Bone Tissue Implants Research Articles

Synergistic Enhancement of Antibacterial and Osteo-Immunomodulatory Activities of Titanium Implants via Dual-Responsive Multifunctional Surfaces.

Bone implant-associated infections and inflammations, primarily caused by bacteria colonization, frequently result in unsuccessful procedures and pose significant health risks to patients. To mitigate these challenges, the development of engineered implants with spatiotemporal regulation capabilities, designed to inhibit bacterial survival and modulate immune responses in the early stage, while promoting bone defect healing in the late stage is proposed. The implants are functionalized with ε-poly-l-lysine-phenylboronic acid (PP) via dynamic boronic ester bonds, which facilitate its release through a reactive oxygen species (ROS) and pH-responsive strategy, thereby establishing an antibacterial microenvironment on and around the implants. Additionally, the dynamic metal coordination interaction facilitates the loading and sustained release of Sr2+ under an acidic environment, providing immunomodulatory and osteogenic effects. The ROS/pH-responsive feature, coupled with the implant-bone tissue integration process, affords precise spatiotemporal regulation of the Ti-TA-Sr-PP implants. This strategy represents a promising approach for the preparation of advanced bone implants.

Biocompatible nanocomposite hydroxyapatite-based granules with increased specific surface area and bioresorbability for bone regenerative medicine applications

Hydroxyapatite (HA) granules are frequently used in orthopedics and maxillofacial surgeries to fill bone defects and stimulate the regeneration process. Optimal HA granules should have high biocompatibility, high microporosity and/or mesoporosity, and high specific surface area (SSA), which are essential for their bioabsorbability, high bioactivity (ability to form apatite layer on their surfaces) and good osseointegration with the host tissue. Commercially available HA granules that are sintered at high temperatures (≥ 900 °C) are biocompatible but show low porosity and SSA (2–5 m2/g), reduced bioactivity, poor solubility and thereby, low bioabsorbability. HA granules of high microporosity and SSA can be produced by applying low sintering temperatures (below 900 °C). Nevertheless, although HA sintered at low temperatures shows significantly higher SSA (10–60 m2/g) and improved bioabsorbability, it also exhibits high ion reactivity and cytotoxicity under in vitro conditions. The latter is due to the presence of reaction by-products. Thus, the aim of this study was to fabricate novel biomaterials in the form of granules, composed of hydroxyapatite nanopowder sintered at a high temperature (1100 °C) and a biopolymer matrix: chitosan/agarose or chitosan/β-1,3-glucan (curdlan). It was hypothesized that appropriately selected ingredients would ensure high biocompatibility and microstructural properties comparable to HA sintered at low temperatures. Synthesized granules were subjected to the evaluation of their biological, microstructural, physicochemical, and mechanical properties. The obtained results showed that the developed nanocomposite granules were characterized by a lack of cytotoxicity towards both mouse preosteoblasts and normal human fetal osteoblasts, and supported cell adhesion to their surface. Moreover, produced biomaterials had the ability to induce precipitation of apatite crystals after immersion in simulated body fluid, which, combined with high biocompatibility, should ensure good osseointegration after implantation. Additionally, nanocomposite granules possessed microstructural parameters similar to HA sintered at a low temperature (porosity approx. 50%, SSA approx. 30 m²/g), Young’s modulus (5–8 GPa) comparable to cancellous bone, and high fluid absorption capacity. Moreover, the nanocomposites were prone to biodegradation under the influence of enzymatic solution and in an acidic environment. Additionally, it was noted that the hydroxyapatite nanoparticles remaining after the physicochemical dissolution of the biomaterial were easily phagocytosed by mouse macrophages, mouse preosteoblasts, and normal human fetal osteoblasts (in vitro studies). The obtained materials show great potential as bone tissue implantation biomaterials with improved bioresorbability. The obtained materials show great potential as bone tissue implantation biomaterials with improved bioresorbability.

Enhanced osseointegration and antimicrobial properties of 3D-Printed porous titanium alloys with copper-strontium doped calcium silicate coatings.

The 3D printing of porous titanium scaffolds reduces the elastic modulus of titanium alloys and promotes osteogenic integration. However, due to the biological inertness of titanium alloy materials, the implant-bone tissue interface is weakly bonded. A calcium silicate (CS) coating doped with polymetallic ions can impart various biological properties to titanium alloy materials. In this study, CuO and SrO binary-doped CS coatings were prepared on the surface of 3D-printed porous titanium alloy scaffolds using atmospheric plasma spraying and characterized by SEM, EDS, and XRD. Both CuO and SrO were successfully incorporated into the CS coating. The in vivo osseointegration evaluation of the composite coating-modified 3D-printed porous titanium alloy scaffolds was conducted using a rabbit bone defect model, showing that the in vivo osseointegration of 2% CuO-10% SrO-CS-modified 3D-printed porous titanium alloy was improved. The in vitro antimicrobial properties of the 2% CuO-10% SrO-CS-modified 3D-printed porous titanium alloy were evaluated through bacterial platform coating, co-culture liquid absorbance detection, and crystal violet staining experiments, demonstrating that the composite coating exhibited good antimicrobial properties. In conclusion, the composite scaffold possesses both osteointegration-promoting and antimicrobial properties, indicating a broad potential for clinical applications.

Suitability of Gelatin Methacrylate and Hydroxyapatite Hydrogels for 3D-Bioprinted Bone Tissue.

Complex bone defects are challenging to treat. Autografting is the gold standard for regenerating bone defects; however, its limitations include donor-site morbidity and increased surgical complexity. Advancements in 3D bioprinting (3DBP) offer a promising alternative for viable bone grafts. In this experiment, gels composed of varying levels of gelatin methacrylate (GelMA) and hydroxyapatite (HA) and gelatin concentrations are explored. The objective was to increase the hydroxyapatite content and find the upper limit before the printability was compromised and determine its effect on the mechanical properties and cell viability. Design of Experiments (DoE) was used to design 13 hydrogel bioinks of various GelMA/HA concentrations. These bioinks were assessed in terms of their pipettability and equilibrium modulus. An optimal bioink was designed using the DoE data to produce the greatest stiffness while still being pipettable. Three bioinks, one with the DoE-designed maximal stiffness, one with the experimentally defined maximal stiffness, and a literature-based control, were then printed using a 3D bioprinter and assessed for print fidelity. The resulting hydrogels were combined with human bone-marrow-derived mesenchymal stromal cells (hMSCs) and evaluated for cell viability. The DoE ANOVA analysis indicated that the augmented three-level factorial design model used was a good fit (p < 0.0001). Using the model, DoE correctly predicted that a composite hydrogel consisting of 12.3% GelMA, 15.7% HA, and 2% gelatin would produce the maximum equilibrium modulus while still being pipettable. The hydrogel with the most optimal print fidelity was 10% GelMA, 2% HA, and 5% gelatin. There were no significant differences in the cell viability within the hydrogels from day 2 to day 7 (p > 0.05). There was, however, a significantly lower cell viability in the gel composed of 12.3% GelMA, 15.7% HA, and 2% gelatin compared to the other gels with a lower HA concentration (p < 0.05), showing that a higher HA content or print pressure may be cytotoxic within hydrogels. Extrusion-based 3DBP offers significant advantages for bone-tissue implants due to its high customizability. This study demonstrates that it is possible to create printable bone-like grafts from GelMA and HA with an increased HA content, favorable mechanical properties (145 kPa), and a greater than 80% cell viability.

Parametric Design of Porous Structure and Optimal Porosity Gradient Distribution Based on Root-Shaped Implants.

Porous structures can reduce the elastic modulus of implants, decrease stress shielding, and avoid bone loss in the alveolar bone and aseptic loosening of implants; however, there is a mismatch between yield strength and elastic modulus as well as biocompatibility problems. This study aimed to investigate the parametric design method of porous root-shaped implants to reduce the stress-shielding effect and improve the biocompatibility and long-term stability and effectiveness of the implants. Firstly, the porous structure part was parametrically designed, and the control of porosity gradient distribution was achieved by using the fitting relationship between porosity and bias and the position function of bias. In addition, the optimal distribution law of the porous structure was explored through mechanical and hydrodynamic analyses of the porous structure. Finally, the biomechanical properties were verified using simulated implant-bone tissue interface micromotion values. The results showed that the effects of marginal and central porosity on yield strength were linear, with the elastic modulus decreasing from 18.9 to 10.1 GPa in the range of 20-35% for marginal porosity, with a maximum decrease of 46.6%; the changes in the central porosity had a more consistent effect on the elastic modulus, ranging from 18.9 to 15.3 GPa in the range of 50-90%, with a maximum downward shift of 19%. The central porosity had a more significant effect on permeability, ranging from 1.9 × 10-7 m2 to 4.9 × 10-7 m2 with a maximum enhancement of 61.2%. The analysis showed that the edge structure had a more substantial impact on the mechanical properties. The central structure could increase the permeability more effectively. Hence, the porous structure with reasonable gradient distribution had a better match between mechanical properties and flow properties. The simulated implantation results showed that the porous implant with proper porosity gradient distribution had better biomechanical properties.

Photothermal effect and antibacterial properties of Zn2+, Cu2+ and Ag+ doped hydroxyapatite @ polydopamine on porous tantalum surface

Porous tantalum finds valuable application in biomedical materials owing to its exceptional elastic modulus and biological activity. Hydroxyapatite nanopowder shares a chemical and crystal structure akin to natural bone apatite, making it a prevalent choice for bone tissue implants. However, addressing concerns like bacterial infections has led to a pressing need for functional modifications. Employing bactericidal ions like Zn/Cu/Ag, through HA doping, holds potential for spectral sterilization. Building upon this premise, a coating involving PDA enveloping ZnHA/CuHA/AgHA can be skillfully applied onto the surface of porous tantalum. This innovation effectively enhances the photothermal properties, culminating in a synergistic antibacterial outcome. The findings reveal that CuHA@PDA boasts the highest photothermal conversion efficiency at an impressive 66.83%. Meanwhile, ZnHA@PDA and AgHA@PDA samples exhibit commendable photothermal performance, further corroborated by bactericidal efficacy demonstrated in both bacterial and in vitro immersion experiments. These results underscore the wide-ranging prospective applications in the realm of HA functionalization and light-mediated sterilization.

Computer simulation of stress-strain states in zygomatic bones after complex installation of implants

The research addresses evaluation of stress-strain state (SSS) in the “zygomatic bones–implants–denture base” system by varying the type and number of the zygomatic implants, as well as applying loads. The load magnitude was varied over a wide range, characteristic of the mastication process. Changing the adhesion conditions at the “zygomatic implant–bone tissue” interface varied both the level of maximum stress and the location of the critical stress concentrator. The local violation of the integrity of bone tissue in the skull was one of the key reasons for the redistribution of stresses in the “zigomatic implant­denture base” system. Such a phenomenon should be primarily taken into account when choosing the standard sizes of installed zygomatic implants in order to reduce the compliance of weakened areas of the skull (as the basis of the load-bearing structure). Based on the results of the FEM-based computer simulation, the algorithm was proposed for planning prosthetic treatment, which involves the iterative method for selecting both size and location of installing zygomatic implants depending on the results of the SSS calculation and the onset of a critical condition (primarily in bone tissue at the contact area with zygomatic implants).

The preliminary in vitro study and application of deep learning algorithm in cone beam computed tomography image implant recognition

To properly repair and maintain implants, which are bone tissue implants that replace natural tooth roots, it is crucial to accurately identify their brand and specification. Deep learning has demonstrated outstanding capabilities in analysis, such as image identification and classification, by learning the inherent rules and degrees of representation of data models. The purpose of this study is to evaluate deep learning algorithms and their supporting application software for their ability to recognize and categorize three dimensional (3D) Cone Beam Computed Tomography (CBCT) images of dental implants. By using CBCT technology, the 3D imaging data of 27 implants of various sizes and brands were obtained. Following manual processing, the data were transformed into a data set that had 13,500 two-dimensional data. Nine deep learning algorithms including GoogleNet, InceptionResNetV2, InceptionV3, ResNet50, ResNet50V2, ResNet101, ResNet101V2, ResNet152 and ResNet152V2 were used to perform the data. Accuracy rates, confusion matrix, ROC curve, AUC, number of model parameters and training times were used to assess the efficacy of these algorithms. These 9 deep learning algorithms achieved training accuracy rates of 100%, 99.3%, 89.3%, 99.2%, 99.1%, 99.5%, 99.4%, 99.5%, 98.9%, test accuracy rates of 98.3%, 97.5%, 94.8%, 85.4%, 92.5%, 80.7%, 93.6%, 93.2%, 99.3%, area under the curve (AUC) values of 1.00, 1.00, 1.00, 1.00, 1.00, 1.00, 1.00, 1.00, 1.00. When used to identify implants, all nine algorithms perform satisfactorily, with ResNet152V2 achieving the highest test accuracy, classification accuracy, confusion matrix area under the curve, and receiver operating characteristic curve area under the curve area. The results showed that the ResNet152V2 has the best classification effect on identifying implants. The artificial intelligence identification system and application software based on this algorithm can efficiently and accurately identify the brands and specifications of 27 classified implants through processed 3D CBCT images in vitro, with high stability and low recognition cost.

Three-Dimensional Printing of Graphene Oxide/Poly-L-Lactic Acid Scaffolds Using Fischer-Koch Modeling.

Accurately printing customizable scaffolds is a challenging task because of the complexity of bone tissue composition, organization, and mechanical behavior. Graphene oxide (GO) and poly-L-lactic acid (PLLA) have drawn attention in the field of bone regeneration. However, as far as we know, the Fischer-Koch model of the GO/PLLA association for three-dimensional (3D) printing was not previously reported. This study characterizes the properties of GO/PLLA-printed scaffolds in order to achieve reproducibility of the trabecula, from virtual planning to the printed piece, as well as its response to a cell viability assay. Fourier-transform infrared and Raman spectroscopy were performed to evaluate the physicochemical properties of the nanocomposites. Cellular adhesion, proliferation, and growth on the nanocomposites were evaluated using scanning electron microscopy. Cell viability tests revealed no significant differences among different trabeculae and cell types, indicating that these nanocomposites were not cytotoxic. The Fischer Koch modeling yielded satisfactory results and can thus be used in studies directed at diverse medical applications, including bone tissue engineering and implants.

Study on the influence of temperature and strain rate on the tensile behavior of Ti–5Mo–5Cu alloy biomaterial alloy: a molecular dynamics simulation

The development of efficient biomedical bone tissue implants has invoked significant impact in the biomedical research fields and aids the aged populated peoples. In this examination, the mechanical features of implant material (Ti–5Mo–5Cu alloy) has been investigated using the molecular dynamics method under varying temperature and strain rate to understand its physical phenomenon and through this study, it is found that the strain rate has offered a complex beneficial impact over the material characteristics such as yield stress and yield strain, owing to its higher impact over the restraining behavior between various atoms and strain toughening effect related to the temperature effect. Furthermore, the shear strain and point defect analysis has confirmed that the structural alteration and the establishment of multiple dislocations lead to induce the deformation behavior of Ti–5Mo–5Cu biomaterial alloy. Additionally, the radial distribution analysis has stated that the introduction of higher ambient temperature leads to invoking multiple dislocations which are responsible for the deformation behavior and cause the major reduction in tensile properties.

On a System of Equations with General Fractional Derivatives Arising in Diffusion Theory

A novel two-compartment model for drug release was formulated. The general fractional derivatives of a specific type and distributed order were used in the formulation. Earlier used models in pharmacokinetics with fractional derivatives follow as special cases of the model proposed here. As a first application, we used this model to study the release of gentamicin from poly(vinyl alcohol)/chitosan/gentamicin (PVA/CHI/Gent) hydrogel aimed at wound dressing in the medical treatment of deep chronic wounds. As a second application, we studied the release of gentamicin from antibacterial biodynamic hydroxyapatite/poly(vinyl alcohol) /chitosan/gentamicin (HAP/PVA/CS/Gent) coating on a titanium substrate for bone tissue implants, which enables drug delivery directly to the infection site. In both cases. a good agreement is obtained between the measured data and the data calculated from the model proposed here. The form of the general fractional derivatives used here results in an additional parameter in the compartmental model used here. This, as a consequence, leads to a better approximation of the experimental data with only a slightly more complicated numerical procedure in obtaining the solution.

A Novel Silver-Based Metal-Organic Framework Incorporated into Nanofibrous Chitosan Coatings for Bone Tissue Implants

In this work, new multi-layer nanocomposite coatings comprised of chitosan (CS) nanofibers functionalized using an innovative silver-based metal–organic framework (SOF) were developed. The SOFs were produced via a facile process using green and environmental-friendly materials. The CS-SOF nanocomposites were coated on hierarchical oxide (HO) layers fabricated on titanium substrates by an innovative two-step etching process. X-ray diffraction revealed fruitful production of the SOF NPs and their stable crystalline structure within the nanocomposite coatings. Energy-dispersive x-ray spectroscopy approved uniform SOFs distribution in the CS-SOF nanocomposites. Atomic force microscopy indicated more than 700% increased nanoscale roughness for the treated surfaces compared to the bare sample. In vitro MTT assay revealed proper cell viabilities on the samples, however, high SOFs concentration led to less biocompatibility. All coatings demonstrated positive cell proliferation rates up to 45% after 72 h. Antibacterial studies showed significant inhibition zones against Escherichia coli and Staphylococcus aureus bacteria with 100–200% effective antibacterial activities. Electron microscopy exhibited excellent cell-implant integration for the CS-SOF nanocomposite surfaces due to the attached cells with expanded morphologies and long filopodia. The prepared coatings showed high apatite formation capability and bone bioactivity.

A Non-Invasive Method for Monitoring Osteogenesis and Osseointegration Using Near-Infrared Fluorescent Imaging: A Model of Maxilla Implantation in Rats.

Currently, computed tomography and conventional X-ray radiography usually generate a micro-artifact around metal implants. This metal artifact frequently causes false positive or negative diagnoses of bone maturation or pathological peri-implantitis around implants. In an attempt to repair the artifacts, a highly specific nanoprobe, an osteogenic biomarker, and nano-Au-Pamidronate were designed to monitor the osteogenesis. In total, 12 Sprague Dawley rats were included in the study and could be chategorized in 3 groups: 4 rats in the X-ray and CT group, 4 rats in the NIRF group, and 4 rats in the sham group. A titanium alloy screw was implanted in the anterior hard palate. The X-ray, CT, and NIRF images were taken 28 days after implantation. The X-ray showed that the tissue surrounded the implant tightly; however, a gap of metal artifacts was noted around the interface between dental implants and palatal bone. Compared to the CT image, a fluorescence image was noted around the implant site in the NIRF group. Furthermore, the histological implant-bone tissue also exhibited a significant NIRF signal. In conclusion, this novel NIRF molecular imaging system precisely identifies the image loss caused by metal artifacts and can be applied to monitoring bone maturation around orthopedic implants. In addition, by observing the new bone formation, a new principle and timetable for an implant osseointegrated with bone can be established and a new type of implant fixture or surface treatment can be evaluated using this system.

Processing of gelatine coated composite scaffolds based on magnesium and strontium doped hydroxyapatite and yttria-stabilized zirconium oxide

Limited bone bank capacity and risk of infection are some of the main drawbacks of autologous and allogenic grafts, giving rise to synthetic materials for bone tissue implants. The aim of this study was to process and evaluate the mechanical properties and bioactivity of magnesium and strontium doped hydroxyapatite (HAp) scaffolds and investigate the effect of adding zirconium oxide and gelatine coating the scaffolds. Doped nanosized hydroxyapatite powder was synthesized by the hydrothermal method and the scaffolds were made by the foam replica technique and sintered at different temperatures. Yttria-stabilized zirconium oxide (YSZ), synthesized by plasma technology, was used as reinforcement of calcium phosphate scaffolds. Element analysis, phase composition, morphology of the powders and microstructure of the scaffolds were investigated, as well as the compressive strength of the coated and uncoated scaffolds and bioactivity in simulated body fluid (SBF). A microporous structure was achieved with interconnected pores and bioactivity in SBF was confirmed in all cases. The best mechanical properties were given by the coated composite HAp/YSZ scaffolds, withstanding average stresses of over 1019 kPa. These results encourage the idea of use of these scaffolds in bone regenerative therapy and bone tissue engineering.

Research on panoramic image reconstruction based on oral cone beam computed tomography

During the automatic reconstruction of panoramic images, the effect of dental arch curve fitting will affect the integrity of the content of the panoramic image. Metal implants in the patient's mouth usually lead to a decrease in the contrast of the panoramic image, which affects the doctor's diagnosis. In this paper, an automatic oral panoramic image reconstruction method was proposed. By calculating key image areas and image extraction fusion algorithms, the dental arch curve could be automatically detected and adjusted on a small number of images, and the intensity distribution of teeth, bone tissue and metal implants on the image could be adjusted to reduce the impact of metal on other tissues, to generate high-quality panoramic images. The method was tested on 50 cases of cone beam computed tomography (CBCT) data with good results, which can effectively improve the quality of panoramic images.

In vitro characterization of primary osteoblasts on titanium surfaces processed with wire-type electric discharge machining.

The fixation of titanium implants in bone tissue is affected by the presence of a passive titanium oxide (TiO2) layer. Specifically, oxidation products in the amorphous TiO2 matrix enhance the mechanical properties of mineralized tissues. In addition, in vitro mineralization mediated by primary osteoblasts on amorphous TiO2 generates stiff tissues in a process that resembles pathological mechanisms connected with tumors and proceeds through hydrogen peroxide-inducible clone-5 (Hic-5) expression. However, the relationship between surface-based peroxidation and stiff mineralized tissue formation remains unclear. In this study, titanium samples were processed using wire electrical discharge machining to generate oxidation products in amorphous TiO2. The gene expression profiles of primary osteoblasts cultured on these specimens were characterized. Increased expression of Hic-5 was correlated with the presence of peroxidation products. The crystallization of amorphous TiO2 in these samples reduced the expression of both Hic-5 and lysyl oxidase, an enzyme that promotes matrix cross-linking.

Biomechanical performance of Ti-PEEK dental implants in bone: An in-silico analysis

Stress-shielding is caused by a significant mismatch in stiffness between bone tissue and Ti alloy dental implants. Therefore, in this study, a Ti-PEEK composite implant was examined and compared with conventional titanium, to determine the behavior of the host bone. Twelve 3D finite element models were modeled with two conditions of marginal cortical bone (with and without marginal bone loss). Six implant designs were constructed. Implant (A) was made with a conventional design (dense titanium), implants (B), (C) and (D) are designed with Ti-PEEK composite (outer layer made of PEEK and inner structures made of Ti with hexagonal, cylindrical, and cross shapes for implants (B), (C) and (D), respectively), the implant (E) is designed with Ti at the upper half section and PEEK at the bottom half section, and the implant (F) is designed with PEEK at the upper half section and Ti at the bottom half section. An axial load of 200 N was applied to the buccal cusp and central fossa of the occlusal surface. The displacements, stress, and equivalent strain were analyzed at the level of bone tissue. The mechanostat of Frost was used to determine the behavior of the cancellous bone under these biomechanical conditions. Results showed that strains were greater in cancellous bone with marginal bone loss than in healthy bone (w/o MBL). When compared to implants (B)-(F), conventional implant (A) did not produce as much strain. Thus, results and analyses suggest that the Ti-PEEK implants outperform compared with the implant (A) in the case of no marginal bone loss. However, the implants (A) and (E) perform equally in terms of bone loss.

A new era in fundamentals of bone homeostasis: biocompatibility of bone mineral doped fluoride ions with osteoblast cells in the balance of calcium and phosphate metabolism

Aim: The use of biocompatible bone tissue grafts, filling materials, bone minerals, and implants, particularly in medicine and dentistry studies, has expanded significantly in recent years, as have expectations from the materials. We aimed to test the biocompatibility and wound and tissue biocompatibility of many grafts and similar materials used in medicine and dentistry with tests such as cytotoxicity, scratch assay, cell adhesion, and hemolysis.&#x0D; Material and Method: In this study, the interaction of fluorine ions with a dental material was investigated by biological activity experiments. In addition, studies were carried out on important osteoblast cells for tissue regeneration control. For this process, cell migration analysis, which we do not encounter frequently in the literature, was used to examine the interaction of cells with biomaterials more sharply.&#x0D; Results: Flor ions do not create a cytotoxic effect and also increase the viability of osteoblasts which is important for tissue regeneration and are bone precursor cells.&#x0D; Conclusions: In this study, in which the efficiency of osteoblast cells was discussed, it was concluded that 2% fluorine added material had more effective biological results compared to the increase in fluorine ion ratio.

Biomechanical comparison of four treatment models for the totally edentulous maxilla: a finite element analysis

The aim of this study is to evaluate by finite element analysis different techniques of totally edentulous maxilla rehabilitation, considering implants, bone tissue, metallic infra-structure, and prosthetic abutments characteristics, by means of a three-dimensional model. Stress distribution on bone tissue, implants, and abutments was analyzed with four configurations (six implants axially installed, all-on-four technique, M-4 technique, and four conventional implants with two zygomatic implants). Greater tension on bone tissue were found around distal implants, in all treatment groups, but not exceeding resistance limits of cortical bone. Von Mises stress was higher on the distal region of distal implants of all-on-four and M-4 techniques. Higher stress concentration was seen on angled abutments of zygomatic implants. The highest values of minimal compression stresses were concentrated on peri implant-bone tissue, especially in the model of All-on-4. Therefore, the present finite element analysis revealed that the four configurations of treatment (six implants axially installed, all-on-four technique, M-4 technique, and four conventional implants with two zygomatic implants) for the totally edentulous maxilla are feasible and safe, from a biomechanical point of view.

Efficiency of Nanohydroxyapatite on Repairing Type II Diabetes Dental Implant-Bone Defect.

The purpose of this study was to see how a nanohydroxyapatite (n-HA) composite polyamide 66 (PA66) affected the repair of bone defects in diabetics with titanium implants, as well as to develop experimental materials for the creation of the interface between bone tissue and titanium implants. Rabbit bone marrow mesenchymal stem cells (MSCs) were isolated using n-HA/PA66 composite material, and the effect of coculture with the material on cell proliferation was analyzed after induction of mineralization. Bone defect models of diabetic experimental rabbits and titanium implants were prepared. Normal rabbits with bone defects were used as control (NC group, N = 8). After the diabetic bone defect (DM group, N = 8) and the implantation of n-HA/PA66 composite material (n-HA/PA66 group, N = 8), the differences in body weight, blood glucose, scanning electron microscopy of the implant-bone interface, bone mineral density, new bone trabecular parameters, histomorphology, and biomechanical properties of the implant-bone interface were compared and analyzed. In vitro test results showed that MSC cell growth could be promoted by mineralization induction, the cell growth condition was good after coculture with n-HA/PA66, and the proliferation activity of MSCs was not affected by the material. In vivo test results showed that the body weight of the DM group and n-HA/PA66 group was considerably inferior to that of the NC group, and the blood glucose was dramatically superior to that of the NC group (P < 0.05). However, the body weight of the n-HA/PA66 group was dramatically superior to that of the DM group (P < 0.05). The bone mineral density, bone volume fraction (BV/TV), bone surface area fraction (BS/BV), bone trabecular thickness (Tb.Th), bone trabecular number (Tb.N), bone trabecular area, and biomechanical properties in the DM group were considerably inferior to those in the NC group and n-HA/PA66 group (P < 0.05). The trabecular space (Tb.Sp) in the NC group and n-HA/PA66 group was dramatically superior to that in the NC group (P < 0.05). The bone mineral density, BV/TV, BS/BV, Tb.Th, Tb.N, trabecular area, and biomechanical properties of the n-HA/PA66 group were dramatically superior to those of the NC group (P < 0.05), while Tb.Sp was considerably inferior to that of the NC group (P < 0.05). These findings showed that the n-HA/PA66 material had good biocompatibility and minimal cytotoxicity, and that filling the space between the surrounding bone and the titanium implant can enhance bone repair. This research paved the way for future research into the tissue-engineered bone in the field of oral surgery.