Abstract
The aim of this study was to produce epithelial attachment on a typical implant abutment surface of smooth titanium. A challenging complication that hinders the success of dental implants is peri-implantitis. A common cause of peri-implantitis may results from the lack of epithelial sealing at the peri-implant collar. Histologically, epithelial sealing is recognized as the attachment of the basement membrane (BM). BM-attachment is promoted by activated platelet aggregates at surgical wound sites. On the other hand, platelets did not aggregate on smooth titanium, the surface typical of the implant abutment. We then hypothesized that epithelial BM-attachment was produced when titanium surface was modified to allow platelet aggregation. Titanium surfaces were coated with a protease activated receptor 4-activating peptide (PAR4-AP). PAR4-AP coating yielded rapid aggregation of platelets on the titanium surface. Platelet aggregates released robust amount of epithelial chemoattractants (IGF-I, TGF-β) and growth factors (EGF, VEGF) on the titanium surface. Human gingival epithelial cells, when they were co-cultured on the platelet aggregates, successfully attached to the PAR4-AP coated titanium surface with spread laminin5 positive BM and consecutive staining of the epithelial tight junction component ZO1, indicating the formation of complete epithelial sheet. These in-vitro results indicate the establishment of epithelial BM-attachment to the titanium surface.
Highlights
The outcomes of dental implants can be classified into three distinct categories: failure, survival and success
Implants are regarded as a failure if it is removed for any reason, with clinical mobility being an absolute indication for their removal
scanning electron microscopy (SEM) captured the dense aggregation of platelets on the protease activated receptor 4-activating peptide (PAR4-AP) coated titanium surface in both Plateletrich plasma (PRP) and whole blood (Fig 3C and 3D, respectively)
Summary
The outcomes of dental implants can be classified into three distinct categories: failure, survival and success. Implants are regarded as a failure if it is removed for any reason, with clinical mobility being an absolute indication for their removal. Establishment of Epithelial Attachment on Titanium Surface including a lack of biologic and/or technical complications [1], achieving an adequate amount of keratinized mucosa and soft tissue coverage, and patient satisfaction [2]. According to these reports, the success rate of implant treatment is estimated to be around 81.3–93.8%. As implant survival has remained very high, the implant success has become increasingly adopted as the standard in assessing clinical outcomes
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