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Frontiers in Bioengineering and... 2022Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically...
Titanium and alloy osseointegrated implants are used to replace missing teeth; however, some fail and are removed. Modifications of the implant surface with biologically active substances have been proposed. MEDLINE [via Pubmed], Embase and Web of Science were searched with the terms "titanium dental implants", "surface properties", "bioactive surface modifications", "biomolecules", "BMP", "antibacterial agent", "peptide", "collagen", "grown factor", "osseointegration", "bone apposition", "osteogenic", "osteogenesis", "new bone formation", "bone to implant contact", "bone regeneration" and " studies", until May 2022. A total of 10,697 references were iden-tified and 26 were included to analyze 1,109 implants, with follow-ups from 2 to 84 weeks. The ARRIVE guidelines and the SYRCLE tool were used to evaluate the methodology and scientific evidence. A meta-analysis was performed (RevMan 2020 software, Cochane Collaboration) with random effects that evaluated BIC at 4 weeks, with subgroups for the different coatings. The heterogeneity of the pooled studies was very high (95% CI, I2 = 99%). The subgroup of BMPs was the most favorable to coating. Surface modification of Ti implants by organic bioactive molecules seems to favor osseointegration in the early stages of healing, but long-term studies are necessary to corroborate the results of the experimental studies.
PubMed: 36225604
DOI: 10.3389/fbioe.2022.986112 -
Antibiotics (Basel, Switzerland) Jun 2023Few studies have been able to elucidate the correlation of factors determining the strength of interaction between bacterial cells and substrate at the molecular level.... (Review)
Review
Few studies have been able to elucidate the correlation of factors determining the strength of interaction between bacterial cells and substrate at the molecular level. The aim was to answer the following question: What biophysical factors should be considered when analyzing the bacterial adhesion strength on titanium surfaces and its alloys for implants quantified by atomic force microscopy? This review followed PRISMA. The search strategy was applied in four databases. The selection process was carried out in two stages. The risk of bias was analyzed. One thousand four hundred sixty-three articles were found. After removing the duplicates, 1126 were screened by title and abstract, of which 57 were selected for full reading and 5 were included; 3 had a low risk of bias and 2 moderated risks of bias. (1) The current literature shows the preference of bacteria to adhere to surfaces of the same hydrophilicity. However, this fact was contradicted by this systematic review, which demonstrated that hydrophobic bacteria developed hydrogen bonds and adhered to hydrophilic surfaces; (2) the application of surface treatments that induce the reduction of areas favorable for bacterial adhesion interfere more in the formation of biofilm than surface roughness; and (3) bacterial colonization should be evaluated in time-dependent studies as they develop adaptation mechanisms, related to time, which are obscure in this review.
PubMed: 37370313
DOI: 10.3390/antibiotics12060994 -
The Cochrane Database of Systematic... Oct 2019Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface... (Review)
Review
BACKGROUND
Dental implants are available in different materials, shapes and with different surface characteristics. In particular, numerous implant designs and surface modifications have been developed for improving clinical outcome. This is an update of a Cochrane review first published in 2002, and previously updated in 2003, 2005 and 2007.
OBJECTIVES
Primary: to compare the clinical effects of different root-formed osseointegrated dental implant types for replacing missing teeth for the following specific comparisons: implants with different surface preparations, but having similar shape and material; implants with different shapes, but having similar surface preparation and material; implants made of different materials, but having similar surface preparation and shape; different implant types differing in surface preparation, shape, material or a combination of these.Secondary: to compare turned and roughened dental implants for occurrence of early implant failure (before prosthetic loading) and occurrence of peri-implantitis.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 17 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 12), MEDLINE via OVID (1946 to 17 January 2014) and EMBASE via OVID (1980 to 17 January 2014). We placed no restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included any randomised controlled trial (RCT) comparing osseointegrated dental implants of different materials, shapes and surface properties having a follow-up in function of at least one year. Outcome measures were success of the implants, radiographic peri-implant marginal bone levels changes and incidence of peri-implantitis.
DATA COLLECTION AND ANALYSIS
At least two review authors independently conducted screening, risk of bias assessment and data extraction of eligible trials in duplicate. We expressed results using fixed-effect models (if up to three studies were present in a meta-analysis) or random-effects models (when there were more than three studies) using mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes with 95% confidence intervals (CI). We reported the following endpoints: one, three, five and 10 years after functional loading.
MAIN RESULTS
We identified 81 different RCTs. We included 27 of these RCTs, reporting results from 1512 participants and 3230 implants in the review. We compared 38 different implant types with a follow-up ranging from one to 10 years. All implants were made of commercially pure titanium or its alloys, and had different shapes and surface preparations. We judged two trials to be at low risk of bias, 10 to be at unclear risk of bias and 15 to be at high risk of bias. On a 'per participant' rather than 'per implant' basis, we found no significant differences between various implant types for implant failures. The only observed statistically significant difference for the primary objective regarded more peri-implant bone loss at Nobel Speedy Groovy implants when compared with NobelActive implants (MD -0.59 mm; 95% CI -0.74 to -0.44, different implant shapes). The only observed statistically significant difference for the secondary objective was that implants with turned (smoother) surfaces had a 20% reduction in risk to be affected by peri-implantitis than implants with rough surfaces three years after loading (RR 0.80; 95% CI 0.67 to 0.96). There was a tendency for implants with turned surfaces to fail early more often than implants with roughened surfaces.
AUTHORS' CONCLUSIONS
Based on the results of the included RCTs, we found no evidence showing that any particular type of dental implant had superior long-term success. There was limited evidence showing that implants with relatively smooth (turned) surfaces were less prone to lose bone due to chronic infection (peri-implantitis) than implants with much rougher surfaces (titanium-plasma-sprayed). These findings were based on several RCTs, often at high risk of bias, with few participants and relatively short follow-up periods.
PubMed: 31600407
DOI: 10.1002/14651858.CD003815.pub5 -
Medicina (Kaunas, Lithuania) Sep 2022The aim of the study was to systematically review the overall outcomes of studies comparing the misfit of yttria-stabilized zirconia (Y-TZP) CAD-CAM implant-supported... (Review)
Review
The aim of the study was to systematically review the overall outcomes of studies comparing the misfit of yttria-stabilized zirconia (Y-TZP) CAD-CAM implant-supported frameworks with frameworks fabricated with other materials and techniques. An electronic literature search of English literature was performed using Google Scholar, Scopus, Web of Science, MEDLINE (OVID), EMBASE, and PubMed, using predetermined inclusion criteria. Specific terms were utilized in conducting a search from the inception of the respective database up to May 2022. After the search strategy was applied, the data were extracted and the results were analyzed. The focused question was: Is the misfit of the implant-supported zirconia CAD-CAM framework lower than that of non-Y-TZP implant-supported fixed restorations? Eleven articles were included for qualitative assessment and critical appraisal in this review. In the included studies, Y-TZP CAD-CAM implant-supported frameworks were compared to Titanium (Ti), Ni-Cr, Co-Cr, PEEK and high-density polymer, and cast and CAD-CAM frameworks. The studies used scanning electron microscopy, one-screw tests, digital or optical microscopy, 3D virtual assessment, and replica techniques for analyzing the misfit of frameworks. Six studies showed comparable misfits among the Y-TZP CAD-CAM frameworks and the controls. Three studies showed higher misfits for the Y-TZP CAD-CAM frameworks, whereas two studies reported lower misfits for Y-TZP CAD-CAM implant frameworks compared to controls. Y-TZP CAD-CAM implant-supported frameworks have comparable misfits to other implant-supported frameworks. However, due to heterogeneity in the methodologies of the included studies, the overall numerical misfit of the frameworks assessed in the reviewed studies is debatable.
Topics: Humans; Titanium; Zirconium; Computer-Aided Design; Polymers
PubMed: 36295507
DOI: 10.3390/medicina58101347 -
Brazilian Oral Research 2019The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they... (Meta-Analysis)
Meta-Analysis
The objective of this systematic review and meta-analysis was to evaluate the effect of welding techniques on implant-supported prostheses and determine whether they contribute to a better adaptation compared with a one-piece cast. A search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases, and articles published until November 2017 were obtained from these databases. This review followed the PRISMA criteria and is registered on the PROSPERO platform (CRD42017081865). The PICO question was "Do welding procedures in one-piece cast implant-supported frameworks influence implant/abutment-framework marginal misfits?" Eleven studies were selected for a qualitative analysis, and seven studies were selected for a quantitative analysis. A total of 189 specimens were fabricated using different materials (cp-Ti, Ni-Cr, Cr-Co, and noble alloys), and welding techniques such as laser welding, conventional welding, tungsten inert gas, and brazing were applied. A vertical marginal misfit was measured using an optical microscope, a stereomicroscope, and/or a scanning electron microscopy. The qualitative analysis in the studies demonstrated a positive effect of the welding techniques on the adaptation of the infrastructures. The meta-analysis confirmed the results (p < 0.00001; MD: -36.14; 95%CI: -48.69 to -23.59). Within the limitations of this study and regarding the heterogeneity of the samples, we conclude that the soldering point technique is effective for obtaining relatively low values of marginal misfit, with laser welding as the most effective technique. However, additional studies were recommended due to the heterogeneity of different variables (alloys, connection, and misfit evaluation) in the included studies.
Topics: Dental Casting Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Soldering; Humans; Prosthesis Fitting; Welding
PubMed: 31778474
DOI: 10.1590/1807-3107bor-2019.vol33.0110 -
Materials (Basel, Switzerland) Jul 2019Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and... (Review)
Review
Sterilization is a fundamental step in the reuse of endodontic instruments. The sterilization procedure involves disinfection, cleaning, washing, drying, packaging, and sterilization by heat. Heat sterilization can lead to changes in the physical and mechanical properties of dental instruments. These changes can affect the external surfaces via micropitting, corrosion, a reduction in cutting capacity, and/or an influence on the resistance to cyclic fatigue or to torsional fatigue. In this study, we examined the modification of the torsional properties of endodontic instruments after hot sterilization, and compared the properties with instruments not subjected to hot sterilization cycles in terms of resistance to torsional fatigue and deflection angle in NiTi and steel instruments. The following work was performed based on the PRISMA indications. Studies were identified through bibliographic research using electronic databases. A total of 725 records were identified in the PubMed and Scopus databases. A total of 685 records remained after exclusion by year of publication (1979 to 2019). With the application of the eligibility criteria (all articles pertaining to the issue of sterilization in endodontics), we found 146 articles, which decreased to 130 articles after elimination of duplications. There were 45 articles that studied the influences of sterilization procedures on the physical and mechanical characteristics of the instruments, and 12 that measured parameters related to resistance to torsional fatigue. Applying the inclusion and exclusion criteria resulted in a total of eight articles for quantitative analysis. The meta-analysis results show a pejorative effect of torsional fatigue for NiTi instruments subjected to heat sterilization compared to the non-sterilized control.
PubMed: 31288384
DOI: 10.3390/ma12132190 -
Journal of Oral & Maxillofacial Research 2021There is a concern whether the enhancement on implant surface roughness is responsible for higher biofilm formation, which acts as an aetiological factor for... (Review)
Review
OBJECTIVES
There is a concern whether the enhancement on implant surface roughness is responsible for higher biofilm formation, which acts as an aetiological factor for peri-implant diseases. The aim of the present systematic review was to answer the following question: "Are rough surfaces more susceptible to early biofilm formation when compared to smoother surfaces on titanium specimens?".
MATERIAL AND METHODS
The research was performed on PubMed, Web of Science and Scopus, up to August 2021. Eligibility criteria included studies that analysed human biofilm formation on titanium specimens with distinct surface roughness (smooth vs minimally, moderate, or rough) over the experimental times of 1 or 3 days. Roughness average (Ra) and biofilm analysis parameters were extracted from selected articles. Risk of bias was evaluated using the Checklist for Quasi-Experimental Studies.
RESULTS
Of 5286 papers, 5 were included and analysed. Smooth titanium surfaces included machined and anodized titanium/Ti-6Al-4V; machined and acid etched TiZr. Minimally, moderately, or rough surfaces comprised titanium and titanium alloys (TiZr, Ti-6Al-4V), that received surface treatments (anodization, acid-etching, blasting, hydroxyapatite-coating). No statistically significant difference on biofilm formation on rough and smooth titanium surfaces was reported by 3 studies, while more contamination on rough titanium surfaces was stated by 2 investigations. An isolated smooth surface has also been associated to higher contamination. Moderate to high quality methodological assessment of studies were identified.
CONCLUSIONS
It is not possible to assume that rough surfaces are more susceptible to early biofilm formation than smooth titanium surfaces. Additional studies are required to study this multifarious interaction.
PubMed: 35222868
DOI: 10.5037/jomr.2021.12401 -
The Saudi Dental Journal Feb 2023The aim of this systematic review was to present the current knowledge on the influence of laser surface treatment on the adhesion of bacteria to titanium and its alloys. (Review)
Review
OBJECTIVE
The aim of this systematic review was to present the current knowledge on the influence of laser surface treatment on the adhesion of bacteria to titanium and its alloys.
DESIGN
This review was structured according to PRISMA guidelines for systematic reviews and -analyses, and registered on the Open Science Framework platform (https://doi.org/10.17605/OSF.IO/FTA3W). Article searches were performed in 4 databases: PubMed, Scopus, Embase, and Science Direct. In addition, a manual search was performed in the reference lists of the selected articles. The selection of articles was performed by two reviewers. The articles found were screened for eligibility using the previously established inclusion and exclusion criteria. The methodological quality of the studies was assessed using the Joanna Briggs Institute (JBI) Critical Assessment Checklist for Quasi-Experimental Studies (non-randomized experimental studies).
RESULTS
Most of the studies evaluated showed that surface treatment by laser irradiation can affect the adhesion of bacteria to titanium surfaces and that this is directly related to changes in surface properties such as chemical composition, morphology, roughness, and wettability, as well as the type of bacterial species involved.
CONCLUSIONS
The studies considered in this systematic review have shown that surface treatment by laser irradiation is a promising technique to reduce the adhesion of bacteria on the surface of titanium implants.
PubMed: 36942202
DOI: 10.1016/j.sdentj.2023.01.004 -
Materials (Basel, Switzerland) Aug 2020Complex dental components which are individually tailored to the patient can be obtained due to new additive manufacturing technology. This paper reviews the metallic... (Review)
Review
Complex dental components which are individually tailored to the patient can be obtained due to new additive manufacturing technology. This paper reviews the metallic powders used in dental applications, the fabrication process (build orientation, process parameters) and post-processing processes (stress relieving, surface finishing). A review of the literature was performed using PubMed, ScienceDirect, Mendeley and Google Scholar. Over eighty articles were selected based on relevance to this review. This paper attempts to include the latest research from 2010 until 2020, however, older manuscripts (10 articles) were also selected. Over 1200 records were identified through the search; these were screened for title and/or summary. Over eighty articles were selected based on relevance to this review. In order to obtain a product which can be used in clinical applications, the appropriate manufacturing parameters should be selected. A discussion was made on optimal selective laser melting (SLM) parameters in dentistry. In addition, this paper includes a critical review of applied thermal treatment methods for Co-Cr alloys used in dentistry.
PubMed: 32785055
DOI: 10.3390/ma13163524 -
Journal of Orthopaedic Surgery and... Feb 2022Titanium and its alloys have been widely employed for bone tissue repair and implant manufacturing. The rapid development of three-dimensional (3D) printing technology...
BACKGROUND
Titanium and its alloys have been widely employed for bone tissue repair and implant manufacturing. The rapid development of three-dimensional (3D) printing technology has allowed fabrication of porous titanium scaffolds with controllable microstructures, which is considered to be an effective method for promoting rapid bone formation and decreasing bone absorption. The purpose of this systematic review was to evaluate the osteogenic potential of 3D-printed porous Ti6Al4V (Ti64) scaffold for repairing long bone defects in animal models and to investigate the influential factors that might affect its osteogenic capacity.
METHODS
Electronic literature search was conducted in the following databases: PubMed, Web of Science, and Embase up to September 2021. The SYRCLE's tool and the modified CAMARADES list were used to assess the risk of bias and methodological quality, respectively. Due to heterogeneity of the selected studies in relation to protocol and outcomes evaluated, a meta-analysis could not be performed.
RESULTS
The initial search revealed 5858 studies. Only 46 animal studies were found to be eligible based on the inclusion criteria. Rabbit was the most commonly utilized animal model. A pore size of around 500-600 µm and porosity of 60-70% were found to be the most ideal parameters for designing the Ti64 scaffold, where both dodecahedron and diamond pores optimally promoted osteogenesis. Histological analysis of the scaffold in a rabbit model revealed that the maximum bone area fraction reached 59.3 ± 8.1% at weeks 8-10. Based on micro-CT assessment, the maximum bone volume fraction was found to be 34.0 ± 6.0% at weeks 12.
CONCLUSIONS
Ti64 scaffold might act as a promising medium for providing sufficient mechanical support and a stable environment for new bone formation in long bone defects. Trail registration The study protocol was registered in the PROSPERO database under the number CRD42020194100.
Topics: Alloys; Animals; Bone and Bones; Osteogenesis; Porosity; Printing, Three-Dimensional; Rabbits; Tissue Engineering; Tissue Scaffolds; Titanium
PubMed: 35109907
DOI: 10.1186/s13018-022-02960-6