Osseointegration Of Titanium Dental Implants Research Articles

The Combined Therapy of Teriparatide and Raloxifene Improves Osseointegration of Dental Implants in the Osteoporotic Rabbit Model.

To evaluate the efficacy of combined therapy of teriparatide and raloxifene on the osseointegration of titanium dental implants in a rabbit model of osteoporotic bone. Sixty female rabbits were randomly divided into six groups. The sham ovariectomy group (control) consisted of animals that received no medication. Animals in the ovariectomy group (OVX) underwent ovariectomy and received no medication. The combined group consisted of ovariectomized animals that received combined teriparatide (10 mg/kg) for 12 weeks and raloxifene (10 mg/kg) for 12 weeks. The sequential group (SEQ) consisted of ovariectomized animals that received teriparatide (10 mg/kg) for the first 6 weeks and raloxifene therapy (10 mg/kg) for the following 6 weeks sequentially. The parathormone (PTH) and raloxifene (RAL) groups consisted of ovariectomized animals that received only teriparatide (10 mg/kg) for 12 weeks or raloxifene (10 mg/kg) for 12 weeks, respectively. Dental implants (Bilimplant) were placed in the proximal metaphysis of both tibias in all rabbits. Histomorphometric and microCT studies were performed on the specimens obtained from the right tibia bone. Removal torque (RTQ) and implant stability quotient (ISQ) tests were performed on the specimens obtained from the left tibia bone. The results were compared and evaluated statistically. RTQ analysis revealed a statistically significant difference between the mean values of the combined group (93.01 ± 27.19 Ncm) and the OVX group (49.6 ± 12.5 Ncm) (P = .015). The highest mean T0 (implantation day) value was obtained in the control group (67.1 ± 3.4 Ncm), and the lowest mean value was obtained in the OVX group (61.4 ± 3.8 Ncm). The highest T1 mean (3 months after implantation) was obtained by the combined group (76.6 ± 3.8 Ncm), and the lowest mean was obtained by the OVX group (68.9 ± 6.2 Ncm). Histomorphometric analyses showed that the mean percentage of bone-to-implant contact (BIC%) of the combined group (51.2%) was significantly higher than that of the OVX group (28.6%) (P =.006). In the microCT examinations, it was found that the mean BIC% value of the combined group (41.1%) was significantly higher than that of the OVX group (24.1%) (P < .001). According to the results of the current study, combined therapy of teriparatide and raloxifene improves the BIC and osseointegration of titanium dental implants in osteoporotic bone compared with sequential or independent therapy with these agents.

Radiographic and histologic assessment of osseointegration for surface-treated titanium dental implants: An experimental study in dogs.

Modifying the dental implant's surface texture enhances its biological response to the bone and implant‒tissue interface, resulting in the successful support of forces. This study assessed the impact of sandblasting, sandblasting plus acid etching, Er,Cr:YSGG laser, and propolis implant surface treatments and occlusal load on the osseointegration of titanium dental implants in dogs. Seventy-two titanium dental implants with a diameter of 4 mm and a length of 10 mm were divided into four groups according to implant surface modifications (n=18 for each group): group A: sandblasting plus acid etching, group B: sandblasting with Al2 O3, group C: Er,Cr:YSGG laser, group D: propolis coating. Twenty-four local breed male dogs were used. Premolar teeth (P1, P2, and P3) were extracted on the left side of the mandible, and after 12 weeks of bone healing, implants were unilaterally installed. The osseointegration at three study times from implant installation (14, 90, and 180 days) was evaluated. The dog jaws were scanned using an intraoral scanner for the virtual design of screw-retained three-unit crowns after 90 days of osseointegration. Final radiographs were taken before the animals were sacrificed at 14, 90, and 180 days, and the histological analysis was performed. Radiographic analysis showed new bone formation (NBF) along and in contact with the implant surface of the treated groups. The histological analysis after 14 days in groups A and B revealed a uniform and ongoing pattern of bone growth and many osteoblasts with few osteocytes within lacunae in new bone trabeculae. Group C showed an increase in the number of osteoblasts lining thin bone trabeculae. Group D showed a generative power concerning bone. At 90 days, there was increased bone ingrowth, and the new bone matured in all the treated implant groups. At 180 days, dense mature bone apposition was in direct contact with delayed-loaded implant surfaces. A radiographic examination revealed that surface modification significantly impacted osseointegration, with a strong bond between the implant surface and the surrounding bone. The histological sections at the 14-day interval revealed obvious bone remodeling activity, especially in sandblasting plus acid etching and sandblasting-modified implant surface groups. At the 90-day interval, bone ingrowth had increased, and the new bone became mature, especially in sandblasting and propolis surface modification groups. After 180 days of the delayed-loaded implant osseointegration, differences were observed between different implant-treated groups with a remarkable remodeling of the bone, especially in the propolis coating group.

SURFACE MATTERS THAN THE IMPLANT ITSELF-A REVIEW

Nowadays dental implants are a predictable and popular treatment option for tooth replacement in completely or partially edentulous patients. Implants are preferred over conventional treatment due to certain advantages it offers like preservation of bone; preservation of adjacent teeth, durability, better mastication and speech etc.Implant comes in direct bone contact and anchors through osseointegration. Successful osseointegration revolves around many factors such as biocompatibility of the implant material, quality and quantity of the available bone, surface treatment of the implant, loading and surgical protocol and various other systemic and local factors. Predictability of clinical success of dental implants can be enhanced by using newer materials or alterations in designs, surgical or loading protocols on the basis of available literature. Various studies have suggested that rough surface of implant enhances its integration with bone than a smooth implant surface. Several approaches are used to attain a rough surface and to improve the process of osseointegration of titanium dental implants. The present paper reviews different methods of treating implant surfaces to enhance bone implant interaction starting from the basic material used in dental implant manufacture.

Biomechanical and Histologic Evaluation of Osseointegration of Titanium Dental Implants Modified by Various Combinations of Sandblasting, Acid-Etching, Hydroxyapatite, and Hyaluronic Acid Coating Techniques.

To compare the osseointegration process of the titanium dental implants with five different surface characteristics-sandblasted, sandblasted and acid-etched, hyaluronic acid-coated (HYA), hydroxyapatite-coated (HA), and machined-in an experimental sheep model at 1- and 3-month examinations. One hundred sixty dental implants were placed in the left and right tibias of 16 sheep. Five experimental groups were designed. Eight animals (80 implants) were used for biomechanical tests of reverse torque analysis and resonance frequency analysis (RFA). Eight of them (80 implants) were used for the evaluation of bone-to-implant contact (BIC) percentage in histomorphometric analysis. Forty of 80 implants (8 implants for each group) were used at 1-month examinations, and the remaining 40 (8 implants for each group) implants were used at 3-month examinations in the biomechanical test group and histomorphometric examination group, separately. Intergroup analysis at the 3-month followup showed that the increase in the implant stability quotient (ISQ) value was statistically significant for only the HYA group (P < .05). According to ISQ values at 1 and 3 months, group HYA showed statistically higher values at the 1 and 3-month examinations (P < .05). Groups HYA and HA had statistically higher reverse torque values than other groups at the 1-month examination (P < .05). At the 3-month evaluation, the HYA group showed significantly higher reverse torque values compared to other groups (P < .05). The BIC values of the sandblasted and acid-etched, HYA, and HA groups were significantly higher than the sandblasted and machined groups at the 1- and 3-month examinations (P < .05). The BIC value for the HA group showed decreased value at the 3-month examination compared to the 1-month examination (P < .05). The RFA, reverse torque, and histomorphometric analysis at 1- and 3-month examinations show that dental implants coated with HYA may have increased potential for osseointegration compared to dental implants with sandblasted, sandblasted and acid-etched, machined, and HA-coated surfaces. Int J Oral Maxillofac Implants 2023;38:583-590. doi: 10.11607/jomi.9935.

Extracorporeal Shock Wave Therapy as a Helpful Method for Rapid Osseointegration of Dental Implants: Animal Study

The aim of this study was to assess the multi-phasic use of extracorporeal shock wave therapy (ESWT) as an adjuvant treatment to accelerate the osseointegration of titanium dental implants. Initially, twelve titanium mini-screws were inserted in femur bones of six New Zealand rabbits in three groups; the one-time treated group, the three-time treated group, and the control group (without ESWT). Then, 1800 focused shockwaves with an energy flux density of 0.3 mJ/mm2 in every phase were used. Fourteen days after the last phase of ESWT, the animals were sacrificed to assess the osseointegration of screws via micro-computed tomography scan (micro-CT scan), biomechanical pull-out test, and histopathological analysis. Pull-out and histopathology analysis showed that the ESWT significantly increased bone regeneration and osseointegration around the implants compared to the control group (p < 0.05). Moreover, the pull-out test confirmed that the three-time treated screws needed more force to pull the bone out compared to the other two groups (p < 0.05). The mean bone volume fraction between the control group, the one-time treated group, and the three-time treatment group were not statistically significant (p > 0.05) according to the micro-CT scan results. Based on our results, ESWT can be suggested as a non-invasive and cost-effective adjuvant for osseointegration of dental implants. However, more in vivo studies and clinical trials are needed for validation of this finding.

Development and Characterization of Antimicrobial Nanocoatings for Titanium Dental Implants to Prevent Peri-Implantitis and Improve Osseointegration

The main cause of peri-implantitis, a serious complication in dental implantology, is bacterial colonization and biofilm formation on implant surfaces, which results in inflammation and bone loss. The current range of treatments, such as antibiotic medication and mechanical debridement, is frequently insufficient to completely eradicate the infection and stop it from returning. By creating and analyzing antimicrobial nanocoatings for titanium dental implants, this project seeks to address this difficulty by reducing the risk of peri-implantitis and enhancing osseointegration. Three goals are being pursued by this research: first, antimicrobial nanocoatings on titanium implants will be synthesized and applied using agents like gentamicin, chitosan, and silver nanoparticles; second, these coatings' physicochemical characteristics and antimicrobial efficacy will be characterized; and third, their potential to improve osseointegration will be assessed. In order to evaluate surface shape and chemical content, the nanocoatings were fully characterized utilizing methods such as energy dispersive spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), and scanning electron microscopy (SEM). In order to evaluate surface shape and chemical content, the nanocoatings were fully characterized utilizing methods such as energy dispersive spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), and scanning electron microscopy (SEM). The findings suggest that antibacterial nanocoatings improve the osseointegration of titanium dental implants while simultaneously lowering the incidence of peri-implantitis. These results imply that by providing a proactive strategy for infection control and bone integration, incorporating antimicrobial nanocoatings into the conventional dental implant production process could completely transform implantology. It is advised that more research be done, including in vivo investigations and clinical trials, in order to corroborate these results and expedite the practical implementation of this technology, ultimately leading to better patient outcomes and longer implant lifespans.

Improvement in Osseointegration of Titanium Dental Implants After Exposure to Ultraviolet-C Light for Varied Durations: An Experimental Study in Beagle Dogs

Ultraviolet-mediated photofunctionalization is a valid technology for enhancing the osseointegration of titanium implants. However, there is no consensus on the effective exposure time to ultraviolet light. The objective of this study was to evaluate the effect of different exposure times of ultraviolet-C (UVC) light on aged titanium implants and explore the optimal treatment duration of UVC photofunctionalization for osseointegration in an animal model. Eight male beagle dogs (n=48) were divided into a control group (n=12) and 3 experimental groups (n=12/12/12) which received 4-week-old implants without UVC treatment (C) or treated with UVC for 1/6hour, 1/2hour, and 1hour (UVC-1/6hour, UVC-1/2hour, UVC-1hour) immediately before placement. All the implants were placed 12weeks after mandibular premolars extraction. Four dogs were euthanized after 4 and 12weeks of healing, respectively. The marginal bone level and implant stability quotient were measured at implant placement and after sacrifice. Subsequently, micro-CT and histomorphometric analyses were performed following block harvesting. No significant difference in marginal bone loss between the UVC-untreated and UVC-treated groups was found at 4 or 12weeks. At 4weeks, significantly higher BV/TV and bone-implant contact were observed in the UVC groups than in the C group, irrespective of the UVC-photofunctionalization duration (BV/TV: UVC-1/6hour 0.48±0.11, UVC-1/2hour 0.50±0.06, and UVC-1hour 0.47±0.08, C 0.34±0.04; bone-implant contact : UVC-1/6hour 84.30±5.02%, UVC-1/2hour 85.82±5.05%, and UVC-1hour 84.98±3.86%, C 71.69±3.52%. P<.05), whereas, no significant difference was observed among the UVC groups. At 12weeks, there were no significant differences between the C group and UVC groups. After 4 and 12weeks of healing, no significant difference in implant stability quotient values was observed between the C group and UVC groups. UVC photofunctionalization improved the early osseointegration of aged titanium implants. However, the effect was not dependent on the UVC-light duration within the range from 1/6hour to 1hour.

Effects of photofunctionalization on early osseointegration of titanium dental implants in the maxillary posterior region: a randomized double-blinded clinical trial

BackgroundThis study aimed to investigate the effects of ultraviolet (UV) photofunctionalization on the stability of implants during the early phase in the posterior region of the maxilla. The study was a randomized double-blinded clinical trial. Half of the participants received conventional commercial implants while the other half received UV-irradiated implants. The surgical sites were classified into three bone quality groups (II, III, IV) based on the grayscale value measured on cone-beam computed tomography. The values obtained from resonance frequency analysis were recorded immediately after implant placement and at 4 weeks and at 4 months postoperatively. The marginal bone level of the implants was evaluated using periapical radiographs at 4 weeks, 4 months, and 1 year postoperatively.ResultsFifty-seven implants placed in 34 participants were analyzed in this study. In group III, significant differences were observed in terms of the differences of resonance frequency analysis values at 4 weeks (p = 0.004) and 4 months (p = 0.017) postoperatively. In group II, the UV-treated group showed significantly lesser bone loss at 4 weeks post-operatively (p = 0.037).ConclusionsWithin the limitation of the present study, we concluded that UV surface treatment on implants may increase the initial stability in the region of the maxilla with poor bone quality.

Effect of low-level laser therapy on osseointegration of titanium dental implants in ovariectomized rabbits: biomechanics and micro-CT analysis

PurposeThe primary aim of this study is to assess, in an animal model, whether biostimulation of osteoporotic bone with low-level laser therapy improves the osseointegration of dental implants.Material and methodsTwenty-two female rabbits were randomly divided into two groups: sham-ovariectomy and bilateral-ovariectomy. Laser therapy was applied to the implants placed in the right tibial bones and was not applied to implants placed in the left tibial bones. The periotest device was used for the stability test. Periotest values were recorded after the implantation (T0) and when the animals were euthanized (T1). The removal torque test and micro-computed tomography examination were evaluated.ResultsAs a result of removal torque, the mean of ovariectomy-laser group (56.1 ± 5.1 Ncm) was higher than sham-ovariectomy group (55.4 ± 18.5 Ncm) (p = 0.9). In periotest analysis, a significant difference was found between the values of T1 and T0 in all groups, except sham-ovariectomy group (p < 0.05); and the highest difference was found in the ovariectomy-laser group. Micro-CT examination demonstrated that ovariectomy-laser group showed an increase of implant–bone contact when compared with ovariectomy (p < 0.05).ConclusionsThe values obtained from biomechanical tests and micro-CT in the ovariectomy-laser group were significantly higher than the ovariectomy group and achieved the values in the healthy bone.

Diabetic Serum Inhibits Osteoblast Adhesion to Titanium Surface Through Advanced Glycation End Products: An In Vitro Study.

Diabetes mellitus has been shown to delay osseointegration of titanium dental implants. This study tested the hypothesis that serum derived from diabetes negatively affects osteoblast adhesion to polystyrene and titanium surfaces, partly through the presence of advanced glycation end products (AGEs). Twenty-four Sprague-Dawley rats were divided into three groups: normoglycemic control, streptozotocin-induced diabetic group, and diabetic group treated with the AGE inhibitor aminoguanidine. Polystyrene or titanium disks were preincubated in serum derived from each group. Human osteoblasts transfected with green fluorescent protein (GFP) were cultured, and the number of adherent osteoblasts was quantified. High-pressure liquid chromatography (HPLC) was used to fractionate eluates, which were further characterized by western blot with AGE antibody and adhesion assays. In parallel, sera derived from healthy patients, patients with controlled diabetes, and patients with uncontrolled diabetes were utilized for osteoblast adhesion assay and western blot. Diabetic serum significantly reduced the number of adherent osteoblast and osteoblast aggregates on titanium disks, whereas aminoguanidine-treated serum rescued the effect of diabetes on the number of adherent osteoblast aggregates. Fractionated diabetic serum revealed distinct AGE bands at ~100 kDa and 44 kDa, whereas healthy serum did not express any. In human serum samples, both controlled and uncontrolled diabetes led to a significant reduction in the number of adherent osteoblasts on polystyrene and titanium surfaces compared with normoglycemic serum. This correlated with presence of AGEs in western blot in diabetic but not in healthy serum. Osteoblast adhesion on the titanium surface was greatly reduced by the exposure of serum derived from diabetic rats or humans. Recovery of osteoblast aggregates by aminoguanidine treatment suggests that AGEs played a role in this negative effect. The correlating presence of AGEs from the fractionated sera of diabetic rats or humans and impaired osteoblast adhesion on the titanium surface further supports this role.

Effect of boron nitride‐coating on the osseointegration of titanium dental implants – A rabbit model

Effect of boron nitride‐coating on the osseointegration of titanium dental implants – A rabbit model

Surface Modification of Titanium Dental Implants: A Review

Osseointegration of titanium dental implants is the most important clinical parameter for an implant to be successful. One of most biocompatible material, titanium can be made to affix fast on to host bone via various modification of its surface. Machined and smooth titanium implant osseointegrate into living bone tissue but with a roughened surface, this is much more predictable as well as promising clinically. Surface modification allows for an increase in the surface area on to which the osteoblasts easily start laying bone. So, there have been various methods to roughen the surface of titanium implants. The article describes various methods used for modifying the surfaces of dental implants, giving a note on their clinical efficacy as well as advantages and disadvantages of these methods.

Surface characteristics of bioactive Ti fabricated by chemical treatment for cartilaginous-integration

Artificial hip joints are generally expected to fail due to wear after approximately 15years and then have to be replaced by revision surgery. If articular cartilage can be integrated onto the articular surfaces of artificial joints in the same way as osseo-integration of titanium dental implants, the wear of joint implants may be reduced or prevented. However, very few studies have focused on the relationship between Ti surface and cartilage. To explore the possibility of cartilaginous-integration, we fabricated chemically treated Ti surfaces with H2O2/HCl, collagen type II and SBF, respectively. Then, we evaluated surface characteristics of the prepared Ti samples and assessed the cartilage formation by culturing chondrocytes on the Ti samples. When oxidized Ti was immersed in SBF for 7days, apatite was formed on the Ti surface. The surface characteristics of Ti indicated that the wettability was increased by all chemical treatments compared to untreated Ti, and that H2O2/HCl treated surface had significantly higher roughness compared to the other three groups. Chondrocytes produced significantly more cartilage matrix on all chemically treated Ti surfaces compared to untreated Ti. Thus, to realize cartilaginous-integration and to prevent wear of the implants in joints, application of bioactive Ti formed by chemical treatment would be a promising and effective strategy to improve durability of joint replacement.

THE EFFECT OF LOW INTENSITY ULTRASOUND THERAPY ON OSSEOINTEGRATION OF TITANIUM DENTAL IMPLANT PLACED IN THE ESTHETIC ZONE

Background: Endosseous dental implants may be considered as the most popular treatment option for partially and fully edentulous patients. It is generally accepted that implant success is primarily dependent upon or achieved by osseointegration, a direct contact between the implant surfaces and living bone and gum. For decrease the time of osseointegration there is a different modalities used as altering the surface and/or shape of the implant has been frequently researched and it has been shown that rough implant surfaces allow a higher percentage of bone-to-implant contact compared to implants with smooth surfaces. Also dual acid etching of titanium, engineering of dental pulp cells on various implant surfaces and biomimetic implant coatings containing bone morphogenetic protein-2. Other methods studied to enhance endogenous bone healing around biomaterials are different forms of biophysical stimulations such as pulsed electromagnetic fields and low intensity pulsed ultrasounds (LIPU). Ultrasound is a form of energy that is transmitted through biological tissues as high-frequency acoustic waves, which is widely used in medicine as a diagnostic, therapeutic and operative tool. The aim of the present study was to evaluate The effect of low-intensity pulsed ultrasound on the osseointegration of titanium dental implants .Patient and methods: Ten implants were placed in ten patients each one receives one implant. The patients were 6 males and 4 females ranged in ages from 25 to 40 years. All the implants were placed in maxilla. Observations were made postoperatively at time of implant placement then after one month, 3 months, 6 months and one year follow up periods for crestal bone loss and stability, Data analysis was performed in several steps. Initially, descriptive statistics for each case results. One way ANOVA followed by pair-wise Tukey post-hoc tests were performed to detect significance between preparation cases. Statistical analysis was performed using Graph-Pad Prism-4 statistics software for Windows. P values ≤0.05 are considered to be statistically significant in all tests.Conclusion: From the a aforementioned review it became clear that Low-intensity pulsed ultrasound could be accelerate the osteointegration of dental implant .

Lack of clinical evidence on low-level laser therapy (LLLT) on dental titanium implant: a systematic review.

Low-level laser therapy (LLLT) has proved to have biostimulating effects on tissues over which they are applied, therefore accelerating the healing process. Most studies in implantology were focused on a reduction of the duration of osseointegration. There exist few articles analyzing the potential effects of these therapies on the osseointegration of titanium dental implants. The aim of this study was to assess the effect of LLLT on the interaction between the bone and the titanium dental implant and the methodological quality of the studies. We conducted an electronic search in PubMed, ISI Web, and Cochrane Library. From 37 references obtained, only 14 articles met the inclusion criteria. The analysis of the studies shows that most of the experiments were performed in animals, which have a high risk of bias from the methodological point of view. Only two studies were conducted in human bone under different conditions. Several protocols for the use of low-power laser and different types of laser for all studies analyzed were used. Although animal studies have shown a positive effect on osseointegration of titanium implants, it can be concluded that it is necessary to improve and define a unique protocol to offer a more conclusive result by meta-analysis.

Advances in surfaces and osseointegration in implantology. Biomimetic surfaces.

The present work is a revision of the processes occurring in osseointegration of titanium dental implants according to different types of surfaces -namely, polished surfaces, rough surfaces obtained from subtraction methods, as well as the new hydroxyapatite biomimetic surfaces obtained from thermochemical processes. Hydroxyapatite’s high plasma-projection temperatures have proven to prevent the formation of crystalline apatite on the titanium dental implant, but lead to the formation of amorphous calcium phosphate (i.e., with no crystal structure) instead. This layer produce some osseointegration yet the calcium phosphate layer will eventually dissolve and leave a gap between the bone and the dental implant, thus leading to osseointegration failure due to bacterial colonization. A new surface -recently obtained by thermochemical processes- produces, by crystallization, a layer of apatite with the same mineral content as human bone that is chemically bonded to the titanium surface. Osseointegration speed was tested by means of minipigs, showing bone formation after 3 to 4 weeks, with the security that a dental implant can be loaded. This surface can be an excellent candidate for immediate or early loading procedures. Key words:Dental implants, implants surfaces, osseointegration, biomimetics surfaces.

Effect of Recombinant Human Growth Hormone on Osseointegration of Titanium Implants: A Histologic and Biomechanical Study in Rabbits.

To evaluate the action of recombinant human growth hormone (rhGH) on osseointegration of titanium implants in rabbits. Fourteen adult New Zealand rabbits, aged 30 weeks, were used in the study, and randomly divided into 2 groups. In each animal, 2 (2.2 mm × 6 mm) pure titanium implants were placed in the left tibia. In one group (test group), 1 IU (0.3 mg) of rhGH as a lyophilized powder was applied to each osteotomy site prior to implant placement. Only titanium implants were placed in osteotomy sites of the other group (control). Animals were humanely killed at 14 and 42 days after surgery, and samples were then prepared for histologic analysis and biomechanical test. The biomechanical test showed tensile pull-out stress values of 33.88 N/cm(2) for controls and 59.26 N/cm(2) for the rhGH group at 14 days and 25.99 N/cm(2) and 29.69 N/cm(2) for the control and the test group, respectively, at 42 days. Scanning electron microscope analysis showed more uniform and abundant bone tissue in contact with the implants for the test group at 14 days, and no differences between groups at 42 days. Furthermore, histologic analysis also showed accelerated bone repair in 14 days and a more advanced stage of bone remodeling for the rhGH-treated group when compared to controls after 42 days of repair. Such results show that the topical use of rhGH induces new bone formation in the early stages of bone repair and hence accelerates osseointegration of titanium dental implants.

Influence of acid-etching after grit-blasted on osseointegration of titanium dental implants: in vitro and in vivo studies

Rough implant surfaces have shown improved osseointegration rates. In a majority of dental implants, the microrough surfaces are obtained by grit blasting and/or acid-etching. The aim of this contribution was to evaluate the effects of acid-etching, after the grit-blasted treatment in titanium dental implants, on surface wettability, surface energy, osteoblast responses and its osseointegration behavior. Four surfaces were studied: as-machined, acid-etched, micro-rough by grit-blasting and the combination grit-blasted surface with acid-etched. The surfaces with increasing roughness show more osteoblastic adhered cells. This effect was most pronounced on samples blasted and blasted with acid-etching. The roughness obtained by grit-blasting is the main factor in comparison with the acid etching treatment in the biological response. These results were confirmed in vivo tests and histological analysis. The results demonstrated that the combination of the grit-blasted and acid-etched accelerated lightly bone regeneration at the different periods of implantation in comparison with the grit-blasted implants.

The Effect of a Keratin Hydrogel Coating on Osseointegration: An Histological Comparison of Coated and Non-coated Dental Titanium Implants in an Ovine Model

Bioactive substances may be used to enhance the rate and quantity of bone healing during osseointegration of titanium dental implants. A pilot observational study was undertaken to assess a novel keratin hydrogel in six adult sheep utilising the femoral condyles as the surgical site to assess osseointegration. Implants and osteotomy sites were coated with the keratin gel prior to implant placement (test implants) whereas the opposite knee received unmodified control implants in each animal. Fifty 3.5mm×7mm Neoss dental implants were surgically implanted with a range of 3-5 Neoss dental implants placed per surgical site in each knee and allowed to heal for 5days or 2, 4, 8, 12 and 16weeks prior to the sheep being sacrificed. Of the 50 placed implants, 24 were used for this study and analysed via resin-embedded, undemineralised sections from test and control implants to assess the range of healing around the unloaded dental implants. These dental implants were analysed using histomorphometric methods for the best 3 consecutive threads on each side and the percentage of bone to implant contact (%BIC) was used to determine the degree of osseointegration between test and control dental implants at each time point. All implants appeared osseointegrated at the time of sacrifice. One each of the pairs of control implants at 2, 4 and 12weeks demonstrated minimal integration histologically, with %BIC <10%. No test implants had %BIC <35% at any time point. Mean %BIC for test implants was higher than controls at all time points except 5days and 2weeks. The range from 2 to 16weeks healing was 39.7% [SD 25.5%] to 85.4% [14.2%] for test implants and 35.6% [43.4%] to 46.6% [23.1%] for controls. %BIC appeared to increase earlier in the test implants (from 4weeks onwards) compared to controls. After 16weeks, %BIC was almost twice as great in test implants as controls. This pilot observational study suggests that keratin hydrogel may promote earlier osseointegration around titanium dental implants. Further cross-sectional studies with larger sample sizes are warranted. The most marked difference between test and control implants was seen after 4weeks. It is recommended that future studies in this model focus on healing after 4weeks.

The Effect of Titanium With Electrochemical Anodization on the Response of the Adherent Osteoblast-Like Cell

The osseointegration of titanium dental implants is essential for successful therapy, and this is strongly affected by the surface chemistry and roughness. In this study, using electrochemical anodization after sand blasting, and acid etching of Ti surface (SLA), SLA specimens with the high wettability of the thick TiO2 layer (SLAffinity) surface was developed to superimpose the nanoscale topographies on the microscale roughness of SLA surface without greatly altering the surface features. The surface characteristics of SLAffinity specimens were investigated using scanning electron microscopy, atomic force microscopy, and x-ray photoelectron spectroscopy. The viability and proliferation of osteoblast-like cells (MG63 cells), which were seeded on SLAffinity specimens, were analyzed. Such electrochemically anodized specimens were predominantly composed of bioactive TiO2. The cell culturing tests revealed that the microscale roughness in combination with the nanoscale structures and bioactive properties improved osteoblast viability and differentiation on the SLAffinity surface. The favorable biological response of SLAffinity surfaces to MG63 osteoblast-like cells suggested that electrochemical anodization after SLA treatments is a potential procedure for better osseointegration in vivo.