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Journal of Environmental Pathology,... 2023Dental implants are medical devices that are surgically inserted into the patient's jawbone by an orthodontist to act as roots of missing teeth. After the implantation,... (Review)
Review
Dental implants are medical devices that are surgically inserted into the patient's jawbone by an orthodontist to act as roots of missing teeth. After the implantation, the maxilla or mandible integrates with the surface of the dental implant. This process, called "osseointegration," is an important period to ensure the long-term use of dental implants and prevent implant failures. Metal implants are the most used implant materials. However, they have disadvantages such as corrosion, metal ion release from metal implant surfaces and associated toxicity. To avoid these adverse effects and improve osseointegration, alternative dental implant materials such as ceramics, polymers, composites, and novel surface modification technologies have been developed. The safety of these materials are also of concern for toxicologists. This review will give general information about dental implant materials, osseointegration and successful implantation process. Moreover, we will focus on the new surface coatings materials for of dental implants and their toxicity and safety concerns will be discussed.
Topics: Humans; Dental Implants; Surface Properties; Osseointegration; Maxilla; Mandible
PubMed: 36749088
DOI: 10.1615/JEnvironPatholToxicolOncol.2022043467 -
Advanced Science (Weinheim,... Oct 2023Owing to their mechanical resilience and non-toxicity, titanium implants are widely applied as the major treatment modality for the clinical intervention against bone... (Review)
Review
Owing to their mechanical resilience and non-toxicity, titanium implants are widely applied as the major treatment modality for the clinical intervention against bone fractures. However, the intrinsic bioinertness of Ti and its alloys often impedes the effective osseointegration of the implants, leading to severe adverse complications including implant loosening, detachment, and secondary bone damage. Consequently, new Ti implant engineering strategies are urgently needed to improve their osseointegration after implantation. Remarkably, metalorganic frameworks (MOFs) are a class of novel synthetic material consisting of coordinated metal species and organic ligands, which have demonstrated a plethora of favorable properties for modulating the interfacial properties of Ti implants. This review comprehensively summarizes the recent progress in the development of MOF-coated Ti implants and highlights their potential utility for modulating the bio-implant interface to improve implant osseointegration, of which the discussions are outlined according to their physical traits, chemical composition, and drug delivery capacity. A perspective is also provided in this review regarding the current limitations and future opportunities of MOF-coated Ti implants for orthopedic applications. The insights in this review may facilitate the rational design of more advanced Ti implants with enhanced therapeutic performance and safety.
Topics: Osseointegration; Metal-Organic Frameworks; Titanium; Prostheses and Implants; Bone and Bones
PubMed: 37705110
DOI: 10.1002/advs.202303958 -
International Journal of Nanomedicine 2022Titanium implants have been widely applied in dentistry and orthopedics due to their biocompatibility and resistance to mechanical fatigue. TiO nanotube arrays (TiO... (Review)
Review
Titanium implants have been widely applied in dentistry and orthopedics due to their biocompatibility and resistance to mechanical fatigue. TiO nanotube arrays (TiO NTAs) on titanium implant surfaces have exhibited excellent biocompatibility, bioactivity, and adjustability, which can significantly promote osseointegration and participate in its entire path. In this review, to give a comprehensive understanding of the osseointegration process, four stages have been divided according to pivotal biological processes, including protein adsorption, inflammatory cell adhesion/inflammatory response, additional relevant cell adhesion and angiogenesis/osteogenesis. The impact of TiO NTAs on osseointegration is clarified in detail from the four stages. The nanotubular layer can manipulate the quantity, the species and the conformation of adsorbed protein. For inflammatory cells adhesion and inflammatory response, TiO NTAs improve macrophage adhesion on the surface and induce M2-polarization. TiO NTAs also facilitate the repairment-related cells adhesion and filopodia formation for additional relevant cells adhesion. In the angiogenesis and osteogenesis stage, TiO NTAs show the ability to induce osteogenic differentiation and the potential for blood vessel formation. In the end, we propose the multi-dimensional regulation of TiO NTAs on titanium implants to achieve highly efficient manipulation of osseointegration, which may provide views on the rational design and development of titanium implants.
Topics: Adsorption; Osseointegration; Osteogenesis; Surface Properties; Titanium
PubMed: 35518451
DOI: 10.2147/IJN.S362720 -
The Journal of Hand Surgery, European... May 2022The long-term outcomes of osseointegration for digital amputations are not well established, and it is not known whether osseointegration can achieve similar function...
The long-term outcomes of osseointegration for digital amputations are not well established, and it is not known whether osseointegration can achieve similar function and patient satisfaction to conventional surgical options such as replantation and microsurgical toe transfer. We compared the long-term outcomes after digital osseointegration and replantation. Six patients treated by osseointegration and seven patients treated by replantation were included, with median follow-ups of 8 years and 4.6 years, respectively. Outcomes were assessed using the Michigan Hand Outcomes Questionnaire, grip and pinch strength, range of motion, two-point discrimination, Semmes-Weinstein tests, Jebsen-Taylor Hand Function Test and clinical photography. Osseointegration was associated with poorer sensibility and range of motion than replantation; no other differences reached statistical significance. Long-term osseointegration is a safe and effective reconstructive option that can deliver excellent outcomes in appropriately selected patients. IV.
Topics: Amputation, Surgical; Amputation, Traumatic; Finger Injuries; Humans; Osseointegration; Replantation
PubMed: 34278813
DOI: 10.1177/17531934211030752 -
ACS Biomaterials Science & Engineering Jun 2023Research on regeneration and accelerated recovery processes of bone tissue has driven a growing interest in the scientific community. Implementing natural materials to... (Review)
Review
Research on regeneration and accelerated recovery processes of bone tissue has driven a growing interest in the scientific community. Implementing natural materials to reduce rejections due to biocompatibility issues is an important trend. Biofunctionalization processes have been proposed to promote osseointegration in implant materials, and those substances able to generate an adequate environment for cell proliferation are the object of several studies. Because of their high protein content and their anti-inflammatory, antibacterial, antimicrobial, and healing properties, microalgae represent a natural source of bioactive compounds, and are proposed as candidates for tissue regeneration applications. In this paper microalgae are reviewed as a source of biofunctionalized materials focused on orthopedic applications.
Topics: Microalgae; Osseointegration; Bone and Bones; Wound Healing
PubMed: 37227297
DOI: 10.1021/acsbiomaterials.2c01389 -
Sovremennye Tekhnologii V Meditsine 2021was to study the influence of pore size and the presence of a biologically active calcium phosphate coating in porous 3D printed titanium implants on the process of...
UNLABELLED
was to study the influence of pore size and the presence of a biologically active calcium phosphate coating in porous 3D printed titanium implants on the process of integration with the bone tissue.
MATERIALS AND METHODS
Samples of cylindrical implants with three different pore diameters (100, 200, and 400 μm) were fabricated from titanium powder on the Arcam 3D printer (Sweden) using electron beam melting technology. A calcium phosphate coating with a thickness of 20±4 μm was applied to some of the products by microarc oxidation. Cytotoxicity of the implants was determined on human dermal fibroblast cultures. The samples were implanted in the femoral bones of 36 rabbits . The animals were divided into 6 groups according to the bone implant samples. The prepared samples and peri-implant tissues were studied on days 90 and 180 after implantation using scanning electron microscopy and histological methods.
RESULTS
All samples under study were found to be non-toxic and well biocompatible with the bone tissue. There were revealed no differences between coated and non-coated implants of 100 and 200 μm pore diameters in terms of their histological structure, intensity of vascularization in the early stages, and bone formation in the later stages. Samples with pore diameters of 100 and 200 μm were easily removed from the bone tissue, the depth of bone growth into the pores of the implant was lower than in the samples with pore diameter of 400 μm (p<0.001). There were differences between coated and non-coated samples of 400 μm pore diameter, which was expressed in a more intensive osseointegration of samples with calcium phosphate coating (p<0.05).
CONCLUSION
The optimal surface characteristics of the material for repairing bone defects are a pore diameter of 400 μm and the presence of a calcium phosphate coating.
Topics: Animals; Calcium Phosphates; Coated Materials, Biocompatible; Osseointegration; Porosity; Rabbits; Surface Properties; Titanium
PubMed: 34513077
DOI: 10.17691/stm2021.13.2.06 -
Tissue Engineering. Part A Jun 2022Dental implants represent an illustrative example of successful medical devices used in increasing numbers to aid (partly) edentulous patients. Particularly in spite of... (Review)
Review
Dental implants represent an illustrative example of successful medical devices used in increasing numbers to aid (partly) edentulous patients. Particularly in spite of the percutaneous nature of dental implant systems, their clinical success is remarkable. This clinical success is at least partly related to the effective surface treatment of the artificial dental root, providing appropriate physicochemical properties to achieve osseointegration. The demographic changes in the world, however, with a rapidly increasing life expectancy and an increase in patients suffering from comorbidities that affect wound healing and bone metabolism, make that the performance of dental implants requires continuous improvement. An additional factor endangering the clinical success of dental implants is peri-implantitis, which affects both the soft and hard tissue interactions with dental implants. In this study, we shed light on the optimization of dental implant surfaces through surface engineering. Depending on the region along the artificial dental root, different properties of the surface are required to optimize prevailing tissue response to facilitate osseointegration, improve soft tissue attachment, and exert antibacterial efficacy. As such, surface engineering represents an important tool for assuring the continued future success of dental implants. Impact Statement Dental implants represent a common treatment modality nowadays for the replacement of lost teeth or fixation of prosthetic devices. This review provides a detailed overview of the role of surface engineering for dental implants and their components to optimize tissue responses at the different regions along the artificial dental root. The surface properties steering immunomodulatory processes, facilitating osseointegration, and rendering antibacterial efficacy (at both artificial root and abutment region) are described. The review finally concludes that surface engineering provides a tool to warrant that dental implants will remain future proof in more challenging applications, including an aging patient population and comorbidities that affect bone metabolism and wound healing.
Topics: Anti-Bacterial Agents; Dental Implants; Humans; Osseointegration; Surface Properties; Wound Healing
PubMed: 35350848
DOI: 10.1089/ten.TEA.2021.0230 -
Advanced Healthcare Materials Jun 2021Aseptic loosening of a permanent prosthesis remains one of the most common reasons for bone implant failure. To improve the fixation between implant and bone tissue as... (Review)
Review
Aseptic loosening of a permanent prosthesis remains one of the most common reasons for bone implant failure. To improve the fixation between implant and bone tissue as well as enhance blood vessel formation, bioactive agents are incorporated into the surface of the biomaterial. This study reviews and compares five bioactive elements (copper, magnesium, silicon, strontium, and zinc) with respect to their effect on the angiogenic behavior of endothelial cells (ECs) when incorporated on the surface of biomaterials. Moreover, it provides an overview of the state-of-the-art methodologies used for the in vitro assessment of the angiogenic properties of these elements. Two databases are searched using keywords containing ECs and copper, magnesium, silicon, strontium, and zinc. After applying the defined inclusion and exclusion criteria, 59 articles are retained for the final assessment. An overview of the angiogenic properties of five bioactive elements and the methods used for assessment of their in vitro angiogenic potential is presented. The findings show that silicon and strontium can effectively enhance osseointegration through the simultaneous promotion of both angiogenesis and osteogenesis. Therefore, their integration onto the surface of biomaterials can ultimately decrease the incidence of implant failure due to aseptic loosening.
Topics: Biocompatible Materials; Endothelial Cells; Osseointegration; Osteogenesis; Strontium
PubMed: 34036754
DOI: 10.1002/adhm.202002254 -
Journal of Biomedical Materials... Mar 2021Osseointegration is defined by a stable and functional union between bone and a surface of a material. This phenomenon is influenced by the geometric and surface... (Review)
Review
Osseointegration is defined by a stable and functional union between bone and a surface of a material. This phenomenon is influenced by the geometric and surface characteristics of the part where the bone cells will attach. A wide variety of studies proves that ceramic materials are strong competitors against conventional metals in the scope of bone tissue engineering. Ceramic scaffolds, porous structures that allow bone ingrowth, have been studied to enhance the osseointegration phenomenon. Geometric and dimensional parameters of the scaffold have influence in its performance as mechanical and structural supporter of bone growth. However, these parameters are conditioned by the manufacturing process by which these scaffolds are obtained. Several studies focusing on the production process of ceramic scaffolds have been developed, using 3D printing, stereolithography, selective laser sintering, green machining, robocasting, and others. The main purpose of this work is to evaluate and compare the different manufacturing processes by which ceramic scaffolds can be produced. This comparison addresses scaffold parameters like pore size, pore shape, porosity percentage, roughness, and so forth. Additionally, the different materials used in different manufacturing processes are also mentioned and discussed given its influence on a successful osseointegration while simultaneously displaying adequate mechanical properties. After making a screening on the available ceramic scaffolds manufacturing processes, several examples are presented, proving the potential of each of these manufacturing process for a given scaffold geometry.
Topics: Animals; Biocompatible Materials; Bone Substitutes; Bone and Bones; Ceramics; Humans; Materials Testing; Osseointegration; Porosity; Printing, Three-Dimensional; Tissue Engineering; Tissue Scaffolds
PubMed: 32924277
DOI: 10.1002/jbm.b.34706 -
Lasers in Medical Science Sep 2023Despite their high success rates, peri-implantitis can affect the stability and function of dental implants. Various treatment modalities have been investigated for the...
Despite their high success rates, peri-implantitis can affect the stability and function of dental implants. Various treatment modalities have been investigated for the treatment of peri-implantitis to achieve re-osseointegration. An electronic literature search was performed supplemented by a manual search to identify studies published until January 2022. Articles that evaluated re-osseointegration in peri-implantitis sites in animal models following laser therapy or antimicrobial photodynamic therapy (aPDT) were included. Case reports, case series, systematic reviews, and letters to the editor were excluded. Risk of bias and GRADE assessment were followed to evaluate the quality of the evidence. Six studies out of 26 articles identified on electronic search were included in this review. The studies included animal studies conducted on canine models. Four out of six studies reported a higher degree of re-osseointegration following treatment of implants with laser therapy. The findings suggest that laser decontamination shows potential in enhancing re-osseointegration, particularly with the Er: YAG laser, which effectively decontaminated implant surfaces. However, conflicting outcomes and limitations in the evidence quality warrant caution in drawing definitive conclusions. Based on the limited available evidence, laser therapy may show a higher degree of re-osseointegration of implants than mechanical debridement.
Topics: Animals; Dental Implants; Lasers; Osseointegration; Peri-Implantitis; Photochemotherapy
PubMed: 37658921
DOI: 10.1007/s10103-023-03860-9