Titanium Discs Research Articles

Efficacy of antibacterial agents combined with erbium laser and photodynamic therapy in reducing titanium biofilm vitality: an in vitro study

Background and objectiveThe emergence of peri-implant diseases has prompted various methods for decontaminating the implant surface. This study compared the effectiveness of three different approaches, chlorhexidine digluconate (CHX) combined with erbium-doped yttrium–aluminum–garnet (Er:YAG) laser, photodynamic therapy (PDT), and CHX only, for reducing biofilm vitality from implant-like titanium surfaces.Study design/Materials and methodsThe study involved eight volunteers, each receiving a custom mouth device containing eight titanium discs. The volunteers were requested to wear the device for 72 h for biofilm development. Fluorescence microscopy was used to evaluate the remaining biofilm with a two-component nucleic acid dye kit. The vital residual biofilm was quantified as a percentage of the surface area using image analysis software. Sixty-four titanium discs were assigned randomly to one of four treatment groups.ResultsThe percentage of titanium disc area covered by vital residual biofilm was 43.9% (7.7%), 32.2% (7.0%), 56.6% (3.6%), and 73.2% (7.8%) in the PDT, Er:YAG, CHX, and control groups, respectively (mean (SD)). Compared to the control group, the treatment groups showed significant differences in the area covered by residual biofilm (P < 0.001). CHX combined with Er:YAG laser treatment was superior to CHX combined with PDT, and CHX only was better than the control.ConclusionWithin the current in vitro model's limitations, CHX combined with Er:YAG laser treatment is a valid method to reduce biofilm vitality on titanium discs.

Microbiological and Physical Changes Produced by Different Air–Powders on Contaminated Titanium Implant Surfaces: An In Vitro Pilot Study

Air–powder abrasive treatment has shown interesting results for dental implant treatments; however, which powder is most effective is still an open question. This in vitro pilot study aims to compare the ability of six different powders (sodium bicarbonate powder—65 µm and 40 µm; glycine powder; erythritol powder—with and without cetylpyridinium chloride and calcium carbonate) to remove biofilm from contaminated titanium discs and to evaluate the physical effects of such treatments on surface topography. Seventy-four titanium discs with two different surface roughness were treated after S. sanguinis contamination. Cleaning ability and surface changes were assessed by scanning electron and confocal laser scanning microscopy as well as profilometry. All treated surfaces showed minimal bacterial residues compared to untreated ones, regardless of the treatment provided (remaining biofilm range 11.4% to 28.4% on machined discs—range 10.7% to 18.3% on moderately rough surface discs). No relevant changes on the microscopic ultrastructure of the disc surfaces were noted. The different treatments reduced biofilm up to 89.3 and 88.6% on moderately rough and machined discs, respectively, and they all showed statistically significant superiority over calcium carbonate powder. None of the tested treatments rendered the disc surfaces biofilm-free. Therefore, combined mechanical and chemical decontamination methods are still recommended to achieve maximum biofilm removal for peri-implantitis treatment.

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.

Investigation of the Wetting Properties of Thalassemia Patients' Blood Samples on Grade 5 Titanium Implant Surfaces: A Pilot Study.

Background and Objectives: Beta-thalassemia (BT) has a high prevalence in Mediterranean, Southeast Asian, and African countries. Studies stated that thalassemia is an endemic disease that causes significant health problems in Cyprus. This study aimed to measure the contact angle between the implant and blood samples from BT major patients and healthy individuals to compare the contact angles and wettability of Grade 5 titanium implant surfaces. Materials and Methods: Grade 5 titanium discs that were 10 mm in diameter were used since they mimic the surface of dental implants. Following receiving informed consent, blood samples were taken from the patients’ index fingers in each group with lancet needles and a photo of the contact angle between the blood samples and the titanium surface was taken; the collected blood was transferred to a titanium disc with a medical pipette. ImageJ software with a specific contact angle plugin was used for the contact angle measurements. Results: Theta-mean, theta-circular, and theta-ellipse values were compared between all groups, and no significant difference was found (p > 0.05). Conclusions: In this study, it was hypothesized that the patients’ rheological property of decreased deformability would affect the wettability of implant surfaces in vitro; however, no such finding was reached in this study. Since in-depth studies associated with dental implant success in BTM patients are absent in the literature and Cyprus is one of the Mediterranean countries with a high prevalence of BTM, this study was conducted to enrich the literature. While some systemic diseases may affect the contact angle between the implant surface and blood, it can be concluded that this condition was not present for BTM patients in our study. Last but not least, we emphasize that this experiment was done on a single surface type and the results can be totally different when using other surface types.

An Experimental Anodized Titanium Surface for Transgingival Dental Implant Elements-Preliminary Report.

The characteristics such as microtopography, physical and chemical properties influence the behavior of an implant in a soft tissue. Anodization-as a potent method of titanium alloy surface modification-of the transgingival abutment or healing screw, has achieved some improvement. One of the possible surface treatment method is low-pressure radiofrequency oxygen plasma treatment. The aim of the study was to evaluate the chemical properties and cytocompatibility of the experimental surface. Titanium discs made of grade-23 titanium alloy (Ti-6Al-4V) anodized (A sample) with different voltage parameters (28, 67, 78, and 98 V) were included in the study. Half of the samples regarded as the "S" group were additionally treated with low-pressure radiofrequency oxygen plasma treatment. The surfaces were characterized using scanning electron microscopy, X-ray spectroscopy and Raman spectroscopy, and electrochemically investigated via a corrosion test. Furthermore, two cell lines were used, including the CHO-compatible reference line and a primary human fibroblast line for the MTT assay; direct (contact) cytotoxicity of the materials was tested with the cells, and the growth of fibroblasts on the surfaces of the different materials was tested. The morphology of the "S"-treated samples did not differ from the morphology of only-anodized samples. However, the oxygen concentration on the surface in that group slightly increased by about 1% as a result of post-trial treatment. The highest corrosion resistance was observed for both A-78 V and S-78 V samples. The cytotoxicity assay revealed no changes in cell morphology or vitality. The MTT test proved comparable culture viability among all groups; however, the "S" samples showed statistically significantly higher fibroblast proliferation and adhesion scores compared to the "A" samples. Through the in vitro study, the low-pressure radiofrequency oxygen plasma treatment of the anodized Ti-6Al-4V alloy presented itself as an auspicious option in the field of transgingival element surface modification of implants.

Impact of Metal Particles Released during Ultrasonic Scaling of Titanium Surfaces on Human Gingival Fibroblasts.

Metal particles found in tissues around dental implants have been proposed to play a pathogenic role in peri-implantitis. Ultrasonic scaling has been suggested as a mechanism by which these particles can be inadvertently released into surrounding tissues. Furthermore, risk factors like diabetes can result in exacerbation of this inflammatory condition. The current study aimed to analyze metal particles released from titanium surfaces during ultrasonic scaling and their impact on pro-inflammatory cytokine production by human gingival fibroblasts. Metal particles generated from ultrasonic scaling of titanium discs using two different tips (metal and poly-etheretherketone tips) were characterized using scanning electron microscopy and elemental analysis. Endotoxin levels and Human gingival fibroblast viability, in the presence commercial and ultrasonically generated particles were determined. Fibroblasts, cultured in high or low glucose growth medium, were incubated with commercial titanium particles or ultrasonically generated particles in the presence or absence of interluekin-1β. Interleukin 6 and interleukin 8 production were then quantified using Enzyme linked immunosorbent assay. Analysis of particles after scaling of titanium discs showed significant levels of titanium particles. Commercial titanium particles and generated particles had no effect of fibroblast viability. Endotoxin levels of all particles were too low to stimulate HGF cells. IL-1β significantly stimulated IL-6 and IL-8 production. However, commercial, and generated particles generally had no significant effect on IL- 6 and IL-8 production. Our study concluded that particles generated during ultrasonic scaling had no significant effect on viability of HGF cells and cytokine production.

Influence of Fiber Laser (1064 nm) on Shear Bond Strength of Titanium Abutment and Resin Cement.

Introduction: The present study was performed to evaluate the influence of a 1064 nm fiber laser on shear bond strength (SBS) at the interface of titanium and resin cement. Methods: Forty titanium discs of 6 mm × 3 mm (diameter and thickness respectively) were categorized into four groups (n=10): control group without any surface treatment and three groups treated with a fiber laser with 81 ns pulse duration, 30 kHz frequency, 10000 mm/s scanning speed, 0.05 mm spot size, and different average power values (3, 5 and 7 W) depending on the tested group. Titanium disc characterization was performed by the scanning electron microscope (SEM) and surface roughness tester. Phase analysis was achieved using an X-ray diffractometer (XRD). Following these tests, resin cement application to titanium discs was performed. SBS values were determined by the universal testing machine. After debonding, the surface of titanium discs was examined by the stereomicroscope for the determination of failure modes. Data analysis was performed using analysis of variance (ANOVA) and Tukey HSD tests (α=0.05). Results: A higher surface roughness value was observed in the 7 W group followed by the 5 W and 3 W groups, and the lowest surface roughness was in the control group. Additionally, the lowest SBS value was obtained from the control group and the highest SBS value was obtained from the 7 W group followed by the 5 W and 3 W groups. Conclusion: SBS between titanium abutment and resin cement can be significantly enhanced by using a fiber laser as a surface treatment considering tested laser parameters; additionally, a positive association between surface roughness and SBS was noted in the experimental groups.

Development and Characterization of a Subcutaneous Implant-Related Infection Model in Mice to Test Novel Antimicrobial Treatment Strategies.

Orthopedic-device-related infection is one of the most severe complications in orthopedic surgery. To reduce the associated morbidity and healthcare costs, new prevention and treatment modalities are continuously under development. Preclinical in vivo models serve as a control point prior to clinical implementation. This study presents a mouse model of subcutaneously implanted titanium discs, infected with Staphylococcus aureus, to fill a gap in the early-stage testing of antimicrobial biomaterials. Firstly, three different inocula were administered either pre-adhered to the implant or pipetted on top of it following implantation to test their ability to reliably create an infection. Secondly, the efficacy of low-dose (25 mg/kg) and high-dose (250 mg/kg) cefazolin administered systemically in infection prevention was assessed. Lastly, titanium implants were replaced by antibiotic-loaded bone cement (ALBC) discs to investigate the efficacy of local antibiotics in infection prevention. The efficacy in infection prevention of the low-dose perioperative antibiotic prophylaxis (PAP) depended on both the inoculum and inoculation method. Bacterial counts were significantly lower in animals receiving the high dose of PAP. ALBC discs with or without the additional PAP proved highly effective in infection prevention and provide a suitable positive control to test other prevention strategies.

Residual extracellular polymeric substances (EPS) detected by fluorescence microscopy on dental implants after different decontamination

Since the existing used detecting techniques were unable to distinguish the types of extracellular polymeric substances (EPS) components (polysaccharides, proteins, and nucleic acids et al.), it is needy to apply more targeted methods to detect the residual EPS components on decontaminated dental implants. Herein we aimed to assess whether fluorescence microscopy method was feasible for detecting residual EPS components on decontaminated dental implants. Six clinical-retrieved dental implants suffered severe peri-implantitis were collected, and also Staphylococcus aureus (S. aureus) cultured titanium discs were prepared. Before and after decontamination (Er:YAG laser, air-abrasive, and citric acid), corresponding fluorochrome stains were used to label polysaccharides, proteins, and nucleic acids on the samples for identification and then observed under confocal laser scanning microscopy (CLSM). Besides, scanning electron microscope (SEM) and X-ray photoelectron spectroscopy (XPS) detection techniques were also used. The results showed that fluorescent signals of EPS components are strong before decontamination and decreased after treatments, indicating that the intensity can roughly reflect the amounts. This preliminary study proved that EPS-stained fluorescence microscopy was feasible as a detection tool of choice for implant decontamination outcome evaluation. However, further study incorporating large sample size and quantified data should be carried out.

Adherence of Escherichia coli and blood elements in titanium discs submitted to anodic oxidation. In vitro study

Modifications of implants by means of surface treatments are performed to optimize the biochemical interactions of the bone deposition process. However, if on the one hand they favor the adhesion of blood elements, on the other hand they can also enable the formation of biofilm. This study evaluated the adherence of blood cells and Escherichia coli in titanium discs submitted to surface treatments by anodic oxidation (OA), sandblasting followed by acid etching (JAT) compared with untreated discs (Li). To evaluate the adherence of microorganisms were performed: atomic force microscopy; Field Emission Gun Scanning Electron Microscopy (FEG-SEM); biofilm formation was evaluated by spectrophotometer turbidity analysis and colony forming unit (CFU/mL) before and after simulated brushing. For blood cell adherence, the blood collected from a patient was deposited and fixed on the discs and analyzed in the FEG-SEM being classified according to the "Blood Element Adherence Index". The results showed a slight increase in the adhesion of microorganisms in samples treated by anodic oxidation. However, the microorganisms were distributed singly and not in conglomerates, with no biofilm formation unlike the Li group. Regarding the adherence of blood elements, the Li group showed higher adherence and lower amount was found in the JAT group, but there was no statistically significant difference between the groups. The results of this study suggest that anodic oxidation treatment may favor the adherence of blood cells and fibrin mesh, contributing to the early stages of bone deposition.

The effect of Er:YAG laser treatment on biofilm formation on titanium and zirconia disc surfaces.

Lasers represent a promising method for implant decontamination, but evidence on implant surface changes and subsequent biofilm formation is limited. This study aimed to assess the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser treatment on zirconia and titanium discs, and the differences in biofilm formation as a result of surface alterations. A two-stage (in vitro and in vivo) experiment utilizing Er:YAG laser on titanium and zirconia discs was performed. In vitro, surface alterations, roughness, and elemental-material weight differences following laser treatment were assessed using scanning electron microscopy and atomic force microscopy. In vivo, four participants wore custom-made intra-oral stents, embedded with laser-treated and untreated titanium and zirconia discs overnight. Biofilm-coated discs were stained using nucleic acid fluorescence dye and visualized using multiphoton confocal laser scanning microscopy. Biofilm 3D structure, biomass, thickness, and live-to-dead bacteria ratio were assessed. Both titanium and zirconia discs treated with Er:YAG laser resulted in visual surface alterations, but showed no significant change in average surface roughness (titanium P=0.53, zirconia P=0.34) or elemental-material-weight (titanium, P=0.98), (zirconia, P=0.96). No significant differences in biofilm biomass, average thickness, and live-to-dead bacteria ratio of laser-treated titanium and zirconia discs were identified compared to untreated groups (titanium P>0.05, zirconia P>0.05). Generally, zirconia discs presented with a lower live-to-dead bacteria ratio compared to titanium discs, regardless of laser treatment. Er:YAG laser treatment of titanium and zirconia implant surfaces does not significantly affect surface roughness, elemental material weight, or early biofilm formation in the oral cavity.

Osseointegration Properties of Titanium Implants Treated by Nonthermal Atmospheric-Pressure Nitrogen Plasma

Pure titanium is used in dental implants owing to its excellent biocompatibility and physical properties. However, the aging of the material during storage is detrimental to the long-term stability of the implant after implantation. Therefore, in this study, we attempted to improve the surface properties and circumvent the negative effects of material aging on titanium implants by using a portable handheld nonthermal plasma device capable of piezoelectric direct discharge to treat pure titanium discs with nitrogen gas. We evaluated the osteogenic properties of the treated samples by surface morphology and elemental analyses, as well as in vitro and in vivo experiments. The results showed that nonthermal atmospheric-pressure nitrogen plasma can improve the hydrophilicity of pure titanium without damaging its surface morphology while introducing nitrogen-containing functional groups, thereby promoting cell attachment, proliferation, and osseointegration to some extent. Therefore, nitrogen plasma treatment may be a promising method for the rapid surface treatment of titanium implants.

Development and characterisation of strontium-doped sol-gel coatings to optimise the initial bone regeneration processes

Strontium plays an important role in bone regeneration; it promotes the differentiation and maturation of osteoblasts and inhibits the activity of osteoclasts. Our principal objective in this study was to formulate new organic-inorganic hybrid sol-gel coatings applied to titanium discs. These coatings were functionalised with different amounts of SrCl 2 and examined using in vitro tests and proteomics. The chemical and morphological characteristics of obtained coatings were scrutinised. The in vitro evaluation using the MC3T3-E1 osteoblasts and RAW264.7 macrophages showed the osteogenic and anti-inflammatory effects of strontium doping. The proteomic assay identified 111 different proteins adhering to the coatings. Six of these proteins reduced their adhesion affinity as a result of Sr-doping, whereas 40 showed increased affinity. Moreover, the proteomic analysis revealed osteogenic and anti-inflammatory properties of these biomaterials. The analysis also showed increased adhesion of proteins related to the coagulation system. We can conclude that proteomic methods are invaluable in developing new biomaterials and represent an important tool for predicting the biocompatibility of dental implants. • A new sol-gel coating doped with SrCl 2 was developed and characterized. • New Sr-enriched coatings with osteogenic, coagulatory and anti-inflammatory properties. • Protein adsorption patterns on Sr-coatings correlates with their in vitro results.

Cartilage-inspired surface textures for improved tribological performance of orthopedic implants

Joint replacements have become one of the most common orthopedic procedures due to the significant demands of retaining functional mobility. While these procedures are of great value to patients, there are some limitations. Durability is the most important limitation associated with joint replacement that needs to be addressed due to the increasing number of younger patients. Titanium is a commonly used implant material which has high biocompatibility, high strength-to-density ratio, and high corrosion resistance. However, current titanium implants have poor wear resistance which shortens their lifespan. In this study, microscale dimples with four different dimple shapes (circular, triangular, square, and star) of similar sizes to the pores found in natural articular cartilage were fabricated on titanium disks to improve implant lubrication and reduce wear. Biotribology tests were performed on dimpled and non-dimpled titanium disks in a condition similar to that inside of a patient's body. It was shown that dimpling the titanium disks optimized the lubricant film formation and decreased the wear rate significantly while also reducing the coefficient of friction (COF). The star-shaped dimples had the lowest COF and almost no detectable wear after 8 h of testing. To investigate whether dimpling increased bacterial colonization due to increased surface area, and to determine whether any increase could be limited by coating with antibacterial materials, bacterial colonization with Staphylococcus aureus was tested with non-dimpled and star-shaped dimpled titanium disks with and without coating with polydopamine (PDA), silver (Ag) nanoparticles (NPs), and PDA + Ag NPs. It was found that dimpling did not increase bacterial colonization, and that coating with PDA, Ag NPs, or PDA + Ag NPs did not decrease bacterial colonization. Nevertheless, we conclude that star-shaped dimpled titanium surfaces have potential utility as more durable orthopedic implants.

Boron- and Boric Acid-Treated Titanium Implant Surfaces in Sheep Tibia: A Histologic, Histomorphometric and Mechanical Study.

The aim of this study was to compare the topographical, chemical and osseointegration characteristics of sandblasting and acid-etching (SLA) surfaces and dental implants treated by boron compounds. Titanium (Ti) disks (n = 20) were modified using boron (B) and boric acid (H3BO3) and then compared with the conventional SLA surface via surface topographic characterizations. Dental implants (3.5 mm in diameter and 8 mm in length) with the experimental surfaces (n = 96) were inserted into the tibias of six sheep, which were left to heal for 3 and 7 weeks. Histologic, histomorphometric (bone-implant contact (BIC%)) and mechanical tests (removal torque value (RTV)) were performed. The boron-coated surface (BC group) was smoother (Rz: 4.51 μm ± 0.13) than the SLA (5.86 μm ± 0.80) and the SLA-B (5.75 μm ± 0.64) groups (p = 0.033). After 3 weeks, the highest mean RTV was found in the SLA group (37 N/cm ± 2.87), and the difference compared with the BC group (30 N/cm ± 2.60) was statistically significant (p = 0.004). After 7 weeks, the mean RTV was &gt;80 N/cm in all groups; the highest was measured in the H3BO3-treated (BS) group (89 N/cm ± 1.53) (p &lt; 0.0001). No statistically significant differences were found in the BIC%s during both healing periods between the groups. H3BO3 seems to be a promising medium for dental implant osseointegration.

The Effect of Amino Sugars on the Composition and Metabolism of a Microcosm Biofilm and the Cariogenic Potential against Teeth and Dental Materials.

Amino sugars N-acetylglucosamine (GlcNAc) and glucosamine (GlcN) are abundant sources of carbon and nitrogen in the oral cavity. The aim of this study was to investigate the effects of GlcNAc metabolism on the genomics and biochemistry of a saliva-derived microbial community, and on the surface integrity of human teeth and restorative surfaces. Pooled cell-containing saliva (CCS) was used to establish a microcosm biofilm in vitro in a biofilm medium (BM) containing 5 different carbohydrates. The microbial composition of each biofilm was analyzed by 16S rRNA amplicon sequencing, and the concentrations of eight organic acids were determined for selected sugars by targeted metabolomics. Meanwhile, extracted human teeth and polished titanium and ceramic disks were submerged in BM supplemented with 1% of glucose or GlcNAc, inoculated with CCS and Streptococcus mutans UA159, and incubated for 30 days. To mimic the effects of other microbial byproducts, the specimens were immersed in 10 mM hydrogen peroxide and 10 mM ammonium hydroxide for 30 days. The surface of each specimen was evaluated by profilometry for roughness (Ra) and imaged by scanning electron microscopy. The pH of the biofilm supernatant was significantly higher for the medium containing GlcNAc (p < 0.0001), and was higher in samples containing teeth than the two restorative disks for media containing the same sugar. For both teeth and titanium specimens, the samples treated with glucose-biofilm presented higher roughness values (Ra) than those with GlcNAc-biofilm and every other group. SEM images of the teeth and titanium disks largely supported the profilometry results, with glucose-biofilm samples demonstrating the largest deviation from the reference. For ceramic disks, slightly higher Ra values were obtained for the ammonia group. These findings provide the first direct evidence to support the ability of amino sugars to significantly reduce the cariogenic potential of oral biofilms by altering their biochemistry and bacterial composition. Additionally, amino sugar metabolism appears to be less detrimental to teeth and restorative surfaces than glucose metabolism.

Oral Microcosm Biofilms Grown under Conditions Progressing from Peri-Implant Health, Peri-Implant Mucositis, and Peri-Implantitis.

Peri-implantitis is a disease influenced by dysbiotic microbial communities that play a role in the short- and long-term outcomes of its clinical treatment. The ecological triggers that establish the progression from peri-implant mucositis to peri-implantitis remain unknown. This investigation describes the development of a novel in vitro microcosm biofilm model. Biofilms were grown over 30 days over machined titanium discs in a constant depth film fermentor (CDFF), which was inoculated (I) with pooled human saliva. Following longitudinal biofilm sampling across peri-implant health (PH), peri-implant mucositis (PM), and peri-implantitis (PI) conditions, the characterisation of the biofilms was performed. The biofilm analyses included imaging by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), selective and non-selective culture media of viable biofilms, and 16S rRNA gene amplification and sequencing. Bacterial qualitative shifts were observed by CLSM and SEM across conditions, which were defined by characteristic phenotypes. A total of 9 phyla, 83 genera, and 156 species were identified throughout the experiment. The phyla Proteobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Actinobacteria showed the highest prevalence in PI conditions. This novel in vitro microcosm model provides a high-throughput alternative for growing microcosm biofilms resembling an in vitro progression from PH-PM-PI conditions.

Assessing the Efficacy of Whole-Body Titanium Dental Implant Surface Modifications in Inducing Adhesion, Proliferation, and Osteogenesis in Human Adipose Tissue Stem Cells.

Although the influence of titanium implants' micro-surface properties on titanium discs has been extensively investigated, the research has not taken into consideration their whole-body effect, which may be considered possible using a combinatorial approach. Five titanium dental implants with a similar moderate roughness and different surface textures were thoroughly characterized. The cell adhesion and proliferation were assessed after adipose-tissue-derived stem cells (ADSCs) were seeded on whole-body implants. The implants' inductive properties were assessed by evaluating the osteoblastic gene expression. The surface micro-topography was analyzed, showing that hydroxyapatite (HA)-blasted and bland acid etching implants had the highest roughness and a lower number of surface particles. Cell adhesion was observed after 24 h on all the implants, with the highest score registered for the HA-blasted and bland acid etching implants. Cell proliferation was observed only on the laser-treated and double-acid-etched surfaces. The ADSCs expressed collagen type I, osteonectin, and alkaline phosphatase on all the implant surfaces, with high levels on the HA-treated surfaces, which also triggered osteocalcin expression on day seven. The findings of this study show that the morphology and treatment of whole titanium dental implants, primarily HA-treated and bland acid etching implants, impact the adherence and activity of ADSCs in osteogenic differentiation in the absence of specific osteo-inductive signals.

Antimicrobial efficiency and cytocompatibility of different decontamination methods on titanium and zirconium surfaces.

The purpose of this study was to investigate the efficiency of different implant-decontamination methods regarding biofilm modification and potential cytotoxic effects. Therefore, the amount of biofilm reduction, cytocompatibility, and elementary surface alterations were evaluated after decontamination of titanium and zirconium surfaces. Titanium and zirconium disks were contaminated with a newly developed high-adherence biofilm consisting of six microbial species. Decontaminations were performed using titanium curette, stainless steel ultrasonic scaler (US), glycine (GPAP) and erythritol (EPAP) powder air-polishing, Er:YAG laser, 1% chlorhexidine (CHX), 10% povidone-iodine (PVI), 14% doxycycline (doxy), and 0.95% NaOCl solution. Microbiologic analysis was done using real-time qPCR. For assessment of cytocompatibility, a multiplex assay for the detection of cytotoxicity, viability, and apoptosis on human gingival fibroblasts was performed. X-ray photoelectron spectroscopy (XPS) was used to evaluate chemical alterations on implant surfaces. Compared with untreated control disks, only GPAP, EPAP, US, and Er:YAG laser significantly reduced rRNA counts (activity) on titanium and zirconium (p< .01), whereas NaOCl decreased rRNA count on titanium (p< .01). Genome count (bacterial presence) was significantly reduced by GPAP, EPAP, and US on zirconium only (p< .05). X-ray photoelectron spectroscopy analyses revealed relevant re-exposure of implant surface elements after GPAP, EPAP, and US treatment on both materials, however, not after Er:YAG laser application. Cytocompatibility was impaired by CHX, PVI, doxy, and NaOCl. CHX and PVI resulted in the lowest viability and doxy in the highest apoptosis. Within the limits of this in vitro study, air-polishing methods and ultrasonic device resulted in effective biofilm inactivation with surface re-exposure and favorable cytocompatibility on titanium and zirconium. Chemical agents, when applied on implant surfaces, may cause potential cytotoxic effects.

Surface Free Energy and Composition Changes and Ob Cellular Response to CHX-, PVPI-, and ClO2-Treated Titanium Implant Materials.

The study evaluated the interaction of a titanium dental implant surface with three different antibacterial solutions: chlorhexidine, povidone-iodine, and chlorine dioxide. Implant surface decontamination is greatly challenging modern implant dentistry. Alongside mechanical cleaning, different antibacterial agents are widely used, though these could alter implant surface properties. Commercially pure (CP) grade 4 titanium (Ti) discs were treated with three different chemical agents (chlorhexidine 0.2% (CHX), povidone-iodine 10% (PVPI), chlorine dioxide 0.12% (ClO2)) for 5 min. Contact angle measurements, X-ray photoelectron spectroscopy (XPS) analysis, and cell culture studies were performed. Attachment and proliferation of primary human osteoblast cells were investigated via MTT (dimethylthiazol-diphenyl tetrazolium bromide), alamarBlue, LDH (lactate dehydrogenase), and fluorescent assays. Contact angle measurements showed that PVPI-treated samples (Θ = 24.9 ± 4.1) gave no difference compared with controls (Θ = 24.6 ± 5.4), while CHX (Θ = 47.2 ± 4.1) and ClO2 (Θ = 39.2 ± 9.8) treatments presented significantly higher Θ values. All samples remained in the hydrophilic region. XPS analysis revealed typical surface elements of CP grade 4 titanium (Ti, O, and C). Both MTT and alamarBlue cell viability assays showed similarity between treated and untreated control groups. The LDH test revealed no significant difference, and fluorescent staining confirmed these results. Although there was a difference in surface wettability, a high proliferation rate was observed in all treated groups. The in vitro study proved that CHX, PVPI, and ClO2 are proper candidates as dental implant decontamination agents.