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Biomedical Papers of the Medical... Mar 2020Titanium surface treatment is a crucial process for achieving sufficient osseointegration of an implant into the bone. If the implant does not heal sufficiently, serious... (Review)
Review
Titanium surface treatment is a crucial process for achieving sufficient osseointegration of an implant into the bone. If the implant does not heal sufficiently, serious complications may occur, e.g. infection, inflammation, aseptic loosening of the implant, or the stress-shielding effect, as a result of which the implant may need to be reoperated. After a titanium graft has been implanted, several interactions are crucial in order to create a strong bone-implant connection. It is essential that cells adhere to the surface of the implant. Surface roughness has a significant influence on cell adhesion, and also on improving and accelerating osseointegration. Other highly important factors are biocompatibility and resistance to bacterial contamination. Bio-inertness of titanium is ensured by the protective film of titanium oxides that forms spontaneously on its surface. This film prevents the penetration of metal compounds, and it is well-adhesive for calcium and phosphate ions, which are necessary for the formation of the mineralized bone structure. Since the presence of the film alone is not sufficient for the biocompatibility of titanium, a suitable surface finish is required to create a firm bone-implant connection. In this review, we explain and compare the most widely-used methods for modulating the surface roughness of titanium implants in order to enhance cell adhesion on the surface of the implant, e.g. plasma spraying, sandblasting, acid etching, laser treatment, sol-gel etc., The methods are divided into three overlapping groups, according to the type of modification.
Topics: Coated Materials, Biocompatible; Humans; Osseointegration; Prostheses and Implants; Titanium
PubMed: 31907491
DOI: 10.5507/bp.2019.062 -
Journal of Biomedical Materials... Jun 2022Tantalum (Ta) and its alloys have been used for various cardiovascular, orthopedic, fracture fixation, dental, and spinal fusion implants. This review evaluates the... (Review)
Review
Tantalum (Ta) and its alloys have been used for various cardiovascular, orthopedic, fracture fixation, dental, and spinal fusion implants. This review evaluates the biological and material properties of Ta and its alloys. Specifically, the biological properties including hemocompatibility and osseointegration, and material properties including radiopacity, MRI compatibility, corrosion resistance, surface characteristics, semiconductivity, and mechanical properties are covered. This review highlights how the material properties of Ta and its alloys contribute to its excellent biological properties for use in implants and medical devices.
Topics: Alloys; Biocompatible Materials; Corrosion; Materials Testing; Osseointegration; Surface Properties; Tantalum; Titanium
PubMed: 35156305
DOI: 10.1002/jbm.a.37373 -
Biomaterials Aug 2021Genetically modified cell sheet technology is emerging as a promising biomedical tool to deliver therapeutic genes for regenerative medicine and tissue engineering.... (Review)
Review
Genetically modified cell sheet technology is emerging as a promising biomedical tool to deliver therapeutic genes for regenerative medicine and tissue engineering. Virus-based gene transfection and non-viral gene transfection have been used to fabricate genetically modified cell sheets. Preclinical and clinical studies have shown various beneficial effects of genetically modified cell sheets in the regeneration of bone, periodontal tissue, cartilage and nerves, as well as the amelioration of dental implant osseointegration, myocardial infarction, skeletal muscle ischemia and kidney injury. Furthermore, this technology provides a potential treatment option for various hereditary diseases. However, the method has several limitations, such as safety concerns and difficulties in controlling transgene expression. Therefore, recent studies explored efficient and safe gene transfection methods, prolonged and controllable transgene expression and their potential application in personalized and precision medicine. This review summarizes various types of genetically modified cell sheets, preparation procedures, therapeutic applications and possible improvements.
Topics: Bone and Bones; Cartilage; Osseointegration; Regenerative Medicine; Tissue Engineering
PubMed: 34119885
DOI: 10.1016/j.biomaterials.2021.120908 -
Clinical Oral Investigations Apr 2022To evaluate re-osseointegration after electrolytic cleaning and regenerative therapy of dental implants with peri-implantitis in humans.
OBJECTIVE
To evaluate re-osseointegration after electrolytic cleaning and regenerative therapy of dental implants with peri-implantitis in humans.
MATERIAL AND METHODS
Four dental implants that developed peri-implantitis underwent electrolytic cleaning followed by regenerative therapy with guided bone regeneration. All four implants developed recurrent peri-implantitis and were therefore explanted 6 to 13 months later. Radiographic bone level, probing depth, and bleeding on probing were determined at the time of surgery, 6 months later, and before implant retrieval. The peri-implant tissues were histologically and histomorphometrically analyzed.
RESULTS
All four implants demonstrated radiographic and histological bone gain, reduced probing depth, and bleeding on probing. Radiographic bone gain was 5.8 mm mesially and 4.8 mm distally for implant #1, 3.3 mm and 2.3 mm for implant #2, 3.1 mm and 0.5 mm for implant #3, and 3.5 mm and 2.8 mm for implant #4. The histometric mean and maximum vertical bone gain for implant #1 to #4 was 1.65 mm and 2.54 mm, 3.04 mm and 3.47 mm, 0.43 mm and 1.27 mm, and 4.16 mm and 5.22 mm, respectively. The percentage of re-osseointegration for implant #1 to #4 was 21.0%, 36.9%, 5.7%, and 39.0%, respectively. In one implant, the newly formed bone was deposited directly onto calculus on the implant surface.
CONCLUSIONS
We found that (1) re-osseointegration is possible on a formerly contaminated implant surface and (2) the electrolytic cleaning process seems to be effective enough at sites with calculus residues.
CLINICAL RELEVANCE
Since re-osseointegration can be achieved by electrolytic cleaning, this decontamination technique may be considered as a future treatment concept.
Topics: Bone Regeneration; Dental Implants; Humans; Osseointegration; Peri-Implantitis
PubMed: 35244779
DOI: 10.1007/s00784-021-04345-1 -
The International Journal of Oral &... 2023To evaluate the performance of one- and two-piece ceramic implants regarding implant survival and success and patient satisfaction. This review followed the PRISMA... (Meta-Analysis)
Meta-Analysis
To evaluate the performance of one- and two-piece ceramic implants regarding implant survival and success and patient satisfaction. This review followed the PRISMA 2020 guidelines using PICO format and analyzed clinical studies of partially or completely edentulous patients. The electronic search was conducted in PubMed/MEDLINE using Medical Subject Headings (MeSH) keywords related to dental zirconia ceramic implants, and 1,029 records were received for detailed screening. The data obtained from the literature were analyzed by single-arm, weighted meta-analyses using a random-effects model. Forest plots were used to synthesize pooled means and 95% CI for the change in marginal bone level (MBL) for short-term (1 year), mid-term (2 to 5 years), and long-term (over 5 years) follow-up time intervals. Among the 155 included studies, the case reports, review articles, and preclinical studies were analyzed for background information. A meta-analysis was performed for 11 studies for one-piece implants. The results indicated that the MBL change after 1 year was 0.94 ± 0.11 mm, with a lower bound of 0.72 and an upper bound of 1.16. For the mid term, the MBL was 1.2 ± 0.14 mm with a lower bound of 0.92 and an upper bound of 1.48. For the long term, the MBL change was 1.24 ± 0.16 mm with a lower bound of 0.92 and an upper bound of 1.56. Based on this literature review, one-piece ceramic implants achieve osseointegration similar to titanium implants, with a stable MBL or a slight bone gain after an individual initial design depending on crestal remodeling. The risk of implant fracture is low for current commercially available implants. Immediate loading or temporization of the implants does not interfere with the course of osseointegration. Scientific evidence for two-piece implants is rare.
Topics: Humans; Dental Implants; Ceramics; Dental Restoration, Temporary; Mouth, Edentulous; Osseointegration
PubMed: 37436947
DOI: 10.11607/jomi.10500 -
Journal of Controlled Release :... May 2021Surface modification of Ti implants has been advocated as a means to augment osseointegration and enable antibacterial functions. Among the various modification... (Review)
Review
Surface modification of Ti implants has been advocated as a means to augment osseointegration and enable antibacterial functions. Among the various modification strategies, the fabrication of TiO nanotubes (TNTs) on Ti implants via electrochemical anodization has shown promising outcomes. However, such systems do not enable activation, deactivation and tuning of the therapies after the implant placement, in response to local bone microenvironment conditions, to achieve a maximal therapeutic effect. Therapies administered from the implant surface in situ and managed by internal/external triggers can shift the paradigm in providing responsive therapy. In this review, we explore the various triggers that have been employed to achieve triggered therapies from the surface of modified Ti implants, with special focus on TNTs. We critically evaluate the current research advances in this domain (including biological, electrical, magnetic and electromagnetic triggers), cytotoxicity concerns and research challenges that must be addressed to achieve clinical translation of triggered therapies from modified Ti implants.
Topics: Nanotubes; Osseointegration; Prostheses and Implants; Surface Properties; Titanium
PubMed: 33766694
DOI: 10.1016/j.jconrel.2021.03.020 -
Current Osteoporosis Reports Dec 2020New biomaterials for biomedical applications have been developed over the past few years. This work summarizes the current cell lines investigations regarding... (Review)
Review
PURPOSE OF REVIEW
New biomaterials for biomedical applications have been developed over the past few years. This work summarizes the current cell lines investigations regarding nanosurface modifications to improve biocompatibility and osseointegration.
RECENT FINDINGS
Material surfaces presenting biomimetic morphology that provides nanoscale architectures have been shown to alter cell/biomaterial interactions. Topographical and biofunctional surface modifications present a positive effect between material and host response. Nanoscale surfaces on titanium have the potential to provide a successful interface for implantable biomedical devices. Future studies need to directly evaluate how the titanium nanoscale materials will perform in in vivo experiments. Biocompatibility should be determined to identify titanium nanoscale as an excellent option for implant procedures.
Topics: Animals; Biocompatible Materials; Cell Line; Cell Proliferation; Humans; Nanostructures; Osseointegration; Prostheses and Implants; Surface Properties; Titanium
PubMed: 33085001
DOI: 10.1007/s11914-020-00635-x -
Advanced Materials (Deerfield Beach,... Jan 2024Titanium implants are widely used ; however, implantation occasionally fails due to infections during the surgery or poor osseointegration after the surgery. To solve...
Titanium implants are widely used ; however, implantation occasionally fails due to infections during the surgery or poor osseointegration after the surgery. To solve the problem, an intelligent functional surface on titanium implant that can sequentially eradicate bacteria biofilm at the initial period and promote osseointegration at the late period of post-surgery time is designed. Such surfaces can be excited by near infrared light (NIR), with rare earth nanoparticles to upconvert the NIR light to visible range and adsorb by Au nanoparticles, supported by titanium oxide porous film on titanium implants. Under NIR irradiation, the implant converts the energy of phonon to hot electrons and lattice vibrations, while the former flows directly to the contact substance or partially reacts with the surrounding to generate reactive oxygen species, and the latter leads to the local temperature increase. The biofilm or microbes on the implant surface can be eradicated by NIR treatment in vitro and in vivo. Additionally, the surface exhibits superior biocompatibility for cell survival, adhesion, proliferation, and osteogenic differentiation, which provides the foundation for osseointegration. In vivo implantation experiments demonstrate osseointegration is also promoted. This work thus demonstrates NIR-generated electrons can sequentially eradicate biofilms and regulate the osteogenic process, providing new solutions to fabricate efficient implant surfaces.
Topics: Osseointegration; Osteogenesis; Titanium; Gold; Metal Nanoparticles; Anti-Bacterial Agents; Surface Properties
PubMed: 37974525
DOI: 10.1002/adma.202307756 -
Spine Apr 2020An in vivo study examining the functional osseointegration of smooth, rough, and porous surface topographies presenting polyether-ether-ketone (PEEK) or titanium surface...
STUDY DESIGN
An in vivo study examining the functional osseointegration of smooth, rough, and porous surface topographies presenting polyether-ether-ketone (PEEK) or titanium surface chemistry.
OBJECTIVE
To investigate the effects of surface topography and surface chemistry on implant osseointegration.
SUMMARY OF BACKGROUND DATA
Interbody fusion devices have been used for decades to facilitate fusion across the disc space, yet debate continues over their optimal surface topography and chemistry. Though both factors influence osseointegration, the relative effects of each are not fully understood.
METHODS
Smooth, rough, and porous implants presenting either a PEEK or titanium surface chemistry were implanted into the proximal tibial metaphyses of 36 skeletally mature male Sprague Dawley rats. At 8 weeks, animals were euthanized and bone-implant interfaces were subjected to micro-computed tomography analysis (n = 12), histology (n = 4), and biomechanical pullout testing (n = 8) to assess functional osseointegration and implant fixation.
RESULTS
Micro-computed tomography analysis demonstrated that bone ingrowth was 38.9 ± 2.8% for porous PEEK and 30.7 ± 3.3% for porous titanium (P = 0.07). No differences in fixation strength were detected between porous PEEK and porous titanium despite titanium surfaces exhibiting an overall increase in bone-implant contact compared with PEEK (P < 0.01). Porous surfaces exhibited increased fixation strength compared with smooth and rough surfaces regardless of surface chemistry (P < 0.05). Across all groups both surface topography and chemistry had a significant overall effect on fixation strength (P < 0.05), but topography accounted for 65.3% of the total variance (ω = 0.65), whereas surface chemistry accounted for 5.9% (ω = 0.06).
CONCLUSIONS
The effect of surface topography (specifically porosity) dominated the effect of surface chemistry in this study and could lead to further improvements in orthopedic device design. The poor osseointegration of existing smooth PEEK implants may be linked more to their smooth surface topography rather than their material composition.
LEVEL OF EVIDENCE
N/A.
Topics: Animals; Benzophenones; Bone-Anchored Prosthesis; Ketones; Male; Osseointegration; Polyethylene Glycols; Polymers; Porosity; Prostheses and Implants; Rats; Rats, Sprague-Dawley; Surface Properties; Titanium; X-Ray Microtomography
PubMed: 31703050
DOI: 10.1097/BRS.0000000000003303 -
Medicina (Kaunas, Lithuania) Jun 2022Background and Objectives: The gold standard for a successful prosthetic approach is the osseointegration of an implant. However, this integration can be a problem in...
Background and Objectives: The gold standard for a successful prosthetic approach is the osseointegration of an implant. However, this integration can be a problem in cases where the implant needs to be removed. Removing the implant with minimal damage to the surrounding tissues is important. Osteocytes cannot survive below −2 °C, but epithelial cells, fibroblasts, and other surrounding tissue cells can. Remodeling can be triggered by cryotherapy at temperatures that specifically affect osteocyte necrosis. In this study, we aimed to develop a method for reversing the osseointegration mechanism and for protecting the surrounding tissues by bone remodeling induced by CO2 cryotherapy. Materials and Methods: In this study, eight 2.8 mm diameter, one-piece mini implants were used in New Zealand rabbit tibias. Two control and six implants were tested in this study. After 2 months of osseointegration, a reverse torque force method was used to remove all osseointegrated implants at 5, 10, 20, and 30 Ncm. The osseointegration of the implants was proven by periotest measurements. Changes in bone tissue were examined in histological sections stained with toluidine blue after rabbit sacrifice. The number of lacunae with osteocyte, empty lacunae, and lacunae greater than 5 µm and the osteon number in a 10,000 µm2 area were calculated. Cryotherapy was applied to the test implants for 1 min, 2 min, and 5 min. Three implants were subjected to cryotherapy at −40 °C, and the other implants were subjected to cryotherapy at −80 °C. Results: Empty lacunae, filled osteocytes, lacunae >5 µm, and the osteon count around the implant applied at −40 °C were not significantly different from the control implants. The application of −40 °C for 1 min was found to cause minimal damage to the bone cells. The implants, which were applied for 1 min and 2 min, were successfully explanted on the 2nd day with the 5 Ncm reverse torque method. Test implants, which were applied cold for 5 min, were explanted on day 1. Tissue damage was detected in all test groups at −80 °C. Conclusions: The method of removing implants with cryotherapy was found to be successful in −40 °C freeze−thaw cycles applied three times for 1 min. To prove implant removal with cryotherapy, more implant trials should be conducted.
Topics: Animals; Dental Implants; Osseointegration; Rabbits; Tibia; Titanium; Torque
PubMed: 35888569
DOI: 10.3390/medicina58070849