Abstract
Early establishment of soft-tissue adhesion and seal at the transmucosal and transcutaneous surface of implants is crucial to prevent infection and ensure the long-term stability and function of implants. Herein, we tested the hypothesis that treatment of titanium with ultraviolet (UV) light would enhance its interaction with epithelial cells. X-ray spectroscopy showed that UV treatment significantly reduced the atomic percentage of surface carbon on titanium from 46.1% to 28.6%. Peak fitting analysis revealed that, among the known adventitious carbon contaminants, C–C and C=O groups were significantly reduced after UV treatment, while other groups were increased or unchanged in percentage. UV-treated titanium attracted higher numbers of human epithelial cells than untreated titanium and allowed more rapid cell spread. Hemi-desmosome-related molecules, integrin β4 and laminin-5, were upregulated at the gene and protein levels in the cells on UV-treated surfaces. The result of the detachment test revealed twice as many cells remaining adherent on UV-treated than untreated titanium. The enhanced cellular affinity of UV-treated titanium was equivalent to laminin-5 coating of titanium. These data indicated that UV treatment of titanium enhanced the attachment, adhesion, and retention of human epithelial cells associated with disproportional removal of adventitious carbon contamination, providing a new strategy to improve soft-tissue integration with implant devices.
Highlights
Oral or orthopedic implants that are transcutaneous or transmucosal, such as most dental implants, maxillofacial epithesis anchors, and various connection devices in orthopedic reconstruction, are prone to bacterial contamination by resident and harbored flora on skin and mucosal surfaces, leading, in some cases, to soft-tissue infections and failure of the implant treatment [1]
Immunoelectron microscopy revealed that epithelial cells responsible for attaching soft tissue to the implant surface act via the internal basal lamina and hemidesmosomes at the plasma membrane and the receptor to ligand binding of integrin to laminin [10,11,12,13]
The present study addressed the detailed mechanisms of the effect of UV treatment on the decomposition of carbon-including compounds and revealed the specific chemical bonds broken by UV light on the acid-etched titanium surfaces
Summary
Oral or orthopedic implants that are transcutaneous or transmucosal, such as most dental implants, maxillofacial epithesis anchors, and various connection devices in orthopedic reconstruction, are prone to bacterial contamination by resident and harbored flora on skin and mucosal surfaces, leading, in some cases, to soft-tissue infections and failure of the implant treatment [1]. Dental implants are the most challenging in this regard, due to the hostile and diverse microbial environment of an oral cavity, which could contain more than 600 different bacterial species and be subject to infectious disease such as peri-implantitis [2,3]. Establishing an early soft-tissue attachment or seal to the surface of implant devices reduces the chance of bacterial invasion at the implant-transmucosal or implanttranscutaneous junction, and increases the chance of long-term treatment success [8,9]. Despite the qualitative and observational studies examining successfully established implant-soft tissue interface, a methodology for enhancing the probability, speed, and strength of the soft-tissue attachment and seal has not been established
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