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K S K, Sreevidya B, T K R, Bm D, Dedeepya NR, Kamal Badiyani B, Kumar A. Comparative Analysis of Surface Modification Techniques for Assessing Oral Implant Osseointegration: An Animal Study. Cureus 2024; 16:e54014. [PMID: 38476793 PMCID: PMC10928455 DOI: 10.7759/cureus.54014] [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: 11/16/2023] [Accepted: 02/11/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Effective implant placement depends critically on the implant's level of osseointegration with the alveolar bone. To increase osseointegration during implant placement, research has concentrated on the surface modification of implants, and morphological analyses have looked at the thread pattern in close interaction with the bone's surface. AIM This study aimed to assess and compare the extent of oral implant osseointegration in different surface modification techniques. MATERIALS AND METHODS In this study, 12 healthy adult dogs aged 18-24 months were used. Tooth extractions were performed on both sides of the mandible, and wounds were closed with sutures. Two months later, the right mandible of each dog underwent local anesthesia and general anesthesia. Four different implant types were placed based on their surface treatments: resorbable blast media (RBM)-treated implants, hydroxyapatite (HA) implants with an ultra-thin HA film, hydrothermal-treated HA implants coated with HA, and sandblasting combined acid etching (SLA) implants treated with plasma spray and acid etching. A total of 48 implants were divided into two- and four-week groups, with identical dimensions. Each dog received two implants from each group, for a total of eight implants per dog. The implants were securely placed into the superior alveolar bone with a torque greater than 35-N up to a depth of 1 mm. Periotest M (Medizintechnik Gulden e.K., Modautal, Germany) was used to calculate the periotest value (PTV) as a typical value on the buccal side of each implant immediately following placement and sacrifice to test the main fixation and stability of the implants. Resonance frequency analysis (RFA) was utilised by Osstell Mentor (Osstell AB, Gothenburg, Sweden) to simultaneously assess the implant stability quotient (ISQ) on the medial, distal, buccal, and lingual sides of the implant. The rotational torque in one of the sacrificed dogs was calculated using the MGT 50 (ELECTROMATIC Equipment Co., Inc., New York, USA) torque analyzer. The histomorphometric evaluation was performed using an optical microscope (Olympus Corporation, Tokyo, Japan). The upper half's bone-implant contact (BIC), which was found to be more important for implant stability, was studied together with the ratio of the new bone formation area (NBFA) to the complete implant. RESULTS The maximum stability was observed in HA-treated implants in the fourth week. The minimum stability was observed in hydrothermal-treated HA implants in the fourth week. The stability in each group was greater in the four-week evaluation as compared to the two-week evaluation. The stability was satisfactory in almost all implants at two- and three-week evaluations. The maximum value of the percentage area of newly formed bone at the two- and four-week evaluations was observed in HA-treated implants. The minimum value of the percentage of the area of newly formed bone at two- and four-week evaluations was observed in SLA and RBM-treated implants respectively. The difference was significant statistically (p ≤ 0.05). CONCLUSION All implant surface modifications, in general, produced satisfactory osseointegration. Excellent osseointegration was seen in the upper portion of the implant with hydrothermally treated HA.
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Affiliation(s)
- Karthik K S
- Department of Prosthodontics and Implantology, KGF (Kolar Gold Fields) College of Dental Sciences, Kolar, IND
| | - B Sreevidya
- Department of Oral and Maxillofacial Surgery, KGF (Kolar Gold Fields) College of Dental Sciences, Kolar, IND
| | - Ramya T K
- Department of Oral Medicine and Radiology, KGF (Kolar Gold Fields) College of Dental Sciences, Kolar, IND
| | - Divya Bm
- Department of Public Health Dentistry, D. A. Pandu Memorial RV (Rashtreeya Vidyalaya) Dental College, Bangalore, IND
| | - N R Dedeepya
- Department of Prosthodontics and Implantology, KGF (Kolar Gold Fields) College of Dental Sciences, Kolar, IND
| | - Bhumika Kamal Badiyani
- Department of Public Health Dentistry, Interdental Multispeciality Dental Clinic, Mumbai, IND
| | - Amit Kumar
- Department of Public Health Dentistry, Interdental Multispeciality Dental Clinic, Mumbai, IND
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Ferrés-Amat E, Al Madhoun A, Ferrés-Amat E, Al Demour S, Ababneh MA, Ferrés-Padró E, Marti C, Carrio N, Barajas M, Atari M. Histologic and Histomorphometric Evaluation of a New Bioactive Liquid BBL on Implant Surface: A Preclinical Study in Foxhound Dogs. MATERIALS 2021; 14:ma14206217. [PMID: 34683810 PMCID: PMC8540508 DOI: 10.3390/ma14206217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/10/2021] [Accepted: 10/16/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bioactive chemical surface modifications improve the wettability and osseointegration properties of titanium implants in both animals and humans. The objective of this animal study was to investigate and compare the bioreactivity characteristics of titanium implants (BLT) pre-treated with a novel bone bioactive liquid (BBL) and the commercially available BLT-SLA active. METHODS Forty BLT-SLA titanium implants were placed in in four foxhound dogs. Animals were divided into two groups (n = 20): test (BLT-SLA pre-treated with BBL) and control (BLT-SLA active) implants. The implants were inserted in the post extraction sockets. After 8 and 12 weeks, the animals were sacrificed, and mandibles were extracted, containing the implants and the surrounding soft and hard tissues. Bone-to-implant contact (BIC), inter-thread bone area percentage (ITBA), soft tissue, and crestal bone loss were evaluated by histology and histomorphometry. RESULTS All animals were healthy with no implant loss or inflammation symptoms. All implants were clinically and histologically osseo-integrated. Relative to control groups, test implants demonstrated a significant 1.5- and 1.7-fold increase in BIC and ITBA values, respectively, at both assessment intervals. Crestal bone loss was also significantly reduced in the test group, as compared with controls, at week 8 in both the buccal crests (0.47 ± 0.32 vs 0.98 ± 0.51 mm, p < 0.05) and lingual crests (0.39* ± 0.3 vs. 0.89 ± 0.41 mm, p < 0.05). At week 12, a pronounced crestal bone loss improvement was observed in the test group (buccal, 0.41 ± 0.29 mm and lingual, 0.54 ± 0.23 mm). Tissue thickness showed comparable values at both the buccal and lingual regions and was significantly improved in the studied groups (0.82-0.92 mm vs. 33-48 mm in the control group). CONCLUSIONS Relative to the commercially available BLT-SLA active implants, BLT-SLA pre-treated with BBL showed improved histological and histomorphometric characteristics indicating a reduced titanium surface roughness and improved wettability, promoting healing and soft and hard tissue regeneration at the implant site.
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Affiliation(s)
- Eduard Ferrés-Amat
- Oral and Maxillofacial Surgery Service, Hospital HM Nens, HM Hospitales, 08009 Barcelona, Spain; (E.F.-A.); (E.F.-A.); (E.F.-P.)
| | - Ashraf Al Madhoun
- Department of Animal and Imaging Core Facilities, Dasman Diabetes Institute, Dasman 15462, Kuwait;
| | - Elvira Ferrés-Amat
- Oral and Maxillofacial Surgery Service, Hospital HM Nens, HM Hospitales, 08009 Barcelona, Spain; (E.F.-A.); (E.F.-A.); (E.F.-P.)
- Oral and Maxillofacial Surgery Department, Universitat Internacional de Catalunya, St Josep Trueta s/n, Sant Cugat del Vallès, 08195 Barcelona, Spain;
| | - Saddam Al Demour
- Department of Special Surgery/Division of Urology, School of Medicine, The University of Jordan, Amman 11942, Jordan;
| | - Mera A. Ababneh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Eduard Ferrés-Padró
- Oral and Maxillofacial Surgery Service, Hospital HM Nens, HM Hospitales, 08009 Barcelona, Spain; (E.F.-A.); (E.F.-A.); (E.F.-P.)
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
| | - Carles Marti
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
- Oral and Maxillofacial Surgery Department, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
| | - Neus Carrio
- Oral and Maxillofacial Surgery Department, Universitat Internacional de Catalunya, St Josep Trueta s/n, Sant Cugat del Vallès, 08195 Barcelona, Spain;
| | - Miguel Barajas
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
- Biochemistry Area, Department of Health Science, Public University of Navarre, 31008 Pamplona, Spain
| | - Maher Atari
- Biointelligent Technology Systems SL, Diputaccion 316, 3D, 08009 Barcelona, Spain; (C.M.); (M.B.)
- Ziacom Medical SL, C. Buhos, 2, 28320 Madrid, Spain
- Correspondence:
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Lei X, Liu Q, Li S, Zhang Z, Yang X. Effects of fluid shear stress on expression of focal adhesion kinase in MG-63 human osteoblast-like cells on different surface modification of titanium. Bioengineered 2021; 12:4962-4971. [PMID: 34374319 PMCID: PMC8806473 DOI: 10.1080/21655979.2021.1962686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to investigate the effect of fluid shear stress (FSS) on cell proliferation and expression of focal adhesion kinase (FAK) in MG-63 cells on different modified titanium surfaces. MG63 cells were cultured on three different surfaces: glass slide, polished treatment (PT) titanium surface and sandblasted/acid-etched surfaces (SLA) titanium surface. The surface topography and roughness were evaluated by scanning electron microscopy (SEM) and atomic force microscopy (AFM), respectively. The cells were subjected to FSS, and the cell appearance before and after the stress was evaluated. MTT assay was applied to estimate cell proliferation. The mRNA and protein levels of FAK were determined by qRT-PCR and western blotting. Titanium plates demonstrated different surface microtopography. Parameter Ra values of SLA group were around 3.4 µm, which was higher than PT group. Exposure to the FSS of 12 dynes/cm2 significantly induced positive upregulation of cellular proliferation and the expression of FAK, which were directly correlated with the duration of exposure and surface. Cells in SLA group were able to endurance the longtime of FSS, especially under the FSS of 16 dynes/cm2. SLA surface had a positive influence on the expression of FAK. Different surface modifications created different microtopography of titanium plates. Cell proliferation and the mRNA and protein expression of FAK were stimulated by FSS and regulated by a marked synergistic effect of surface topography and the level and duration of FSS.
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Affiliation(s)
- Xin Lei
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Qiong Liu
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
| | - Shiyi Li
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
| | - Zhaoqiang Zhang
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
| | - Xiaoyu Yang
- Stomatological Hospital, Southern Medical University, Guangzhou Guangdong, China
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Influence of Three Dental Implant Surfaces on Cell Viability and Bone Behavior. An In Vitro and a Histometric Study in a Rabbit Model. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10144790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The chemical composition and the surface characteristics of dental implants are factors that have a decisive effect on the osseointegration process. The surface characterization at the compositional and topographic level of three dental implants available in the market was performed with different surface treatments: (1) sandblasted and acid etched surface (SLA), (2) hydroxyapatite (HA) and tricalcium phosphate (TCP) blasted surface (HA/TCP), and (3) HA-blasted and non-etching acid washed surface (HA + AW). In addition, an in vitro viability study of MG-63 osteoblast cells was performed with a JC-1 test. To complete the study, an in vivo study was conducted in New Zealand rabbits. The study analyzed the histometric characteristics of the bone formed around the implants at the level of area, volume, bone density, accumulated bone density, and bone–implant contact (BIC). The rabbits were sacrificed at 6 weeks after implants were placed in the tibial metaphysis. No statistically significant differences were observed at the level of cell viability or histometric parameters between the different study groups (p > 0.05). SLA and HA/TCP surfaces were the ones that obtained a higher BIC value. Taking into account the limitations of this study, it can be concluded that the different implant surfaces analyzed favor a good bone response.
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Witek L, Tovar N, Lopez CD, Morcos J, Bowers M, Petrova RS, Coelho PG. Assessing osseointegration of metallic implants with boronized surface treatment. Med Oral Patol Oral Cir Bucal 2020; 25:e311-e317. [PMID: 32271322 PMCID: PMC7211368 DOI: 10.4317/medoral.23175] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 03/21/2020] [Indexed: 11/05/2022] Open
Abstract
Background Modification of endosteal implants through surface treatments have been investigated to improve osseointegration. Boronization has demonstrated favorable mechanical properties, but limited studies have assessed translational, in vivo outcomes. This study investigated the effect of implant surface boronization on bone healing.
Material and Methods Two implant surface roughness profiles (acid etched, machined) in CP titanium (type II) alloy implants were boronized by solid-state diffusion until 10-15µm boron coating was achieved. The surface-treated implants were placed bilaterally into 5 adult sheep ilia for three and six weeks. Four implant groups were tested: boronized machined (BM), boronized acid-etched (BAA), control machined (CM), and control acid-etched (CAA). Osseointegration was quantified by calculating bone to implant contact (BIC) and bone area fraction occupancy (BAFO).
Results Both implant types treated with boronization had BIC values not statistically different from machined control implants at t=3 weeks, and significantly less than acid-etched control (p<0.02). BAFO values were not statistically different for all 3-week groups except machined control (significantly less at p<0.02). BAFO had a significant downward trend from 3 to 6 weeks in both boronized implant types (p<0.03) while both control implant types had significant increases in BIC and BAFO from 3 to 6 weeks.
Conclusions Non-decalcified histology depicted intramembranous-like healing/remodeling in bone for controls, but an absence of this dynamic process in bone for boronized implants. These findings are inconsistent with in vitro work describing bone regenerative properties of elemental Boron and suggests that effects of boron on in vivo bone healing warrant further investigation. Key words:Boronization, acid-etched, machined, implants, osseointegration, in vivo, solid-state diffusion.
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Affiliation(s)
- L Witek
- 433 1st Ave, Room 842 New York University College of Dentistry Department of Biomaterials and Biomimetics New York, NY
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Kang DW, Kim SH, Choi YH, Kim YK. Repeated failure of implants at the same site: a retrospective clinical study. Maxillofac Plast Reconstr Surg 2019; 41:27. [PMID: 31355159 PMCID: PMC6616583 DOI: 10.1186/s40902-019-0209-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Implants are becoming the first choice of rehabilitation for tooth loss. Even though they have a high success rate, failures still occur for many reasons. The objective of this study is to analyze the reasons for recurring failure at the same site and the results of re-implantation. Methods Thirteen patients (11 males and 2 females, mean age 60 ± 9.9 years) who experienced implant surgery failure at the same site (same tooth extraction area) two or more times in the Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, between 2004 and 2017 were selected. The medical records on a type, sites, diameter, and length of implants; time and estimated cause of failure; and radiographs were reviewed. Data were collected and analyzed retrospectively, and the current statuses were evaluated. Results A total of 14 implants experienced failure in the same site more than two times. Twelve implants were placed in the maxilla, while 2 implants were placed in the mandible. The maxillary molar area was the most common site of failure (57.1%), followed by the mandibular molar, anterior maxilla, and premolar areas (14.3% each).The first failure occurred most commonly after prosthetic treatment (35.7%) with an average period of failure of 3.8 months after loading. Ten cases were treated as immediate re-implantation, while the other 4 were delayed re-implantation after an average of 3.9 months. The second failure occurred most commonly after prosthetic treatment (42.9%), with an average of 31 months after loading; during the healing period (42.9%); and during the ongoing prosthetic period (14.3%). In 3 cases (21.4%), the treatment plan was altered to an implant bridge, while the other 11 cases underwent another implant placement procedure (78.6%).Finally, a total of 9 implants (64.3%) survived, with an average functioning period of 60 months. Conclusions Implants can fail repeatedly at the same site due to overloading, infection, and other unspecified reasons. The age and sex of the patient and the location of implant placement seem to be associated with recurring failure. Type of implant, bone augmentation, and bone materials used are less relevant.
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Affiliation(s)
- Dong-Woo Kang
- 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 Korea
| | - So-Hyun Kim
- 2Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yong-Hoon Choi
- 3Department of Conservative Dentistry, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Kyun Kim
- 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 Korea.,4Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Jang TH, Park JH, Moon W, Chae JM, Chang NY, Kang KH. Effects of acid etching and calcium chloride immersion on removal torque and bone-cutting ability of orthodontic mini-implants. Am J Orthod Dentofacial Orthop 2018; 154:108-114. [DOI: 10.1016/j.ajodo.2017.10.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 10/01/2017] [Accepted: 10/01/2017] [Indexed: 11/30/2022]
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