Enhanced Corrosion Resistance and Local Therapy from Nano-Engineered Titanium Dental Implants

3D printed porous magnesium metal scaffolds with bioactive coating for bone defect repair: enhancing angiogenesis and osteogenesis

In orthopedics, the effective treatment of bone defects remains a major challenge. Magnesium (Mg) metals, with their excellent biocompatibility and favorable osteoconductivity, osteoinductivity, and osseointegration properties, hold great promise for addressing this issue. However, the rapid degradation rate of magnesium restricts its clinical application. In this study, a triply periodic minimal surface (TPMS)-structured porous magnesium alloy (Mg-Nd-Zn-Zr, JDBM) was fabricated using the laser powder bed fusion (LPBF) process. Strontium-doped octacalcium phosphate (SrOCP) and strontium hydrogen phosphate biphasic composite coatings were applied to the surface of the scaffolds. The results showed that the TPMS structure exhibited porous biomimetic characteristics that resemble cancellous bone, promoting vascular ingrowth and new bone formation. Additionally, the SrOCP coating significantly increased the surface roughness and hydrophilicity of the scaffold, which enhanced cell adhesion and osteogenic differentiation. The SrOCP coating also markedly reduced the degradation rate of the JDBM scaffolds while ensuring the sustained release of bioactive ions (Mg²⁺, Zn²⁺, Sr²⁺, and Ca²⁺), thus maintaining the scaffolds' biofunctional activity. Compared to JDBM scaffolds, JDBM/SrOCP scaffolds exhibited better biocompatibility and stronger vascularization and bone regeneration capabilities both in vitro and in vivo. Overall, this study presents a novel strategy for the repair of bone defects using magnesium-based biomaterials, providing new insights for future clinical applications.

The impact of biocorrosion and titanium ions release on peri-implantitis

OBJECTIVES

Biofilm accumulation is considered the primary cause of peri-implant inflammation. Still, metallosis caused by an increased concentration of titanium ions at the site of peri-implantitis site cannot be ignored. Whether titanium ions alone or in concert with bacterial biofilm trigger inflammation and bone destruction in peri-implant tissues remains unproven.

MATERIALS AND METHODS

Articles were retrieved from PubMed/Medline, Web of Science. All studies focusing on titanium ions release in peri-implant reactions were included and evaluated.

RESULTS

Titanium implants are considered non-inert and may release titanium ions in the intraoral microenvironment, the most important of which is the acidic environment created by bacterial biofilms. Although the correlation between titanium ion release and the incidence or progression of peri-implantitis is controversial, several studies have confirmed the potential role of titanium ions. Diffusion or entry of titanium ions into the circulation may be a scavenging effect on local titanium ions but can cause systemic adverse effects. However, existing measures are not yet able to balance reducing biocorrosion and maintaining osteogenic results, and the exploration of new materials requires long-term clinical data.

CONCLUSIONS

Titanium ions have potential impacts on peri-implant tissue and systemic circulation. Titanium ions are closely associated with bacterial biofilms in the occurrence and development of periimplantitis. The preventive strategies for the release and action of titanium ions remain to be explored.

CLINICAL RELEVANCE

Our findings may provide the hope of shedding light on the pathogenesis of peri-implantitis and its treatment.

Three-dimensional finite element analysis of the biomechanical properties of different material implants for replacing missing teeth

The purpose of this study was to analyze the biomechanical properties of implants made of different materials to replace missing teeth by using three-dimensional finite element analysis and provide a theoretic basis for clinical application. CBCT data was imported into the Mimics and 3-Matic to construct the three-dimensional finite element model of a missing tooth restored by an implant. Then, the model was imported into the Marc Mentat. Based on the variations of the implant materials (titanium, titanium-zirconia, zirconia and poly (ether-ether-ketone) (PEEK)) and bone densities (high and low), a total of eight models were created. An axial load of 150 N was applied to the crown of the implant to simulate the actual occlusal situation. Both the maximum values of stresses in the cortical bone and implant were observed in the Zr-low model. The maximum displacements of the implants were also within the normal range except for the PEEK models. The cancellous bone strains were mainly distributed in the apical area of the implant, and the maximum value (3225 μstrain) was found in PEEK-low model. Under the premise of the same implant material, the relevant data from various indices in low-density bone models were larger than that in high-density bone models. From the biomechanical point of view, zirconia, titanium and titanium-zirconia were all acceptable implant materials for replacing missing teeth and possessed excellent mechanical properties, while the application of PEEK material needs to be further optimized and modified.

Anodized SLM Ti6Al4V surfaces: influence of surface characteristics on NTs growth and resulted surfaces properties

TiO2 nanotubes (NTs) obtained via electrochemical anodization (EA) on conventionally machined titanium surfaces are reported to be promising for achieving mucointegration in dental implant therapy. Dental abutments, manufactured by selective laser melting (SLM), combined with thermal post-treatment, present a promising alternative to conventionally machined titanium. Based on an original protocol, this study aims to investigate how the characteristic microstructure of the α + β phases in post-heated SLM Ti6Al4V can influence the growth of NTs and the resulting physical and chemical surface properties. Ti6Al4V-SLM discs were fabricated, heat post-treated and mechanically polished. The samples were then subjected to EA under different voltage conditions (10, 20 and 30 V). The specimens' surfaces were characterized at the same location, before NTs formation by electron backscatter diffraction (EBSD), and after by scanning electron microscopy (SEM). Then, roughness and wettability were studied to determine how EA affects surface properties compared to conventionally machined and polished titanium surfaces without NTs (reference). Surface reactivity was evaluated through chemical analysis and collagen binding capacities. The self-organized TiO2 layer was developed on the α phase only and the β phase was preferentially dissolved. The characteristic dimensions of the nanotubes (diameter, length and wall thickness), measured by SEM image analysis, increased proportionally with the rise in voltage but were not affected by the crystallographic orientation of the underlying α grain. Micro-roughness was the same for nanotubular and reference surfaces. Wettability was improved, as was surface reactivity towards collagen, which may contribute to improved bioactivity of titanium surfaces in dentistry.

Nano-Based Approaches in Surface Modifications of Dental Implants: A Literature Review

Rehabilitation of fully or partially edentulous patients with dental implants represents one of the most frequently used surgical procedures. The work of Branemark, who observed that a piece of titanium embedded in rabbit bone became firmly attached and difficult to remove, introduced the concept of osseointegration and revolutionized modern dentistry. Since then, an ever-growing need for improved implant materials towards enhanced material-tissue integration has emerged. There is a strong belief that nanoscale materials will produce a superior generation of implants with high efficiency, low cost, and high volume. The aim of this review is to explore the contribution of nanomaterials in implantology. A variety of nanomaterials have been proposed as potential candidates for implant surface customization. They can have inherent antibacterial properties, provide enhanced conditions for osseointegration, or act as reservoirs for biomolecules and drugs. Titania nanotubes alone or in combination with biological agents or drugs are used for enhanced tissue integration in dental implants. Regarding immunomodulation and in order to avoid implant rejection, titania nanotubes, graphene, and biopolymers have successfully been utilized, sometimes loaded with anti-inflammatory agents and extracellular vesicles. Peri-implantitis prevention can be achieved through the inherent antibacterial properties of metal nanoparticles and chitosan or hybrid coatings bearing antibiotic substances. For improved corrosion resistance various materials have been explored. However, even though these modifications have shown promising results, future research is necessary to assess their clinical behavior in humans and proceed to widespread commercialization.

Ultrathin TiS2@N,S-Doped Carbon Hybrid Nanosheets as Highly Efficient Photoresponsive Antibacterial Agents

Nanobactericides are employed as a promising class of nanomaterials for eradicating microbial infections, considering the rapid resistance risks of conventional antibiotics. Herein, we present a pioneering approach, reporting the synthesis of two-dimensional titanium disulfide nanosheets coated by nitrogen/sulfur-codoped carbon nanosheets (2D-TiS2@NSCLAA hybrid NSs) using a rapid l-ascorbic acid-assisted sulfurization of Ti3C2Tx-MXene to achieve efficient alternative bactericides. The as-developed materials were systematically characterized using a suite of different spectroscopy and microscopy techniques, in which the X-ray diffraction/Raman spectroscopy/X-ray photoelectron spectroscopy data confirm the existence of TiS2 and C, while the morphological investigation reveals single- to few-layered TiS2 NSs confined by N,S-doped C, suggesting the successful synthesis of the ultrathin hybrid NSs. From in vitro evaluation, the resultant product demonstrates impressive bactericidal potential against both Gram-positive Staphylococcus aureus and Gram-negative Escherichia coli bacteria, achieving a substantial decrease in the bacterial viability under a 1.2 J dose of visible-light irradiation at the lowest concentration of 5 μg·mL-1 compared to Ti3C2Tx (15 μg·mL-1), TiS2-C (10 μg·mL-1), and standard antibiotic ciprofloxacin (15 μg·mL-1), respectively. The enhanced degradation efficiency is attributed to the ultrathin TiS2 NSs encapsulated within heteroatom N,S-doped C, facilitating effective photogenerated charge-carrier separation that generates multiple reactive oxygen species (ROS) and induced physical stress as well as piercing action due to its ultrathin structure, resulting in multimechanistic cytotoxicity and damage to bacterial cells. Furthermore, the obtained results from molecular docking studies conducted via computational simulation (in silico) of the as-synthesized materials against selected proteins (β-lactamasE. coli/DNA-GyrasE. coli) are well-consistent with the in vitro antibacterial results, providing strong and consistent validation. Thus, this sophisticated study presents a simple and effective synthesis technique for the structural engineering of metal sulfide-based hybrids as functionalized synthetic bactericides.

Influencing factors and evaluation methods for early stability of immediate implant

At present, implant restoration has become a hot research topic in the field of prosthodontics. The in-depth studies of new materials and new technologies enable immediate implantation, immediate and early loading to be realized, which meets the needs of patients for shortening the course of implant restoration and obtaining better aesthetic effects. However, compared with the traditional delayed implantation technology, it is equally challenging for clinicians how to achieve and even improve the initial and long-term stability of implants in order to raise the success rate of implant restoration. The initial stability of the implant is influenced by a combination of factors, including the implant, the patient's condition, and the surgical procedure. Recently, there have been a lot of studies on the influencing factors and common research methods for immediate implant stability and bone healing. Summarizing and analyzing them can provide reference for preoperative evaluation, surgical plan and loading timing of immediate implant restoration in the later stage.

The current applications of nano and biomaterials in drug delivery of dental implant

BACKGROUND AND AIM

Dental implantology has revolutionized oral rehabilitation, offering a sophisticated solution for restoring missing teeth. Despite advancements, issues like infection, inflammation, and osseointegration persist. Nano and biomaterials, with their unique properties, present promising opportunities for enhancing dental implant therapies by improving drug delivery systems. This review discussed the current applications of nano and biomaterials in drug delivery for dental implants.

METHOD

A literature review examined recent studies and advancements in nano and biomaterials for drug delivery in dental implantology. Various materials, including nanoparticles, biocompatible polymers, and bioactive coatings, were reviewed for their efficacy in controlled drug release, antimicrobial properties, and promotion of osseointegration.

RESULTS

Nano and biomaterials exhibit considerable potential in improving drug delivery for dental implants. Nanostructured drug carriers demonstrate enhanced therapeutic efficacy, sustained release profiles, and improved biocompatibility. Furthermore, bioactive coatings contribute to better osseointegration and reduced risks of infections.

CONCLUSION

Integrating current nano and biomaterials in drug delivery for dental implants holds promise for advancing clinical outcomes. Enhanced drug delivery systems can mitigate complications associated with dental implant procedures, offering improved infection control, reduced inflammation, and optimized osseointegration.

Surface-modified titanium and titanium-based alloys for improved osteogenesis: A critical review

As implantable materials, titanium, and its alloys have garnered enormous interest from researchers for dental and orthopedic procedures. Despite their success in wide clinical applications, titanium, and its alloys fail to stimulate osteogenesis, resulting in poor bonding strength with surrounding bone tissue. Optimizing the surface topology and altered compositions of titanium and titanium-based alloys substantially promotes peri-implant bone regeneration. This review summarizes the utilization and importance of various osteogenesis components loaded onto titanium and its alloys. Further, different surface-modification methods and the release efficacy of loaded substances are emphasized. Finally, we summarize the article with prospects. We believe that further investigation studies must focus on identifying novel loading components, exploring various innovative, optimized surface-modification methods, and developing a sustained-release system on implant surfaces to improve peri-implant bone formation.

Titanium particles in peri-implantitis: distribution, pathogenesis and prospects

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.

Emerging Applications of Nanotechnology in Dentistry

Dentistry is a branch of healthcare where nanobiotechnology is reverberating in multiple ways to produce beneficial outcomes. The purpose of this review is to bring into the awareness of the readers the various practical dimensions of the nano-dental complex (nanodentistry) in healthcare and how novelties linked with the field are revolutionizing dentistry. A methodological approach was adopted to collect the latest data on nanotechnology and dentistry from sources, including PubMed, Google Scholar, Scopus, and official websites like the WHO. Nanodentistry is an emerging field in dentistry that involves the use of nanomaterials, nanorobots, and nanotechnology to diagnose, treat, and prevent dental diseases. The results summarize the descriptive analyses of the uses of nanodentistry within orthodontics, preventive dentistry, prosthodontics, restorative dentistry, periodontics, dental surgeries, dental restoration technologies, and other areas of dentistry. The future directions of nano-industries and nano-healthcare have been included to link them with the oral healthcare sector, treatment plans, and improved medical services which could be explored in the future for advanced healthcare regulation. The major limitations to the use of dental nanoproducts are their cost-effectiveness and accessibility, especially in financially constrained countries. These data will help the readers to experience a detailed analysis and comprehensive covering of the diverse achievements of nanodentistry with past analyses, present scenarios, and future implications.

Fit and forget: The future of dental implant therapy via nanotechnology

Unlike orthopedic implants, dental implants require the orchestration of both osseointegration at the bone-implant interface and soft-tissue integration at the transmucosal region in a complex oral micro-environment with ubiquitous pathogenic bacteria. This represents a very challenging environment for early acceptance and long-term survival of dental implants, especially in compromised patient conditions, including aged, smoking and diabetic patients. Enabling advanced local therapy from the surface of titanium-based dental implants via novel nano-engineering strategies is emerging. This includes anodized nano-engineered implants eluting growth factors, antibiotics, therapeutic nanoparticles and biopolymers to achieve maximum localized therapeutic action. An important criterion is balancing bioactivity enhancement and therapy (like bactericidal efficacy) without causing cytotoxicity. Critical research gaps still need to be addressed to enable the clinical translation of these therapeutic dental implants. This review informs the latest developments, challenges and future directions in this domain to enable the successful fabrication of clinically-translatable therapeutic dental implants that would allow for long-term success, even in compromised patient conditions.

Improving Pure Titanium's Biological and Mechanical Characteristics through ECAP and Micro-Arc Oxidation Processes

Pure titanium is limited to be used in biomedical applications due to its lower mechanical strength compared to its alloy counterpart. To enhance its properties and improve medical implants feasibility, advancements in titanium processing technologies are necessary. One such technique is equal-channel angular pressing (ECAP) for its severe plastic deformation (SPD). This study aims to surface modify commercially pure titanium using micro-arc oxidation (MAO) or plasma electrolytic oxidation (PEO) technologies, and mineral solutions containing Ca and P. The composition, metallography, and shape of the changed surface were characterized using X-ray diffraction (XRD), digital optical microscopy (OM), and scanning electron microscope (SEM), respectively. A microhardness test is conducted to assess each sample's mechanical strength. The weight % of Ca and P in the coating was determined using energy dispersive spectroscopy (EDS), and the corrosion resistance was evaluated through potentiodynamic measurement. The behavior of human dental pulp cell and periodontal cell behavior was also studied through a biomedical experiment over a period of 1-, 3-, and 7-days using culture medium, and the cell death and viability can be inferred with the help of enzyme-linked immunosorbent assay (ELISA) since it can detect proteins or biomarkers secreted by cells undergoing apoptosis or necrosis. This study shows that the mechanical grain refinement method and surface modification might improve the mechanical and biomechanical properties of commercially pure (CP) titanium. According to the results of the corrosion loss measurements, 2PassMAO had the lowest corrosion rate, which is determined to be 0.495 mmpy. The electrode potentials for the 1-pass and 2-pass coated samples are 1.44 V and 1.47 V, respectively. This suggests that the coating is highly effective in reducing the corrosion rate of the metallic CP Ti sample. Changes in the grain size and the presence of a high number of grain boundaries have a significant impact on the corrosion resistance of CP Ti. For ECAPED and surface-modified titanium samples in a 3.6% NaCl electrolyte solution, electrochemical impedance spectroscopy (EIS) properties are similar to Nyquist and Bode plot fitting. In light of ISO 10993-5 guidelines for assessing in vitro cytotoxicity, this study contributes valuable insights into pulp and periodontal cell behavior, focusing specifically on material cytotoxicity, a critical factor determined by a 30% decrease in cell viability.