1
|
Tang K, Luo ML, Zhou W, Niu LN, Chen JH, Wang F. The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies. Bioact Mater 2023; 27:348-361. [PMID: 37180640 PMCID: PMC10172871 DOI: 10.1016/j.bioactmat.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/23/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.
Collapse
Affiliation(s)
- Kai Tang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Meng-Lin Luo
- Institute of Stomatology & Oral Maxilla Facial Key Laboratory, The First Medical Center, Chinese PLA General Hospital & Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhou
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Li-Na Niu
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ji-Hua Chen
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
| | - Fu Wang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
| |
Collapse
|
2
|
Razali M, Chai WL, Omar RA, Ngeow WC. Contour Analysis of Three-Dimensional Peri-Implant Mucosal Model as an Endpoint Analysis of Photofunctionalization Effects on Implant Abutment Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5529. [PMID: 37629819 PMCID: PMC10456501 DOI: 10.3390/ma16165529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION The objective of this study was to examine the effect of photofunctionalization on the soft-tissue contour formed at the interface of various abutment materials using end-point analyses obtained from the three-dimensional oral mucosal model (3D-OMMs). METHODS Commercially pure titanium (CPTi), alumina-toughened zirconia (ATZ), and yttria-stabilized zirconia (YSZ) made into discs shapes were classified into two groups: UV-treated (PTx) and non-treated (NTx). The materials in PTx groups were exposed to UV light for 12 min. Human gingival fibroblasts and TR146 epithelial cell lines co-cultured on the acellular dermal membrane were used to construct the 3D-OMM. After 4 days of culture, the discs were inserted into the holes prepared within the membrane of 3D-OMMs. The contour formed by the tissue was evaluated after 14 days of culture. RESULTS The UV treatment of abutment materials resulted in the formation of more non-pocket-tissue types among the PTx group (p = 0.002). Of all materials tested, soft tissue contour around YSZ showed higher scores for the non-pocket type in both non- and UV-treated groups. CONCLUSIONS The non-pocket type of tissue attachment was frequently found in all surfaces modified by photofunctionalization, particularly zirconia. The 3D-OMM can be used to evaluate the biological endpoints of implant surface modifications.
Collapse
Affiliation(s)
- Masfueh Razali
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (W.L.C.); (R.A.O.)
| | - Ros Anita Omar
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia; (W.L.C.); (R.A.O.)
| | - Wei Cheong Ngeow
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia
| |
Collapse
|
3
|
Tuna T, Wein M, Altmann B, Steinberg T, Fischer J, Att W. Effect of Hydrogen Peroxide on the Surface and Attractiveness of Various Zirconia Implant Materials on Human Osteoblasts: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:961. [PMID: 36769968 PMCID: PMC9918077 DOI: 10.3390/ma16030961] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The aim of this in vitro study was to investigate the effect of hydrogen peroxide (H2O2) on the surface properties of various zirconia-based dental implant materials and the response of human alveolar bone osteoblasts. For this purpose, discs of two zirconia-based materials with smooth and roughened surfaces were immersed in 20% H2O2 for two hours. Scanning electron and atomic force microscopy showed no topographic changes after H2O2-treatment. Contact angle measurements (1), X-ray photoelectron spectroscopy (2) and X-ray diffraction (3) indicated that H2O2-treated surfaces (1) increased in hydrophilicity (p < 0.05) and (2) on three surfaces the carbon content decreased (33-60%), while (3) the monoclinic phase increased on all surfaces. Immunofluorescence analysis of the cell area and DNA-quantification and alkaline phosphatase activity revealed no effect of H2O2-treatment on cell behavior. Proliferation activity was significantly higher on three of the four untreated surfaces, especially on the smooth surfaces (p < 0.05). Within the limitations of this study, it can be concluded that exposure of zirconia surfaces to 20% H2O2 for 2 h increases the wettability of the surfaces, but also seems to increase the monoclinic phase, especially on roughened surfaces, which can be considered detrimental to material stability. Moreover, the H2O2-treatment has no influence on osteoblast behavior.
Collapse
Affiliation(s)
- Taskin Tuna
- Department of Prosthodontics and Biomaterials, School of Dentistry, RWTH University Aachen, Pauwelsstr. 30, 52062 Aachen, Germany
| | - Martin Wein
- Division of Oral Biotechnology, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Brigitte Altmann
- G.E.R.N. Research Center for Tissue Replacement, Regeneration & Neogenesis, Department of Prosthetic Dentistry, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Thorsten Steinberg
- Division of Oral Biotechnology, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Jens Fischer
- Division of Biomaterials and Technology, Clinic for Reconstructive Dentistry University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland
| | - Wael Att
- Department of Prosthodontics, School of Dental Medicine Tufts University, Boston, MA 02111, USA
| |
Collapse
|
4
|
Tang S, Ding N, Zhang Z. Polycrystalline particulates synthesized on zirconia for enhanced bioactivity: An in vitro study. J Biomed Mater Res B Appl Biomater 2023; 111:117-126. [PMID: 35841321 DOI: 10.1002/jbm.b.35138] [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: 04/27/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 11/06/2022]
Abstract
Zirconia is a promising material for dental implant with its excellent biocompatibility, good mechanical properties, and esthetic effect similar to natural teeth. To improve the bioactivity and osteogenic properties of zirconia, pre-sintered zirconia discs were divided into C, T3 , T5 , and T7 group. Group C was as control. T3 , T5 , and T7 groups were soaked in hydrofluoric acid (HF) for 30, 50, and 70 s, respectively. Then, they were placed into CaCl2 solution and heated in NaOH solution. After sintering, the samples were characterized by scanning electron microscopy, energy dispersive spectrometry, and X-ray diffraction, which confirmed the ZrO2 polycrystalline particulates in situ synthesized on the treated sample discs. The surface roughness of the treated samples was increased with the prolonged of acid treatment time (p < .05), while the three-point bending strength did not decrease significantly (p > .05). MC3T3-E1 cells were cultured on zirconia discs to evaluate the bioactivity and osteogenic effect of modified zirconia. The living&dead fluorescence staining and CCK-8 assay showed that the specimens were non-toxic and significantly promoted cell proliferation. In addition, the cell proliferation was enhanced with the increase of zirconia surface roughness. Polycrystalline particles modified zirconia were beneficial to cell spreading. After osteogenic induction, MC3T3-E1 cells inoculated on modified zirconia exhibited higher alkaline phosphatase activity, mineralization activity and up-regulated osteogenesis-related gene expression. Above all, in situ synthesized polycrystalline particulates significantly improve the biological activity of zirconia, which will promote the widespread application of zirconia implants.
Collapse
Affiliation(s)
- Shuang Tang
- Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China
| | - Ning Ding
- Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China
| | - Zutai Zhang
- Beijing Institute of Dental Research, School of Stomatology, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
Matsumoto H, Yamamoto T, Hayakawa T. Color changes of dental zirconia immersed in food and beverage containing water-soluble/lipid-soluble pigments. Dent Mater J 2022; 41:824-832. [PMID: 35793942 DOI: 10.4012/dmj.2022-021] [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: 11/23/2022]
Abstract
The present study examined color changes in the tooth-colored restorative materials, zirconia (3Y-TZP), resin composite, and porcelain. The colors (CIELab) of these materials were measured using a spectrophotometer. Specimens were immersed in black tea or curry for 1 and 7 days, after which colors were re-assessed. Color differences (∆E*ab) before and after immersion were calculated. Specimens after the 7-day immersion were ultrasonically cleaned, and colors were measured again to assess the color recovery rate. The surface free energy, roughness, and water sorption/solubility of each material were also evaluated. Specimens were observed under a scanning electron microscope. The ∆E*ab of 3Y-TZP was the smallest with both immersions. Resin composite had the smallest recovery rate. The surface free energy and roughness of 3Y-TZP were smaller than those of porcelain. 3Y-TZP and porcelain showed almost no sorption during the 7-day period. The present results revealed that 3Y-TZP exhibited the strongest resistance to discoloration.
Collapse
Affiliation(s)
- Hiro Matsumoto
- Department of Operative Dentistry, Tsurumi University School of Dental Medicine
| | - Takatsugu Yamamoto
- Department of Operative Dentistry, Tsurumi University School of Dental Medicine
| | - Tohru Hayakawa
- Department of Dental Engineering, Tsurumi University School of Dental Medicine
| |
Collapse
|
6
|
Chopra D, Jayasree A, Guo T, Gulati K, Ivanovski S. Advancing dental implants: Bioactive and therapeutic modifications of zirconia. Bioact Mater 2022; 13:161-178. [PMID: 35224299 PMCID: PMC8843948 DOI: 10.1016/j.bioactmat.2021.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/22/2021] [Accepted: 10/06/2021] [Indexed: 12/16/2022] Open
Abstract
Zirconium-based implants have gained popularity in the dental implant field owing to their corrosion resistance and biocompatibility, attributed to the formation of a native zirconia (ZrO2) film. However, enhanced bioactivity and local therapy from such implants are desirable to enable the earlier establishment and improved long-term maintenance of implant integration, especially in compromised patient conditions. As a result, surface modification of zirconium-based implants have been performed using various physical, chemical and biological techniques at the macro-, micro-, and nano-scales. In this extensive review, we discuss and detail the development of Zr implants covering the spectrum from past and present advancements to future perspectives, arriving at the next generation of highly bioactive and therapeutic nano-engineered Zr-based implants. The review provides in-depth knowledge of the bioactive/therapeutic value of surface modification of Zr implants in dental implant applications focusing on clinical translation.
Collapse
Affiliation(s)
| | | | | | - Karan Gulati
- Corresponding authors. School of Dentistry, University of Queensland, 288 Herston Road, Herston QLD, 4006, Australia.
| | - Sašo Ivanovski
- Corresponding authors. School of Dentistry, University of Queensland, 288 Herston Road, Herston QLD, 4006, Australia.
| |
Collapse
|
7
|
Krautwald L, Smeets R, Stolzer C, Rutkowski R, Guo L, Reitmeier A, Gosau M, Henningsen A. Osseointegration of Zirconia Implants after UV-Light or Cold Atmospheric Plasma Surface Treatment In Vivo. MATERIALS 2022; 15:ma15020496. [PMID: 35057216 PMCID: PMC8781961 DOI: 10.3390/ma15020496] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 12/04/2021] [Accepted: 12/15/2021] [Indexed: 12/04/2022]
Abstract
The influence of UV light and non-thermal plasma on the osseointegration of yttria-stabilized zirconia implants (Y-TZP) comparing the two methods is unclear. The aim of this study was to show the influence of these methods on the osseointegration of dental zirconia implants in an animal model. A total of 54 implants were either untreated, treated with UV light (UV), or non-thermal oxygen plasma for 12 min and inserted into the parietal bones of six domestic pigs. The animals were sacrificed after a healing interval of two, four, and nine weeks. The degree of osseointegration was determined using histomorphometric determination of bone-to-implant contact values (BIC) and the bone-to-implant contact values within the retentive parts of the implants (BAFO). BIC values decreased in all groups after four weeks of healing and re-increased after nine weeks in all groups. BAFO increased significantly over time in all groups. However, there were no statistically significant differences in BIC and BAFO values between the control group and the test groups and over time. Clinical studies may follow to confirm the influence of cold plasma and UV light on the healing and survival of zirconia implants.
Collapse
Affiliation(s)
- Lisa Krautwald
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Ralf Smeets
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Carolin Stolzer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Rico Rutkowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (C.S.); (R.R.)
| | - Linna Guo
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Aline Reitmeier
- Department of Laboratory Animal Science, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;
| | - Martin Gosau
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
| | - Anders Henningsen
- Division “Regenerative Orofacial Medicine”, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany; (L.K.); (R.S.); (L.G.); (M.G.)
- Private Practice ELBE MKG, Suelldorfer Kirchenweg 1A, 22587 Hamburg, Germany
- Correspondence:
| |
Collapse
|
8
|
Sun L, Hong G. Surface Modifications for Zirconia Dental Implants: A Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.733242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Zirconia-based bioceramic is a potential material for dental implants developed and introduced in dentistry 30 years ago. However, some limitations still exist for zirconia implants caused by several factors, such as manufacturing difficulties, low-temperature degradation (LTD), long-term stability, and clinical experience. Several studies validated that some subtle changes on the zirconia surface might significantly impact its mechanical properties and osseointegration. Thus, attention was paid to the effect of surface modification of zirconia implants. This review generally summarizes the surface modifications of zirconia implants to date classified as physical treatment, chemical treatment, and surface coating, aiming to give an overall perspective based on the current situation. In conclusion, surface modification is an effective and essential method for zirconia implant application. However, before clinical use, we need more knowledge about these modification methods.
Collapse
|
9
|
Jaikumar RA, Karthigeyan S, Ramesh Bhat TR, Naidu M, Praveen Raj GR, Natarajan S. Analysis of Surface Roughness and Three-dimensional Scanning Topography of Zirconia Implants before and after Photofunctionalization by Atomic Force Microscopy: An In Vitro Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2021; 13:S766-S771. [PMID: 34447198 PMCID: PMC8375956 DOI: 10.4103/jpbs.jpbs_724_20] [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: 11/02/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022] Open
Abstract
Aim: To analyze surface roughness and three-dimensional (3D) scanning topography parameters of zirconia implants before and after photofunctionalization by atomic force microscopy (AFM). Materials and Methods: Ten commercially available zirconia implants five each in the study and control group were taken. The study group was subjected to ultraviolet (UV) radiation for 48 h using the shorter wavelength of 254 nm. After washing all the implants with 70% alcohol and drying, 3D surface topography and roughness parameters were analyzed using CSC 17 probe AFM at three different magnifications 25 μm, 50 μm, and 80 μm, respectively. Results: The surface topography and calculated mean amplitude, spatial, and hybrid parameters of the study group were higher than the control group (P < 0.05) in all three magnifications. Up to scale depth and peak value for the study and control group were (−0.4–0.4: −2-1) (−0.75 to 0.6:−1–1.3) (−0.75-−0.5: −1.5-1.3) for the study and control group at 25, 50, and 80 μm magnification, respectively. This indicates that photofunctionalization increased surface roughness of Zirconia implants to desirable extent. Conclusion: There is a definite difference in the quantitative topographic characteristics with zirconia implants being microroughned after photofunctionalization (UV treatment).
Collapse
Affiliation(s)
- R Arun Jaikumar
- Department of Prosthodontics, Best Dental Science College, Madurai, Tamil Nadu, India
| | - Suma Karthigeyan
- Department of Prosthodontics, Rajah Mutiah Dental College, Chidambaram, Tamil Nadu, India
| | - T R Ramesh Bhat
- Department of Prosthodontics, Best Dental Science College, Madurai, Tamil Nadu, India
| | - Madhulika Naidu
- Department of Oral Medicine and Radiology, Best Dental Science College, Madurai, Tamil Nadu, India
| | - G R Praveen Raj
- Department of Prosthodontics, Vinayaka Mission Sankarachariya Dental College, Salem, Tamil Nadu, India
| | - Senthil Natarajan
- Department of Conservative Dentistry and Endodontics, Tagore Dental College, Rathinamangalam, Tamil Nadu, India
| |
Collapse
|
10
|
Qu Y, Liu L. Zirconia Materials for Dental Implants: A Literature Review. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.687983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Titanium is currently the most commonly used material for manufacturing dental implants. However, its potential toxic effects and the gray color have resulted in increasing requests for metal-free treatment options. Zirconia is a type of ceramic materials that has been extensively used in medicine field, such as implant abutments and various joint replacement appliances. Amounts of clinical evaluations have indicated good biocompatibility for zirconia products. Besides, its toothlike color, low affinity for plaque and outstanding mechanical and chemical properties have made it an ideal candidate for dental implants. The aim of this study is to review the laboratory and clinical papers about several kinds of zirconia materials and zirconia surface modification techniques. Although there are plenty of literatures on these topics, most of the researches focused on the mechanical properties of the materials or based on cell and animal experiments. Randomized clinical trials on zirconia materials are still urgently needed to validate their application as dental implants.
Collapse
|
11
|
Rathee G, Bartwal G, Rathee J, Mishra YK, Kaushik A, Solanki PR. Emerging Multimodel Zirconia Nanosystems for High‐Performance Biomedical Applications. ADVANCED NANOBIOMED RESEARCH 2021. [DOI: 10.1002/anbr.202100039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Garima Rathee
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
| | - Gaurav Bartwal
- Hemwati Nandan Bahuguna Garhwal University Birla Campus, Pauri Garhwal Srinagar Uttarakhand 246174 India
| | - Jyotsna Rathee
- CSE Department Deenbandhu Chhoturam University of Science and Technology Murthal Haryana 131039 India
| | - Yogendra Kumar Mishra
- Mads Clausen Institute NanoSYD University of Southern Denmark Alison 2 6400 Sønderborg Denmark
| | - Ajeet Kaushik
- NanoBioTech Laboratory Department of Natural Sciences, Division of Sciences, Art, and Mathematics Florida Polytechnic University Lakeland FL 33805 USA
| | - Pratima R. Solanki
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
| |
Collapse
|
12
|
Han J, Zhang F, Van Meerbeek B, Vleugels J, Braem A, Castagne S. Laser surface texturing of zirconia-based ceramics for dental applications: A review. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 123:112034. [PMID: 33812647 DOI: 10.1016/j.msec.2021.112034] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 02/07/2023]
Abstract
Laser surface texturing is widely explored for modifying the surface topography of various materials and thereby tuning their optical, tribological, biological, and other surface properties. In dentistry, improved osseointegration has been observed with laser textured titanium dental implants in clinical trials. Due to several limitations of titanium materials, dental implants made of zirconia-based ceramics are now considered as one of the best alternatives. Laser surface texturing of zirconia dental implants is therefore attracting increasing attention. However, due to the brittle nature of zirconia, as well as the metastable tetragonal ZrO2 phase, laser texturing in the case of zirconia is more challenging than in the case of titanium. Understanding these challenges requires different fields of expertise, including laser engineering, materials science, and dentistry. Even though much progress was made within each field of expertise, a comprehensive analysis of all the related factors is still missing. This review paper provides thus an overview of the common challenges and current status on the use of lasers for surface texturing of zirconia-based ceramics for dental applications, including texturing of zirconia implants for improving osseointegration, texturing of zirconia abutments for reducing peri-implant inflammation, and texturing of zirconia restorations for improving restoration retention by bonding.
Collapse
Affiliation(s)
- Jide Han
- KU Leuven, Department of Mechanical Engineering and Flanders Make@KU Leuven-MaPS, Celestijnenlaan 300, 3001 Leuven, Belgium
| | - Fei Zhang
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, 3001 Leuven, Belgium; KU Leuven, Department of Oral Health Sciences, BIOMAT, Kapucijnenvoer 7 Block A, 3000 Leuven, Belgium
| | - Bart Van Meerbeek
- KU Leuven, Department of Oral Health Sciences, BIOMAT, Kapucijnenvoer 7 Block A, 3000 Leuven, Belgium
| | - Jozef Vleugels
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, 3001 Leuven, Belgium
| | - Annabel Braem
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, 3001 Leuven, Belgium
| | - Sylvie Castagne
- KU Leuven, Department of Mechanical Engineering and Flanders Make@KU Leuven-MaPS, Celestijnenlaan 300, 3001 Leuven, Belgium.
| |
Collapse
|
13
|
Razali M, Ngeow WC, Omar RA, Chai WL. An In-Vitro Analysis of Peri-Implant Mucosal Seal Following Photofunctionalization of Zirconia Abutment Materials. Biomedicines 2021; 9:biomedicines9010078. [PMID: 33467486 PMCID: PMC7830892 DOI: 10.3390/biomedicines9010078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 12/17/2022] Open
Abstract
The presence of epithelial and connective tissue attachment at the peri-implant-soft tissue region has been demonstrated to provide a biological barrier of the alveolar bone from the oral environment. This barrier can be improved via surface modification of implant abutment materials. The effect of photofunctionalization on creating a bioactive surface for the enhancement of the epithelial and connective tissue attachment of zirconia implant abutment's peri-implant mucosal interface using organotypic model has not been investigated. Therefore, this study aimed to evaluate the soft tissue seal around peri-implant mucosa and to understand the effect of photofunctionalization on the abutment materials. Three types of abutment materials were used in this study; yttria-stabilized zirconia (YSZ), alumina-toughened zirconia, and grade 2 commercially pure titanium (CPTi) which were divided into nontreated (N-Tx) and photofunctionalized group (UV-Tx). The three-dimensional peri-implant mucosal model was constructed using primary human gingival keratinocytes and fibroblasts co-cultured on the acellular dermal membrane. The biological seal was determined through the concentration of tritiated water permeating the material-soft tissue interface. The biological seal formed by the soft tissue in the N-Tx group was significantly reduced compared to the UV-treated group (p < 0.001), with YSZ exhibiting the lowest permeability among all materials. Photofunctionalization of implant abutment materials improved the biological seal of the surrounding soft tissue peri-implant interface.
Collapse
Affiliation(s)
- Masfueh Razali
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Correspondence: (M.R.); (W.L.C.); Tel.: +603-92897745 (M.R.); +603-79674548 (W.L.C.)
| | - Wei Cheong Ngeow
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Ros Anita Omar
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Wen Lin Chai
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
- Correspondence: (M.R.); (W.L.C.); Tel.: +603-92897745 (M.R.); +603-79674548 (W.L.C.)
| |
Collapse
|
14
|
Alagiriswamy G, Krishnan CS, Ramakrishnan H, Jayakrishnakumar SK, Mahadevan V, Azhagarasan NS. Surface Characteristics and Bioactivity of Zirconia (Y-TZP) with Different Surface Treatments. J Pharm Bioallied Sci 2020; 12:S114-S123. [PMID: 33149441 PMCID: PMC7595469 DOI: 10.4103/jpbs.jpbs_39_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 03/02/2020] [Indexed: 12/04/2022] Open
Abstract
Background: Zirconia being a bio-inert material needs to be surface treated to render it more bioactive and enhance its osseointegration potential. However, bioactivity studies focusing on the ability of sandblasting and ultraviolet photofunctionalization (UVP) surface treatments in inducing apatite precipitation using simulated body fluid (SBF) are lacking. Aim: The aim of the study was to comparatively evaluate the effect of two different surface treatments—sandblasting with 50 µm alumina and UVP with ultraviolet C (UVC) light on the bioactivity of zirconia. Materials and Methods: A total of 33 discs with dimensions 10 mm × 2 mm were obtained from zirconia blanks (Amann Girrbach, Koblach, Austria) and randomly divided into three groups (n = 11), namely Group I (untreated), Group II (sandblasted), and Group III (UVP). Surface characteristics of representative test samples were analyzed using X-ray diffraction (XRD), atomic force microscopy (AFM), contact angle goniometry, scanning electron microscopy (SEM), and energy dispersive X-ray spectroscopy (EDX), to assess type of crystal phase of zirconia, surface roughness, wettability, surface topography, and elemental composition, respectively. SBF was prepared and calcium content in SBF (Ca-SBF) was determined using inductively coupled plasma mass spectrometry (ICP-MS). Results: Data were analyzed by one-way analysis of variance (ANOVA), post hoc Tukey honestly significant difference (HSD), and Student’s t test for statistical significance (P < 0.05, significant; P < 0.01, highly significant). Surface characteristics analyses revealed that XRD showed predominant tetragonal (t) zirconia crystal phase for all test groups. Mean surface roughness (Sa) of Group I was 41.83 nm, and it was significantly lesser than that of Group II (115.65 nm) and Group III (102.43 nm). Mean contact angles were 98.26°, 86.77°, and 68.03° for Groups I, II, and III, respectively, and these differences were highly significant. Mean pre-immersion Ca content in SBF was found to be 159 mg/L. Mean post-immersion Ca content was 70.10, 60.80, and 56.20 mg/L for Groups I, II, and III, respectively. Significant differences were found between Group I as compared to both Groups II and III. Bioactivity of Group III was marginally, but insignificantly higher with respect to Group II. Groups II and III were insignificant with respect to each other. Post-immersion XRD revealed predominant “t” phase, and SEM-EDX revealed well-formed, abundant calcium apatite layer on the treated samples as compared to that on untreated sample and an increasing Ca/P ratio from 1.15, 1.79 to 2.08, respectively from Group I to Group III. Conclusion: Within the limitations of this study, both sandblasting and UVP significantly and similarly improved bioactivity of zirconia as compared to the untreated samples, which was corroborated by the SEM-EDX results.
Collapse
Affiliation(s)
- Gayathree Alagiriswamy
- Department of Prosthodontics & Implantology, Ragas Dental College & Hospital, Chennai, Tamil Nadu, India
| | - Chitra Shankar Krishnan
- Department of Prosthodontics & Implantology, Ragas Dental College & Hospital, Chennai, Tamil Nadu, India
| | - Hariharan Ramakrishnan
- Department of Prosthodontics & Implantology, Ragas Dental College & Hospital, Chennai, Tamil Nadu, India
| | | | - Vallabh Mahadevan
- Department of Prosthodontics & Implantology, Ragas Dental College & Hospital, Chennai, Tamil Nadu, India
| | | |
Collapse
|
15
|
Novel Osteogenic Behaviors around Hydrophilic and Radical-Free 4-META/MMA-TBB: Implications of an Osseointegrating Bone Cement. Int J Mol Sci 2020; 21:ijms21072405. [PMID: 32244335 PMCID: PMC7177939 DOI: 10.3390/ijms21072405] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 12/15/2022] Open
Abstract
Poly(methyl methacrylate) (PMMA)-based bone cement, which is widely used to affix orthopedic metallic implants, is considered bio-tolerant but lacks osteoconductivity and is cytotoxic. Implant loosening and toxic complications are significant and recognized problems. Here we devised two strategies to improve PMMA-based bone cement: (1) adding 4-methacryloyloxylethyl trimellitate anhydride (4-META) to MMA monomer to render it hydrophilic; and (2) using tri-n-butyl borane (TBB) as a polymerization initiator instead of benzoyl peroxide (BPO) to reduce free radical production. Rat bone marrow-derived osteoblasts were cultured on PMMA-BPO, common bone cement ingredients, and 4-META/MMA-TBB, newly formulated ingredients. After 24 h of incubation, more cells survived on 4-META/MMA-TBB than on PMMA-BPO. The mineralized area was 20-times greater on 4-META/MMA-TBB than PMMA-BPO at the later culture stage and was accompanied by upregulated osteogenic gene expression. The strength of bone-to-cement integration in rat femurs was 4- and 7-times greater for 4-META/MMA-TBB than PMMA-BPO during early- and late-stage healing, respectively. MicroCT and histomorphometric analyses revealed contact osteogenesis exclusively around 4-META/MMA-TBB, with minimal soft tissue interposition. Hydrophilicity of 4-META/MMA-TBB was sustained for 24 h, particularly under wet conditions, whereas PMMA-BPO was hydrophobic immediately after mixing and was unaffected by time or condition. Electron spin resonance (ESR) spectroscopy revealed that the free radical production for 4-META/MMA-TBB was 1/10 to 1/20 that of PMMA-BPO within 24 h, and the substantial difference persisted for at least 10 days. The compromised ability of PMMA-BPO in recruiting cells was substantially alleviated by adding free radical-scavenging amino-acid N-acetyl cysteine (NAC) into the material, whereas adding NAC did not affect the ability of 4-META/MMA-TBB. These results suggest that 4-META/MMA-TBB shows significantly reduced cytotoxicity compared to PMMA-BPO and induces osteoconductivity due to uniquely created hydrophilic and radical-free interface. Further pre-clinical and clinical validations are warranted.
Collapse
|
16
|
Han A, Ding H, Tsoi JKH, Imazato S, Matinlinna JP, Chen Z. Prolonged UV-C Irradiation is a Double-Edged Sword on the Zirconia Surface. ACS OMEGA 2020; 5:5126-5133. [PMID: 32201799 PMCID: PMC7081443 DOI: 10.1021/acsomega.9b04123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/25/2020] [Indexed: 05/28/2023]
Abstract
Zirconia has become an excellent choice of dental implants because of its excellent mechanical strength, aesthetic, and biocompatibility. Although some studies have shown ultraviolet (UV) irradiation is effective to photofunctionalize dental zirconia that can improve osteoblastic function, the scattered information has not identified the most effective exposure time and wavelength of UV. Herein, this study has investigated the effects of UV irradiation on zirconia after UV-A (365 nm) or UV-C (243 nm) photofunctionalization for different times (15 min, 3 and 24 h). After irradiation, the zirconia surface was analyzed by color spectrophotometry, scanned electron microscopy (SEM), energy-dispersive X-ray spectrometry, water contact angle (WCA) with goniometer, and X-ray diffraction. Osteoblastic (MC3T3-E1) cells were cultured on zirconia discs and evaluated with a CCK-8 test kit for cell proliferation (3 h and 1 day) and with alkaline phosphatase (ALP) activity (14 days). Significant color change (ΔE) was observed by irradiating with UV-C for 15 min (1.99), 3 h (1.92), and 24 h (3.35), whereas only minute changes were observed with UV-A (respectively, ΔE: 0.18, 0.14, 0.57). No surface textural changes were observed nor a monoclinic phase was detected on both the UV-A and UV-C irradiated samples. UV-C significantly decreased the C/Zr ratios and WCA, with irradiating for 24 h presenting the lowest values, and it was the only condition to give significantly higher ALP activity at 14 days (p < 0.05) and CCK-8 values for 1 day culture (p < 0.05). It is concluded that UV-C (but not UV-A) irradiation can significantly change the aesthetic in color, and only prolonged 24 h UV-C irradiation can enhance MC3T3-E1 cell adhesion on zirconia by photofunctionalization.
Collapse
Affiliation(s)
- Aifang Han
- Dental
Materials Science, Division of Applied Oral Sciences and Community
Dental Care, Faculty of Dentistry, The University
of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
| | - Hao Ding
- Dental
Materials Science, Division of Applied Oral Sciences and Community
Dental Care, Faculty of Dentistry, The University
of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
| | - James Kit Hon Tsoi
- Dental
Materials Science, Division of Applied Oral Sciences and Community
Dental Care, Faculty of Dentistry, The University
of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
| | - Satoshi Imazato
- Department
of Biomaterials Science, Osaka University
Graduate School of Dentistry, Osaka 565-0871, Japan
| | - Jukka P. Matinlinna
- Dental
Materials Science, Division of Applied Oral Sciences and Community
Dental Care, Faculty of Dentistry, The University
of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
| | - Zhuofan Chen
- Dental
Materials Science, Division of Applied Oral Sciences and Community
Dental Care, Faculty of Dentistry, The University
of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
- Zhujiang
New Town Dental Clinic, Hospital of Stomatology, Guanghua School of
Stomatology, Sun Yat-sen University, Guangzhou 510275, P.R. China
| |
Collapse
|
17
|
Iinuma Y, Hirota M, Hayakawa T, Ohkubo C. Surrounding Tissue Response to Surface-Treated Zirconia Implants. MATERIALS 2019; 13:ma13010030. [PMID: 31861679 PMCID: PMC6981750 DOI: 10.3390/ma13010030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 11/16/2022]
Abstract
Yttria-stabilized tetragonal zirconia polycrystals (Y-TZP), which are partially stabilized zirconia, have been used for fabricating dental implants. This study investigated the soft tissue attachment, the collagen fiber orientation to zirconia at different surface conditions, and the bone response using implantation experiments in animals. The zirconia implant surfaces were treated with ultraviolet irradiation (UV), a combination of large-grit sandblasting and hydrofluoric acid etching (blastedHF), and a combination of blastedHF and UV (blastedHF+UV). The surface treated with blastedHF and blastedHF+UV appeared rough and hydrophilic. The surface treated with blastedHF+UV appeared to be superhydrophilic. Subsequently, tapered cylindrical zirconia implants were placed in the alveolar sockets of the maxillary molars of rats. The bone-to-implant contact ratio of blastedHF and blastedHF+UV implants was significantly higher than that of the non-treated controls and UV-treated implants. The four different surface-treated zirconia implants demonstrated tight soft tissue attachments. Perpendicularly oriented collagen fibers towards zirconia implants were more prominent in blastedHF and blastedHF+UV implants compared to the controls and UV-treated implants. The area of the soft tissue attachment was the greatest with the perpendicularly oriented collagen fibers of blastedHF+UV-treated implants. In conclusion, blastedHF+UV treatment could be beneficial for ensuring greater soft-tissue attachment for zirconia implants.
Collapse
Affiliation(s)
- Yohei Iinuma
- Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan;
- Correspondence: ; Tel.: +81-45580-8421
| | - Masatsugu Hirota
- School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan; (M.H.); (T.H.)
| | - Tohru Hayakawa
- School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan; (M.H.); (T.H.)
| | - Chikahiro Ohkubo
- Department of Removable Prosthodontics, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi, Yokohama, Kanagawa 230-8501, Japan;
| |
Collapse
|
18
|
Schünemann FH, Galárraga-Vinueza ME, Magini R, Fredel M, Silva F, Souza JCM, Zhang Y, Henriques B. Zirconia surface modifications for implant dentistry. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 98:1294-1305. [PMID: 30813009 DOI: 10.1016/j.msec.2019.01.062] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Zirconia has emerged as a versatile dental material due to its excellent aesthetic outcomes such as color and opacity, unique mechanical properties that can mimic the appearance of natural teeth and decrease peri-implant inflammatory reactions. OBJECTIVE The aim of this review was to critically explore the state of art of zirconia surface treatment to enhance the biological and osseointegration behavior of zirconia in implant dentistry. MATERIALS AND METHODS An electronic search in PubMed database was carried out until May 2018 using the following combination of key words and MeSH terms without time periods: "zirconia surface treatment" or "zirconia surface modification" or "zirconia coating" and "osseointegration" or "biological properties" or "bioactivity" or "functionally graded properties". RESULTS Previous studies have reported the influence of zirconia-based implant surface on the adhesion, proliferation, and differentiation of osteoblast and fibroblasts at the implant to bone interface during the osseointegration process. A large number of physicochemical methods have been used to change the implant surfaces and therefore to improve the early and late bone-to-implant integration, namely: acid etching, gritblasting, laser treatment, UV light, CVD, and PVD. The development of coatings composed of silica, magnesium, graphene, dopamine, and bioactive molecules has been assessed although the development of a functionally graded material for implants has shown encouraging mechanical and biological behavior. CONCLUSION Modified zirconia surfaces clearly demonstrate faster osseointegration than that on untreated surfaces. However, there is no consensus regarding the surface treatment and consequent morphological aspects of the surfaces to enhance osseointegration.
Collapse
Affiliation(s)
- Fernanda H Schünemann
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - María E Galárraga-Vinueza
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - Ricardo Magini
- School of Dentistry (DODT), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900 Florianópolis, SC, Brazil
| | - Márcio Fredel
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil
| | - Filipe Silva
- CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal
| | - Júlio C M Souza
- CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal; Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116, Gandra, Portugal
| | - Yu Zhang
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, NYU, New York, NY 10010, USA
| | - Bruno Henriques
- Ceramic and Composite Materials Research Group (CERMAT), Federal University of Santa Catarina (UFSC), Campus Trindade, 88040-900, Florianópolis, SC, Brazil; CMEMS-UMinho, University of Minho, Campus de Azurém, 4800-058 Guimarães, Portugal.
| |
Collapse
|
19
|
|
20
|
Current status of zirconia implants in dentistry: preclinical tests. J Prosthodont Res 2018; 63:1-14. [PMID: 30205949 DOI: 10.1016/j.jpor.2018.07.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/18/2018] [Accepted: 07/26/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE This systematic review aimed to provide an overview of zirconia implants as well as regarding the outcome of the implant-restorative complex in preclinical studies. STUDY SELECTION An electronic search of the literature prior to July 2017 was performed to identify all articles related to preclinical research on zirconia implants. The search was conducted using MEDLINE (National Library of Medicine) and PubMed without restrictions concerning the date of publication. The search terminology included: zirconia implant, osseointegration, bone-to-implant contact, soft tissue, histology, histomorphometry, surface modification, surface roughness, surface characteristics, and restoration (connecting multiple keywords with AND, OR). RESULTS Fifty-seven studies were finally selected from an initial yield of 654 titles, and the data were extracted. The identified preclinical studies focused on several aspects related to zirconia implants, namely biocompatibility, mechanical properties, implant design, osseointegration capacity, soft tissue response, and restorative options. Due to heterogeneity of the studies, a meta-analysis was not possible. The most frequently used zirconia material for the fabrication of implants is yttria-stabilized tetragonal zirconia polycrystal. The resistance-to-fracture for zirconia implants ranged between 516-2044N. The mostly investigated parameter was osseointegration, which is compared to that of titanium. A lack of evidence was found with other parameters. CONCLUSIONS Due to its good biocompatibility as well as favorable physical and mechanical properties, zirconia implants are a potential alternative to titanium implants. However, knowledge regarding the implant-restorative complex and related aspects is still immature to recommend its application for daily practice.
Collapse
|
21
|
Rezaei NM, Hasegawa M, Ishijima M, Nakhaei K, Okubo T, Taniyama T, Ghassemi A, Tahsili T, Park W, Hirota M, Ogawa T. Biological and osseointegration capabilities of hierarchically (meso-/micro-/nano-scale) roughened zirconia. Int J Nanomedicine 2018; 13:3381-3395. [PMID: 29922058 PMCID: PMC5997135 DOI: 10.2147/ijn.s159955] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Zirconia is a potential alternative to titanium for dental and orthopedic implants. Here we report the biological and bone integration capabilities of a new zirconia surface with distinct morphology at the meso-, micro-, and nano-scales. METHODS Machine-smooth and roughened zirconia disks were prepared from yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), with rough zirconia created by solid-state laser sculpting. Morphology of the surfaces was analyzed by three-dimensional imaging and profiling. Rat femur-derived bone marrow cells were cultured on zirconia disks. Zirconia implants were placed in rat femurs and the strength of osseointegration was evaluated by biomechanical push-in test. RESULTS The rough zirconia surface was characterized by meso-scale (50 µm wide, 6-8 µm deep) grooves, micro-scale (1-10 µm wide, 0.1-3 µm deep) valleys, and nano-scale (10-400 nm wide, 10-300 nm high) nodules, whereas the machined surface was flat and uniform. The average roughness (Ra) of rough zirconia was five times greater than that of machined zirconia. The expression of bone-related genes such as collagen I, osteopontin, osteocalcin, and BMP-2 was 7-25 times upregulated in osteoblasts on rough zirconia at the early stage of culture. The number of attached cells and rate of proliferation were similar between machined and rough zirconia. The strength of osseointegration for rough zirconia was twice that of machined zirconia at weeks two and four of healing, with evidence of mineralized tissue persisting around rough zirconia implants as visualized by electron microscopy and elemental analysis. CONCLUSION This unique meso-/micro-/nano-scale rough zirconia showed a remarkable increase in osseointegration compared to machine-smooth zirconia associated with accelerated differentiation of osteoblasts. Cell attachment and proliferation were not compromised on rough zirconia unlike on rough titanium. This is the first report introducing a rough zirconia surface with distinct hierarchical morphology and providing an effective strategy to improve and develop zirconia implants.
Collapse
Affiliation(s)
- Naser Mohammadzadeh Rezaei
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Masakazu Hasegawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Manabu Ishijima
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Kourosh Nakhaei
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Takahisa Okubo
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Takashi Taniyama
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Amirreza Ghassemi
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Tania Tahsili
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Wonhee Park
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Makoto Hirota
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Advanced Prosthodontics, UCLA School of Dentistry, Los Angeles, CA, USA
| |
Collapse
|
22
|
Nassif W, Rifai M. Surface Characterization and Cell Adhesion of Different Zirconia Treatments: An in vitro Study. J Contemp Dent Pract 2018; 19:181-188. [PMID: 29422468 DOI: 10.5005/jp-journals-10024-2234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study was to characterize the surface of zirconia subjected to different treatments and evaluate its effect on cell adhesion and proliferation. MATERIALS AND METHODS A total of 80 zirconia disks were divided into four groups (n = 20) according to the surface treatments used: group I: as-sintered (AS), no surface treatment applied; group II: abrasion treatment applied using Rocatec (ROC; 3M ESPE) system with silica-coated alumina powder of grit size 110 μm; group III: erbium, chromium:yttrium, scandium, gallium, garnet (Er, Cr:YSGG) laser (LAS; BIOLASE) was used at a frequency of 20 Hz and output power of 3 W; and group IV: specimens were subjected to the selective infiltration etching (SIE) technique. Surface characterization was evaluated for the different groups (roughness, hardness, and morphology), and cell behavior (adhesion and proliferation) was tested (a = 0.05). RESULTS The ROC group reported a significant increase in surface roughness (2.201 ± 0.352) and Vickers hardness (1758 ± 16.6) compared with the other surface treatments. The SIE surface-treated group reported a significantly higher number of cells (64.5 ± 2.6 and 53.5 ± 2.2 respectively) compared with the other surface-treated groups. CONCLUSION The SIE is a promising surface treatment for zirconia that significantly enhances cell adhesion and osseointegration. CLINICAL SIGNIFICANCE The SIE treatment of zirconia implants may help in a faster and better osseointegration.
Collapse
Affiliation(s)
- Wadih Nassif
- Department of Prosthodontics, Faculty of Dental Medicine Lebanese University, Beirut, Lebanon, Phone: +9613686787, e-mail:
| | - Mohamad Rifai
- Department of Prosthodontics, Faculty of Dental Medicine Lebanese University, Beirut, Lebanon
| |
Collapse
|
23
|
Brezavšček M, Fawzy A, Bächle M, Tuna T, Fischer J, Att W. The Effect of UV Treatment on the Osteoconductive Capacity of Zirconia-Based Materials. MATERIALS 2016; 9:ma9120958. [PMID: 28774080 PMCID: PMC5457022 DOI: 10.3390/ma9120958] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 11/24/2022]
Abstract
Objective: Improvements in the bioactivity of zirconia implants for accelerated healing and reduced morbidity have been of continuing interest in the fields of dentistry and orthopedic surgery. The aim of the present study was to examine whether UV treatment increases the osteoconductivity of zirconia-based materials. Materials and Methods: Smooth and rough zirconia-based disks and cylindrical implants were treated with UV light for 15 min and subsequently placed in rat femurs. Surface characterization was performed using scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS) and contact angle measurements. Results: In vivo histomorphometry revealed that the percentage of bone-implant contact and the amount of bone volume, formed around UV-treated implants, increased by 3–7-fold for smooth surfaces and by 1.4–1.7-fold for rough surfaces compared to non-treated specimens at Weeks 2 and 4 of healing, respectively. A biomechanical test showed that UV treatment accelerated the establishment of bone-zirconia integration and enhanced the strength of the bone-implant interface by two-fold. Additionally, surface characterization of the zirconia disks revealed that UV treatment decreased the amount of surface carbon and converted the hydrophilic status from hydrophobic to superhydrophilic. Conclusions: This study indicates that UV light pretreatment enhances the osteoconductive capacity of zirconia-based materials.
Collapse
Affiliation(s)
- Miha Brezavšček
- Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Hugstetter Strasse 55, 79106 Freiburg, Germany.
| | - Ahmed Fawzy
- Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Hugstetter Strasse 55, 79106 Freiburg, Germany.
| | - Maria Bächle
- Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Hugstetter Strasse 55, 79106 Freiburg, Germany.
| | - Taskin Tuna
- Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Hugstetter Strasse 55, 79106 Freiburg, Germany.
| | - Jens Fischer
- Institute for Dental Materials and Engineering, University Hospital for Dental Medicine, University of Basel, 4056 Basel, Switzerland.
| | - Wael Att
- Department of Prosthodontics, School of Dentistry, Albert-Ludwigs University, Hugstetter Strasse 55, 79106 Freiburg, Germany.
| |
Collapse
|
24
|
Wang J, Wu P, Chen PC, Lee C, Chen W, Hung S. Generation of Osteosarcomas from a Combination of Rb Silencing and c-Myc Overexpression in Human Mesenchymal Stem Cells. Stem Cells Transl Med 2016; 6:512-526. [PMID: 28191765 PMCID: PMC5442803 DOI: 10.5966/sctm.2015-0226] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 07/15/2016] [Indexed: 12/18/2022] Open
Abstract
Osteosarcoma (OS) was a malignant tumor occurring with unknown etiology that made prevention and early diagnosis difficult. Mesenchymal stem cells (MSCs), which were found in bone marrow, were claimed to be a possible origin of OS but with little direct evidence. We aimed to characterize OS cells transformed from human MSCs (hMSCs) and identify their association with human primary OS cells and patient survival. Genetic modification with p53 or retinoblastoma (Rb) knockdown and c-Myc or Ras overexpression was applied for hMSC transformation. Transformed cells were assayed for proliferation, differentiation, tumorigenecity, and gene expression profile. Only the combination of Rb knockdown and c-Myc overexpression successfully transformed hMSCs derived from four individual donors, with increasing cell proliferation, decreasing cell senescence rate, and increasing ability to form colonies and spheres in serum-free medium. These transformed cells lost the expression of certain surface markers, increased in osteogenic potential, and decreased in adipogenic potential. After injection in immunodeficient mice, these cells formed OS-like tumors, as evidenced by radiographic analyses and immunohistochemistry of various OS markers. Microarray with cluster analysis revealed that these transformed cells have gene profiles more similar to patient-derived primary OS cells than their normal MSC counterparts. Most importantly, comparison of OS patient tumor samples revealed that a combination of Rb loss and c-Myc overexpression correlated with a decrease in patient survival. This study successfully transformed human MSCs to OS-like cells by Rb knockdown and c-Myc overexpression that may be a useful platform for further investigation of preventive and target therapy for human OS. Stem Cells Translational Medicine 2017;6:512-526.
Collapse
Affiliation(s)
- Jir‐You Wang
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Institute of Traditional Medicine, School of Medicine, National Yang‐Ming University, Taipei, Taiwan, Republic of China
| | - Po‐Kuei Wu
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Paul Chih‐Hsueh Chen
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Chia‐Wen Lee
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Wei‐Ming Chen
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Shih‐Chieh Hung
- Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Department of Orthopaedics, Therapeutical and Research Center of Musculoskeletal Tumor, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Institute of Traditional Medicine, School of Medicine, National Yang‐Ming University, Taipei, Taiwan, Republic of China
- Institute of Clinical Medicine, School of Medicine, National Yang‐Ming University, Taipei, Taiwan, Republic of China
- Department of Pharmacology, School of Medicine, National Yang‐Ming University, Taipei, Taiwan, Republic of China
- Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, Republic of China
- Integrative Stem Cell Center, China Medical University Hospital, Taichung, Taiwan, Republic of China
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, Republic of China
| |
Collapse
|