedimplants.2022043080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Metal particles found in tissues around dental implants have been proposed to play a pathogenic role in peri-implantitis. Ultrasonic scaling has been suggested as a mechanism by which these particles can be inadvertently released into surrounding tissues. Furthermore, risk factors like diabetes can result in exacerbation of this inflammatory condition. The current study aimed to analyze metal particles released from titanium surfaces during ultrasonic scaling and their impact on pro-inflammatory cytokine production by human gingival fibroblasts. METHODS Metal particles generated from ultrasonic scaling of titanium discs using two different tips (metal and poly-etheretherketone tips) were characterized using scanning electron microscopy and elemental analysis. Endotoxin levels and Human gingival fibroblast viability, in the presence commercial and ultrasonically generated particles were determined. Fibroblasts, cultured in high or low glucose growth medium, were incubated with commercial titanium particles or ultrasonically generated particles in the presence or absence of interluekin-1β. Interleukin 6 and interleukin 8 production were then quantified using Enzyme linked immunosorbent assay. RESULTS Analysis of particles after scaling of titanium discs showed significant levels of titanium particles. Commercial titanium particles and generated particles had no effect of fibroblast viability. Endotoxin levels of all particles were too low to stimulate HGF cells. IL-1β significantly stimulated IL-6 and IL-8 production. However, commercial, and generated particles generally had no significant effect on IL- 6 and IL-8 production. CONCLUSION Our study concluded that particles generated during ultrasonic scaling had no significant effect on viability of HGF cells and cytokine production.
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Affiliation(s)
- Pooja AjitSankardas
- Department of Periodontology, University of Tennessee Health Science Center, College of Dentistry, Memphis, TN 38103
| | - Sidney H Stein
- Department of Periodontology, University of Tennessee Health Science Center, College of Dentistry, Memphis, TN 38103
| | - David Tipton
- Department of Bioscience Research, University of Tennessee Health Science Center, College of Dentistry, University of Tennessee Health Science Center, College of Dentistry, Memphis, TN 38103
| | - Vrushali Abhyankar
- Department of Periodontology, University of Tennessee Health Science Center, College of Dentistry, Memphis, TN 38103
| | - Brian R Morrow
- Department of Bioscience Research, University of Tennessee Health Science Center, College of Dentistry, University of Tennessee Health Science Center, College of Dentistry, Memphis, TN 38103
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Bio-Tribocorrosion of Titanium Dental Implants and Its Toxicological Implications: A Scoping Review. ScientificWorldJournal 2022; 2022:4498613. [PMID: 36312451 PMCID: PMC9616655 DOI: 10.1155/2022/4498613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/30/2022] [Indexed: 11/18/2022] Open
Abstract
Bio-tribocorrosion is a phenomenon that combines the essentials of tribology (friction, wear, and lubrication) and corrosion with microbiological processes. Lately, it has gained attention in implant dentistry because dental implants are exposed to wear, friction, and biofilm formation in the corrosive oral environment. They may degrade upon exposure to various microbial, biochemical, and electrochemical factors in the oral cavity. The mechanical movement of the implant components produces friction and wear that facilitates the release of metal ions, promoting adverse oro-systemic reactions. This review describes the bio-tribocorrosion of the titanium (Ti) dental implants in the oral cavity and its toxicological implications. The original research related to the bio-tribo or tribocorrosion of the dental implants was searched in electronic databases like Medline (Pubmed), Embase, Scopus, and Web of Science. About 34 studies included in the review showed that factors like the type of Ti, oral biofilm, acidic pH, fluorides, and micromovements during mastication promote bio-tribocorrosion of the Ti dental implants. Among the various grades of Ti, grade V, i.e., Ti6Al4V alloy, is most susceptible to tribocorrosion. Oral pathogens like Streptococcus mutans and Porphyromonas gingivalis produce acids and lipopolysaccharides (LPS) that cause pitting corrosion and degrade the TiO2. The low pH and high fluoride concentration in saliva hinder passive film formation and promote metal corrosion. The released metal ions promote inflammatory reactions and bone destruction in the surrounding tissues resulting in peri-implantitis, allergies, and hyper-sensitivity reactions. However, further validation of the role of bio-tribocorrosion on the durability of the Ti dental implants and Ti toxicity is warranted through clinical trials.
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Ivanovski S, Bartold PM, Huang Y. The role of foreign body response in peri-implantitis: What is the evidence? Periodontol 2000 2022; 90:176-185. [PMID: 35916872 PMCID: PMC9804527 DOI: 10.1111/prd.12456] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Historically, there has been broad consensus that osseointegration represents a homeostasis between a titanium dental implant and the surrounding bone, and that the crestal bone loss characteristic of peri-implantitis is a plaque-induced inflammatory process. However, this notion has been challenged over the past decade by proponents of a theory that considers osseointegration an inflammatory process characterized by a foreign body reaction and peri-implant bone loss as an exacerbation of this inflammatory response. A key difference in these two schools of thought is the perception of the relative importance of dental plaque in the pathogenesis of crestal bone loss around implants, with obvious implications for treatment. This review investigates the evidence for a persistent foreign body reaction at osseointegrated dental implants and its possible role in crestal bone loss characteristic of peri-implantitis. Further, the role of implant-related material release within the surrounding tissue, particularly titanium particles and corrosion by-products, in the establishment and progression in peri-implantitis is explored. While it is acknowledged that these issues require further investigation, the available evidence suggests that osseointegration is a state of homeostasis between the titanium implant and surrounding tissues, with little evidence that a persistent foreign body reaction is responsible for peri-implant bone loss after osseointegration is established. Further, there is a lack of evidence for a unidirectional causative role of corrosion by-products and titanium particles as possible non-plaque related factors in the etiology of peri-implantitis.
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Affiliation(s)
- Sašo Ivanovski
- School of DentistryThe University of QueenslandHerstonQueenslandAustralia
| | - Peter Mark Bartold
- School of DentistryUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Yu‐Sheng Huang
- School of DentistryThe University of QueenslandHerstonQueenslandAustralia
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Evaluation of the inflammatory and osteogenic response induced by titanium particles released during implantoplasty of dental implants. Sci Rep 2022; 12:15790. [PMID: 36138061 PMCID: PMC9500064 DOI: 10.1038/s41598-022-20100-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
Implantoplasty is a mechanical decontamination technique that consists of removing the threads and polishing and smoothing the dental implant surface. During implantoplasty there is a large release of titanium metal particles that might provoke a proinflammatory response and reduce the viability of osteogenic cells. We analyze the inflammatory and osteogenic response induced by Ti6Al4V particles released during implantoplasty and by as-received commercially pure Ti particles. Macrophages stimulated with metal particles obtained by implantoplasty and with as-received Ti particles showed an increased proinflammatory expression of TNF-α and a decreased expression of TGF-β and CD206. Regarding cytokine release, there was an increase in IL-1β, while IL-10 decreased. The osteogenic response of Ti6Al4V extracts showed a significant decrease in Runx2 and OC expression compared to the controls and commercially pure Ti extracts. There were no relevant changes in ALP activity. Thus, implantoplasty releases metal particles that seems to induce a pro-inflammatory response and reduce the expression of osteogenic markers.
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Nemec M, Behm C, Maierhofer V, Gau J, Kolba A, Jonke E, Rausch-Fan X, Andrukhov O. Effect of Titanium and Zirconia Nanoparticles on Human Gingival Mesenchymal Stromal Cells. Int J Mol Sci 2022; 23:ijms231710022. [PMID: 36077419 PMCID: PMC9456558 DOI: 10.3390/ijms231710022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Nano- and microparticles are currently being discussed as potential risk factors for peri-implant disease. In the present study, we compared the responses of human gingival mesenchymal stromal cells (hG-MSCs) on titanium and zirconia nanoparticles (<100 nm) in the absence and presence of Porphyromonas gingivalis lipopolysaccharide (LPS). The primary hG-MSCs were treated with titanium and zirconia nanoparticles in concentrations up to 2.000 µg/mL for 24 h, 72 h, and 168 h. Additionally, the cells were treated with different nanoparticles (25−100 µg/mL) in the presence of P. gingivalis LPS for 24 h. The cell proliferation and viability assay and live−dead and focal adhesion stainings were performed, and the expression levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein (MCP)-1 were measured. The cell proliferation and viability were inhibited by the titanium (>1000 µg/mL) but not the zirconia nanoparticles, which was accompanied by enhanced apoptosis. Both types of nanoparticles (>25 µg/mL) induced the significant expression of IL-8 in gingival MSCs, and a slightly higher effect was observed for titanium nanoparticles. Both nanoparticles substantially enhanced the P. gingivalis LPS-induced IL-8 production; a higher effect was observed for zirconia nanoparticles. The production of inflammatory mediators by hG-MSCs is affected by the nanoparticles. This effect depends on the nanoparticle material and the presence of inflammatory stimuli.
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Affiliation(s)
- Michael Nemec
- Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Christian Behm
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Vera Maierhofer
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Jonas Gau
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Anastasiya Kolba
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Erwin Jonke
- Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Xiaohui Rausch-Fan
- Clinical Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Oleh Andrukhov
- Competence Center for Periodontal Research, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence: ; Tel.: +43-1-40070-2620
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Zhou F, Zhang G, Wu Y, Xiong Y. Inflammasome Complexes: Crucial mediators in osteoimmunology and bone diseases. Int Immunopharmacol 2022; 110:109072. [DOI: 10.1016/j.intimp.2022.109072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/15/2022] [Accepted: 07/14/2022] [Indexed: 11/05/2022]
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Wawrzyk A, Rahnama M, Sofińska-Chmiel W, Wilczyński S, Gutarowska B, Konka A, Zeljas D, Łobacz M. Analysis of the Microbiome on the Surface of Corroded Titanium Dental Implants in Patients with Periimplantitis and Diode Laser Irradiation as an Aid in the Implant Prosthetic Treatment: An Ex Vivo Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5890. [PMID: 36079272 PMCID: PMC9456760 DOI: 10.3390/ma15175890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
The paper presents the optimization of diode laser irradiation of corroded dental implants in order to reduce the number of microorganisms associated peri-implantitis. The research included the identification of microorganisms on the surface of removed dental implants in patients with peri-implantitis and the assessment of the biocidal effectiveness of the diode laser against these microorganisms. Laser desorption/mass spectrometry (MALDI-TOF MS) was used to identify microorganisms and metagens were examined by next generation sequencing (NGS). Irradiation was performed with a diode laser with a wavelength of λ = 810, operating mode: 25 W/15.000 Hz/10 μs, average = 3.84 W with the number of repetitions t = 2 × 15 s and t = 3 × 15 s. The structure and surface roughness of the implants were analysed before and after laser irradiation by optical profilometry and optical microscopy with confocal fixation. In total, 16 species of Gram-positive bacteria and 23 species of Gram-negative bacteria were identified on the surface of the implants. A total of 25 species of anaerobic bacteria and 12 species with corrosive potential were detected. After diode laser irradiation, the reduction in bacteria on the implants ranged from 88.85% to 100%, and the reduction in fungi from 87.75% to 96.77%. The reduction in microorganisms in the abutment was greater than in the endosseous fixture. The applied laser doses did not damage, but only cleaned the surface of the titanium implants. After 8 years of embedding, the removed titanium implant showed greater roughness than the 25-year-old implant, which was not exposed to direct influence of the oral cavity environment. The use of a diode laser in an optimised irradiation dose safely reduces the number of microorganisms identified on corroded dental implants in patients with peri-implantitis.
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Affiliation(s)
- Anna Wawrzyk
- Silesian Park of Medical Technology Kardio-Med Silesia in Zabrze, M. Curie Skłodowskiej 10C Str., 41-800 Zabrze, Poland
| | - Mansur Rahnama
- Chair and Department of Oral Surgery, Medical University of Lublin, Chodźki 6, 20-093 Lublin, Poland
| | - Weronika Sofińska-Chmiel
- Analytical Laboratory, Institute of Chemical Sciences, Faculty of Chemistry, Maria Curie Skłodowska University, Maria Curie Skłodowska Sq. 2, 20-031 Lublin, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Kasztanowa 3, 41-205 Sosnowiec, Poland
| | - Beata Gutarowska
- Department of Environmental Biotechnology, Faculty of Biotechnology and Food Sciences, Lodz University of Technology, Wólczańska 171/173, 90-530 Lodz, Poland
| | - Adam Konka
- Silesian Park of Medical Technology Kardio-Med Silesia in Zabrze, M. Curie Skłodowskiej 10C Str., 41-800 Zabrze, Poland
| | - Dagmara Zeljas
- Faculty of Drilling, Oil & Gas, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059 Krakow, Poland
| | - Michał Łobacz
- Chair and Department of Oral Surgery, Medical University of Lublin, Chodźki 6, 20-093 Lublin, Poland
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Larsson L, Kavanagh NM, Nguyen TVN, Castilho RM, Berglundh T, Giannobile WV. Influence of epigenetics on periodontitis and peri-implantitis pathogenesis. Periodontol 2000 2022; 90:125-137. [PMID: 35913702 DOI: 10.1111/prd.12453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Periodontitis is a disease characterized by tooth-associated microbial biofilms that drive chronic inflammation and destruction of periodontal-supporting tissues. In some individuals, disease progression can lead to tooth loss. A similar condition can occur around dental implants in the form of peri-implantitis. The immune response to bacterial challenges is not only influenced by genetic factors, but also by environmental factors. Epigenetics involves the study of gene function independent of changes to the DNA sequence and its associated proteins, and represents a critical link between genetic and environmental factors. Epigenetic modifications have been shown to contribute to the progression of several diseases, including chronic inflammatory diseases like periodontitis and peri-implantitis. This review aims to present the latest findings on epigenetic influences on periodontitis and to discuss potential mechanisms that may influence peri-implantitis, given the paucity of information currently available.
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Affiliation(s)
- Lena Larsson
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nolan M Kavanagh
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Trang V N Nguyen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Rogerio M Castilho
- Department of Periodontics and Oral Medicine and Laboratory of Epithelial Biology, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - William V Giannobile
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Asa'ad F, Thomsen P, Kunrath MF. The Role of Titanium Particles and Ions in the Pathogenesis of Peri-Implantitis. J Bone Metab 2022; 29:145-154. [PMID: 36153850 PMCID: PMC9511127 DOI: 10.11005/jbm.2022.29.3.145] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022] Open
Abstract
Titanium (Ti) particles and ions have been investigated in recent years as important factors in the pathogenesis of peri-implantitis. However, their role in the pathogenesis is yet to be fully understood. A review of pertinent literature was performed in various databases to determine the current position of Ti particles and ions role in the pathogenesis of peri-implantitis. There are several in vitro, preclinical and clinical published studies that have addressed the role of Ti particles and ions in the pathogenesis of peri-implantitis. These studies explored the effect of Ti particles and ions in the pathogenesis of peri-implantitis with respect to foreign body reaction, cellular response, epigenetic mechanisms, namely DNA methylation, and the oral microbiome. Studies have shown that the release of Ti particles/ions during implant insertion, early healing stages, late healing stages, and treatments during peri-implantitis might contribute to peri-implantitis through different mechanisms, such as foreign body reaction, cellular response, DNA methylation, and shaping the oral microbiome by increasing dysbiosis. However, further studies are needed to elucidate the complex interactions between all these mechanisms and Ti particles/ions in the pathogenesis and progression of peri-implantitis.
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Affiliation(s)
- Farah Asa'ad
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral Biochemistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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43
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Diagnostic tests for titanium hypersensitivity in implant dentistry: a systematic review of the literature. Int J Implant Dent 2022; 8:29. [PMID: 35819566 PMCID: PMC9276909 DOI: 10.1186/s40729-022-00428-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/30/2022] [Indexed: 01/10/2023] Open
Abstract
PURPOSE There are rising concerns about titanium hypersensitivity reaction regarding dental endosseous implants. This review aims to summarize and compare the validity and reliability of the available dermatological and laboratory diagnostic tests regarding titanium hypersensitivity. The following PICO design was used: In Patients with titanium dental implants (P) does epicutaneous testing (ECT) (I), compared to lymphocyte transformation test (LTT) or Memory Lymphocyte Immunostimulation Assay (MELISA) (C) detect hypersensitivity reactions (O)? A literature search was performed including all studies dealing with this topic. Studies regarding orthopedic implants were excluded. METHODS Three databases (MEDLINE PubMed, Cochrane Library, SciELO) were screened for suitable studies and an additional manual search was also performed. Literature regarding hypersensitivity reactions in orthopedic implants, hypersensitivity reactions regarding implants not related to dental or maxillofacial surgery, animal studies and in vitro studies were excluded. A quality assessment of all selected full-text articles was performed. Randomized, controlled trials were evaluated with the Cochrane Risk of Bias Tool I. Cohort studies were assessed according to the New Castle-Ottawa Scale and case series according to Moga et al. (Development of a quality appraisal tool for case series studies using a modified Delphi technique. 2012). RESULTS 10 studies were included in the quantitative synthesis and available for the endpoint diagnostics of intolerance reactions to titanium dental implants: 2 clinical studies, 7 cohort studies and 1 case series. The potential for bias (internal validity) for these studies was overall rated as high. CONCLUSIONS The study of the available literature regarding ECT and MELISA or LTT in patients with suspected titanium hypersensitivity showed inconsistent results in terms of reliability and validity and thus, those tests should be regarded cautiously. There is strong evidence that titanium hypersensitivity in dental implants is associated with innate immunity: unspecific pro-inflammatory responses due to particle induced hyperreactivity of macrophages or toxicological responses especially towards nanoparticles rather than activation of the adaptive immune system. Therefore, tests detecting allergies do not seem expedient and inflammatory clinical signs should be regarded as leading parameters.
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Ti Ions Induce IL-1β Release by Activation of the NLRP3 Inflammasome in a Human Macrophage Cell Line. Inflammation 2022; 45:2027-2037. [PMID: 35726039 PMCID: PMC9499900 DOI: 10.1007/s10753-022-01672-7] [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: 02/11/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/05/2022]
Abstract
The aim of the present study was to investigate whether titanium (Ti)-induced release of interleukin (IL)-1β acts through the assembly of the NACHT, LRR, and PYD domain-containing protein 3 (NLRP3) inflammasome. In addition, we examined whether particulate Ti or TiO2 activates the same intracellular pathways with the assembly of the NLRP3 inflammasome as Ti ions. Ti ions are known to induce IL-1β maturation and release by the formation of metal-protein aggregates. Wild-type THP-1 (wt.) cells and NLRP3- and ASC- (apoptosis-associated speck-like protein containing caspase recruitment domain (CARD)) knockdown cells were used in the experimental analyses. Macro- and nanoparticles (NPs) of both Ti and TiO2 were used as test agents. IL-1β release as a biomarker for inflammasome activation and cell viability was also analyzed. Periodate-oxidized adenosine triphosphate (oATP) was used to attenuate downstream signaling in NLRP3 inflammasome activation. Cellular uptake of Ti was examined using transmission electron microscopy. Cells exposed to the Ti-ion solution showed a dose-dependent increase in the release of IL-1β; conversely, exposure to particulate Ti did not result in increased IL-1β release. Cell viability was not affected by particulate Ti. Knockdown cells exposed to Ti showed a statistically significant reduction in the release of IL-1β compared with wt. cells (p < 0.001). Cellular uptake was detected in all Ti mixtures, and aggregates with various structures were observed. Ti ion-induced release of bioactive IL-1β in THP-1 cells involves the assembly of the NLRP3 inflammasome.
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Lind KH, Ulvik IM, Berg E, Leknes KN. Reversible, non‐plaque‐induced marginal bone loss around an osseointegrated implant: A case report. Clin Case Rep 2022; 10:e05946. [PMID: 35685828 PMCID: PMC9172590 DOI: 10.1002/ccr3.5946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022] Open
Abstract
This case report documents a non‐plaque‐induced marginal bone loss around an osseointegrated implant. The loss of osseointegration, most likely caused by overload and/or suboptimal distribution of occlusal loading, may be reversed when the loading is reduced by optimally transmitting stress forces to the implant‐to‐bone interface and surrounding bone. Limited crestal bone width and a history of ridge augmentation may make peri‐implant supporting bone vulnerable to occlusal overload. In such cases, the prosthetic restoration should be planned with particular focus on reducing and optimizing the occlusal load.
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Affiliation(s)
- Kristian H. Lind
- Department of Clinical Dentistry Faculty of Medicine University of Bergen Bergen Norway
| | - Ingvild M. Ulvik
- Department of Clinical Dentistry Faculty of Medicine University of Bergen Bergen Norway
| | - Einar Berg
- Department of Clinical Dentistry – Prosthodontics Faculty of Medicine University of Bergen Bergen Norway
| | - Knut N. Leknes
- Department of Clinical Dentistry – Periodontics Faculty of Medicine University of Bergen Bergen Norway
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The Characterization of Titanium Particles Released from Bone-Level Titanium Dental Implants: Effect of the Size of Particles on the Ion Release and Cytotoxicity Behaviour. MATERIALS 2022; 15:ma15103636. [PMID: 35629663 PMCID: PMC9148149 DOI: 10.3390/ma15103636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023]
Abstract
Many studies are being carried out on the particles released during the implantoplasty process in the machining of dental implants to remove bacterial biofilms. However, there are no studies on the release of particles produced by the insertion of bone-level dental implants due to the high compressive frictional loads between the rough titanium implant and the bone tissue. This paper aims to characterize the released particles and determine the release of titanium ions into the physiological environment and their cytocompatibility. For this purpose, 90 dental implants with a neck diameter of 4 mm and a torque of 22 Ncm were placed in 7 fresh cow ribs. The placement was carried out according to the established protocols. The implants had a roughness Ra of 1.92 μm. The arrangement of the particles in the bone tissue was studied by micro-CT, and no particle clusters were observed. The different granulometries of 5, 15, and 30 μm were obtained; the specific surface area was determined by laser diffraction; the topography was determined by scanning electron microcopy; and the particles were chemically analysed by X-ray energy microanalysis. The residual stresses of the particles were obtained by X-ray diffraction using the Bragg-Bentano configuration. The release of titanium ions to the physiological medium was performed using ICP-MS at 1, 3, 7, 14, and 21 days. The cytocompatibility of the particles with HFF-1 fibroblast and SAOS-2 osteoblast cultures was characterized. The results showed that the lowest specific surface area (0.2109 m2/g) corresponds to the particles larger than 30 μm being higher than 0.4969 and 0.4802 m2/g of those that are 5 and 15 μm, respectively, observing in all cases that the particles have irregular morphologies without contamination of the drills used in the surgery. The highest residual stresses were found for the small particles, -395 MPa for the 5 μm particles, and -369 for the 15 μm particles, and the lowest residual stresses were found for the 30 μm particles with values of -267 MPa. In all cases, the residual stresses were compressive. The lowest ion release was for the 30 μm samples, as they have the lowest specific surface area. Cytocompatibility studies showed that the particles are cytocompatible, but it is the smallest ones that are lower and very close to the 70% survival limit in both fibroblasts and osteoblasts.
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Li L, Sun W, Yu J, Lei W, Zeng H, Shi B. Effects of titanium dioxide microparticles and nanoparticles on cytoskeletal organization, cell adhesion, migration, and proliferation in human gingival fibroblasts in the presence of lipopolysaccharide. J Periodontal Res 2022; 57:644-659. [PMID: 35438207 DOI: 10.1111/jre.12993] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/02/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Titanium wear particles may participate in the etiology of peri-implantitis. However, the influence of titanium wear particles on biological behavior of human gingival fibroblasts (HGFs) in the presence of LPS is still not clear. The present study demonstrated the effects of titanium dioxide micro- and nanoparticles (TiO2 MPs and NPs) on HGF cell viability, cytoskeletal organization, adhesion, migration, and proliferation in vitro, and LPS was used to mimic the in vivo condition. METHODS Primary HGFs were treated with TiO2 MPs (primary particle size <5 μm, 0.1 mg/ml) and NPs (primary particle size <100 nm, 0.1 mg/ml) with or without 1 μg/ml LPS. The effects of TiO2 MPs and NPs on HGFs cell viability was measured by CCK-8 assay. The proliferation of HGF was detected by Ki67 nuclear staining. The confocal laser scanning microscope (CLSM) was used to detect the internalization of TiO2 MPs and NPs in HGFs as well as the arrangement of F-actin, vinculin, and vimentin organization. Wound healing assay and transwell assay were performed to measure the migration of HGFs induced by TiO2 MPs and NPs. Cell adhesion was measured using fibronectin-coated plates. The relative mRNA and protein expression of adhesion relative protein such as focal adhesion kinase (FAK), fibronectin (FN), and type I collagen (COL1) were measured using quantitative RT-PCR and western blot analysis. One-way analysis of variance (ANOVA) and Student's t-test were used to analyze the statistical significance, and p < .05 was considered statistically significant. RESULTS TiO2 NPs significantly inhibited HGF cell viability, proliferation, and migration compared with TiO2 MPs group and control group. Compared with control group (2.64 ± 0.09), the mean absorbance of the cells in 1 mg/ml TiO2 MPs group and 0.25 mg/ml TiO2 NPs group were significantly decreased to 1.93 ± 0.33 (p < .05) and 2.22 ± 0.18 (p < .01), respectively. The cytoskeleton disruption was found in TiO2 NPs group. The mRNA and protein expression were significantly downregulated by TiO2 NPs. Furthermore, both TiO2 NPs and MPs induced more adverse effects on HGFs in the presence of LPS. CONCLUSION Our results indicate that TiO2 NPs but not TiO2 MPs significantly disrupt the cytoskeletal organization and inhibited cell adhesion, migration, and proliferation of HGFs. However, in the presence of LPS, TiO2 MPs, and TiO2 NPs enhance these negative effects in HGFs. Titanium wear particles are probably involved in the initiation and progression of peri-implant diseases.
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Affiliation(s)
- Lei Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Sun
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jian Yu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wenlong Lei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hao Zeng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Bin Shi
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedical Ministry of Education, Wuhan, China.,School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Rakic M, Radunovic M, Petkovic-Curcin A, Tatic Z, Basta-Jovanovic G, Sanz M. Study on the immunopathological effect of titanium particles in peri-implantitis granulation tissue: a case-control study. Clin Oral Implants Res 2022; 33:656-666. [PMID: 35344630 PMCID: PMC9321593 DOI: 10.1111/clr.13928] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 01/26/2022] [Accepted: 01/31/2022] [Indexed: 11/27/2022]
Abstract
Objectives To identify titanium particles (TPs) in biopsy specimens harvested from peri‐implantitis lesions and secondarily to study the histopathological characteristics in peri‐implantitis compared to periodontitis, in order to evaluate whether the presence of TPs could alter respective inflammatory patterns. Material and methods Biopsies containing granulation tissue were harvested during routine surgical treatment in 39 peri‐implantitis cases and 35 periodontitis controls. Serial sections were obtained using titanium‐free microtome blades. The first and last sections of the peri‐implantitis specimens were used for identification of TPs by scanning electron microscopy coupled with dispersive X‐ray spectrometry. Intermediate sections and periodontitis specimens were processed for descriptive histological study using haematoxylin–eosin staining and for immunohistochemical analysis using CD68, IL‐6, Nf‐kB and VEGF markers. Results TPs were identified in all peri‐implantitis specimens as free metal bodies interspersed within granulation tissue. However, presence of macrophages or multinucleated giant cells engulfing the TPs were not identified in any specimen. Peri‐implantitis granulations were characterized by a chronic inflammatory infiltrate rich in neutrophils. About half of peri‐implantitis patients exhibited a subacute infiltrate characterized with lymphocytes interweaved with neutrophils and eosinophils. When compared to periodontitis, peri‐implantitis tissues showed higher proportions of macrophages and a more intense neovascularization, based on significantly higher expression of CD68 and VEGF respectively. Conclusion TPs were identified in all peri‐implantitis specimens, but without evidencing any foreign body reaction suggestive for direct pathological effects of TPs. The peri‐implantitis granulation tissue was characterized by intense neovascularization and presence of a chronic inflammatory infiltrate dominated by plasma cells, neutrophils and macrophages.
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Affiliation(s)
- Mia Rakic
- Facultad de Odontologia, Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Universidad Complutense de Madrid, Madrid, Spain
| | - Milena Radunovic
- Department of Microbiology and Immunology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | | | | | | | - Mariano Sanz
- Facultad de Odontologia, Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Universidad Complutense de Madrid, Madrid, Spain
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Clinical and Radiographic Outcomes of Zirconia Dental Implants-A Clinical Case Series Study. MATERIALS 2022; 15:ma15072437. [PMID: 35407772 PMCID: PMC8999721 DOI: 10.3390/ma15072437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this clinical series was to evaluate the clinical and radiographic outcomes of 20 zirconia dental implants, with a minimum follow-up of two years. Patients with at least one zirconia dental implant were included, with a mean follow-up of 34.05 months. The patient complaints such as pain and foreign body sensation, as well as clinical parameters including peri-implant infections with suppuration, implant mobility, gingival index (GI), modified plaque index (mPI), modified sulcus bleeding index (mBI), probing depth (PD) and radiological distance between the implant shoulder to the closest mesial and distal bone-to-implant contact (BIC), were assessed. All zirconia implants were successfully integrated without any pain or foreign body sensation. No mobility was detected in any of the 20 implants. Clinical examination revealed a mean PD of 2.56 mm and a radiological mean distance between the implant shoulder and the initial site of visible bone-to-implant contact (BIC) of 1.44 mm. In addition, GI, mPI and mBI indicated minimal to no inflammation. Results obtained from this series suggest that one-piece zirconia dental implants achieve good clinical and radiographic outcomes over a mean follow-up of 34 months and may be deemed a good option in patients with favorable bone conditions.
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Insight Into Corrosion of Dental Implants: From Biochemical Mechanisms to Designing Corrosion-Resistant Materials. CURRENT ORAL HEALTH REPORTS 2022; 9:7-21. [PMID: 35127334 PMCID: PMC8799988 DOI: 10.1007/s40496-022-00306-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 02/07/2023]
Abstract
Purpose of Review Despite advanced technologies to avoid corrosion of dental implants, the mechanisms toward the release of metals and their role in the onset of peri-implant diseases are still under-investigated. Effective knowledge on the etiopathogenesis of corrosive products and preventive strategies mitigating the risks for surface degradation are thus in dire need. This review aimed to summarize evidence toward biocorrosion in the oral environment and discuss the current strategies targeting the improvement of dental implants and focusing on the methodological and electrochemical aspects of surface treatments and titanium-based alloys. Recent Findings Recent studies suggest the existence of wear/corrosion products may correlate with peri-implantitis progress by triggering microbial dysbiosis, the release of pro-inflammatory cytokines, and animal bone resorption. Furthermore, current clinical evidence demonstrating the presence of metal-like particles in diseased tissues supports their possible role as a risk factor for peri-implantitis. For instance, to overcome the drawback of titanium corrosion, researchers are primarily focusing on developing corrosion-resistant alloys and coatings for dental implants by changing their physicochemical features. Summary The current state-of-art discussed in this review found corrosion products effective in affecting biofilm virulence and inflammatory factors in vitro. Controversial and unstandardized data are limitations, making the premise of corrosion products being essential for peri-implantitis onset. On the other hand, when it comes to the strategies toward reducing implant corrosion rate, it is evident that the chemical and physical properties are crucial for the in vitro electrochemical behavior of the implant material. For instance, it is foreseeable that the formation of films/coatings and the incorporation of some functional compounds into the substrate may enhance the material’s corrosion resistance and biological response. Nevertheless, the utmost challenge of research in this field is to achieve adequate stimulation of the biological tissues without weakening its protective behavior against corrosion. In addition, the translatability from in vitro findings to clinical studies is still in its infancy. Therefore, further accumulation of high-level evidence on the role of corrosion products on peri-implant tissues is expected to confirm the findings of the present review besides the development of better methods to improve the corrosion resistance of dental implants. Furthermore, such knowledge could further develop safe and long-term implant rehabilitation therapy.
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