Dental Titanium Research Articles

Structure Protects Function: A Multilevel Engineered Surface Modification Renders the Surface of Titanium Dental Implants Resistant to Bacterial Colonization.

The global dental implant market is projected to reach $9.5 billion by 2032, growing at a 6.5% compound annual growth rate due to the rising prevalence of dental diseases. Importantly, this growth raises concerns about postoperative infections, which present significant challenges within our healthcare system and lead to a two-thirds failure rate for infected implants. In this study, we present an innovative multilevel coating system that makes the surface of dental titanium implants resistant to bacterial colonization, thereby minimizing the risk of infection development. This multilevel coating features a nanometer-thick biohybrid coating layer combined with a microgroove surface microstructuring, creating physical barriers that enhance the stability of the biohybrids against mechanical abrasion. Our coating demonstrates excellent biocompatibility and strong antifouling properties against undiluted blood plasma proteins. Furthermore, the combination of surface microstructuring and the biohybrid coating remains stable under prolonged mechanical stress simulation and effectively repels clinically relevant bacteria, achieving a 99% reduction in bacterial colonization on the implant. These findings underscore the potential of this approach to prevent implant-associated infections and highlight the critical role of surface engineering in ensuring long-term implant performance.

PEEK stress-shielding with artificial bone for dental implants.

Dental titanium implants and their surface modifications markedly improve implant biocompatibility. However, studies evaluating the mechanical biocompatibility of implants are scarce. In particular, the analysis of mechanical biocompatibility deficiencies leading to stress shield-induced bone resorption. Recently, we focused on using PEEK as a dental material. This study explored the hypothesis that PEEK implants improve the stress shielding of titanium. In this study, artificial bone surfaces were examined to measure strains on the artificial bone surface under compressive loading with the implants in place. Additionally, 3D image analysis of the fracture state inside the bone tissue was performed using micro-CT (µCT). This hypothesis was supported by µCT imaging analysis of bone tissue changes under stress, which revealed that PEEK implants transfer greater loads than titanium implants. µCT imaging and statistical analysis showed that bone porosity had little effect on stress shielding.

Osseointegration, inflammatory process and foreign body reaction of dental titanium implants

There has yet to be a consensus among researchers, professionals, companies, regulatory agencies, and technical standards regarding the definition of osseointegration. The divergence is conceptual and occurs due to explanations of the mechanisms of interactions among cells and proteins with the implant. In medicine, osseointegration is assessed visually in radiographic examinations by the absence of implant-bone space or by mechanical stability and absence of pain. In the medical field, it is mentioned that there is osseointegration of cemented orthopedic prostheses, stainless steel prostheses, Co-Cr-Mo alloys, and zirconia. In dentistry, osseointegration occurs only with titanium implants and is characterized by bonding bone cells with the implant surface through proteins. Titanium implants are chemically, physically, and mechanically linked to the bone through proteins adhered to their surface without a fibrous connective tissue interface. The protein-titanium connection has mechanical strength and can withstand functional loads on dental implants. Given the divergences in the understanding of osseointegration of titanium and zirconia implants, concepts are presented that explain the differences in biocompatibility and applications of biomaterials, inflammatory processes, osseointegration, foreign body reaction, and the mechanisms of protein interactions with surfaces of titanium and zirconia implants.

The influence of simvastatin on osteoblast functionality in the presence of titanium dioxide particles In-vitro

ObjectiveLeaching of particles from dental titanium implant surfaces into preimplant microenvironment causes detrimental effects on bone cells. The current study investigated influence of simvastatin in mitigating adverse pro-inflammatory effects of titanium dioxide (TiO2) micro (MP) and nano (NP) particles on hFOB 1.19 cells in vitro. DesignViability of hFOB 1.19 cells following exposure to varying concentrations of TiO2 MPs and NPs and simvastatin were measured by XTT assay. hFOB 1.19 cells were treated with 100 µg/mL of TiO2 MPs, 100 µg/mL of TiO2 NPs, 0.1 µM simvastatin, 100 µg/mL of TiO2 MPs+ 0.1 µM simvastatin and 100 µg/mL of TiO2 NPs+ 0.1 µM simvastatin. After 24 h, ROS was measured by flow cytometry. On day 14, real-time PCR analysis for pro-inflammatory cytokines and bone formation markers was done for TNFα, IL1β, osteocalcin, ALP, and Col1 markers; while ALP and RANKL/OPG ratio were determined by colorimetric and ELISA assays respectively. Further, mineralization study using Alizarin Red S staining (ARS) and calcium quantification were performed. ResultsExposure of hFOB to TiO2 MPs and NPs generated ROS and reduced cell viability significantly, with upregulation of pro-inflammatory markers TNFα and IL1β and downregulation of bone formation markers OC and increased RANKL/OPG ratio and lowered degree of mineralization. Treatment with 0.1 µM of simvastatin treatment reversed the effects by mitigating oxidative stress, dampening pro-inflammatory markers, upregulation of bone formation markers, lowering RANKL/OPG ratio and increasing degree of mineralization. ConclusionSimvastatin possesses antioxidant, anti-inflammatory, and pro-osteogenic properties that may support bone healing around titanium implants.

Bacterial reduction and temperature increase of titanium dental implant models treated with a 445 nm diode laser: an in vitro study

In this in vitro study, the use of a 445 nm diode laser was investigated for the decontamination of titanium dental implants. Different irradiation protocols and the effect of repetitive laser irradiation on temperature increase and decontamination efficacy were evaluated on titanium implant models. An automated setup was developed to realize a scanning procedure for a full surface irradiation to recapitulate a clinical treatment. Three irradiation parameter sets A (continuous wave, power 0.8 W, duty cycle (DC) 100%, and 5 s), B (pulsed mode, DC 50%, power 1.0 W, and 10 s), and C (pulsed mode, DC 10%, power 3.0 W, and 20 s) were used to treat the rods for up to ten consecutive scans. The resulting temperature increase was measured by a thermal imaging camera and the decontamination efficacy of the procedures was evaluated against Escherichia coli and Staphylococcus aureus, and correlated with the applied laser fluence. An implant’s temperature increase of 10 °C was set as the limit accepted in literature to avoid thermal damage to the surrounding tissue in vivo. Repeated irradiation of the specimens resulted in a steady increase in temperature. Parameter sets A and B caused a temperature increase of 11.27 ± 0.81 °C and 9.90 ± 0.37 °C after five consecutive laser scans, respectively, while parameter set C resulted in a temperature increase of only 8.20 ± 0.53 °C after ten surface scans. The microbiological study showed that all irradiation parameter sets achieved a complete bacterial reduction (99.9999% or 6-log10) after ten consecutive scans, however only parameter set C did not exceed the temperature threshold. A 445 nm diode laser can be used to decontaminate dental titanium rods, and repeated laser irradiation of the contaminated areas increases the antimicrobial effect of the treatment; however, the correct choice of parameters is needed to provide adequate laser fluence while preventing an implant’s temperature increase that could cause damage to the surrounding tissue.

Adhesion Forces of Dextran on Dental Materials as a Function of Contact Time and pH Value

The formation and colonization of biofilms inside the oral cavity are still not understood in detail, although biofilms inside the oral cavity can lead to expensive dental diseases like caries, periodontitis, or the detachment of implants. Such biofilms consist, to a large extent, of proteins, carbohydrates, and other macromolecules. Whereas the interaction of proteins with dental materials is widely studied, the literature does not report interactions of polysaccharides. Here, scanning force spectroscopy is used to investigate the adhesion forces of dextran as an abundant polysaccharide on different dental materials. The focus is dental titanium, accompanied by comparisons with dental gold and silicon as reference material. Different pH values and dental materials mimic representative conditions in the oral cavity. The main finding is that dextran adheres very well to dental materials, but with lower adhesion forces than proteins of similar mass, such as bovine serum albumin. As proteins, the adhesion forces increase with the contact time until a plateau is reached and the forces differ with the dental material. However, in contrast to proteins, pH does not play a role because dextran is uncharged over the measured range between pH 4.5 and pH 13.

Evaluation of antibacterial activity and biocompatibility of nano-titanium dioxide coatings prepared by atomic layer deposition for dental titanium abutments

To reduce the adhered bacteria on the dental titanium (Ti) abutments and the risk of peri‑implantitis, an antibacterial nanometer titanium dioxide (nano-TiO2) coating was developed by atomic layer deposition (ALD). The effects of the nano-TiO2 coatings on surface characteristics, antibacterial efficacy, biocompatibility, and corrosion resistance of Ti abutment materials were investigated. Specifically, the colors of Ti samples were changed from silver-gray to blue, yellow, and purple corresponding to the coating thicknesses were 50 nm, 100 nm, and 150 nm, respectively. Moreover, these coatings with different thicknesses all presented uniform morphologies with anatase TiO2 phases and hydrophobic characteristics. Simultaneously, the prepared coatings exhibited strong antibacterial effects against Staphylococcus aureus (S. aureus), Streptococcus mutans (S. mutans), and Porphyromonas gingivalis (P. gingivalis), which were independent of coating thicknesses. Additionally, Ti substrates coated with 100 nm nano-TiO2 demonstrated exceptional cell compatibility and corrosion resistance. In conclusion, these antibacterial and biocompatible nano-TiO2 coatings prepared by ALD possess great potential in dental aesthetic restorative materials.

Titanium Surfaces with a Laser-Produced Microchannel Structure Enhance Pre-Osteoblast Proliferation, Maturation, and Extracellular Mineralization In Vitro.

The clinical success of dental titanium implants is profoundly linked to implant stability and osseointegration, which comprises pre-osteoblast proliferation, osteogenic differentiation, and extracellular mineralization. Because of the bio-inert nature of titanium, surface processing using subtractive or additive methods enhances osseointegration ability but limits the benefit due to accompanying surface contamination. By contrast, laser processing methods increase the roughness of the implant surface without contamination. However, the effects of laser-mediated distinct surface structures on the osteointegration level of osteoblasts are controversial. The role of a titanium surface with a laser-mediated microchannel structure in pre-osteoblast maturation remains unclear. This study aimed to elucidate the effect of laser-produced microchannels on pre-osteoblast maturation. Pre-osteoblast human embryonic palatal mesenchymal cells were seeded on a titanium plate treated with grinding (G), sandblasting with large grit and acid etching (SLA), or laser irradiation (L) for 3-18 days. The proliferation and morphology of pre-osteoblasts were evaluated using a Trypan Blue dye exclusion test and fluorescence microscopy. The mRNA expression, protein expression, and protein secretion of osteogenic differentiation markers in pre-osteoblasts were evaluated using reverse transcriptase quantitative polymerase chain reaction, a Western blot assay, and a multiplex assay, respectively. The extracellular calcium precipitation of pre-osteoblast was measured using Alizarin red S staining. Compared to G- and SLA-treated titanium surfaces, the laser-produced microchannel surfaces enhanced pre-osteoblast proliferation, the expression/secretion of osteogenic differentiation markers, and extracellular calcium precipitation. Laser-treated titanium implants may enhance the pre-osteoblast maturation process and provide extra benefits in clinical application.

Surface-Mediated Modulation of Different Biological Responses on Anatase-Coated Titanium.

Various surface modification strategies are being developed to endow dental titanium implant surfaces with micro- and nano-structures to improve their biocompatibility, and first of all their osseointegration. These modifications have the potential to address clinical concerns by stimulating different biological processes. This study aims to evaluate the biological responses of ananatase-modified blasted/etched titanium (SLA-anatase) surfaces compared to blasted/acid etched (SLA) and machined titanium surfaces. Using unipolar pulsed direct current (DC) sputtering, a nanocrystalline anatase layer was fabricated. In vitro experiments have shown that SLA-anatase discs can effectively promote osteoblast adhesion and proliferation, which are regarded as important features of a successful dental implant with bone contact. Furthermore, anatase surface modification has been shown to partially enhance osteoblast mineralization in vitro, while not significantly affecting bacterial colonization. Consequently, the recently created anatase coating holds significant potential as a promising candidate for future advancements in dental implant surface modification for improving the initial stages of osseointegration.

Enhanced Bacterial and Biofilm Adhesion Resistance of ALD Nano-TiO2 Coatings Compared to AO Coatings on Titanium Abutments.

The study was intended to compare the surface properties and the bacterial and biofilm adhesion resistance of two potential antibacterial nanometer titanium dioxide (nano-TiO2) coatings on dental titanium (Ti) abutments prepared by atomic layer deposition (ALD) and the anodic oxidation (AO) techniques. Nano-TiO₂ coatings were developed using ALD and AO techniques and applied to Ti surfaces. The surface properties and the bacterial and biofilm adhesion resistance of these coatings were evaluated against commonly used Ti and Zirconia (ZrO₂) surfaces. The chemical compositions, crystalline forms, surface topography, roughness and hydrophilicity were characterized. The antibacterial performance was assessed by the scanning electron microscope (SEM), the Colony-forming unit (CFU) assay and the 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay using in vitro models of Staphylococcus aureus (S. aureus), Streptococcus mutans (S. mutans), and Porphyromonas gingivalis (P. gingivalis) in both single- and mixed-species bacterial compositions. ALD-prepared nano-TiO₂ coatings resulted in a dense, smooth, and less hydrophilic surface with an anatase phase, significantly reducing the adhesion of the three bacteria by over 50%, comparable to ZrO₂. In contrast, AO-prepared coatings led to a less hydrophilic surface, characterized by various nano-sized pores within the oxide film. This alteration, however, had no impact on the adhesion of the three bacteria. The adhesion patterns for mixed-species bacteria were generally consistent with single-species results. ALD-prepared nano-TiO₂ coatings on Ti abutments demonstrated promising antibacterial properties comparable to ZrO₂ surfaces, suggesting potential in preventing peri-implantitis. However, the bacterial and biofilm adhesion resistance of AO-produced nano-TiO₂ coatings was limited.

INFLUENCE OF DIFFERENT TITANIUM SURFACE TREATMENTS ON THE BIOLOGICAL BEHAVIOR OF OSTEOBLASTIC CELLS

Introduction: Different methods of treatment to dental titanium surfaces have been adopted to improve mechanical and chemical properties of the implant and to improve osseous integration. Objective:The objective of the present work was to compare the performance of three titanium surfaces, Porous® (obtained by double acid treatment), Vulcano Actives® (obtained by anodization), and PorousNano® (obtained by double acid treatment and fluoride incorporation) in regards to cell proliferation of osteoblast precursors and gene expression of extracellular matrix proteins type 1 collagen, osteocalcin, osteopontin and ostenectin. Materials and Methods: We utilized commercially pure grade 4 titanium discs to cultivate osteoblastic precursor cell line MC3T3-E1 (ATCC - USA). After 3, 7 and 10 days, we performed cell proliferation assay using Trypan blue exclusion testand gene expression analysis by Real-Time PCR. Results and Conclusion: Results were recorded and analyzed statistically using a level of significance of P<0.05. We observed higher cell proliferation and higher gene expression of proteins linked to synthesis and mineralization of the extracellular matrix on the Vulcano Actives® surface.

Chemical reaction and strength of tricalcium phosphate nano-coating application on dental implants by atomistic calculations

The success of dental titanium implants depends on the interaction of the implant with the surrounding bone, including the type of coating that promotes osseointegration. The most popular are calcium phosphate coatings, in particular tricalcium phosphate (TCP). Since cases of delamination of coatings from titanium have been observed in practice, it is important to be able to evaluate and predict the adhesion strength of coatings of different compositions to titanium.The work involves ab initio quantum chemical modeling of the interaction of TCP with titanium oxide and calculation of their binding energy. Considering that titanium instantly oxidizes in air, calculations were carried out with titanium dioxide. The Gaussian09 DFT B3LYP package with the 6-31G basis set was used. We synthesized tricalcium phosphate stepwise by assessing the binding energies between its constituents and titanium dioxide, as well as other structural characteristics including bond lengths, bond angles, dihedral angles, and charges. A method for assessing adhesion strength at the macro level using binding energy values calculated at the nano level is proposed. The values obtained are in reasonable agreement with experimental data and other numerical calculations. Using the methods of micromechanics of inhomogeneous media for the polycrystalline/amorphous structures of hydroxyapatite (HA) and β-TCP coatings, their anisotropic elastic characteristics were averaged and the degree of their closeness to the characteristics of the Ti substrate was compared.A comparison of two CFs showed that HA has an advantage over TCP both in terms of greater chemical affinity with the titanium substrate (higher adhesive bond energy) and in terms of proximity to the substrate in terms of mechanical characteristics (lower stress concentration at the bond boundary).

Improved osseointegration of dental titanium implants by TiO2 nanotube arrays with self-assembled recombinant IGF-1 in type 2 diabetes mellitus rat model

Abstract Improvement of poor implant osseointegration under diabetes is always a poser in clinics. The purpose of this study was to investigate the effect of TiO2 nanotubes (TNTs) and self-assembled minTBP-1-IGF-1 on implant osseointegration in type 2 diabetes mellitus (T2DM) rats. There were four groups, the control group, the TNTs group, the minTBP-1-IGF-1 group, and the minTBP-1-IGF-1-TNTs group. The atomic force microscopy and scanning electron microscope (SEM) results showed that 500 nm nanotubes were formed by anodic oxidation and minTBP-1-IGF-1 could self-assemble into almost all nanotubes. ELISA assay confirmed that more protein was adsorbed on TNTs surface. The contact angle of the minTBP-1-IGF-1-TNTs group was the lowest, confirmed that the hydrophilicity was the highest. The double fluorescence staining was used to evaluate the mineral apposition rate (MAR) at early stage and the MAR of the minTBP-1-IGF-1-TNTs group was the highest. Micro-CT images displayed that bone formed around the minTBP-1-IGF-1-TNTs implant was the most homogeneous and dense, and the quantitative analysis of these images at 12 weeks also confirmed these results. The cross-section SEM results showed that the connection between bone and minTBP-1-IGF-1-TNTs implant was the tightest. All results demonstrated that minTBP-1-IGF-1-TNTs can significantly improve low implant osseointegration under T2DM condition.

Photofunctionalization of Dental Implant Surfaces - A Histomorphometric Animal Study.

To compare and evaluate the degree of osseointegration of UV-treated (photo functionalized) and non-treated dental implants surface coated with Calcium phosphate using the Resorbable Blast Media (RBM) technique in an animal model. Evaluative-Animal study design. Six titanium dental implants of diameter 3.2 mm and length of 8 mm with Calcium phosphate coated surface using RBM or resorbable blast media technology (Implant Genesis: Genesis Normo Implant system) were placed epicrestally into the proximal femoral condyle of New Zealand white female rabbits such that each animal received two implants. Before implantation, one out of the two dental implants was photo functionalized with intense UV light for 15 minutes. After twelve weeks of healing, the animals were euthanized and the harvested specimens were analyzed using histomorphometric light microscopy to assess two parameters bone-implant contact and bone volume density. SPSS version 23. P less than 0.05 is considered statistically significant. Tests used ANOVA followed by Tukey post hoc test. All six dental implants were osseointegrated. The overall mean bone-implant contact area (BIC) was 57.76% for non-UV treated whereas 88.4367% for UV-treated dental implants. The overall mean bone volume density (BVD) was 32.2333% for non-UV treated whereas 67.7533% for UV-treated dental implants. Significant effects were observed on the osseointegration of dental titanium implants within twelve weeks after UV photo functionalization. The UV photo functionalization of dental titanium implants in the current study significantly altered the BIC and bone density on osseointegration when observed over twelve weeks.

Influence of Dental Titanium Implants with Different Surface Treatments Using Femtosecond and Nanosecond Lasers on Biofilm Formation.

This study aimed to evaluate the impact of different surface treatments (machined; sandblasted, large grit, and acid-etched (SLA); hydrophilic; and hydrophobic) on dental titanium (Ti) implant surface morphology, roughness, and biofilm formation. Four groups of Ti disks were prepared using distinct surface treatments, including femtosecond and nanosecond lasers for hydrophilic and hydrophobic treatments. Surface morphology, wettability, and roughness were assessed. Biofilm formation was evaluated by counting the colonies of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) at 48 and 72 h. Statistical analysis was conducted to compare the groups using the Kruskal-Wallis H test and the Wilcoxon signed-rank test (α = 0.05). The analysis revealed that the hydrophobic group had the highest surface contact angle and roughness (p < 0.05), whereas the machined group had significantly higher bacterial counts across all biofilms (p < 0.05). At 48 h, the lowest bacterial counts were observed in the SLA group for Aa and the SLA and hydrophobic groups for Pg and Pi. At 72 h, low bacterial counts were observed in the SLA, hydrophilic, and hydrophobic groups. The results indicate that various surface treatments affect implant surface properties, with the hydrophobic surface using femtosecond laser treatment exerting a particularly inhibitory effect on initial biofilm growth (Pg and Pi).

In-Vitro Biofilm Removal Efficacy Using Water Jet in Combination with Cold Plasma Technology on Dental Titanium Implants.

Peri-implantitis-associated inflammation can lead to bone loss and implant failure. Current decontamination measures are ineffective due to the implants' complex geometry and rough surfaces providing niches for microbial biofilms. A modified water jet system (WaterJet) was combined with cold plasma technology (CAP) to achieve superior antimicrobial efficacy compared to cotton gauze treatment. Seven-day-old multi-species-contaminated titanium discs and implants were investigated as model systems. The efficacy of decontamination on implants was determined by rolling the implants over agar and determining colony-forming units supported by scanning electron microscopy image quantification of implant surface features. The inflammatory consequences of mono and combination treatments were investigated with peripheral blood mononuclear cell surface marker expression and chemokine and cytokine release profiles on titanium discs. In addition, titanium discs were assayed using fluorescence microscopy. Cotton gauze was inferior to WaterJet treatment according to all types of analysis. In combination with the antimicrobial effect of CAP, decontamination was improved accordingly. Mono and CAP-combined treatment on titanium surfaces alone did not unleash inflammation. Simultaneously, chemokine and cytokine release was dramatically reduced in samples that had benefited from additional antimicrobial effects through CAP. The combined treatment with WaterJet and CAP potently removed biofilm and disinfected rough titanium implant surfaces. At the same time, non-favorable rendering of the surface structure or its pro-inflammatory potential through CAP was not observed.

Antibacterial Activity and Biocompatibility with the Concentration of Ginger Fraction in Biodegradable Gelatin Methacryloyl (GelMA) Hydrogel Coating for Medical Implants.

The gingerols and shogaols derived from ginger have excellent antibacterial properties against oral bacteria. However, some researchers have noted their dose-dependent potential toxicity. The aim of this study was to enhance the biofunctionality and biocompatibility of the application of ginger to dental titanium screws. To increase the amount of coating of the n-hexane-fractionated ginger on the titanium surface and to control its release, ginger was loaded in different concentrations in a photo-crosslinkable GelMA hydrogel. To improve coating stability of the ginger hydrogel (GH), the wettability of the surface was modified by pre-calcification (TNC), then GH was applied on the surface. As a result, the ginger fraction, with a high content of phenolic compounds, was effective in the inhibition of the growth of S. mutans and P. gingivalis. The GH slowly released the main compounds of ginger and showed excellent antibacterial effects with the concentration. Although bone regeneration was slightly reduced with the ginger-loading concentration due to the increased contents of polyphenolic compounds, it was strongly supplemented through the promotion of osteosis formation by the hydrogel and TNC coating. Finally, we proved the biosafety and superior biofunctionalities the GH-TNC coating on a Ti implant. However, it is recommended to use an appropriate concentration, because an excessive concentration of ginger may affect the improved biocompatibility in clinical applications.

Antibacterial Adhesion Strategy for Dental Titanium Implant Surfaces: From Mechanisms to Application.

Dental implants are widely used to restore missing teeth because of their stability and comfort characteristics. Peri-implant infection may lead to implant failure and other profound consequences. It is believed that peri-implantitis is closely related to the formation of biofilms, which are difficult to remove once formed. Therefore, endowing titanium implants with anti-adhesion properties is an effective method to prevent peri-implant infection. Moreover, anti-adhesion strategies for titanium implant surfaces are critical steps for resisting bacterial adherence. This article reviews the process of bacterial adhesion, the material properties that may affect the process, and the anti-adhesion strategies that have been proven effective and promising in practice. This article intends to be a reference for further improvement of the antibacterial adhesion strategy in clinical application and for related research on titanium implant surfaces.

The role of current herbal extracts in bone regeneration through dental implants: in vitro/in vivo/clinical studies.

The quality and quantity of bone at the interface of an implant system are determining factors in the implant's stability. Alternative agents have been studied to augment implants and bone defects, including bone-conductive and bone-inducing agents. By modifying implant surface coatings on the nanoscale, one can enhance osseointegration by stimulating bone cell adhesion, bone matrix formation, and mineralization. Because alternative agents stimulate osteoblasts to mineralize and can control pectin structure, plant-derived silicone has been suggested as a potential candidate for surface nanocoatings on orthopedic and dental titanium implants. Inducing the differentiation of cells or accelerating bone regeneration is possible with the plant extract. Coating these extracts on implant devices can improve cell attachment, differentiation, and proliferation. This review article discusses the role of herbal materials in bone regeneration through dental implants.

Histomorphometric and biomechanical evaluation of the osseointegration around micro- and nano-level boron-nitride coated titanium dental implants

IntroductionTitanium dental implants has been coated with different materials such as polymers and biomimetic agents, bone morphogenetic protein, calcium phosphate to enhance surface properties of the titanium implants for osseointegration. The aim of this study was to evaluate the bone tissue healing around Boron Nitride-coated (BN-coated) titanium implants histomorphometrically and biomechanically and also observe the effect of different coating thicknesses on osseointegration. Materials and methodsBN was coated on dental titanium implants with two different coating thicknesses by using RF magnetron sputtering system. Totally fifty-four implants were inserted into the tibias’ of 12 New Zealand rabbits bilaterally under general anesthesia. All animals were sacrificed after 4-weeks. Bone-implant contact (BIC) and new bone area/total area ratios (BATA) were calculated. Also, the removal torque (RT) test was performed. ResultsThe highest new bone area in the medullary cavity was around the nano-BN-coated surface with 15.70%. In micro-BN-coated surface and control group, this ratio was determined as 10.48% and 8.23%, respectively. The BIC ratios in upper-side of implants and cortical-associated BIC ratios in lower-side were found significantly higher in control and micro-BN-coated group than nano-BN-coated group (p < 0.05). Similar BIC values were observed between control and micro-BN-coated groups (p > 0.05). BATA values did not show statistically significant differences between all three groups (p > 0.05). The RT values measured in all groups were found comparable and no statistically significant differences were found (p > 0.05). ConclusionNo inflammatory reaction developed around any implant. Relatively more new bone formation around nano-BN-coated titanium implants indicates the promising osseoinductive effect of BN coating. BN-coated implants showed similar biomechanical and histomorphometrical outcomes to that of the conventional titanium implants through a 4-week evaluation period.